Lista Medicamentelor

ANEXA 2a
SUBLISTA A - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 90% DIN PRETUL DE REFERINTA CONFORM
Nr crt.
cod ATC
DCI
Denumire Comerciala
forma farm.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
A02BC01
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
LANSOPRAZOLUM
LANSOPRAZOLUM
LANSOPRAZOLUM
LANSOPRAZOLUM
PAPAVERINI HYDROCHLORIDUM
PAPAVERINI HYDROCHLORIDUM
METOCLOPRAMIDUM
METOCLOPRAMIDUM
METOCLOPRAMIDUM
METOCLOPRAMIDUM
METOCLOPRAMIDUM
ULTOP
OMEPRAZOL 20 mg
OMEPRAZOL LPH 20 mg
OMERAN 20
OMEPRAZOL 20 mg
OMEPRAZOL TERAPIA 20 mg
OMEPRAZOL ARENA 20 mg
OMEPRAZOL FARMEX 20 mg
NOVOGAST 20 mg
CAPS. GASTROREZ.
OMEPRAZOL ROMPHARM 20 mg
CAPS. GASTROREZ.
ORTANOL 20 mg
HELICID 20
OMEZ 20mg
CAPS. GASTROREZ.
OMEPRAZOL AUROBINDO 20 mg
CAPS. GASTROREZ.
OMZATOL 20 mg
OMZATOL 20 mg
OMZATOL 20 mg
OMEPRAZOL ATB 20 mg
OMEPRAZOL ZENTIVA 20 mg
OMEPRAZOL LPH 20 mg
OMERAN 20 mg
ORTANOL 40 mg
CAPS. GASTROREZ.
OMEPRAZOL AUROBINDO 40 mg
CAPS. GASTROREZ.
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC03
A02BC03
A02BC03
A02BC03
A03AD01
A03AD01
A03FA01
A03FA01
A03FA01
A03FA01
A03FA01
A05AA02
A05AA02
A05AA02
A05AA02
A05AA02
A05AA02
A06AD11
A06AD11
ACIDUM URSODEOXYCHOLICUM*
LACTULOSUM
LACTULOSUM
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
concentratie
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
40mg
40mg
20mg
40mg
40mg
tara det.
APP
Detinator APP
KRKA D.D.
Ambalaj
SLOVENIA CUTIE X 1 FLAC. PE X 14 CAPS. GASTROREZ.
ROMANIA
LABORMED PHARMA SA ROMANIA
EUROPHARM SA
ROMANIA
SLAVIA PHARM SRL ROMANIA
TERAPIA SA
ROMANIA
ARENA GROUP S.A. ROMANIA
FARMEX COMPANY SRL ROMANIA
ANTIBIOTICE S.A.
ROMANIA
ROMPHARM COMPANY SRL ROMANIA
GEDEON RICHTER ROMANIA SA
Prescriptie
DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU CONTRIBUTIE
PERSONALA DIN HG NR. 720/2008 CU COMPLETARILE SI MODIFICARILE ULTERIOARE
VALABILA INCEPAND CU 01 OCTOMBRIE 2015
P-6L
CUTIE X 2 BLIST. PVC-AL-PA/AL X 7 CAPS. GASTROREZ. P-6L
CUTIE X 2 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L
CUTIE X 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L

CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L
CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR. P-6L

CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L
LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE CU 2 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L
ZENTIVA K.S.
CEHIA
CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ. P-6L
ROMANIA CUTIE X 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ. P-6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 28 CAPS. GASTROREZ. P6L
ROMASTRU TRADING S.R.L. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L
NEOLA PHARMA S.R.L. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L
NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L
ANTIBIOTICE S.A.
ROMANIA CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR. P-6L
ZENTIVA K.S.
CEHIA
CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ. P-6L
ZENTIVA, K.S.
REPUBLICA CEHA
P6L
ZENTIVA, K.S.
REPUBLICA CEHA
P6L
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ P-6L
GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P6L
DR. REDDY'S LABORATORIES
CUTIE CU 2 BLISTERE DIN OPA-AL-PED-PE-DESICANT-PED/AL A CATE 14 CAPSULE GASTROREZISTENTE
CUTIE CU 4 BLISTERE DIN OPA-AL-PED-PE-DESICANT-PED/AL A CATE 7 CAPSULE GASTROREZISTENTE
LEK PHARMACEUTICALS D.D. SLOVENIA

AUROBINDO PHARMA (MALTA) LIMITED
MALTA
ROMANIA
ROMANIA
CEHIA
CEHIA
CUTIE X 1 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L

CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 14 CAPS. GASTROREZ.
P6L
OMEDAR 20 mg
COMPR. GASTROREZ.
DAR AL DAWA PHARMA S.R.L.
CUTIE X 1 FLAC. DE STICLA BRUNA X 28 COMPR. FILM. GASTROREZ. P-6L
OMEZ 40 mg
PULB. PT. SOL. PERF.
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATE DE 15 ML CU PULB.PT. SOL. PERF.
S/P-RF
OMEPRAZOL ZENTIVA 40 mg PULB. PT. SOL. PERF.
ZENTIVA K.S.
CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF
HELICID 40 INF
PULB. PT. SOL. PERF. FARA CONCENTRATIE ZENTIVA K.S.
CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF. S/P-RF
LEVANT 15 mg
CAPS. GASTROREZ. 15mg
RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L
LANZUL
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 7 CAPS. GASTROREZ.
P-6L
LEVANT 30 mg
RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L
LANZAP 30mg
DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L
PAPAVERINA ARENA 100 mg COMPR.
100mg
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
PAPAVERINA FARMACOM 200 mg COMPR.
200 mg
FARMACOM S.A.
ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L
METOCLOPRAMID
COMPR.
10mg
SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L
METOCLOPRAMID 10 mg
COMPR.
10mg
TERAPIA SA
ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L
METOCLOPRAMID ARENA 10 mg COMPR.
10mg
ARENA GROUP S.A. ROMANIA CUTIE CU 4 BLIST. PVC/AL A CATE 10 COMPR. P6L
METOCLOPRAMID BIOFARM 1mg/5ml SIROP
1mg/5ml
BIOFARM S.A.
ROMANIA CUTIE X 1 FLAC. DIN STICLA X 100 ML SIROP + MASURA DOZATOARE P-RF
METOCLOPRAMID 5mg/ml
SOL. INJ.
5mg/ml
TERAPIA SA
ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF
URSOFALK (R)
CAPS.
250mg
DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS.
P6L
URSOFALK (R)
CAPS.
250mg
DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS.
P-6L
URSOSAN
CAPS.
250mg
PRO. MED. CS PRAHA AS CEHIA
CUTIE X 5 BLIST. AL/PVC X 10 CAPS.
P-6L
URSOROM 250 mg
CAPS.
250mg
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS.
P6L
URSOFALK 500 mg
COMPR. FILM. 500mg
DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L
URSOFALK 250 mg/5 ml
SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PPP6L
DUPHALAC (R)
LICHID ORAL 66,7%
ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L
LACTULOSE
SIROP
65%
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 300 ML
P-6L
Pagina 1 din 21
cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj
14
14
20
28
30
30
30
30
20
30
14
28
30
28
28
28
14
20
28
28
28
30
28
7
14
28
1
1
1
14
14
14
20
20
20
40
40
40
1
5
100
50
50
60
100
1
1
1
0,541671
0,541671
0,541671
0,541671
0,541671
0,541671
0,541671
0,541671
0,541671
0,541671
0,437857
0,541671
0,541671
0,331428
0,541671
0,541671
0,541671
0,541671
0,376785
0,376785
0,376785
0,541671
0,541671
1,083342
0,645714
0,535357
15,153749
15,153749
15,153749
0,270835
0,541671
0,541671
0,541671
0,217500
0,427000
0,103500
0,104000
0,104000
9,010000
2,742000
0,879550
0,879550
0,788600
0,788500
1,759100
43,977542
6,899858
10,085999
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
Val. maxima suportata de

sistemul de asigurari
sociale de sanatate / UT
beneficiaza de
compensare 90% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,134043
0,144043
0,122329
0,251900
0,240995
0,237329
0,219995
0,153329
0,305829
0,196995
0,000000
0,114400
0,198995
0,000000
0,251900
0,251900
0,251900
0,305829
0,000000
0,000000
0,000000
0,122995
0,251900
0,108086
0,000000
0,000000
1,676251
1,686251
1,676251
0,215593
0,431186
0,300471
0,321829
0,012000
0,000000
0,000000
0,043250
0,000000
0,000000
0,000000
0,272850
0,333850
0,000000
0,000000
0,922600
53,512458
3,850142
0,714001
0,487503
0,487503
0,487503
0,487503
0,487503
0,487503
0,487503
0,487503
0,487503
0,487503
0,394071
0,487503
0,487503
0,298285
0,487503
0,487503
0,487503
0,487503
0,339106
0,339106
0,339106
0,487503
0,487503
0,975007
0,581142
0,481821
13,638374
13,638374
13,638374
0,243751
0,487503
0,487503
0,487503
0,195750
0,384300
0,093150
0,093600
0,093600
8,109000
2,467800
0,791595
0,791595
0,709740
0,709650
1,583190
39,579787
6,209872
9,077399
0,188211
0,198211
0,176497
0,306068
0,295163
0,291497
0,274163
0,207497
0,359997
0,251163
0,043786
0,168568
0,253163
0,033143
0,306068
0,306068
0,306068
0,359997
0,037679
0,037679
0,037679
0,177163
0,306068
0,216421
0,064572
0,053536
3,191626
3,201626
3,191626
0,242677
0,485354
0,354639
0,375997
0,033750
0,042700
0,010350
0,053650
0,010400
0,901000
0,274200
0,360805
0,421805
0,078860
0,078850
1,098510
57,910213
4,540128
1,722601
cod ATC
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
A06AD11
A06AD11
A06AD11
A06AD11
A07AA02
A07EC01
A07EC01
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
DCI
LACTULOSUM
LACTULOSUM
LACTULOSUM
LACTULOSUM
NYSTATINUM
SULFASALAZINUM
SULFASALAZINUM
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
ACENOCUMAROLUM
ACENOCUMAROLUM
TICLOPIDINUM1)
TICLOPIDINUM1)
PHYTOMENADIONUM
FERROSI SULFAS
FERROSI SULFAS
Denumire Comerciala
LACTULOSE
LACTULOSE-MIP 650 mg/ml
LACTULAK 660 mg/ml
NISTATINA
SULFASALAZIN EN
SALAZIDIN GR 500 mg
PENTASA 1 g
PENTASA 500mg
SALOFALK 250 mg COMPRIMATE GASTROREZISTENTE
MESALAZINA SOFARFARM 400 mg

B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT
PENTASA 1000mg
SALOFALK 1 g
SALOFALK (R) 250 mg
SALOFALK (R) 500 mg
SALOFALK 4 g/ 60 ml
TROMBOSTOP 2 mg
SINTROM 4 mg
TICLODIN
IPATON
FITOMENADION 10 mg/ml
FERROGRADUMET (R)
TARDYFERON 80 mg
MALTOFER
FER ROMPHARM 50 mg/ml
FERGLUROM FORTE 50 mg/ml
FERRUM HAUSMANN (R)

FERRUM HAUSMANN (R)
FERGLUROM 50mg/5ml
SORBIFER DURULES
ACIFOL 5 mg
DIGOXIN ZENTIVA 0,25 mg
DIGOXIN 0,5 mg/2 ml
DIGOXIN ZENTIVA 0,5 mg/2ml
CHINIDINA ARENA 200 mg
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
B01AA07
B01AA07
B01AC05
B01AC05
B02BA01
B03AA07
B03AA07

B03AEN1
COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM)
B03BB01
ACIDUM FOLICUM
DIGOXINUM
DIGOXINUM
DIGOXINUM
CHINIDINI SULFAS
CHINIDINI SULFAS
CHINIDINI SULFAS
CHINIDINI SULFAS
PROPAFENONUM
PROPAFENONUM
PROPAFENONUM
PROPAFENONUM
PROPAFENONUM
PROPAFENONUM
AMIODARONUM
AMIODARONUM
AMIODARONUM
AMIODARONUM
NITROGLYCERINUM
NITROGLYCERINUM
NITROGLYCERINUM
NITROGLYCERINUM
NITROGLYCERINUM
C01AA05
C01AA05
C01AA05
C01BA01
C01BA01
C01BA01
C01BA01
C01BC03
C01BC03
C01BC03
C01BC03
C01BC03
C01BC03
C01BD01
C01BD01
C01BD01
100 C01BD01
101 C01DA02
102 C01DA02
103 C01DA02
104 C01DA02
105 C01DA02
PROPAFENONA ARENA 150 mg

PROPAFENONA ARENA 150 mg
RYTMONORM (R)
PROPAFENON AL 150
PROPAFENON SANDOZ 150 mg
RYTMONORM
CORDARONE 200 mg
AMIODARONA LPH 200 mg
AMIODARONA ARENA 200 MG
CORDARONE 200 mg
NITROMINT 2,6 mg
NITROGLICERINA 0,5 mg
NITRODERM (R) TTS 5
NITROMINT
NITROMINT
forma farm.
SIROP
SIROP
650mg/ml
SIROP
650mg/ml
SOL. ORALA 660 mg/ml
COMPR. FILM. 500.000ui
COMPR. FILM. GASTROREZ. 500mg
COMPR. GASTROREZ. 500mg
COMPR. CU ELIB. PREL. 1g
COMPR. ELIB. PREL. 500mg
COMPR. GASTROREZISTENTE 400mg
SUPOZ.
1000mg
SUPOZ.
1g
SUPOZ.
250mg
SUPOZ.
500mg
SUSP. RECTALA 4g/60ml
COMPR.
2mg
COMPR.
4mg
COMPR. FILM. 250mg
COMPR. FILM. 250mg
SOL. INJ.
10mg/ml
DRAJ. ELIB. PREL. 80mg
COMPR. MAST. 100mg
PIC. ORALE, SOL. 50mg/ml
PICATURI ORALE, SOL. 50mg/ml
PICATURI ORALE-SOL. 50mg/ml
SIROP
10mg/ml
SIROP
50mg/5ml
COMPR. FILM. 100mg+60mg
COMPR. FILM. 5mg
COMPR.
0,25mg
SOL. INJ.
0,5mg/2ml
SOL. INJ.
0,5mg/2ml
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
150mg
COMPR.
150mg
COMPR. FILM. 150mg
COMPR. FILM. 150mg
COMPR. FILM. 150mg
SOL. INJ.
70mg/20ml
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR. ELIB. PREL. 2,6mg
COMPR. SUBLING. 0,5mg
SIST. TERAP. TRANSDERM. 25mg
SPRAY SUBLINGUAL 0,4mg/doza
SPRAY SUBLINGUAL 0,4mg/doza
Prescriptie
Nr crt.
tara det.
concentratie
Detinator APP
APP
Ambalaj
65%
P-6L
MIP PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 500 ML SIROP + 1 MASURA DOZATOARE DIN PP P-6L
MIP PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 1000 ML SIROP + 1 MASURA DOZATOARE DIN PP P-6L
ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PEID X 200 ML SOL. ORALA SI O LINGURITA DOZATOARE P-6L
ANTIBIOTICE SA
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L
AC HELCOR PHARMA S.R.L.
ROMANIA
CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P6L
FERRING GMBH
FERRING GMBH
GERMANIA CUTIE CU 6 BLIST. AL/AL X 10 COMPR. CU ELIB. PREL. P6L

GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L
DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L
DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L
DR. FALK PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ.
P-6L
SOFARFARM S.R.L.
SOFARFARM S.R.L.
SOFARFARM S.R.L.
FERRING GMBH
DR. FALK PHARMA GMBH
ROMANIA
ROMANIA
ROMANIA
CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE

P6L
P6L
P6L
GERMANIA CUTIE X 4 BLIST. AL X 7 SUPOZ. + CUTIE PLASTIC X 28 CAUCIURI DE PROTECTIE A DEGETULUI P-6L
GERMANIA CUTIE CU FOLII TERMOSUDATE PVC/PE X 30 SUPOZ. P6L
GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ.
P-6L
GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ.
P-6L
GERMANIA
P-6L
CUTIE X 7 BLIST. AL/PE CONTINAND FIECARE CATE 1 FLACON UNIDOZA X 60 ML SUSPENSIE RECTALA + APLICA
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF

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

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

SANOFI-AVENTIS FRANCE FRANTA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. P-RF
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 60 COMPR. ELIB. PREL. P-6L
ZENTIVA SA
ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. SUBLINGUALE P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 PLICURI X 1 SIST. TERAPEUTIC TRANSDERMIC
EGIS PHARMACEUTICALS P.L.C.
UNGARIA
UNGARIA
P-6L
CUTIE X 1 FLACON X 10G (180 DOZE) SPRAY SUBLINGUAL P-6L

CUTIE X 1 FLACON DIN PLASTIC X 10G (180 DOZE) SPRAY SUBLINGUALP-6L
Pagina 2 din 21
cant.
Pret de
UT/
(RON)
aj
1
1
1
1
20
50
50
60
100
100
100
50
60
60
90
28
30
10
10
7
30
20
20
20
5
30
30
30
1
1
1
1
1
50
30
25
5
5
20
20
30
50
20
100
50
100
50
5
30
30
30
30
60
20
10
1
1
3,361999
16,809999
33,340000
6,730000
0,480000
0,584200
0,585200
1,650889
0,825444
0,412721
0,825444
0,825444
0,660354
1,320712
1,320712
5,886666
5,886666
1,471662
2,943333
20,875714
0,187749
0,350000
0,272892
0,272892
3,340000
0,282000
0,228972
0,636035
8,780000
9,120000
9,120000
9,120000
6,080000
0,307800
0,255666
0,138800
1,652000
1,652000
0,641350
0,641350
0,641350
0,639400
0,329400
0,329400
0,329400
0,329400
0,329400
7,358000
0,291916
0,291916
0,253666
0,291916
0,150882
0,088402
1,557999
12,730000
12,730000
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,228001
0,420001
0,000000
0,000000
0,000000
0,000000
0,000000
1,542444
0,557556
0,176979
0,294956
0,395756
0,150312
0,185788
0,133732
0,320476
0,000000
0,702338
0,656667
0,000000
0,038251
0,000000
1,503608
0,415108
0,000000
0,000000
0,186694
0,107298
0,000000
0,000000
4,920000
6,860000
4,310000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000650
0,045650
0,024650
0,000000
0,011100
0,000000
0,194200
0,000000
0,032400
0,000000
0,177084
0,012750
0,000000
0,177084
0,044284
0,112098
0,000001
0,000000
0,000000
3,025799
15,128999
30,006000
6,057000
0,432000
0,525780
0,526680
1,485800
0,742899
0,371448
0,742899
0,742899
0,594318
1,188640
1,188640
5,297999
5,297999
1,324495
2,648999
18,788142
0,168974
0,315000
0,245602
0,245602
3,006000
0,253800
0,206074
0,572431
7,902000
8,208000
8,208000
8,208000
5,472000
0,277020
0,230099
0,124920
1,486800
1,486800
0,577215
0,577215
0,577215
0,575460
0,296460
0,296460
0,296460
0,296460
0,296460
6,622200
0,262724
0,262724
0,228299
0,262724
0,135793
0,079561
1,402199
11,457000
11,457000
0,564201
2,101001
3,334000
0,673000
0,048000
0,058420
0,058520
1,707533
0,640101
0,218252
0,377501
0,478301
0,216348
0,317860
0,265804
0,909143
0,588667
0,849505
0,951001
2,087572
0,057026
0,035000
1,530898
0,442398
0,334000
0,028200
0,209592
0,170902
0,878000
0,912000
5,832000
7,772000
4,918000
0,030780
0,025567
0,013880
0,165200
0,165200
0,064785
0,109785
0,088785
0,063940
0,044040
0,032940
0,227140
0,032940
0,065340
0,735800
0,206276
0,041942
0,025367
0,206276
0,059373
0,120939
0,155801
1,273000
1,273000
cod ATC
DCI
155 C03DA01
ISOSORBIDI DINITRAS
ISOSORBIDI DINITRAS
ISOSORBIDI MONONITRAS
ALPROSTADILUM***
ALPROSTADILUM***
METHYLDOPUM
CLONIDINUM
CLONIDINUM
CLONIDINUM
HYDROCHLOROTHIAZIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
156 C03EB01
COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM)
157 C03EB01
158 C03EB01
159 C03EB01
160 C04AD03
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
106 C01DA08
107 C01DA08
108 C01DA14
109 C01DA14
110 C01DA14
111 C01DA14
112 C01EA01
113 C01EA01
114 C02AB01
115 C02AC01
116 C02AC01
117 C02AC01
118 C03AA03
119 C03BA11
120 C03BA11
121 C03BA11
122 C03BA11
123 C03BA11
124 C03BA11
125 C03BA11
126 C03BA11
127 C03BA11
128 C03BA11
129 C03BA11
130 C03BA11
131 C03BA11
132 C03BA11
133 C03BA11
134 C03BA11
135 C03BA11
136 C03BA11
137 C03BA11
138 C03BA11
139 C03CA01
140 C03CA01
141 C03CA01
142 C03CA01
143 C03CA01
144 C03CA01
145 C03CA01
146 C03CA01
147 C03DA01
148 C03DA01
149 C03DA01
150 C03DA01
151 C03DA01
152 C03DA01
153 C03DA01
154 C03DA01
161 C04AD03
162 C04AD03
Denumire Comerciala
forma farm.
ISOSORBID DINITRAT 10 mg COMPR.

ISODINIT(R) RETARD
COMPR. ELIB. PREL.
MONO ROM SR 40 mg
CAPS. ELIB. PREL.
OLICARD 40 mg RETARD
CAPS. ELIB. PREL.
MONO ROM SR 60 mg
CAPS. ELIB. PREL.
MONONITRON (R) EP 60 mg COMPR. ELIB. PREL.
PRIDAX 20mcg
CONC. PT. SOL. PERF.
VASAPROSTAN 20
LIOF. PT. SOL. PERF.
DOPEGYT
COMPR.
CLONIDINA SINTOFARM 0,15 mg COMPR.
CLONIDINA ARENA 0,15 mg COMPR.
CLONIDINA ARENA 0,15 mg COMPR.
NEFRIX 25 mg
COMPR.
SERDIMID 1,5 mg
COMPR. CU ELIB. PREL.
Prescriptie
Nr crt.
cant.
UT/
Pret de
tara det.
(RON)
aj
concentratie
Detinator APP
APP
Ambalaj
10mg
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 3, BLIST. AL/PVC X 20 COMPR. P-6L
60
0,031000
20mg
PHARMAKI GENERICS LIMITED MAREA BRITANIE CUTIE X 6 BLIST. X 10 COMPR. ELIB. PREL. P-6L
60
0,068333
40mg
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L
20
0,290159
40mg
60mg
60mg
20mcg
20g
250mg
0,15mg
0,15mg
0,15mg
25mg
1,5mg
INDAPAMIDA SOPHARMA 1,5 mg COMPR. CU ELIB. PREL. 1,5mg
SERDIMID 2,5 mg
COMPR. CU ELIB. PREL. 2,5mg
INDAPAMIDA TERAPIA 1,5 mg COMPR. CU ELIB. PRELUNGITA 1,5mg
INDAPAMIDA TERAPIA 2,5mg COMPR. CU ELIB. PRELUNGITA 2,5mg
INDAPAMID SR ZENTIVA 1,5 mg COMPR. ELIB. PREL 1,5 mg
INDAPAMIDA MYLAN 1,5 mg COMPR. ELIB. PREL. 1,5 mg
TERTENSIF SR 1,5 mg
INDAPAMID MCC 1,5 mg
IDUREN SR 1,5 mg
DIUREMID SR 1,5 mg
INDAPAMIDA TEVA 1,5 mg
INDAPAMIDA SR TORRENT 1,5 mg COMPR. ELIB. PREL. 1,5mg
INDAPAGAMMA 1,5 mg
INDAPAMID LPH (R) 2,5 mg COMPR. FILM. 2,5mg
INDAPAMID SR 1,5 mg LAROPHARM COMPR. FILM. ELIB. PREL. 1,5 mg
INDAPAMID LPH (R) 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg
RAWEL SR 1,5 mg
COMPR. FILM. ELIB. PREL. 1,5mg
IMPAMID SR 1,5 mg
INDAPAMIDA ACTAVIS 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg
FUROSEMID MCC 40 mg
COMPR.
40mg
FUROSEMID SLAVIA
COMPR.
40mg
FUROSEMID ZENTIVA
COMPR.
40mg
FUROSEMID LPH 40 mg
COMPR.
40mg
FUROSEMID ARENA 40 mg COMPR.
40mg
FUROSEMID BIOEEL 40 mg COMPR.
40mg
FUROSEMID LPH 40 mg
COMPR.
40mg
FUROSEMID 20 mg/2 ml
SOL. INJ.
10mg/ml
VEROSPIRON
CAPS.
100mg
SPIRONOLACTONA ARENA 25 mg CAPS.
25mg
SPIRONOLACTONA LPH 25 mg CAPS.
25mg
VEROSPIRON
CAPS.
50mg
50mg
SPIRONOLACTONA BIOEEL 25 mg COMPR.
25mg
SPIRONOLACTONA TERAPIA 25 mg COMPR. FILM. 25mg
ALSPIRON 25 mg
COMPR. FILM. 25mg
ALSPIRON 50 mg
COMPR. FILM. 50mg
DIUROCARD 50 mg/20 mg
CAPS.
50mg/20 mg
DIUREX 50
CAPS.
50mg/20mg
DIOCOR 50 mg/20 mg
CAPS.
50mg/20mg
DIOCOR 50 mg/20 mg
CAPS.
50mg/20mg
PENTOXI RETARD 400 mg
PENTOXI RETARD 400 mg
PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg
ABBOTT LABORATORIES GMBH
GERMANIA CUTIE X 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L
ROMANIA CUTIE CU 2 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L

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

CUTIE X 1 FLAC. DIN PEID X 20 COMPR.
CUTIE X 2 BLIST. X 10 COMPR.
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L

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

CUTIE CU 5 BLIST. PVC/AL X 10 CAPS.
P-6L
P-6L
P6L
P-6L
P-6L
P-6L
CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L

CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L

P-6L
P6L
P6L
CUTIE X 4 BLIST. X 10 COMPR. CU ELIB. PREL. P-6L

CUTIE X 2 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L
Pagina 3 din 21
P-6L
20
20
40
5
10
50
50
50
50
25
30
30
30
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30
30
30
30
30
30
30
30
30
30
20
30
30
30
30
20
20
20
20
20
20
30
5
30
50
60
30
30
20
50
20
20
30
20
30
20
40
20
20
0,290159
0,435238
0,435016
42,012500
38,580000
0,554400
0,195499
0,195499
0,195499
0,173200
0,280664
0,280664
0,467774
0,280664
0,467774
0,280664
0,268000
0,280664
0,280664
0,280664
0,280664
0,264666
0,280664
0,280664
0,467774
0,280664
0,280664
0,264666
0,280664
0,268666
0,156500
0,156500
0,156750
0,156750
0,156750
0,156750
0,156750
1,260000
0,753000
0,220833
0,220833
0,441666
0,441666
0,220833
0,220833
0,215000
0,441666
1,079083
1,079083
1,049333
1,079083
0,432283
0,432283
0,432283
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,000000
0,000000
0,302841
0,151841
0,489262
0,509484
10,297500
0,000000
0,000000
0,044501
0,060501
0,060301
0,000000
0,069002
0,041336
0,053559
0,069002
0,047226
0,069002
0,000000
0,257669
0,069002
0,069002
0,069002
0,000000
0,069002
0,069002
0,053559
0,069336
0,069002
0,000000
0,069002
0,000000
0,000000
0,000000
0,156250
0,000250
0,156250
0,114250
0,000916
0,000000
0,000000
0,112567
0,115500
0,000000
0,120334
0,001667
0,148967
0,000000
0,245334
0,009917
0,130417
0,000000
0,086417
0,149467
0,460717
0,098717
0,027900
0,061499
0,261143
0,261143
0,391714
0,391514
37,811250
34,722000
0,498960
0,175949
0,175949
0,175949
0,155880
0,252597
0,252597
0,420996
0,252597
0,420996
0,252597
0,241200
0,252597
0,252597
0,252597
0,252597
0,238199
0,252597
0,252597
0,420996
0,252597
0,252597
0,238199
0,252597
0,241799
0,140850
0,140850
0,141075
0,141075
0,141075
0,141075
0,141075
1,134000
0,677700
0,198749
0,198749
0,397499
0,397499
0,198749
0,198749
0,193500
0,397499
0,971174
0,971174
0,944399
0,971174
0,389054
0,389054
0,389054
0,003100
0,006834
0,331857
0,180857
0,532786
0,552986
14,498750
3,858000
0,055440
0,064051
0,080051
0,079851
0,017320
0,097069
0,069403
0,100337
0,097069
0,094004
0,097069
0,026800
0,285736
0,097069
0,097069
0,097069
0,026467
0,097069
0,097069
0,100337
0,097403
0,097069
0,026467
0,097069
0,026867
0,015650
0,015650
0,171925
0,015925
0,171925
0,129925
0,016591
0,126000
0,075300
0,134651
0,137584
0,044167
0,164501
0,023751
0,171051
0,021500
0,289501
0,117826
0,238326
0,104934
0,194326
0,192696
0,503946
0,141946
cod ATC
163 C04AD03
164 C04AD03
165 C04AD03
166 C04AD03
167 C04AD03
168 C04AD03
169 C04AD03
170 C07AA05
171 C07AA05
172 C07AA05
173 C07AA05
174 C07AA05
175 C07AA05
176 C07AA07
177 C07AA07
178 C07AA07
179 C07AA07
180 C07AB02
181 C07AB02
182 C07AB02
183 C07AB02
184 C07AB02
185 C07AB02
186 C07AB02
187 C07AB02
188 C07AB02
189 C07AB02
190 C07AB02
191 C07AB02
192 C07AB02
193 C07AB02
194 C07AB02
195 C07AB02
196 C07AB02
197 C07AB02
198 C07AB02
199 C07AB02
200 C07AB02
201 C07AB02
202 C07AB02
203 C07AB02
204 C07AB02
205 C07AB02
206 C07AB02
207 C07AB02
208 C07AB02
209 C07AB02
210 C07AB02
211 C07AB02
212 C07AB02
213 C07AB02
214 C07AB02
215 C07AB02
216 C07AB03
217 C07AB03
218 C07AB03
219 C07AB03
DCI
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PROPRANOLOLUM
PROPRANOLOLUM
PROPRANOLOLUM
PROPRANOLOLUM
PROPRANOLOLUM
PROPRANOLOLUM
SOTALOLUM
SOTALOLUM
SOTALOLUM
SOTALOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
ATENOLOLUM
ATENOLOLUM
ATENOLOLUM
ATENOLOLUM
Denumire Comerciala
forma farm.
concentratie
400mg
VASONIT RETARD 600 mg
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
HEMANGIOL 3,75 mg/ml
SOL. ORALA 3,75 mg/ml
SOTALOL AL 160
COMPR.
160mg
DAROB (R) 80 mg
COMPR.
80mg
SOTAGAMMA 80
COMPR.
80mg
SOTALOL AL 80
COMPR.
80mg
BLOXAN
COMPR.
100mg
BETAPROL 100 mg
COMPR.
100mg
EGILOK 100 mg
COMPR.
100mg
METOPROLOL LPH 100 mg COMPR.
100mg
METOPROLOL LAROPHARM 100 mg COMPR.
100mg
METOPROLOL 100 mg
COMPR.
100mg
METOPROLOL TERAPIA 100 mg COMPR.
100mg
METOPROLOL VIM SPECTRUM 100 mg COMPR.
100mg
METOPROLOL ARENA 100 MG COMPR.
100mg
METOPROLOL 100 mg
COMPR.
100mg
METOPROLOL AL 100
COMPR.
100mg
METOPROLOL ZENTIVA 100 mg COMPR.
100mg
EGILOK 25 mg
COMPR.
25mg
METOPROLOL LPH 25 mg
COMPR.
25mg
METOPROLOL 25 mg
COMPR.
25mg
25mg
COMPR.
25mg
50mg
BETAPROL 50 mg
COMPR.
50mg
EGILOK 50 mg
COMPR.
50mg
COMPR.
50mg
METOPROLOL 50 mg
COMPR.
50mg
50mg
50mg
50mg
METOPROLOL 50 mg
COMPR.
50mg
METOPROLOL AL 50
COMPR.
50mg
50mg
METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg
METOPROLOL TARTRAT AUROBINDO 100 mg
COMPR. FILM. 100mg
METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM. 50mg
BETALOC (R) ZOK 100 mg
METOSUCCINAT SANDOZ 190 mg COMPR.FILM.ELIB.MOD. 190mg
METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg
ATENOLOL LPH 100 mg
COMPR.
100mg
ATENOLOL LPH 100 mg
COMPR.
100mg
ATENOLOL ARENA 100 MG COMPR.
100mg
ATENOLOL LPH 50 mg
COMPR.
50mg
PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL.
Detinator APP
ZENTIVA AS
ZENTIVA AS
ZENTIVA AS
LANNACHER HEILMITTEL GES.M.B.H.
AC HELCOR PHARMA SRL

LABORMED PHARMA S.A.
BIO EEL S.R.L.

SINTOFARM SA
BIO EEL SRL
SINTOFARM SA
ARENA GROUP SA
PIERRE FABRE DERMATOLOGIE
AUSTRIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
FRANTA
Ambalaj
Prescriptie
Nr crt.
tara det.
APP
SLOVACIA
SLOVACIA
SLOVACIA
P-6L
P-6L
P-6L
CUTIE X 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L

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

CUTIE X 2 BLIST., AL/PVC X 10 COMPR. FILM. ELIB. PREL.
CUTIE CU 2 BLIST. PVC/AL X 25 COMPR.

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

ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. AL/PVP X 10 COMPR.
P-6L
P6L
P-6L
P-6L
P-6L
P-6L
PR/PRF
P-6L
P-6L
GERMANIA CUTIE X 10 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L

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

UNGARIA CUTIE X, 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
LAROPHARM SRL
MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
TERAPIA SA
VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
SLAVIA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L
ZENTIVA S.A.
ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
LAROPHARM SRL
AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
TERAPIA SA
SLAVIA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L
ZENTIVA S.A.
TERAPIA SA
ROMANIA 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
ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L
HEXAL AG
HEXAL AG
Pagina 4 din 21
cant.
Pret de
UT/
(RON)
aj
50
50
100
50
20
60
20
50
50
50
50
50
1
50
20
100
50
30
30
20
30
20
30
30
20
30
20
30
30
20
20
30
30
60
20
30
20
30
30
30
20
30
20
30
30
20
30
30
30
30
30
30
30
30
20
20
20
0,426200
0,648425
0,648425
0,648425
0,318000
0,318166
0,648425
0,025273
0,025273
0,099600
0,099600
0,101092
1,137290
0,404370
0,202185
0,202185
0,202185
0,077000
0,225734
0,225734
0,225734
0,225734
0,225734
0,225734
0,225734
0,225734
0,225734
0,225734
0,225734
0,056433
0,056433
0,056433
0,056433
0,056433
0,112867
0,112867
0,112867
0,112867
0,112867
0,112867
0,112867
0,112867
0,112867
0,112867
0,112867
0,225734
0,225734
0,112867
0,225734
0,112867
0,428895
0,107223
0,214447
0,365666
0,365000
0,324500
0,204000
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,000000
0,053575
0,029875
0,027375
0,000000
0,000000
0,174575
0,042127
0,056727
0,000000
0,000000
0,002108
1.066,852710
0,154430
0,315315
0,134315
0,124815
0,000000
0,070599
0,070766
0,020266
0,070766
0,070599
0,070599
0,070766
0,016599
0,064766
0,070599
0,070599
0,042067
0,042067
0,042233
0,042233
0,041900
0,069633
0,069466
0,069633
0,051466
0,069466
0,131133
0,059633
0,069466
0,069633
0,038799
0,069466
0,070766
0,070599
0,068466
0,230266
0,267133
0,075105
0,108443
0,143886
0,000000
0,000000
0,000000
0,000000
0,383580
0,583582
0,583582
0,583582
0,286200
0,286349
0,583582
0,022745
0,022745
0,089640
0,089640
0,090982
1,023561
0,363933
0,181966
0,181966
0,181966
0,069300
0,203160
0,203160
0,203160
0,203160
0,203160
0,203160
0,203160
0,203160
0,203160
0,203160
0,203160
0,050789
0,050789
0,050789
0,050789
0,050789
0,101580
0,101580
0,101580
0,101580
0,101580
0,101580
0,101580
0,101580
0,101580
0,101580
0,101580
0,203160
0,203160
0,101580
0,203160
0,101580
0,386005
0,096500
0,193002
0,329099
0,328500
0,292050
0,183600
0,042620
0,118418
0,094718
0,092218
0,031800
0,031817
0,239418
0,044655
0,059255
0,009960
0,009960
0,012218
1.066,966439
0,194867
0,335534
0,154534
0,145034
0,007700
0,093173
0,093340
0,042840
0,093340
0,093173
0,093173
0,093340
0,039173
0,087340
0,093173
0,093173
0,047711
0,047711
0,047877
0,047877
0,047544
0,080920
0,080753
0,080920
0,062753
0,080753
0,142420
0,070920
0,080753
0,080920
0,050086
0,080753
0,093340
0,093173
0,079753
0,252840
0,278420
0,117995
0,119166
0,165331
0,036567
0,036500
0,032450
0,020400
cod ATC
220 C07AB03
221 C07AB03
222 C07AB05
223 C07AB07
224 C07AB07
225 C07AB07
226 C07AB07
227 C07AB07
228 C07AB07
229 C07AB07
230 C07AB07
231 C07AB07
232 C07AB07
233 C07AB07
234 C07AB07
235 C07AB07
236 C07AB07
237 C07AB07
238 C07AB07
239 C07AB07
240 C07AB07
241 C07AB07
242 C07AB07
243 C07AB07
244 C07AB07
245 C07AB07
246 C07AB07
247 C07AB07
248 C07AG02
249 C07AG02
250 C07AG02
251 C07AG02
252 C07AG02
253 C07AG02
254 C07AG02
255 C07AG02
256 C07AG02
257 C07AG02
258 C07AG02
259 C07AG02
260 C07AG02
261 C07AG02
262 C07AG02
263 C07AG02
264 C07AG02
265 C07AG02
266 C07AG02
267 C07AG02
268 C07AG02
269 C07AG02
270 C07AG02
271 C07AG02
272 C07AG02
273 C07AG02
274 C07AG02
275 C07AG02
276 C08CA01
DCI
ATENOLOLUM
ATENOLOLUM
BETAXOLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
AMLODIPINUM
Denumire Comerciala
ATENOLOL LPH 50 mg
ATENOLOL ARENA 50 MG
LOKREN 20 mg
BISOPROLOL LPH 10mg
BISOBLOCK 10 mg
BISOPROLOL LPH 5mg
BISOBLOCK 5 mg
BOREZ 10 mg
CONCOR 10 mg
BISOGAMMA (R) 10
BISOGAMMA (R) 10
CONCOR COR 10 mg
BISOTENS 10 mg
BISOPROLOL FUMARAT AUROBINDO 10 mg
CONCOR COR 10 mg
SOBYC 10 mg
BOREZ 2,5 mg
CONCOR COR 2,5 mg
CONCOR COR 2,5 mg
SOBYC 2,5 mg
CONCOR 5 mg
BISOGAMMA (R) 5
BISOGAMMA (R) 5
CONCOR COR 5 mg
BISOTENS 5 mg
BISOPROLOL FUMARAT AUROBINDO 5 mg
CONCOR COR 5 mg
SOBYC 5 mg
Prescriptie
Nr crt.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CARVEDILOL SANDOZ 12,5 mg COMPR.
DILATREND (R) 12,5 mg

CORYOL 12,5 mg
TALLITON (R) 12,5 mg
CARVEDILOL LPH 12,5 mg
CARVEDILOL VIM SPECTRUM 12,5mg
GLADYCOR 12,5 mg
MIOCARVIL 12,5 mg
CARVEDILOL HELCOR 12,2 mg
DILATREND (R) 25 mg
CORYOL 25 mg
TALLITON (R) 25 mg
CARVEDILOL LPH 25 mg
GLADYCOR 25 mg
MIOCARVIL 25 mg
CARVEDILOL HELCOR 25 mg
CARVEDILOL SANDOZ 25 mg
CORYOL (R)
TALLITON 6,25 mg
CARVEDILOL VIM SPECTRUM 6,25 mg
GLADYCOR 6,25 mg
MIOCARVIL 6,25 mg
CARVEDILOL SANDOZ 6,25 mg
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
CARVEDILOL AUROBINDO 12,5mg COMPR. FILM.

CARVEDILOL AUROBINDO 25mg COMPR. FILM.
CARVEDILOL AUROBINDO 6,25mg COMPR. FILM.
AMLODIPINA TEVA 10 mg
cant.
UT/
Pret de
tara det.
(RON)
aj
forma farm. concentratie
Detinator APP
APP
Ambalaj
COMPR.
50mg
30
0,204000
COMPR.
50mg
20
0,185000
COMPR. FILM. 20mg
SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.FILM. P-6L
28
0,338601
COMPR.
10mg
LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L
30
0,338601
COMPR.
10mg
5mg
5mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
2,5 mg
2,5mg
2,5mg
2,5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
12,5 mg
12,5mg
12,5mg
12,5mg
12,5mg
12,5mg
12,5mg
12,5mg
12,5mg
25mg
25mg
25mg
25mg
25mg
25mg
25mg
25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
12,5mg
25mg
6,25mg
10 mg
ACTAVIS GROUP PTC EHF.

ISLANDA CUTIE X 3 BLIST. X 10 COMPR.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR.
ISLANDA CUTIE X 3 BLIST. X 10 COMPR.
P-6L
P-6L
P-6L
ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM.
P-6L/S
P-6L
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
ANTIBIOTICE S.A.
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L
MERCK KGAA
GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L
MERCK KGAA
MERCK KGAA
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L
P-6L
P-6L
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. FILM. P-6L
ANTIBIOTICE S.A.
CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L
MERCK KGAA
HEXAL AG
GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L
ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR.
UNGARIA
VIM SPECTRUM SRL ROMANIA
ANTIBIOTICE S.A.
ROMANIA
SLAVIA PHARM S.R.L. ROMANIA
ROCHE ROMANIA S.R.L. ROMANIA
P-6L
CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.
P-6L

CUTIE X 3 BLIST. PVC/AL X 10 COMPR.
P-6L
P-6L
P-6L
P-6L
P-6L
CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. P-6L
UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L
ANTIBIOTICE S.A.
P-6L
ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L

SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L
HEXAL AG
KRKA D.D.
SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 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
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
Pagina 5 din 21
30
30
30
30
30
100
30
30
30
30
30
30
30
30
30
30
30
30
100
30
30
30
30
30
30
28
28
30
30
20
30
30
20
28
28
30
30
30
30
20
30
28
28
30
30
20
30
30
30
28
28
28
30
0,231000
0,169300
0,122333
0,338601
0,338601
0,338601
0,338601
0,338601
0,338601
0,338601
0,338601
0,338601
0,084650
0,084650
0,084650
0,084650
0,169300
0,160333
0,168900
0,169300
0,169300
0,169300
0,169300
0,169300
0,252074
0,252074
0,252074
0,252074
0,252074
0,252074
0,252074
0,252074
0,252074
0,504149
0,355000
0,504149
0,504149
0,504149
0,504149
0,504149
0,317333
0,126037
0,126037
0,126037
0,126037
0,126037
0,126037
0,126037
0,126037
0,252074
0,285714
0,126037
0,123333
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,000000
0,000000
0,017470
0,235065
0,000000
0,083366
0,000000
0,024399
0,544399
0,162599
0,022065
0,746732
0,288065
0,134065
0,746732
0,008732
0,158683
0,289683
0,289683
0,124350
0,345700
0,000000
0,000000
0,220033
0,126700
0,103033
0,220033
0,037033
0,025259
0,582211
0,007211
0,028926
0,210259
0,083926
0,200926
0,210259
0,199926
0,422636
0,000000
0,019184
0,097851
0,098184
0,096851
0,098351
0,000000
0,263605
0,072177
0,058963
0,112296
0,101963
0,105629
0,112296
0,054296
0,005068
0,000000
0,053963
0,000000
0,183600
0,166500
0,304740
0,304740
0,207900
0,152370
0,110099
0,304740
0,304740
0,304740
0,304740
0,304740
0,304740
0,304740
0,304740
0,304740
0,076185
0,076185
0,076185
0,076185
0,152370
0,144299
0,152010
0,152370
0,152370
0,152370
0,152370
0,152370
0,226866
0,226866
0,226866
0,226866
0,226866
0,226866
0,226866
0,226866
0,226866
0,453734
0,319500
0,453734
0,453734
0,453734
0,453734
0,453734
0,285599
0,113433
0,113433
0,113433
0,113433
0,113433
0,113433
0,113433
0,113433
0,226866
0,257142
0,113433
0,110999
0,020400
0,018500
0,051331
0,268926
0,023100
0,100296
0,012234
0,058260
0,578260
0,196460
0,055926
0,780593
0,321926
0,167926
0,780593
0,042593
0,167148
0,298148
0,298148
0,132815
0,362630
0,016034
0,016890
0,236963
0,143630
0,119963
0,236963
0,053963
0,050467
0,607419
0,032419
0,054134
0,235467
0,109134
0,226134
0,235467
0,225134
0,473051
0,035500
0,069599
0,148266
0,148599
0,147266
0,148766
0,031734
0,276209
0,084781
0,071567
0,124900
0,114567
0,118233
0,124900
0,066900
0,030276
0,028572
0,066567
0,012334
cod ATC
277 C08CA01
278 C08CA01
279 C08CA01
280 C08CA01
281 C08CA01
282 C08CA01
283 C08CA01
284 C08CA01
285 C08CA01
286 C08CA01
287 C08CA01
288 C08CA01
289 C08CA01
290 C08CA01
291 C08CA01
292 C08CA01
293 C08CA01
294 C08CA01
295 C08CA01
296 C08CA01
297 C08CA01
298 C08CA01
299 C08CA01
300 C08CA01
301 C08CA01
302 C08CA01
303 C08CA01
304 C08CA01
305 C08CA01
306 C08CA02
307 C08CA02
308 C08CA02
309 C08CA02
310 C08CA02
311 C08CA02
312 C08CA02
313 C08CA02
314 C08CA02
315 C08CA02
316 C08CA02
317 C08CA05
318 C08CA05
319 C08DA01
320 C08DA01
321 C08DA01
322 C08DA01
323 C08DA01
324 C08DA01
325 C08DA01
326 C08DA01
327 C08DB01
328 C08DB01
329 C08DB01
330 C08DB01
331 C08DB01
332 C08DB01
333 C08DB01
DCI
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
NIFEDIPINUM
NIFEDIPINUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
Denumire Comerciala
AMLOHEXAL 10 mg
TENOX (R) 10
forma farm.
COMPR.
COMPR.
AMLODIPINE MEDOCHEMIE 10 mg COMPR.
ALMACOR 10 mg
COMPR.
AMLODIPINA LPH 10 mg
COMPR.
AMLODIPINA TERAPIA 10 mg COMPR.
RECOTENS 10 mg
COMPR.
AMLODIPIN VIM SPECTRUM 10 mg COMPR.
AMLODIPINA ACTAVIS 10 mg COMPR.
AMLODIPINA ZENTIVA 10 mg COMPR.
NORVASC 10 mg
COMPR.
AMLODIPINA HELCOR 10 mg COMPR.
AMLODIPINA ARENA 10 mg COMPR.
AMLODIPINA TEVA 5 mg
COMPR.
AMLOHEXAL 5 mg
COMPR.
TENOX (R) 5
COMPR.
AMLODIPINE MEDOCHEMIE 5 mg COMPR.
ALMACOR 5 mg
COMPR.
AMLODIPINA LPH 5 mg
COMPR.
RECOTENS 5 mg
COMPR.
AMLODIPIN VIM SPECTRUM 5 mg COMPR.
AMLODIPINA ACTAVIS 5 mg COMPR.
AMLODIPINA ZENTIVA 5 mg COMPR.
NORVASC 5 mg
COMPR.
AMLODIPINA HELCOR 5 mg COMPR.
AMLODIPINA ARENA 5 mg
COMPR.
PLENDIL
COMPR. ELIB. PREL.
PLENDIL
COMPR. ELIB. PREL.
PLENDIL
COMPR. ELIB. PREL.
SISTAR 10 mg
COMPR. FILM. ELIB. MODIF.
SISTAR 2,5 mg
SISTAR 5 mg
AURONAL 10 mg
COMPR. FILM. ELIB. PREL.
FELODIPIN SANDOZ 10 mg COMPR. FILM. ELIB. PREL.
AURONAL 2,5 mg
AURONAL 5 mg
FELODIPIN SANDOZ 5 mg
ADALAT CR 30
COMPR. ELIB. MODIF.
concentratie
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
10mg
2,5mg
5mg
10mg
2,5mg
5mg
10mg
10mg
2,5mg
5mg
5mg
30mg
NIFEDIPIN RETARD TERAPIA 20 mg COMPR. ELIB. PREL. 20mg
VERAPAMIL ARENA 40 mg
CAPS.
40mg
VERAPAMIL ARENA 80 mg CAPS.
80mg
ISOPTIN RR
CORDAMIL 40 mg
COMPR. FILM. 40mg
CORDAMIL 80 mg
COMPR. FILM. 80mg
ISOPTIN (R) 80 mg
COMPR. FILM. 80mg
VERAPAMIL 40 mg
DRAJ.
40mg
VERAPAMIL 80 mg
DRAJ.
80mg
DILTIAZEM SR ROMPHARM 180 mg CAPS. ELIB. PREL. 180mg
DILTIAZEM SR ROMPHARM 90 mg CAPS. ELIB. PREL. 90mg
DILTIAZEM EIPICO 60 mg
COMPR.
60mg
DILTIAZEM LPH 60 mg
COMPR.
60mg
DILTIAZEM ARENA 60 mg
COMPR.
60mg
DILTIAZEM BIOEEL 60 mg
COMPR.
60mg
DILTIAZEM LPH 60 mg
COMPR.
60mg
Detinator APP
HEXAL AG
KRKA D.D.
MEDOCHEMIE LTD.
ANTIBIOTICE S.A.
Ambalaj
Prescriptie
Nr crt.
tara det.
APP
GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L

CIPRU
CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L
ROMANIA
ROMANIA
TERAPIA SA
ROMANIA
TERAPIA SA
ROMANIA
ICN POLFA RZESZOW S.A. POLONIA
ZENTIVA K.S.
REPUBLICA CEHA

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

CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L
CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L
CUTIE X 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. P-6L
CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P6L

PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
P6L
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L
KRKA D.D.
MEDOCHEMIE LTD.
ANTIBIOTICE S.A.
CIPRU
ROMANIA
TERAPIA SA
ROMANIA
TERAPIA SA
ROMANIA
ICN POLFA RZESZOW S.A. POLONIA
ZENTIVA K.S.
REPUBLICA CEHA
CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L

P-6L
P-6L

CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L
CUTIE X 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. P-6L

PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
P6L
ASTRAZENECA AB
ASTRAZENECA AB
ASTRAZENECA AB
SUEDIA CUTIE X 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL.

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

HEXAL AG
BAYER PHARMA AG
TERAPIA SA
ARENA GROUP S.A.
ARENA GROUP S.A.
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L

GERMANIA CUTIE X 2 BLIST. AL/PP X 14 COMPR. ELIB. MODIF. P-6L
ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.

ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS.
P-6L
P6L
P6L
ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L
AC HELCOR SRL
AC HELCOR SRL
ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM.

ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM.
P-6L
P-6L
ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
ROMANIA
ROMANIA
ROMPHARM COMPANY S.R.L. ROMANIA
E.I.P.I.CO. MED S.R.L. ROMANIA
ARENA GROUP SA ROMANIA
BIO EEL SRL
ROMANIA
SANOFI-AVENTIS ROMANIA S.R.L.
CUTIE X 2 BLIST. AL/PVC X 25 DRAJ.

P-6L
CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 10 CAPS. ELIB. PREL.
P6L
P6L
CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 7 CAPS. ELIB. PREL.
CUTIE X 2, BLIST. AL/PVC X 10 COMPR.

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

CUTIE X 2 BLIST. DIN AL/ PVC X 10 COMPR. P-6L
CUTIE X 6 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L
Pagina 6 din 21
cant.
Pret de
UT/
(RON)
aj
30
30
30
30
30
30
30
30
20
20
30
30
20
30
30
30
30
30
30
30
30
30
30
20
20
30
30
20
30
30
30
30
30
30
30
30
30
30
30
30
28
50
30
30
20
30
30
50
50
50
30
21
20
20
50
20
60
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,192500
0,264299
0,264299
0,264299
0,264299
0,125333
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,121500
0,132149
0,132149
0,132149
0,132149
0,264299
0,066074
0,132149
0,264299
0,066074
0,132149
0,264299
0,264299
0,066074
0,132149
0,132149
0,132149
0,088099
0,099832
0,199666
0,598999
0,099832
0,197666
0,199666
0,099832
0,197600
0,781541
0,227619
0,260513
0,260513
0,260513
0,260513
0,260513
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,029367
0,029367
0,029367
0,029367
0,029367
0,029367
0,029367
0,029367
0,029201
0,000000
0,009034
0,187701
0,029201
0,029367
0,000000
0,238184
0,097517
0,096851
0,238184
0,238184
0,238184
0,238184
0,131184
0,237851
0,000000
0,003851
0,437517
0,237851
0,140517
1,030367
0,703926
0,712184
0,605367
0,434259
0,416851
0,605367
0,546034
0,434592
0,416851
0,251517
0,409993
0,135901
0,015168
0,000667
0,229001
0,011168
0,000000
0,104134
0,145368
0,000000
0,411459
0,000000
0,008987
0,018987
0,017087
0,008987
0,019153
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,173250
0,237869
0,237869
0,237869
0,237869
0,112799
0,118934
0,118934
0,118934
0,118934
0,118934
0,118934
0,118934
0,118934
0,118934
0,109350
0,118934
0,118934
0,118934
0,118934
0,237869
0,059466
0,118934
0,237869
0,059466
0,118934
0,237869
0,237869
0,059466
0,118934
0,118934
0,118934
0,079289
0,089848
0,179699
0,539099
0,089848
0,177899
0,179699
0,089848
0,177840
0,703386
0,204857
0,234461
0,234461
0,234461
0,234461
0,234461
0,055797
0,055797
0,055797
0,055797
0,055797
0,055797
0,055797
0,055797
0,055631
0,019250
0,035464
0,214131
0,055631
0,055797
0,012534
0,251399
0,110732
0,110066
0,251399
0,251399
0,251399
0,251399
0,144399
0,251066
0,012150
0,017066
0,450732
0,251066
0,153732
1,056797
0,710534
0,725399
0,631797
0,440867
0,430066
0,631797
0,572464
0,441200
0,430066
0,264732
0,423208
0,144711
0,025152
0,020634
0,288901
0,021152
0,019767
0,124101
0,155352
0,019760
0,489614
0,022762
0,035039
0,045039
0,043139
0,035039
0,045205
cod ATC
334 C08DB01
335 C09AA01
336 C09AA01
337 C09AA01
338 C09AA01
339 C09AA01
340 C09AA01
341 C09AA01
342 C09AA01
343 C09AA01
344 C09AA01
345 C09AA01
346 C09AA01
347 C09AA01
348 C09AA01
349 C09AA02
350 C09AA02
351 C09AA02
352 C09AA02
353 C09AA02
354 C09AA02
355 C09AA02
356 C09AA02
357 C09AA02
358 C09AA02
359 C09AA02
360 C09AA02
361 C09AA02
362 C09AA02
363 C09AA02
364 C09AA02
365 C09AA02
366 C09AA02
367 C09AA02
368 C09AA02
369 C09AA02
370 C09AA02
371 C09AA02
372 C09AA02
373 C09AA02
374 C09AA02
375 C09AA02
376 C09AA02
377 C09AA02
378 C09AA02
379 C09AA03
380 C09AA03
381 C09AA03
382 C09AA03
383 C09AA03
384 C09AA03
385 C09AA03
386 C09AA03
387 C09AA03
388 C09AA03
389 C09AA03
390 C09AA03
DCI
DILTIAZEMUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
Denumire Comerciala
DILZEM 90 mg RETARD
CAPTOPRIL MCC 12,5 mg
CAPTOPRIL 25 mg
CAPTOPRIL 25 EEL
CAPTOPRIL - AC 25 mg
CAPTOPRIL MCC 25 mg
CAPTOPRIL LPH 25 mg
CAPTOPRIL SINTOFARM 25 mg
CAPTOPRIL ARENA 25 mg
CAPTOPRIL 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 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
ENAP 1,25 mg/ml

RANOLIP
LISIREN 10 mg
LISINOPRIL SANDOZ 10 mg
LISIGAMMA 10 mg
LISINOPRIL 10 MEDO
LISINOPRIL ACTAVIS 10 mg
LISINOPRIL ATB 10 MG
TONOLYSIN 10 mg
TONOLYSIN 2,5 mg
RANOLIP
LISIREN 20 mg
forma farm.
concentratie
90mg
COMPR.
12,5mg
COMPR.
25mg
COMPR.
25mg
COMPR.
25mg
COMPR.
25mg
COMPR.
25mg
COMPR.
25mg
COMPR.
25mg
COMPR.
50 mg
COMPR.
50mg
COMPR.
50mg
COMPR.
50mg
COMPR.
50mg
COMPR.
50mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
SOL. INJ./PERF. 1,25mg/ml
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
2,5mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR. ELIB. PREL.
Detinator APP
PFIZER EUROPE MA EEIG
MAREA BRITANIE
MAGISTRA C & C
TERAPIA SA
BIO EEL SRL
ROMANIA
ROMANIA
ROMANIA
MAGISTRA C & C
ROMANIA
SINTOFARM SA
ROMANIA
TERAPIA SA
ROMANIA
BIO EEL SRL
ROMANIA
MAGISTRA C & C
ROMANIA
MAGISTRA C & C
ROMANIA
Ambalaj
Prescriptie
Nr crt.
tara det.
APP
CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L
CUTIE X 3 BLIST. AL/PVC, X 10 COMPR.

CUTIE X 3 BLIST. AL/AL X 10 COMPR.
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L

ROMANIA
TERAPIA SA
ROMANIA
LAROPHARM SRL
ROMANIA
MAGISTRA C & C
ROMANIA
MERCK SHARP & DOHME
CUTIE X 2 BLIST. PVC/ AL X 10 COMPR.

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

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

P6L
P-6L
P-6L
MERCK SHARP & DOHME
TERAPIA SA
ARENA GROUP SA
ARENA GROUP SA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
LAROPHARM SRL
ROMANIA
MAGISTRA C & C
ROMANIA

CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
P-6L
P-6L
P-6L
P6L
P6L
P-6L
MERCK SHARP & DOHME
ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR.
P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR.

P-6L
TERAPIA SA
ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
LAROPHARM SRL
ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR.
P-6L
P6L
P6L
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.
PR/PRF
RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR.
P-6L
AC HELCOR SRL
HEXAL AG
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

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

CUTIE CU BLIST. PVC/AL X 30 COMPR.
ANTIBIOTICE SA
RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR.
AC HELCOR SRL
ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR.
HEXAL AG
MEDOCHEMIE ROMANIA SRL
ROMANIA
ISLANDA
ROMANIA
ROMANIA
ROMANIA
Pagina 7 din 21
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
cant.
Pret de
UT/
(RON)
aj
30
30
30
20
20
30
30
30
20
20
30
20
20
30
30
20
30
20
20
20
28
20
30
50
100
20
20
20
20
20
28
20
30
50
20
20
20
20
28
20
20
30
20
20
5
30
20
30
30
30
30
30
28
28
30
20
30
0,350333
0,037241
0,074482
0,074482
0,074482
0,074482
0,074482
0,074482
0,074482
0,138000
0,148965
0,148965
0,138000
0,148965
0,136000
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,074482
0,074482
0,074482
0,074482
0,074482
0,074482
0,074482
0,074482
3,204000
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,037241
0,297931
0,297931
0,297931
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,000000
0,080425
0,067184
0,076518
0,044018
0,043518
0,043518
0,080184
0,044018
0,000000
0,081701
0,044535
0,000000
0,006701
0,000000
0,050535
0,050368
0,050035
0,050535
0,041535
0,157463
0,050535
0,050368
0,050435
0,050235
0,050535
0,050035
0,032569
0,032569
0,032569
0,210997
0,032569
0,032735
0,032669
0,032569
0,032569
0,018518
0,019518
0,069803
0,018518
0,018518
0,018851
0,015518
0,015518
0,000000
0,369368
0,388035
0,121035
0,149035
0,105368
0,121035
0,264368
0,237463
0,273830
0,501402
0,484569
0,081069
0,315299
0,033516
0,067033
0,067033
0,067033
0,067033
0,067033
0,067033
0,067033
0,124200
0,134068
0,134068
0,124200
0,134068
0,122400
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,268137
0,268137
0,268137
0,268137
0,268137
0,268137
0,268137
0,268137
0,268137
0,067033
0,067033
0,067033
0,067033
0,067033
0,067033
0,067033
0,067033
2,883600
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,033516
0,268137
0,268137
0,268137
0,035034
0,084150
0,074633
0,083967
0,051467
0,050967
0,050967
0,087633
0,051467
0,013800
0,096598
0,059432
0,013800
0,021598
0,013600
0,065432
0,065265
0,064932
0,065432
0,056432
0,172360
0,065432
0,065265
0,065332
0,065132
0,065432
0,064932
0,062363
0,062363
0,062363
0,240791
0,062363
0,062529
0,062463
0,062363
0,062363
0,025967
0,026967
0,077252
0,025967
0,025967
0,026300
0,022967
0,022967
0,320400
0,384265
0,402932
0,135932
0,163932
0,120265
0,135932
0,279265
0,252360
0,277555
0,531196
0,514363
0,110863
cod ATC
391 C09AA03
392 C09AA03
393 C09AA03
394 C09AA03
395 C09AA03
396 C09AA03
397 C09AA03
398 C09AA03
399 C09AA03
400 C09AA03
401 C09AA03
402 C09AA05
403 C09AA05
404 C09AA05
405 C09AA05
406 C09AA05
407 C09AA05
408 C09AA05
409 C09AA05
410 C09AA05
411 C09AA05
412 C09AA05
413 C09AA05
414 C09AA05
415 C09AA05
416 C09AA05
417 C09AA05
418 C09AA05
419 C09AA05
420 C09AA05
421 C09AA05
422 C09AA05
423 C09AA05
424 C09AA05
425 C09AA05
426 C09AA05
427 C09AA05
428 C09AA05
429 C09AA05
430 C09AA05
431 C09AA05
432 C09AA05
433 C09AA06
434 C09AA06
435 C09AA06
436 C09AA09
437 C09AA09
438 C09AA09
439 C09AA09
440 C09AA09
441 C09AA09
442 C09AA09
443 C09AA09
444 C09BA02
445 C09BA02
446 C09BA02
447 C09BA02
DCI
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
QUINAPRILUM
QUINAPRILUM
QUINAPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
Denumire Comerciala
LISIGAMMA 20 mg
TONOLYSIN 20 mg
LISINOPRIL 20 MEDO
RANOLIP
LISIGAMMA 5 mg
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
RAMIPRIL TEVA 10 mg
RAMIRAN 10 mg
RAMIRAN 10 mg
VIVACE 2,5 mg
PIRAMIL 2,5 mg
RAMIPRIL-AC 2,5 mg
AMPRIL 2,5 mg
ZENRA 2,5
TRITACE(R) 2,5
AMPRIGEN 2,5 mg
RAMIRAN 2,5 mg
RAMIRAN 2,5 mg
VIVACE 5 mg
PIRAMIL 5 mg
RAMIPRIL-AC 5 mg
AMPRIL 5 mg
ZENRA 5
TRITACE 5
AMPRIGEN 5 mg
RAMIPRIL TEVA 5 mg
RAMIRAN 5 mg
RAMIRAN 5 mg
ACCUPRO 10 mg
ACCUPRO (R) 20
ACCUPRO (R) 5
MONOPRIL 10 mg
FOSYPRIL 10 mg
forma farm.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
concentratie
20mg
20mg
20mg
20mg
20mg
40mg
5mg
5mg
5mg
5mg
5mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
2,5 mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
COMPR. FILM. 10mg
COMPR. FILM. 20mg
COMPR. FILM. 5mg
COMPR.
10mg
COMPR.
10mg
FOSINOPRIL AUROBINDO 10 mg COMPR.
10mg
MONOPRIL 10 mg
COMPR.
10mg
MONOPRIL 20 mg
COMPR.
20mg
FOSYPRIL 20 mg
COMPR.
20mg
FOSINOPRIL AUROBINDO 20 mg COMPR.
20mg
MONOPRIL 20 mg
COMPR.
20mg
COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM)ENAP HL
COMPR.
10mg+12,5mg
COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM)ENAP H
COMPR.
10mg+25mg
COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM)VIMAPRIL H
COMPR.
10mg/25mg
COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM)ENAP (R) HL 20 mg/12,5 mg
COMPR.
20 mg/12,5mg
Detinator APP
Ambalaj
Prescriptie
Nr crt.
tara det.
APP
ISLANDA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ANTIBIOTICE SA
ANTIBIOTICE SA

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

P-6L
P-6L
P-6L
P-6L
P-6L
RANBAXY U.K. LIMITED MAREA BRITANIE

P-6L
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
ROMANIA
ISLANDA
ACTAVIS GROUP HF ISLANDA
SANDOZ SRL
ROMANIA
P-6L
P-6L
P-6L
CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L
P-6L
ZENTIVA S.A.
ROMANIA CUTIE X 2 BLIST. X 14 COMPR.

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

P-6L
P-6L

TERAPIA SA
TERAPIA SA
ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR.
P-6L
SANDOZ SRL
ZENTIVA S.A.

P-6L
P-6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L
TERAPIA SA
TERAPIA SA
MAREA BRITANIE
CUTIE X 3 BLIST. PVC/AL/PA X 10 COMPR. FILM.P-6L
MAREA BRITANIE
CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L
MAREA BRITANIE
CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L
UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L

TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. P-6L
BRISTOL MYERS SQUIBB KFT
PHARMASWISS CESK REPUBLIKA S.R.O. REPUBLICA CEHA
CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L
BRISTOL-MYERS SQUIBB UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL, X 10 COMPR. P-6L

MALTA
PHARMASWISS CESK REPUBLIKA S.R.O. REPUBLICA CEHA
CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L
CUTIE X 3 BLIST.OPA-AL-PVC/AL A CATE 10 CAPS. P-6L
Pagina 8 din 21
cant.
Pret de
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(RON)
aj
30
30
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28
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30
28
28
28
30
30
30
30
28
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30
30
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28
28
30
30
30
30
30
30
30
28
30
30
28
28
30
30
28
20
20
30
20
0,297931
0,297931
0,297931
0,297931
0,297931
0,595863
0,074482
0,074482
0,074482
0,074482
0,074482
0,238214
0,302142
0,302000
0,302000
0,302142
0,464285
0,302142
0,302000
0,302000
0,302000
0,302000
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,172142
0,248214
0,248000
0,248000
0,239285
0,297931
0,248214
0,248000
0,239333
0,248000
0,248000
0,099310
0,198620
0,049655
0,099310
0,099310
0,099310
0,099310
0,198620
0,198620
0,198620
0,198620
0,374175
0,374175
0,374175
0,374175
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,149402
0,081069
0,514069
0,350997
0,130569
0,763470
0,190184
0,150518
0,118184
0,118518
0,188732
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000677
0,023177
0,019368
0,023035
0,017106
0,115677
0,023035
0,023035
0,023035
0,000000
0,000000
0,000000
0,000000
0,000000
0,083854
0,000000
0,000000
0,000000
0,000000
0,000000
0,302356
0,378046
0,142345
0,486047
0,281356
0,281356
0,486047
0,650308
0,353380
0,353380
0,650308
0,052825
0,092825
0,019825
0,037825
0,268137
0,268137
0,268137
0,268137
0,268137
0,536276
0,067033
0,067033
0,067033
0,067033
0,067033
0,214392
0,271927
0,271800
0,271800
0,271927
0,417856
0,271927
0,271800
0,271800
0,271800
0,271800
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,154927
0,223392
0,223200
0,223200
0,215356
0,268137
0,223392
0,223200
0,215399
0,223200
0,223200
0,089379
0,178758
0,044689
0,089379
0,089379
0,089379
0,089379
0,178758
0,178758
0,178758
0,178758
0,336757
0,336757
0,336757
0,336757
0,179196
0,110863
0,543863
0,380791
0,160363
0,823057
0,197633
0,157967
0,125633
0,125967
0,196181
0,023822
0,030215
0,030200
0,030200
0,030215
0,046429
0,030215
0,030200
0,030200
0,030200
0,030200
0,015574
0,038074
0,034265
0,037932
0,032003
0,130574
0,037932
0,037932
0,037932
0,017215
0,024822
0,024800
0,024800
0,023929
0,113648
0,024822
0,024800
0,023934
0,024800
0,024800
0,312287
0,397908
0,147311
0,495978
0,291287
0,291287
0,495978
0,670170
0,373242
0,373242
0,670170
0,090243
0,130243
0,057243
0,075243
cod ATC
DCI
448 C09BA05
COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM)
449 C09BA05
450 C09BA05
451 C09CA01
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
LOVASTATINUM
LOVASTATINUM
PRAVASTATINUM
PRAVASTATINUM
452 C09CA01
453 C09CA01
454 C09CA01
455 C09CA01
456 C09CA01
457 C09CA01
458 C09CA01
459 C09CA01
460 C09CA01
461 C09CA01
462 C09CA01
463 C09CA01
464 C10AA01
465 C10AA01
466 C10AA01
467 C10AA01
468 C10AA01
469 C10AA01
470 C10AA01
471 C10AA01
472 C10AA01
473 C10AA01
474 C10AA01
475 C10AA01
476 C10AA01
477 C10AA01
478 C10AA01
479 C10AA01
480 C10AA01
481 C10AA01
482 C10AA01
483 C10AA01
484 C10AA01
485 C10AA01
486 C10AA01
487 C10AA01
488 C10AA01
489 C10AA01
490 C10AA01
491 C10AA01
492 C10AA01
493 C10AA01
494 C10AA01
495 C10AA01
496 C10AA01
497 C10AA01
498 C10AA01
499 C10AA01
500 C10AA01
501 C10AA02
502 C10AA02
503 C10AA03
504 C10AA03
Denumire Comerciala
TRITACE 2,5 PLUS

HARTIL HCT 5 mg/25mg
TRITACE 5 PLUS
LODIAL 100mg
TALOSAN 100 mg
TALOSAN 100 mg
LOZAP 100
LORISTA 100 mg
LOSARTAN ZENTIVA 100 mg
LODIAL 50mg
TALOSAN 50 mg
TALOSAN 50 mg
LOZAP 50
COZAAR 50 mg
LORISTA 50 mg
LOSARTAN ZENTIVA 50 mg
SIMVASTATINA ARENA 10 mg
SIMVAHEXAL (R) 10 mg
ZEPLAN (R) 10 mg
SINTENAL 10 mg
VASILIP 10 mg
SIMVASTATIN LPH 10 mg
SIMVASTATINA SUN 10 mg
SIMVACARD 10 mg
SIMVASTATIN AUROBINDO 10 mg
SIMVASTATIN ACTAVIS 10 mg
SIMVASTATIN TERAPIA 10 mg
ZEPLAN (R) 20 mg
ZOCOR 20 mg
SINTENAL 20 mg
VASILIP 20 mg
SIMCOR 20 mg
SIMVACARD 20 mg
VASILIP (R) 40 mg
ZEPLAN (R) 40 mg
SINTENAL 40 mg
SIMCOR 40 mg
SIMVACARD 40 mg
MEDOSTATIN
LOVASTATINA ARENA 20 mg
PRAVATOR 20 mg
PRAVATOR 40 mg
forma farm.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
COMPR.
COMPR.
concentratie
2,5mg/12,5mg
5mg/25mg
5mg/25mg
100 mg
100mg
100mg
100mg
100mg
100mg
50 mg
50mg
50mg
50mg
50mg
50mg
50mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
20 mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
30mg
40 mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
20mg
20mg
20mg
40mg
Detinator APP

ALKALOID-INT D.O.O.
TERAPIA SA
TERAPIA SA
ZENTIVA A.S.
KRKA, D.D., NOVO MESTO
ZENTIVA A.S.
ALKALOID-INT D.O.O.
TERAPIA SA
TERAPIA SA
ZENTIVA A.S.
MERCK SHARP & DOHME
Ambalaj
Prescriptie
Nr crt.
tara det.
APP
ROMANIA
UNGARIA
ROMANIA
SLOVENIA
ROMANIA
ROMANIA
SLOVACIA
SLOVENIA
SLOVACIA
SLOVENIA
ROMANIA
ROMANIA
SLOVACIA
ROMANIA
SLOVENIA
SLOVACIA
ROMANIA
P-6L
CUTIE X 2 BLIST. PVC-PCTFE/AL X 14 COMPR. P-6L
P-6L
CUTIE CU 2 BLIST. DIN PVC/AL X 15 COMPR. FILM.
P6L
CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM.
P-6L
CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM.
P-6L
CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
P-6L

P-6L
CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPR. FILM.
P6L
CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM.
P-6L
CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM.
P-6L
P-6L
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L

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

TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L
HEXAL AG
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM P-6L
MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L
KRKA D.D.
SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L
ANTIBIOTICE SA
ZENTIVA K.S.
CEHIA
P6L
MAREA BRITANIE
ISLANDA
ROMANIA
MAREA BRITANIE
TERAPIA SA
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
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L
HEXAL AG
ANTIBIOTICE S.A.
LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
ZENTIVA K.S.
CEHIA
P6L
ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L

TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
MEDOCHEMIE LTD. CIPRU
P-6L
RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR.P-6L

RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PE-AL-PVC/AL X 7 COMPR.P-6L
Pagina 9 din 21
cant.
Pret de
UT/
(RON)
aj
28
28
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30
30
30
30
28
30
30
30
30
30
28
28
30
28
30
28
30
28
30
28
28
30
30
30
28
30
28
28
30
28
30
30
28
28
30
30
30
30
28
28
28
30
30
30
30
28
28
30
30
30
10
30
28
28
0,314285
0,374175
0,374175
0,705631
0,705631
0,705631
0,445333
0,517857
0,445333
0,334333
0,334333
0,334333
0,268000
0,352815
0,334642
0,268000
0,125095
0,125095
0,125095
0,125095
0,125095
0,125095
0,125095
0,125095
0,125095
0,125095
0,125095
0,250191
0,250191
0,250191
0,250191
0,250191
0,250191
0,250191
0,250191
0,235000
0,245357
0,246000
0,118666
0,250191
0,375287
0,500383
0,500383
0,500383
0,500383
0,500383
0,500383
0,500383
0,323571
0,337857
0,338000
0,237333
0,500383
0,166794
0,166794
0,250191
0,500383
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,000000
0,000110
0,201539
0,519035
0,412369
0,412369
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,161827
0,000000
0,000000
0,199190
0,022238
0,198476
0,186571
0,198476
0,198905
0,017047
0,023476
0,022905
0,022238
0,179571
0,183023
0,090475
0,183023
0,416237
0,182809
0,183023
0,182809
0,182809
0,000000
0,000000
0,000000
0,000000
0,182809
0,108046
0,606759
0,451045
0,606402
0,565950
0,126283
0,605950
0,605950
0,000000
0,000000
0,000000
0,000000
0,391617
0,358206
0,727872
0,581951
0,815688
0,282856
0,336757
0,336757
0,635067
0,635067
0,635067
0,400799
0,466071
0,400799
0,300899
0,300899
0,300899
0,241200
0,317533
0,301177
0,241200
0,112585
0,112585
0,112585
0,112585
0,112585
0,112585
0,112585
0,112585
0,112585
0,112585
0,112585
0,225171
0,225171
0,225171
0,225171
0,225171
0,225171
0,225171
0,225171
0,211500
0,220821
0,221400
0,106799
0,225171
0,337758
0,450344
0,450344
0,450344
0,450344
0,450344
0,450344
0,450344
0,291213
0,304071
0,304200
0,213599
0,450344
0,150114
0,150114
0,225171
0,450344
0,031429
0,037528
0,238957
0,589599
0,482933
0,482933
0,044534
0,051786
0,044534
0,033434
0,033434
0,033434
0,026800
0,197109
0,033465
0,026800
0,211700
0,034748
0,210986
0,199081
0,210986
0,211415
0,029557
0,035986
0,035415
0,034748
0,192081
0,208043
0,115495
0,208043
0,441257
0,207829
0,208043
0,207829
0,207829
0,023500
0,024536
0,024600
0,011867
0,207829
0,145575
0,656798
0,501084
0,656441
0,615989
0,176322
0,655989
0,655989
0,032358
0,033786
0,033800
0,023734
0,441656
0,374886
0,744552
0,606971
0,865727
cod ATC
505 C10AB05
506 C10AB05
507 C10AB05
508 C10AB05
509 D01AC02
510 D07AA02
511 D07AC01
512 D07AC01
513 D07AC01
514 G01AF04
515 G01AF04
516 G02AB03
517 G03BA03
518 G03BA03
519 G03BA03
520 G03BA03
521 G03CA03
522 G03CA03
523 G04CAN1
524 G04CAN1
525 G04CAN1
526 G04CAN1
527 G04CAN1
528 G04CAN1
529 G04CAN1
530 G04CAN1
531 H02AB04
532 H02AB04
533 H02AB04
534 H02AB07
535 H02AB07
536 H02AB07
537 H02AB07
538 H02AB09
539 H02AB09
540 H02AB09
541 H02AB09
542 H02AB09
543 J01AA02
544 J01AA02
545 J01AA02
546 J01CA04
547 J01CA04
548 J01CA04
549 J01CA04
550 J01CA04
551 J01CA04
552 J01CA04
553 J01CA04
554 J01CA04
555 J01CA04
556 J01CA04
557 J01CA04
558 J01CA04
559 J01CA04
560 J01CA04
561 J01CA04
DCI
FENOFIBRATUM
FENOFIBRATUM
FENOFIBRATUM
FENOFIBRATUM
MICONAZOLUM
HYDROCORTISONUM
BETAMETHASONUM
BETAMETHASONUM
BETAMETHASONUM
MICONAZOLUM
MICONAZOLUM
ERGOMETRINUM
TESTOSTERONUM*
TESTOSTERONUM*
TESTOSTERONUM*
TESTOSTERONUM*
ESTRADIOLUM*
ESTRADIOLUM*
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
METHYLPREDNISOLONUM*
PREDNISONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
HYDROCORTISONUM*
HYDROCORTISONUM*
HYDROCORTISONUM*
HYDROCORTISONUM*
HYDROCORTISONUM*
DOXYCYCLINUM
DOXYCYCLINUM
DOXYCYCLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
Denumire Comerciala
LIPOFIB 160 mg
LIPIVIM
LIPANTHYL SUPRA 160 mg
LIPANTIL NANO 145 mg
MICONAZOL NITRAT 2%
HIDROCORTIZON 1%
EKARZIN 0,5MG/G
BETADERM 1 mg/g
BETADERM 1mg/g
GYNOZOL 200
GYNOZOL 400
forma farm.
CAPS.
CAPS. PULB. MICRONIZATA
COMPR. FILM. 145mg
LAB. FOURNIER SA
P-6L
P-6L
FRANTA CUTIE X 3 BLIST. PVC- PE-PVDC/AL X 10 COMPR. CU ELIB. MOD. P-6L

FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
CREMA
2%
SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G
P-RF
UNGUENT
1%
ANTIBIOTICE SA
ROMANIA CUTIE X 1 TUB X 20 G
P-RF
CREMA
0,5mg/g
ANTIBIOTICE S.A.
ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA
P-RF
CREMA
1mg/g
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G
P-RF
UNGUENT
1mg/g
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G
P-RF
CAPS. VAG. 200mg
PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. X 3 CAPS. VAG. MOI
P-RF
CAPS. VAG. 400mg
PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 CAPS. VAG. MOI
P-RF
MALEAT DE ERGOMETRINA ZENTIVA 0,2 mg/ml SOL. INJ.
0,2mg/ml
ZENTIVA S.A.
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ., CU INEL DE RUPERE P-RF
UNDESTOR TESTOCAPS 40 mg CAPS. MOI
40mg
N.V. ORGANON
OLANDA CUTIE X 6 PLICURI DIN PES-AL-PE X 1 BLIST. AL/PVC X 10 CAPS. MOI P-RF
ANDROGEL 50 mg
GEL
50mg
LAB. BESINS INTERNATIONAL FRANTA CUTIE X 30 PLICURI DIN FOLIE PET/AL/PE X 5 G GEL P-RF
TESTIM 50 mg
GEL TRANSDERMIC 50mg
FERRING GMBH
GERMANIA CUTIE CU 30 TUBURI DIN AL X 5 G GEL TRANSDERMICPR/PRF
NEBIDO 1000 mg/4 ml
SOL. INJ.
1000mg/4ml BAYER PHARMA AG GERMANIA CUTIE CU 1 FIOLA DIN STICLA BRUNA, CU CAPACITATEA DE 5 ML A 4 ML SOL. INJ.S/P-RF
OESTROGEL 0,6 mg/g
GEL
0,6mg/g
LABORATOIRES BESINS INTERNATIONAL FRANTA
CUTIE CU 1 TUB AL X 80 G GEL + DISPOZITIV DE DOZARE DIN POLISTIREN P-6L
CLIMARA
PLASTURE TRANSDERM. 50g/24ore
BAYER PHARMA AG GERMANIA CUTIE X 4 PLICURI X 1 PLASTURE TRANSDERM. P-6L
KAMIREN (vezi G04CAN1)
COMPR.
1mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
COMPR.
1mg
COMPR.
2mg
COMPR.
2mg
COMPR.
4mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L
COMPR.
4mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L
CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL. P-6L
CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL. P-6L
SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE
P-RF
LEMOD SOLU 125 mg
125mg
STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF
LEMOD SOLU 500 mg
500mg
STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF
PREDNISON MCC 5 mg
COMPR.
5mg
MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
PREDNISON ARENA 5 mg
COMPR.
5mg
PREDNISON 5 mg
COMPR.
5mg
SINTOFARM SA
PREDNISON - RICHTER 5 mg COMPR.
5mg
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF
HYDROCORTISONE ROUSSEL COMPR.
10mg
CN UNIFARM
ROMANIA CUTIE X 1 FLAC. 25 COMPR.
PRF
HYDROCORTISONE SUCCINAT SODIC LIOF. + SOLV. PT. SOL. INJ. 100mg
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. + 1 FIOLA SOLV. X 2 ML S/P-RF
HIDROCORTIZON HF 500 mg
500mg
STADA HEMOFARM S.R.L. ROMANIA
PR/PRF
100mg
PR/PRF
HIDROCORTIZON HEMISUCCINAT SOL. INJ. I.V. 25mg/5ml
ZENTIVA S.A.
ROMANIA CUTIE X 5 FIOLE X 1 ML SOL. A + 5 FIOLE X 4 ML SOL. B S/P-RF
DOXICICLINA ATB 100 mg
CAPS.
100 mg
ANTIBIOTICE S.A.
ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF
DOXICICLINA ARENA
CAPS.
100mg
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
P-RF
DOXICICLINA SANDOZ 100 mg CAPS.
100mg
SANDOZ SRL
ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS.
P-RF
AMOXICILINA ARENA 250 mg CAPS.
250mg
P-RF
AMOXICILINA ANTIBIOTICE 250 mg CAPS.
250mg
ANTIBIOTICE SA
P-RF
OSPAMOX 250 mg
CAPS.
250mg
SANDOZ GMBH
AUSTRIA CUTIE X 2 BLIST. AL-PVC/PVDC X 6 CAPS. P-RF/S
AMOXICILINA SANDOZ 250 mg CAPS.
250mg
SANDOZ SRL
P-RF
AMOXICILINA ANTIBIOTICE 500 mg CAPS.
500mg
ANTIBIOTICE SA
P-RF
AMOXICILINA FORTE 500 mg CAPS.
500mg
FARMEX COMPANY SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS.
P-RF
AMOXICILINA FORTE 500 mg CAPS.
500mg
FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. X 10 CAPS.
P-RF
AMOXICILINA ARENA 500 mg CAPS.
500mg
P-RF
AMOXICILINA SANDOZ 500 mg CAPS.
500mg
SANDOZ SRL
P-RF
OSPAMOX 1000 mg
COMPR. FILM. 1000mg
SANDOZ GMBH
AUSTRIA CUTIE 2 BLIST. PVC-PVDC/AL X 6 COMPR. FILM.P-RF
OSPAMOX 500 mg
COMPR. FILM. 500mg
SANDOZ GMBH
AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM. P-RF
AMOXICILINA TERAPIA 1 g COMPR. PT. DISP. ORALA 1g
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 7 COMPR. PT. DISP. ORALA P-RF
DUOMOX 1000 mg
COMPR. PT. DISPERSIE ORALA 1000mg
ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR.
P-RF
DUOMOX 250 mg
P-RF
DUOMOX 500 mg
P-RF
DUOMOX 750 mg
P-RF
COMPR. ELIB. MODIF.
160mg
Prescriptie
Nr crt.
tara det.
concentratie
Detinator APP
APP
Ambalaj
160mg
TERAPIA SA
200mg
VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS.
LABORATOIRES FOURNIER S.A.S.
CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV
PULB+SOLV. PT. SOL. INJ./PERF.

PULB. + SOLV. PT. SOL. INJ./PERF.
CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 20 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, CONTINAND PULB. PT. SOL. INJ./PERF. SI 1 FIOLA CU 4 ML SOLV.
PULB. SI SOLV. PT. SOL. INJ./PERF.
CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV.
Pagina 10 din 21
cant.
Pret de
UT/
(RON)
aj
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
30
0,754650
30
0,881000
30
0,754650
30
0,683901
1
4,633333
1
7,670000
1
7,670000
1
3,512400
1
3,512400
6
1,031666
3
1,976666
5
1,480000
60
0,818333
30
4,574333
30
4,832083
1 435,370000
1
6,415578
4
7,755000
30
0,148687
30
0,148687
30
0,297374
30
0,297374
30
0,594749
30
0,594749
28
0,594749
28
0,594749
1 16,565000
1
8,282500
1 31,020000
20
0,090333
30
0,090333
30
0,090333
20
0,090333
25
0,506800
1
3,527999
1 11,910000
1
3,527999
5
0,881999
10
0,376250
20
0,363000
10
0,361000
20
0,308000
20
0,314775
12
0,314775
20
0,314775
10
0,483636
10
0,483636
20
0,440500
10
0,483636
10
0,483636
12
0,910000
12
0,483636
21
0,959047
20
0,967273
20
0,314775
20
0,483636
20
0,725455
0,034350
0,000000
0,420016
0,486765
2,376667
0,000000
0,000000
2,247600
2,247600
0,000000
0,000000
0,000000
0,000000
0,000000
0,773250
0,000000
7,404422
0,000000
0,203646
0,203646
0,293292
0,293292
0,044251
0,044251
0,388465
0,388465
3,915000
0,527500
0,000000
0,046667
0,000000
0,033333
0,043167
0,000000
0,382001
0,000000
3,562001
3,544001
0,039750
0,000000
0,000000
0,000000
0,045225
0,055225
0,004225
0,123364
0,108364
0,000000
0,106364
0,009364
0,000000
0,008030
0,000000
0,008227
0,115225
0,115864
0,035545
0,679185
0,792900
0,679185
0,615510
4,169999
6,903000
6,903000
3,161160
3,161160
0,928499
1,778999
1,332000
0,736499
4,116899
4,348874
391,833000
5,774020
6,979500
0,133818
0,133818
0,267636
0,267636
0,535274
0,535274
0,535274
0,535274
14,908500
7,454250
27,918000
0,081299
0,081299
0,081299
0,081299
0,456120
3,175199
10,719000
3,175199
0,793799
0,338625
0,326700
0,324900
0,277200
0,283297
0,283297
0,283297
0,435272
0,435272
0,396450
0,435272
0,435272
0,819000
0,435272
0,863142
0,870545
0,283297
0,435272
0,652909
0,109815
0,088100
0,495481
0,555156
2,840001
0,767000
0,767000
2,598840
2,598840
0,103167
0,197667
0,148000
0,081834
0,457434
1,256459
43,537000
8,045980
0,775500
0,218515
0,218515
0,323030
0,323030
0,103726
0,103726
0,447940
0,447940
5,571500
1,355750
3,102000
0,055701
0,009034
0,042367
0,052201
0,050680
0,734801
1,191000
3,914801
3,632201
0,077375
0,036300
0,036100
0,030800
0,076703
0,086703
0,035703
0,171728
0,156728
0,044050
0,154728
0,057728
0,091000
0,056394
0,095905
0,104955
0,146703
0,164228
0,108091
cod ATC
562 J01CA04
563 J01CA04
564 J01CA04
565 J01CE02
566 J01CE02
567 J01CE02
568 J01CE02
569 J01CE08
570 J01CE08
571 J01CF04
572 J01CF04
573 J01CF04
574 J01CF04
575 J01CF04
576 J01CF04
577 J01CF04
578 J01CF04
579 J01CF04
580 J01CF04
581 J01CF04
582 J01CF04
583 J01CF04
584 J01CF04
585 J01CF04
586 J01CR02
587 J01CR02
588 J01CR02
589 J01CR02
DCI
Denumire Comerciala
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
PHENOXYMETHYLPENICILLINUM
AMOXICILINA SANDOZ 125 mg/5 ml
forma farm.
concentratie
Detinator APP
SANDOZ S.R.L.
AMOXICILINA SANDOZ 250 mg/ 5 ml
SANDOZ S.R.L.
OSPAMOX 250 mg/5 ml
SANDOZ GMBH
AUSTRIA
OSPEN (R) 1000
SANDOZ GMBH
AUSTRIA
OSPEN 1500
SANDOZ GMBH
AUSTRIA
OSPEN (R) 500
SANDOZ GMBH
AUSTRIA
OSPEN 400.000 U.I./5 ml
SUSP. ORALA 400.000U.I./5ml SANDOZ GMBH
AUSTRIA
BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI
PULB. PT. SUSP. INJ. 1200000UI
ANTIBIOTICE S.A.
ROMANIA
BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI
PULB. PT. SUSP. INJ. 1200000UI
ANTIBIOTICE S.A.
ROMANIA
OXACILLINUM
OXACILINA ARENA 250 mg CAPS.
250mg
OXACILLINUM
OXACILINA 250 mg
CAPS.
250mg
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
OXACILINA SANDOZ 250 mg CAPS.
250mg
SANDOZ SRL
ROMANIA
OXACILLINUM
OXACILINA 500 mg
CAPS.
500mg
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
OXACILINA ARENA 500 mg CAPS.
500mg
OXACILLINUM
OXACILINA FORTE 500 mg CAPS.
500mg
OXACILLINUM
OXACILINA SANDOZ 500 mg CAPS.
500mg
SANDOZ SRL
ROMANIA
OXACILLINUM
OXACILINA ATB 1000 mg
PULB. PT. SOL. INJ./PERF. 1000mg
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
ANTIBIOTICE S.A.
ROMANIA
OXACILLINUM
ANTIBIOTICE S.A.
ROMANIA
OXACILLINUM
OXACILINA ANTIBIOTICE 500 mg
500mg
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
OXACILINA ANTIBIOTICE 500 mg
500mg
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
OXACILINA ANTIBIOTICE 1 g
1g
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
OXACILINA ANTIBIOTICE 1 g
1g
ANTIBIOTICE SA
ROMANIA
AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 1000 mg
COMPR. FILM. 1000mg
AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 500 mg/125mg
COMPR. FILM. 500 mg/125 mg RANBAXY UK LIMITED MAREA BRITANIE
AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 500/125 mg
COMPR. FILM. 500/125mg ANTIBIOTICE S.A.
ROMANIA
AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 500 mg/125 mg COMPR. FILM. 500mg/125mg BEECHAM GROUP PLC MAREA BRITANIE
590 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM

AMOKSIKLAV 156,25mg/5ml
AMOKSIKLAV 2x
AMOKSIKLAV 2x
AMOXICILINA/ACID CLAVULANIC AUROBINDO 400 mg/57 mg/5 ml
P-RF
P-RF
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 20 G PULB. PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE PE CU GRADATII PT. 1,25 ML, 2,5 ML, 5 ML
CUTIE X 1 FLAC. X 6,6 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE
P-RF
CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF

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

CUTIE 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
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF
CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF.
PRF
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF
CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF.
PRF
CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF/S
PULB. PT. SOL. INJ./PERF. I.M./I.V.
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V.
PULB. PT. SOL. INJ./PERF.I.M./I.V.
CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF/S
PULB. PT. SOL. INJ./PERF.I.M./I.V.
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V.
P-RF
CUTIE X 2 BLIST. AL/AL X 7 COMPR.FILM.

CUTIE X 4 FOLII AL-PEJD X 7 COMPR. FILM.
P-RF
CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM.
P-RF
COMPR. FILM.
AMOKSIKLAV 2 x 625 mg
COMPR. FILM.
AMOXIPLUS 875 mg/125 mg COMPR. FILM.
AUGMENTIN 875 mg/125 mg COMPR. FILM.
AMOXICILINA/ACID CLAVULANIC AUROBINDO 875 mg/125 mg COMPR. FILM.
596 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 625 mg
Ambalaj
CUTIE X 1 FLAC. DIN STICLA BRUNA CONTINAND 20 G PULB PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE
PULB. PT. SOL. INJ./PERF. I.M./I.V.
AMOXICILINA/ACID CLAVULANIC AUROBINDO 500 mg/125 mg
595 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 1000 mg

125mg/5ml
PULB. PT. SUSP. ORALA 250mg/5ml
PULB. PT. SUSP. ORALA 250mg/5ml
COMPR. FILM. 1000000ui
PULB. PT. SUSP. ORALA
Prescriptie
Nr crt.
tara det.
APP
ROMANIA
ROMANIA
500mg/125mg
MAREA BRITANIE
CUTIE X 2 BLISTERE PVC-PVDC/AL X 7 COMPRIMATE FILMATE, FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOARE DIN AL LAMINAT, CONTINAND UN DESICANT
P-RF
P-RF
P-RF
CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P-RF
625mg
LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 14 COMPR. FILM. P-RF
875mg/125mg ANTIBIOTICE S.A.
ROMANIA CUTIE CU 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF
875mg/125mg BEECHAM GROUP PLC MAREA BRITANIE
P-RF
875mg/125mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P-RF
1000mg
BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF
625mg
BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF
156,25mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 MG PULB. PT. 100 ML SUSP. ORALA P-RF
400mg+57mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 35 ML SUSP.ORALA + SERINGA DOZATOARE P-RF
400mg+57mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 70 ML SUSP.ORALA + SERINGA DOZATOARE P-RF
COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE
COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE

CUTIE X 2 BLISTERE PVC-PVDC/AL X 7 COMPRIMATE FILMATE, FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOARE DIN AL LAMINAT, CONTINAND UN DESICANT
MALTA
PRF
400mg/57mg/5ml
601 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM 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
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + MASURA DOZATOARE
P-RF
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 70 ML SUSP. ORALA + MASURA DOZATOARE
P-RF
SMITHKLINE BEECHAM LTD. MAREA BRITANIE
CUTIE X 1 FLACON DIN STICLA CU PULB. PT. 100 ML SUSP. ORALA + 1 MASURA DOZATOARE
P-RF
CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 G PULB. PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE
P-RF

606 J01DB01
607 J01DB01
608 J01DB01
609 J01DB01
610 J01DB01
611 J01DB01
612 J01DB01
613 J01DB01
614 J01DB01
615 J01DB01
616 J01DB01
617 J01DB01
618 J01DB01
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
AUGMENTIN (R) ES
PULB. PT. SUSP. ORALA 600 mg/42,9mg/5ml
AMOKSIKLAV 312,5mg/5ml
PULB. PT.SUSP. ORALA 312,5mg/5ml
CEFALEXINA ARENA 250 mg CAPS.
250mg
CEFALEXINA ATB 250 mg
CAPS.
250mg
OSPEXIN (R) 250 mg
CAPS.
250mg
CEFALEXIN SANDOZ 250 mg CAPSULE CAPS.
250mg
CEFALEXINA ATB 500 mg
CAPS.
500mg
CEFALEXINA ARENA 500 mg CAPS.
500mg
CEFALEXIN SANDOZ
CAPS.
500mg
OSPEXIN 1000 mg
COMPR. FILM. 1000mg
OSPEXIN 500 mg
COMPR. FILM. 500mg
KEFLEX (R) 125 mg/5 ml
GRAN. PT. SUSP. ORALA 125mg/5ml
OSPEXIN (R) 125 mg/5 ml
KEFLEX (R) 250 mg/5 ml
CEFALEXIN SANDOZ 125 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA
ARENA GROUP SA
ANTIBIOTICE SA
SANDOZ GMBH
SANDOZ SRL
ANTIBIOTICE SA
ARENA GROUP SA
SANDOZ S.R.L.
SANDOZ GMBH
SANDOZ GMBH
ACTAVIS GROUP HF
SANDOZ GMBH
SANDOZ SRL
ACTAVIS GROUP HF
ROMANIA
ROMANIA
AUSTRIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
AUSTRIA
AUSTRIA
ISLANDA
AUSTRIA
ROMANIA
ISLANDA
CUTIE CU 1 FLAC. PEID CARE CONTINE PULB. PT. SUSP. ORALA PT. OBTINEREA A 35 ML SUSP. RECONSTITUITA + 1 SERINGA DE POLISTIREN CU GRADATII LA INTERVALE DE 0,5 ML

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

P-RF

CUTIE X 1 BLIST. PVC/AL X 10 CAPS.
P-RF
P-RF
P-RF
P-RF
P-RF
CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM. P-RF

CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR.FILM. P-RF
CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE
P-RF
CUTIE X 1 FLAC. X 33 G GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA PP
P-RF
P-RF
CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE
CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE
Pagina 11 din 21
P-RF
cant.
Pret de
UT/
(RON)
aj
1
1
1
12
12
12
1
1
100
20
20
20
10
10
20
10
1
100
1
100
100
1
100
1
14
28
14
14
14
14
14
14
14
14
14
1
1
1
1
1
1
1
1
1
20
20
12
10
10
10
10
12
12
1
1
1
1
1,888650
3,777300
3,777300
0,299166
0,457031
0,152343
0,203124
4,970048
4,662700
0,307220
0,307220
0,307220
0,614440
0,614440
0,558500
0,614440
5,303075
4,622300
2,651537
2,651537
2,651537
2,651537
4,622300
5,303075
0,962142
0,570254
0,570254
0,570254
0,570254
0,570254
0,962142
0,997945
0,962142
0,997945
0,570254
5,986607
6,700000
13,410000
6,700000
6,705000
6,705000
13,410000
28,735714
11,973214
0,467549
0,467549
0,467549
0,467549
0,935099
0,934000
0,935099
1,365000
0,935099
5,307500
5,307500
5,307500
10,615000
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
4,061350
1,232700
1,212700
0,000000
0,070469
0,073490
8,716876
0,619952
0,000000
0,061280
0,084280
0,092780
0,163560
0,028560
0,000000
0,115560
0,226925
0,000000
2,448463
1,668063
1,668063
2,448463
0,000000
0,226925
0,000000
0,020817
0,020460
0,339031
0,020460
0,020460
0,000000
0,481340
0,000000
0,859912
0,654746
4,833393
0,000000
0,000000
0,000000
3,615000
3,615000
7,220000
6,844286
7,026786
0,150451
0,155951
0,149951
0,153451
0,155901
0,000000
0,103901
0,000000
0,092401
1,122500
1,842500
1,842500
0,265000
1,699785
3,399570
3,399570
0,269249
0,411327
0,137108
0,182811
4,473043
4,196430
0,276498
0,276498
0,276498
0,552996
0,552996
0,502650
0,552996
4,772767
4,160070
2,386383
2,386383
2,386383
2,386383
4,160070
4,772767
0,865927
0,513228
0,513228
0,513228
0,513228
0,513228
0,865927
0,898150
0,865927
0,898150
0,513228
5,387946
6,030000
12,069000
6,030000
6,034500
6,034500
12,069000
25,862142
10,775892
0,420794
0,420794
0,420794
0,420794
0,841589
0,840600
0,841589
1,228500
0,841589
4,776750
4,776750
4,776750
9,553500
4,250215
1,610430
1,590430
0,029917
0,116173
0,088725
8,737189
1,116957
0,466270
0,092002
0,115002
0,123502
0,225004
0,090004
0,055850
0,177004
0,757233
0,462230
2,713617
1,933217
1,933217
2,713617
0,462230
0,757233
0,096215
0,077843
0,077486
0,396057
0,077486
0,077486
0,096215
0,581135
0,096215
0,959707
0,711772
5,432054
0,670000
1,341000
0,670000
4,285500
4,285500
8,561000
9,717858
8,224108
0,197206
0,202706
0,196706
0,200206
0,249411
0,093400
0,197411
0,136500
0,185911
1,653250
2,373250
2,373250
1,326500
cod ATC
619 J01DB01
620 J01DB01
621 J01DB05
622 J01DB05
623 J01DB05
624 J01DB05
625 J01DB05
626 J01DB05
627 J01DC02
628 J01DC02
629 J01DC02
630 J01DC02
631 J01DC02
632 J01DC02
633 J01DC02
634 J01DC02
635 J01DC02
636 J01DC02
637 J01DC04
638 J01DC04
639 J01DC04
640 J01DC04
641 J01DC04
642 J01DC04
643 J01DC04
644 J01DC04
645 J01DC04
646 J01DC04
647 J01DC04
648 J01DC04
649 J01DC04
650 J01DC04
651 J01DC04
652 J01DC04
653 J01DC04
654 J01DC04
655 J01DC04
656 J01DC04
657 J01DC04
658 J01DC04
659 J01DD08
660 J01DD08
661 J01DD08
662 J01DD08
DCI
CEFALEXINUM
CEFALEXINUM
CEFADROXILUM
CEFADROXILUM
CEFADROXILUM
CEFADROXILUM
CEFADROXILUM
CEFADROXILUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFIXIMUM
CEFIXIMUM
CEFIXIMUM
CEFIXIMUM
663 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM

669 J01FA01
670 J01FA01
671 J01FA01
672 J01FA01
673 J01FA09
674 J01FA09
675 J01FA09
ERYTHROMYCINUM
ERYTHROMYCINUM
ERYTHROMYCINUM
ERYTHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
Denumire Comerciala
CEFALEXIN SANDOZ 250 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA
OSPEXIN (R) 250 mg/5 ml

CEXYL 250 mg
CEXYL 500 mg
CEFORAN 500 mg
CEXYL 1000 mg
CEXYL 125 mg/5 ml
CEXYL 250 mg/5 ml
forma farm.
GRAN. PT. SUSP. ORALA
CAPS.
CAPS.
CAPS.
COMPR. FILM.
GRAN. SUSP. ORALA
COMPR.
CEFUROXIMA ANTIBIOTICE 250 mg COMPR.
CEFUROXIMA AUROBINDO 250 mg COMPR.
CEFUROXIMA AUROBINDO 500 mg COMPR.
ZINNAT (R) 125 mg
COMPR. FILM.
ZINNAT (R) 250 mg
COMPR. FILM.
ZINNAT (R) 500 mg
COMPR. FILM.
ZINNAT
CEFACLOR ARENA 250 mg CAPS.
CLORACEF (R) 250
CAPS.
CEFACLOR TERAPIA 250 mg CAPS.
CLORACEF (R) FORTE 500 CAPS.
CEFACLOR ARENA 500 mg CAPS.
CEFACLOR TERAPIA 500 mg CAPS.
CECLOR MR 500 mg
CECLOR MR 750 mg
CEFACLOR TERAPIA MR 375 COMPR. ELIB. PREL.
CEFACLOR TERAPIA MR 750 COMPR. ELIB. PREL.
CECLODYNE (R) MR 375 mg COMPR. FILM. ELIB. MODIF.
CECLOR (R) 125 mg/5 ml
CEFUROXIMA ANTIBIOTICE 250 mg
CEFACLOR TERAPIA 125mg/5ml

CECLOR (R) 250 mg/5 ml

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

CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
COMPR.
COMPR.
concentratie
250mg/5ml
250mg/5ml
250mg
500mg
500mg
1000mg
125mg/5ml
250mg/5ml
250mg
250mg
250mg
500mg
500mg
500mg
125mg
250mg
500mg
125mg/5ml
250mg
250mg
250mg
500mg
500mg
500mg
500mg
750mg
375mg
750mg
375mg
500mg
750mg
125mg/5ml
125mg/5ml
250 mg/5 ml
250 mg/5 ml
250mg/5ml
125mg/5ml
125mg/5ml
250mg/5ml
250mg/5ml
100mg
200mg
400mg
400mg
400mg/80mg
400mg/80mg
400mg/80mg
400mg/80mg
Detinator APP
SANDOZ SRL
SANDOZ GMBH
SANDOZ S.R.L.
SANDOZ S.R.L.
ANTIBIOTICE S.A.
SANDOZ S.R.L.
SANDOZ S.R.L.
SANDOZ S.R.L.
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
Prescriptie
Nr crt.
tara det.
APP
ROMANIA
Ambalaj
P-RF
CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE
AUROBINDO PHARMA ROMANIA S.R.L.
AUSTRIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
GLAXOWELLCOME UK LTD.
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
CUTIE X 1 BLIST. X 10 COMPR. FILM.

CUTIE X 1 BLIST. X, 10 COMPR.FILM
CUTIE X 1 BLIST. X 10 COMPR.FILM
GLAXO WELLCOME UK LTD.
MAREA BRITANIE
CUTIE CU 1 FLAC. DIN STICLA BRUNA CONTINAND GRANULE PT. 50 ML SUSP. ORALA + 1 MASURA DOZATOARE
ARENA GROUP SA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ISLANDA
ISLANDA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ISLANDA
ROMANIA
ROMANIA
ROMANIA
ISLANDA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

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

CUTIE CU 1 BLIST. AL/PVC X 10 CAPS.
P-RF
CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS.
P-RF
AUROBINDO PHARMA ROMANIA S.R.L.
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
TERAPIA SA
ARENA GROUP S.A.

TERAPIA SA
ACTAVIS GROUP HF
ACTAVIS GROUP HF
TERAPIA SA
TERAPIA SA
SANDOZ SRL
SANDOZ SRL
SANDOZ SRL
ACTAVIS GROUP HF
TERAPIA SA
TERAPIA SA
TERAPIA SA
ACTAVIS GROUP HF
STADA HEMOFARM S.R.L.

ANTIBIOTICE S.A.
ANTIBIOTICE SA
INN-FARM D.O.O.
INN-FARM D.O.O.
ZENTIVA S.A.
SLOVENIA
SLOVENIA
ROMANIA
EGIS PHARMACEUTICALS P.L.C. UNGARIA
BIO EEL SRL
ROMANIA
SUSP. ORALA 200mg/40mg /5ml E.I.P.I.CO. MED S.R.L. ROMANIA
SUSP. ORALA 25mg/5mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA
COMPR.
200mg
COMPR.
200mg
ANTIBIOTICE SA
ROMANIA
ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR.
200mg
SANDOZ S.R.L.
ROMANIA
ERITROMICINA ATB 200 mg COMPR.
200mg
ANTIBIOTICE SA
ROMANIA
CLAXIRIT 500 mg
COMPR. CU ELIB. PREL. 500mg
KLACID SR
ABBOTT LABORATORIES LTD. MAREA BRITANIE
CLARITROMICINA TEVA 500 mg COMPR. ELIB. PREL. 500mg
TEVA PHARMACEUTICALS S.R.L. ROMANIA
CUTIE X 1 FLAC. X 33G GRANULE PT. 60ML SUSP.+ LINGURITA DOZATOARE X 5MLP-RF

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

CUTIE X 1 FLAC. CU GRAN PENTRU 60 ML SUSP. ORALA + O LINGURITA DOZATOARE
P-RF
CUTIE X 1 FLAC. CU GRAN. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE
P-RF
CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR.

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

CUTIE CU 1 BLIST. PVC-ACLAR/AL X 10 COMPR. CU ELIB. PREL. PRF
CUTIE X 1 BLIST. PVC/PVDC/AL X 10 COMPR. ELIB. PREL.
P-RF
CUTIE X 1 BLIST. X 10 COMPR. ELIB. PREL.
P-RF
CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF.
P-RF
CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF.
P-RF
CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF.
P-RF
CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE
P-RF
CUTIE X 1 FLAC. DIN PEID CU GRAN.PT. 75 ML SUSP.ORALA
P-RF
CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 75 ML SUSP. ORALA
P-RF
CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 100 ML SUSP. ORALA P-RF
CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE
P-RF
CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP.+ LINGURITA DOZATOARE
P-RF
CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE
P-RF
CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP. + LINGURITA DOZATOARE
P-RF
CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE
P-RF

P-RF
CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATE
PRF
PRF
CUTIE CU 2 BLISTERE PVC-PVDC/AL A CATE 5 COMPRIMATE FILMATE
PRF

P-RF
CUTIE X 1 FLACON DIN STICLA BRUNA CU MASURA DOZATOARE X 100 ML
P-RF
CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE
P-RF

P-RF
CUTIE CU BLIST. PVC/PVDC//AL X 7 COMPR. CU ELIB. PREL.
PRF
P-RF
P-RF
P-RF
P-RF
P-RF
PRF
CUTIE X 1 BLIST. PVC-PVDC/AL X 5 COMPR. ELIB. PREL. P-RF

CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR. ELIB. PREL. PRF
Pagina 12 din 21
cant.
Pret de
UT/
(RON)
aj
1
1
10
10
10
10
1
1
10
10
10
10
10
10
10
10
10
1
10
16
15
16
10
15
10
10
10
10
10
10
10
1
1
1
1
1
1
1
1
1
10
10
5
10
20
20
20
20
1
1
20
20
20
20
7
5
6
9,820000
9,820000
0,467549
0,935099
0,935099
1,870199
5,307500
10,615000
0,982800
0,982800
0,982800
1,863000
1,863000
1,863000
1,076700
0,982800
1,965600
10,767000
0,491400
0,491400
0,491400
0,982800
0,982800
0,982800
0,982800
1,474200
0,737100
1,474200
0,737100
0,982800
1,474200
8,075250
8,075250
16,150500
17,950000
16,150500
8,075250
6,460200
16,150500
12,920400
1,915987
3,609000
7,663950
7,663950
0,360750
0,348000
0,360750
0,360750
4,710000
4,205531
0,367500
0,382692
0,382692
0,382692
1,913463
1,913463
1,913463
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,000000
0,000000
1,456451
0,460901
0,415901
0,842801
7,192500
0,955000
0,109200
0,109200
0,109200
0,000000
0,000000
0,000000
0,054300
0,698200
0,900400
9,373000
1,081600
0,896100
0,463933
0,782200
1,911200
0,783200
1,733200
2,238800
2,557900
1,020800
2,811900
0,783200
1,020800
5,854750
0,984750
1,799500
0,000000
11,459500
0,984750
2,599800
1,789500
3,609600
0,321013
0,000000
2,356050
1,852050
0,039750
0,000000
0,004250
0,039750
0,000000
5,654469
0,000000
0,114808
0,039308
0,114808
0,520822
1,834537
0,521537
8,838000
8,838000
0,420794
0,841589
0,841589
1,683179
4,776750
9,553500
0,884520
0,884520
0,884520
1,676700
1,676700
1,676700
0,969030
0,884520
1,769040
9,690300
0,442260
0,442260
0,442260
0,884520
0,884520
0,884520
0,884520
1,326780
0,663390
1,326780
0,663390
0,884520
1,326780
7,267725
7,267725
14,535450
16,155000
14,535450
7,267725
5,814180
14,535450
11,628360
1,724388
3,248100
6,897555
6,897555
0,324675
0,313200
0,324675
0,324675
4,239000
3,784977
0,330750
0,344422
0,344422
0,344422
1,722116
1,722116
1,722116
0,982000
0,982000
1,503206
0,554411
0,509411
1,029821
7,723250
2,016500
0,207480
0,207480
0,207480
0,186300
0,186300
0,186300
0,161970
0,796480
1,096960
10,449700
1,130740
0,945240
0,513073
0,880480
2,009480
0,881480
1,831480
2,386220
2,631610
1,168220
2,885610
0,881480
1,168220
6,662275
1,792275
3,414550
1,795000
13,074550
1,792275
3,245820
3,404550
4,901640
0,512612
0,360900
3,122445
2,618445
0,075825
0,034800
0,040325
0,075825
0,471000
6,075023
0,036750
0,153078
0,077578
0,153078
0,712169
2,025884
0,712884
cod ATC
676 J01FA09
677 J01FA09
678 J01FA09
679 J01FA09
680 J01FA09
681 J01FA09
682 J01FA09
683 J01FA09
684 J01FA09
685 J01FA09
686 J01FA09
687 J01FA09
688 J01FA09
689 J01FA09
690 J01FA09
691 J01FA09
692 J01FA09
693 J01FA09
694 J01FA09
695 J01FA09
696 J01FA09
697 J01FA09
698 J01FA09
699 J01FA09
700 J01MA01
701 J01MA01
702 J01MA02
703 J01MA02
704 J01MA02
705 J01MA02
706 J01MA02
707 J01MA02
708 J01MA02
709 J01MA02
710 J01MA02
711 J01MA02
712 J01MA02
713 J01MA02
714 J01MA02
715 J01MA02
716 J01MA02
717 J01MA02
718 J01MA02
719 J01MA02
720 J01MA02
721 J01MA02
722 J01MA02
723 J01MA03
724 J01MA06
725 J01MA06
726 J01MA06
727 J01MB02
728 J01XD01
729 J01XD01
730 J01XD01
731 J01XD01
732 J01XD01
DCI
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
OFLOXACINUM
OFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
PEFLOXACINUM
NORFLOXACINUM
NORFLOXACINUM
NORFLOXACINUM
ACIDUM NALIDIXICUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
Denumire Comerciala
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CLARITROMICINA TEVA 250 mg COMPR. FILM.
LEKOKLAR 250 mg
COMPR. FILM.
CLARITROMICINA AUROBINDO 250 mg COMPR. FILM.
KLERIMED (R) 500
COMPR. FILM.
KLABAX 500 mg
COMPR. FILM.
FROMILID 500
COMPR. FILM.
ROCLARIN 500 mg
COMPR. FILM.
CLAR 500
COMPR. FILM.
CLARITROMICINA TEVA 500 mg COMPR. FILM.
LEKOKLAR 500 mg
COMPR. FILM.
CLARITROMICINA AUROBINDO 500 mg COMPR. FILM.
KLACID (R)
KLERIMED (R) 250
KLABAX 250 mg
FROMILID 250
FROMILID (R) UNO

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

COMPR. FILM.
COMPR. FILM.
CIPROFLOXACINA ARENA 100 mg COMPR. FILM.
CIPROCIN 250 mg
COMPR. FILM.
CIPRINOL 250 mg
COMPR. FILM.
CIPROLEN (R) 250 mg
COMPR. FILM.
CUMINOL 250 mg
COMPR. FILM.
CIFRAN
COMPR. FILM.
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.
CIPRINOL 750 mg
COMPR. FILM.
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
CAPS.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
SOL. PERF.
concentratie
250mg
250mg
250mg
250mg
250mg
250mg
250mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
125mg/5ml
125mg/5ml
125mg/5ml
125mg/5ml
250mg/5ml
250mg/5ml
250mg/5ml
500mg
200mg
200mg
100mg
100mg
250mg
250mg
250mg
250mg
250mg
250mg
250mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
750mg
750mg
1000 mg
500 mg
400mg
400mg
400mg
400mg
500mg
250mg
250mg
250mg
250mg
5g/l
Detinator APP
ABBOTT S.R.L.
MEDOCHEMIE LTD.
TERAPIA SA
Ambalaj
ITALIA
CIPRU
ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM.
Prescriptie
Nr crt.
tara det.
APP
P-RF
P-RF
P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.
P-RF
ROMANIA
SANDOZ S.R.L.
ROMANIA
TERAPIA SA
ROMANIA
PRF
TEVA PHARMACEUTICALS S.R.L.
CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR)
CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF

CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF
P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.
P-RF
ANTIBIOTICE S.A.

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR)
PRF
SANDOZ S.R.L.
ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF
CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF
KRKA D.D.
SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. ELIB. PREL. P-RF
ABBOTT S.R.L.
ITALIA
P-RF
ABBOTT S.R.L.
ITALIA
P-RF
SANDOZ SRL
ROMANIA CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PPP-RF
TERAPIA SA
ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF
TERAPIA SA
ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF
TERAPIA SA
ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF
SANDOZ S.R.L.
ROMANIA
PRF
ABBOTT LABORATORIES LTD. FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. PERF. S/P-RF
RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF
ZENTIVA K.S.
CEHIA
CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF
ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF
CUTIE X 1 FLACON PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML
CUTIE X 1 FLACON PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML
CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF
AC HELCOR SRL
ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

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

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

ROMANIA
RANBAXY UK LIMITED MAREA BRITANIE
ANTIBIOTICE SA
ROMANIA
AC HELCOR SRL
P-RF
CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF
P-RF

P-RF
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.
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.
P-RF
P-RF
P-RF
P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
ROMANIA
ROMANIA
ROMANIA
ROMANIA
LABORATOIRE AVENTIS FRANTA
LABORATOIRE AVENTIS FRANTA
INFOMED FLUIDS SRL ROMANIA
A.C. HELCOR PHARMA S.R.L.
CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
ZENTIVA SA
ARENA GROUP SA
ARENA GROUP SA

P-RF
P-RF
P-RF

CUTIE X 12 FLACOANE X 200 ML
Pagina 13 din 21
S/P-RF
cant.
Pret de
UT/
(RON)
aj
14
14
14
14
14
14
14
14
14
14
20
20
14
14
14
7
1
1
1
1
1
1
1
1
10
10
10
20
10
10
10
10
10
10
20
10
10
10
10
10
10
10
20
10
10
7
3
10
20
20
20
30
30
30
20
20
12
0,956731
0,956731
0,956731
0,956731
0,840714
0,842142
0,756428
1,911428
1,913463
1,913463
1,913463
1,913463
1,825000
1,911428
1,642142
1,913463
23,854500
14,312700
12,820000
12,820000
47,709000
28,625400
28,625400
39,540000
1,179000
1,216800
0,243360
0,243360
0,608400
0,608400
0,608400
0,608400
0,608400
0,608400
0,608400
1,183000
0,920000
1,216800
1,216800
0,911000
1,216800
0,957000
0,852000
1,031000
1,825200
2,433600
1,216800
1,216800
0,804000
0,792000
0,804000
1,013000
0,238666
0,238666
0,301762
0,301762
8,667500
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,990411
0,215411
0,130411
0,278983
0,000000
0,000000
0,000000
0,000000
0,125822
0,007965
0,335037
0,442537
0,000000
0,000000
0,000000
0,520822
6,125500
5,407300
0,000000
0,000000
5,301000
4,244600
1,234600
0,000000
0,000000
0,860200
3,627640
3,160640
0,074600
0,098600
0,074600
0,100600
0,111600
0,072600
0,029600
0,000000
0,000000
0,105200
0,154200
0,000000
0,154200
0,000000
0,000000
0,000000
2,045800
10,120685
8,336533
1,674200
0,012000
0,000000
0,076000
0,000000
0,000000
0,000000
0,065738
0,065738
0,000000
0,861057
0,861057
0,861057
0,861057
0,756642
0,757927
0,680785
1,720285
1,722116
1,722116
1,722116
1,722116
1,642500
1,720285
1,477927
1,722116
21,469050
12,881430
11,538000
11,538000
42,938100
25,762860
25,762860
35,586000
1,061100
1,095120
0,219024
0,219024
0,547560
0,547560
0,547560
0,547560
0,547560
0,547560
0,547560
1,064700
0,828000
1,095120
1,095120
0,819900
1,095120
0,861300
0,766800
0,927900
1,642680
2,190240
1,095120
1,095120
0,723600
0,712800
0,723600
0,911700
0,214799
0,214799
0,271585
0,271585
7,800750
1,086085
0,311085
0,226085
0,374657
0,084072
0,084215
0,075643
0,191143
0,317169
0,199312
0,526384
0,633884
0,182500
0,191143
0,164215
0,712169
8,510950
6,838570
1,282000
1,282000
10,071900
7,107140
4,097140
3,954000
0,117900
0,981880
3,651976
3,184976
0,135440
0,159440
0,135440
0,161440
0,172440
0,133440
0,090440
0,118300
0,092000
0,226880
0,275880
0,091100
0,275880
0,095700
0,085200
0,103100
2,228320
10,364045
8,458213
1,795880
0,092400
0,079200
0,156400
0,101300
0,023867
0,023867
0,095915
0,095915
0,866750
cod ATC
733 J01XD01
734 J01XD01
735 J01XD01
736 J01XD01
737 J01XD01
738 J01XD01
739 J02AC01
740 J02AC01
741 J02AC01
742 J02AC01
743 J02AC01
744 J02AC01
745 J02AC01
746 J02AC01
747 J02AC01
748 J02AC01
749 J02AC01
750 J02AC01
751 J02AC01
752 J02AC01
753 J02AC01
754 J02AC01
755 J02AC01
756 J02AC01
757 J02AC01
758 J02AC01
759 J02AC01
760 J02AC01
761 J02AC01
762 J02AC01
763 J02AC01
764 J02AC01
765 J02AC01
766 J02AC01
767 J02AC01
768 J02AC01
769 J02AC01
770 J05AB01
771 J05AB01
772 J05AB01
773 J05AB01
774 J05AB01
775 J05AB01
776 J05AB01
777 J05AB01
778 J05AB01
779 J05AB01
780 J05AB01
781 M01AB01
782 M01AB01
783 M01AB01
784 M01AB01
785 M01AB01
786 M01AB01
787 M01AB05
788 M01AB05
789 M01AB05
DCI
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
INDOMETACINUM
INDOMETACINUM
INDOMETACINUM
INDOMETACINUM
INDOMETACINUM
INDOMETACINUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
Denumire Comerciala
forma farm.
METRONIDAZOL A 5 g/l
METRONIDAZOL B 5 g/l
METRONIDAZOL B 5 g/l
SOL. PERF.
SOL. PERF.
SOL. PERF.
METRONIDAZOL BRAUN 5mg/ml SOL. PERF.
FLUCOVIM 100
CAPS.
FUNGOLON 100 mg
CAPS.
FLUCONAZOLE TEVA 100 mg CAPS.
FLUCONAZOL AUROBINDO 100 mg CAPS.
FLUCOVIM 150
CAPS.
DIFLUCAN 150 mg
CAPS.
FLUCORIC 150 mg
CAPS.
FLUCONAZOL SANDOZ (R) 150 CAPS.
FLUCONAZOL 150 mg
CAPS.
FLUCONAZOL MEDOCHEMIE 150 mg CAPS.
FLUCONAZOL BIOGALENICA 150 mg CAPS.
FLUCONAZOL ARENA 150 MG CAPS.
FLUCONAZOL ACTAVIS 150 mg CAPS.
FLUCONAZOL LPH 150 mg
CAPS.
FLUCONAZOL ROMPHARM 150 mg CAPS.
FLUCONAZOL ZENTIVA 150 mg CAPS.
FLUCOVIM 50
CAPS.
DIFLUCAN 50 mg
CAPS.
FLUCORIC 50 mg
CAPS.
FLUCONAZOL SANDOZ (R) 50 CAPS.
FLUCONAZOL 50 mg
CAPS.
FLUCONAZOL MEDOCHEMIE 50 mg CAPS.
FLUCONAZOL ARENA 50 MG CAPS.
FLUCONAZOL LPH 50 mg
CAPS.
DIFLUCAN 10 mg/ml
DIFLAZON 2mg/ml
SOL. PERF.
ACICLOVIR 200 mg
CAPS.
ACICLOVIR ARENA 200 mg CAPS.
ACICLOVIR FARMEX 200 mg CAPS.
ACICLOVIR ARENA 400 mg CAPS.
ACICLOVIR TERAPIA 200 mg COMPR.
ACICLOVIR 200 mg
COMPR.
ACICLOVIR 200 mg
COMPR.
ACICLOVIR LAROPHARM 200 mg COMPR.
ACICLOVIR-RICHTER 200 mg COMPR.
ACICLOVIR 400 mg
COMPR.
VIROLEX
PULB. PT. SOL. INJ./PERF.
INDOMETACIN LAROPHARM 25 mg CAPS.
INDOMETACIN ARENA 25 MG CAPS.
INDOMETACIN ARENA 50 MG CAPS.
INDOMETACIN 50 mg
SUPOZ.
INDOMETACIN 50 mg
SUPOZ.
INDOMETACIN 50 mg
SUPOZ.
DICLOREUM 150 mg
CAPS. ELIB. PREL.
DICLOFENAC DUO PHARMASWISS 75 mg
CAPS. ELIB. PREL.
DICLOTARD 100 mg
5mg/ml
5mg/ml
5mg/ml
100mg
100mg
100mg
100mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
200mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
10mg/ml
2mg/ml
200mg
200mg
200mg
400mg
200mg
200mg
200mg
200mg
200mg
400mg
250mg
25mg
25mg
50mg
50mg
50mg
50mg
150mg
75mg
100mg
Prescriptie
Nr crt.
tara det.
concentratie
Detinator APP
APP
Ambalaj
5g/l
INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML
5g/l
INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML
5g/l
INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML
S/P-RF
S/P-RF
S/P-RF
B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF.
S/P-RF
B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN PEJD X 100 ML SOL. PERF.
S/P-RF
B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. DIN PEJD X 100 ML SOL. PERF.
S/P-RF
VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS.

P-RF
BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS.
P-RF
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF
CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS.PRF
VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS.
P-RF
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS.
P-RF
TERAPIA SA
ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF
SANDOZ SRL
GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS.
P-RF
SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS.
P-RF
MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS.
P-RF
LABORATOARELE PROF.DR.MORAIT S.R.L.
ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF
P-RF
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PRF
LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS.
PRF
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS.
PRF
CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS.
PRF
ZENTIVA K.S.
REPUBLICA CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS.
P-RF
VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS.
P-RF
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS.
P-RF
TERAPIA SA
ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF
SANDOZ SRL
P-RF
P-RF
MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS.
P-RF
P-RF
LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS.
PRF
CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS.PRF
MAREA BRITANIE
CUTIE X 1 FLACON PEID DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 LINGURITA DOZATOARE A 5ML, CU PULB. PENTRU 35 ML SUSP. ORALA
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML
PRF
S/PR-F

P-RF
P-RF
FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS.
P-RF
ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS.
P-RF
TERAPIA SA
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF
LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
PRF
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL. INJ./PERF.
LAROPHARM SRL
ARENA GROUP SA
ARENA GROUP SA
ANTIBIOTICE SA
SINTOFARM SA
MAGISTRA C & C
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ALFA WASSERMANN SPA ITALIA
PHARMASWISS CESKA REPUBLIKA S.R.O. CEHIA
TERAPIA SA
ROMANIA
CUTIE X 2 BLIST., PVC/AL, X 10 CAPS.

S/P-RF
P-6L
P-6L
P-6L
CUTIE X 2 FOLII TERMOSUDATE AL-PE X 3 SUPOZ. P-6L
CUTIE X 2 FOLII PVC/PE X 5 SUPOZ.
P-6L
CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ.
P-6L
CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L

CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL.
P-6L
CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL
P-6L
Pagina 14 din 21
cant.
Pret de
UT/
(RON)
aj
1
12
1
10
10
20
4
16
7
7
1
1
1
1
1
1
1
1
1
1
1
1
1
1
7
7
7
7
7
7
7
7
7
7
7
1
1
20
20
20
10
20
20
20
20
20
10
5
20
30
20
6
10
10
20
30
20
8,953750
8,499166
8,953750
4,476875
4,476875
4,476875
3,027150
2,178750
3,027150
3,027150
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
5,834285
1,513575
1,513575
1,513575
1,513575
1,513575
1,513575
1,513575
1,513575
1,513575
1,513575
10,595025
22,050000
0,804149
0,804149
0,804149
1,608299
0,804149
0,804149
0,716500
0,804149
0,804149
1,608299
47,124000
0,063112
0,063112
0,126225
0,326250
0,326250
0,326250
0,378675
0,189337
0,252450
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,496250
0,000000
0,286250
0,530125
0,530125
0,278625
3,375350
0,000000
1,644278
0,392850
2,619275
6,489275
2,619275
2,619275
1,779275
2,619275
2,619275
2,039275
2,619275
2,619275
2,619275
2,619275
1,699275
2,619275
0,000000
1,266425
2,763567
1,266425
0,013567
0,452139
1,264996
0,879282
1,266425
1,266425
0,196425
18,974975
25,400000
0,244351
0,306851
0,266851
0,411701
0,085851
0,089351
0,000000
0,089351
0,089351
1,149701
0,000000
0,020888
0,010888
0,057275
0,387083
0,360750
0,357750
2,095825
0,391663
0,102050
8,058375
7,649249
8,058375
4,029187
4,029187
4,029187
2,724435
1,960875
2,724435
2,724435
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
5,250856
1,362217
1,362217
1,362217
1,362217
1,362217
1,362217
1,362217
1,362217
1,362217
1,362217
9,535522
19,845000
0,723734
0,723734
0,723734
1,447469
0,723734
0,723734
0,644850
0,723734
0,723734
1,447469
42,411600
0,056800
0,056800
0,113602
0,293625
0,293625
0,293625
0,340807
0,170403
0,227205
1,391625
0,849917
1,181625
0,977813
0,977813
0,726313
3,678065
0,217875
1,946993
0,695565
3,073348
6,943348
3,073348
3,073348
2,233348
3,073348
3,073348
2,493348
3,073348
3,073348
3,073348
3,073348
2,153348
3,073348
0,583429
1,417783
2,914925
1,417783
0,164925
0,603497
1,416354
1,030640
1,417783
1,417783
0,347783
20,034478
27,605000
0,324766
0,387266
0,347266
0,572531
0,166266
0,169766
0,071650
0,169766
0,169766
1,310531
4,712400
0,027200
0,017200
0,069898
0,419708
0,393375
0,390375
2,133693
0,410597
0,127295
cod ATC
790 M01AB05
791 M01AB05
792 M01AB05
793 M01AB05
794 M01AB05
795 M01AB05
796 M01AB05
797 M01AB05
798 M01AB05
799 M01AB05
800 M01AB05
801 M01AB05
802 M01AB05
803 M01AB05
804 M01AB05
805 M01AB05
806 M01AB05
807 M01AB05
808 M01AB05
809 M01AB05
810 M01AB05
811 M01AB15
812 M01AB15
813 M01AB15
814 M01AB15
815 M01AB16
816 M01AB16
817 M01AC02
818 M01AC02
819 M01AC02
820 M01AC06
821 M01AC06
822 M01AC06
823 M01AC06
824 M01AC06
825 M01AC06
826 M01AC06
827 M01AC06
828 M01AC06
829 M01AC06
830 M01AC06
831 M01AC06
832 M01AC06
833 M01AC06
834 M01AC06
835 M01AC06
836 M01AC06
837 M01AC06
838 M01AC06
839 M01AC06
840 M01AE03
841 M01AE03
842 M01AE03
843 M01AE03
844 M01AE03
845 M01AE03
846 M01AE03
DCI
Denumire Comerciala
forma farm.
DICLOFENACUM
DICLAC (R) 75 ID
COMPR. ELIB. MODIF.
DICLOFENACUM
VOLTAREN (R) RETARD
DICLOFENACUM
REFEN (R) RETARD
DICLOFENACUM
VOLTAREN (R) 50
COMPR. FILM. GASTROREZ.
DICLOFENACUM
DICLOFENAC 50 mg
DICLOFENACUM
DICLOFENAC HELCOR 50 mg COMPR. FILM. GASTROREZ.
DICLOFENACUM
VOLTAREN RAPID (R)
DRAJ.
DICLOFENACUM
DICLOFENAC ARENA 25 mg DRAJ. GASTROREZ.
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
VOLTAREN (R)
SOL. INJ.
DICLOFENACUM
TRATUL (R)
SOL. INJ.
DICLOFENACUM
DICLOFENAC 75 mg
SOL. INJ.
DICLOFENACUM
REFEN 75 mg
SOL. INJ./PERF.
DICLOFENACUM
CLAFEN 100 mg
SUPOZ.
DICLOFENACUM
VOLTAREN (R)
SUPOZ.
DICLOFENACUM
DICLOFENAC 100 mg
SUPOZ.
DICLOFENACUM
DICLOFENAC SODIC 100 mg SUPOZ.
DICLOFENACUM
DICLOFENAC SINTOFARM 12,5 mg SUPOZ.
DICLOFENACUM
DICLOFENAC SINTOFARM 12,5 mg SUPOZ.
DICLOFENACUM
VOLTAREN (R)
SUPOZ.
KETOROLACUM TROMETHAMIN KETOROL
COMPR. FILM.
KETOROLACUM TROMETHAMIN KETANOV 10 mg
COMPR. FILM.
KETOROLACUM TROMETHAMIN KETANOV
SOL. INJ.
KETOROLACUM TROMETHAMIN KETOROL
SOL. INJ.
ACECLOFENACUM
AFLAMIL 100mg
COMPR. FILM.
ACECLOFENACUM
ACE-TAB 100 mg
COMPR. FILM.
TENOXICAMUM
TENOXICAM ARENA 20 mg COMPR.
TENOXICAMUM
NEO - ENDUSIX (R)
COMPR. FILM.
TENOXICAMUM
NEO - ENDUSIX (R)
LIOF. + SOLV. PT. SOL. INJ.
MELOXICAMUM
MOVALIS (R) 15 mg
COMPR.
MELOXICAMUM
MOVALIS (R) 15 mg
COMPR.
MELOXICAMUM
MELOXICAM LPH 15 mg
COMPR.
MELOXICAMUM
MELOXICAM SANDOZ 15 mg COMPR.
MELOXICAMUM
MELOXICAM MCC 15 mg
COMPR.
MELOXICAMUM
MELOXICAM VIM SPECTRUM 15 mg COMPR.
MELOXICAMUM
Meloxicam Zentiva 15 mg comprimate COMPR.
MELOXICAMUM
MELOXICAM LPH 15 mg
COMPR.
MELOXICAMUM
MOVALIS (R) 7,5 mg
COMPR.
MELOXICAMUM
MOVALIS (R) 7,5 mg
COMPR.
MELOXICAMUM
MELOXICAM LPH 7,5 mg
COMPR.
MELOXICAMUM
MELOXICAM SANDOZ 7,5 mg COMPR.
MELOXICAMUM
MELOXICAM MCC 7,5 mg
COMPR.
MELOXICAMUM
MELOXICAM VIM SPECTRUM 7,5 mg COMPR.
MELOXICAMUM
MELOXICAM LPH 7,5 mg
COMPR.
MELOXICAMUM
MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ.
MELOXICAMUM
MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ.
MELOXICAMUM
MELOX 15 mg/1,5 ml
SOL. INJ.
MELOXICAMUM
MOVALIS 15mg/1,5ml
SOL. INJ.
MELOXICAMUM
MELOXICAM 15 mg
SUPOZ.
KETOPROFENUM
KETOPROFEN SR TERAPIA 100 MG CAPS. ELIB. PREL.
KETOPROFENUM
KETONAL (R) DUO 150 mg
CAPS. ELIB. PREL.
KETOPROFENUM
KETOPROFEN SR TERAPIA 200 MG CAPS. ELIB. PREL.
KETOPROFENUM
KETONAL RETARD
COMPR. ELIB. PREL.
KETOPROFENUM
PROFENID (R) 100 mg
COMPR. FILM.
KETOPROFENUM
KETONAL FORTE 100 mg
COMPR. FILM.
KETOPROFENUM
KETOPROXIN 100 mg
COMPR. FILM.
concentratie
75mg
100mg
100mg
50mg
50mg
50mg
50mg
25mg
50mg
50mg
25mg/ml
30mg/ml
75mg/3ml
25mg/ml
100mg
100mg
100mg
100mg
12,5 mg
12,5 mg
50mg
10mg
10mg
30mg/ml
30mg/ml
100mg
100mg
20mg
20mg
20mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
7,5mg
7,5mg
7,5mg
7,5mg
7,5mg
7,5mg
7,5mg
15mg/1,5ml
15mg/1,5ml
10mg/ml
15mg/1,5ml
15mg
100mg
150mg
200mg
150mg
100mg
100mg
100mg
Detinator APP
Ambalaj
Prescriptie
Nr crt.
tara det.
APP
HEXAL AG

NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL. P-6L
ROMANIA
CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL.
P-6L
NOVARTIS PHARMA GMBH GERMANIA
CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ.
P-6L
TERAPIA SA
CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L
ROMANIA
ROMANIA
CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L
ARENA GROUP SA
ARENA GROUP SA
ARENA GROUP SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L

ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L
ROMANIA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ GASTROREZ. P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 ML
P-RF
AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF
TERAPIA SA
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.
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ.
P-6L
DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L
TERAPIA SA
ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. FILM. P-6L
TERAPIA SA
ROMANIA CUTIE X 10 FIOLE X 1 ML
P-RF
DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. X 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR.
P-6L
LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM. P6L
ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA
P-6L
CUTIE X 1 FLAC. PULB. + 1 FIOLA SOLV. P-RF
GEROT PHARMAZEUTIKA GES.M.B.H.
BOEHRINGER INGELHEIM INTERNATIONAL GMBH


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

P-6L
HEXAL AG

ZENTIVA AS
CEHIA
CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L

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

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

VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.
PRF
PRF
CUTIE CU 1 BLIST. DIN PVC A 5 FIOLE TRANSPARENTE DIN STICLA CU CAPACITATEA DE 2 ML, CONTINAND 1,5 ML
PRF
CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1,5 ML SIL. INJ.
P-RF
MAGISTRA C & C
TERAPIA SA
SANDOZ S.R.L.
TERAPIA SA
ROMANIA CUTII X 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ.

ROMANIA CUTIE X 1 BLIST. X 10 CAPS. CU ELIB. PREL.
ROMANIA CUTIE X 2 BLIST. AL/PVC-TE-PVDC X 10 CAPS. ELIB. PREL.
ROMANIA CUTIE X 1 BLIST. X 10 CAPS. CU ELIB. PREL.
P-6L
P-6L
P-6L
P-6L
CUTIE X 1 FLAC. X 20 COMPR. CU ELIB. PREL. P-6L
FRANTA CUTIE X 2 BLIST X 15 COMPR. FILM.

P-6L
CUTIE X 1 FLAC. X, 20 COMPR. FILM.
P-6L
ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L
P6L
CUTIE CU 5 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ.
GERMANIA
LAB. AVENTIS
P-6L
CUTIE CU 3 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ.
P-6L
Pagina 15 din 21
cant.
Pret de
UT/
(RON)
aj
10
10
20
20
20
20
10
30
20
30
5
5
5
5
6
5
10
10
6
10
10
20
20
10
10
20
20
20
10
1
20
10
20
20
20
20
20
30
10
20
20
20
20
20
30
3
5
5
5
6
10
20
10
20
30
20
20
0,163000
0,252450
0,252450
0,126225
0,117000
0,117000
0,126225
0,063112
0,117000
0,117000
0,902550
1,083060
0,902550
0,842000
0,570000
0,652500
0,570000
0,572000
0,081562
0,081562
0,326250
0,084149
0,084149
1,203400
1,203400
0,126225
0,126225
0,324000
0,324000
1,768500
0,324000
0,324000
0,324000
0,324000
0,324000
0,324000
0,324000
0,324000
0,162000
0,162000
0,162000
0,162000
0,162000
0,162000
0,162000
1,768500
1,768500
1,768500
1,768500
0,759249
0,297000
0,712800
0,644000
0,712800
0,431333
0,475199
0,280500
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,000000
0,292550
0,102050
0,054275
0,000000
0,000000
0,116775
0,134554
0,000000
0,000000
0,779450
0,010940
0,191450
0,000000
0,000000
0,225500
0,000000
0,000000
0,525104
0,519438
0,633750
0,265851
0,441851
1,363600
0,830600
0,609275
0,352275
0,408000
0,334000
3,871500
0,230000
0,231000
0,036000
0,036000
0,036000
0,036000
0,026500
0,036000
0,285000
0,285000
0,128500
0,128500
0,128500
0,128500
0,128333
0,194833
0,195500
0,197500
1,255500
0,877417
0,000000
0,133700
0,000000
0,066700
0,000000
0,091301
0,000000
0,146700
0,227205
0,227205
0,113602
0,105300
0,105300
0,113602
0,056800
0,105300
0,105300
0,812295
0,974754
0,812295
0,757800
0,513000
0,587250
0,513000
0,514800
0,073405
0,073405
0,293625
0,075734
0,075734
1,083060
1,083060
0,113602
0,113602
0,291600
0,291600
1,591650
0,291600
0,291600
0,291600
0,291600
0,291600
0,291600
0,291600
0,291600
0,145800
0,145800
0,145800
0,145800
0,145800
0,145800
0,145800
1,591650
1,591650
1,591650
1,591650
0,683324
0,267300
0,641520
0,579600
0,641520
0,388199
0,427679
0,252450
0,016300
0,317795
0,127295
0,066898
0,011700
0,011700
0,129398
0,140866
0,011700
0,011700
0,869705
0,119246
0,281705
0,084200
0,057000
0,290750
0,057000
0,057200
0,533261
0,527595
0,666375
0,274266
0,450266
1,483940
0,950940
0,621898
0,364898
0,440400
0,366400
4,048350
0,262400
0,263400
0,068400
0,068400
0,068400
0,068400
0,058900
0,068400
0,301200
0,301200
0,144700
0,144700
0,144700
0,144700
0,144533
0,371683
0,372350
0,374350
1,432350
0,953342
0,029700
0,204980
0,064400
0,137980
0,043134
0,138821
0,028050
cod ATC
847 M01AE03
848 M01AE03
849 M01AE03
850 M01AE03
851 M01AE03
852 M01AE03
853 M04AA01
854 M04AA01
855 M04AC01
856 N02AX02
857 N02AX02
858 N02AX02
859 N02AX02
860 N02AX02
861 N02AX02
862 N02AX02
863 N02AX02
864 N02AX02
865 N02AX02
866 N02AX02
867 N02AX02
868 N02AX02
869 N02AX02
870 N02AX02
871 N02AX02
872 N02AX02
873 N02AX02
874 N02AX02
875 N02AX02
876 N02AX02
877 N02AX02
878 N02AX02
879 N02AX02
880 N02AX02
881 N02AX02
882 N02AX02
883 N02AX02
884 N02AX02
885 N02AX02
886 N02AX02
887 N02AX02
888 N02AX02
889 N02AX02
890 N02CC01
891 N02CC01
892 N02CC01
893 N02CC01
894 N02CC01
895 N02CC01
896 N03AF01
897 N03AF01
898 N03AF01
899 N03AF01
900 N03AF01
901 N03AF01
902 N03AF01
903 N03AF01
DCI
KETOPROFENUM
KETOPROFENUM
KETOPROFENUM
KETOPROFENUM
KETOPROFENUM
KETOPROFENUM
ALLOPURINOLUM*
ALLOPURINOLUM*
COLCHICINUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
SUMATRIPTANUM*
SUMATRIPTANUM*
SUMATRIPTANUM*
SUMATRIPTANUM*
SUMATRIPTANUM*
SUMATRIPTANUM*
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
MABRON RETARD 100 mg

TRADOLAN RETARD 150 mg
TRAMADOL SR ZENTIVA 150 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
100mg
100mg
COMPR. FILM. 50mg
COMPR. ORODISPERSABILE 50mg
SOL. INJ.
100mg
SOL. INJ.
100mg
SOL. INJ.
50mg/ml
SOL. INJ.
50mg/ml
SUPOZ.
100mg
COMPR. DISP. 100mg
COMPR. DISP. 50mg
COMPR. FILM. 100mg
COMPR. FILM. 100mg
COMPR. FILM. 50mg
COMPR. FILM. 50mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
Prescriptie
Nr crt.
tara det.
Denumire Comerciala
Detinator APP
APP
KETOPROXIN 50 mg
COMPR. FILM. 50mg
KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ.
100 mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA
KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ.
100 mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA
KETONAL 100 mg/ 2 ml
SOL. INJ.
100mg/2ml LEK PHARMACEUTICALS D.D. SLOVENIA
KETOPROFEN TERAPIA 100MG/2ML SOL. INJ./CONC. SOL. PERF. 100mg/2ml
TERAPIA SA
ROMANIA
KETOMAG
SUPOZ.
100mg
MAGISTRA C & C
ROMANIA
MILURIT 100 mg
COMPR.
100mg
MILURIT 300 mg
COMPR.
300mg
COLCHICINA
COMPR.
1mg
BIOFARM SA
ROMANIA
TRAMADOL
CAPS.
50mg
KRKA D.D.
SLOVENIA
K-ALMA (R)
CAPS.
50mg
ANTIBIOTICE SA
ROMANIA
TRAMADOL ARENA
CAPS.
50mg
TRAMACALM
CAPS.
50mg
A.C. HELCOR PHARMA S.R.L. ROMANIA
TRAMADOL ZENTIVA 50 mg CAPS.
50mg
ZENTIVA A.S.
SLOVACIA
TRAMAG 50
COMPR.
50mg
MAGISTRA C & C
ROMANIA
TRAMADOL EEL
COMPR.
50mg
BIO EEL SRL
ROMANIA
TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg
KRKA, D.D., NOVO MESTO SLOVENIA
TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL. 100mg
ZENTIVA AS
SLOVACIA
Ambalaj
CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L
CUTIE CU 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ
PRF
CUTIE CU 10 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ
PRF
CUTIE X 10 FIOLE X 2 ML SOL. INJ/CONC PT.SOL. PERF. P-RF
CUTIE X 5 FIOLE X 2 ML
P-RF
CUTIE X 2 FOLII LAMINATE PVC/PE X 5 SUPOZ. P-6L
CUTIE X 1 FLAC. X 50 COMPR.

P-6L
CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL.
PRF
P-6L
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
CIPRU
CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
CIPRU
CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
CIPRU
CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF
CIPRU
PRF
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF
ZENTIVA AS
SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF
PRF
PRF
PRF
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF
PRF
PRF
PRF
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.
P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR., FILM. ELIB. PREL.
P-RF
ZENTIVA, A.S.
ZENTIVA, A.S.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
KRKA D.D.
KRKA D.D.
KRKA D.D.
PRF
REPUBLICA SLOVACA
CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE
REPUBLICA SLOVACA
CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE
PRF
CIPRU
CIPRU
CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.
S/P-RF
S/P-RF
SLOVENIA CUTIE X 5 FIOLE X 1 ML

SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ.
GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP.
GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP.

ROMANIA
ISLANDA
ROMANIA
ISLANDA
CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM.
S/P-RF
S/P-RF
P-RF
P-RF
P-RF
P-RF
CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM. PRF

CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM.
P-RF
CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM. PRF
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 6 BLISTERE PVC-PVDC/AL X 10 COMPRIMATE P-6L/S


ROMANIA
BIO EEL SRL
ROMANIA

Pagina 16 din 21
P-6L
P-6L
P-6L
P-6L
P-6L
cant.
Pret de
UT/
(RON)
aj
20
5
10
10
5
10
50
30
40
20
20
20
10
20
20
20
30
30
10
30
10
30
30
30
10
30
10
30
30
10
30
10
30
30
30
30
10
10
5
100
5
5
5
2
2
6
6
6
6
50
60
50
50
50
20
20
20
0,237599
1,138000
1,136000
0,971000
1,138000
0,678000
0,151450
0,435000
0,149500
0,263832
0,263832
0,263832
0,263832
0,263832
0,263832
0,263832
0,527666
0,527666
0,527000
0,527666
0,527000
0,527666
0,791500
0,791500
0,791500
0,791333
0,791500
0,791333
1,055333
1,055000
1,055333
1,055000
1,055333
0,263832
0,791500
1,055333
0,263832
0,263832
1,580422
1,396100
0,790208
1,580422
1,158000
8,246250
4,123125
8,246250
7,645000
4,123125
1,315000
0,141833
0,141833
0,141800
0,141800
0,141800
0,140000
0,141833
0,141833
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,119901
0,002000
0,000000
0,000000
0,858000
0,000000
0,019350
0,000000
0,000000
0,035668
0,134668
0,203168
0,121168
0,020668
0,134668
0,119668
0,126000
0,102667
0,000000
0,000334
0,000000
0,000334
0,326500
0,112833
0,000500
0,000000
0,000500
0,000000
0,115333
0,000000
0,000000
0,000000
0,000000
0,066501
0,493833
0,640667
0,134168
0,134168
0,295578
0,000000
0,233792
1,137578
0,000000
8,653750
4,391875
1,803750
0,000000
1,408541
0,000000
0,076367
0,000000
0,000000
0,000000
0,000000
0,000000
0,000167
0,000167
0,213839
1,024200
1,022400
0,873900
1,024200
0,610200
0,136305
0,391500
0,134550
0,237448
0,237448
0,237448
0,237448
0,237448
0,237448
0,237448
0,474899
0,474899
0,474300
0,474899
0,474300
0,474899
0,712350
0,712350
0,712350
0,712199
0,712350
0,712199
0,949799
0,949500
0,949799
0,949500
0,949799
0,237448
0,712350
0,949799
0,237448
0,237448
1,422379
1,256490
0,711187
1,422379
1,042200
7,421625
3,710812
7,421625
6,880500
3,710812
1,183500
0,127649
0,127649
0,127620
0,127620
0,127620
0,126000
0,127649
0,127649
0,143661
0,115800
0,113600
0,097100
0,971800
0,067800
0,034495
0,043500
0,014950
0,062052
0,161052
0,229552
0,147552
0,047052
0,161052
0,146052
0,178767
0,155434
0,052700
0,053101
0,052700
0,053101
0,405650
0,191983
0,079650
0,079134
0,079650
0,079134
0,220867
0,105500
0,105534
0,105500
0,105534
0,092885
0,572983
0,746201
0,160552
0,160552
0,453621
0,139610
0,312813
1,295621
0,115800
9,478375
4,804188
2,628375
0,764500
1,820854
0,131500
0,090551
0,014184
0,014180
0,014180
0,014180
0,014000
0,014351
0,014351
cod ATC
904 N03AF01
905 N03AF01
906 N03AF01
907 N03AF01
908 N03AF01
909 N03AF01
910 N03AF01
911 N03AF01
912 N03AF01
913 N03AF01
914 N03AX12
915 N03AX12
916 N03AX12
917 N03AX12
918 N03AX12
919 N03AX12
920 N03AX12
921 N03AX12
922 N03AX12
923 N03AX12
924 N03AX12
925 N03AX12
926 N03AX12
927 N03AX12
928 N03AX12
929 N03AX12
930 N03AX12
931 N03AX12
932 N03AX12
933 N03AX12
934 N03AX12
935 N03AX12
936 N03AX12
937 N03AX12
938 N03AX12
939 N05AD01
940 N05AD01
941 N05AD01
942 N05AD01
943 N05AD01
944 N05AD01
945 N05AD01
946 N05AD01
947 N05BA01
948 N05BA01
949 N05BA01
950 N05BA01
951 N05BA01
952 N05BA01
953 N05BA01
954 N05BA03
955 N05BA03
956 N05BA03
957 N05BA03
958 N05BA03
959 N05BA06
960 N05BA08
DCI
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
DIAZEPAMUM
DIAZEPAMUM
DIAZEPAMUM
DIAZEPAMUM
DIAZEPAMUM
DIAZEPAMUM
DIAZEPAMUM
MEDAZEPAMUM*
MEDAZEPAMUM*
MEDAZEPAMUM*
MEDAZEPAMUM*
MEDAZEPAMUM*
LORAZEPAMUM*
BROMAZEPAMUM*
Denumire Comerciala
forma farm.
CARBEPSIL 400mg
COMPR.
CARBAMAZEPINA ARENA 400 mg COMPR.
TIMONIL RETARD 150 mg
COMPR. CU ELIB. PRELUNGITA 150mg
300mg
600mg
NEUROTOP (R) RETARD 300 mg COMPR. ELIB. PREL. 300mg
NEUROTOP (R) RETARD 600 mg COMPR. ELIB. PREL. 600mg
TEGRETOL CR 200
TEGRETOL CR 400
TIMONIL SIROP
SUSP. ORALA 100mg/5ml
GABAPENTIN AUROBINDO 100 mg CAPS.
100 mg
GABAGAMMA 100 mg
CAPS.
100mg
GRIMODIN 100 mg
CAPS.
100mg
GABAPENTINA PFIZER 100 mg CAPS.
100mg
100mg
GABAPENTIN ARENA 100 mg CAPS.
100mg
300 mg
GABAGAMMA 300 mg
CAPS.
300mg
GABARAN 300 mg
CAPS.
300mg
GABALEPT 300 mg
CAPS.
300mg
GRIMODIN 300 mg
CAPS.
300mg
300mg
300mg
300mg
400 mg
GABAGAMMA 400 mg
CAPS.
400mg
GABARAN 400 mg
CAPS.
400mg
GABALEPT 400 mg
CAPS.
400mg
GRIMODIN 400 mg
CAPS.
400mg
400mg
400mg
400mg
GABARAN 600 mg
COMPR. FILM. 600mg
GRIMODIN 600 mg
COMPR. FILM. 600mg
GABARAN 800 mg
COMPR. FILM. 800mg
HALOPERIDOL LAROPHARM 0,5 mg COMPR.
0,5mg
HALOPERIDOL ARENA 1 mg COMPR.
1mg
2mg
HALDOL
COMPR.
5mg
HALOPERIDOL ROMPHARM 2 mg/ml PIC. ORALE, SOL. 2 mg/ml
HALOPERIDOL 2 mg/ml
PIC. ORALE-SOL. 2mg/ml
HALOPERIDOL DECANOAT SOL. INJ.
50mg/ml
HALOPERIDOL RICHTER 5 mg/ml SOL. INJ.
5mg/ml
DIAZEPAM RICHTER 10 mg COMPR.
10mg
DIAZEPAM
COMPR.
10mg
DIAZEPAM LAROPHARM 10 mg COMPR.
10mg
DIAZEPAM 10 mg
SOL. INJ.
10mg/2ml
DIAZEPAM 5 mg/ml
SOL. INJ.
10mg/2ml
DIAZEPAM DESITIN (R) SOLUTIE RECTALA 10 mg SOL. RECTALA 10mg/2,5ml
DIAZEPAM DESITIN (R) SOLUTIE RECTALA 5 mg SOL. RECTALA 5mg/2,5ml
MEDAZEPAM ARENA 10mg COMPR.
10 mg
MEDAZEPAM ARENA 10mg COMPR.
10 mg
MEDAZEPAM 10 mg
COMPR.
10mg
MEDAZEPAM LPH 10 mg
COMPR.
10mg
MEDAZEPAM LPH 10 mg
COMPR.
10mg
ANXIAR (R) 1 mg
COMPR.
1 mg
BROMAZEPAM LPH 1,5 mg COMPR.
1,5mg
DESITIN ARZNEIMITTEL GMBH
COMPR. CU ELIBERARE PRELUNGITA

GEROT PHARMAZEUTIKA GMBH
Prescriptie
Nr crt.
tara det.
concentratie
Detinator APP
APP
Ambalaj
400mg
AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR.
400mg
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR.
P-6L
P-6L
P6L
P6L
P6L
GERMANIA
GERMANIA
GERMANIA
CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIB. PRELUNGITA
AUSTRIA
AUSTRIA
CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL P-6L
CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA

CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA
CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL.
P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L
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.
GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS.
P6L
P-6L
UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L

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

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

LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.
P-RF/S
P-RF
P-RF
Pagina 17 din 21
P-RF
cant.
Pret de
UT/
(RON)
aj
50
20
50
50
50
50
50
50
30
1
50
100
60
50
100
60
50
100
50
100
60
50
100
60
50
100
50
100
60
50
100
60
30
60
30
20
30
30
25
1
1
5
5
20
30
20
5
5
5
5
20
50
20
20
30
50
20
0,283666
0,283666
0,106374
0,212749
0,425498
0,212749
0,425498
0,141833
0,283666
23,360000
0,149200
0,173669
0,173669
0,173669
0,173669
0,173669
0,447800
0,521011
0,521011
0,521011
0,521011
0,447400
0,433000
0,521011
0,597600
0,694684
0,694684
0,694684
0,694684
0,596200
0,577100
0,694684
1,042026
1,042026
1,389368
0,093037
0,186074
0,372149
0,299600
3,721497
3,721497
8,452000
1,066859
0,103000
0,138666
0,108000
2,392000
2,392000
5,178000
4,530000
0,127000
0,116400
0,132000
0,128000
0,128000
0,105600
0,039600
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,108534
0,108334
0,197426
0,199851
0,306102
0,143251
0,260502
0,205567
0,320334
0,000000
0,000000
0,020431
0,402831
0,294131
0,279031
0,233664
0,000000
0,235089
0,825589
0,835289
0,054489
0,000000
0,000000
0,376322
0,000000
0,498416
0,814316
1,060416
0,334649
0,000000
0,000000
0,426982
1,137974
0,825807
2,215632
0,074963
0,080926
0,001184
0,000000
1,668503
3,178503
0,000000
1,139141
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,026000
0,000000
0,000000
0,033400
0,071400
0,255299
0,255299
0,095736
0,191474
0,382948
0,191474
0,382948
0,127649
0,255299
21,024000
0,134280
0,156302
0,156302
0,156302
0,156302
0,156302
0,403020
0,468909
0,468909
0,468909
0,468909
0,402660
0,389700
0,468909
0,537840
0,625215
0,625215
0,625215
0,625215
0,536580
0,519390
0,625215
0,937823
0,937823
1,250431
0,083733
0,167466
0,334934
0,269640
3,349347
3,349347
7,606800
0,960173
0,092700
0,124799
0,097200
2,152800
2,152800
4,660200
4,077000
0,114300
0,104760
0,118800
0,115200
0,115200
0,095040
0,035640
0,136901
0,136701
0,208064
0,221126
0,348652
0,164526
0,303052
0,219751
0,348701
2,336000
0,014920
0,037798
0,420198
0,311498
0,296398
0,251031
0,044780
0,287191
0,877691
0,887391
0,106591
0,044740
0,043300
0,428424
0,059760
0,567885
0,883785
1,129885
0,404118
0,059620
0,057710
0,496451
1,242177
0,930010
2,354569
0,084267
0,099534
0,038399
0,029960
2,040653
3,550653
0,845200
1,245827
0,010300
0,013867
0,010800
0,239200
0,239200
0,517800
0,453000
0,012700
0,011640
0,039200
0,012800
0,012800
0,043960
0,075360
cod ATC
961 N05BA08
962 N05BA08
963 N05BA08
964 N05BA08
965 N05BA08
966 N05BA08
967 N05BA12
968 N05BA12
969 N05BA12
970 N05BA12
971 N05BA12
972 N05BA12
973 N05BA12
974 N05BA12
975 N05BA12
976 N05BA12
977 N05BA12
978 N05BA12
979 N05BA12
980 N05BA12
981 N05BA12
982 N05BA12
983 N05BA12
984 N05BA12
985 N05BA12
986 N05BA12
987 N05BA12
988 N05CD02
989 N05CD02
990 N05CD02
991 N05CD02
992 N05CD02
993 N05CD02
994 N05CF01
995 N05CF02
996 N05CF02
997 N05CF02
998 N05CF02
999 N05CF02
1000
N05CF02
1001
N05CF02
1002
N06AA04
1003
N06AA04
1004
N06AA09
1005
N06AA12
1006
N06AB03
1007
N06AB03
1008
N06AB03
1009
N06AB03
1010
N06AB03
1011
N06AB04
1012
N06AB04
1013
N06AB05
1014
N06AB05
1015
N06AB05
1016
N06AB05
1017
N06AB05
DCI
BROMAZEPAMUM*
BROMAZEPAMUM*
BROMAZEPAMUM*
BROMAZEPAMUM*
BROMAZEPAMUM*
BROMAZEPAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
NITRAZEPAMUM
NITRAZEPAMUM
NITRAZEPAMUM
NITRAZEPAMUM
NITRAZEPAMUM
NITRAZEPAMUM
ZOPICLONUM*
ZOLPIDEMUM*
ZOLPIDEMUM*
ZOLPIDEMUM*
ZOLPIDEMUM*
ZOLPIDEMUM*
ZOLPIDEMUM*
ZOLPIDEMUM*
CLOMIPRAMINUM*
CLOMIPRAMINUM*
AMITRIPTYLINUM*
DOXEPINUM*
FLUOXETINUM*
FLUOXETINUM*
FLUOXETINUM*
FLUOXETINUM*
FLUOXETINUM*
CITALOPRAMUM**
CITALOPRAMUM**
PAROXETINUM*
PAROXETINUM*
PAROXETINUM*
PAROXETINUM*
PAROXETINUM*
Denumire Comerciala
BROMAZEPAM LPH 1,5 mg

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

FRONTIN 0,25 mg
ALPRAZOLAM ATB 0,25 mg
XANAX 0,5 mg
ALPRAZOLAM LPH (R) 0,5 mg
FRONTIN 0,5 mg
PRAZOLEX (R) 0,5 mg
XANAX 1 mg
ALPRAZOLAM LPH (R) 1 mg
PRAZOLEX (R) 1 mg
FRONTIN 1mg
ALPRAZOLAM ATB 1 mg
ALPRAZOLAM ATB 1 mg
ALPRAZOLAM ATB 1 mg
NITRAZEPAM LPH (R) 2,5 mg
NITRAZEPAM LPH 2,5 mg
NITRAZEPAM LPH (R) 5 mg
NITRAZEPAM 5 mg
NITRAZEPAM - RICHTER 5 mg
NITRAZEPAM LPH 5 mg
IMOVANE 7,5 mg
SANVAL (R) 10 mg
SANVAL (R) 10 mg
ZOLPIDEM ATB 10 MG
STILNOX 10 mg
STILNOX 10 mg
ZOLPIDEM AUROBINDO 10 mg
STILNOX 10 mg
ANAFRANIL (R) 10 mg
ANAFRANIL (R) 25 mg
AMITRIPTILINA ARENA 25 mg
DOXEPIN 25 mg
FLUOXIN 20 mg
FLUOXIN 20 mg
MAGRILAN 20 mg
ROFLUXIN 20 mg
PROZAC 20 mg
LINISAN 10 mg
LINISAN 20 mg
ARKETIS
PAROXETINA ATB 20 mg
SEROXAT 20 mg
PAXETIN 20 mg
PALUXETIL 40 mg
forma farm.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
0,25mg
0,25mg
0,25mg
0,25mg
0,25mg
0,25mg
0,25mg
0,5mg
0,5mg
0,5mg
0,5mg
0,5mg
0,5mg
0,5mg
1mg
1mg
1mg
1mg
1mg
1mg
1mg
2,5mg
2.5mg
5mg
5mg
5mg
5mg
COMPR. FILM. 7,5mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
DRAJ.
10mg
DRAJ.
25mg
COMPR. FILM. 25mg
DRAJ.
25mg
CAPS.
20mg
CAPS.
20mg
CAPS.
20mg
CAPS.
20mg
COMPR. DISP. 20mg
COMPR. FILM. 10mg
COMPR. FILM. 20mg
COMPR.
20mg
COMPR. FILM. 20 mg
COMPR. FILM. 20mg
COMPR. FILM. 20mg
COMPR. FILM. 40mg
MAREA BRITANIE
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
ROMANIA
UNGARIA
ROMANIA
ROMANIA
ROMANIA
MAREA BRITANIE

ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
UNGARIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
MAREA BRITANIE

Ambalaj

Prescriptie
Nr crt.
tara det.
concentratie
Detinator APP
APP
1,5mg
3mg
3mg
3mg
3mg
3mg
PRF
P-RF
P-RF
P-RF
P-RF
PRF
P-RF
P-RF
P-RF
P-RF
PRF
PRF
PRF
P-RF
P-RF
P-RF
P-RF
PRF
PRF
PRF
P-RF
P-RF
ROMANIA
ANTIBIOTICE S.A.
ROMANIA
ANTIBIOTICE S.A.
ROMANIA
ANTIBIOTICE S.A.
ROMANIA
SANOFI AVENTIS
FRANTA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. FILM.
LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. X 10 COMPR. FILM.
LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 10 COMPR. FILM.
ANTIBIOTICE S.A.
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM.
CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ.
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ.
ARENA GROUP S.A. ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. FILM.
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ.
VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 CAPS.
VIM SPECTRUM SRL ROMANIA CUTIE X 4 BLIST. PVC/AL X 7 CAPS.
ANTIBIOTICE S.A.
ELI LILLY SA
SPANIA CUTIE X 2 BLIST. PVC-PE-ACLAR/AL X 14 COMPR. DISP.
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.
ANTIBIOTICE SA
ROMANIA CUTIE CU 3 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. FILM.
P-RF
SMITHKLINE BEECHAM MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.

ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. AL/AL X 10 COMPR. FILM.
P-RF
SANDOZ S.R.L.
P-RF
ROMANIA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR.FILM.
Pagina 18 din 21
P-RF
PRF
PRF
PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
PRF
P-RF
cant.
Pret de
UT/
(RON)
aj
30
30
20
10
10
30
30
20
30
30
10
20
30
30
20
30
30
10
20
30
30
20
30
30
10
20
30
20
30
20
20
20
30
20
10
20
10
10
20
10
20
30
30
50
30
14
28
30
20
28
30
30
30
30
30
30
30
0,039600
0,079200
0,079200
0,079200
0,079200
0,079200
0,066000
0,066000
0,066000
0,066000
0,066000
0,066000
0,066000
0,132000
0,132000
0,132000
0,132000
0,132000
0,132000
0,132000
0,264000
0,263500
0,264000
0,264000
0,263000
0,264000
0,264000
0,051374
0,051374
0,081500
0,102749
0,102749
0,081666
0,363000
0,225000
0,224000
0,225000
0,225000
0,225000
0,225000
0,225000
0,145412
0,363532
0,311600
0,363532
0,585803
0,585803
0,422333
0,585803
0,585803
0,246000
0,585803
0,519666
0,585803
0,585803
0,519666
1,171606
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,071400
0,159466
0,028800
0,020800
0,028800
0,028800
0,126666
0,059000
0,059333
0,059333
0,059000
0,059500
0,059333
0,174666
0,067000
0,067333
0,067333
0,068000
0,068500
0,067333
0,141666
0,000000
0,000000
0,000000
0,000000
0,000500
0,000000
0,019626
0,019959
0,000000
0,022251
0,022251
0,000000
0,000000
0,000000
0,000000
0,000000
0,120000
0,120000
0,000000
0,120000
0,099588
0,097134
0,000000
0,396134
0,219911
0,202054
0,000000
0,198697
0,729197
0,000000
0,782197
0,000000
0,031197
0,362863
0,000000
0,054060
0,035640
0,071280
0,071280
0,071280
0,071280
0,071280
0,059400
0,059400
0,059400
0,059400
0,059400
0,059400
0,059400
0,118800
0,118800
0,118800
0,118800
0,118800
0,118800
0,118800
0,237600
0,237150
0,237600
0,237600
0,236700
0,237600
0,237600
0,046236
0,046236
0,073350
0,092474
0,092474
0,073499
0,326700
0,202500
0,201600
0,202500
0,202500
0,202500
0,202500
0,202500
0,130870
0,327178
0,280440
0,327178
0,527222
0,527222
0,380099
0,527222
0,527222
0,221400
0,527222
0,467699
0,527222
0,527222
0,467699
1,054445
0,075360
0,167386
0,036720
0,028720
0,036720
0,036720
0,133266
0,065600
0,065933
0,065933
0,065600
0,066100
0,065933
0,187866
0,080200
0,080533
0,080533
0,081200
0,081700
0,080533
0,168066
0,026350
0,026400
0,026400
0,026300
0,026900
0,026400
0,024764
0,025097
0,008150
0,032526
0,032526
0,008167
0,036300
0,022500
0,022400
0,022500
0,142500
0,142500
0,022500
0,142500
0,114130
0,133488
0,031160
0,432488
0,278492
0,260635
0,042234
0,257278
0,787778
0,024600
0,840778
0,051967
0,089778
0,421444
0,051967
0,171221
cod ATC
1018
N06AB06
1019
N06AB06
1020
N06AB06
1021
N06AB06
1022
N06AB06
1023
N06AB06
1024
N06AB06
1025
N06AB06
1026
N06AB06
1027
N06AB06
1028
N06AB06
1029
N06AB06
1030
N06AB06
1031
N06AB06
1032
N06AB06
1033
N06AB08
1034
N06AB08
1035
N06AX11
1036
N06AX11
1037
N06AX11
1038
N06AX11
1039
N06AX11
1040
N06AX11
1041
N06AX11
1042
N06AX11
1043
N06AX11
1044
N06AX11
1045
N06AX11
1046
N06AX16
1047
N06AX16
1048
N06AX16
1049
N06AX16
1050
N06AX16
1051
N06AX16
1052
N06AX16
1053
N06AX16
1054
N06AX16
1055
N06AX16
1056
N06AX16
1057
N06AX16
1058
N06AX16
1059
N06AX16
1060
N06AX16
1061
N06AX16
1062
N06AX16
1063
N06AX16
1064
N06AX16
1065
N06AX16
1066
N06AX16
1067
N06AX16
1068
N06AX16
1069
N06AX16
1070
N06AX16
1071
N06AX16
1072
N06AX16
1073
N07AA01
1074
P01AB02
DCI
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
FLUVOXAMINUM*
FLUVOXAMINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
NEOSTIGMINI BROMIDUM
TINIDAZOLUM
Denumire Comerciala
SERLIFT 100 mg
ASENTRA (R)
SETALOFT 100 mg
ZOLOFT 100 mg
ADJUVIN 100 mg
STIMULOTON 100 mg
SERTRALINA ARENA 100 mg
SERLIFT 50 mg
ASENTRA (R)
SETALOFT 50 mg
ZOLOFT 50 mg
ADJUVIN 50 mg
STIMULOTON 50 mg
SERTRALINA ARENA 50 mg
ZOLOFT 20 mg/ml
FEVARIN (R) 100
FEVARIN (R) 50
REMERON SOLTAB 30 mg
MIRTAZAPIN ARENA 15 mg
MIRZATEN (R) 30 mg
PHARMATAZ 30 mg
ESPRITAL (R) 30
MIRTAZAPIN ARENA 45 mg
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
concentratie
100mg
100mg
100mg
100mg
100mg
100mg
100mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
CONC. PT. SOL. ORALA 20mg/ml
COMPR. FILM. 100mg
COMPR. FILM. 50mg
COMPR. DISP. 30mg
COMPR. FILM. 15mg
COMPR. FILM. 30mg
COMPR. FILM. 30mg
COMPR. FILM. 30mg
COMPR. FILM. 45mg
MIRTAZAPINA AUROBINDO 15 mg COMPR. ORODISPERSABILE 15mg
MIRZATEN Q-TAB 30 mg
ZULIN 30 mg
EFECTIN EP 150 mg
CAPS. ELIB. PREL. 150 mg
ELIFY EP 150 mg
IVRYX 150mg
VELAXIN 150 mg
CAPS. ELIB. PREL. 150mg
ALVENTA 150mg
VENLAFAXINA ACTAVIS 150 mg CAPS. ELIB. PREL. 150mg
VENLAFAXINA ARENA EP 150 mg CAPS. ELIB. PREL. 150mg
VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg
FOBILESS 37,5 mg
CAPS. ELIB. PREL. 37,5mg
VENLAFAXINA ARENA EP 37,5 mg CAPS. ELIB. PREL. 37,5mg
EFECTIN EP 75 mg
ELIFY EP 75 mg
IVRYX 75mg
IVRYX 75mg
VELAXIN 75 mg
ALVENTA 75 mg
FOBILESS 75 mg
VENLAFAXINA ARENA 37,5 mg COMPR.
37,5mg
VENLAFAXINA ARENA 50 mg COMPR.
50mg
75mg
ARGOFAN 150 SR
ARGOFAN 75 SR
NEOSTIGMINA LPH 15 mg
COMPR.
15mg
TINIZOL (R) 500 mg (J01XD02) COMPR. FILM. 500mg
Detinator APP
TERAPIA SA
KRKA D.D.
ISLANDA
MAREA BRITANIE CUTIE X BLISTERE DIN AL/PVC X 28 COMPRIMATE FILMATE
CUTIE, CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM.
Prescriptie
Nr crt.
tara det.
APP
Ambalaj
SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM.
P-RF
P-RF
P-RF
P-RF
AUSTRIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF

EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
TERAPIA SA
P-RF
KRKA D.D.
P-RF
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE, CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM.
P-RF
MAREA BRITANIE
CUTIE X BLIST. DIN AL/PVC X 28 COMPR. FILM. P-RF
ARENA GROUP SA
AUSTRIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF

UNGARIA CUTIE X 3 BLIST. X 10 COMPR. FILM.
P-RF
ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
MAREA BRITANIE
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML CONC. PT. SOL. ORALA + 1 PIPETA GRADATA
P-RF
OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM. P-RF

ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM. P-RF
NV ORGANON
OLANDA
P-RF
ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM.PRF
KRKA D.D.
SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL, X 10 COMPR. FILM. P-RF
ZENTIVA KS
CEHIA
ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM.PRF
ABBOTT HEALTHCARE PRODUCTS B.V.
CUTIE X 5 BLIST. AL/PVC-PA-POLIESTER PERFORAT PT. ELIB. UNEI UNIT. DOZATE X 6 COMPR. DISP.
MAREA BRITANIE 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
P-RF
ANTIBIOTICE S.A.
ROMANIA
MAREA BRITANIE
CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF
MEDOCHEMIE LTD.
CIPRU
CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL. PRF
NEOLA PHARMA S.R.L. ROMANIA

UNGARIA
CUTIE X 5 BLIST. AL/AL X 6 COMPR. ORODISPERSABILE P-RF
CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL.
P-RF
P-RF
CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF
ISLANDA
TERAPIA S.A.
ROMANIA
TERAPIA S.A.
ROMANIA
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA
CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL.
CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF
MEDOCHEMIE LTD.
MAREA BRITANIE
CIPRU
P-RF
CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF
CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF

CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL.
PRF
CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF

CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF
PRF
CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL.
P-RF

CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL
P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF
AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF

ISLANDA CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF
ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF
ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF
ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. PRF
ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF
ARENA GROUP S.A.

TERAPIA S.A.
TERAPIA S.A.
ARENA GROUP S.A.
ARENA GROUP S.A.
ARENA GROUP S.A.
ZENTIVA A.S.
SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL.
ZENTIVA A.S.
SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL.
ZENTIVA S.A.
Pagina 19 din 21
P-RF
P-RF
P-6L
P-RF
cant.
Pret de
UT/
(RON)
aj
28
28
28
28
30
28
30
28
28
28
28
30
30
30
1
30
30
30
30
30
30
30
30
30
30
30
30
30
28
30
28
28
30
28
30
30
30
30
30
28
30
28
28
28
30
30
28
30
30
30
30
30
30
30
30
20
4
1,171606
1,076428
0,719642
1,171606
1,171606
1,171606
1,171606
0,585803
0,438571
0,355000
0,585803
0,585803
0,533666
0,585803
14,059283
0,585803
0,292901
0,656333
0,328166
0,481666
0,656333
0,481333
0,984499
0,328166
0,495000
0,656333
0,656333
0,984499
1,153452
0,998333
0,860714
1,153452
0,554666
0,856428
1,153452
1,153452
1,153452
0,288363
0,288363
0,576726
0,576726
0,576726
0,576726
0,576726
0,326000
0,576726
0,576726
0,576726
0,576726
0,576726
0,288363
0,384484
0,576726
0,665000
0,391000
0,712000
0,603524
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0,110894
0,000000
0,000000
0,801608
0,091394
0,110894
0,110727
0,138482
0,000000
0,000000
0,607054
0,108197
0,000000
0,115197
37,530717
0,530863
0,265432
1,529000
0,523500
0,000000
0,161333
0,000000
1,139167
0,522500
0,000000
0,219333
0,654333
0,273501
0,859405
0,000000
0,000000
0,155119
0,000000
0,000000
0,155214
0,155214
0,155214
0,307970
0,543303
0,741488
0,172607
0,086488
0,086488
0,308274
0,000000
0,085940
0,079702
0,302607
0,308607
0,308607
0,543303
0,462849
0,302607
0,000000
0,000000
0,000000
0,356476
1,054445
0,968785
0,647677
1,054445
1,054445
1,054445
1,054445
0,527222
0,394713
0,319500
0,527222
0,527222
0,480299
0,527222
12,653354
0,527222
0,263610
0,590699
0,295349
0,433499
0,590699
0,433199
0,886049
0,295349
0,445500
0,590699
0,590699
0,886049
1,038106
0,898499
0,774642
1,038106
0,499199
0,770785
1,038106
1,038106
1,038106
0,259526
0,259526
0,519053
0,519053
0,519053
0,519053
0,519053
0,293400
0,519053
0,519053
0,519053
0,519053
0,519053
0,259526
0,346035
0,519053
0,598500
0,351900
0,640800
0,543171
0,228055
0,107643
0,071965
0,918769
0,208555
0,228055
0,227888
0,197063
0,043858
0,035500
0,665635
0,166778
0,053367
0,173778
38,936646
0,589444
0,294723
1,594634
0,556317
0,048167
0,226967
0,048134
1,237617
0,555317
0,049500
0,284967
0,719967
0,371951
0,974751
0,099834
0,086072
0,270465
0,055467
0,085643
0,270560
0,270560
0,270560
0,336807
0,572140
0,799161
0,230280
0,144161
0,144161
0,365947
0,032600
0,143613
0,137375
0,360280
0,366280
0,366280
0,572140
0,501298
0,360280
0,066500
0,039100
0,071200
0,416829
cod ATC
1075
P01AB02
1076
P01AB02
1077
P01AB02
1078
P02CA03
1079
P02CA03
1080
P02CA03
1081
P02CA03
1082
P02CA03
1083
P02CA03
1084
P02CE01
1085
P02CE01
1086
P02CE01
1087
P02CE01
1088
R01AD01
1089
R03AC02
1090
R03AC02
1091
R03AC02
1092
R03BA01
1093
R03BA02
1094
R03BA02
1095
R03BA02
1096
R03BA02
1097
R03BA02
1098
R03BA02
1099
R03BB01
1100
R03CC02
1101
R03CC02
1102
R03DA04
1103
R03DA04
1104
R05DA04
1105
R05DA04
1106
R05DA04
1107
R05DA04
1108
R05DA04
1109
R05DA04
1110
R06AB04
1111
R06AE07
1112
R06AE07
1113
R06AE07
1114
R06AX17
1115
R06AX17
1116
R06AX17
1117
R06AX17
1118
R06AX17
1119
R06AX17
1120
S01BC03
1121
S01BC03
1122
S01BC03
TINIDAZOLUM
TINIDAZOLUM
TINIDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
LEVAMISOLUM
LEVAMISOLUM
LEVAMISOLUM
LEVAMISOLUM
BECLOMETASONUM
SALBUTAMOLUM
SALBUTAMOLUM
SALBUTAMOLUM
BECLOMETASONUM*
BUDESONIDUM*
BUDESONIDUM*
BUDESONIDUM*
BUDESONIDUM*
BUDESONIDUM*
BUDESONIDUM*
IPRATROPII BROMIDUM*
SALBUTAMOLUM
SALBUTAMOLUM
THEOPHYLLINUM
THEOPHYLLINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CHLORPHENAMINUM
CETIRIZINUM
CETIRIZINUM
CETIRIZINUM
KETOTIFENUM
KETOTIFENUM
KETOTIFENUM
KETOTIFENUM
KETOTIFENUM
KETOTIFENUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
1123
S01CA05
COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM)
1124
S01CA05
COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM)
ESKAZOLE
DUADOR 200 mg
ALBENDAZOL LPH 200 mg
ZENTEL 0,4 g/10 ml
COMPR.
400mg
COMPR. FILM. 200mg
COMPR.FILM 200 mg
SUSP. ORALA 0,4g/10ml
VERMIGAL NOVO 400 mg/10 ml SUSP. ORALA 400mg/10ml
DECARIS 150 mg
COMPR.
150mg
LEVAMISOL ARENA 150 mg COMPR.
150mg
DECARIS 50 mg
COMPR.
50mg
LEVAMISOL ARENA 50 mg
COMPR.
50mg
RINOCLENIL 100
SPRAY NAZ.,SUSP. 100mcg/doza
VENTOLIN (R)
SOL. INHAL. 5mg/ml
VENTOLIN 100 INHALER CFC-FREE SUSP. INHAL. PRESURIZATA 100mcg/doza
ASTHALIN INHALER
SUSP. INHAL. PRESURIZATA 100mcg/doza
CLENIL (R) JET 250 mcg
SOL. INHALAT PRESURIZATA
250mcg/doza
FRENOLYN 200
PULB. INHAL. 200 mcg/doza
FRENOLYN 200
PULMICORT TURBUHALER 200 mcg/doza PULB. INHAL. 200mcg/doza
FRENOLYN 400
BUDIAIR 200 mcg
200 mcg/doza
BUDIAIR 200 mcg JET
200mcg/doza
IPRAVENT INHALER 20mcg/doza SUSP. INHAL. PRESURIZATA 20mcg/doza
SALBUTAMOL EIPICO 2mg/5ml SIROP
2mg/5ml
VENTOLIN (R)
SOL. INJ.
0,5mg/ml
TEOTARD (R) 200 mg
TEOTARD (R) 350 mg
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
Prescriptie
DCI
Nr crt.
tara det.
Denumire Comerciala
Detinator APP
APP
TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg
AC HELCOR SRL
ROMANIA
TINIZOL (R) 500 mg (J01XD02) COMPR. FILM. 500mg
ZENTIVA S.A.
ROMANIA
TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg
AC HELCOR SRL
ROMANIA
ALBENDAZOL VIM SPECTRUM 200 mg COMPR.
200mg
Ambalaj
CUTIE X 1 BLIST. X 4 COMPR.FILM.

CUTIE X 1 BLIST. X 4 COMPR.FILM.
P6L
P-RF
P6L
P-RF
CUTIE X 12 BLIST. PVC-PVDC/AL X 1 COMPR.
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
GLAXO SMITHKLINE EXPORT LTD. MAREA BRITANIE
BIOFARM S.A.
ROMANIA
CHIESI FARMACEUTICI SPA ITALIA
P-RF
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 10 ML SUSP. ORALA
PRF

P-RF
CUTIE X 1 FLACON DIN PET X 30 ML SPRAY NAZ.,SUSP., PREVAZUT CU POMPA DOZATOARE
P-RF
P-RF
P-RF
P-RF
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
CIPLA (UK) LIMITED
MAREA BRITANIE
CUTIE X 1 FLAC. AL + VALVA DOZATOARE + DISP. ADM. X 200 DOZE SUSP. INHAL. PRESURIZATA
P-6L
SOL. DE INHALAT PRESURIZATA
CHIESI FARMACEUTICI SPA
ITALIA
P-RF
ROMANIA CUTIE X 1 PUNGA, X 1 INHALATOR X 100 DOZE P-RF
ROMANIA
P-RF
SUEDIA CUTIE X 1 FLACON MULTIDOZA DIN PEID X 100 DOZE PULB. INHAL. P-RF
ROMANIA
P-RF
ITALIA
P-RF
ITALIA
P-RF
CIPLA (UK) LIMITED
MAREA BRITANIE CUTIE X 1 FLACON AL PRESURIZAT X 200 DOZE SUSP.DE INHALAT PRESURIZATAP-6L

ASTRAZENECA AB
CUTIE X 1 FLACON PRESURIZAT DIN AL X 200 DOZE, PREVAZUT CU VALVA DOZATOARE + DISPOZITIV DE ADM., "SPASER JET" CU CAPAC
CUTIE CU 1 PUNGA DIN POLISTIREN/AL/PE CONTINAND 1 INHALATOR TIP MIAT-HALER X 200 DOZE
CUTIE CU 1 PUNGA DIN POLISTIREN/AL/PE CONTINAND 1 INHALATOR TIP MIAT-HALER X 100 DOZE
CUTIE X 1 FLACON X 200 DOZE SOL. DE INHALAT PRESURIZATA + VALVA DOZATOARE + DISPOZITIV DE ADMINISTRA
CUTIE X 1 FLACON X 200 DOZE SOL. DE INHALAT PRESURIZATA = VALVA DOZATOARE + DISPOZITIV JET DE ACTION
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 125 ML SIROP P-6L
CUTIE X 5 FIOLE DIN STICLA X 1 ML
MAREA BRITANIE
KRKA D.D.
KRKA D.D.
SINTOFARM SA
BIO EEL SRL
FARMACOM SA
SLAVIA PHARM SRL
SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL.

SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL.
P-6L
P-RF
P-RF

P-RF
LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-RF
MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L
KRKA D.D.
P-6L
UCB PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA + PICURATOR DIN PEJD X 20 ML PIC. ORALE, SOL. P6L
AC HELCOR SRL
P-6L
MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-6L
LAROPHARM SRL
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. PVC X 10 COMPR
P6L
LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR P6L
HEXAL AG
GERMANIA CUTIE X 1 FLACON X 100 ML SIROP + MASURA DOZATOARE P-6L
ROMPHARM COMPANY SRL ROMANIA FLACON PICURATOR DIN PEJD X 5 ML PIC. OFT., SOL. P-6L
UNIMED PHARMA LTD. SLOVACIA
LABORATOIRES THEA FRANTA
THEA FARMA S.P.A. ITALIA

THEA FARMA S.P.A. ITALIA
CUTIE X 1 FLACON DIN PE X 10 ML PIC. OFTALMICE, SOL., PREVAZUT CU PICURATOR
P-6L
P-6L
CUTIE X 1 FLAC. PEJD X 5 ML PICATURI OFT.-SOL. + PICURATOR PEJD + CAPAC CU INEL DE SIGURANTA
CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT.,SUSP. + APLICATOR PT. PICURARE P-RF
CUTIE X 1 TUB AL X 5 G
P-RF
cant.
Pret de
UT/
(RON)
aj
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
4
0,603524
4
0,603524
4
0,603524
2
3,107291
12
6,198333
2
3,107291
2
3,107291
1
3,951000
1
3,870000
1
3,540000
1
3,540000
2
1,179988
2
1,179988
1 42,718000
1
1,616400
1
8,082000
1
7,070000
1 101,960000
1 26,670000
1 66,167500
1 33,083750
1 66,167500
1 63,460000
1 66,167500
1 13,080000
1
3,050000
5
0,740000
40
0,243500
40
0,362500
30
0,167500
25
0,167500
20
0,151000
20
0,167500
20
0,165500
20
0,167500
20
0,120000
20
0,504900
20
0,504900
1 10,098000
20
0,175250
20
0,175250
20
0,175250
20
0,172000
30
0,172000
1 11,860000
1
8,678750
1 11,650000
1
8,678750
1 13,940000
1 14,459999
0,316476
0,356476
0,316476
0,002709
0,000000
0,207709
0,212709
1,999000
0,000000
0,000000
0,000000
0,385012
0,385012
5,802000
6,183600
2,808000
0,000000
0,000000
0,000000
11,652500
6,626250
21,192500
0,000000
8,122500
0,000000
0,000000
0,000000
0,000000
0,000000
0,032833
0,037700
0,000000
0,006000
0,000000
0,022000
0,000000
0,593100
0,045100
3,062000
0,007250
0,003250
0,003250
0,000000
0,000000
0,000000
0,951250
0,000000
6,141250
0,000000
1,560001
0,543171
0,543171
0,543171
2,796561
5,578499
2,796561
2,796561
3,555900
3,483000
3,186000
3,186000
1,061989
1,061989
38,446200
1,454760
7,273800
6,363000
91,764000
24,003000
59,550750
29,775375
59,550750
57,114000
59,550750
11,772000
2,745000
0,666000
0,219150
0,326250
0,150750
0,150750
0,135900
0,150750
0,148950
0,150750
0,108000
0,454410
0,454410
9,088200
0,157725
0,157725
0,157725
0,154800
0,154800
10,674000
7,810875
10,485000
7,810875
12,546000
13,013999
0,376829
0,416829
0,376829
0,313439
0,619834
0,518439
0,523439
2,394100
0,387000
0,354000
0,354000
0,503011
0,503011
10,073800
6,345240
3,616200
0,707000
10,196000
2,667000
18,269250
9,934625
27,809250
6,346000
14,739250
1,308000
0,305000
0,074000
0,024350
0,036250
0,049583
0,054450
0,015100
0,022750
0,016550
0,038750
0,012000
0,643590
0,095590
4,071800
0,024775
0,020775
0,020775
0,017200
0,017200
1,186000
1,819125
1,165000
7,009125
1,394000
3,006001
NOT:
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu(*) se iniiaza de medicul de specialitate in limita competenei i poate fi prescris n continuare de medicul de familie pe baza scrisorii medicale emise
de medicul de specialitate;
Pagina 20 din 21
cod ATC
DCI
Denumire Comerciala
forma farm.
concentratie
Detinator APP
Ambalaj
Prescriptie
Nr crt.
tara det.
APP
cant.
Pret de
UT/
(RON)
aj
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Snt
ii;
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Snt
ii i cu aprobarea comisiilor de la
nivelul Caselor Judeene de Asigurri de Sntate;
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu(1) se efectueaza pentru pacienii cu intoleran la acidum acetylsalicylicum.
Pagina 21 din 21
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 90% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
ANEXA 2b
SUBLISTA B - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 50% DIN PRETUL DE REFERINTA CONFORM
Nr. crt
cod ATC
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
A02BC02
DCI
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A03AB06 OTILONIUM BROMIDUM
A06AD15 MACROGOLUM*2)
A06AD15 MACROGOLUM*2)
A07AA11 RIFAXIMINUM
A07AA11 RIFAXIMINUM
A07AA11 RIFAXIMINUM
A07EA06 BUDESONIDUM**#
A07EA06 BUDESONIDUM**#
A07XA04 RACECADOTRILUM
A08AB01 ORLISTATUM****
A08AB01 ORLISTATUM****
A11CC03 ALFACALCIDOLUM
A02BC02
A02BC02
Denumire Comerciala
CONTROLOC 20 mg
CONTROLOC 40mg
SELTRAZ 40 mg
ZENCOPAN 20 mg
PANTEXEL 20 mg
NOLPAZA 20 mg
AZATOL 20 mg
PANTOPRAZOL TERAPIA 20 mg
PANTOPRAZOL TORRENT 20 mg
PANTOPRAZOL AUROBINDO 20 mg
CONTROLOC 20 mg
ZENCOPAN 40 mg
PANTEXEL 40 mg
NOLPAZA 40mg
PANTOPRAZOL ATB 40 mg
AZATOL 40 mg
PANTOPRAZOL TORRENT 40 mg
PANTOPRAZOL AUROBINDO 40 mg
CONTROLOC 40mg
GESOFLUX 20 mg
GESOFLUX 40 mg
NOLPAZA 40 mg
CONTROLOC 40mg
CONTROLOC 40mg
EMANERA 20 mg
HELIDES 20 mg
EMANERA 40 mg
HELIDES 40 mg
NEXIUM 20 mg
ESOMEPRAZOL SANDOZ 20 mg
ESOMEPRAZOL TEVA 20 mg
PRAGASTROL 20 mg
NEXIUM 40 mg
ESOMEPRAZOL TEVA 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
ALPHA D3 0,50 mcg
ALFACALCIDOL SANDOZ 0,5 mcg
forma farm.
concentratie
20mg
40mg
40mg
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
Detinator APP
Tara det.
APP
Prescriptie
DENUMIRILOR COMUNE INTERNATIONALE (DCI) ALE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU CONTRIBUTIE PERSONALA DIN HG NR. 720/2008 CU
MODIFICARILE SI COMPLETARILE ULTERIOARE VALABILA INCEPAND CU 01 OCTOMBRIE 2015
Ambalaj
NYCOMED GMBH
NYCOMED GMBH
GERMANIA
CUTIE X 6 BLIST. AL/AL IN SUPORT DE CARTON X 5 COMPR. FILM. GASTROREZ.
P-6L
GERMANIA
CUTIE X 6 BLIST. AL/AL IN SUPORT DE CARTON X 5 COMPR. FILM. GASTROREZ.
P-6L
ROMANIA
CUTIE X 2 BLIST. DIN OPA-AL-PVC/AL X 14 COMPR. FILM. GASTROREZISTENTE
P-6L
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. NYLON/AL/PVC/AL A CATE 28 COMPR. GASTROREZ.
COMPR. GASTROREZISTENTE
GRAN. GASTROREZ. PT. SUSP.ORALA
CONC. PT. SOL. ORALA
FARA CONCENTRATIE
CONC. PT. SOL. ORALA
FARA CONCENTRATIE
COMPR. FILM. 200mg

COMPR. FILM. 200mg
CAPS. GASTROREZ.
SPUMA RECTALA
CAPS.
PULB. PT. SOL. ORALA
CAPS.
CAPS.
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
ROMANIA
KRKA D.D., NOVO MESTO SLOVENIA
NEOLA PHARMA SRL ROMANIA
TERAPIA S.A.
ROMANIA
TORRENT PHARMA S.R.L. ROMANIA
P6L
P-6L
CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ
CUTIE X 2 BLIST. OPA-AL-PVC/AL X 15 COMPR. GASTR. P-6L
P6L
P6L
P6L
CUTIE CU BLIST. PVC-PCTFE-PVDC/AL X 28 COMPR. GASTROREZ.
CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ.

CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. GASTROREZ.
MALTA
CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L
TAKEDA GMBH
ZENTIVA K.S.
GERMANIA
CUTIE DE CARTON CU BLIST. DIN AL/AL CU RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ.
REPUBLICA CEHA CUTIE CU BLIST. NYLON/AL/PVC/AL A CATE 28 COMPR. GASTROREZ.
ROMANIA
TERAPIA S.A.
ROMANIA
TERAPIA S.A.
ROMANIA
ANTIBIOTICE SA
ROMANIA
CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ
P6L
P6L
P-6L
CUTIE X 2 BLIST. OPA-AL-PVC/AL X 15 COMPR. GASTR. P-6L

CUTIE X 1 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P-6L
CUTIE X 3 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P-6L
P6L
P6L
CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. GASTROREZ. P6L
CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L
CUTIE CU 3 BLIST. AL/AL X 10 COMPR. GASTROREZ.
CUTIE CU BLIST. PVC-PCTFE-PVDC/AL X 28 COMPR. GASTROREZ.
MALTA
TAKEDA GMBH
GERMANIA
P6L
G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/AL X 30 COMPR. GASTROREZISTENTE P6L
G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/AL X 30 COMPR. GASTROREZISTENTE P6L
CUTIE DE CARTON CU BLIST. DIN AL/AL CU RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ.
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ.
NYCOMED GMBH
TAKEDA GMBH
CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. S/P-RF
GERMANIA
GERMANIA
ZENTIVA K.S.
CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA, CU CAPSA DIN AL SI DOP DIN CAUCIUC A 40 MG CU PULB. PT. SOL. INJ.
PRF
CUTIE CU BLIST. OPA-AL-PE+DESICANT/AL+ PE X 28 CAPS. GASTROREZ.
P-6L
REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ.
P-RF
P-6L
CUTIE CU BLIST. OPA-AL-PE+DESICANT/AL+ PE X 28 CAPS. GASTROREZ.
P-6L
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ.
ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. X 7 COMPR. FILM. GASTROREZ.
SANDOZ SRL
ROMANIA CUTIE CU BLIST. AL/AL X14 COMPR. GASTROREZ.
P-6L
ROMANIA
ALVOGEN IPCO S.A.R.L
LUXEMBOURG CUTIE CU BLIST. AL-PVC/AL X 30 (3X10) COMPR. GASTROREZ.
ASTRAZENECA AB SUEDIA
SANDOZ SRL
ROMANIA
CUTIE CU BLIST. AL/AL X 14 COMPR. GASTROREZ.
CUTIE X 2 BLIST. AL/PVC X 7 COMPR. FILM. GASTROREZ.
ROMANIA
LUXEMBOURG CUTIE CU BLIST. AL-PVC/AL X 30 (3X10) COMPR. GASTROREZ.
TERAPIA S.A.
TERAPIA S.A.
ASTRAZENECA AB
SANDOZ S.R.L.
ROMANIA
ROMANIA
SUEDIA
PHARMACEUTICAL WORKS POLPHARMA SA
A. MENARINI IND. FARM. RIUNITE SRL
ITALIA
CNP PHARMA GMBH GERMANIA

CNP PHARMA GMBH GERMANIA
ALFA WASSERMANN SPA
ALFA WASSERMANN SPA
ITALIA
ITALIA
ITALIA
P-6L
P6L
P6L
P-6L
CUTIE CU BLIST. AL/AL X14 COMPR. GASTROREZ. P-6L
ROMANIA
POLONIA
P-6L
CUTIE CU BLIST. AL/AL X 14 COMPR. GASTROREZ.
P6L
P6L
CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE
P-6L
CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE
P-6L
CUTIE X 28 PLICURI DIN PET/AL/PEJD CONTINAND GRANULE GASTROREZ. PT. SUSP. ORALA
P-6L
CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML CU PULB. PT. SOL. INJ./PERF.
PRF
CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 15 ML CONTINAND PULB. PT. SOL. INJ./PERF.
P6L
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L

CUTIE CU 1 FLAC. DIN PET X 500 ML CONC. PT. SOL. ORALA, INSOTIT DE UN RECIPIENT DOZATOR GRADAT
PRF
CUTIE CU 1 FLAC. DIN PET X 200 ML CONC. PT. SOL. ORALA, INSOTIT DE UN RECIPIENT DOZATOR GRADAT
PRF

CUTIE X 3 BLIST. AL/PVC A CATE 12 COMPR. FILM. P-RF
200mg/10ml ALFA WASSERMANN SPA

P-RF
3mg
DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 CAPS. CU PELETE GASTROREZ.
P-RF
2mg/doza
DR. FALK PHARMA GMBH GERMANIA
P-RF
100mg
LABORATOIRES FOURNIER S.A.S. FRANTA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 CAPS.
P-RF
10mg
LABORATOIRES FOURNIER S.A.S. FRANTA CUTIE X 16 PLICURI X 1 G
P-RF
30mg
LAB. FOURNIER SA FRANTA CUTIE X 16 PLICURI X 3 G
P-RF
120mg
ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 21 CAPS. TARI (BLISTER PVC/PE/PVDC) P-RF
120mg
ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 84 CAPS. TARI (BLISTER PVC/PE/PVDC) P-RF
0,25mcg
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN PPID X 50 CAPS. MOI P-RF
0,25g
SANDOZ S.R.L.
ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF
0,50mcg
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 30 CAPS. MOI
P-RF
0,5g
SANDOZ S.R.L.
ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF
CUTIE X 1 FLAC. GRAN. PT. 60 ML SUSP. ORALA + 1 MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML
CUTIE X 1 FLAC. DIN AL X 14 DOZE X 1,2G SPUMA RECTALA, 14 APLICATOARE LUBREFIANTE PVC SI 14 PUNGI PL
Pagina 1 din 16
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
30
0,508333
30
0,935666
28
0,608214
28
0,236785
28
0,330714
30
0,273666
28
0,330714
30
0,330666
30
0,330666
30
0,212666
30
0,508333
28
0,430714
28
0,608214
30
0,576666
10
0,609000
30
0,608000
30
0,608000
28
0,608214
30
0,608000
30
0,387666
30
0,935666
30
0,177333
30
0,246000
1
8,810000
1 13,560000
1 13,560000
28
0,644285
28
0,480000
28
1,038571
28
0,878928
14
0,722227
14
0,555000
14
0,472142
30
0,720000
14
1,444456
14
1,057857
14
0,735000
30
1,156000
14
0,722227
14
1,384285
28
2,539642
10 20,061000
10 20,060000
30
1,103333
1 33,340000
1 13,949499
12
2,519583
36
2,413333
1 15,117513
100
3,516900
1 303,800000
20
2,076500
16
2,307000
16
2,307000
21
2,029672
84
1,677500
50
0,543166
30
0,543166
30
1,086333
30
1,086333
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,795630
0,000000
0,000000
0,000000
0,686258
0,000000
0,000000
0,000000
0,215630
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
1,840501
0,106250
0,000000
4,692487
0,000000
0,000000
0,000000
0,353000
0,230500
1,056518
0,000000
0,045834
0,222500
0,000000
0,047333
0,254166
0,467833
0,304107
0,118392
0,165357
0,136833
0,165357
0,165333
0,165333
0,106333
0,254166
0,215357
0,304107
0,288333
0,304500
0,304000
0,304000
0,304107
0,304000
0,193833
0,467833
0,088666
0,123000
4,405000
6,780000
6,780000
0,322142
0,240000
0,519285
0,439464
0,361113
0,277500
0,236071
0,360000
0,722228
0,528928
0,367500
0,578000
0,361113
0,692142
1,269821
10,030500
10,030000
0,551666
16,670000
6,974749
1,259791
1,206666
7,558756
1,758450
151,900000
1,038250
1,153500
1,153500
1,014836
0,838750
0,271583
0,271583
0,543166
0,543166
0,254167
0,467833
0,304107
0,118393
0,165357
0,136833
0,165357
0,165333
0,165333
0,106333
0,254167
0,215357
0,304107
0,288333
0,304500
0,304000
0,304000
0,304107
0,304000
0,193833
0,467833
0,088667
0,123000
4,405000
6,780000
6,780000
0,322143
0,240000
0,519286
0,439464
1,156744
0,277500
0,236071
0,360000
1,408486
0,528929
0,367500
0,578000
0,576744
0,692143
1,269821
10,030500
10,030000
0,551667
16,670000
8,815251
1,366042
1,206667
12,251244
1,758450
151,900000
1,038250
1,506500
1,384000
2,071354
0,838750
0,317417
0,494083
0,543167
0,590500
0,457499
0,842099
0,547392
0,213106
0,297642
0,246299
0,297642
0,297599
0,297599
0,191399
0,457499
0,387642
0,547392
0,518999
0,548100
0,547200
0,547200
0,547392
0,547200
0,348899
0,842099
0,159599
0,221400
7,929000
12,204000
12,204000
0,579856
0,432000
0,934713
0,791035
0,650004
0,499500
0,424927
0,648000
1,300010
0,952071
0,661500
1,040400
0,650004
1,245856
2,285677
18,054900
18,054000
0,992999
30,006000
12,554549
2,267624
2,171999
13,605761
3,165210
273,420000
1,868850
2,076300
2,076300
1,826704
1,509750
0,488849
0,488849
0,977699
0,977699
0,050834
0,093567
0,060822
0,023679
0,033072
0,027367
0,033072
0,033067
0,033067
0,021267
0,050834
0,043072
0,060822
0,057667
0,060900
0,060800
0,060800
0,060822
0,060800
0,038767
0,093567
0,017734
0,024600
0,881000
1,356000
1,356000
0,064429
0,048000
0,103858
0,087893
0,867853
0,055500
0,047215
0,072000
0,830704
0,105786
0,073500
0,115600
0,287853
0,138429
0,253965
2,006100
2,006000
0,110334
3,334000
3,235451
0,358209
0,241334
6,204239
0,351690
30,380000
0,207650
0,583700
0,461200
1,259486
0,167750
0,100151
0,276817
0,108634
0,155967
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
cod ATC
DCI
A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#

A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#
B01AB04
B01AB04
B01AB04
B01AB04
B01AB04
B01AB04
B01AB04
B01AB05
B01AB05
B01AB05
B01AB05
B01AB06
B01AB06
B01AB06
B01AB06
B01AB06
B01AB06
B01AB06
B01AB06
B01AB10
B01AB10
B01AB10
B01AB10
B01AB10
B01AB10
B01AB10
B01AB11
B01AB11
B01AB11
B01AB11
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
100 B01AC04
101 B01AC04
102 B01AC04
103 B01AC04
104 B01AC04
105 B01AC04
106 B01AC04
107 B01AC04
108 B01AC04
109 B01AC04
110 B01AC04
111 B01AC04
112 B01AC18
113 B01AC18
114 B01AC30
115 B01AF01
116 B01AF01
117 B01AX05
118 B01AX05
119 B01AX05
120 B01AX05
121 B03AC02
122 C01EB17
123 C01EB17
124 C02AC05
125 C02AC05
126 C02AC05
DALTEPARINUM**#
DALTEPARINUM**#
DALTEPARINUM**#
DALTEPARINUM**#
DALTEPARINUM**#
DALTEPARINUM**#
DALTEPARINUM**#
ENOXAPARINUM**#
ENOXAPARINUM**#
ENOXAPARINUM**#
ENOXAPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
TINZAPARINUM**#
TINZAPARINUM**#
TINZAPARINUM**#
TINZAPARINUM**#
TINZAPARINUM**#
TINZAPARINUM**#
TINZAPARINUM**#
SULODEXIDUM**
SULODEXIDUM**
SULODEXIDUM**
SULODEXIDUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
TRIFLUSALUM
TRIFLUSALUM
Denumire Comerciala
THIOSSEN 600 (vezi N07XN03)

THIOCTACID 600T (vezi N07XN03)
FRAGMIN 10000 UI/0,4 ml
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
CLOPIGAMMA 75 mg
CLOPIGAMMA 75 mg
PLAVOCORIN 75 mg
CLOPIDOGREL ACTAVIS 75 mg
DEFROZYP 75 mg
TESSYRON 75 mg
CLOPIDOGREL DR. REDDY'S 75 mg
CLOPIDOGREL TERAPIA 75 mg
DEPLATT 75 mg
TROMBEX 75 mg
TROMBEX 75 mg
CLOPIDOGREL AUROBINDO 75 mg
PLAVIX 75mg
PLATROX 300 mg
AFLEN (R)
COMBINATII (ACID ACETYLSALICYLICUM+DIPYRIDAMOLUM)** AGGRENOX 200mg/25mg
RIVAROXABANUM**
XARELTO 10mg
RIVAROXABANUM**
XARELTO 10mg
FONDAPARINUX SODIUM**#
ARIXTRA 2,5mg/0,5ml
ARIXTRA 2,5mg/0,5ml
ARIXTRA 7,5mg/0,6ml
ARIXTRA 7,5mg/0,6ml
COMPLEX DE HIDROXID DE FER (III) SUCROZA VENOFER (R)
IVABRADINUM**
CORLENTOR 5mg
IVABRADINUM**
CORLENTOR 7,5mg
MOXONIDINUM
MOXOGAMMA 0,2 mg
MOXONIDINUM
PHYSIOTENS 0,2
MOXONIDINUM
MOXONIDINA MYLAN 0,2 mg
Tara det.
APP
Detinator APP
COMPR. FILM. 600mg
AAA - PHARMA GMBH GERMANIA
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
25mg/ml
10000UI/0,4ml PFIZER EUROPE MA EEIG

12500 UI/0,5ml PFIZER EUROPE MA EEIG
15000ui/0,6ml PFIZER EUROPE MA EEIG
S/P-RF
S/P-RF
MAREA BRITANIE
CUTIE CU 5 BLISTERE INDIVIDUALE CONTINND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,6 ML SOLUTIE INJECTABILA
S/P-RF
MAREA BRITANIE
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
MAREA BRITANIE
S/P-RF
MAREA BRITANIE
S/P-RF
PR/PRF
CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML SOL. INJ.
PR/PRF
CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ.
PR/PRF
8000UI anti-Xa/0,8ml
LABORATOIRE AVENTIS
FRANTA
FRANTA
FRANTA
FRANTA
CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML SOL. INJ.
6000ui anti-Xa/0,6ml
LAB. AVENTIS
LAB. AVENTIS
LAB. AVENTIS
CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,8 ML SOL INJ.
PR/PRF
2850 ui AFXa/0,3ml
GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE
MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,3 ML SOL. INJ.
18000 UI/0,72ml PFIZER EUROPE MA EEIG
2500ui/0,2ml
5000ui/0,2ml
7500ui/0,3ml
2850 ui AFXa/0,3ml ASPEN PHARMA TRADING LIMITED IRLANDA

3800 ui AFXa/0,4ml
5700 ui AFXa/0,6ml
7600 ui AFXa/0,8ml
10000UI anti-XA/ml
SOL. INJ. IN SERINGI PREUMPLUTE
20000UI anti-Xa/ml
20000UI anti-Xa/ml
20000UI anti-Xa/ml
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ./PERF.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
250ULS
250ULS
600ULS/2ml
600ULS/2ml
300mg
300mg
75 mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
300 mg
300mg
25mg/200mg
10mg
10mg
2,5mg/0,5ml
2,5mg/0,5ml
7,5mg/0,6ml
7,5mg/0,6ml
20mg/ml
5mg
7,5mg
0,2mg
0,2mg
0,2mg
S/P-RF
CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,3 ML SOL. INJ.
S/P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
10000UI anti-XA/ml
COMPR. FILM.
COMPR. FILM.
S/P-RF
20000 UI anti-Xa/ml
CAPS. ELIB. MODIF.
CUTIE X 5 FIOLE X 24 ML SOL.INJ.

SOL. INJ. IN FLACOANE
CAPS.
CAPS.
Ambalaj
CUTIE X 3 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM. P-6L
MAREA BRITANIE
10000UI anti-XA/ml
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
GERMANIA
MAREA BRITANIE
SOL. INJ. IN FLACOANE
CAPS. MOI
CAPS. MOI
SOL INJ.
SOL. INJ.
MEDA PHARMA GMBH & CO KG
Prescriptie
Nr. crt
S/P-RF
LEO PHARMA A/S

LEO PHARMA A/S
LEO PHARMA A/S
LEO PHARMA A/S
LEO PHARMA A/S
LEO PHARMA A/S
LEO PHARMA A/S
DANEMARCA
ALFA WASSERMANN SPA
ITALIA
SANIENCE S.R.L.
SANIENCE S.R.L.
ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. MOI

ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ.
ALFA WASSERMANN SPA
CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA)
P-RF
SANOFI CLIR SNC
ITALIA
FRANTA
FRANTA
P-RF
KRKA D.D. NOVO MESTO
SLOVENIA
CUTIE CU BLIST. OPA/AL/PVC-AL X 28 COMPR. FILM.
FRANTA
FRANTA
CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-RF
SANOFI PHARMA - BRISTOL MYERS SQUIBB
MYLAN S.A.S.
DANEMARCA
DANEMARCA
DANEMARCA
DANEMARCA
DANEMARCA
DANEMARCA
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA
CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (20000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT IN AURIU SI CAPSA DE SIGURANTA DIN PP DE CULOARE PORTOCALIE
CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (40000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT CU LAC DE CULOARE VERDE SI CAPSA DE SIGURANTA DIN PP DE CULOARE VERDE INCHIS
PR/PRF
PR/PRF
CUTIE CU 10 SERINGI PREUMPLUTE X 0.35 ML (3500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC VERDE
PR/PRF
CUTIE CU 10 SERINGI PREUMPLUTE X 0.45 ML (4500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ALBASTRU
PR/PRF
CUTIE CU 2 SERINGI PREUMPLUTE X 0,50 ML (10000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ROSU
PR/PRF
CUTIE CU 2 SERINGI PREUMPLUTE X 0,70 ML (14000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC GALBEN
PR/PRF
CUTIE CU 2 SERINGI PREUMPLUTE X 0,90 ML (18000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ALBASTRU
PR/PRF
CUTIE X 2 BLIST. PVDC-PVC/AL-PVDC X 25 CAPS. MOI P-RF
PRF
PRF
CUTIE X 10 FIOLE DIN STICLA GALBENA X 2 ML P-RF
CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 28 COMPR.FILM.
P-RF
P-RF
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF
GERMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM.
GERMANIA
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF
SANDOZ S.R.L.
ROMANIA
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
P-RF
ISLANDA
CUTIE CU BLIST. AL/AL X 28 COMPR. FILM.
P-RF
P-RF
LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVDC/AL X 28 COMPR. FILM. P-RF
ROMANIA
ROMANIA
ROMANIA
CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 30 COMPR. FILM.
P-RF
P-RF
TERAPIA S.A.
CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM.
PRF
ZENTIVA K.S.
ZENTIVA K.S.
SANOFI CLIR SNC
CEHIA
CEHIA
MALTA
FRANTA
PRF
CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 30 COMPRIMATE FILMATE
P-RF
CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 90 COMPRIMATE FILMATE
P-RF
CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF

CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL)
P-RF
CUTIE CU 5 BLIST. AL-PVC/PVDC X 10 CAPS. PRF
GALENICA S.A.
GRECIA CUTIE X 5 BLIST. X 10 CAPS.
GERMANIA
CUTIE X 1 FLAC. DIN PP X 60 CAPS. CU ELIB.MODIF. CU SISTEM DE INCHIDERE SECURIZAT PT. COPII +DESICAN
BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 10 COMPR. FILM.

BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 30 COMPR. FILM.
GLAXO GROUP LTD. MAREA BRITANIE
ASPEN PHARMA TRADING LIMITED IRLANDA
GLAXO GROUP LTD. MAREA BRITANIE
ASPEN PHARMA TRADING LIMITED IRLANDA
VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML
LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR)
LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR)
P-RF
P-6L
P-RF
P-RF
CUTIE X 10 SERINGI PREUMPLUTE DIN STICLA X 0,5ML SOLUTIE INJECTABILA PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA DE CULOARE ALBASTRA
P-RF
CUTIE X 10 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE ALBASTRA
P-RF
CUTIE X 10 SERINGI PREUMPLUTE DIN STICLA X 0,6ML SOLUTIE INJECTABILA PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA DE CULOARE PURPURIE
P-RF
CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE PURPURIE
P-RF
S/P-RF
P-6L
P-6L
WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L
ABBOTT PRODUCTS GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR.FILM. P-6L
GENERICS (UK) LTD
MAREA BRITANIE
Pagina 2 din 16
P6L
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
30
5
5
5
5
5
10
10
10
10
10
10
6
10
10
10
10
10
10
10
10
10
10
10
10
2
2
2
50
50
10
10
30
30
28
28
28
28
28
28
28
28
28
30
30
30
30
30
90
28
28
50
50
60
10
30
10
10
10
10
5
56
56
30
28
28
1,592000
24,924000
18,430000
23,398000
27,346000
33,530000
5,280730
10,561460
13,673000
5,280730
10,561460
14,988000
19,778333
5,280730
5,280730
7,040971
7,040971
10,561460
10,561460
14,081943
14,081943
30,175597
60,351199
5,280730
6,789508
7,543897
21,122920
27,158040
1,540449
1,365800
5,413000
6,037000
4,366281
4,366281
0,460714
1,091570
0,545714
1,091570
0,637142
0,637142
0,618928
0,422142
1,091570
0,688666
1,091570
1,091570
0,919333
0,581000
0,562000
0,593928
1,091570
0,545785
0,545785
0,880833
11,170250
11,020000
19,409000
19,409000
58,227000
48,522499
31,080000
2,633544
3,856071
0,483666
0,781998
0,383571
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,918270
0,889540
0,000000
1,146270
1,098540
0,000000
0,000000
1,164270
1,164270
1,456029
1,456029
2,623540
2,623540
1,936057
1,936057
22,635403
52,533801
7,047270
9,064492
29,446103
29,297080
32,616960
0,523951
0,000000
0,000000
1,872000
4,976052
4,976052
0,000000
0,556287
0,000000
0,015215
0,000000
0,000000
0,000000
0,000000
0,015215
0,000000
0,014763
0,014763
0,000000
0,000000
0,000000
0,000000
0,556287
0,151815
0,527215
0,000000
0,450750
0,000000
0,000000
0,000000
0,293000
9,997501
0,000000
1,358956
0,000000
0,000000
0,297644
0,000000
0,796000
12,462000
9,215000
11,699000
13,673000
16,765000
2,640365
5,280730
6,836500
2,640365
5,280730
7,494000
9,889166
2,640365
2,640365
3,520485
3,520485
5,280730
5,280730
7,040971
7,040971
15,087798
30,175599
2,640365
3,394754
3,771948
10,561460
13,579020
0,770224
0,682900
2,706500
3,018500
2,183140
2,183140
0,230357
0,545785
0,272857
0,545785
0,318571
0,318571
0,309464
0,211071
0,545785
0,344333
0,545785
0,545785
0,459666
0,290500
0,281000
0,296964
0,545785
0,272892
0,272892
0,440416
5,585125
5,510000
9,704500
9,704500
29,113500
24,261249
15,540000
1,316772
1,928035
0,241833
0,390999
0,191785
0,796000
12,462000
9,215000
11,699000
13,673000
16,765000
3,558635
6,170270
6,836500
3,786635
6,379270
7,494000
9,889167
3,804635
3,804635
4,976515
4,976515
7,904270
7,904270
8,977029
8,977029
37,723202
82,709401
9,687635
12,459246
33,218052
39,858540
46,195980
1,294176
0,682900
2,706500
4,890500
7,159193
7,159193
0,230357
1,102072
0,272857
0,561000
0,318571
0,318571
0,309464
0,211071
0,561000
0,344333
0,560548
0,560548
0,459667
0,290500
0,281000
0,296964
1,102072
0,424708
0,800108
0,440417
6,035875
5,510000
9,704500
9,704500
29,406500
34,258751
15,540000
2,675728
1,928036
0,241833
0,688643
0,191786
1,432800
22,431600
16,587000
21,058200
24,611400
30,177000
4,752657
9,505314
12,305700
4,752657
9,505314
13,489200
17,800499
4,752657
4,752657
6,336873
6,336873
9,505314
9,505314
12,673748
12,673748
27,158037
54,316079
4,752657
6,110557
6,789507
19,010628
24,442236
1,386404
1,229220
4,871700
5,433300
3,929652
3,929652
0,414642
0,982413
0,491142
0,982413
0,573427
0,573427
0,557035
0,379927
0,982413
0,619799
0,982413
0,982413
0,827399
0,522900
0,505800
0,534535
0,982413
0,491206
0,491206
0,792749
10,053225
9,918000
17,468100
17,468100
52,404300
43,670249
27,972000
2,370189
3,470463
0,435299
0,703798
0,345213
0,159200
2,492400
1,843000
2,339800
2,734600
3,353000
1,446343
1,945686
1,367300
1,674343
2,154686
1,498800
1,977834
1,692343
1,692343
2,160127
2,160127
3,679686
3,679686
3,344252
3,344252
25,652963
58,568921
7,575343
9,743443
30,200493
31,409372
35,332764
0,677996
0,136580
0,541300
2,475700
5,412681
5,412681
0,046072
0,665444
0,054572
0,124372
0,063715
0,063715
0,061893
0,042215
0,124372
0,068867
0,123920
0,123920
0,091934
0,058100
0,056200
0,059393
0,665444
0,206394
0,581794
0,088084
1,567775
1,102000
1,940900
1,940900
6,115700
14,849751
3,108000
1,622311
0,385608
0,048367
0,375844
0,038358
DCI
MOXONIDINUM
MOXONIDINUM
MOXONIDINUM
MOXONIDINUM
MOXONIDINUM
RILMENIDINUM
RILMENIDINUM
EPLERENONUM*#
EPLERENONUM*#
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
128 C02AC05
129 C02AC05
130 C02AC05
131 C02AC05
132 C02AC06
133 C02AC06
134 C03DA04
135 C03DA04
136 C07AB12
137 C07AB12
138 C07AB12
139 C07AB12
140 C07AB12
141 C07AB12
142 C07AB12
143 C07AB12
144 C07AB12
145 C07AB12
146 C07BB07
147 C07BB07
148 C07BB07
149 C07BB07
150 C08CA09
151 C08CA13
152 C08CA13
153 C08CA13
154 C08CA13
155 C08CA13
156 C08CA13
157 C08CA13
158 C08CA13
159 C08CA13
160 C08CA13
161 C08CA13
162 C08CA13
163 C09AA04
164 C09AA04
165 C09AA04
166 C09AA04
167 C09AA04
168 C09AA04
169 C09AA04
170 C09AA04
171 C09AA04
172 C09AA04
173 C09AA04
174 C09AA04
175 C09AA04
176 C09AA04
177 C09AA04
178 C09AA04
179 C09AA04
180 C09AA04
181 C09AA04
182 C09AA07
183 C09AA07
184 C09AA10
185 C09AA10
186 C09AA10
187 C09AA15
188 C09AA15
189 C09BA04
190 C09BA04
191 C09BA04
192 C09BA04
Denumire Comerciala
MOXOGAMMA 0,3 mg
MOXOGAMMA 0,4 mg
PHYSIOTENS 0,4
TENAXUM
RILMENIDINA TEVA 1 mg
INSPRA 25 mg
INSPRA 50 mg
NEBILET (R)
NEBIVOLOL ACTAVIS 5 mg
X-PRESSOL 5 mg
NOLET 5 mg
NEBIVOLOL TEVA 5 mg
NEBIVOLOL TEVA 5 mg
NEBINORM 5 mg
NEBIVOLOL SANDOZ 5 mg
NEBIVOLOL TERAPIA 5mg
NEBIVOLOL TORRENT 5 mg
COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg
COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg
COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg
COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg
LACIDIPINUM
LACIPIL 4 mg
LERCANIDIPINUM
LERCANIDIPINA TEVA 10 mg
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPIN ACTAVIS 10 mg
LERCANIDIPINUM
LERIDIP
LERCANIDIPINUM
KAPIDIN10 mg
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINA ZENTIVA 10 mg
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERIDIP 20
LERCANIDIPINUM
PERINDOPRILUM
PRENESSA 2 mg
PERINDOPRILUM
PERINDOPRIL TEVA 4 mg
PERINDOPRILUM
VIDOTIN 4 mg
PERINDOPRILUM
STOPRESS 4 mg
PERINDOPRILUM
TREZEN 4 mg
PERINDOPRILUM
TREZEN 4 mg
PERINDOPRILUM
PRENESSA 4 mg
PERINDOPRILUM
PRINDEX 4 mg
PERINDOPRILUM
PERINDOPRIL TEVA 8 mg
PERINDOPRILUM
VIDOTIN 8 mg
PERINDOPRILUM
STOPRESS 8 mg
PERINDOPRILUM
TREZEN 8 mg
PERINDOPRILUM
TREZEN 8 mg
PERINDOPRILUM
PRINDEX 8 mg
PERINDOPRILUM
PRENESSA 8 mg
PERINDOPRILUM
PRESTARIUM 10 mg
PERINDOPRILUM
PERINDOPRIL TOSILAT TEVA 10 mg
PERINDOPRILUM
PRESTARIUM 5 mg
PERINDOPRILUM
PERINDOPRIL TOSILAT TEVA 5 mg
BENAZEPRILUM
CIBACEN (R) 20 mg
BENAZEPRILUM
CIBACEN (R) 5 mg
TRANDOLAPRILUM
GOPTEN (R) 0,5 mg
TRANDOLAPRILUM
GOPTEN (R) 2 mg
TRANDOLAPRILUM
GOPTEN (R) 4 mg
ZOFENOPRILUM
ZOMEN (R) 30 mg
ZOFENOPRILUM
ZOMEN (R) 7,5 mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) COTREZEN 2 mg/0,625 mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRINDEX PLUS 2 mg/0,625 mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 2mg/0,625 mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) COTREZEN 4 mg/1,25 mg
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
concentratie
0,3mg
0,3mg
0,4mg
0,4mg
0,4mg
COMPR.
1mg
COMPR.
1mg
COMPR. FILM. 25mg
COMPR. FILM. 50mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CAPS.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
COMPR.
COMPR.
Detinator APP
Tara det.
APP
Ambalaj
Prescriptie
cod ATC
127 C02AC05
Nr. crt
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
P6L
LES LABORATOIRES SERVIER
FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR.
P-6L
ROMANIA
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
MAREA BRITANIE
ACTAVIS S.R.L.
CUTIE X BLISTERE AL/AL (FOLIE AL CFF FORMATA LA RECE/FOLIE AL ACOPERITA LA CALD CU UN STRAT DE LAC) X 30 COMPRIMATE
P6L
ROMANIA
ANTIBIOTICE S.A. ROMANIA
CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L

CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L
CUTIE X 3 BLIST. PVC- PE- PVDC/AL X 10 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
2,5mg/6,25mg MERCK KGAA

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

P-6L
GERMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-6L
GLAXO OPERATIONS UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-6L
ROMANIA
ROMANIA
CUTIE CU BLIST. DIN PVC-PVDC/AL X 60 COMPR. FILM. P-6L
ISLANDA
CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L
GERMANIA CUTIE X 4 BLIST. AL/PVC X 15 COMPR.FILM.
ZENTIVA K.S.
REPUBLICA CEHA
P-6L
ISLANDA
ZENTIVA K.S.
REPUBLICA CEHA
CUTIE CU BLIST. AL/PVDC X 30 COMPR. FILM. P-6L

ROMANIA
ROMANIA
ISLANDA
ISLANDA
POLONIA CUTIE CU 1 BLIST. DIN PVC-PE-PVDC/AL X 30 COMPR. P-6L

TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 PUNGA DIN AL X 1 BLIST. PVC/VMCH-AL X 30 COMPR.
P-6L
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L
POLONIA CUTIE CU BLIST. ACLAR-PVC/AL X 30 COMPR. FILM. P-6L
TERAPIA S.A.
ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L
TERAPIA S.A.
KRKA POLSKA SP. Z.O.O. POLONIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 PUNGA DIN AL X 1 BLIST PVC/VMCH-AL X 30 COMPR. P-6L
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L
POLONIA CUTIE CU BLIST. ACLAR-PVC/AL X 30 COMPR. FILM. P-6L
TERAPIA S.A.
ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L
TERAPIA S.A.
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L
KRKA POLSKA SP Z O.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L
KRKA POLSKA SP. Z.O.O.
FRANTA
ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L
FRANTA
CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM.

CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM.
P-6L
P-6L
ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L

CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L
ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 10 CAPS.
P-6L
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

2 mg/0,625mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC/PVDC-AL IN AMBALAJ DE AL X 30 (30X1) COMPR. P6L
2mg/0,625mg KRKA POLSKA SP ZO.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L
4 mg/1,25 mg TERAPIA S.A.
ROMANIA CUTIE CU BLIST. AL/AL A CATE 30 COMPR. P6L
2 mg/0,625 mg
Pagina 3 din 16
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
30
28
30
28
28
30
30
30
30
28
30
30
30
28
30
30
28
28
30
30
30
30
30
14
60
30
30
60
30
30
30
60
30
30
60
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
28
28
20
28
28
28
28
30
30
30
30
0,697000
0,575000
0,772000
1,563998
0,928928
1,003000
0,651666
3,016791
4,889000
0,647142
0,363000
0,420666
0,420666
0,420357
0,229000
0,229000
0,420357
0,420357
0,420666
0,722000
0,722000
0,722000
0,722000
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,528598
0,528598
0,528598
0,528598
0,528598
0,148965
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,595863
0,595863
0,595863
0,595863
0,595863
0,595863
0,595863
0,744828
0,744828
0,372414
0,372414
0,794483
0,198620
0,074482
0,297931
0,595863
0,297931
0,074482
0,543333
0,559333
0,372333
0,748350
0,000000
0,000000
0,000000
0,038859
0,000000
0,000000
0,000000
1,716875
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,397129
0,165034
0,165034
0,165034
0,374867
0,165034
0,165034
0,165034
0,150068
0,173068
0,113402
0,515402
0,113402
0,224035
0,342069
0,079735
0,216735
0,596735
0,596735
0,190069
0,097069
0,221137
0,094470
0,314803
1,103137
1,103137
0,028803
0,214137
0,950172
0,120172
0,617252
0,271252
1,324088
0,584594
0,310018
0,314926
0,581279
1,250640
0,655160
0,000000
0,000000
0,000000
0,088983
0,348500
0,287500
0,386000
0,781999
0,464464
0,501500
0,325833
1,508395
2,444500
0,323571
0,181500
0,210333
0,210333
0,210178
0,114500
0,114500
0,210178
0,210178
0,210333
0,361000
0,361000
0,361000
0,361000
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,264299
0,264299
0,264299
0,264299
0,264299
0,074482
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,372414
0,372414
0,186207
0,186207
0,397241
0,099310
0,037241
0,148965
0,297931
0,148965
0,037241
0,271666
0,279666
0,186166
0,374175
0,348500
0,287500
0,386000
0,820858
0,464464
0,501500
0,325833
3,225271
2,444500
0,323571
0,181500
0,210333
0,210333
0,210179
0,114500
0,114500
0,210179
0,210179
0,210333
0,361000
0,361000
0,361000
0,361000
0,529279
0,297184
0,297184
0,297184
0,507017
0,297184
0,297184
0,297184
0,414367
0,437367
0,377701
0,779701
0,377701
0,298518
0,491035
0,228701
0,365701
0,745701
0,745701
0,339035
0,246035
0,519069
0,392402
0,612735
1,401069
1,401069
0,326735
0,512069
1,322586
0,492586
0,803459
0,457459
1,721330
0,683904
0,347259
0,463892
0,879211
1,399606
0,692401
0,271667
0,279667
0,186167
0,463158
0,627300
0,517500
0,694800
1,407598
0,836035
0,902700
0,586499
2,715111
4,400100
0,582427
0,326700
0,378599
0,378599
0,378321
0,206100
0,206100
0,378321
0,378321
0,378599
0,649800
0,649800
0,649800
0,649800
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,475738
0,475738
0,475738
0,475738
0,475738
0,134068
0,268137
0,268137
0,268137
0,268137
0,268137
0,268137
0,268137
0,536276
0,536276
0,536276
0,536276
0,536276
0,536276
0,536276
0,670345
0,670345
0,335172
0,335172
0,715034
0,178758
0,067033
0,268137
0,536276
0,268137
0,067033
0,488999
0,503399
0,335099
0,673515
0,069700
0,057500
0,077200
0,195259
0,092893
0,100300
0,065167
2,018555
0,488900
0,064715
0,036300
0,042067
0,042067
0,042036
0,022900
0,022900
0,042036
0,042036
0,042067
0,072200
0,072200
0,072200
0,072200
0,423559
0,191464
0,191464
0,191464
0,401297
0,191464
0,191464
0,191464
0,202928
0,225928
0,166262
0,568262
0,166262
0,238932
0,371863
0,109529
0,246529
0,626529
0,626529
0,219863
0,126863
0,280724
0,154057
0,374390
1,162724
1,162724
0,088390
0,273724
1,024655
0,194655
0,654494
0,308494
1,403537
0,604456
0,317467
0,344720
0,640866
1,280434
0,662609
0,054334
0,055934
0,037234
0,163818
cod ATC
DCI
Denumire Comerciala
193 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRINDEX

194 C09BA04
195 C09BA04
196 C09BA04
197 C09BA04
198 C09BA04
PLUS 4 mg/1,25mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PANINDORIL 4 mg/1,25 mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 4mg/1,25 mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 8 mg/2,5mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLITERAX 10 mg/2,5mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLIPREL ARG 2,5mg/0,625mg
199 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM)PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 2,5 mg/0,625 mg

200 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLIPREL
ARG FORTE 5mg/1,25mg
201 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM)PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 5 mg/1,25 mg
ACCUZIDE
ACCUZIDE FORTE
ENEAS
COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 4 mg/10 mg
COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/2 mg
COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/4 mg
COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA
VALSARTANUM
VALSARTAN TEVA 160 mg
VALSARTANUM
VALSARTANUM
WENZELL 160 mg
VALSARTANUM
WENZELL 160 mg
VALSARTANUM
VALSARGAMMA 160 mg
VALSARTANUM
DIOVAN 160 mg
VALSARTANUM
VALSACOR 160 mg
VALSARTANUM
AVASSAN 160 mg
VALSARTANUM
VALSARTAN ZENTIVA 160 mg
VALSARTANUM
VAPRESS 160 mg
VALSARTANUM
VAPRESS 160 mg
VALSARTANUM
DIOVAN 40 mg
VALSARTANUM
AVASSAN 40 mg
VALSARTANUM
VAPRESS 40 mg
VALSARTANUM
VAPRESS 40 mg
VALSARTANUM
WENZELL 80 mg
VALSARTANUM
WENZELL 80 mg
VALSARTANUM
VALSARGAMMA 80 mg
VALSARTANUM
DIOVAN 80 mg
VALSARTANUM
VALSACOR 80 mg
VALSARTANUM
AVASSAN 80 mg
VALSARTANUM
VALSARTANUM
VAPRESS 80 mg
VALSARTANUM
VAPRESS 80 mg
VALSARTANUM
DIOVAN 3 mg/ml
IRBESARTANUM
IRBESARTAN AUROBINDO 150 mg
IRBESARTANUM
IRBESARTANUM
IRBESARTAN GALENICA 150 mg
IRBESARTANUM
APROVEL 150mg
IRBESARTANUM
IRBESARTAN TERAPIA 150 mg
IRBESARTANUM
IRBESARTAN SANDOZ 150 mg
IRBESARTANUM
IRPRESTAN 150 mg
IRBESARTANUM
IFIRMASTA 150 mg
IRBESARTANUM
IRBESARTAN TEVA 150 mg
IRBESARTANUM
ATOKKEN 150 mg
IRBESARTANUM
IRBESARTAN ZENTIVA 150mg
IRBESARTANUM
IRBESARTAN HF 150 mg
IRBESARTANUM
APROVEL 150mg
IRBESARTANUM
ATOKKEN 150 mg
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
APROVEL 300mg
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IFIRMASTA 300mg
IRBESARTANUM
ATOKKEN 300 mg
IRBESARTANUM
202 C09BA06
COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM)
203 C09BA06
COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM)
204 C09BB02 COMBINATII (NITRENDIPINUM+ENALAPRILUM)

205 C09BB04
206 C09BB04
207 C09BB04
208 C09BB04
209 C09BB10
210 C09BB10
211 C09BB10
212 C09CA03
213 C09CA03
214 C09CA03
215 C09CA03
216 C09CA03
217 C09CA03
218 C09CA03
219 C09CA03
220 C09CA03
221 C09CA03
222 C09CA03
223 C09CA03
224 C09CA03
225 C09CA03
226 C09CA03
227 C09CA03
228 C09CA03
229 C09CA03
230 C09CA03
231 C09CA03
232 C09CA03
233 C09CA03
234 C09CA03
235 C09CA03
236 C09CA03
237 C09CA04
238 C09CA04
239 C09CA04
240 C09CA04
241 C09CA04
242 C09CA04
243 C09CA04
244 C09CA04
245 C09CA04
246 C09CA04
247 C09CA04
248 C09CA04
249 C09CA04
250 C09CA04
251 C09CA04
252 C09CA04
253 C09CA04
254 C09CA04
255 C09CA04
256 C09CA04
257 C09CA04
258 C09CA04
forma farm.
concentratie
Detinator APP
COMPR.
COMPR.
COMPR.
COMPR.
4 mg/1,25mg GLENMARK PHARMACEUTICALS S.R.O.

4mg/1, 25mg SANDOZ S.R.L.
4mg/1,25mg KRKA POLSKA SP ZO.O.
8mg/2,5mg KRKA-POLSKA SP. Z O.O.
COMPR. FILM. 10mg/2,5mg LES LAB. SERVIER
Prescriptie
Nr. crt
Tara det.
APP
Ambalaj
P6L
ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L
POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L
POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L
REPUBLICA CEHA CUTIE CU 1 BLIST. PVC/PVDC-AL IN AMBALAJ DE AL X 30 (30X1) COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
2,5mg/0,625mg
FRANTA
FRANTA
2,5mg/0,625mg
ROMANIA CUTIE CU 1 FLAC. DIN PP X 30 COMPR. FILM. P6L
5mg/1,25mg
5mg/1,25mg
FRANTA
ROMANIA CUTIE CU 1 FLAC. DIN PP X 30 COMPR. FILM. P6L
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
20mg+10mg
4mg/10mg
4mg/5mg
8mg/10mg
8mg/5mg
240mg/2mg
240mg/4mg
180mg/2mg
160mg
80mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
40mg
40mg
40mg
40mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
3mg/ml
150mg
300mg
150 mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
300 mg
300 mg
300mg
300mg
300mg
300mg
300mg
300mg
COMPR. CU ELIB. MODIF.

COMPR.FILM.ELIB.MODIF.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
SOL. ORALA
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
10mg/12,5mg PFIZER EUROPE MA EEIG

20mg/12,5mg PFIZER EUROPE MA EEIG
GALENICA S.A.
CUTIE X 1 FLAC. DIN PP CU CAPAC PEJD CU SILICAGEL X 30 COMPR. FILM. P-6L
CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM.
CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM.
P-6L
P-6L
MAREA BRITANIE
CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM.
P-6L
MAREA BRITANIE
CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM.
P-6L
GRECIA
CUTIE X 3 BLIST. PA-PVC-AL/AL X 10 COMPR. P-6L
KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
P6L
P6L
P6L
P6L

ABBOTT GMBH & CO.KG GERMANIA
CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF.
ABBOTT GMBH & CO.KG GERMANIA
CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF.
P6L
P6L
ABBOTT GMBH&CO.KG GERMANIA
CUTIE X 2 BLIST. AL/PVDC-PVC X 14 COMPR. FILM. CU ELIB. PREL.
P-6L
ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS.

ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS.
ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 28 COMPR. FILM.
ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 30 COMPR. FILM.

GERMANIA
P-6L
P-6L
P-6L
P-6L
P6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L
SLOVENIA
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM.
P6L
TERAPIA S.A.
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L
ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM.
P-6L
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM. P6L
TERAPIA S.A.
ROMANIA
P6L
P6L
ROMANIA
ROMANIA
CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 28 COMPR. FILM.
P-6L
ROMASTRU TRADING S.R.L.
P-6L
GERMANIA
P6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM.
P6L
P6L
P6L
SLOVENIA
CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L
TERAPIA S.A.
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM.
P-6L
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L
CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML )
P-6L
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
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L

GALENICA S.A.

CUTIE CU BLIST. PVC/PVDC/AL A CATE 28 COMPR. FILM.
KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PE/PVDC/AL X 28 COMPR. FILM.
TEVA PHARMA B.V. OLANDA

FRANTA
P-6L
P-6L
CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P-6L
ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.

SANOFI-AVENTIS GROUPE
P6L
CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L
P6L
CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L
STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
SANOFI CLIR SNC
FRANTA

GALENICA S.A.
GRECIA
FRANTA
TERAPIA S.A.
ROMANIA
SANDOZ S.R.L.
ROMANIA

P6L
CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P-6L

P6L

CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L
P-6L
P-6L
ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.
P6L
SANOFI-AVENTIS GROUPE
FRANTA
Pagina 4 din 16
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
28
28
28
28
28
28
30
30
28
28
28
28
28
28
28
28
28
28
28
30
30
28
28
28
28
28
28
1
28
28
28
28
28
28
30
28
28
28
28
30
28
28
28
28
28
28
28
28
28
28
0,748350
0,703000
0,694000
0,748350
0,748350
0,748350
0,339333
0,748350
0,679666
0,536666
0,748350
2,927000
0,732000
0,505253
1,010506
0,729810
1,829285
1,829285
1,829285
0,459642
0,409285
1,070357
1,070333
0,761333
1,411263
0,534285
1,070357
0,561785
0,772142
0,772142
0,352815
0,352815
0,352815
0,352815
0,705631
0,705631
0,611666
0,705631
0,437857
0,705631
0,522857
0,385714
0,385714
4,233791
0,368571
0,516071
0,368571
0,705631
0,705631
0,616785
0,299333
0,537500
0,597500
0,705631
0,567500
0,705631
0,705631
0,705631
0,812142
0,576785
1,411263
1,075357
0,802500
0,863571
1,075357
0,887142
0,009650
0,000000
0,000000
0,249983
1,026983
0,580650
0,000000
0,419650
0,000000
0,000000
0,234650
0,000000
0,000000
0,159747
0,172827
0,389190
0,225357
0,864286
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,182665
0,000000
0,000000
0,000000
0,000000
0,000000
2,215399
1,226827
0,060399
0,060399
0,097226
0,097035
0,000000
0,489369
0,000000
0,097226
0,000000
0,000000
0,000000
37,186209
0,000000
0,000000
0,000000
0,500083
0,077940
0,000000
0,000000
0,000000
0,000000
0,077940
0,000000
0,054369
0,500083
0,077940
0,000000
0,000000
0,189451
0,000000
0,000000
0,000000
0,000000
0,000000
0,374175
0,351500
0,347000
0,374175
0,374175
0,374175
0,169666
0,374175
0,339833
0,268333
0,374175
1,463500
0,366000
0,252626
0,505253
0,364905
0,914642
0,914642
0,914642
0,229821
0,204642
0,535178
0,535166
0,380666
0,705631
0,267142
0,535178
0,280892
0,386071
0,386071
0,176407
0,176407
0,176407
0,176407
0,352815
0,352815
0,305833
0,352815
0,218928
0,352815
0,261428
0,192857
0,192857
2,116895
0,184285
0,258035
0,184285
0,352815
0,352815
0,308392
0,149666
0,268750
0,298750
0,352815
0,283750
0,352815
0,352815
0,352815
0,406071
0,288392
0,705631
0,537678
0,401250
0,431785
0,537678
0,443571
0,383825
0,351500
0,347000
0,624158
1,401158
0,954825
0,169667
0,793825
0,339833
0,268333
0,608825
1,463500
0,366000
0,412374
0,678080
0,754095
1,140000
1,778929
0,914643
0,229821
0,204643
0,535179
0,535167
0,380667
0,888297
0,267143
0,535179
0,280893
0,386071
0,386071
2,391807
1,403235
0,236807
0,236807
0,450042
0,449851
0,305833
0,842185
0,218929
0,450042
0,261429
0,192857
0,192857
39,303105
0,184286
0,258036
0,184286
0,852899
0,430756
0,308393
0,149667
0,268750
0,298750
0,430756
0,283750
0,407185
0,852899
0,430756
0,406071
0,288393
0,895083
0,537679
0,401250
0,431786
0,537679
0,443571
0,673515
0,632700
0,624600
0,673515
0,673515
0,673515
0,305399
0,673515
0,611699
0,482999
0,673515
2,634300
0,658800
0,454727
0,909455
0,656829
1,646356
1,646356
1,646356
0,413677
0,368356
0,963321
0,963299
0,685199
1,270136
0,480856
0,963321
0,505606
0,694927
0,694927
0,317533
0,317533
0,317533
0,317533
0,635067
0,635067
0,550499
0,635067
0,394071
0,635067
0,470571
0,347142
0,347142
3,810411
0,331713
0,464463
0,331713
0,635067
0,635067
0,555106
0,269399
0,483750
0,537750
0,635067
0,510750
0,635067
0,635067
0,635067
0,730927
0,519106
1,270136
0,967821
0,722250
0,777213
0,967821
0,798427
0,084485
0,070300
0,069400
0,324818
1,101818
0,655485
0,033934
0,494485
0,067967
0,053667
0,309485
0,292700
0,073200
0,210273
0,273878
0,462171
0,408286
1,047215
0,182929
0,045965
0,040929
0,107036
0,107034
0,076134
0,323792
0,053429
0,107036
0,056179
0,077215
0,077215
2,250681
1,262109
0,095681
0,095681
0,167790
0,167599
0,061167
0,559933
0,043786
0,167790
0,052286
0,038572
0,038572
37,609589
0,036858
0,051608
0,036858
0,570647
0,148504
0,061679
0,029934
0,053750
0,059750
0,148504
0,056750
0,124933
0,570647
0,148504
0,081215
0,057679
0,330578
0,107536
0,080250
0,086358
0,107536
0,088715
cod ATC
DCI
Denumire Comerciala
312 C09DA01
313 C09DA03
COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM)VALSARTAN HIDROCLOROTIAZIDA TORRENT 160 mg/12,5 mg
314 C09DA03
COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM)VALSARTAN HIDROCLOROTIAZIDA TORRENT 80 mg/12,5 mg
260 C09CA04
261 C09CA04
262 C09CA04
263 C09CA06
264 C09CA06
265 C09CA06
266 C09CA06
267 C09CA06
268 C09CA06
269 C09CA06
270 C09CA06
271 C09CA06
272 C09CA06
273 C09CA06
274 C09CA06
275 C09CA06
276 C09CA06
277 C09CA06
278 C09CA06
279 C09CA06
280 C09CA06
281 C09CA06
282 C09CA06
283 C09CA06
284 C09CA06
285 C09CA06
286 C09CA06
287 C09CA06
288 C09CA06
289 C09CA06
290 C09CA06
291 C09CA06
292 C09CA07
293 C09CA07
294 C09CA07
295 C09CA07
296 C09CA07
297 C09CA07
298 C09CA07
299 C09CA07
300 C09CA07
301 C09CA07
302 C09CA07
303 C09CA07
304 C09CA07
305 C09CA07
306 C09CA07
307 C09CA07
308 C09CA07
309 C09CA07
310 C09CA07
311 C09DA01
315 C09DA04
316 C09DA04
317 C09DA04
318 C09DA04
319 C09DA04
320 C09DA04
321 C09DA04
322 C09DA04
323 C09DA04
324 C09DA04
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
CANDESARTANUM CILEXETIL
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
forma farm.
COMPR. FILM.
APROVEL 300mg
COMPR. FILM.
ATOKKEN 300 mg
COMPR. FILM.
ATOKKEN 75 mg
COMPR. FILM.
ATACAND
COMPR.
TANDESAR 16 mg
COMPR.
CANDESARTAN SANDOZ 16 mg
COMPR.
KARBIS 16 mg
COMPR.
CANDESARTAN TORRENT 16 mg
COMPR.
ATACAND 16mg
COMPR.
CANZENO 16mg
COMPR.
CANDESARTAN LABORMED 16 mg
COMPR.
CANDESARTAN AUROBINDO 16 mg
COMPR.
CADEXYL 16 mg
COMPR.
CANDESARTAN CILEXETIL MCC 16 mg COMPR.
ATACAND 32 mg
COMPR.
KARBIS 32 mg
COMPR.
COMPR.
ATACAND 32 mg
COMPR.
CANZENO 32mg
COMPR.
CADEXYL 32 mg
COMPR.
ATACAND
COMPR.
TANDESAR 8 mg
COMPR.
COMPR.
KARBIS 8 mg
COMPR.
COMPR.
ATACAND 8mg
COMPR.
CANZENO 8mg
COMPR.
COMPR.
COMPR.
CADEXYL 8 mg
COMPR.
TELMISARTAN ACTAVIS 40mg
COMPR.
TOLURA 40 mg
COMPR.
TEZEO 40 mg
COMPR.
TELMISARTAN TEVA 40 mg
COMPR.
TELMISARTAN RANBAXY 40 mg
COMPR.
TELMISARTAN ACTAVIS 80mg
COMPR.
MICARDIS 80 mg
COMPR.
TOLURA 80 mg
COMPR.
TEZEO 80 mg
COMPR.
TELMISARTAN TEVA 80 mg
COMPR.
TELMISARTAN RANBAXY 80 mg
COMPR.
TELMARK 40 mg
COMPR. FILM.
TANYDON 40 mg
COMPR. FILM.
TELMISARTAN EGIS 40 mg
COMPR. FILM.
TELMOTENS 40mg
COMPR. FILM.
TELMARK 80 mg
COMPR. FILM.
TANYDON 80 mg
COMPR. FILM.
TELMISARTAN EGIS 80 mg
COMPR. FILM.
TELMOTENS 80mg
COMPR. FILM.
COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA HL 100 mg/12,5 mg
COMPR.FILM
COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA H
COMPR.FILM
259 C09CA04
concentratie
300mg
300mg
300mg
75mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
32mg
32mg
32mg
32mg
32mg
32mg
32mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
40 mg
40mg
40mg
40mg
40mg
80 mg
80mg
80mg
80mg
80mg
80mg
40mg
40mg
40mg
40mg
80mg
80mg
80mg
80mg
Detinator APP
Tara det.
APP
Ambalaj
Prescriptie
Nr. crt
STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
SANOFI CLIR SNC
FRANTA


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

TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-6L
SANDOZ SRL
SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
P6L
ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L

ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14COMPR.
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

TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L

ZENTIVA K.S.

TERAPIA SA
SANDOZ SRL

P6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.

ZENTIVA K.S.
LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR.
MALTA
P6L

ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L
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
MAREA BRITANIE
CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. P6L
ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L
GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC)
P-6L
SLOVENIA CUTIE CU BLIST.OPA-AL-PVC/AL X 28 COMPR.
P-6L
ZENTIVA, K.S.
REPUBLICA CEHA
CUTIE CU BLIST. AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE 30X1
MAREA BRITANIE
P-6L
ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM.

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

ALVOGEN IPCO S.AR.L.
100mg/12,5mg KRKA D.D. NOVO MESTO

50mg+ 12,50mg KRKA D.D. NOVO MESTO
COMPR. FILM. 160mg/12,5mg TORRENT PHARMA S.R.L.

COMPR. FILM. 80mg/12,5mg TORRENT PHARMA S.R.L.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg
COMPR.
150mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB
COMPR.
300mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 150mg/12,5mg COMPR. FILM 150mg/12,5mg SANOFI-AVENTIS GROUPE
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5mg COMPR. FILM 300mg/12,5mg SANOFI-AVENTIS GROUPE
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN/ HYDROCHLOROTHIAZIDE TEVA 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg TEVA PHARMA B.V.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IFIRMACOMBI 150mg/12,5mg
COMPR. FILM. 150mg/12,5mg KRKA D.D. NOVO MESTO
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg RANBAXY (U.K.) LIMITED
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg RANBAXY (U.K.) LIMITED
COMPR. FILM. 150mg/12,5mg SANOFI CLIR SNC
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 150 mg/12,5 mg
COMPR. FILM. 150mg/12,5mg MEDOCHEMIE LTD
CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L
ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L

UNGARIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L
LUXEMBURG CUTIE CU 3 BLIST. NYLON-AL-PVC/AL X 10 COMPR. FILM. P6L
SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L
SLOVENIA CUTIE X 2 BLIST. DIN PVC-PVDC/AL X 14 COMPR. FILM. P-6L
FRANTA
FRANTA
FRANTA
FRANTA
OLANDA
SLOVENIA
CUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM.
MAREA BRITANIE

CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L
CUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM. P-6L
CUTIE X BLIST. AL/AL X 28 COMPR. FILM.
P-6L
MAREA BRITANIE
P6L
P6L
CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. P6L
FRANTA
CIPRU
CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM.
Pagina 5 din 16
P6L
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
30
28
28
28
28
28
28
30
30
28
30
28
30
28
30
28
30
30
28
30
28
30
28
28
28
30
30
28
30
28
30
28
30
28
28
30
30
28
28
28
28
30
30
28
28
30
28
30
28
30
28
30
28
28
28
28
28
28
28
28
28
30
28
28
28
28
1,036000
1,411263
1,075357
0,352815
1,411263
1,062500
0,998928
1,062000
0,700000
1,411263
0,866000
1,062142
1,012333
1,062500
1,062000
2,229285
1,449000
0,603000
2,229285
0,963000
1,357857
1,449000
0,705631
0,531071
0,531071
0,531000
0,531000
0,705631
0,531000
0,531071
0,531000
0,531071
0,531000
0,546428
0,593214
0,594666
0,705631
0,705631
0,914642
1,411263
0,861785
0,788000
0,976333
0,976785
0,593214
0,705631
0,547500
0,705631
0,914642
0,976333
0,892500
0,976333
0,618571
0,455000
0,684031
0,684031
0,684031
0,684031
0,610714
0,684031
0,659642
0,370666
0,684031
0,684031
0,684031
0,684031
0,000000
0,189451
0,000000
0,503613
0,170522
0,000000
0,000000
0,000000
0,000000
0,170522
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,111511
0,000000
0,000000
0,000000
0,000000
0,111511
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,097035
0,756154
0,000000
0,042665
0,000000
0,000000
0,000000
0,000000
0,000000
0,386702
0,000000
0,703369
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
2,375969
1,953469
0,502397
0,765969
0,000000
0,289897
0,000000
0,000000
0,087040
0,087040
0,502397
0,087040
0,518000
0,705631
0,537678
0,176407
0,705631
0,531250
0,499464
0,531000
0,350000
0,705631
0,433000
0,531071
0,506166
0,531250
0,531000
1,114642
0,724500
0,301500
1,114642
0,481500
0,678928
0,724500
0,352815
0,265535
0,265535
0,265500
0,265500
0,352815
0,265500
0,265535
0,265500
0,265535
0,265500
0,273214
0,296607
0,297333
0,352815
0,352815
0,457321
0,705631
0,430892
0,394000
0,488166
0,488392
0,296607
0,352815
0,273750
0,352815
0,457321
0,488166
0,446250
0,488166
0,309285
0,227500
0,342015
0,342015
0,342015
0,342015
0,305357
0,342015
0,329821
0,185333
0,342015
0,342015
0,342015
0,342015
0,518000
0,895083
0,537679
0,680021
0,876154
0,531250
0,499464
0,531000
0,350000
0,876154
0,433000
0,531071
0,506167
0,531250
0,531000
1,114643
0,724500
0,301500
1,114643
0,481500
0,678929
0,724500
0,464327
0,265536
0,265536
0,265500
0,265500
0,464327
0,265500
0,265536
0,265500
0,265536
0,265500
0,273214
0,296607
0,297333
0,449851
1,108970
0,457321
0,748297
0,430893
0,394000
0,488167
0,488393
0,296607
0,739518
0,273750
1,056185
0,457321
0,488167
0,446250
0,488167
0,309286
0,227500
2,717985
2,295485
0,844413
1,107985
0,305357
0,631913
0,329821
0,185333
0,429056
0,429056
0,844413
0,429056
0,932400
1,270136
0,967821
0,317533
1,270136
0,956250
0,899035
0,955800
0,630000
1,270136
0,779400
0,955927
0,911099
0,956250
0,955800
2,006356
1,304100
0,542700
2,006356
0,866700
1,222071
1,304100
0,635067
0,477963
0,477963
0,477900
0,477900
0,635067
0,477900
0,477963
0,477900
0,477963
0,477900
0,491785
0,533892
0,535199
0,635067
0,635067
0,823177
1,270136
0,775606
0,709200
0,878699
0,879106
0,533892
0,635067
0,492750
0,635067
0,823177
0,878699
0,803250
0,878699
0,556713
0,409500
0,615627
0,615627
0,615627
0,615627
0,549642
0,615627
0,593677
0,333599
0,615627
0,615627
0,615627
0,615627
0,103600
0,330578
0,107536
0,538895
0,311649
0,106250
0,099893
0,106200
0,070000
0,311649
0,086600
0,106215
0,101234
0,106250
0,106200
0,222929
0,144900
0,060300
0,222929
0,096300
0,135786
0,144900
0,182075
0,053108
0,053108
0,053100
0,053100
0,182075
0,053100
0,053108
0,053100
0,053108
0,053100
0,054643
0,059322
0,059467
0,167599
0,826718
0,091465
0,183792
0,086179
0,078800
0,097634
0,097679
0,059322
0,457266
0,054750
0,773933
0,091465
0,097634
0,089250
0,097634
0,061858
0,045500
2,444373
2,021873
0,570801
0,834373
0,061072
0,358301
0,065965
0,037067
0,155444
0,155444
0,570801
0,155444
cod ATC
325 C09DA04
326 C09DA04
327 C09DA04
328 C09DA04
329 C09DA04
330 C09DA04
331 C09DA04
332 C09DA04
333 C09DA04
334 C09DA04
335 C09DA04
336 C09DA04
337 C09DA04
338 C09DA04
339 C09DA04
forma farm.
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN/ HYDROCHLOROTHIAZIDE TEVA 300 mg/12,5 mg COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IFIRMACOMBI 300mg/12,5mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/12,5 mg COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/12,5 mg COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/25mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IFIRMACOMBI 300mg/25mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mg COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mg COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/25mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/25 mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/25 mg
COMPR. FILM.
DCI
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)
Denumire Comerciala
concentratie
CONVERIDE 150 mg/12,5 mg
150mg/12,5mg
340 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT)
CANDESARTAN HIDROCLOROTIAZIDA TORRENT 16 mg/12,5 mg
345 C09DA07
COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)
346 C09DA07
347 C09DA07
348 C09DA07
349 C09DA07
350 C09DA07
351 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
352 C09DA07
TELMISARTAN/HIDROCLOROTIAZIDA EGIS 80 mg/12,5 mg
353 C09DA07
354 C09DA07
355 C09DA07
COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mg
356 C09DA07
COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mg
357 C09DA07
358 C09DA07
359 C09DA07
360 C09DA07
COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mg
361 C09DA07
COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mg

362 C09DB01 COMBINATII ( VALSARTANUM+AMLODIPINUM)

365 C09DB02
COMBINATII(OLMESARTAN MEDOXOMIL+ AMLODIPINA)
366 C09DB02
367 C09DB02
368 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT)

372 C10AA04
373 C10AA04
374 C10AA04
375 C10AA05
376 C10AA05
377 C10AA05
378 C10AA05
379 C10AA05
380 C10AA05
381 C10AA05
382 C10AA05
383 C10AA05
384 C10AA05
385 C10AA05
386 C10AA05
387 C10AA05
388 C10AA05
389 C10AA05
390 C10AA05
FLUVASTATINUM
FLUVASTATINUM
FLUVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
TEZEO HCT 80 mg/12,5 mg

TELMARK PLUS 80mg/12,5mg
TANYDON HCT 80 mg/25 mg

TEZEO HCT 80 mg/25 mg
TELMARK PLUS 80mg/25mg
EXFORGE 10mg/160mg
EXFORGE 5mg/160mg
EXFORGE 5mg/80mg
SEVIKAR 20 mg/5 mg
SEVIKAR 40 mg/10 mg
SEVIKAR 40 mg/5 mg
EXFORGE HCT
EXFORGE HCT
EXFORGE HCT
EXFORGE HCT
LESCOL 20 mg
LESCOL 40 mg
LESCOL XL 80 mg
TORVALIPIN 10 mg
SORTIS 10 mg
TORVACARD 10 mg
ATORIS 10 mg
GLETOR 10 mg
ASCORD 10 mg
ATORGAMMA 10 mg
TORVAZIN 10 mg
XAMARA 10 mg
VOREDANIN 10 mg
ATORVASTATIN RANBAXY 10 mg
ATORVASTATINA TEVA 10 mg
STAVRA 10 mg
ATORVASTATINA TORRENT 10 mg
ATORVASTATINA AUROBINDO 10 mg
TORVALIPIN 20 mg
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CAPS.
CAPS.
COMPR. ELIB. PREL.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
300 mg/12,5mg
Detinator APP
Tara det.
APP
MEDOCHEMIE LTD CIPRU

300mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA

300mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE
300mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE
300mg/12,5mg SANOFI CLIR SNC FRANTA
300mg/12,5mg MEDOCHEMIE LTD CIPRU
300mg/12,5mg MEDOCHEMIE LTD CIPRU
300mg/25mg
300mg/25mg
300mg/25mg
300mg/25mg
300mg/25mg
300mg/25mg
300mg/25mg
16mg/12,5mg
16mg/12,5mg
8mg/12,5mg
8mg/12,5mg
8mg/12,5mg
Ambalaj
Prescriptie
Nr. crt
CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM.
P6L
CUTIE X BLIST. AL/AL X 28 COMPR. FILM.
P-6L
P6L
P6L

P6L
P6L
FRANTA
SLOVENIA
MAREA BRITANIE
MAREA BRITANIE
P6L
P6L
SANOFI CLIR SNC FRANTA

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

SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE
80 mg/25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATE
80/12,5mg
GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC)
80/25mg
GERMANIA CUTIE X 28 COMPR. (BLIST. PA/AL/PVC/AL SAU PA/PA/AL/PVC/AL)
80mg/12,5mg GEDEON RICHTER ROMANIA SA

80mg/12,5mg EGIS PHARMACEUTICALS P.L.C.
80mg/12,5mg ZENTIVA, K.S.
80mg/12,5mg GLENMARK PHARMACEUTICALS S.R.O.
80mg/12,5mg TERAPIA S.A.
80mg/12,5mg TERAPIA S.A.
80mg/25mg
80mg/25mg
80mg/25mg
80mg/25mg
80mg/25mg
10mg/160mg
5mg/160mg
5mg/80mg
20mg/5mg
40mg/10mg
40mg/5mg
ZENTIVA, K.S.
PRF
PRF
PRF
P-6L
P-6L
ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L

UNGARIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L
REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
P6L
REPUBLICA CEHA
CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATE
P-6L

ROMANIA CUTIE CU BLIST. AL/AL X 28X1 COMPR. P6L
REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
P6L
CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATE
P-6L
TERAPIA S.A.
TERAPIA S.A.

ROMANIA CUTIE CU BLIST. AL/AL X 28X1 COMPR. P6L
NOVARTIS EUROPHARM LTD.
MAREA BRITANIE
CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC )
MAREA BRITANIE
CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC )
MAREA BRITANIE
CUTIE X 56 COMPR. FILM.(BLIST.PVC/PVDC ) P-6L
TERAPIA S.A.
TERAPIA S.A.
TERAPIA S.A.
ROMANIA
ROMANIA
ROMANIA
P-6L
P-6L
P6L
P6L
P6L
10mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM.
PRF
10mg/160mg/25 mg NOVARTIS EUROPHARM LTD.
MAREA BRITANIE
CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF
MAREA BRITANIE
5mg/160mg/25 mg NOVARTIS EUROPHARM LTD.
MAREA BRITANIE
5mg/160mg/12,5 mg
20mg
40mg
80mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
20 mg

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

CUTIE X 4 BLIST. AL/AL X 7 CAPS.
P-6L
P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. AL/AL X 28 (4X7) COMPR. ELIB. PREL. P-6L
ISLANDA
CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM.
P-6L
MAREA BRITANIE
P-6L
ZENTIVA K.S.
CEHIA
CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L
SLOVENIA
CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM.
P-6L
P-6L
TERAPIA SA
ROMANIA
CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM.
P-6L
GERMANIA
P-6L
UNGARIA
DR. REDDY'S LABORATORIES ROMANIA
P-6L
P-6L
P6L
P6L
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L
ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L
CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L
MAREA BRITANIE
ISLANDA
Pagina 6 din 16
P-6L
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
28
28
30
28
28
28
28
28
28
30
28
28
28
28
28
28
30
30
30
30
28
30
30
28
28
28
30
28
30
30
28
28
30
30
30
28
28
56
56
56
28
28
28
28
28
28
28
28
28
28
30
30
30
30
30
30
30
30
30
30
30
28
30
30
30
30
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,661428
0,684031
0,441333
0,441333
0,441333
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
3,194642
3,003750
1,669285
1,669285
3,338570
3,004713
3,125344
3,339410
3,039719
3,167500
0,250191
0,500383
0,967500
0,129333
0,375287
0,277000
0,365666
0,375287
0,375287
0,215666
0,375287
0,375287
0,375287
0,222333
0,183928
0,375287
0,375287
0,236333
0,227000
0,087040
0,289897
0,004302
0,289897
0,289897
0,765969
0,289897
0,289897
0,768111
0,064969
0,291683
0,291683
0,768111
0,290969
0,290969
0,000000
0,050969
0,000000
0,000000
0,000000
0,410611
0,324302
0,324302
0,413826
0,950969
0,950969
0,324302
0,405611
0,006302
0,412635
0,414183
0,414183
0,324302
0,412969
0,414635
0,414183
0,414183
0,000000
0,000000
1,524643
1,770357
0,431787
0,434929
0,243584
0,029518
0,127781
0,000000
0,341951
0,470331
0,000000
0,000000
0,712046
0,000000
0,000000
0,131046
0,331379
0,000000
0,274046
0,331379
0,296379
0,000000
0,000000
0,331379
0,331379
0,000000
0,000000
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,330714
0,342015
0,220666
0,220666
0,220666
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
1,597321
1,501875
0,834642
0,834642
1,669285
1,502356
1,562672
1,669705
1,519859
1,583750
0,125095
0,250191
0,483750
0,064666
0,187643
0,138500
0,182833
0,187643
0,187643
0,107833
0,187643
0,187643
0,187643
0,111166
0,091964
0,187643
0,187643
0,118166
0,113500
0,429056
0,631913
0,346318
0,631913
0,631913
1,107985
0,631913
0,631913
1,110127
0,406985
0,633699
0,633699
1,110127
0,632985
0,632985
0,330714
0,392985
0,220667
0,220667
0,220667
0,752627
0,666318
0,666318
0,755842
1,292985
1,292985
0,666318
0,747627
0,348318
0,754651
0,756199
0,756199
0,666318
0,754985
0,756651
0,756199
0,756199
1,597321
1,501875
2,359286
2,605000
2,101072
1,937286
1,806256
1,699223
1,647641
1,583750
0,467047
0,720523
0,483750
0,064667
0,899690
0,138500
0,182833
0,318690
0,519023
0,107833
0,461690
0,519023
0,484023
0,111167
0,091964
0,519023
0,519023
0,118167
0,113500
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,595285
0,615627
0,397199
0,397199
0,397199
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
2,875177
2,703375
1,502356
1,502356
3,004713
2,704241
2,812809
3,005469
2,735747
2,850750
0,225171
0,450344
0,870750
0,116399
0,337758
0,249300
0,329099
0,337758
0,337758
0,194099
0,337758
0,337758
0,337758
0,200099
0,165535
0,337758
0,337758
0,212699
0,204300
0,155444
0,358301
0,072706
0,358301
0,358301
0,834373
0,358301
0,358301
0,836515
0,133373
0,360087
0,360087
0,836515
0,359373
0,359373
0,066143
0,119373
0,044134
0,044134
0,044134
0,479015
0,392706
0,392706
0,482230
1,019373
1,019373
0,392706
0,474015
0,074706
0,481039
0,482587
0,482587
0,392706
0,481373
0,483039
0,482587
0,482587
0,319465
0,300375
1,691572
1,937286
0,765644
0,735401
0,556119
0,363459
0,431753
0,316750
0,366971
0,520370
0,096750
0,012934
0,749575
0,027700
0,036567
0,168575
0,368908
0,021567
0,311575
0,368908
0,333908
0,022234
0,018393
0,368908
0,368908
0,023634
0,022700
cod ATC
391 C10AA05
392 C10AA05
393 C10AA05
394 C10AA05
395 C10AA05
396 C10AA05
397 C10AA05
398 C10AA05
399 C10AA05
400 C10AA05
401 C10AA05
402 C10AA05
403 C10AA05
404 C10AA05
405 C10AA05
406 C10AA05
407 C10AA05
408 C10AA05
409 C10AA05
410 C10AA05
411 C10AA05
412 C10AA05
413 C10AA05
414 C10AA05
415 C10AA05
416 C10AA05
417 C10AA05
418 C10AA05
419 C10AA05
420 C10AA05
421 C10AA05
422 C10AA05
423 C10AA05
424 C10AA05
425 C10AA05
426 C10AA05
427 C10AA05
428 C10AA07
429 C10AA07
430 C10AA07
431 C10AA07
432 C10AA07
433 C10AA07
434 C10AA07
435 C10AA07
436 C10AA07
437 C10AA07
438 C10AA07
439 C10AA07
440 C10AA07
441 C10AA07
442 C10AA07
443 C10AA07
444 C10AA07
445 C10AA07
446 C10AA07
447 C10AA07
448 C10AA07
449 C10AA07
450 C10AA07
451 C10AA07
452 C10AA07
453 C10AA07
454 C10AA07
455 C10AA07
456 C10AA07
DCI
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
Denumire Comerciala
forma farm.
SORTIS 20 mg
COMPR. FILM.
TORVACARD 20 mg
COMPR. FILM.
ATORIS 20 mg
COMPR. FILM.
GLETOR 20 mg
COMPR. FILM.
ASCORD 20 mg
COMPR. FILM.
ATORGAMMA 20 mg
COMPR. FILM.
TORVAZIN 20 mg
COMPR. FILM.
XAMARA 20 mg
COMPR. FILM.
VOREDANIN 20 mg
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
STAVRA 20 mg
COMPR. FILM.
COMPR. FILM.
ATORVASTATINA AUROBINDO 20 mg COMPR. FILM.
TORVALIPIN 40 mg
COMPR. FILM.
SORTIS 40 mg
COMPR. FILM.
TORVACARD 40 mg
COMPR. FILM.
ATORIS 40 mg
COMPR. FILM.
ATORIS 40 mg
COMPR. FILM.
GLETOR 40 mg
COMPR. FILM.
ASCORD 40 mg
COMPR. FILM.
ATORGAMMA 40 mg
COMPR. FILM.
TORVAZIN 40 mg
COMPR. FILM.
VOREDANIN 40 mg
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
STAVRA 40 mg
COMPR. FILM.
COMPR. FILM.
SORTIS 80 mg
COMPR. FILM.
ASCORD 80 mg
COMPR. FILM.
TORVACARD 80 mg
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
STAVRA 80 mg
COMPR. FILM.
COMPR. FILM.
ROSUVASTATINA RATIOPHARM 10 mg COMPR. FILM.
CRESTOR 10 mg
COMPR. FILM.
ROSUCARD 10 mg
COMPR. FILM.
ROSUVASTATINA TEVA 10 mg
COMPR. FILM.
ROXARDIO 10 mg
COMPR. FILM.
ROSWERA 10 mg
COMPR. FILM.
ROSTAT 10 mg
COMPR. FILM.
TINTAROS 10 mg
COMPR. FILM.
ROSUVASTATINA TERAPIA 10 mg
COMPR. FILM.
COMPR. FILM.
ROSUVASTATINA AUROBINDO 10 mg COMPR. FILM.
ROVASTAMED 10mg
COMPR. FILM.
STARCREST 10 mg
COMPR. FILM.
ROZUCOR 10 mg
COMPR. FILM.
ROSUVASTATINA ATB 10 mg
COMPR. FILM.
ROSUVASTATINA RATIOPHARM 20 mg COMPR. FILM.
CRESTOR 20 mg
COMPR. FILM.
ROSUCARD 20 mg
COMPR. FILM.
COMPR. FILM.
ROXARDIO 20 mg
COMPR. FILM.
ROSWERA 20 mg
COMPR. FILM.
ROSTAT 20 mg
COMPR. FILM.
TINTAROS 20 mg
COMPR. FILM.
ROSUVASTATINA LABORMED 20 mg COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
ROSUVASTATINA AUROBINDO 20 mg COMPR. FILM.
ROVASTAMED 20mg
COMPR. FILM.
STARCREST 20 mg
COMPR. FILM.
concentratie
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
40 mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
20 mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
Prescriptie
Nr. crt
Detinator APP
Tara det.
APP
MAREA BRITANIE
Ambalaj
ZENTIVA K.S.
CEHIA
SLOVENIA
P-6L
P-6L
P-6L
TERAPIA SA
ROMANIA
P-6L
GERMANIA
P-6L
UNGARIA
P-6L
P-6L
P6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L
MAREA BRITANIE
ISLANDA
P-6L
MAREA BRITANIE
P-6L
ZENTIVA K.S.
CEHIA
SLOVENIA
P-6L
SLOVENIA
P-6L
P-6L
TERAPIA SA
ROMANIA
P-6L
GERMANIA
P-6L
UNGARIA
P-6L
P6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L
MAREA BRITANIE
MAREA BRITANIE
P-6L
TERAPIA SA
ZENTIVA, K.S.
ROMANIA
P-6L
REPUBLICA CEHA
P6L
P6L
RATIOPHARM GMBH GERMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L
ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L
MAREA BRITANIE
REPUBLICA CEHA
ZENTIVA K.S.
P-6L
CUTIE CU BLIST. PVC-PVAC-AL/OPA-AL-PVC X 30 COMPR. FILM.
P-6L
SANDOZ S.R.L.
P-6L
P6L
P-6L
P6L
P6L
P6L
ROMANIA
ROMANIA
ISLANDA
CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM.
TERAPIA SA
TERAPIA SA
ROMANIA
ROMANIA
MALTA
CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM.
CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM.
P6L
LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L

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

P6L
P6L

P6L
Pagina 7 din 16
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
30
30
30
30
30
30
30
30
30
30
28
30
30
30
30
14
30
14
30
30
30
30
30
30
30
28
30
30
30
14
30
30
30
28
30
30
30
30
28
30
30
28
30
30
28
28
28
30
28
28
30
30
30
28
30
30
28
30
30
28
28
28
28
30
28
28
0,750575
0,408666
0,501333
0,404333
0,750575
0,431333
0,334000
0,750575
0,750575
0,267000
0,211428
0,750575
0,750575
0,278333
0,531000
1,501151
0,871666
1,102857
0,647000
0,514666
1,102666
0,863000
1,102666
1,102333
1,053000
0,674285
1,102666
1,102666
0,478666
1,677142
1,090333
1,090333
1,090333
1,090000
1,090333
1,090333
0,768000
0,711000
0,750575
0,750575
0,577666
0,311071
0,629333
0,750575
0,680714
0,750575
0,750575
0,750575
0,711071
0,688928
0,750575
0,750575
1,094000
1,501151
0,907666
0,907666
0,621428
0,930666
1,109333
0,907500
0,664642
1,501151
1,501151
1,501151
1,093928
0,689642
0,615758
0,000000
0,000000
0,000000
0,167091
0,000000
0,000000
0,167091
0,166758
0,000000
0,000000
0,167091
0,167091
0,000000
0,000000
0,194563
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
2,575853
0,082425
0,000000
0,000000
0,000000
0,003425
0,000000
0,491210
0,491210
0,455091
0,000000
0,000000
0,815091
0,796758
0,000000
3,363849
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,283491
0,283491
0,283849
0,000000
0,000000
0,375287
0,204333
0,250666
0,202166
0,375287
0,215666
0,167000
0,375287
0,375287
0,133500
0,105714
0,375287
0,375287
0,139166
0,265500
0,750575
0,435833
0,551428
0,323500
0,257333
0,551333
0,431500
0,551333
0,551166
0,526500
0,337142
0,551333
0,551333
0,239333
0,838571
0,545166
0,545166
0,545166
0,545000
0,545166
0,545166
0,384000
0,355500
0,375287
0,375287
0,288833
0,155535
0,314666
0,375287
0,340357
0,375287
0,375287
0,375287
0,355535
0,344464
0,375287
0,375287
0,547000
0,750575
0,453833
0,453833
0,310714
0,465333
0,554666
0,453750
0,332321
0,750575
0,750575
0,750575
0,546964
0,344821
0,991046
0,204333
0,250667
0,202167
0,542379
0,215667
0,167000
0,542379
0,542046
0,133500
0,105714
0,542379
0,542379
0,139167
0,265500
0,945139
0,435833
0,551429
0,323500
0,257333
0,551333
0,431500
0,551333
0,551167
0,526500
0,337143
0,551333
0,551333
0,239333
0,838571
0,545167
0,545167
0,545167
0,545000
0,545167
0,545167
0,384000
0,355500
2,951141
0,457713
0,288833
0,155536
0,314667
0,378713
0,340357
0,866498
0,866498
0,830379
0,355536
0,344464
1,190379
1,172046
0,547000
4,114425
0,453833
0,453833
0,310714
0,465333
0,554667
0,453750
0,332321
1,034067
1,034067
1,034425
0,546964
0,344821
0,675517
0,367799
0,451199
0,363899
0,675517
0,388199
0,300600
0,675517
0,675517
0,240300
0,190285
0,675517
0,675517
0,250499
0,477900
1,351035
0,784499
0,992571
0,582300
0,463199
0,992399
0,776700
0,992399
0,992099
0,947700
0,606856
0,992399
0,992399
0,430799
1,509427
0,981299
0,981299
0,981299
0,981000
0,981299
0,981299
0,691200
0,639900
0,675517
0,675517
0,519899
0,279963
0,566399
0,675517
0,612642
0,675517
0,675517
0,675517
0,639963
0,620035
0,675517
0,675517
0,984600
1,351035
0,816899
0,816899
0,559285
0,837599
0,998399
0,816750
0,598177
1,351035
1,351035
1,351035
0,984535
0,620677
0,690816
0,040867
0,050134
0,040434
0,242149
0,043134
0,033400
0,242149
0,241816
0,026700
0,021143
0,242149
0,242149
0,027834
0,053100
0,344679
0,087167
0,110286
0,064700
0,051467
0,110267
0,086300
0,110267
0,110234
0,105300
0,067429
0,110267
0,110267
0,047867
0,167715
0,109034
0,109034
0,109034
0,109000
0,109034
0,109034
0,076800
0,071100
2,650911
0,157483
0,057767
0,031108
0,062934
0,078483
0,068072
0,566268
0,566268
0,530149
0,071108
0,068893
0,890149
0,871816
0,109400
3,513965
0,090767
0,090767
0,062143
0,093067
0,110934
0,090750
0,066465
0,433607
0,433607
0,433965
0,109393
0,068965
cod ATC
457 C10AA07
458 C10AA07
459 C10AA07
460 C10AA07
461 C10AA07
462 C10AA07
463 C10AA07
464 C10AA07
465 C10AA07
466 C10AA07
467 C10AA07
468 C10AA07
469 C10AA07
470 C10AA07
471 C10AA07
472 C10AA07
473 C10AA07
474 C10AA07
475 C10AA07
476 C10AA07
477 C10AA07
478 C10AA07
479 C10AA07
480 C10AA07
481 C10AA07
482 C10AA07
483 C10AB02
484 C10AB02
485 C10AB02
486 C10AX09
487 C10AX09
DCI
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
BEZAFIBRATUM
BEZAFIBRATUM
BEZAFIBRATUM
EZETIMIBUM
EZETIMIBUM
488 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM)

504 D01BA02
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
505 D05AX52
COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM)*
506 D05AX52
COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM)*
507 D05BB02
ACITRETINUM**
ACIDUM FUSIDICUM
ACIDUM FUSIDICUM
SULFADIAZINUM
PODOPHYLLOTOXINUM*
PODOPHYLLOTOXINUM*
IMIQUIMODUM*
498 D01BA02
499 D01BA02
500 D01BA02
501 D01BA02
502 D01BA02
503 D01BA02
508 D06AX01
509 D06AX01
510 D06BA01
511 D06BB04
512 D06BB04
513 D06BB10
514 D07AB02
515 D07AB02
516 D07AB02
517 D07AB02
518 D07AC13
519 D07AC13
520 D07AC13
521 D07AC13
HYDROCORTISONUM BUTYRATUM
MOMETASONUM
MOMETASONUM
MOMETASONUM
MOMETASONUM
522 D07AC14 METHYLPREDNISOLONUM ACEPONAT
Denumire Comerciala
ROZUCOR 20 mg
ROSUCARD 40 mg
ROSWERA 40 mg
ROSTAT 40 mg
TINTAROS 40 mg
ROSUVASTATINA AUROBINDO 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
ROSUVASTATINA AUROBINDO 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
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
200mg
200mg
200mg
10mg
10mg
10mg/10mg
10mg/10mg
10mg/10mg
10mg/10mg
10mg/5mg
10mg/5mg
10mg/5mg
10mg/5mg
20mg/10mg
20mg/5mg
250mg
250mg
250mg
250mg
250mg
250mg
250mg
50micrograme/0,5mg/g
Detinator APP
Ambalaj
ANTIBIOTICE S.A.
ZENTIVA K.S.
ROMANIA
P6L
P6L
REPUBLICA CEHA
P-6L
P-6L
P6L
P-6L

P6L
P6L
P6L
ROMANIA
ISLANDA
TERAPIA SA
TERAPIA SA
ROMANIA
ROMANIA
MALTA

P6L

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

P6L

P6L
ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L

SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC/AL X 10 COMPR. P-6L
FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L
MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PCTFE/PVC/AL X 14 COMPR.
ROMANIA
MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM.
ROMANIA
CUTIE CU BLIST. PVC-PE-PVDC-PE-PVC/AL X 30 COMPR.
P-RF
PRF
P-6L
ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.
P6L
P6L
P6L
MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM.
P-6L
ROMANIA
P6L
CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM.
ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L
ROMANIA
ROMANIA
CUTIE X BLISTERE OPA-AL-PVC/AL X 30 COMPRIMATE FILMATE P6L
P6L
P6L
P-RF
RANBAXY UK LIMITED
RANBAXY UK LIMITED
MAREA BRITANIE
CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-RF
MAREA BRITANIE
CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR.

P-RF
ACTAVIS GROUP HF ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR.

SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 COMPR.
P-RF
ROMANIA CUTIE CU 2 BLIST. PVC/AL X 14 COMPR.

ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.
P-RF
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 CREMA

CUTIE X 1 TUB DIN AL X 15 G UNGUENT
P-RF
50micrograme/0,5mg/g LEO PHARMACEUTICAL PRODUCTS
10mg
20mg/g
20mg/g
1%
1,5 mg/g
5mg/ml
5%
0,1%
0,1%
EMULSIE CUT. 0.1%
SOL. CUT. 0,1%
CREMA
1mg/g
CREMA
1mg/g
UNGUENT 1mg/g
UNGUENT 1mg/g
CREMA
1mg/g
Tara det.
APP
Prescriptie
Nr. crt
GLAXOSMITHKLINE (GSK) SRL

ASTELLAS PHARMA EUROPE BV
MEDA AB
MERCK SHARP & DOHME
DANEMARCA
ROMANIA BORCAN X 500 G CREMA

ROMANIA CUTIE X 1 TUB X 5 G CREMA
OLANDA
SUEDIA CUTIE X 12 PLICURI DIN POLIESTER/AL X 250 MG CREMA
OLANDA CUTIE X 1 TUB DIN AL X 30 G
OLANDA CUTIE X 1 TUB DIN AL X 30 G
OLANDA CUTIE X 1 FLACON X 30 G
OLANDA CUTIE X 1 FLACON PICURATOR DIN PP X 30 ML
ROMANIA CUTIE X 1 TUB DIN AL X 15 G
CUTIE X 1 FLACON DIN STICLA BRUNA X 3,5 ML SOL. CUTANATA + 15 DISPOZITIVE DE APLICARE
ANTIBIOTICE SA
P-RF
PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
ROMANIA CUTIE CU 1 TUB DIN AL X 15 G UNG. P6L

MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G
P-RF
ANTIBIOTICE SA
ROMANIA CUTIE CU 1 TUB DIN AL X 15 G UNG. P6L
INTENDIS GMBH
GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF
Pagina 8 din 16
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
30
1,501151
30
1,501151
30
1,748666
30
1,589000
30
1,522333
30
1,096000
28
1,746785
28
2,784285
28
2,784285
30
2,499000
28
1,640357
28
1,335000
30
2,620000
30
2,498000
28
0,375287
28
0,375287
30
0,327333
30
0,375287
28
0,375287
28
0,375287
28
0,375287
30
0,375287
28
0,375287
28
0,375287
30
0,375287
30
0,375287
20
0,381500
20
0,383500
20
0,370000
28
4,156410
30
3,728666
30
0,571332
30
0,571332
30
0,571332
30
0,571332
30
0,571332
30
0,548666
30
0,548666
30
0,548666
30
0,571332
30
0,571332
14
1,267321
30
1,267321
28
1,267321
28
0,712142
14
1,267321
28
1,267321
28
1,185357
1 53,860000
1 53,945000
30
1,581666
1 11,170000
1 11,170000
1 100,400000
1 44,916785
1 78,810000
12 21,387500
1 11,799999
1 11,799999
1 11,799999
1 11,230000
1
3,530000
1
3,530000
1
3,530000
1
3,530000
1 21,360500
0,511849
0,355182
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
2,260784
0,828284
0,000000
0,397046
0,008284
1,428998
1,428998
0,652379
0,651141
0,313284
1,041379
1,017046
0,000000
0,000000
0,000000
1,283232
0,000000
0,465001
0,102668
0,102668
0,068001
0,272668
0,000000
0,000000
0,000000
0,587668
0,327334
1,170536
0,317345
0,317679
0,000000
0,081964
0,317679
0,000000
0,000000
0,255000
0,000000
0,000000
0,000000
0,000000
33,423215
0,000000
0,000000
0,220001
0,190001
1,000001
0,000000
1,910000
0,000000
1,910000
0,000000
3,709500
0,750575
0,750575
0,874333
0,794500
0,761166
0,548000
0,873392
1,392142
1,392142
1,249500
0,820178
0,667500
1,310000
1,249000
0,187643
0,187643
0,163666
0,187643
0,187643
0,187643
0,187643
0,187643
0,187643
0,187643
0,187643
0,187643
0,190750
0,191750
0,185000
2,078205
1,864333
0,285666
0,285666
0,285666
0,285666
0,285666
0,274333
0,274333
0,274333
0,285666
0,285666
0,633660
0,633660
0,633660
0,356071
0,633660
0,633660
0,592678
26,930000
26,972500
0,790833
5,585000
5,585000
50,200000
22,458392
39,405000
10,693750
5,899999
5,899999
5,899999
5,615000
1,765000
1,765000
1,765000
1,765000
10,680250
1,262425
1,105758
0,874333
0,794500
0,761167
0,548000
0,873393
1,392143
1,392143
1,249500
0,820179
0,667500
1,310000
1,249000
2,448428
1,015928
0,163667
0,584690
0,195928
1,616642
1,616642
0,840023
0,838785
0,500928
1,229023
1,204690
0,190750
0,191750
0,185000
3,361437
1,864333
0,750667
0,388334
0,388334
0,353667
0,558334
0,274333
0,274333
0,274333
0,873334
0,613000
1,804197
0,951006
0,951340
0,356071
0,715625
0,951340
0,592679
26,930000
27,227500
0,790833
5,585000
5,585000
50,200000
55,881608
39,405000
10,693750
6,120001
6,090001
6,900001
5,615000
3,675000
1,765000
3,675000
1,765000
14,389750
1,351035
1,351035
1,573799
1,430100
1,370099
0,986400
1,572106
2,505856
2,505856
2,249100
1,476321
1,201500
2,358000
2,248200
0,337758
0,337758
0,294599
0,337758
0,337758
0,337758
0,337758
0,337758
0,337758
0,337758
0,337758
0,337758
0,343350
0,345150
0,333000
3,740769
3,355799
0,514198
0,514198
0,514198
0,514198
0,514198
0,493799
0,493799
0,493799
0,514198
0,514198
1,140588
1,140588
1,140588
0,640927
1,140588
1,140588
1,066821
48,474000
48,550500
1,423499
10,053000
10,053000
90,360000
40,425106
70,929000
19,248750
10,619999
10,619999
10,619999
10,107000
3,177000
3,177000
3,177000
3,177000
19,224450
0,661965
0,505298
0,174867
0,158900
0,152234
0,109600
0,174679
0,278429
0,278429
0,249900
0,164036
0,133500
0,262000
0,249800
2,298313
0,865813
0,032734
0,434575
0,045813
1,466527
1,466527
0,689908
0,688670
0,350813
1,078908
1,054575
0,038150
0,038350
0,037000
1,698873
0,372867
0,522135
0,159802
0,159802
0,125135
0,329802
0,054867
0,054867
0,054867
0,644802
0,384468
1,297269
0,444078
0,444412
0,071215
0,208697
0,444412
0,118536
5,386000
5,649500
0,158167
1,117000
1,117000
10,040000
37,914894
7,881000
2,138750
1,400001
1,370001
2,180001
1,123000
2,263000
0,353000
2,263000
0,353000
5,845550
cod ATC
DCI
524 D07AC14
525 D07AC14
526 D07AC14
527 D07AC14
528 D07AC17
529 D07AC17
530 D07AD01
531 D07AD01
532 D07AD01
533 D07CA01
534 D07CC01
535 D07XC03
536 D07XC03
537 D10AD54
538 D10AD54
539 D10AX03
540 D10AX03
541 D10AX03
542 D10AX03
543 D10BA01
544 D10BA01
545 D10BA01
546 G01AA51
547 G01AA51
548 G01AA51
549 G01AF12
550 G01AF12
551 G01AF12
552 G01AF15
553 G01AF20
554 G01AF20
555 G01AF20
556 G01AF20
557 G01AF20
558 G02CB03
559 G02CB03
560 G03CA09
561 G03CA09
562 G03CX01
563 G03DA04
564 G03DA04
565 G03DA04
566 G03DA04
567 G03DA04
568 G03DA04
569 G03DA04
570 G03DA04
571 G03DB01
572 G03DC03
573 G03FA17
574 G03FB01
575 G03FB08
576 G03GA05
577 G03GA05
578 G03GA05
579 G03GA05
580 G03GA06
581 G03GA06
582 G03GA06
583 G03GA06
584 G03GA07
585 G03GB02
586 G03XC01
587 G04BD04
588 G04BD07
Denumire Comerciala
ADVANTAN 1mg/g crema

METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g
METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g
METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g unguent
METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent
FLUTICASONUM PROPIONAT
CUTIVATE
FLUTICASONUM PROPIONAT
CUTIVATE
CLOBETASOLUM*
DERMOVATE 0,5 mg/g
CLOBETASOLUM*
DERMOVATE (R)
CLOBETASOLUM*
DERMOVATE 0,5 mg/g
COMBINATII (ACIDUM FUSIDICUM+HYDROCORTISONUM) FUCIDIN H
COMBINATII (ACIDUM FUSIDICUM+ BETAMETHASONUM) FUCICORT 20 mg/1mg pe gram
COMBINATII (MOMETASONUM + AC. SALICILICUM) ELOSALIC 1mg+5mg/gram
COMBINATII (MOMETASONUM + AC. SALICILICUM) ELOSALIC 1mg+5mg/gram
COMBINATII (ISOTRETINOINUM + ERITROMICINUM) ISOTREXIN GEL
COMBINATII (ISOTRETINOINUM + ERITROMICINUM) ISOTREXIN GEL
ACIDUM AZELAICUM
SKINOREN
ACIDUM AZELAICUM
SKINOREN
ACIDUM AZELAICUM
SKINOREN 150mg/g
ACIDUM AZELAICUM
SKINOREN 150mg/g
ISOTRETINOINUM**
ROACCUTANE 10 mg
ISOTRETINOINUM**
SOTRET 10 mg
ISOTRETINOINUM**
SOTRET 20 mg
COMBINATII
MACMIROR COMPLEX
COMBINATII
POLYGYNAX
COMBINATII
MACMIROR COMPLEX
FENTICONAZOLUM
LOMEXIN 1000 mg
FENTICONAZOLUM
LOMEXIN 600 mg
FENTICONAZOLUM
LOMEXIN CREMA VAGINALA
BUTOCONAZOLUM
GYNOFORT 2%
COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLODIN
COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON
CABERGOLINUM*
DOSTINEX
CABERGOLINUM*
DOSTINEX
PROMESTRIENUM*
COLPOTROPHINE 10 mg
PROMESTRIENUM*
COLPOTROPHINE 10mg/g
TIBOLONUM**
LIVIAL (R) 2,5 mg
PROGESTERONUM*
UTROGESTAN (R) 100 mg
PROGESTERONUM*
AREFAM 100 mg
PROGESTERONUM*
AREFAM 100 mg
PROGESTERONUM*
UTROGESTAN (R) 200 mg
PROGESTERONUM*
AREFAM 200 mg
PROGESTERONUM*
AREFAM 200 mg
PROGESTERONUM*
PROGESTOGEL 10 mg/g
PROGESTERONUM*
MASTOPROFEN 10 mg/g
DYDROGESTERONUM*
DUPHASTON 10 mg
LYNESTRENOLUM*
ORGAMETRIL 5 mg
COMBINATII**
ANGELIQ
COMBINATII**
CYCLO-PROGYNOVA
COMBINATII**
FEMOSTON 2/10
FOLLITROPINUM ALFA****#
GONAL - f 75 UI (5,5 g)
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)
FOLLITROPINUM BETA****#
PUREGON 300UI/0,36 ml
LUTROPINUM ALFA****#
LUVERIS 75UI
CLOMIFENUM
CLOSTILBEGYT
RALOXIFENUM
EVISTA 60mg
OXYBUTYNINUM
DRIPTANE ( R ) 5 mg
TOLTERODINUM**#
UROFLOW 1
523 D07AC14 METHYLPREDNISOLONUM ACEPONAT
forma farm.
concentratie
CREMA
1mg/g
EMULSIE CUT. 1mg/g
EMULSIE CUT. 1mg/g
UNGUENT 1mg/g
UNGUENT 1mg/g
CREMA
0,05%
UNGUENT 0,005%
CREMA
0,5mg/g
SOL. CUT. 0,05%
UNGUENT 0,5mg/g
CREMA
20mg/g+10mg/g
CREMA
20mg/1mg pe gram
UNGUENT 1mg+50mg/gram
UNGUENT 1mg+50mg/gram
GEL
0,05%/0,2%
GEL
0.5mg/g+20mg/g
CREMA
200mg/g
CREMA
200mg/g
GEL
150mg/g
GEL
150mg/g
CAPS. MOI 10mg
CAPS. MOI 10mg
CAPS. MOI 20mg
Detinator APP
GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA
GLAXO WELLCOME UK LIMITED
MAREA BRITANIE
MAREA BRITANIE
GLAXO WELLCOME UK LTD. MAREA BRITANIE
LEO PHARMA A/S

LEO PHARMA A/S
CUTIE X 1 TUB X 50 G
CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA
P-RF
P-RF
PRF
GERMANIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT
P-RF
GERMANIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT
P-RF

CUTIE X 1 TUB DIN AL X 15 G UNGUENT
P-RF
CUTIE CU 1 TUB AL X 25 G CREMA
P-RF
P-RF
DANEMARCA
DANEMARCA
CUTIE CU 1 TUB AL X 25 G UNGUENT

P-RF
P-RF
P-RF
MERCK SHARP & DOHME ROMANIA
P-RF
MERCK SHARP & DOHME
CUTIE X 1 TUB DIN AL X 15 G

ROMANIA CUTIE X 1 TUB DIN AL X 45 G
MAREA BRITANIE CUTIE X 1 TUB DIN AL X 30 G GEL
ROMANIA CUTIE X 1 TUB DIN AL X 30 G GEL
P-RF
P-RF
P-RF
STIEFEL LABORATORIES LTD.

INTENDIS GMBH
BAYER PHARMA AG
INTENDIS GMBH
BAYER PHARMA AG
GERMANIA
GERMANIA
ROCHE ROMANIA SRL ROMANIA

TERAPIA S.A.
ROMANIA
TERAPIA S.A.
ROMANIA
CREMA
FARA CONCENTRATIE
ALFA WASSERMANN SPA
CREMA VAG.
FARA CONCENTRATIE
ALFA WASSERMAN SPA
OVULE
500mg/100mg ALFA WASSERMAN SPA
SOL. VAGINALA
FARA CONCENTRATIE
CAPS. MOI VAG.
GERMANIA
CREMA VAG.
CREMA VAG.
COMPR. VAG.
CAPS. MOI VAG.
GERMANIA
GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON CU PICURATOR DIN PP X 25 ML P-RF
POLICHEM SA
FARA CONCENTRATIE LAB. INNOTECH INT.
10g/400000UI POLICHEM SA
1000mg
RECORDATI SPA
600mg
RECORDATI SPA
2%
RECORDATI SPA
20mg/g
500mg/200mg ARENA GROUP S.A.
CREMA VAG.
Ambalaj
BAYER PHARMA AG
INTENDIS GMBH
BAYER PHARMA AG
INTENDIS GMBH
BAYER PHARMA AG
CAPS. MOI VAG. 500mg/200000UI

CAPS. MOI VAG.
Tara det.
APP
Prescriptie
Nr. crt
ALFA WASSERMAN SPA
CUTIE X 1 TUB AL X 50 G GEL

CUTIE X 1 TUB AL X 50 G GEL
P-RF
P-RF
P-RF
P-RF
CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. MOI P-RF

CUTIE X 3 BLIST. PE-PVDC-PVC/HARTIE-AL X 10 CAPS. MOI P-RF
CUTIE X 3 BLIST. PE-PVDC-PVC/HARTIE-AL X 10 CAPS. MOI P-RF
LUXEMBURG CUTIE X 1 BLIST. AL/PVDC-PVC X 12 CAPS. MOI. VAG. P-RF
FRANTA
CUTIE X 2 BLIST. AL/PVC X 6 CAPS. MOI. VAG. P-RF
LUXEMBURG CUTIE X 1 TUB DIN AL CREMA VAG. X 30 G + APLICATOR
ITALIA
ITALIA
ITALIA
ROMANIA
ROMANIA
ITALIA
ITALIA
ITALIA
ITALIA
P-RF
CUTIE X 1 BLIST. PVC/PVDC-AL X 2 CAPS. VAG. MOI P-RF

CUTIE X 1 BLIST. PVC/PVDC-AL X 1 CAPS. VAG. MOALE P-RF
CUTIE X 1 TUB AL + APLICATOR X 78 G CREMA P-RF

CUTIE X 1 APLICATOR PREUMPLUT UNIDOZA DIN PP CU 5 G CREMA VAG.
P-RF
CUTIE X 2 BLIST. TRANSPARENT DIN AL/PVC X 5 COMPR. VAG. P-RF
CUTIE X 1 TUB DIN AL X 30 G
P-RF
CUTIE X 1 TUB DIN AL X 30 G CREMA VAG. + 6 APLICATOARE DIN POLIPROPILENA
P-RF
CUTIE X 2 FOLII PVC-PE X 5 OVULE
P-RF
CUTIE X 5 FLACOANE PVC-PE X 10 ML + 5 FLACOANE PEJD X 130 ML + 5 CANULE
P-RF
COMPR.
0,5mg
PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR.
P-RF
COMPR.
0,5mg
PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR.
P-RF
CAPS. VAG. 10mg
LABORATOIRE THERAMEX MONACO CUTIE CU 1 BLIST. AL/PVC X 10 CAPS. VAG. PRF
CREMA VAG. 10mg/g
LABORATOIRE THERAMEX MONACO CUTIE CU 1 TUB DIN AL X 15 G CREMA VAGINALA PRF
COMPR.
2,5mg
ORGANON NV
OLANDA CUTIE X 1 BLIST. X 28 COMPR.
P-RF
CAPS. MOI 100mg
LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. X 15 CAPS. MOI P-6L
CAPS. MOI 100mg
MEDICO UNO PHARMA KFT. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. MOI P-6L
CAPS. MOI 100mg
PHARMASWISS CESK REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. MOI
P-6L
CAPS. MOI 200mg
LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. AL/PVC X 7 CAPS. MOI P-6L
CAPS. MOI 200mg
MEDICO UNO PHARMA KFT. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 CAPS. MOI P-6L
CAPS. MOI 200mg
PHARMASWISS CESK REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 CAPS. MOI P-6L
GEL
10mg/g
LABORATOIRES BESINS INTERNATIONAL
FRANTA CUTIE CU 1 TUB DIN AL X 80 G GEL + DISPOZITIV DE DOZARE PRF
GEL
10mg/g
ANTIBIOTICE SA
ROMANIA CUTIE CU 1 TUB DIN AL X 40 G GEL P6L
COMPR. FILM. 10mg
ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM.
P-RF
COMPR.
5mg
ORGANON NV
OLANDA CUTIE X 1 BLIST. X 30 COMPR.
P-6L
COMPR. FILM. 1mg+2mg
BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. CALENDARISTIC PVC/AL X 28 COMPR. FILM. P6L
DRAJ.
FARA CONCENTRATIE BAYER PHARMA AG GERMANIA CUTIE CU 1 BLIST. PVC/AL TIP CALENDAR X 21 DRAJ. P-6L
COMPR. FILM. FARA CONCENTRATIE ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA
P-RF
PULB. + SOLV. PT. SOL. INJ.
75UI
MERCK SERONO EUROPE LIMITED MAREA BRITANIE
P-RF/R
300UI/0,5ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE
P-RF/R
P-RF/R
P-RF/R
SOL. INJ.
300UI/0,36ml N. V. ORGANON
OLANDA CUTIE X 1 CARTUS + 6 ACE
PR/PRF
SOL. INJ.
300UI/0,36ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS + 6 ACE
PR/PRF
SOL. INJ.
900UI/1,08ml N. V. ORGANON
OLANDA CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF
SOL. INJ.
900UI/1,08ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF
PULB+SOLV.PT.SOL.INJ 75UI
SERONO EUROPE LTD. MAREA BRITANIE
P-RF/R
COMPR.
50mg
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. P-RF
COMPR. FILM. 60mg
DAIICHI SANKYO EUROPE GMBH GERMANIA CUTIE X 28 COMPR. FILM. (BLIST. ACLAR) P-RF
COMPR.
5mg
LAB. FOURNIER SA FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. P-6L
COMPR. FILM. 1mg
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L
CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GAL
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV.
SOL. INJ. IN STILOU INJECTOR PREUMPLUT
CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 8 ACE PT. ADM.
CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 12 ACE PT. ADM. SUBCUTANATA
CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1,5 ML SOL. INJ. + 20 ACE PT. ADM. SUBCUTANATA
CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ.+ 1 FLAC. A 2 ML SAU 3 ML X 1 ML SOLV.
Pagina 9 din 16
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
30
30
30
12
12
1
2
1
1
1
10
1
1
10
5
2
8
10
1
28
30
30
30
14
30
30
1
1
20
30
28
21
28
1
1
1
1
1
1
1
1
1
10
28
60
28
21,360500
33,540000
33,540000
21,360500
21,360500
10,080000
10,080000
6,592499
5,410000
6,592499
21,030000
15,445000
16,387500
48,760000
37,580000
37,580000
30,710000
30,710000
38,387500
38,387500
1,070583
1,066666
2,141166
1,860416
1,860416
34,650000
17,380091
10,428054
27,112942
1,738009
1,151700
9,980000
13,340000
1,151700
1,151700
5,505249
5,505249
0,967250
14,390000
1,586071
0,565333
0,549000
0,549000
1,130666
1,130666
1,130666
16,162500
7,120000
1,113000
0,258333
2,062500
0,383809
0,536963
105,302120
421,208483
631,812725
1.263,625450
403,900000
403,900000
1.263,120000
1.263,120000
131,710000
1,770000
2,345357
0,357500
0,421683
3,709500
0,000000
0,000000
3,709500
3,709500
0,000000
0,000000
5,877501
0,000000
2,647501
0,000000
6,815000
0,402500
0,000000
0,000000
0,000000
0,000000
0,000000
10,062500
10,062500
0,518083
0,000000
0,007834
1,360417
0,705417
0,000000
9,184909
4,621946
8,997058
32,241991
0,406300
0,000000
0,000000
2,683300
3,412300
5,289751
4,407251
0,023750
0,000000
0,000000
0,279667
0,000000
0,000000
0,822905
0,098000
0,098000
5,767500
0,000000
0,000000
0,000000
0,000000
0,000000
0,459465
27,227880
84,441517
103,967275
120,794550
0,000000
0,000000
17,140000
17,140000
0,000000
0,000000
0,000000
0,000000
0,394388
10,680250
16,770000
16,770000
10,680250
10,680250
5,040000
5,040000
3,296249
2,705000
3,296249
10,515000
7,722500
8,193750
24,380000
18,790000
18,790000
15,355000
15,355000
19,193750
19,193750
0,535291
0,533333
1,070583
0,930208
0,930208
17,325000
8,690045
5,214027
13,556471
0,869004
0,575850
4,990000
6,670000
0,575850
0,575850
2,752624
2,752624
0,483625
7,195000
0,793035
0,282666
0,274500
0,274500
0,565333
0,565333
0,565333
8,081250
3,560000
0,556500
0,129166
1,031250
0,191904
0,268481
52,651060
210,604241
315,906362
631,812725
201,950000
201,950000
631,560000
631,560000
65,855000
0,885000
1,172678
0,178750
0,210841
14,389750
16,770000
16,770000
14,389750
14,389750
5,040000
5,040000
9,173751
2,705000
5,943751
10,515000
14,537500
8,596250
24,380000
18,790000
18,790000
15,355000
15,355000
29,256250
29,256250
1,053375
0,533333
1,078417
2,290625
1,635625
17,325000
17,874955
9,835973
22,553529
33,110996
0,982150
4,990000
6,670000
3,259150
3,988150
8,042376
7,159876
0,507375
7,195000
0,793036
0,562334
0,274500
0,274500
1,388238
0,663333
0,663333
13,848750
3,560000
0,556500
0,129167
1,031250
0,191905
0,727947
79,878940
295,045759
419,873638
752,607275
201,950000
201,950000
648,700000
648,700000
65,855000
0,885000
1,172679
0,178750
0,605230
19,224450
30,186000
30,186000
19,224450
19,224450
9,072000
9,072000
5,933249
4,869000
5,933249
18,927000
13,900500
14,748750
43,884000
33,822000
33,822000
27,639000
27,639000
34,548750
34,548750
0,963524
0,959999
1,927049
1,674374
1,674374
31,185000
15,642081
9,385248
24,401647
1,564208
1,036530
8,982000
12,006000
1,036530
1,036530
4,954724
4,954724
0,870525
12,951000
1,427463
0,508799
0,494100
0,494100
1,017599
1,017599
1,017599
14,546250
6,408000
1,001700
0,232499
1,856250
0,345428
0,483266
94,771908
379,087634
568,631452
1.137,262905
363,510000
363,510000
1.136,808000
1.136,808000
118,539000
1,593000
2,110821
0,321750
0,379514
5,845550
3,354000
3,354000
5,845550
5,845550
1,008000
1,008000
6,536751
0,541000
3,306751
2,103000
8,359500
2,041250
4,876000
3,758000
3,758000
3,071000
3,071000
13,901250
13,901250
0,625142
0,106667
0,221951
1,546459
0,891459
3,465000
10,922919
5,664752
11,708353
32,415792
0,521470
0,998000
1,334000
2,798470
3,527470
5,840276
4,957776
0,120475
1,439000
0,158608
0,336201
0,054900
0,054900
0,935972
0,211067
0,211067
7,383750
0,712000
0,111300
0,025834
0,206250
0,038381
0,513162
37,758092
126,562366
167,148548
247,157095
40,390000
40,390000
143,452000
143,452000
13,171000
0,177000
0,234536
0,035750
0,436557
cod ATC
589 G04BD07
590 G04BD08
591 G04BD08
592 G04BD08
593 G04BD08
594 G04BD08
595 G04BD09
596 G04BD09
597 G04CA01
598 G04CA01
599 G04CA01
600 G04CA01
601 G04CA02
602 G04CA02
603 G04CA02
604 G04CA02
605 G04CA02
606 G04CA02
607 G04CB01
608 G04CB01
609 G04CB02
610 H01AA02
611 H01AC01
612 H01AC01
613 H01AC01
614 H01AC01
615 H01AC01
616 H01AC01
617 H01CC01
618 H01CC01
619 H01CC02
620 H02AA02
621 H02AB01
622 H03BB02
623 H03BB02
624 H03BB02
625 J01CR01
626 J01CR04
627 J01CR04
628 J01FA02
629 J01FA02
630 J01FA02
631 J01FA10
632 J01FA10
633 J01FA10
634 J01FA10
635 J01FA10
636 J01FA10
637 J01FA10
638 J01FA10
639 J01FA10
640 J01FA10
641 J01FA10
642 J01FA10
643 J01FA10
644 J01FA10
645 J01FA10
646 J01FA10
647 J01FA10
648 J01FA10
649 J01FA10
650 J01FA10
651 J01FA10
652 J01FA10
653 J01FF01
654 J01FF01
DCI
TOLTERODINUM**#
SOLIFENACINUM SUCCINATE**#
TROSPIUM
TROSPIUM
ALFUZOSINUM
ALFUZOSINUM
ALFUZOSINUM
ALFUZOSINUM
TAMSULOSINUM
TAMSULOSINUM
TAMSULOSINUM
TAMSULOSINUM
TAMSULOSINUM
TAMSULOSINUM
FINASTERIDUM*
FINASTERIDUM*
DUTASTERIDUM*
TETRACOSACTIDUM
SOMATROPINUM***#
SOMATROPINUM***#
SOMATROPINUM***#
SOMATROPINUM***#
SOMATROPINUM***#
SOMATROPINUM***#
GANIRELIXUM***#
GANIRELIXUM***#
CETRORELIXUM***#
FLUDROCORTISONUM
BETAMETHASONUM
THIAMAZOLUM
THIAMAZOLUM
THIAMAZOLUM
AMPICILLINUM + SULBACTAM
SULTAMICILLINUM
SULTAMICILLINUM
SPIRAMYCINUM
SPIRAMYCINUM
SPIRAMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
CLINDAMYCINUM
CLINDAMYCINUM
Denumire Comerciala
UROFLOW 2
VESICARE 10 mg
SOLIFENACIN ACTAVIS 10 mg
VESICARE 5 mg
ASOLFENA 5 mg
SOLIFENACIN ACTAVIS 5 mg
INKONTAN 15 mg
INKONTAN 30 mg
ALFURAN MR 10 mg
XATRAL SR 10 mg
XATRAL SR 10 mg
XATRAL LP 5 mg
TAMSOL 0,4 mg
FOKUSIN
CONTIFLO MR
TAMSULOSIN AUROBINDO 400 micrograme
TAMSULOSIN TEVA 400 g

OMNIC TOCAS (R) 0,4
PROSCAR 5 mg
FINASTERIDA ARENA 5 mg
AVODART 0,5 mg
SYNACHTEN DEPOT
GENOTROPIN 16 UI/ml (5,3 mg/ml)
ZOMACTON
NUTROPINAq 10 mg/2 ml
OMNITROPE 3,3mg/ml
OMNITROPE 6,7mg/ml
NORDITROPIN SIMPLEXx 10 mg/1,5ml
ORGALUTRAN 0.25mg/0,5ml
ORGALUTRAN 0.25mg/0,5ml
CETROTIDE 0,25 mg
ASTONIN H
DIPROPHOS
THYROZOL 10 mg
THYROZOL 20mg
THYROZOL 5 mg
AMPIPLUS 1000 mg/500 mg
UNASYN
UNASYN
ROVAMYCINE (R) 1,5 Mil. UI
ROVAMYCINE (R) 3 Mil. UI
ROVAMYCINE 3 Mil. UI
AZATRIL 250 mg
SUMAMED 250 mg
SUMAMED 125 mg
AZITROMICINA SANDOZ 250 mg COMPRIMATE FILMATE
AZITROMICINA TERAPIA 250 mg

SUMAMED 500 mg
AZITROMICINA SANDOZ 500 mg COMPRIMATE FILMATE
AZIBIOT 500 mg
AZITROX (R) 500
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
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
CAPS. ELIB. MODIF.

CAPS. ELIB. MODIF.
CAPS. ELIB. PREL.
concentratie
2mg
10mg
10mg
5mg
5mg
5mg
15mg
30mg
10mg
10mg
10mg
5mg
0,4mg
0,4mg
0,4mg
CAPS. ELIB. PREL. 400micrograme
400 g
COMPR. FILM. 5mg
COMPR. FILM. 5mg
CAPS. MOI 0,5mg
SUSP. INJ. 1mg/ml
COMPR. CU ELIB. PRELUNGITA

SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ. IN CARTUS
SOL. INJ.
SOL. INJ.
16UI/ml (5,3mg/ml)
1000mg/500mg
COMPR. FILM. 375mg

250mg/5ml
COMPR. FILM. 1,5 M ui

COMPR. FILM. 3M ui
COMPR. FILM. 3MilU.I.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
PULB. + SOLV. SUSP. ORALA

CAPS.
CAPS.
P6L

KRKA, TOVARNA ZDRAVIL, D.D. NOVO MESTO
SLOVENIA

PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H.
PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H.
TERAPIA SA
250mg
250mg
125mg
250mg
250mg
250mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
600mg
600mg
200mg/5ml
100mg/5ml
200 mg/5 ml
200mg/5ml
200mg/5ml
200mg/5ml
150mg
300mg
CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L

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

AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ZENTIVA KS
CEHIA
RANBAXY UK LTD. MAREA BRITANIE
CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. ELIB. PREL.
P-6L
CUTIE X 3 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-6L

CUTIE CU 1 BLIST. PVC/AL CU 30 COMPR. ELIB. PREL. P-6L
P-6L
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. CU ELIB. PREL.
P-6L
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. MODIF.
P-6L
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. PREL. P-6L

CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 CAPS. ELIB. PREL.
P6L
P6L
ROMANIA
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. CU ELIB. PRELUNG.
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
ROMANIA CUTIE X 3 BLIST.PVC-PVDC/AL X 10 CAPS. MOI P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FIOLA DIN STICLA X 1 ML SUSP. INJ.
S/P-RF
MAREA BRITANIE CUTIE X 1 CARTUS BICAMERAL MULTIDOZA CU PULB. SI SOLV. PT. SOL. INJ.
P-RF
GERMANIA
PR/PRF
0,25mg/0,5ml MERCK SHARP & DOHME
SUSP. INJ. I.M.
OLANDA
ISLANDA
OLANDA
FERRING GMBH
IPSEN PHARMA
SANDOZ GMBH
SANDOZ GMBH
NOVO NORDISK A/S
0,25mg/0,5ml N. V. ORGANON
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
Ambalaj
REPUBLICA CEHA
Detinator APP
ZENTIVA K.S.
4mg (12ui)
10mg/2ml
3,3mg/ml
6,7mg/ml
10mg/1,5ml
0,25mg
0,1mg
7mg/ml
10mg
20mg
5mg
PULB+SOLV. PT. SOL. INJ.
Tara det.
APP
Prescriptie
Nr. crt
CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1 FIOLA X 3,5 ML SOLV.
FRANTA CUTIE X 1 CARTUS X 2 ML. SOL. INJ.

AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ.
AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ.
P-RF/R
P-RF/R
P-RF/R
DANEMARCA CUTIE X 1 CARTUS DIN STICLA INCOLORA X 1,5 ML SOL. INJ.
P-RF
OLANDA
CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT
P-RF/R
MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT
P-RF/R
SERONO EUROPE LTD.
MAREA BRITANIE
P-RF
MERCK KGAA
GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR.
P-RF
P-RF
MERCK KGAA
MERCK KGAA
MERCK KGAA
ANTIBIOTICE S.A.
GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L
ROMANIA
CUTIE CU 50 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF.
PR, PRF
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
FRANTA
FRANTA
FRANTA
LABORATOIRES AVENTIS
CUTIE CU UN SUPORT CONTINAND: 7 FLAC.PULB. + 7 SERINGI PRE-UMPLUTE X 1 ML SOLV. + 7 ACE PT. INJECTII + 7 ACE PT. INJECTII SUBCUTANATE + 14 TAMPOANE IMBIBATE IN ALCOOL
GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L

GERMANIA CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P6L
P-RF
P-RF
P-RF
CUTIE CU 1 BLIST. AL/PVC X 10 COMPR. FILM.
PRF
BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS.

PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS.
PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 6 COMPR. FILM.
P-RF
SANDOZ S.R.L.
TERAPIA SA
TERAPIA SA
P-RF
BALKANPHARMA RAZGRAD AD
ROMANIA
ROMANIA
ROMANIA
PLIVA LJUBLJANA D.O.O. SLOVENIA
SANDOZ S.R.L.
ROMANIA
TERAPIA SA
ROMANIA
TERAPIA SA
ROMANIA
ZENTIVA K.S.
CEHIA
ISLANDA
ARENA GROUP S.A.

TERAPIA SA
TERAPIA SA
ZENTIVA S.A.
SANDOZ SRL
SANDOZ SRL
P-RF
P-RF
CUTIE X 1 BLIST. PVC-ACLAR/AL X 6 COMPR. FILM. P-RF

CUTIE X 1 BLIST. PA-AL-PVC/AL X 6 COMPR. FILM. P-RF
P-RF
P-RF
P-RF
CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF

P-RF
CUTIE CU BLIST. OPA-PVC-AL/AL X 3 COMPR. FILM. PRF
ROMANIA CUTIE CU 1 BLIST. AL/PVC X 3 COMPR. FILM. PRF

ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF
ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM. P-RF
ROMANIA
P-RF
ROMANIA
P-RF
ROMANIA
P-RF
PLIVA LJUBLIJANA D.O.O. SLOVENIA
P-RF
P-RF
P-RF
CUTIE X 1 FLACON DIN PE CU PULBERE PENTRU 15ML SUSPENSIE ORALA RECONSTITUITA + FLACON CU SOLVENT X 7.5ML SOLVENT + 1 SERINGA PENTRU ADMINISTRAREA ORALA + O LINGURITA DOZATOARE
CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (400 MG) SUSP. ORALA
CUTIE 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
MAREA BRITANIE
MAREA BRITANIE

Pagina 10 din 16
P-RF
P-RF
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
28
30
30
30
30
30
30
30
30
30
30
28
30
30
30
30
30
30
28
28
30
1
1
1
1
1
1
1
1
1
7
50
5
50
50
100
50
12
1
16
10
10
6
6
6
6
6
6
3
3
3
3
3
3
3
3
3
3
1
1
1
1
1
1
16
16
0,843366
3,373466
3,215000
1,686733
1,686733
1,686733
0,632524
1,265049
0,706666
1,087333
1,087333
0,582142
0,916666
0,726333
0,496666
0,909666
0,565333
1,189499
0,983124
0,876071
3,160666
5,960000
423,587000
317,690250
794,225625
384,340000
712,690000
794,225625
127,422857
127,422857
111,215714
0,403000
5,366000
0,312165
0,529400
0,156082
15,073600
2,861666
23,499996
0,637818
1,275641
1,275641
3,189105
3,189105
1,594550
3,189105
3,189105
3,189105
6,378210
4,063333
5,316666
5,576666
5,576666
5,576666
5,130000
5,576666
7,653855
7,653855
14,470000
12,722396
19,290000
19,083600
38,167200
47,709000
0,497046
0,994093
0,015205
1,316867
0,000000
2,888600
1,204933
1,203267
0,685476
0,858617
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,323501
0,321161
0,000000
0,000000
0,000000
40,873000
130,819750
157,414375
0,000000
0,000000
365,654375
16,207143
16,207143
0,000000
0,000000
0,000000
0,116835
0,000000
0,164118
0,000000
0,000000
1,820004
0,000932
1,337359
1,337359
0,102561
1,877561
2,552116
0,102561
0,102561
0,102561
2,205123
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
7,772811
7,772811
0,000000
6,617604
0,000000
3,176400
1,512800
12,651000
0,290454
0,365907
0,421683
1,686733
1,607500
0,843366
0,843366
0,843366
0,316262
0,632524
0,353333
0,543666
0,543666
0,291071
0,458333
0,363166
0,248333
0,454833
0,282666
0,594749
0,491562
0,438035
1,580333
2,980000
211,793500
158,845125
397,112812
192,170000
356,345000
397,112812
63,711428
63,711428
55,607857
0,201500
2,683000
0,156082
0,264700
0,078041
7,536800
1,430833
11,749998
0,318909
0,637820
0,637820
1,594552
1,594552
0,797275
1,594552
1,594552
1,594552
3,189105
2,031666
2,658333
2,788333
2,788333
2,788333
2,565000
2,788333
3,826927
3,826927
7,235000
6,361198
9,645000
9,541800
19,083600
23,854500
0,248523
0,497046
0,436888
3,003600
1,607500
3,731967
2,048300
2,046634
1,001738
1,491142
0,353333
0,543667
0,543667
0,291071
0,458333
0,363167
0,248333
0,454833
0,282667
0,918251
0,812723
0,438036
1,580333
2,980000
252,666500
289,664875
554,527188
192,170000
356,345000
762,767188
79,918572
79,918572
55,607857
0,201500
2,683000
0,272918
0,264700
0,242159
7,536800
1,430833
13,570002
0,319841
1,975180
1,975180
1,697114
3,472114
3,349391
1,697114
1,697114
1,697114
5,394228
2,031667
2,658333
2,788333
2,788333
2,788333
2,565000
2,788333
11,599739
11,599739
7,235000
12,978802
9,645000
12,718200
20,596400
36,505500
0,538977
0,862954
0,759029
3,036119
2,893500
1,518059
1,518059
1,518059
0,569271
1,138544
0,635999
0,978599
0,978599
0,523927
0,824999
0,653699
0,446999
0,818699
0,508799
1,070549
0,884811
0,788463
2,844599
5,364000
381,228300
285,921225
714,803062
345,906000
641,421000
714,803062
114,680571
114,680571
100,094142
0,362700
4,829400
0,280948
0,476460
0,140473
13,566240
2,575499
21,149996
0,574036
1,148076
1,148076
2,870194
2,870194
1,435095
2,870194
2,870194
2,870194
5,740389
3,656999
4,784999
5,018999
5,018999
5,018999
4,617000
5,018999
6,888469
6,888469
13,023000
11,450156
17,361000
17,175240
34,350480
42,938100
0,447341
0,894683
0,099542
1,654214
0,321500
3,057274
1,373607
1,371941
0,748729
0,985122
0,070667
0,108734
0,108734
0,058215
0,091667
0,072634
0,049667
0,090967
0,056534
0,442451
0,419474
0,087608
0,316067
0,596000
83,231700
162,588775
236,836938
38,434000
71,269000
445,076938
28,949429
28,949429
11,121572
0,040300
0,536600
0,148052
0,052940
0,179727
1,507360
0,286167
4,170004
0,064714
1,464924
1,464924
0,421472
2,196472
2,711571
0,421472
0,421472
0,421472
2,842944
0,406334
0,531667
0,557667
0,557667
0,557667
0,513000
0,557667
8,538197
8,538197
1,447000
7,889844
1,929000
5,084760
5,329520
17,421900
0,340159
0,465317
cod ATC
655 J01FF01
656 J01FF01
657 J01FF01
658 J01FF01
659 J01MA12
660 J01MA12
661 J01MA12
662 J01MA12
663 J01MA12
664 J01MA12
665 J01MA12
666 J01MA14
667 J01MA14
668 J01MA14
669 J01MA14
670 J01MA14
671 J02AC02
672 J02AC02
673 J02AC02
674 J02AC02
675 J02AC02
676 J02AC02
677 J05AB11
678 J05AB11
679 J05AB15
680 L01AA01
681 L02AE02
682 L02AE02
683 L02AE03
684 L02AE04
685 L02AE04
686 L02AE04
687 L02AE04
688 L04AX01
689 L04AX01
690 M01AC05
691 M01AC05
692 M01AE17
693 M01AE17
694 M01AE17
695 M01AE17
696 M01AE17
DCI
CLINDAMYCINUM
CLINDAMYCINUM
CLINDAMYCINUM
CLINDAMYCINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
MOXIFLOXACINUM
MOXIFLOXACINUM
MOXIFLOXACINUM
MOXIFLOXACINUM
MOXIFLOXACINUM
ITRACONAZOLUM*
ITRACONAZOLUM*
ITRACONAZOLUM*
ITRACONAZOLUM*
ITRACONAZOLUM*
ITRACONAZOLUM*
VALACYCLOVIRUM*
VALACYCLOVIRUM*
BRIVUDINUM*#
CYCLOPHOSPHAMIDUM*
LEUPRORELINUM***#
LEUPRORELINUM***#
GOSERELINUM***#
TRIPTORELINUM***#
TRIPTORELINUM***#
TRIPTORELINUM***#
TRIPTORELINUM***#
AZATHIOPRINUM*
AZATHIOPRINUM*
LORNOXICAMUM
LORNOXICAMUM
DEXKETOPROFENUM
DEXKETOPROFENUM
DEXKETOPROFENUM
DEXKETOPROFENUM
DEXKETOPROFENUM
697 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL)

698 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL)
699 M01AH01
700 M01AH01
701 M01AH01
702 M01AH01
703 M01AH01
704 M01AH01
705 M01AH01
706 M01AH01
707 M01AH01
708 M01AH01
709 M01AH01
710 M01AH01
711 M01AH01
712 M01AH01
713 M01AH01
714 M01AH01
715 M01AH05
716 M01AH05
717 M01AH05
718 M01AH05
719 M01AH05
720 M01AH05
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM
Denumire Comerciala
CLINDAMYCIN - MIP 300 mg

LEVOFLOXACINA ACTAVIS 250 mg
TAVANIC 250 mg
LEVOTOR 250 mg
FLERADAY 500 mg
LEVOFLOXACINA ACTAVIS 500 mg
TAVANIC 500 mg
LEVOTOR 500 mg
AVELOX 400 mg
MOXIFLOXACINA AUROBINDO 400 mg
MOFINACIN 400 mg
MOFIL 400 mg
MOFLAXA 400 mg
ORUNGAL
ITRACONAZOL 100 mg
OMICRAL 100 mg
MICOGAL 100 mg
ITRACONAZOL ARENA 100 mg
OMICRAL 100 mg
VALTREX 500 mg
VALACICLOVIR ARENA 500 mg
BRIVAL 125mg
ENDOXAN (R) 50 mg
LUCRIN DEPOT 11,25mg
LUCRIN DEPOT 3,75mg
ZOLADEX (R)
DIPHERELINE 0,1 mg
DIPHERELINE PR 11,25 mg
DIPHERELINE 3,75 mg
GONAPEPTYL ZILNIC 0,1 mg/ml
IMURAN
IMURAN
XEFO RAPID 8 mg
XEFO 8 mg/ 2 ml
TADOR 25 mg
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR.
DRAJ.
PULB. PT. SUSP. INJ. CU ELIB. PREL.
PULB. PT. SUSP. INJ. CU ELIB. PREL.
IMPLANT
PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.
SOL. INJ.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
DEXKETOPROFEN TROMETAMOL SANDOZ 25mg
COMPR. FILM.
COMPR. FILM.
TADOR INJECT
SOL. INJ./CONC. PT. SOL. PERF.
DEXKETOPROFEN ROMPHARM 50 mg/2 ml

DEXKETOPROFEN ROMPHARM 50 mg/2 ml
VIMOVO 500 mg/20 mg

VIMOVO 500 mg/20 mg
CELEBREX 100 mg
ALGOXIB 100 mg
ACLEXA 100 mg
CELECOXIB ACTAVIS 100 mg
CELETOR 100 mg
CALIDEM 100 mg
CELECOXIB TERAPIA 100 mg
CELEBREX 200 mg
CELEBREX 200 mg
ALGOXIB 200 mg
ACLEXA 200 mg
CELECOXIB ACTAVIS 200 mg
CELETOR 200 mg
CALIDEM 200 mg
CALIDEM 200 mg
CELECOXIB TERAPIA 200 mg
ARCOXIA 120 mg
ARCOXIA 120 mg
ARCOXIA 30 mg
ARCOXIA 60 mg
ARCOXIA 60 mg
ARCOXIA 90 mg
COMPR. ELIB. MODIF.

COMPR. ELIB. MODIF.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
concentratie
300mg
300mg
600mg
600mg
250mg
250mg
250mg
500 mg
500mg
500mg
500mg
400mg
400mg
400mg
400mg
400mg
100mg
100mg
100mg
100mg
100mg
100mg
500 mg
500mg
125mg
50mg
11,25mg
3,75mg
3,6mg
0,1mg
11,25mg
3,75mg
0,1mg/ml
50mg
50mg
8mg
8mg/2ml
25mg
25mg
50mg/2ml
50mg/2ml
50mg/2ml
Detinator APP
Tara det.
APP
MIP PHARMA GMBH GERMANIA

TERAPIA S.A.
ROMANIA
Ambalaj
Prescriptie
Nr. crt
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
16
30
CUTIE X 2 BLIST. PVC/AL X 8 COMPR. FILM. P-RF
16
CUTIE X 5 BLIST. PVC/AL X 6 COMPR. FILM. P-RF
30
7
CUTIE X1 BLIST. PVC/AL. X 7 COMPR. FILM. P-RF
7
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-RF
7
DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/PVDC - AL X 7 COMPR. FILM. PRF
7
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-RF
7
TERAPIA S.A.
ROMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF
7
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-RF
7
BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. TRANSPARENT PP/AL X 5 COMPR. FILM. P-RF
5
CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR. FILM. PRF
5
ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. OPA-AL-PVC/AL X 5 COMPR. FILM PRF
5
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 5 COMPR. FILM. PRF
5
PRF
5
CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF
15
SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF
15
MEDICO UNO PHARMACEUTICAL SRL
ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF
15
ROMPHARM COMPANY SRL ROMANIA CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF
15
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF
15
PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF
15
THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM. PRF
10
ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC ALB OPAC/AL X 10 COMPR. FILM. PRF
10
BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 BLIST. PVC/AL X 7 COMPR.
P-RF
7
BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ.
P-RF
50
ABBVIE FARMACEUTICA S.L.U. SPANIA
PR/PRF
1
PR/PRF
1
ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 1 PLIC X 1 SERINGA PRE-UMPLUTA X 3,6 MG S/P-RF
1
IPSEN PHARMA
FRANTA CUTIE X 7 FLAC. CU LIOF. PT. SOL. INJ. + 7 FIOLE X 1 ML SOLV. S/P-RF
7
IPSEN PHARMA
FRANTA
S/P-RF
1
IPSEN PHARMA
FRANTA
S/P-RF
1
FERRING GMBH
GERMANIA CUTIE X 28 SERINGI PREUMPLUTE DIN STICLA INCOLORA X 1 ML SOL. INJ S/P-RF
28
ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100
ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF
100
NYCOMED AUSTRIA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L
10
NYCOMED AUSTRIA GMBH AUSTRIA
PRF
10
BERLIN CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-6L
10
SANDOZ S.R.L.
ROMANIA CUTIE BLIST. DIN PVC-PVDC/AL X 20 COMPRIMATE FILMATE P6L
20
MENARINI INTERNATIONAL OPERATIONS S.A. LUXEMBOURG CUTIE X 5 FIOLE X 2 ML SOL. INJ./CONC. PT.SOL.PERF.
P-RF
5
PRF
5
PRF
10
500 mg/20 mg ASTRA ZENECA AB SUEDIA
PRF
30
500 mg/20 mg ASTRA ZENECA AB SUEDIA
PRF
60
100mg
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF
30
100mg
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS.
PRF
30
100mg
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF
30
100mg
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF
30
100mg
TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS.
PRF
30
100mg
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF
30
100mg
TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF
30
200mg
10
200mg
30
200mg
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS.
PRF
30
200mg
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF
30
200mg
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF
30
200mg
TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS.
PRF
30
200mg
10
200mg
30
200mg
TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF
30
120mg
MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF
7
120mg
MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL, X 14 COMPR. FILM. P-RF
14
30mg
28
60mg
14
60mg
14
90mg
14
CUTIE X 2 BLIST. PVC/AL X 8 COMPR. FILM.
P-RF
CUTIE X 5 BLIST. PVC/AL X 6 COMPR. FILM.
P-RF
CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONAINND 5 COMPRIMATE FILMATE
CUTIE CU1 KIT CU 1 FLAC. DIN STICLA INCOLORA,O FIOLA DIN STICLA INCOLORA CU PUNCT DE RUPERE A 2 ML SOLV,O SERINGA STERILA,APIROGENA DE UNICA FOLOSINTA A 2,5 ML,2 ACE(23G 1)STERILE,DE UNICA FOLOSINTA SI 1 TAMPON IMBIBAT CU ALCOOL IZOPROPILIC 70%.
CUTIE CU1 KIT CU 1 FLAC. DIN STICLA INCOLORA,O FIOLA DIN STICLA INCOLORA CU PUNCT DE RUPERE A 2 ML SOLV,O SERINGA STERILA,APIROGENA DE UNICA FOLOSINTA A 2,5 ML,2 ACE(22G 1)STERILE,DE UNICA FOLOSINTA SI 1 TAMPON IMBIBAT CU ALCOOL IZOPROPILIC 70%.
CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV. + 1 BLIST. CU 1 SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE
CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV. + 1 BLIST. CU O SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE
CUTIE CU 10 FLAC. DIN STICLA BRUNA CU PULB. PT. SOL. INJ. + 10 FIOLE DIN STICLA INCOLORA X 2 ML SOLV
CUTIE CU 5 FIOLE DIN STICLA BRUNA (UN SUPORT A 5 FIOLE), PREVAZUTE CU INEL DE RUPERE, CONTINAND 2 ML DE SOL. INJ./CONC. PT. SOL. PERF.
CUTIE CU 10 FIOLE DIN STICLA BRUNA (DOUA SUPORTURI A CATE 5 FIOLE), PREVAZUTE CU INEL DE RUPERE, CONTINAND 2 ML DE SOL. INJ./CONC. PT. SOL. PERF.
CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 30 COMPR. ELIB. MODIF.
CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 60 COMPR. ELIB. MODIF.
Pagina 11 din 16
0,883750
0,884000
1,988187
1,988187
1,555714
2,433600
1,555714
4,427142
3,280000
4,867200
3,228571
4,867200
4,867200
4,867200
4,867200
4,867200
3,194000
2,144666
2,144666
2,144666
2,144666
2,144666
4,661000
3,131000
48,002857
0,542400
630,670000
246,930000
298,459994
6,802854
765,321751
371,770000
0,911583
0,614116
0,614116
0,431999
1,178998
0,475199
0,475199
2,276000
2,276000
2,276000
1,611749
1,584666
0,586583
0,584000
0,584000
0,584000
0,584000
0,584000
0,584000
1,173166
1,173166
1,173166
1,173166
1,173166
1,173166
1,173166
1,173166
1,173166
2,346333
2,346333
0,586583
1,173166
1,173166
1,759749
0,000000
0,000000
0,660563
0,747146
0,000000
1,417828
0,000000
0,000000
0,000000
1,724228
0,000000
6,216800
2,338800
2,338800
2,338800
2,338800
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
4,700006
6,878574
121,558249
0,000000
21,261274
0,088184
0,088184
0,540001
7,921002
0,396801
0,091801
1,788000
0,364000
0,365000
0,081251
0,000000
0,311750
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,972834
0,640167
0,005167
0,005167
0,005167
0,005167
0,220834
0,005167
0,005167
2,212238
2,065095
2,234488
2,023262
2,023262
1,757393
0,441875
0,442000
0,994093
0,994093
0,777857
1,216800
0,777857
2,213571
1,640000
2,433600
1,614285
2,433600
2,433600
2,433600
2,433600
2,433600
1,597000
1,072333
1,072333
1,072333
1,072333
1,072333
2,330500
1,565500
24,001428
0,271200
315,335000
123,465000
149,229997
3,401427
382,660875
185,885000
0,455791
0,307058
0,307058
0,215999
0,589499
0,237599
0,237599
1,138000
1,138000
1,138000
0,805874
0,792333
0,293291
0,292000
0,292000
0,292000
0,292000
0,292000
0,292000
0,586583
0,586583
0,586583
0,586583
0,586583
0,586583
0,586583
0,586583
0,586583
1,173166
1,173166
0,293291
0,586583
0,586583
0,879874
0,441875
0,442000
1,654657
1,741240
0,777857
2,634628
0,777857
2,213571
1,640000
4,157828
1,614286
8,650400
4,772400
4,772400
4,772400
4,772400
1,597000
1,072333
1,072333
1,072333
1,072333
1,072333
2,330500
1,565500
24,001429
0,271200
315,335000
123,465000
153,930003
10,280001
504,219125
185,885000
21,717066
0,395242
0,395242
0,756001
8,510501
0,634401
0,329401
2,926000
1,502000
1,503000
0,887126
0,792333
0,605042
0,292000
0,292000
0,292000
0,292000
0,292000
0,292000
1,559417
1,226750
0,591750
0,591750
0,591750
0,591750
0,807417
0,591750
0,591750
3,385405
3,238262
2,527780
2,609845
2,609845
2,637268
0,795375
0,795600
1,789368
1,789368
1,400142
2,190240
1,400142
3,984427
2,952000
4,380480
2,905713
4,380480
4,380480
4,380480
4,380480
4,380480
2,874600
1,930199
1,930199
1,930199
1,930199
1,930199
4,194900
2,817900
43,202571
0,488160
567,603000
222,237000
268,613994
6,122568
688,789575
334,593000
0,820424
0,552704
0,552704
0,388799
1,061098
0,427679
0,427679
2,048400
2,048400
2,048400
1,450574
1,426199
0,527924
0,525600
0,525600
0,525600
0,525600
0,525600
0,525600
1,055849
1,055849
1,055849
1,055849
1,055849
1,055849
1,055849
1,055849
1,055849
2,111699
2,111699
0,527924
1,055849
1,055849
1,583774
0,088375
0,088400
0,859382
0,945965
0,155572
1,661188
0,155572
0,442715
0,328000
2,210948
0,322858
6,703520
2,825520
2,825520
2,825520
2,825520
0,319400
0,214467
0,214467
0,214467
0,214467
0,214467
0,466100
0,313100
4,800286
0,054240
63,067000
24,693000
34,546006
7,558860
198,090425
37,177000
21,352433
0,149596
0,149596
0,583201
8,038902
0,444321
0,139321
2,015600
0,591600
0,592600
0,242426
0,158467
0,370409
0,058400
0,058400
0,058400
0,058400
0,058400
0,058400
1,090151
0,757484
0,122484
0,122484
0,122484
0,122484
0,338151
0,122484
0,122484
2,446872
2,299729
2,293147
2,140579
2,140579
1,933368
cod ATC
DCI
737 M05BA07
ETORICOXIBUM
BACLOFENUM
BACLOFENUM
ACIDUM ALENDRONICUM*
ACIDUM RISEDRONICUM*
738 M05BB03
COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)*
739 M05BB03
740 M05BB03
741 N02AA05
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
DIHYDROCODEINUM*
DIHYDROCODEINUM*
DIHYDROCODEINUM*
721 M01AH05
722 M03BX01
723 M03BX01
724 M05BA04
725 M05BA04
726 M05BA04
727 M05BA04
728 M05BA04
729 M05BA04
730 M05BA04
731 M05BA07
732 M05BA07
733 M05BA07
734 M05BA07
735 M05BA07
736 M05BA07
742 N02AA05
743 N02AA05
744 N02AA05
745 N02AA05
746 N02AA05
747 N02AA05
748 N02AA05
749 N02AA05
750 N02AA05
751 N02AA05
752 N02AA05
753 N02AA05
754 N02AA05
755 N02AA05
756 N02AA05
757 N02AA05
758 N02AA05
759 N02AA08
760 N02AA08
761 N02AA08
762 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM

763 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
775 N03AX16
776 N03AX16
777 N03AX16
778 N03AX16
779 N03AX16
780 N03AX16
781 N04BC05
782 N04BC05
783 N04BC05
784 N04BC05
785 N04BC05
786 N04BC05
PREGABALINUM**#
PREGABALINUM**#
PREGABALINUM**#
PREGABALINUM**#
PREGABALINUM**#
PREGABALINUM**#
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
Denumire Comerciala
ARCOXIA 90 mg
LIORESAL (R)
LIORESAL (R)
TEVANAT 70 mg
ACID ALENDRONIC AUROBINDO 70 mg
FOSAMAX 70 mg
ALENDRONAT SANDOZ 70 mg
ADRONIK 70 mg
ADRONIK 70 mg
ADRONIK 70 mg
RISEDRONAT TEVA 35 mg
LORINE 35mg
OSODENS 35 mg
RISEDRONAT SODIC ZENTIVA 35mg
RISEDRONAT AUROBINDO 35 mg
ACTONEL SAPTAMANAL 35 mg
ACTONEL 75 mg
FOSAVANCE 70mg/2800UI
OXYCONTIN 10 mg
OXYCONTIN 20 mg
OXYCONTIN 40 mg
OXYCONTIN 80 mg
RELTEBON 10 mg
RELTEBON 20 mg
Tara det.
APP
Detinator APP
COMPR. FILM. 90mg
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.
10mg
25mg
70 mg
70mg
70mg
70mg
70mg
70mg
70mg
35mg
35mg
35mg
35mg
35mg
35mg
75mg
COMPR.
COMPR.
COMPR.
70mg/2800UI MERCK SHARP & DOHME

MAREA BRITANIE CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.)
P-6L
P-6L
P-6L
10 mg
20 mg
40 mg
80mg
10mg
20mg
20mg
40mg
40mg
80mg
80mg
10mg
20mg
40mg
40mg
60mg
80mg
80mg
120mg
60mg
90mg
AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.

ISLANDA
ISLANDA
PS
PS
PS
PS


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
LINEROL 37,5 mg/325 mg
DORETA 75 mg/650 mg
DORETA 75 mg/650 mg
PALGOTAL 75 mg/650 mg
LYRICA 150 mg
LYRICA 150 mg
LYRICA 300 mg
LYRICA 300 mg
LYRICA 75 mg
LYRICA 75 mg
OPRYMEA 0,088mg
PRAMIPEXOL ZENTIVA 0,18 mg
OPRYMEA 0,18mg
MEDOPEXOL 0,18 mg
GLEPARK 0,18 mg
PRAMIPEXOL TORRENT 0,18 mg
Ambalaj
Prescriptie
Nr. crt
COMPR. ELIB. PREL.

COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. FILM. 37,5mg+325mg

CAPS.
37,5mg/325mg
CAPS.
37,5mg/325mg
COMPR. FILM. 37,5mg/325mg
COMPR. FILM. 75 mg/650 mg
COMPR. FILM. 75 mg/650 mg
COMPR. FILM. 75mg/650mg
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
150mg
150mg
300mg
300mg
75mg
75mg
0,088mg
0,18 mg
0,18mg
0,18mg
0,18mg
0,18mg

ROMANIA CUTIE X 1 BLIST. PVC-AL-OPA/AL X 4 COMPR. P-6L
MALTA CUTIE CU BLIST. TRANSPARENTE PVC-ACLAR/AL X 4 COMPR. P6L
ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L
ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 2 COMPR. FILM P-6L
ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR. FILM. P-6L
ROMANIA CUTIE X BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L
ROMANIA CUTIE X 1BLIST. PVC- PVDC/AL X 4 COMPR. FILM. P-6L
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR. FILM. P-6L

NOVARTIS PHARMA GMBH
MERCK SHARP & DOHME
SANDOZ S.R.L.
ARENA GROUP S.A.
ARENA GROUP S.A.
ARENA GROUP S.A.
TEVA PHARMACEUTICALS SRL
ANTIBIOTICE S.A.
TERAPIA SA
ZENTIVA KS

MUNDIPHARMA GES.M.B.H
REPUBLICA CEHA CUTIE X 1 BLISTER OPA-AL-PVC/AL X 4 COMPRIMATE FILMATE

ISLANDA

ISLANDA
CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL.
PR, PS
PR, PS
CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL.
PR, PS
PR, PS
PR, PS
PR, PS
PR, PS
AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL.

SANDOZ S.R.L.
SANDOZ S.R.L.
ROMANIA
ROMANIA
SANDOZ S.R.L.
ROMANIA

P-6L
MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 4 COMPR. FILM. P6L

ISLANDA CUTIE CU 1 BLIST. PVC/AL X 4 COMPR. FILM. P-6L
ISLANDA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L
CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL.

P-TS
P-TS
P-TS
PS
PS
P-TS

PS
AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS
GRUNENTHAL GMBH GERMANIA

CUTIE X 2 BLISTERE PVC/PE/PVDC/AL X 15 CAPSULE
PRF
CUTIE CU 1 BLIST. DIN PVC/PE/PVDC/AL A 15 CAPS.
PRF
STADA ARZNEIMITTEL AG GERMANIA
CUTIE CU 1 BLIST.DIN HRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF
SLOVENIA
CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
CUTIE X 1 BLIST. PVC OPAC/AL X 10 COMPR. FILM. P-RF
POLONIA CUTIE CU BLIST. PVC/AL X 20 COMPR. FILM.
P-RF
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMP.FILM. PRF
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMP.FILM. PRF
ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVCDC/AL X 30 COMPR. FILM.
PRF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF
PFIZER LIMITED
PFIZER LIMITED
MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF
PFIZER LIMITED
PFIZER LIMITED
KRKA D.D.
SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF
ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF
KRKA D.D.
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
CUTIE CU BLIST. AL/AL X 30 COMPR.
P-RF
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF
Pagina 12 din 16
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
14
50
50
4
4
2
2
12
2
4
4
4
4
4
4
4
2
4
2
4
60
60
60
60
60
60
60
60
60
60
60
60
60
60
20
20
60
20
56
56
56
10
30
15
10
20
30
50
10
20
20
10
20
30
14
56
56
14
14
56
30
30
30
30
30
30
1,759749
0,333959
0,666000
2,705000
2,487500
6,594412
4,890000
6,594412
6,594412
6,594412
2,220000
6,594412
6,594412
3,712500
3,712500
6,594412
14,130883
6,594412
6,594412
6,594412
0,437249
0,874498
1,748999
3,497999
0,437249
0,874498
0,874498
1,748999
1,748999
3,303666
3,304000
0,437249
0,874498
1,748999
1,748999
2,623501
3,303666
3,497999
1,366660
0,543750
1,024995
0,272750
0,272750
0,272750
0,272750
0,272750
0,272750
0,272750
0,272750
0,272500
0,272750
0,545000
0,545500
0,537333
3,126081
3,126081
5,731785
6,045000
1,563040
1,563040
0,087088
0,178135
0,178135
0,178135
0,178135
0,178135
1,757393
0,079241
0,000000
0,000000
0,000000
7,025588
0,000000
1,541421
2,255588
1,973088
0,000000
0,628088
0,628088
0,000000
0,000000
4,155588
19,064117
11,895588
11,080588
10,493088
0,608584
0,971835
1,086334
1,584834
0,242417
0,325668
0,325668
0,194334
0,194334
0,000000
0,000000
0,242417
0,325668
0,194334
0,297001
4,606499
0,000000
0,048501
0,792447
0,000000
0,437147
0,534250
0,240916
0,253250
0,534250
0,533750
0,517250
0,387450
0,000250
0,000000
0,251750
0,000000
0,000000
0,000000
1,254633
0,770169
0,000000
0,000000
1,069817
0,850888
0,442912
0,208531
0,248531
0,473198
0,144531
0,412531
0,879874
0,166979
0,333000
1,352500
1,243750
3,297206
2,445000
3,297206
3,297206
3,297206
1,110000
3,297206
3,297206
1,856250
1,856250
3,297206
7,065441
3,297206
3,297206
3,297206
0,218624
0,437249
0,874499
1,748999
0,218624
0,437249
0,437249
0,874499
0,874499
1,651833
1,652000
0,218624
0,437249
0,874499
0,874499
1,311750
1,651833
1,748999
0,683330
0,271875
0,512497
0,136375
0,136375
0,136375
0,136375
0,136375
0,136375
0,136375
0,136375
0,136250
0,136375
0,272500
0,272750
0,268666
1,563040
1,563040
2,865892
3,022500
0,781520
0,781520
0,043544
0,089067
0,089067
0,089067
0,089067
0,089067
2,637268
0,246221
0,333000
1,352500
1,243750
10,322794
2,445000
4,838627
5,552794
5,270294
1,110000
3,925294
3,925294
1,856250
1,856250
7,452794
26,129559
15,192794
14,377794
13,790294
0,827209
1,409084
1,960834
3,333834
0,461042
0,762917
0,762917
1,068834
1,068834
1,651833
1,652000
0,461042
0,762917
1,068834
1,171501
5,918250
1,651833
1,797501
1,475777
0,271875
0,949645
0,670625
0,377291
0,389625
0,670625
0,670125
0,653625
0,523825
0,136625
0,136250
0,388125
0,272500
0,272750
0,268667
2,817674
2,333210
2,865893
3,022500
1,851337
1,632408
0,486456
0,297599
0,337599
0,562266
0,233599
0,501599
1,583774
0,300563
0,599400
2,434500
2,238750
5,934970
4,401000
5,934970
5,934970
5,934970
1,998000
5,934970
5,934970
3,341250
3,341250
5,934970
12,717794
5,934970
5,934970
5,934970
0,393524
0,787048
1,574099
3,148199
0,393524
0,787048
0,787048
1,574099
1,574099
2,973299
2,973600
0,393524
0,787048
1,574099
1,574099
2,361150
2,973299
3,148199
1,229994
0,489375
0,922495
0,245475
0,245475
0,245475
0,245475
0,245475
0,245475
0,245475
0,245475
0,245250
0,245475
0,490500
0,490950
0,483599
2,813472
2,813472
5,158606
5,440500
1,406736
1,406736
0,078379
0,160321
0,160321
0,160321
0,160321
0,160321
1,933368
0,112637
0,066600
0,270500
0,248750
7,685030
0,489000
2,200863
2,915030
2,632530
0,222000
1,287530
1,287530
0,371250
0,371250
4,815030
20,477206
12,555030
11,740030
11,152530
0,652309
1,059285
1,261234
1,934634
0,286142
0,413118
0,413118
0,369234
0,369234
0,330367
0,330400
0,286142
0,413118
0,369234
0,471901
4,868850
0,330367
0,398301
0,929113
0,054375
0,539647
0,561525
0,268191
0,280525
0,561525
0,561025
0,544525
0,414725
0,027525
0,027250
0,279025
0,054500
0,054550
0,053734
1,567242
1,082778
0,573179
0,604500
1,226121
1,007192
0,451621
0,226345
0,266345
0,491012
0,162345
0,430345
cod ATC
787 N04BC05
788 N04BC05
789 N04BC05
790 N04BC05
791 N04BC05
792 N04BC05
793 N04BC05
794 N04BC05
795 N04BC05
796 N04BC05
797 N04BC05
798 N04BC05
799 N04BC05
800 N04BC05
801 N04BC05
802 N04BC05
803 N04BC05
804 N04BC05
805 N04BC05
806 N04BC05
807 N04BC05
808 N04BC05
809 N04BC05
810 N04BC08
811 N05AL03
812 N05BE01
813 N05BE01
814 N06AB10
815 N06AB10
816 N06AB10
817 N06AB10
818 N06AB10
819 N06AB10
820 N06AB10
821 N06AB10
822 N06AB10
823 N06AB10
824 N06AB10
825 N06AB10
826 N06AB10
827 N06AB10
828 N06AB10
829 N06AB10
830 N06AB10
831 N06AB10
832 N06AB10
833 N06AB10
834 N06AB10
835 N06AB10
836 N06AB10
837 N06AB10
838 N06AB10
839 N06AB10
840 N06AB10
841 N06AB10
842 N06AB10
843 N06AX05
844 N06AX05
845 N06AX05
846 N06AX05
847 N06AX05
848 N06AX05
849 N06AX12
850 N06AX14
851 N06AX14
852 N06AX14
DCI
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PIRIBEDILUM**
TIAPRIDUM
BUSPIRONUM
BUSPIRONUM
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
BUPROPIONUM**#
TIANEPTINUM**
TIANEPTINUM**
TIANEPTINUM**
Denumire Comerciala
PRAMIPEXOL AUROBINDO 0,18 mg

MIGLASEN 0,18 mg
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
MIRAPEXIN 3,15 mg
PRONORAN 50 mg
TIAPRIDAL (R) 100 mg
SPITOMIN 10 mg
SPITOMIN 5 mg
DEPRESINAL 10 mg
CIPRALEX 10 mg
ESCITIL 10 mg
ESCITALOPRAM-TEVA 10 mg
LENUXIN 10 mg
ESLOREX 10 mg
SERODEPS 10mg
ESTAN 10 mg
ESTAN 10 mg
ESCITALOPRAM ACTAVIS 10 mg
ELICEA 10 mg
ESCITALOPRAM AUROBINDO 10 mg
ESCITALOPRAM ATB 10 mg
ESCITALOPRAM TORRENT 10 mg
ELICEA 15 mg
SERODEPS 20mg
ESCITALOPRAM TORRENT 20 mg
ESCITALOPRAM ACTAVIS 20 mg
ELICEA 20 mg
ELICEA Q-TAB 10 mg
ELICEA Q-TAB 10 mg
ESCITALOPRAM TEVA 10 mg
ELICEA Q-TAB 15 mg
ELICEA Q-TAB 15 mg
ELICEA Q-TAB 20 mg
ELICEA Q-TAB 20 mg
ESCITALOPRAM TEVA 20 mg
TRITTICO AC 150 mg
TRITTICO AC 150 mg
TRITTICO AC 150 mg
TRITTICO AC 150 mg
TRITTICO AC 75 mg
TRITTICO AC 75 mg
ELONTRIL 150 mg
LYXIT 12,5 mg
LYXIT 12,5 mg
NOBIXAL 12,5 mg
forma farm.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
DRAJ. ELIB. PREL.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. ORODISPERSABILE
COMPR. ELIB. PREL.

COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. MODIF.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
concentratie
0,18mg
0,18mg
0,7 mg
0,7 mg
0,7mg
0,7mg
0,7mg
0,7mg
0,7mg
0,7mg
0,26mg
0,26mg
0,26mg
0,52mg
0,52mg
0,52mg
1,05mg
1,05mg
1,57mg
2,10mg
2,1mg
2,1mg
3,15mg
50mg
100mg
10mg
5mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
15mg
15mg
20mg
20mg
20mg
20mg
20mg
10mg
10mg
10mg
15mg
15mg
20mg
20mg
20mg
150mg
150mg
150mg
150mg
75mg
75mg
150mg
12,5 mg
12,5 mg
12,5mg
Detinator APP
Tara det.
APP
MALTA
Ambalaj
Prescriptie
Nr. crt
CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF
NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L
MALTA CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF

ZENTIVA, K.S.
KRKA D.D.
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
P-RF

STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. OPA-AL -PVC/AL X 10 COMPR. P-RF

GERMANIA CUTIE CU 1 BLIST.OPA-AL-PVC/AL X 10 COMPR.
P-RF
KRKA D.D.
SLOVENIA
P-RF
G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 10 COMPR. ELIB. PREL. PRF
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA
P-RF
KRKA D.D.
SLOVENIA
P-RF
KRKA D.D.
KRKA D.D.
KRKA D.D.
P-RF
SLOVENIA
P-RF
P-RF
P-RF
SLOVENIA
SLOVENIA
P-RF

SANOFI-SYNTHELABO FRANCE
P-RF
FRANTA CUTIE X 2 BLIST. AL/PVC X 15 DRAJ. CU ELIB. PREL.

FRANTA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
P-RF
P-RF
UNGARIA
UNGARIA
AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.
P-RF
H. LUNDBECK A/S
DANEMARCA
CUTIE X 2 BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 14 COMPR. FILM.
P-RF
UNGARIA
ROMANIA
ROMANIA
P-RF
CEHIA
PRF
ROMANIA
CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM.
P-RF

ZENTIVA K.S.
TERAPIA SA
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
CUTIE X 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-RF

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

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

CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM.
ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM.
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.
MAREA BRITANIE
ANTIBIOTICE S.A.
ROMANIA
P-RF
PRF
PRF
PRF
PRF

CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM.
ROMANIA
TERAPIA SA
ROMANIA
PRF
PRF

P-RF
PRF
ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM.
PRF
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.
PRF
CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE
PRF
CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE
PRF
CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE
PRF
PRF
PRF
PRF
PRF
CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE
PRF

ANGELINI FRANCESCO SPA

ROMANIA
SLOVENIA
SLOVENIA
SLOVENIA
SLOVENIA
ROMANIA
ITALIA
ITALIA
ITALIA
ITALIA
ITALIA
ITALIA
ROMANIA
ANTIBIOTICE S.A. ROMANIA
CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF

CUTIE X 2 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-RF
CUTIE CU 1 FLAC. PEID CU DESICANT X 30 COMPR. ELIB. MODIF.
P-RF
CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF

CUTIE CU BLIST. DIN PVC-PVDC/AL X 90 COMPR. FILM. PRF
CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM. PRF
Pagina 13 din 16
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
30
30
30
30
30
30
30
30
30
30
10
30
10
30
30
30
30
30
30
30
30
30
30
30
20
60
60
30
28
28
30
28
30
28
14
28
28
30
28
28
28
30
30
30
28
28
28
30
28
28
30
28
28
28
28
30
20
60
60
20
30
30
30
30
90
30
0,178135
0,178135
0,692748
0,692748
0,692748
0,692748
0,692748
0,692748
0,692748
0,692748
0,257306
0,257306
0,257306
0,514613
0,514613
0,514613
1,039122
1,039122
1,553735
2,078245
2,078245
2,078245
3,117367
0,618525
0,402000
0,246333
0,129916
0,778666
1,171606
0,848928
0,776000
0,848928
0,780666
0,780357
0,848571
0,848928
0,778214
0,780666
0,778214
0,765000
0,848928
1,130333
1,369000
1,370000
1,359642
2,268571
1,399642
1,406000
0,780357
0,780357
0,933666
1,369285
1,351071
1,576785
1,576785
1,369000
1,137124
1,094833
1,094833
1,137124
0,568562
0,568562
1,950333
0,460333
0,445222
0,460333
0,345198
0,335865
1,196585
1,416252
1,335252
1,341585
1,563918
1,745252
1,334585
1,754918
1,261694
0,378694
0,378694
1,638720
0,885053
0,885053
3,062878
1,085878
3,495598
2,644088
5,186755
2,644088
8,832633
0,316808
0,000000
0,000000
0,020250
0,000000
0,092679
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,126876
0,000000
0,000000
0,126876
0,076104
0,076104
0,000000
0,000000
0,000000
0,000000
0,089067
0,089067
0,346374
0,346374
0,346374
0,346374
0,346374
0,346374
0,346374
0,346374
0,128653
0,128653
0,128653
0,257306
0,257306
0,257306
0,519561
0,519561
0,776867
1,039122
1,039122
1,039122
1,558683
0,309262
0,201000
0,123166
0,064958
0,389333
0,585803
0,424464
0,388000
0,424464
0,390333
0,390178
0,424285
0,424464
0,389107
0,390333
0,389107
0,382500
0,424464
0,565166
0,684500
0,685000
0,679821
1,134285
0,699821
0,703000
0,390178
0,390178
0,466833
0,684642
0,675535
0,788392
0,788392
0,684500
0,568562
0,547416
0,547416
0,568562
0,284281
0,284281
0,975166
0,230166
0,222611
0,230166
0,434266
0,424933
1,542959
1,762626
1,681626
1,687959
1,910292
2,091626
1,680959
2,101292
1,390347
0,507347
0,507347
1,896027
1,142360
1,142360
3,582439
1,605439
4,272466
3,683211
6,225878
3,683211
10,391317
0,626071
0,201000
0,123167
0,085208
0,389333
0,678482
0,424464
0,388000
0,424464
0,390333
0,390179
0,424286
0,424464
0,389107
0,390333
0,389107
0,382500
0,424464
0,565167
0,684500
0,685000
0,679821
1,134286
0,699821
0,703000
0,390179
0,390179
0,466833
0,684643
0,675536
0,788393
0,788393
0,684500
0,695438
0,547417
0,547417
0,695438
0,360385
0,360385
0,975167
0,230167
0,222611
0,230167
0,160321
0,160321
0,623473
0,623473
0,623473
0,623473
0,623473
0,623473
0,623473
0,623473
0,231575
0,231575
0,231575
0,463151
0,463151
0,463151
0,935209
0,935209
1,398361
1,870420
1,870420
1,870420
2,805630
0,556672
0,361800
0,221699
0,116924
0,700799
1,054445
0,764035
0,698400
0,764035
0,702599
0,702321
0,763713
0,764035
0,700392
0,702599
0,700392
0,688500
0,764035
1,017299
1,232100
1,233000
1,223677
2,041713
1,259677
1,265400
0,702321
0,702321
0,840299
1,232356
1,215963
1,419106
1,419106
1,232100
1,023411
0,985349
0,985349
1,023411
0,511705
0,511705
1,755299
0,414299
0,400699
0,414299
0,363012
0,353679
1,265860
1,485527
1,404527
1,410860
1,633193
1,814527
1,403860
1,824193
1,287425
0,404425
0,404425
1,690182
0,936515
0,936515
3,166791
1,189791
3,650972
2,851913
5,394580
2,851913
9,144370
0,378661
0,040200
0,024634
0,033242
0,077867
0,209840
0,084893
0,077600
0,084893
0,078067
0,078036
0,084858
0,084893
0,077822
0,078067
0,077822
0,076500
0,084893
0,113034
0,136900
0,137000
0,135965
0,226858
0,139965
0,140600
0,078036
0,078036
0,093367
0,136929
0,135108
0,157679
0,157679
0,136900
0,240589
0,109484
0,109484
0,240589
0,132961
0,132961
0,195034
0,046034
0,044523
0,046034
cod ATC
853 N06AX14
854 N06AX14
855 N06AX21
856 N06AX21
857 N06BX16
858 N06BX18
859 N06BX18
860 N06BX18
861 N07CA01
862 N07CA01
863 N07CA01
864 N07CA01
865 N07CA01
866 N07CA01
867 N07CA01
868 N07CA01
869 N07CA01
870 N07CA01
871 N07CA01
872 N07CA01
873 N07CA01
874 N07CA01
875 N07CA01
876 N07CA01
877 N07CA01
878 N07CA01
879 N07CA01
880 N07CA01
881 N07CA01
882 N07CA01
883 N07CA01
884 N07CA01
885 N07CA01
886 N07CA01
887 N07CA52
888 N07XN03
889 N07XN03
890 N07XXN3
891 N07XXN3
892 N07XXN3
893 P01BA02
894 R01AD05
895 R01AD08
896 R01AD09
897 R01AD09
898 R01AD09
899 R01AD09
900 R01AD09
901 R03AC04
902 R03AC18
903 R03AC18
904 R03AK03
905 R03AK06
906 R03AK06
907 R03AK06
DCI
TIANEPTINUM**
TIANEPTINUM**
DULOXETINUM**
DULOXETINUM**
PRAMIRACETAMUM**#
VINPOCETINUM
VINPOCETINUM
VINPOCETINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
Denumire Comerciala
NOBIXAL 12,5 mg
COAXIL (R)
CYMBALTA 30mg
CYMBALTA 60mg
PRAMISTAR
VINPOCETINA VIM SPECTRUM 5 mg
CAVINTON(R) FORTE
CAVINTON(R)
VERTIMED 16 mg
BETAHISTINA LPH 16 mg
Prescriptie
Nr. crt
Tara det.
APP
Detinator APP
Ambalaj
COMPR. FILM. 12,5mg
ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM. PRF
DRAJ.
12,5mg
LES LAB. SERVIER IND. FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ. P-RF
30mg
ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF
60mg
ELI LILLY NEDERLAND BV OLANDA CUTIE, X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL)
P-RF
COMPR. FILM. 600mg
F.I.R.M.A. S.P.A. (MENARINI GROUP) ITALIA
CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR.FILM. P-6L
CAPS.
5mg
VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. X PVC/AL X10 CAPS. P6L
COMPR.
10mg
P-6L
COMPR.
5mg
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-6L
COMPR.
16mg
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. P6L
COMPR.
16mg
LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
BETAHISTINA DICLORHIDRAT AUROBINDO 16 mg COMPR.
16mg
EMPERIN 24 mg
COMPR.
24 mg
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 60 COMPR.P6L
COMPR.
24 mg
LABORMED PHARMA SA ROMANIA CUTIE CU 6 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L
BETAHISTIN MCC 24 mg
COMPR.
24mg
MAGISTRA C&C SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L
COMPR.
24mg
BETASERC 24 mg
COMPR.
24mg
ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 20 COMPR.
P-6L
VERTIMED 24 mg
COMPR.
24mg
VERTIMED 24 mg
COMPR.
24mg
VESTIBO 24 mg
COMPR.
24mg
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
MARBETA 24 mg
COMPR.
24mg
MEDREG S.R.O.
REPUBLICA CEHA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR.
P6L
COMPR.
24mg
BETAHISTINA DICLORHIDRAT AUROBINDO 24 mg COMPR.
24mg
MARBETA 24 mg
COMPR.
24mg
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR.
P6L
BETASERC 24 mg
COMPR.
24mg
P6L
BETAHISTIN MCC 8 mg
COMPR.
8mg
BETASERC 8 mg
COMPR.
8mg
P-6L
COMPR.
8mg
BETAHISTIN MCC 8 mg
COMPR.
8mg
MARBETA 8 mg
COMPR.
8mg
MEDREG S.R.O.
REPUBLICA CEHA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. P6L
COMPR.
8mg
BETAHISTINA DICLORHIDRAT AUROBINDO 8 mg
COMPR.
8mg
MARBETA 8 mg
COMPR.
8mg
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. P6L
ACUVER 8 mg/doza
SOL. ORALA 8mg/doza
AUSTRIA CUTIE X 1 FLAC. STICLA BRUNA X 60 ML SOL. ORALA P-6L
ACUVER 8 mg/doza
SOL. ORALA 8mg/doza
AUSTRIA CUTIE X 1 FLAC. STICLA BRUNA X 120 ML SOL. ORALA P-6L
COMBINATII (CINARIZINUM +DIMENHIDRINATUM) ARLEVERT
COMPR.
FARA CONCENTRATIE HENNIG ARZNEIMITTEL GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 24 COMPR. P-RF
ACIDUM TIOCTICUM (ALFA-LIPOICUM)**# THIOCTACID (R) 600 HR (vezi A16AX01)COMPR. FILM. 600mg
MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 FLAC. X 30 COMPR. FILM. P-6L
ACIDUM TIOCTICUM (ALFA-LIPOICUM)**# THIOCTACID (R) 600 HR (vezi A16AX01)COMPR. FILM. 600mg
MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 FLAC. X 100 COMPR. FILM.
P-6L
HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA**
CEREBROLYSIN 215,2 mg/ml
215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA
PR/PRF
PR/PRF
PR/PRF
HYDROXYCHLOROQUINUM
PLAQUENIL
COMPR. FILM. 200mg
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L
BUDESONIDUM*
RHINOCORT AQUA 32 micrograme/doza SPRAY NAZAL SUSP. 32micrograme/doza ASTRAZENECA AB SUEDIA
PRF
FLUTICASONUM*
FLIXONASE 0,05g/100g
SPRAY NAZAL SUSP. 0,05g/100g
GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON X 120 DOZE, PREVAZUT CU POMPA DOZATOARE P-RF
MOMETASONUM*
MOMETAZONA FUROAT CIPLA 50 micrograme/doza SPRAY NAZ., SUSP. 50micrograme/doza CIPLA (EU) LIMITED MAREA BRITANIE
PRF
MOMETASONUM*
KALMENTE 50 micrograme/doza
SPRAY NAZ., SUSP. 50micrograme/doza ALVOGEN IPCO S.AR.L. LUXEMBURG
PRF
MOMETASONUM*
MOMETAZONA FUROAT SANDOZ 50 micrograme/doza SPRAY NAZ.,SUSP. 50micrograme/doza SANDOZ S.R.L.
ROMANIA
PRF
MOMETASONUM*
MOMETAZONA TEVA 50 micrograme/doza SPRAY NAZ.,SUSP. 50g/doza TEVA PHARMACEUTICALS S.R.L. ROMANIA
PRF
MOMETASONUM*
NASONEX 50mcg/doza
SPRAY NAZAL SUSP. 50mcg/doza MERCK SHARP & DOHME ROMANIA
P-RF
FENOTEROLUM
BEROTEC N - 100 mcg
100mcg/doza
GERMANIA CUTIE X 1 FLACON PRESURIZAT X 200 DOZE SOL. DE INHALAT PRESURIZATA P-6L
INDACATEROLUM**
ONBREZ BREEZHALER 150 g
CAPS. CU PULB.INHAL. 150 g
NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIECU BLIST. DIN PA/AL/PVC X 30 CAPSULE (3 BIST X10)+ UN INHALATORPRF
INDACATEROLUM**
ONBREZ BREEZHALER 300 g
CAPS. CU PULB.INHAL. 300 g
NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PA/AL/PVC X 30 CAPSULE (1 BLIST. X10)+ UN INHALATOR PRF
COMBINATII (FENOTEROLUM + IPRATROPIUM)*BERODUAL (R) N
AEROSOL SOL. INHAL. 0,020mg+0,050mg
GERMANIA
P-6L
SALMETEROLUM+FLUTICASONUM* SERETIDE DISKUS 50/100
PULB. INHAL. 50mg/100mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 1DISPOZITIV DE INHALAT X 60 DOZE PULB. DE INHAL. P-6L
PULB. INHAL. 50mg/250mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1, DISPOZITIV DE INHALAT X 60 DOZE PULB. DE INHAL. P-6L
PULB. INHAL. 50mg/500mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 DISPOZITIV DE INHALAT X 60 DOZE PULB. DE INHAL. P-6L
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CYATHUS EXQUIRERE PHARMAFORSCHUNGS GMBH
CYATHUS EXQUIRERE PHARMAFORSCHUNGS GMBH
CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 10 ML SOL. INJ./CONC. PT. SOL. PERF.
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 10 ML SPRAY NAZAL, SUSP. ECHIVALENT CU 120 DOZE, PREVAZUT CU POMPA DOZATOARE, APLICATOR SI CAPAC DE PROTECTIE
CUTIE CU UN FLAC. DIN PEID, PREVAZUT CU POMPA DOZATOARE MANUALA DIN PP CARE CONTINE 18 G SUSPENSIE, ECHIVALENT CU 140 DOZE
CUTIE CU 1 FLAC. PEID PREVAZUT CU POMPA DOZATOARE SI APLICATOR NAZAL CARE CONTINE SPRAY NAZAL, SUSP. PT. 140 PULVERIZARI
CUTIE CU 1 FLAC. PEID PREVAZUT CU O POMPA PULVERIZATOARE NAZALA DIN PE/PP CARE CONTINE 18 G SUSP. NAZALA CORESPUNZATOR LA 140 DOZE MASURATE
CUTIE CU 1 FLACON DIN PEID, CU POMPA DOZATOARE DIN PP SI SISTEM DE ACTIONARE X 140 DOZE SPRAY NAZAL,
CUTIE X 1 FLACON DIN PE PREVAZUT CU POMPA DOZATOARE, DISPOZITIV DE ACTIONARE DIN PP SI CAPAC, CU UN VOLUM DE 23,5 ML SUSPENSIE PT. 140 PULVERIZARI SPRAY NAZAL, SUSPENSIE
908 R03AK06 SALMETEROLUM+FLUTICASONUM*
SERETIDE DISKUS 50 micrograme/100 micrograme
PULB. INHAL.
PULB. INHAL.
PULB. INHAL.
SERETIDE 25 mcg/125 mcg INHALER CFC FREE
SUSP. INHAL. PRESURIZATA
SERETIDE 25 mcg/50 mcg INHALER CFC FREE
25mcg/50mcg GLAXOWELLCOME UK LTD.
SERROFLO 25 micrograme/125 micrograme/doza
25micrograme/125micrograme/doz
SERROFLO 25 micrograme/250 micrograme/doza
25micrograme/250micrograme/doz
915 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM)*
SYMBICORT TURBUHALER 160 micrograme/4,5 micrograme/inhalatie
PULB. DE INHAL.
160micrograme/4,5micrograme/in
SYMBICORT TURBUHALER 320 micrograme/9 micrograme/inhalatie
PULB. DE INHAL. 320micrograme/9micrograme/inha
SYMBICORT TURBUHALER 80 micrograme/4,5 micrograme/inhalatie
PULB. DE INHAL.
80micrograme/4,5micrograme/inh
100/6micrograme pe doza
918 R03AK08 COMBINATII (BECLOMETASONUM+FORMOTEROLUM) FOSTER
100/6 micrograme pe doza
CUTIE X 1 FLACON PRESURIZAT DIN OTEL X 200 DOZE SOLUTIE DE INHALAT PRESURIZATA
P6L
P6L
50micrograme/100micrograme
MAREA BRITANIE
CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU INDICATOR CE ARATA NR. DOZELOR RAMASE X 60 DOZE PULB. DE INHAL.
MAREA BRITANIE
MAREA BRITANIE
25mcg/125mcg GLAXOWELLCOME UK LTD.
MAREA BRITANIE
CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA
P-6L
MAREA BRITANIE
CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA
P-6L
CIPLA EUROPE NV
CIPLA EUROPE NV
ASTRAZENECA AB
ASTRAZENECA AB
ASTRAZENECA AB
BELGIA
BELGIA
SUEDIA CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL.
CHIESI PHARMACEUTICALS GMBH AUSTRIA
CUTIE CU UN FLACON DIN AL PREVAZUT CU O VALVA DE MASURA SI DOZATOR DIN PLASTIC, CU INDICATOR PENTRU DOZA, INTRODUS NTR-O PUNGA CU SAC DE SILICAGEL A 120 DE DOZE SUSPENSIE DE INHALAT PRESURIZATA
CUTIE CU UN FLACON DIN AL PREVAZUT CU O VALVA DE MASURA SI DOZATOR DIN PLASTIC, CU INDICATOR PENTRU DOZA, INTRODUS NTR-O PUNGA CU SAC DE SILICAGEL A 120 DE DOZE SUSPENSIE DE INHALAT PRESURIZATA
CUTIE CU 1 FLAC. PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE, INTRODUS IN DISPOZITIVUL DE ADMINISTRARE DIN PE CU CAPAC PROTECTOR DIN PLASTIC A 180 DOZE SOL. DE INHALAT
Pagina 14 din 16
P6L
PRF
PRF
P6L
P6L
P6L
PRF
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
30
30
28
28
20
50
30
50
30
30
60
60
60
20
50
20
30
60
30
60
60
60
60
60
30
100
30
100
100
90
100
100
1
1
48
30
100
5
5
10
60
1
1
1
1
1
1
1
1
30
30
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
0,460333
0,460333
2,446071
4,562857
3,661500
0,163400
0,362232
0,181116
0,317360
0,317360
0,276000
0,432500
0,476041
0,476000
0,476041
0,476041
0,437000
0,437333
0,424333
0,476041
0,476041
0,354166
0,476041
0,476041
0,158680
0,158680
0,158680
0,158680
0,158680
0,158680
0,158680
0,158680
11,901037
23,802075
1,586666
1,899050
1,899050
25,828000
15,321000
3,064200
0,542833
26,220000
28,340000
22,700000
22,700000
22,700000
19,570000
22,700000
16,660000
2,685625
4,297000
33,540000
36,422000
91,055000
182,110000
36,422000
91,055000
182,110000
91,055000
36,422000
90,970000
116,890000
74,496666
148,993333
74,496666
216,080000
0,000000
0,247333
0,493929
0,000000
0,000000
0,000000
0,035434
0,070084
0,041640
0,264973
0,000000
0,000000
0,000125
0,000000
0,000159
0,256459
0,000000
0,000000
0,000000
0,000125
0,000125
0,000000
0,000125
0,232959
0,031320
0,133420
0,030986
0,031120
0,031120
0,031208
0,021020
0,031120
17,048963
16,477925
0,000000
0,468616
0,307050
0,000000
2,407000
1,004800
0,000000
0,000000
0,000000
0,010000
0,000000
0,010000
0,000000
11,100000
0,000000
1,611375
0,000000
0,000000
70,538000
44,995000
0,000000
70,538000
44,995000
0,000000
44,075000
70,958000
0,000000
0,000000
16,763334
14,796667
0,823334
0,000000
0,230166
0,230166
1,223035
2,281428
1,830750
0,081700
0,181116
0,090558
0,158680
0,158680
0,138000
0,216250
0,238020
0,238000
0,238020
0,238020
0,218500
0,218666
0,212166
0,238020
0,238020
0,177083
0,238020
0,238020
0,079340
0,079340
0,079340
0,079340
0,079340
0,079340
0,079340
0,079340
5,950518
11,901037
0,793333
0,949525
0,949525
12,914000
7,660500
1,532100
0,271416
13,110000
14,170000
11,350000
11,350000
11,350000
9,785000
11,350000
8,330000
1,342812
2,148500
16,770000
18,211000
45,527500
91,055000
18,211000
45,527500
91,055000
45,527500
18,211000
45,485000
58,445000
37,248333
74,496666
37,248333
108,040000
0,230167
0,477500
1,716965
2,281429
1,830750
0,081700
0,216550
0,160642
0,200320
0,423653
0,138000
0,216250
0,238146
0,238000
0,238180
0,494480
0,218500
0,218667
0,212167
0,238146
0,238146
0,177083
0,238146
0,470980
0,110660
0,212760
0,110326
0,110460
0,110460
0,110548
0,100360
0,110460
22,999482
28,378963
0,793333
1,418141
1,256575
12,914000
10,067500
2,536900
0,271417
13,110000
14,170000
11,360000
11,350000
11,360000
9,785000
22,450000
8,330000
2,954188
2,148500
16,770000
88,749000
90,522500
91,055000
88,749000
90,522500
91,055000
89,602500
89,169000
45,485000
58,445000
54,011667
89,293334
38,071667
108,040000
0,414299
0,414299
2,201463
4,106571
3,295350
0,147060
0,326008
0,163004
0,285624
0,285624
0,248400
0,389250
0,428436
0,428400
0,428436
0,428436
0,393300
0,393599
0,381899
0,428436
0,428436
0,318749
0,428436
0,428436
0,142812
0,142812
0,142812
0,142812
0,142812
0,142812
0,142812
0,142812
10,710933
21,421867
1,427999
1,709145
1,709145
23,245200
13,788900
2,757780
0,488549
23,598000
25,506000
20,430000
20,430000
20,430000
17,613000
20,430000
14,994000
2,417062
3,867300
30,186000
32,779800
81,949500
163,899000
32,779800
81,949500
163,899000
81,949500
32,779800
81,873000
105,201000
67,046999
134,093999
67,046999
194,472000
0,046034
0,293367
0,738537
0,456286
0,366150
0,016340
0,071658
0,088196
0,073376
0,296709
0,027600
0,043250
0,047730
0,047600
0,047764
0,304064
0,043700
0,043734
0,042434
0,047730
0,047730
0,035417
0,047730
0,280564
0,047188
0,149288
0,046854
0,046988
0,046988
0,047076
0,036888
0,046988
18,239067
18,858133
0,158667
0,658521
0,496955
2,582800
3,939100
1,311220
0,054284
2,622000
2,834000
2,280000
2,270000
2,280000
1,957000
13,370000
1,666000
1,879938
0,429700
3,354000
74,180200
54,100500
18,211000
74,180200
54,100500
18,211000
53,180500
74,600200
9,097000
11,689000
24,213001
29,696001
8,273001
21,608000
cod ATC
919 R03BA05
920 R03BA05
921 R03BA05
922 R03BA05
923 R03BA05
924 R03BA05
925 R03BA05
926 R03BA07
927 R03BA07
928 R03BA08
929 R03BA08
930 R03BB04
931 R03BB04
932 R03BB06
933 R03DA05
934 R03DA05
935 R03DA05
936 R03DA05
937 R03DA05
938 R03DC03
939 R03DC03
940 R03DC03
941 R03DC03
942 R03DC03
943 R03DC03
944 R03DC03
945 R03DC03
946 R03DC03
947 R03DC03
948 R03DC03
949 R03DC03
950 R03DC03
951 R03DC03
952 R03DC03
953 R03DC03
954 R03DC03
955 R03DC03
956 R03DC03
957 R03DC03
958 R03DC03
959 R03DC03
960 R03DC03
961 R03DC03
962 R03DC03
963 R03DC03
964 R03DC03
965 R03DC03
966 R03DC03
967 R03DC03
968 R03DC03
969 R03DC03
970 R03DC03
971 R03DC03
972 R03DC03
973 R03DC03
974 R03DC03
975 R03DC03
976 R03DC03
977 R03DC03
978 R03DX03
979 R03DX03
980 R05DA09
981 R05DA09
982 R05DA09
983 R05DA09
984 R05DA09
DCI
FLUTICASONUM PROPIONAT*
MOMETASONUM*
MOMETASONUM*
CICLESONIDUM*
CICLESONIDUM*
TIOTROPIUM*
TIOTROPIUM*
GLICOPIRONIUM BROMIDUM**
AMINOPHYLLINUM
AMINOPHYLLINUM
AMINOPHYLLINUM
AMINOPHYLLINUM
AMINOPHYLLINUM
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
FENSPIRIDUM
FENSPIRIDUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
Denumire Comerciala
FLIXOTIDE DISKUS 100 mcg

FLIXOTIDE 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
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
EURESPAL 80 mg
EURESPAL 2 mg/ml
TUSSIN FORTE 20 mg
ROFEDEX
TUSSIN 6,5mg/5ml
ROBITUSSIN JUNIOR
ROBITUSSIN ANTITUSSICUM
forma farm.
PULB. INHAL.
PULB. INHAL.
PULB. INHAL.
concentratie
100mcg/doza
250mcg/doza
500mcg/doza
125mcg/doza
Detinator APP
Tara det.
APP
Ambalaj
Prescriptie
Nr. crt
CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE
P-RF
P-RF
P-RF
CUTIE X 1 FLACON PRESURIZAT DIN AL X 60 DOZE SUSP. DE INHALAT PRESURIZATA
P-RF
50mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE

0,5mg/2ml GLAXO WELLCOME UK LIMITED MAREA BRITANIE
2mg/2ml
GLAXO WELLCOME UK LIMITED MAREA BRITANIE
PULB. INHAL. 200g/doza MERCK SHARP & DOHME ROMANIA
PULB. INHAL. 400g/doza MERCK SHARP & DOHME ROMANIA
160g/doza NYCOMED GMBH GERMANIA
80g/doza NYCOMED GMBH GERMANIA
CUTIE X 1 FLACON PRESURIZAT X 120 DOZE X 50 MCG, PREVAZUT CU VALVA DOZATOARE
P-RF
SUSP. INHAL. PRIN NEBULIZATOR
CUTIE CU 2 FOLII SIGILATE POLIESTER/AL/ PEJD A CATE 5 FIOLE DIN PEJD X 2,5ML CONTINAND CATE 2ML SUSP
PRF
SUSP. INHAL. PRIN NEBULIZATOR
CUTIE CU 2 FOLII SIGILATE POLIESTER/AL/ PEJD A CATE 5 FIOLE DIN PEJD X 2,5ML CONTINAND CATE 2ML SUSP
PRF
CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE
P-6L
CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE
P-6L
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
18micrograme
GERMANIA
SOL. DE INHALAT 2,5micrograme
GERMANIA
MAREA BRITANIE
CAPS. CU PULB. INHAL.
CAPS. CU PULB. INHAL.
44 micrograme
CAPS.
COMPR.
COMPR.
COMPR.
SOL. INJ.
COMPR.
100mg
100mg
100mg
200mg
24mg/ml
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
4 mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
4mg
80mg
2mg/ml
20mg
15mg/5ml
6,5mg/5ml
3,75mg/5ml
7,5mg/5ml
ZENTIVA SA
BIO EEL SRL
ARENA GROUP SA
ARENA GROUP SA
ZENTIVA S.A.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
GRANULE
SIROP
COMPR.
SIROP
SIROP
SOL. ORALA
SOL. ORALA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
CUTIE CU 1 AMBALAJ UNIC CU UN INHALATOR RESPIMAT SI UN CARTUS CARE FURNIZEAZA 60 PUFURI (30 DOZE MEDICINALE) SOL. PT. INHALAT
CUTIE CU BLIST. PERFORATE PA-AL-PVC/AL CE CONTINE 30 X 1 CAPSULA CU PULBERE PENTRU INHALAT INSOTITE DE UN INHALATOR

P-RF
P-RF
CUTIE X 2 BLIST. OPA-AL-PVC X 14 COMPR. FILM.
P6L
P6L
P6L
P6L
P6L
P6L
P6L
ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

CUTIE CU 1 FLAC. PEID X 28 COMPR. FILM.
MALTA
P-RF
ROMANIA
TERAPIA S.A.
ROMANIA
PRF
P-RF
CUTIE X 5 FIOLE PREVAZUTE CU INEL DE RUPERE X 10 ML SOL.INJ. S/P-RF
KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. FILM.
SANDOZ S.R.L.
PRF
CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. FILM.
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST.
CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM.
ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST.
P6L
P6L
P6L
P6L
P6L
MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P-RF
ROMANIA CUTIE CU BLIST. DIN AL/AL X 28 COMPR. MAST. P6L

ROMANIA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. MAST. P6L
ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. MAST. P6L
KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. MAST. P6L
ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PA-ALL-PVC/AL X 28 COMPR. MASTICABILE P6L
DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. MAST. P6L
TERAPIA S.A.
ROMANIA CUTIE CU BLIST. PAPVC/AL X 28 COMPR. MAST. P6L
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 28 COMPR. MAST.
P6L
CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L
MERCK SHARP & DOHME ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L
ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L
SANDOZ SRL
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L
MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 28 COMPR. MAST. P6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. MAST. P6L
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. MAST. P6L
KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. MAST. P6L
ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PA-ALL-PVC/AL X 28 COMPR. MASTICABILE P6L
DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. MAST. P6L
TERAPIA S.A.
ROMANIA CUTIE CU BLIST. PA/PVC/AL X 28 COMPR. MAST. P6L
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 28 COMPR. MAST.
P6L
CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L
ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L
SANDOZ SRL
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L
SANDOZ S.R.L.
ROMANIA CUTIE CU 28 PLICURI PET/AL/PE CONTINAND GRANULE P6L
LES LAB. SERVIER IND.

BIOFARM SA
ROPHARMA S.A.
PFIZER CORPORATION AUSTRIA GMBH
PFIZER CORPORATION AUSTRIA GMBH
FRANTA
FRANTA
CUTIE X 2 BLIST. AL/PVC X 15 COMPR.CU ELIBERARE PRELUGITA
P-6L
CUTIE X 1 FLACON PVC DE CULOARE BRUNA X 150 ML P-6L
ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L

ROMANIA CUTIE X 1 FLACON DIN STILCA BRUNA X 100 ML + MASURA DOZATOARE P-RF
ROMANIA
P-RF
CUTIE X 1 FLAC. X 115ML SIROP + O LINGURITA DOZATOARE GRADATA LA 1,25ML; 2,5ML SI 5 ML
AUSTRIA
AUSTRIA
CUTIE X 1 FL. DIN STICLA BRUNA CU CAPAC SECURIZAT X 100 ML SOL. ORALA + MASURA DOZATOARE PT.2,5ML;5M
P-RF
CUTIE X 1 FL. DIN STICLA BRUNA CU CAPAC SECURIZAT X 100 ML SOL. ORALA + MASURA DOZATOARE PT.2,5ML;5M
P-RF
Pagina 15 din 16
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
1 24,317999
1 60,795000
1 118,180000
1 30,397500
1 24,317999
10
0,810599
10
3,242399
1 33,613750
1 62,550000
1 89,330000
1 51,371249
30
3,536553
1 158,080000
30
4,986000
20
0,172934
50
0,140800
40
0,172934
20
0,345870
5
2,452000
28
0,913189
28
0,913189
28
0,720714
30
0,721000
30
0,826333
28
0,913189
28
0,913189
28
0,913189
28
0,913189
28
0,913189
28
0,913189
28
0,913189
28
0,528124
28
0,528124
28
0,527857
30
0,527333
30
0,434000
28
0,528124
28
0,528124
28
0,528124
28
0,528124
28
0,528124
28
0,528124
28
0,528124
28
0,528124
28
0,528124
28
0,660155
28
0,660155
28
0,542500
30
0,542333
30
0,483666
28
0,660155
28
0,660155
28
0,660155
28
0,660155
28
0,660155
28
0,660155
28
0,660155
28
0,560357
28
0,528124
30
0,952666
1 20,370000
20
0,352000
1
5,470000
1
2,725883
1
1,367499
1
2,734999
10,812001
6,285000
0,000000
3,612500
10,902001
1,995401
4,963601
7,016250
0,000000
0,000000
20,118751
1,827447
0,000000
0,000000
0,015066
0,000000
0,007316
0,054630
0,000000
0,803239
1,639668
0,000000
0,000000
0,000000
0,086096
0,275382
0,803239
0,803239
0,803239
0,028953
0,803239
1,060090
1,833661
0,000000
0,000000
0,000000
0,220447
1,059376
1,059018
1,040090
1,040090
1,060090
1,833661
1,059376
0,000090
1,056273
1,892702
0,000000
0,000000
0,000000
0,120202
1,056273
1,056273
1,056273
1,056273
1,056273
1,056273
0,000000
1,060090
0,000000
0,000000
0,000000
0,000000
5,444117
7,572501
6,205001
12,158999
30,397500
59,090000
15,198750
12,158999
0,405299
1,621199
16,806875
31,275000
44,665000
25,685624
1,768276
79,040000
2,493000
0,086467
0,070400
0,086467
0,172935
1,226000
0,456594
0,456594
0,360357
0,360500
0,413166
0,456594
0,456594
0,456594
0,456594
0,456594
0,456594
0,456594
0,264062
0,264062
0,263928
0,263666
0,217000
0,264062
0,264062
0,264062
0,264062
0,264062
0,264062
0,264062
0,264062
0,264062
0,330077
0,330077
0,271250
0,271166
0,241833
0,330077
0,330077
0,330077
0,330077
0,330077
0,330077
0,330077
0,280178
0,264062
0,476333
10,185000
0,176000
2,735000
1,362941
0,683749
1,367499
22,971001
36,682500
59,090000
18,811250
23,061001
2,400701
6,584801
23,823125
31,275000
44,665000
45,804376
3,595724
79,040000
2,493000
0,101533
0,070400
0,093783
0,227565
1,226000
1,259834
2,096263
0,360357
0,360500
0,413167
0,542691
0,731977
1,259834
1,259834
1,259834
0,485548
1,259834
1,324152
2,097723
0,263929
0,263667
0,217000
0,484509
1,323438
1,323080
1,304152
1,304152
1,324152
2,097723
1,323438
0,264152
1,386351
2,222780
0,271250
0,271167
0,241833
0,450280
1,386351
1,386351
1,386351
1,386351
1,386351
1,386351
0,280179
1,324152
0,476333
10,185000
0,176000
2,735000
6,807059
8,256251
7,572501
21,886199
54,715500
106,362000
27,357750
21,886199
0,729539
2,918159
30,252375
56,295000
80,397000
46,234124
3,182897
142,272000
4,487400
0,155640
0,126720
0,155640
0,311283
2,206800
0,821870
0,821870
0,648642
0,648900
0,743699
0,821870
0,821870
0,821870
0,821870
0,821870
0,821870
0,821870
0,475311
0,475311
0,475071
0,474599
0,390600
0,475311
0,475311
0,475311
0,475311
0,475311
0,475311
0,475311
0,475311
0,475311
0,594139
0,594139
0,488250
0,488099
0,435299
0,594139
0,594139
0,594139
0,594139
0,594139
0,594139
0,594139
0,504321
0,475311
0,857399
18,333000
0,316800
4,923000
2,453294
1,230749
2,461499
13,243801
12,364500
11,818000
6,652250
13,333801
2,076461
5,287841
10,377625
6,255000
8,933000
25,255876
2,181103
15,808000
0,498600
0,032360
0,014080
0,024610
0,089217
0,245200
0,894558
1,730987
0,072072
0,072100
0,082634
0,177415
0,366701
0,894558
0,894558
0,894558
0,120272
0,894558
1,112903
1,886474
0,052786
0,052734
0,043400
0,273260
1,112189
1,111831
1,092903
1,092903
1,112903
1,886474
1,112189
0,052903
1,122289
1,958718
0,054250
0,054234
0,048367
0,186218
1,122289
1,122289
1,122289
1,122289
1,122289
1,122289
0,056036
1,112903
0,095267
2,037000
0,035200
0,547000
5,716706
7,709251
6,478501
cod ATC
985 R06AE09
986 R06AE09
987 R06AE09
988 R06AE09
989 R06AE09
990 R06AE09
991 R06AE09
992 R06AX27
993 R06AX27
994 R06AX27
995 R06AX27
996 R06AX27
997 R06AX27
998 R06AX27
999 R06AX27
1000
R06AX27
1001
R06AX27
1002
R06AX27
1003
R06AX27
1004
R06AX27
1005
R06AX27
1006
R06AX27
1007
R06AX27
1008
R06AX27
1009
R06AX27
1010
S01AA11
1011
S01AA12
1012
S01AA12
1013
S01AA12
1014
S01AA12
1015
S01AA23
1016
S01AA23
1017
S01AA23
1018
S01AX11
1019
S01AX11
1020
S01BA01
1021
S01BA01
1022
S01BA01
1023
S01BA06
1024
S01CA01
1025
S01CA01
1026
S01CA01
1027
S01CA01
1028
S01CA01
1029
S01CA01
1030
S01GX09
DCI
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
GENTAMICINUM
TOBRAMYCINUM
TOBRAMYCINUM
TOBRAMYCINUM
TOBRAMYCINUM
NETILMICINUM
NETILMICINUM
NETILMICINUM
OFLOXACINUM
OFLOXACINUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
BETAMETHASONUM
Denumire Comerciala
XYZAL (R)
LEVOCETIRIZINA SANDOZ 5 mg
CETIZAL 5 mg
LEVOCETIRIZINA ACTAVIS 5 mg
ZENARO 5 mg
XYZAL
ZENARO 0,5 mg/ml
DYNID 5 mg
DESLORATADINA ACTAVIS
DESLORATADINA ACTAVIS
DESLORATADINA SANDOZ 5 mg
DASSELTA
DESLORATADINA TERAPIA 5 mg
LORDESTIN 5 mg
DESLORATADINA TEVA
AERIUS 5mg
AERIUS 5mg
AERIUS 2,5mg
AERIUS 5mg
DESLORATADINA SANDOZ 0.5 mg/ml
DESLORATADINA ALVOGEN 0,5 mg/ml
DYNID 0,5 mg/ml
DESLORATADINA TEVA 0,5 mg/ml
AERIUS 0,5mg/ml
LORDESTIN 0,5 mg/ml
GENTAMICIN SULPHATE
TOBROM 3 mg/ml
TOBREX
TOBREX 2 X
TOBREX (R)
NETTACIN (R)
NETTACIN (R)
NETTAVISC 3mg/g
FLOXAL (R)
FLOXAL (R)
DEXAMETAZONA ROMPHARM 1mg/ml
DEXAMETAZONA ROMPHARM 1mg/ml
MAXIDEX (R)
OPHTAMESONE 1 mg/ml
COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX
COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX
COMBINATII (CLORAMPHENICOLUM+DEXAMETHASONUM)SPERSADEX COMP
COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) DEXATOBROM 3 mg+1 mg/ml
COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX ( R )
COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX (R)
OLOPATADINUM
OPATANOL 1mg/ml
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
concentratie
PIC. OFT./AURIC./NAZALE SOL.
5mg
5mg
5mg
5mg
5mg
5mg/ml
0,5mg/ml
5mg
5 mg
5 mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
2,5mg
5mg
0,5 mg/ml
0,5mg/ml
0,5mg/ml
0,5mg/ml
0,5mg/ml
0,5mg/ml
0,3%
3mg/ml
3mg/ml
0,3%
0,3%
0,3%
0,3%
3mg/g
0,3%
0,3%
1mg/ml
1mg/ml
0,1%
1 mg/ml
PIC. ORALE, SOL.
SIROP
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
SOL. ORALA
SOL. ORALA
SOL. ORALA
SOL. ORALA
SOL. ORALA
SOL. ORALA
PIC. OFT., SOL
PIC. OFT., SOL
PIC. OFT.,SOL.
PICATURI OFT.-SOL.
UNG. OFT.
PIC. OFT., SOL
PICATURI OFT.-SOL.
UNG. OFT.
PICATURI OFT.-SOL.
UNG. OFT.
PIC. OFT. SUSP.
PIC. OFT. SUSP.
PICATURI OFT.-SUSP.
PIC. OFT.,SOL.
4,55 mg/1,32 mg/ml
PIC. OFT.SOL. UNIDOZA
4,55 mg/1,32 mg/ml
PICATURI OFT.-SOL.
5mg/ml+1mg/ml
Detinator APP
U.C.B. GMBH
SANDOZ S.R.L.
Tara det.
APP
Ambalaj
GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L
ROMANIA

ISLANDA
ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 20 COMPR. FILM.
UCB PHARMA GMBH GERMANIA
ZENTIVA, K.S.
REPUBLICA CEHA

Prescriptie
Nr. crt
CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL., PREVAZUT CU PICURATOR
CUTIE X 1 FLACON DIN STICLA BRUNA CU CAPAC DIN PP PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 200ML SIROP + 1 LINGURITA DOZATOARE DE 5ML
P6L
P6L
P-6L
P6L
ISLANDA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 10 PRF

ISLANDA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X30 PRF
SANDOZ S.R.L.
ROMANIA
TERAPIA SA
ROMANIA
CUTIE CU BLIST. NON UNIDOZA OPA-AL-PVC/AL X 30 COMPR.FILM.
P6L
CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE FILMATE
PRF
CUTIE CU BLIST. PCTFE-PVC/AL X 30 COMPR. FILM. P6L

P6L
CUTIE CU BLIST. DIN OPA/AL/PVC - AL X 30 COMPR. FILM.
PRF
MERCK SHARP&DOHME LTD.
MAREA BRITANIE
CUTIE X 10 COMPR. FILM. ( PCTFE/ PVC/AL)
P-RF
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
SANDOZ S.R.L.
ROMANIA
LUXEMBURG
ROMANIA
MAREA BRITANIE
CUTIE X 30 COMPR. ORODISPERSABILE (PVC/OPA/AL) P-RF

CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 125 ML X 120 ML, SOL. ORALA + LINGURITA DOZATOARE DE 2,5 ML SI 5 ML SAU CU SERINGA DOZATOARE DE 5 ML, MARCATA LA FIECARE 0,5ML
CUTIE CU 1 FLAC. DIN STICLA BRUNA A 120 ML SOL. ORALA + 1 LINGURITA DOZATOARE SAU O SERINGA DOZATOAR
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 120 ML SOL. ORALA + 1 LINGURITA DOZATOARE SAU O SERINGA DOZATOARE ( SERINGA DOZATOARE ARE GRADATII DE 2,5 ML SI 5 ML; LINGURITA DOZATOARE ARE CAPACITATEA DE 2,5 ML SI 5 ML
CUTIE X 1 FLACON DIN STICLA PREVAZUT CU SISTEM DE SIGURANTA PENTRU COPII (PP) SI INEL DE SIGILARE, CU O LINGURITA DOZATOARE DIN PEID GRADATA LA DOZE DE 2.5ML SI 5ML, A 120ML SOLUTIE ORALA
CUTIE X 1 FLACON X 120 ML SOL. ORALA + LIGURITA DOZATOARE DE 2,5 ML SI 5 ML
P6L
P6L
P6L
P6L
P-RF
ROMANIA
P6L
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 10ML
P-RF
ROMPHARM COMPANY SRL ROMANIA CUTIE C 1 FLAC. PEJD X 5 ML PIC. OFT. SOL P-RF
CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU O LINGURITA DOZATOARE GRADATA LA 2,5 ML SI 5 ML X 120 ML SOL.
S.I.F.I. SPA
S.I.F.I. SPA
S.I.F.I. SPA
BELGIA
BELGIA
BELGIA
ITALIA
ITALIA
ITALIA
DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH
GERMANIA
CUTIE X 1 FLACON DIN PEJD X 5 ML PICATURI OFT., SOL. P-RF
ALCON COUVREUR NV
ALCON COUVREUR NV
ALCON COUVREUR NV
CUTIE X 1 FLACON DIN PEJD CU PICURATOR X 5 ML PIC. OFTALMICE, SOL. P-RF
CUTIE X 1 FLAC. PEID CU PICURATOR DIN PEID X 5 ML P-RF
CUTIE X 1 TUB DIN AL X 3,5 G UNGUENT OFTALMIC P-RF
CUTIE X 1 FLACON X 5ML
P-RF
CUTIE X 3 FOLII TERMOSUDATE X 5 FLACOANE UNIDOZA DIN POLIETILENA X 0,3 ML
P-RF
CUTIE X 1 TUB DIN AL X 5 G UNGUENT OFTALMIC, PREV. CU APLICATOR
P-RF
GERMANIA
CUTIE X 1 TUB DIN AL PREVAZUT CU APLICATOR X 3 GP-RF
ROMANIA
ROMANIA
CUTIE X 1 FLAC. DIN PEID X 10 ML PIC. OFT., SUSPENSIE
P-RF
ROMPHARM COMPANY SRL
CUTIE X 1 FLAC. DIN PEID X 5 ML PIC. OFT., SUSPENSIE
P-RF
ALCON COUVREUR NV
BELGIA
CUTIE X 1 FLACON PICURATOR DIN PE X 5 ML
P-RF
ROMANIA
S.I.F.I. SPA
S.I.F.I. SPA
ITALIA
ITALIA
CUTIE CU 1 FLAC. PEJD, PREVAZUT CU APLICATOR PT. PICURARE DIN PEJD A 10 ML PIC. OFT., AURICULARE, NAZALE SOL.
P6L
CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT.SOL. P-RF

CUTIE X 20 FLAC. UNIDOZA DIN PEJD X 0,3 ML PIC.OFT. SOL.
P-RF
CUTIE X 1 FLACON X 5 ML SOL. OFT. + PICURATOR P-RF
3mg+1mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. PEJD A 5 ML + PICURATOR P-RF
PICATURI OFT.-SUSP. 3mg+1mg/ml ALCON COUVREUR NV BELGIA
CUTIE X 1 FLACON PICURATOR PEJD X 5 ML P-RF
UNG. OFT. 3 mg/1 mg/g ALCON COUVREUR NV BELGIA CUTIE X 1 TUB AL, PREVAZUT CU APLICATOR PEID X 3,5 G P-RF
PIC. OFT., SOL. 1mg/ml
ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON X 5 ML
P-RF
PIC. OFT. SUSP.
NOT:
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (*) se iniiaza de medicul de specialitate in limita competenei i poate fi prescris n continuare de medicul de familie pe baza scrisorii
medicale emise de medicul de specialitate;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii i cu aprobarea
comisiilor de la nivelul Caselor Judeene de Asigurri de Sntate;
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (****) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS si cu aprobarea comisiilor de la
nivelul Casei Nationale de Asigurari de Sanatate;
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (2) se prescrie numai in etapa pregtitoare pentru colonoscopie;
- Pentru medicamentele corespunztoare DCI-urilor notate cu (#) regulile de prescriere sunt stabilite prin Contractul Cadru.
Pagina 16 din 16
Co-plata maxima a
Co-plata maxima a
Co-plata maxima a
asiguratii care
asiguratii care
asiguratii care
cant.
beneficiaza de
beneficiaza de
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
referinta)
referinta)
30
10
10
10
20
1
1
30
10
30
30
30
30
30
30
10
30
30
30
1
1
1
1
1
1
1
1
1
1
1
1
15
1
1
1
1
1
1
1
1
20
1
1
1
1
1
0,863333
0,561000
0,561000
0,362000
0,561000
20,196000
20,196000
0,359833
0,322000
0,322666
0,350333
0,359833
0,359833
0,359833
0,359833
0,359833
0,359833
0,179916
0,359833
10,630000
10,620000
10,630000
10,630000
10,630000
10,630000
4,710000
4,080000
4,080000
4,080000
3,060000
14,710000
1,297769
21,629497
10,895000
14,680000
10,120000
5,382500
5,382500
4,670000
8,160750
0,489645
8,160750
5,050000
7,770000
5,712525
28,000000
0,000000
0,000000
0,000000
0,000000
0,000000
5,534000
3,644000
0,162500
0,000000
0,000000
0,000000
0,003167
0,193167
0,179500
0,130167
0,487167
0,491167
0,807750
0,627833
0,000000
0,000000
0,000000
0,000000
5,720000
0,000000
0,000000
0,000000
3,810000
15,810000
5,580000
0,000000
0,703564
12,080503
3,325000
0,000000
0,000000
0,107500
3,057500
0,000000
24,409250
2,171855
4,799250
0,000000
0,000000
7,357475
0,000000
0,431666
0,280500
0,280500
0,181000
0,280500
10,098000
10,098000
0,179916
0,161000
0,161333
0,175166
0,179916
0,179916
0,179916
0,179916
0,179916
0,179916
0,089958
0,179916
5,315000
5,310000
5,315000
5,315000
5,315000
5,315000
2,355000
2,040000
2,040000
2,040000
1,530000
7,355000
0,648884
10,814748
5,447500
7,340000
5,060000
2,691250
2,691250
2,335000
4,080375
0,244822
4,080375
2,525000
3,885000
2,856262
14,000000
0,431667
0,280500
0,280500
0,181000
0,280500
15,632000
13,742000
0,342417
0,161000
0,161333
0,175167
0,183084
0,373084
0,359417
0,310084
0,667084
0,671084
0,897708
0,807750
5,315000
5,310000
5,315000
5,315000
11,035000
5,315000
2,355000
2,040000
5,850000
17,850000
7,110000
7,355000
1,352449
22,895252
8,772500
7,340000
5,060000
2,798750
5,748750
2,335000
28,489625
2,416678
8,879625
2,525000
3,885000
10,213738
14,000000
0,776999
0,504900
0,504900
0,325800
0,504900
18,176400
18,176400
0,323849
0,289800
0,290399
0,315299
0,323849
0,323849
0,323849
0,323849
0,323849
0,323849
0,161924
0,323849
9,567000
9,558000
9,567000
9,567000
9,567000
9,567000
4,239000
3,672000
3,672000
3,672000
2,754000
13,239000
1,167992
19,466547
9,805500
13,212000
9,108000
4,844250
4,844250
4,203000
7,344675
0,440680
7,344675
4,545000
6,993000
5,141272
25,200000
0,086334
0,056100
0,056100
0,036200
0,056100
7,553600
5,663600
0,198484
0,032200
0,032267
0,035034
0,039151
0,229151
0,215484
0,166151
0,523151
0,527151
0,825742
0,663817
1,063000
1,062000
1,063000
1,063000
6,783000
1,063000
0,471000
0,408000
4,218000
16,218000
5,886000
1,471000
0,833341
14,243453
4,414500
1,468000
1,012000
0,645750
3,595750
0,467000
25,225325
2,220820
5,615325
0,505000
0,777000
7,928728
2,800000
ANEXA 2c
NR.CRT
COD ATC
DCI
Denumire Comerciala
forma farm.
concentratie
DETINATOR APP
TARA
DET. APP
AMBALAJ
Prescriptie
SECIUNEA C1 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% DIN PREUL DE REFERIN CONFORM
DCI-urilor UTILIZATE N TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOLI
DIN H.G. NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE;
MEDICAMENTELE DIN ACEAST SUBLIST SE ELIBEREAZ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZ DE PRESCRIPIE MEDICAL CU REINERE N FARMACIE
VALABIL NCEPND CU 01 OCTOMBRIE 2015
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,226000
0,350000
0,138800
1,652000
1,652000
0,173200
0,156500
0,156500
0,187800
0,157000
0,187800
0,187800
0,157666
1,260000
0,753000
0,258000
0,258000
0,441666
0,529999
0,222500
0,258000
0,215000
0,529999
0,077000
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,098500
0,098500
0,098666
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,125200
0,000000
0,125200
0,083200
0,000000
0,000000
0,000000
0,075400
0,078333
0,000000
0,032001
0,000000
0,111800
0,000000
0,157001
0,000000
0,203933
0,204100
0,153600
0,204100
0,203933
0,203933
0,204100
0,149933
0,198100
0,203933
0,203933
0,000000
0,000000
0,000000
1.INSUFICIENTA CARDIACA CRONICA(CLASA III SAU IV NYHA) - G 1

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34
35
36
37
38
B01AA07
B01AA07
C01AA05
C01AA05
C01AA05
C03AA03
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
ACENOCUMAROLUM
ACENOCUMAROLUM
DIGOXINUM
DIGOXINUM
DIGOXINUM
HYDROCHLOROTHIAZIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
TROMBOSTOP 2 mg
SINTROM 4 mg
DIGOXIN ZENTIVA 0,25 mg
DIGOXIN 0,5 mg/2 ml
DIGOXIN ZENTIVA 0,5 mg/2ml
NEFRIX 25 mg
FUROSEMID MCC 40 mg
FUROSEMID SLAVIA
FUROSEMID ZENTIVA
FUROSEMID LPH 40 mg
FUROSEMID ARENA 40 mg
FUROSEMID BIOEEL 40 mg
FUROSEMID LPH 40 mg
VEROSPIRON
COMPR.
COMPR.
COMPR.
SOL. INJ.
SOL. INJ.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
SOL. INJ.
CAPS.
VEROSPIRON
CAPS.
SPIRONOLACTONA TERAPIA 25 mg COMPR. FILM.
ALSPIRON 25 mg
COMPR. FILM.
ALSPIRON 50 mg
COMPR. FILM.
BLOXAN
COMPR.
BETAPROL 100 mg
COMPR.
EGILOK 100 mg
COMPR.
METOPROLOL LPH 100 mg COMPR.
METOPROLOL 100 mg
COMPR.
METOPROLOL 100 mg
COMPR.
METOPROLOL AL 100
COMPR.
EGILOK 25 mg
COMPR.
COMPR.
METOPROLOL 25 mg
COMPR.
2mg
4mg
0,25mg
0,5mg/2ml
0,5mg/2ml
25mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
10mg/ml
100mg
25mg
25mg
50mg
50mg
25mg
25mg
25mg
50mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
25mg
25mg
25mg
TERAPIA SA
P-RF
NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
P-RF
ZENTIVA S.A.
ZENTIVA S.A.
ZENTIVA S.A.
ZENTIVA SA
MAGISTRA C&C S.R.L.
SLAVIA PHARM SRL

ZENTIVA SA
LABORMED PHARMA SA
ARENA GROUP S.A.

BIO EEL SRL
LABORMED PHARMA SA
ZENTIVA SA
ARENA GROUP S.A.

ARENA GROUP S.A.

BIO EEL SRL
TERAPIA SA

ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ.S/P-RF
ROMANIA
S/P-RF
ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L
P-6L
ROMANIA CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L
ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L
ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. P-6L
ROMANIA CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L
ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P-6L
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.

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

SLAVIA PHARMA S.R.L.

ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.
ZENTIVA S.A.
P-6L

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

UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L
Pagina 1 din 39
30
20
25
5
5
25
20
20
20
20
20
20
30
5
30
50
60
30
30
20
50
20
20
30
30
20
30
20
30
30
20
30
20
30
30
20
20
30
0,226000
0,350000
0,138800
1,652000
1,652000
0,173200
0,156500
0,156500
0,187800
0,157000
0,187800
0,187800
0,157666
1,260000
0,753000
0,258000
0,258000
0,441666
0,529999
0,222500
0,258000
0,215000
0,529999
0,077000
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,098500
0,098500
0,098666
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
DCI
COD ATC
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB12
C07AB12
C07AB12
C07AB12
C07AB12
C07AB12
C07AB12
C07AB12
C07AB12
C07AB12
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
Denumire Comerciala
forma farm.

COMPR.
BETAPROL 50 mg
COMPR.
EGILOK 50 mg
COMPR.
COMPR.
METOPROLOL 50 mg
COMPR.
METOPROLOL 50 mg
COMPR.
METOPROLOL AL 50
COMPR.
concentratie
25mg
25mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg
METOPROLOL TARTRAT AUROBINDO 100 mg
COMPR. FILM.
100mg
METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM.
50mg
METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg
BETALOC
SOL. INJ./PERF. 5mg/5ml
BOREZ 10 mg
COMPR. FILM.
10 mg
CONCOR COR 10 mg
COMPR. FILM.
10mg
CONCOR COR 10 mg
COMPR. FILM.
10mg
SOBYC 10 mg
COMPR. FILM.
10mg
BOREZ 2,5 mg
COMPR. FILM.
2,5 mg
CONCOR COR 2,5 mg
COMPR. FILM.
2,5mg
CONCOR COR 2,5 mg
COMPR. FILM.
2,5mg
SOBYC 2,5 mg
COMPR. FILM.
2,5mg
CONCOR COR 5 mg
COMPR. FILM.
5mg
CONCOR COR 5 mg
COMPR. FILM.
5mg
SOBYC 5 mg
COMPR. FILM.
5mg
NEBILET (R)
COMPR.
5mg
NEBIVOLOL ACTAVIS 5 mg COMPR.
5mg
X-PRESSOL 5 mg
COMPR.
5mg
NOLET 5 mg
COMPR.
5mg
NEBIVOLOL TEVA 5 mg
COMPR.
5mg
NEBIVOLOL TEVA 5 mg
COMPR.
5mg
NEBINORM 5 mg
COMPR.
5mg
NEBIVOLOL SANDOZ 5 mg COMPR.
5mg
NEBIVOLOL TERAPIA 5mg
COMPR.
5mg
NEBIVOLOL TORRENT 5 mg COMPR.
5mg
CARVEDILOL SANDOZ 12,5 mg COMPR.
12,5 mg
COMPR.
12,5mg
CORYOL 12,5 mg
COMPR.
12,5mg
TALLITON (R) 12,5 mg
COMPR.
12,5mg
COMPR.
12,5mg
CARVEDILOL VIM SPECTRUM 12,5mg COMPR.
12,5mg
DETINATOR APP

LAROPHARM SRL
ROMANIA
UNGARIA
MAGISTRA C & C SRL ROMANIA
TERAPIA SA
ROMANIA
SLAVIA PHARMA S.R.L. ROMANIA
ALIUD PHARMA GMBH GERMANIA
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP

P-6L
P-6L

P-6L
CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
ZENTIVA S.A.
TERAPIA SA

ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L
HEXAL AG
HEXAL AG
HEXAL AG
ASTRAZENECA AB SUEDIA CUTIE X 5 FIOLE X 5 ML SOL.INJ. I.V./PERF. S
MERCK KGAA
MERCK KGAA
MERCK KGAA
MERCK KGAA
MERCK KGAA
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. FILM. P-6L

P-6L
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
GLENMARK PHARMACEUTICALS S.R.O.
REPUBLICA CEHA
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
UNGARIA
P-6L
P-6L
P-6L
Pagina 2 din 39
cant.
UT/
Pret de
aj
(RON)
30
60
20
30
20
30
30
30
20
30
20
30
30
20
30
30
30
30
30
30
30
5
30
30
30
30
30
30
30
30
30
30
30
28
30
30
30
28
30
30
28
28
30
30
28
28
30
30
20
0,098666
0,098333
0,181999
0,181999
0,181999
0,164333
0,181999
0,181999
0,172500
0,181999
0,181999
0,151666
0,181999
0,092400
0,092400
0,181333
0,092400
0,181999
0,504000
0,215666
0,358333
4,086000
0,277200
0,277200
0,277200
0,277200
0,243333
0,250800
0,250800
0,209000
0,146799
0,146799
0,146799
0,274800
0,274800
0,274800
0,274800
0,274800
0,229000
0,229000
0,274800
0,274800
0,274800
0,277333
0,308570
0,259285
0,281000
0,308570
0,308570

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,098666
0,098333
0,181999
0,181999
0,181999
0,164333
0,181999
0,181999
0,172500
0,181999
0,181999
0,151666
0,181999
0,092400
0,092400
0,181333
0,092400
0,181999
0,504000
0,215666
0,358333
4,086000
0,277200
0,277200
0,277200
0,277200
0,243333
0,250800
0,250800
0,209000
0,146799
0,146799
0,146799
0,274800
0,274800
0,274800
0,274800
0,274800
0,229000
0,229000
0,274800
0,274800
0,274800
0,277333
0,308570
0,259285
0,281000
0,308570
0,308570
0,000000
0,000000
0,000501
0,000334
0,000501
0,000000
0,000334
0,062001
0,000000
0,000334
0,000501
0,000000
0,000334
0,204100
0,203933
0,000000
0,363600
0,198001
0,000000
0,000000
0,000000
0,000000
0,085800
0,808133
0,808133
0,070133
0,000000
0,123533
0,123533
0,000000
0,242534
0,242534
0,059534
0,372342
0,088200
0,145866
0,145866
0,145557
0,000000
0,000000
0,145557
0,145557
0,145866
0,000000
0,525715
0,000000
0,000000
0,153763
0,027430
88
89
90
91
92
93
94
95
96
97
98
99
DCI
COD ATC
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
100 C07AG02
101 C07AG02
102 C07AG02
103 C07AG02
104 C07AG02
105 C07AG02
106 C07AG02
107 C07AG02
108 C07AG02
109 C07AG02
110 C09AA01
111 C09AA01
112 C09AA01
113 C09AA01
114 C09AA01
115 C09AA01
116 C09AA01
117 C09AA01
118 C09AA01
119 C09AA01
120 C09AA01
121 C09AA01
122 C09AA01
123 C09AA01
124 C09AA02
125 C09AA02
126 C09AA02
127 C09AA02
128 C09AA02
129 C09AA02
130 C09AA02
131 C09AA02
132 C09AA02
133 C09AA02
134 C09AA02
135 C09AA02
136 C09AA02
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
Denumire Comerciala
GLADYCOR 12,5 mg
MIOCARVIL 12,5 mg
CARVEDILOL HELCOR 12,2 mg
DILATREND (R) 25 mg
CORYOL 25 mg
TALLITON (R) 25 mg
CARVEDILOL LPH 25 mg
GLADYCOR 25 mg
MIOCARVIL 25 mg
CARVEDILOL HELCOR 25 mg
CARVEDILOL SANDOZ 25 mg
CORYOL (R)
TALLITON 6,25 mg
CARVEDILOL VIM SPECTRUM 6,25 mg
GLADYCOR 6,25 mg
MIOCARVIL 6,25 mg
CARVEDILOL SANDOZ 6,25 mg
CARVEDILOL AUROBINDO 12,5mg
CARVEDILOL AUROBINDO 25mg

CARVEDILOL AUROBINDO 6,25mg
CAPTOPRIL MCC 12,5 mg

CAPTOPRIL 25 mg
CAPTOPRIL 25 EEL
CAPTOPRIL 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
forma farm.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
concentratie
12,5mg
12,5mg
12,5mg
25mg
25mg
25mg
25mg
25mg
25mg
25mg
25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
12,5mg
25mg
6,25mg
12,5mg
25mg
25mg
25mg
25mg
25mg
25mg
25mg
50 mg
50mg
50mg
50mg
50mg
50mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
20mg
DETINATOR APP
AMBALAJ
ANTIBIOTICE S.A.

SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR.
AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR.
Prescriptie
NR.CRT
TARA
DET. APP
P-6L
P-6L
P-6L
P-6L
UNGARIA
P-6L
P-6L
ANTIBIOTICE S.A.
P-6L

HEXAL AG
GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR.
ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR.
KRKA D.D.
SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR.
UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.
ANTIBIOTICE S.A.
HEXAL AG
GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR.
MAGISTRA C & C
ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR.
TERAPIA SA
BIO EEL SRL
MAGISTRA C & C
SINTOFARM SA
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
TERAPIA SA
BIO EEL SRL
MAGISTRA C & C
MAGISTRA C & C
P-6L
P-6L
P6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P6L
P6L
P6L
P6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L

ROMANIA
TERAPIA SA
ROMANIA
LAROPHARM SRL
ROMANIA
MAGISTRA C & C
ROMANIA
MERCK SHARP & DOHME
Pagina 3 din 39
CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L
P-6L
CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L

CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L
P-6L
cant.
UT/
Pret de
aj
(RON)
30
30
20
28
28
30
30
30
30
20
30
28
28
30
30
20
30
30
30
28
28
28
30
30
20
20
30
30
30
20
20
30
20
20
30
30
20
30
20
20
20
28
20
30
50
100
20
20
20
0,308570
0,308570
0,308570
0,342856
0,342856
0,342856
0,342856
0,342856
0,342856
0,342856
0,317333
0,216000
0,198214
0,185000
0,216000
0,216000
0,216000
0,216000
0,180333
0,257142
0,285714
0,180000
0,117666
0,141600
0,141600
0,118500
0,118000
0,118000
0,141600
0,118500
0,138000
0,163200
0,163200
0,138000
0,155666
0,136000
0,199500
0,199333
0,199000
0,199500
0,190500
0,228600
0,199500
0,199333
0,199400
0,199200
0,199500
0,199000
0,330500

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,308570
0,308570
0,308570
0,342856
0,342856
0,342856
0,342856
0,342856
0,342856
0,342856
0,317333
0,216000
0,198214
0,185000
0,216000
0,216000
0,216000
0,216000
0,180333
0,257142
0,285714
0,180000
0,117666
0,141600
0,141600
0,118500
0,118000
0,118000
0,141600
0,118500
0,138000
0,163200
0,163200
0,138000
0,155666
0,136000
0,199500
0,199333
0,199000
0,199500
0,190500
0,228600
0,199500
0,199333
0,199400
0,199200
0,199500
0,199000
0,330500
0,144430
0,153763
0,143430
0,583929
0,012144
0,180477
0,259144
0,259477
0,258144
0,259644
0,000000
0,173642
0,000000
0,000000
0,022333
0,012000
0,015666
0,022333
0,000000
0,000000
0,000000
0,000000
0,000000
0,000066
0,009400
0,000000
0,000000
0,000000
0,013066
0,000000
0,000000
0,067466
0,030300
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,077828
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
DCI
COD ATC
137 C09AA02
138 C09AA02
139 C09AA02
140 C09AA02
141 C09AA02
142 C09AA02
143 C09AA02
144 C09AA02
145 C09AA02
146 C09AA02
147 C09AA02
148 C09AA02
149 C09AA02
150 C09AA02
151 C09AA02
152 C09AA02
153 C09AA02
154 C09AA03
155 C09AA03
156 C09AA03
157 C09AA03
158 C09AA03
159 C09AA03
160 C09AA03
161 C09AA03
162 C09AA03
163 C09AA03
164 C09AA03
165 C09AA03
166 C09AA03
167 C09AA03
168 C09AA03
169 C09AA03
170 C09AA03
171 C09AA03
172 C09AA03
173 C09AA03
174 C09AA03
175 C09AA03
176 C09AA03
177 C09AA05
178 C09AA05
179 C09AA05
180 C09AA05
181 C09AA05
182 C09AA05
183 C09AA05
184 C09AA05
185 C09AA05
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
Denumire Comerciala
forma farm.
ENALAPRIL LPH 20 mg
ENAP 20 mg
RENITEC 20 mg
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
SOL. INJ./PERF.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
ENALAPRIL 5 mg
ENAP 5 mg
RENITEC 5 mg
ENALAPRIL LPH (R) 5 mg
ENAP 1,25 mg/ml

RANOLIP
LISIREN 10 mg
LISIGAMMA 10 mg
LISINOPRIL 10 MEDO
TONOLYSIN 10 mg
TONOLYSIN 2,5 mg
RANOLIP
LISIREN 20 mg
LISIGAMMA 20 mg
TONOLYSIN 20 mg
LISINOPRIL 20 MEDO
RANOLIP
LISIGAMMA 5 mg
LISINOPRIL 5 MEDO
TONOLYSIN 5 mg
VIVACE 10 mg
PIRAMIL 10 mg
RAMIPRIL-AC 10 mg
AMPRIL 10 mg
ZENRA 10
TRITACE 10
AMPRIGEN 10 mg
RAMIPRIL TEVA 10 mg
concentratie
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
1,25mg/ml
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
2,5mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
40mg
5mg
5mg
5mg
5mg
5mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L

MERCK SHARP & DOHME
TERAPIA SA
ARENA GROUP SA
ARENA GROUP SA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
LAROPHARM SRL
ROMANIA
MAGISTRA C & C
ROMANIA
P-6L

P-6L
P-6L
P-6L
P6L
P6L
MERCK SHARP & DOHME
ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR.
P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L
TERAPIA SA
ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L
SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L
LAROPHARM SRL
ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L
CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.
PR/PRF
RANBAXY U.K. LIMITED
MAREA BRITANIE
P-6L
AC HELCOR SRL
HEXAL AG
P-6L
P-6L

P-6L
ROMANIA
ISLANDA
ROMANIA
ROMANIA
ROMANIA
MAREA BRITANIE
P-6L
AC HELCOR SRL
HEXAL AG
P-6L
P-6L

CUTIE X 2 BLIST. PVDC/AL X 10 COMPR.
P-6L
ANTIBIOTICE SA
ISLANDA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
MAREA BRITANIE
P-6L
ANTIBIOTICE SA
ANTIBIOTICE SA
ROMANIA
ISLANDA
ACTAVIS GROUP HF ISLANDA
SANDOZ SRL
ROMANIA
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L

CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L
P-6L
CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L
ZENTIVA S.A.
P-6L

P-6L
P-6L

Pagina 4 din 39
ROMANIA
CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. P6L
cant.
UT/
Pret de
aj
(RON)
20
20
28
20
30
50
20
20
20
20
28
20
20
30
20
20
5
30
20
30
30
30
30
30
28
28
30
20
30
30
30
30
28
20
30
30
30
30
30
28
28
28
30
30
28
28
28
30
30
0,330500
0,330500
0,396600
0,330500
0,330666
0,330600
0,330500
0,330500
0,093000
0,094000
0,108000
0,093000
0,093000
0,093333
0,090000
0,090000
3,204000
0,305199
0,305199
0,270000
0,298000
0,254333
0,270000
0,305199
0,305199
0,311071
0,454800
0,454800
0,379000
0,447333
0,379000
0,454800
0,454800
0,428500
1,359333
0,231199
0,225000
0,192666
0,193000
0,231199
0,238214
0,285856
0,285856
0,285856
0,285856
0,285856
0,285856
0,285856
0,285856

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,330500
0,330500
0,396600
0,330500
0,330666
0,330600
0,330500
0,330500
0,093000
0,094000
0,108000
0,093000
0,093000
0,093333
0,090000
0,090000
3,204000
0,305199
0,305199
0,270000
0,298000
0,254333
0,270000
0,305199
0,305199
0,311071
0,454800
0,454800
0,379000
0,447333
0,379000
0,454800
0,454800
0,428500
1,359333
0,231199
0,225000
0,192666
0,193000
0,231199
0,238214
0,285856
0,285856
0,285856
0,285856
0,285856
0,285856
0,285856
0,285856
0,000000
0,000000
0,112328
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,036285
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,213134
0,231801
0,000000
0,000000
0,000000
0,000000
0,108134
0,081229
0,000000
0,344533
0,327700
0,000000
0,000000
0,000000
0,357200
0,194128
0,000000
0,000000
0,033467
0,000000
0,000000
0,000000
0,032015
0,000000
0,016286
0,016144
0,016144
0,016286
0,178429
0,016286
0,016144
0,016144
COD ATC
186 C09AA05
187 C09AA05
188 C09AA05
189 C09AA05
190 C09AA05
191 C09AA05
192 C09AA05
193 C09AA05
194 C09AA05
195 C09AA05
196 C09AA05
197 C09AA05
198 C09AA05
199 C09AA05
200 C09AA05
201 C09AA05
202 C09AA05
203 C09AA05
204 C09AA05
205 C09AA05
206 C09AA05
207 C09AA05
208 C09CA03
209 C09CA03
210 C09CA03
211 C09CA03
212 C09CA03
213 C09CA03
214 C09CA03
215 C09CA03
216 C09CA03
217 C09CA03
218 C09CA03
219 C09CA03
220 C09CA03
221 C09CA03
222 C09CA03
223 C09CA03
224 C09CA03
225 C09CA03
226 C09CA03
227 C09CA03
228 C09CA03
229 C09CA03
230 C09CA03
231 C09CA03
232 C09CA03
233 C09CA06
234 C09CA06
DCI
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
CANDESARTANUM CILEXETIL**
Denumire Comerciala
RAMIRAN 10 mg
RAMIRAN 10 mg
VIVACE 2,5 mg
PIRAMIL 2,5 mg
RAMIPRIL-AC 2,5 mg
AMPRIL 2,5 mg
ZENRA 2,5
TRITACE(R) 2,5
AMPRIGEN 2,5 mg
RAMIRAN 2,5 mg
RAMIRAN 2,5 mg
VIVACE 5 mg
PIRAMIL 5 mg
RAMIPRIL-AC 5 mg
AMPRIL 5 mg
ZENRA 5
TRITACE 5
AMPRIGEN 5 mg
RAMIPRIL TEVA 5 mg
RAMIRAN 5 mg
RAMIRAN 5 mg
WENZELL 160 mg
WENZELL 160 mg
VALSARGAMMA 160 mg
DIOVAN 160 mg
VALSACOR 160 mg
AVASSAN 160 mg
VAPRESS 160 mg
VAPRESS 160 mg
DIOVAN 40 mg
AVASSAN 40 mg
VAPRESS 40 mg
VAPRESS 40 mg
WENZELL 80 mg
WENZELL 80 mg
VALSARGAMMA 80 mg
DIOVAN 80 mg
VALSACOR 80 mg
AVASSAN 80 mg
VAPRESS 80 mg
VAPRESS 80 mg
DIOVAN 3 mg/ml
ATACAND
TANDESAR 16 mg
forma farm.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
SOL. ORALA
COMPR.
COMPR.
concentratie
10mg
10mg
2,5 mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
160mg
80mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
40mg
40mg
40mg
40mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
3mg/ml
16mg
16mg
DETINATOR APP
TERAPIA SA
TERAPIA SA
ACTAVIS GROUP HF
SANDOZ SRL
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP

ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR. P-6L
ZENTIVA S.A.

P-6L
P-6L

TERAPIA SA
TERAPIA SA
ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L
SANDOZ SRL
ZENTIVA S.A.
P-6L

P-6L
P-6L

TERAPIA SA
TERAPIA SA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
GERMANIA

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

CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. P-6L
P-6L
P-6L
P6L
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
CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM.P-6L
CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM.
P6L
P6L
P6L
P6L
P6L
P6L
P-6L
P-6L
P6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM.
TERAPIA S.A.
ROMANIA
ROMASTRU TRADING S.R.L. ROMANIA
ROMASTRU TRADING S.R.L. ROMANIA
GERMANIA
NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM. P6L
TERAPIA S.A.
ROMANIA
ZENTIVA, K.S.
REPUBLICA CEHA
ASTRAZENECA AB
TERAPIA SA
Pagina 5 din 39
SUEDIA
ROMANIA
P6L
P6L
CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM.P-6L

CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML )
P6L
P6L
P-6L

CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-6L
cant.
UT/
Pret de
aj
(RON)
30
30
28
28
30
30
28
28
30
30
30
28
28
30
30
28
28
28
30
30
30
30
28
28
28
30
30
28
28
28
28
28
28
28
28
28
28
28
30
30
28
28
28
28
28
28
1
28
28
0,285856
0,285856
0,149642
0,172142
0,168333
0,172000
0,166071
0,179570
0,172000
0,172000
0,172000
0,172142
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,459642
0,409285
0,551570
0,551570
0,551570
0,551570
0,534285
0,551570
0,551570
0,551570
0,551570
0,495856
0,495856
0,413214
0,413214
0,462856
0,462856
0,462856
0,462856
0,437857
0,462856
0,462856
0,385714
0,385714
41,420000
0,840000
0,840000

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,285856
0,285856
0,149642
0,172142
0,168333
0,172000
0,166071
0,179570
0,172000
0,172000
0,172000
0,172142
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,459642
0,409285
0,551570
0,551570
0,551570
0,551570
0,534285
0,551570
0,551570
0,551570
0,551570
0,495856
0,495856
0,413214
0,413214
0,462856
0,462856
0,462856
0,462856
0,437857
0,462856
0,462856
0,385714
0,385714
41,420000
0,840000
0,840000
0,016144
0,016144
0,000000
0,000000
0,000000
0,000000
0,000000
0,085072
0,000000
0,000000
0,000000
0,000000
0,041644
0,041430
0,041430
0,032715
0,175215
0,041644
0,041430
0,032763
0,041430
0,041430
0,000000
0,000000
0,518787
0,518763
0,209763
1,042358
0,000000
0,518787
0,010215
0,220572
0,220572
2,072358
1,083786
0,000000
0,000000
0,340001
0,339810
0,148810
0,732144
0,000000
0,340001
0,060001
0,000000
0,000000
0,000000
0,741785
0,222500
COD ATC
235 C09CA06
236 C09CA06
237 C09CA06
238 C09CA06
239 C09CA06
240 C09CA06
241 C09CA06
242 C09CA06
243 C09CA06
244 C09CA06
245 C09CA06
246 C09CA06
247 C09CA06
248 C09CA06
249 C09CA06
250 C09CA06
251 C09CA06
252 C09CA06
253 C09CA06
254 C09CA06
255 C09CA06
256 C09CA06
257 C09CA06
258 C09CA06
259 C09CA06
260 C09CA06
261 C09CA06
DCI
forma farm.
Denumire Comerciala
CANDESARTAN SANDOZ 16 mg COMPR.
KARBIS 16 mg
ATACAND 16mg
CANZENO 16mg
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
concentratie
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
32mg
32mg
32mg
32mg
32mg
32mg
32mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
COMPR.
COMPR.
2mg
4mg
DETINATOR APP
SANDOZ SRL
AMBALAJ
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR.
Prescriptie
NR.CRT
TARA
DET. APP
P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L
TORRENT PHARMA S.R.L.
ASTRAZENECA AB
ZENTIVA K.S.
ROMANIA
SUEDIA
CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR.
REPUBLICA CEHA
ROMANIA
MALTA
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L

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

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

ZENTIVA K.S.
TERAPIA SA
SANDOZ SRL
ASTRAZENECA AB
ZENTIVA K.S.
ROMANIA
SUEDIA
CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR.
REPUBLICA CEHA
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L

P-6L
ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. P6L

MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
28
30
30
28
30
28
30
28
30
28
30
30
28
30
28
30
28
28
28
30
30
28
30
28
30
28
30
0,840000
0,840000
0,700000
0,840000
0,840000
0,840000
0,840000
0,840000
0,840000
0,723600
0,723600
0,603000
0,723600
0,723600
0,723600
0,723600
0,637200
0,531071
0,531071
0,531000
0,531000
0,637200
0,531000
0,531071
0,531000
0,531071
0,531000
0,840000
0,840000
0,700000
0,840000
0,840000
0,840000
0,840000
0,840000
0,840000
0,723600
0,723600
0,603000
0,723600
0,723600
0,723600
0,723600
0,637200
0,531071
0,531071
0,531000
0,531000
0,637200
0,531000
0,531071
0,531000
0,531071
0,531000
0,158928
0,222000
0,000000
0,741785
0,026000
0,222142
0,172333
0,222500
0,222000
1,505685
0,725400
0,000000
1,505685
0,239400
0,634257
0,725400
0,179942
0,000000
0,000000
0,000000
0,000000
0,179942
0,000000
0,000000
0,000000
0,000000
0,000000
30
20
0,226000
0,350000
0,226000
0,350000
0,000000
0,000000
30
30
28
28
28
28
28
28
28
28
9,342333
9,342333
0,460714
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,422142
9,342333
9,342333
0,460714
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,422142
0,000000
0,000000
0,000000
1,141287
0,039144
0,600215
0,130572
0,130572
0,112358
0,000000
2. BOLNAVI CU PROTEZE VALVULARE SI VASCULARE - G2

1
2
B01AA07
B01AA07
ACENOCUMAROLUM
ACENOCUMAROLUM
TROMBOSTOP 2 mg
SINTROM 4 mg
TERAPIA SA
P-RF
NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
P-RF
Tratamentul se iniiaz de ctre medicul n specialitatea cardiologie, chirurgie cardiovascular i chirurgie vascular.
3. BOLNAVI CU PROCEDURI INTERVENTIONALE PERCUTANE, NUMAI DUPA IMPLANTAREA UNEI PROTEZE ENDOVASCULARE (STENT)- G3
1
2
3
4
5
6
7
8
9
10
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
PLAVIX 300mg
PLAVIX 300mg
ZYLLT
PLAVIX 75mg
CLOPIDOGREL MYLAN 75mg
TROGRAN 75 mg
CLOPIGAMMA 75 mg
CLOPIGAMMA 75 mg
PLAVOCORIN 75 mg
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CLOPIDOGREL ACTAVIS 75 mg COMPR. FILM.
300mg
300mg
75 mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
SANOFI 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
GERMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM.
P-RF
GERMANIA
P-RF
SANDOZ S.R.L.
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.

ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM.
Pagina 6 din 39
CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 28 COMPR.FILM. P-RF
P-RF
P-RF
P-RF
11
12
13
14
15
16
17
18
19
COD ATC
DCI
B01AC04
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
Denumire Comerciala
forma farm.
DEFROZYP 75 mg
TESSYRON 75 mg
COMPR. FILM.
COMPR. FILM.
CLOPIDOGREL DR. REDDY'S 75 mg COMPR. FILM.
CLOPIDOGREL TERAPIA 75 mg COMPR. FILM.
DEPLATT 75 mg
COMPR. FILM.
TROMBEX 75 mg
COMPR. FILM.
TROMBEX 75 mg
COMPR. FILM.
CLOPIDOGREL AUROBINDO 75 mg COMPR. FILM.
PLAVIX 75mg
COMPR. FILM.
concentratie
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
ROMANIA CUTIE CU BLIST. OPA-AL-PVDC/AL X 28 COMPR. FILM. P-RF

GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 30 COMPR. FILM.
P-RF
DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF
TERAPIA S.A.
ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF
ZENTIVA K.S.
CEHIA
CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 30 COMPRIMATE FILMATEP-RF
ZENTIVA K.S.
CEHIA
CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 90 COMPRIMATE FILMATEP-RF
SANOFI CLIR SNC
FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
28
30
30
30
30
30
90
28
28
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,600215
0,182096
0,599763
0,599763
0,412763
0,074430
0,055430
0,087358
1,141287
140
168
168
56
56
30
28
30
30
30
30
30
1
1
1
5
1
5
1
1
1
1
1
1
1
1
1
1
1
1
1
50
2,333071
1,949464
5,206845
10,544464
13,558214
2,836666
3,403999
32,970399
27,475333
41,273333
57,113666
61,447000
110,870000
170,380000
127,437600
106,198000
195,360000
162,800000
87,430000
178,400000
390,310000
604,410000
674,210000
674,210000
794,880000
794,880000
975,890000
975,890000
370,000000
370,000000
781,040000
0,354400
2,333071
1,949464
5,206845
10,544464
13,558214
2,836666
3,403999
32,970399
27,475333
41,273333
57,113666
61,447000
110,870000
170,380000
127,437600
106,198000
195,360000
162,800000
87,430000
178,400000
390,310000
604,410000
674,210000
674,210000
794,880000
794,880000
975,890000
975,890000
370,000000
370,000000
781,040000
0,354400
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,959572
8,027267
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
34,512400
0,000000
72,090000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
Tratamentul se iniiaz de ctre medicul n specialitatea cardiologie, chirurgie cardiovascular i chirurgie vascular.
4. HEPATITELE CRONICE DE ETIOLOGIE VIRALA B, C i D - G4

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
J05AB04
J05AB04
J05AB04
J05AB04
J05AB04
J05AF05
J05AF05
J05AF07
RIBAVIRINUM****
RIBAVIRINUM****
RIBAVIRINUM****
RIBAVIRINUM****
RIBAVIRINUM****
LAMIVUDINUM****
LAMIVUDINUM****
REBETOL 200 mg
COPEGUS 200mg
MODERIBA 200 mg
MODERIBA 400 mg
MODERIBA 600 mg
LAMIVUDINE TEVA 100 mg
ZEFFIX 100 mg
TENOFOVIRUM DISOPROXIL FUMARATE**** VIREAD 245mg
J05AF07 TENOFOVIRUM DISOPROXIL FUMARATE**** TENOFOVIR DISOPROXIL TEVA 245 mg

J05AF08
J05AF10
J05AF10
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AB04
L03AB04
L03AB05
L03AB05
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB11
N04BB01
ADEFOVIRUM DIPIVOXILUM****
ENTECAVIRUM****
ENTECAVIRUM****
FILGRASTIMUM (G-CSF)**
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
TEVAGRASTIM 30MUI/0,5ml
NIVESTIM 30 MU/0,5 ml
TEVAGRASTIM 48MUI/0,8ml
ROFERON A
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
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR. FILM.
COMPR. FILM.
SOL. INJ. /PERF. IN SERINGA PREUMPLUTA
200mg
200mg
200mg
400mg
600mg
100 mg
100mg
245mg
245mg
10mg
0,5mg
1mg
60MU/ml
96MU/ml
MERCK SHARP & DOHME
MAREA BRITANIE
CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC )
P-RF/R
ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R
ABBVIE LIMITED
MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 168 COMPR.
PRF
ABBVIE LIMITED
MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 56 COMPR. PRF
ABBVIE LIMITED
TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R
GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R
CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM P-RF/R
GILEAD SCIENCE INTERNATIONAL LIMITED
MAREA BRITANIE
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.
PR
SOL. INJ./PERF.
SOL. INJ./PERF.
SOL. INJ./PERF.
SOL. INJ./PERF.
SOL. INJ.
SOL. INJ.
300mcg/0,5ml TEVA GENERICS GMBH GERMANIA
CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF.S/P-RF/R
300g/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE
CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.P-RF
CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML SOL. INJ. SAU PERF.S/P-RF/R
SOL. INJ. PEN MULTIDOZA
18 milioane U.I. MERCK SHARP & DOHME

480g/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.P-RF
3Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML + AC STERIL PR
9Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC STERIL PR
MAREA BRITANIE
CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML SOL. INJ. + 12 ACE + 12 TAMPOANE DEZINFECTANTE
P-RF/R
MAREA BRITANIE
CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE
P-RF/R
CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV.
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MERCK SHARP & DOHME
MAREA BRITANIE
100g
100g
120g
120g
150g
150g
50g
50g
MERCK SHARP & DOHME
180mcg/0,5ml
ROCHE REGISTRATION LTD.
MAREA BRITANIE
CAPS.
100mg
UNGARIA CUTIE X 1 FLAC. X 50 CAPS.

CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC
Tratamentul se initiaz de ctre medicul n specialitatea gastroenterologie / boli infectioase si nefrologie (doar pentru pacientii cu afectare renala consecutiva infectiei cu virusuri hepatitice)
Pagina 7 din 39
PR
PR
PR
PR
PR
PR
PR
PR
P-RF/R
P-6L
DCI
COD ATC
Denumire Comerciala
forma farm.
concentratie
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
MAREA BRITANIE
CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR.
P-RF
MAREA BRITANIE
CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF
MAREA BRITANIE
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
5. HEPATITA AUTOIMUNA - G5
1
2
3
4
5
6
7
8
H02AB04
H02AB04
H02AB04
H02AB04
H02AB04
L04AX01
L04AX01
L04AX01
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM
MEDROL A 16
MEDROL 32
SOLU - MEDROL ACT-O-VIAL
LEMOD SOLU 125 mg
LEMOD SOLU 500 mg
IMURAN
IMURAN
IMMUNOPRIN 75 mg
COMPR.
COMPR.
LIOF. SI SOLV.PT.SOL.INJ
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
16mg
32mg
250mg/4ml
125mg
500mg
50mg
50mg
75mg
50
20
1
1
1
100
100
100
0,543200
1,234000
20,480000
8,810000
31,020000
0,702300
0,702300
0,788900
0,543200
1,234000
20,480000
8,810000
31,020000
0,702300
0,702300
0,788900
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
P6L
P6L
P6L
100
50
50
60
100
1
0,946200
0,946200
0,788600
0,788500
2,681700
97,490000
0,946200
0,946200
0,788600
0,788500
2,681700
97,490000
0,206200
0,267200
0,000000
0,000000
0,000000
0,000000
OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L

P-6L
P-6L
P-6L
P-6L
ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PEID X 200 ML SOL. ORALA SI O LINGURITA DOZATOARE P-6L
CUTIE X 3 BLIST. AL/PVC A CATE 12 COMPR. FILM. P-RF
P-RF
MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ZENTIVA SA
ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L
BIO EEL SRL
P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L
ZENTIVA SA
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L
ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. P-6L
1
1
1
1
1
1
12
36
1
20
20
20
20
20
20
30
5
30
50
10,750000
10,800000
3,590000
17,230000
33,340000
6,730000
2,625833
2,413333
19,810000
0,156500
0,156500
0,187800
0,157000
0,187800
0,187800
0,157666
1,260000
0,753000
0,258000
10,750000
10,800000
3,590000
17,230000
33,340000
6,730000
2,625833
2,413333
19,810000
0,156500
0,156500
0,187800
0,157000
0,187800
0,187800
0,157666
1,260000
0,753000
0,258000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,125200
0,000000
0,125200
0,083200
0,000000
0,000000
0,000000
0,075400
ROMANIA
S/P-RF
CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML
S/P-RF
ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM.

ASPEN PHARMA TRADING LIMITED
EBEWE PHARMA GES.M.B.H. NFG KG
IRLANDA
AUSTRIA
P-RF
CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML
S/P-RF
S/P-RF
PR
Tratamentul se initiaz de ctre medicul n specialitatea gastroenterologie
6. CIROZA BILIARA PRIMARA, COLANGITA SCLEROZANTA PRIMITIVA, HEPATITA CRONICA SI CIROZE DE ALTE ETIOLOGII CU COLESTAZA - G6
1
2
3
4
5
6
A05AA02
A05AA02
A05AA02
A05AA02
A05AA02
A05AA02
ACIDUM URSODEOXYCHOLICUM
URSOFALK (R)
URSOFALK (R)
URSOSAN
URSOROM 250 mg
URSOFALK 500 mg
URSOFALK 250 mg/5 ml
CAPS.
CAPS.
CAPS.
CAPS.
COMPR. FILM.
SUSP. ORALA
250mg
250mg
250mg
250mg
500mg
250mg/5ml
LICHID ORAL
SIROP
SIROP
SIROP
SIROP
SOL. ORALA
COMPR. FILM.
COMPR. FILM.
66,7%
65%
65%
650mg/ml
650mg/ml
660 mg/ml
200mg
200mg
200mg/10ml
40mg
40mg
40mg
40mg
40mg
40mg
40mg
10mg/ml
100mg
25mg

PRO. MED. CS PRAHA AS
CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L

CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L
CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L
CEHIA
DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM.

CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP
Tratamentul se initiaz de ctre medicul n specialitatea gastroenterologie
7. CIROZA HEPATICA - G7
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
A06AD11
A06AD11
A06AD11
A06AD11
A06AD11
A06AD11
A07AA11
A07AA11
A07AA11
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03DA01
C03DA01
LACTULOSUM
LACTULOSUM
LACTULOSUM
LACTULOSUM
LACTULOSUM
LACTULOSUM
RIFAXIMINUM
RIFAXIMINUM
RIFAXIMINUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
SPIRONOLACTONUM
SPIRONOLACTONUM
DUPHALAC (R)
LACTULOSE
LACTULOSE
LACTULAK 660 mg/ml
NORMIX 200 mg
NORMIX 200 mg
NORMIX 200mg/10ml
FUROSEMID MCC 40 mg
FUROSEMID SLAVIA
FUROSEMID ZENTIVA
FUROSEMID LPH 40 mg
FUROSEMID ARENA 40 mg
FUROSEMID BIOEEL 40 mg
FUROSEMID LPH 40 mg
VEROSPIRON
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
SOL. INJ.
CAPS.
ABBOTT HEALTHCARE PRODUCTS B.V.
CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 500 ML SIROP + 1 MASURA DOZATOARE DIN PP
CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 1000 ML SIROP + 1 MASURA DOZATOARE DIN PP
CUTIE X 1 FLAC. GRAN. PT. 60 ML SUSP. ORALA + 1 MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML
Pagina 8 din 39
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
COD ATC
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
J05AB04
J05AB04
J05AB04
J05AB04
J05AB04
J05AF05
J05AF05
J05AF08
J05AF10
J05AF10
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AB04
L03AB04
L03AB05
L03AB05
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB11
N04BB01
DCI
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
RIBAVIRINUM****
RIBAVIRINUM****
RIBAVIRINUM****
RIBAVIRINUM****
RIBAVIRINUM****
LAMIVUDINUM****
LAMIVUDINUM****
ADEFOVIRUM DIPIVOXILUM****
ENTECAVIRUM****
ENTECAVIRUM****
PEGINTERFERON ALFA-2A****
AMANTADINUM**
forma farm.
Denumire Comerciala
VEROSPIRON
CAPS.
SPIRONOLACTONA TERAPIA 25 mg COMPR. FILM.
ALSPIRON 25 mg
COMPR. FILM.
ALSPIRON 50 mg
COMPR. FILM.
REBETOL 200 mg
CAPS.
COPEGUS 200mg
COMPR. FILM.
MODERIBA 200 mg
COMPR. FILM.
MODERIBA 400 mg
COMPR. FILM.
MODERIBA 600 mg
COMPR. FILM.
LAMIVUDINE TEVA 100 mg COMPR. FILM.
ZEFFIX 100 mg
COMPR. FILM.
HEPSERA
COMPR.
BARACLUDE 0,5mg
COMPR. FILM.
BARACLUDE 1mg
COMPR. FILM.
ZARZIO 30MU/0,5ml
ZARZIO 48MU/0,5ml
TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF.
SOL. INJ./PERF.
TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF.
SOL. INJ./PERF.
ROFERON A
SOL. INJ.
ROFERON A
SOL. INJ.
PEGINTRON 100 g
PEGINTRON 100 g
PEGINTRON 120 g
PEGINTRON 120 g
PEGINTRON 150 g
PEGINTRON 150 g
PEGINTRON 50 g
PEGINTRON 50 g
PEGASYS 180 mcg/0,5ml
VIREGYT (R)- K
CAPS.
concentratie
25mg
50mg
50mg
25mg
25mg
25mg
50mg
200mg
200mg
200mg
400mg
600mg
100 mg
100mg
10mg
0,5mg
1mg
60MU/ml
96MU/ml
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
ROMANIA
BIO EEL SRL
ROMANIA
TERAPIA SA
ROMANIA
P6L
P-6L
MERCK SHARP & DOHME
CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC )
MAREA BRITANIE
CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P-6L

P-RF/R
ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R
ABBVIE LIMITED
MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 168 COMPR.
PRF
ABBVIE LIMITED
ABBVIE LIMITED
TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R
GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R
MAREA BRITANIE
P-RF/R
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
P-RF/R
P-RF/R
CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF.S/P-RF/R
300g/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE
CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.P-RF
CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML SOL. INJ. SAU PERF.S/P-RF/R
480g/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.P-RF
3Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML + AC STERIL PR
9Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC STERIL PR
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
100g
100g
120g
120g
150g
150g
50g
50g
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
180mcg/0,5ml
MAREA BRITANIE
100mg
PR
PR
PR
PR
PR
PR
PR
PR
P-RF/R
P-6L
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
60
30
30
20
50
20
20
140
168
168
56
56
30
28
30
30
30
1
1
1
5
1
5
1
1
1
1
1
1
1
1
1
1
1
1
1
50
0,258000
0,441666
0,529999
0,222500
0,258000
0,215000
0,529999
6,248214
6,248214
5,206845
10,544464
13,558214
2,836666
3,403999
41,273333
57,113666
61,447000
110,870000
170,380000
127,437600
106,198000
195,360000
162,800000
87,430000
178,400000
390,310000
604,410000
674,210000
674,210000
794,880000
794,880000
975,890000
975,890000
370,000000
370,000000
781,040000
0,354400
0,258000
0,441666
0,529999
0,222500
0,258000
0,215000
0,529999
6,248214
6,248214
5,206845
10,544464
13,558214
2,836666
3,403999
41,273333
57,113666
61,447000
110,870000
170,380000
127,437600
106,198000
195,360000
162,800000
87,430000
178,400000
390,310000
604,410000
674,210000
674,210000
794,880000
794,880000
975,890000
975,890000
370,000000
370,000000
781,040000
0,354400
0,078333
0,000000
0,032001
0,000000
0,111800
0,000000
0,157001
1,633857
1,549643
0,000000
0,000000
0,000000
0,000000
0,959572
0,000000
0,000000
0,000000
0,000000
0,000000
34,512400
0,000000
72,090000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
10
10
5
5
5
5
1,975000
3,345000
9,078000
4,936000
9,074000
4,936000
1,975000
3,345000
9,078000
4,936000
9,074000
4,936000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
Tratamentul se iniiaz de ctre medicul in specialitatea gastroenterologie sau boli infectioase
8. Leucemii, limfoame, aplazie medulara, gamapatii monoclonale maligne, mieloproliferari cronice si tumori maligne, sindroame mielodisplazice - G10
1
2
3
4
5
6
A04AA01
A04AA01
A04AA01
A04AA01
A04AA01
A04AA01
ONDANSETRONUM**
ONDANSETRONUM**
ONDANSETRONUM**
ONDANSETRONUM**
ONDANSETRONUM**
ONDANSETRONUM**
OSETRON 4 mg
OSETRON 8 mg
OSETRON 8 mg SOLUTIE INJECTABILA
OSETRON 4 mg SOLUTIE INJECTABILA
EMESET 8 mg/4 ml
EMESET 4 mg/2 ml
COMPR. FILM.
COMPR. FILM.
SOL. INJ.
SOL. INJ.
SOL. INJ./PERF.
SOL. INJ./PERF.
4mg
8mg
2mg/ml
2mg/ml
2mg/ml
2mg/ml

CIPLA (UK) LIMITED

CIPLA (UK) LIMITED
Pagina 9 din 39
ROMANIA
ROMANIA
ROMANIA
ROMANIA
CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X 10 COMPR. FILM. P-RF

CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X 10 COMPR. FILM. P-RF
CUTIE X 1 BLIST. AL/PVC X 5 FIOLE X 4 ML SOL. INJ.
S/P-RF
CUTIE 1 BLIST. AL/PVC X 5 FIOLE X 2 ML SOL. INJ.
S/P-RF
MAREA BRITANIE CUTIE X 5 FIOLE STICLA + INEL RUPERE X 4ML SOL. INJ. / PERF.S/P-RF
MAREA BRITANIE CUTIE X 5 FIOLE STICLA + INEL RUPERE X 2ML SOL. INJ/ PERF. S/P-RF
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
COD ATC
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA05
A04AA05
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
G03HA01
H02AB02
H02AB02
H02AB02
H02AB02
DCI
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
PALONOSETRONUM**
PALONOSETRONUM**
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM BETA***
EPOETINUM BETA***
EPOETINUM BETA***
EPOETINUM BETA***
EPOETINUM BETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
DARBEPOETINUM ALFA***
CYPROTERONUM**
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
forma farm.
Denumire Comerciala
GRANISETRON ACTAVIS 1 mg COMPR. FILM.
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.
GRANISETRON TEVA 1mg/1ml CONC. PT. SOL. PERF./INJ.

GRANISETRON TEVA 3mg/3ml CONC. PT. SOL. PERF./INJ.
GRANISETRON KABI 1 mg/ml SOL. INJ.
RETACRIT 10000UI/1,0ml
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
DEXAMETAZONA ROMPHARM 4 mg/ml
CAPS. MOI
SOL. INJ.
ISLANDA
UNGARIA
ROMANIA
AMBALAJ
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
GRANISETRON ACTAVIS 2 mg COMPR. FILM.
GRANORED 2 mg
COMPR. FILM.
NEORECORMON 10000UI/0,6ml
DETINATOR APP
1mg
1mg
1mg
1mg
2mg
2mg
1mg/1ml
3mg/3ml
1mg/ml
FRESENIUS KABI ROMANIA SRL
500mcg
HELSINN BIREX PHARMACEUTICALS LTD.
250 mcg/5ml HELSINN BIREX PHARMACEUTICALS LTD.
1000UI/0,5ml SANDOZ GMBH
40 000UI/ml JOHNSON & JOHNSON D.O.O.
40000 UI/1 ml SANDOZ GMBH
GRANEGIS 1 mg
GRANORED 1 mg
SETROGEN 1 mg
ALOXI 500mcg
ALOXI
BINOCRIT 1000UI/0,5ml
EPREX 40000 UI/ml
BINOCRIT 40000 UI/1 ml
concentratie
Prescriptie
NR.CRT
TARA
DET. APP
S/P-RF/R
S/P-RF/R
S/P-RF/R
SLOVENIA
CUTIE CU 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ.
S/P-RF
AUSTRIA
AUSTRIA
AUSTRIA
CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ.
P-RF/R
MAREA BRITANIE
10000UI/1,0ml HOSPIRA UK LIMITED MAREA BRITANIE

COMPR.
COMPR.
SOL. INJ.
SOL. INJ.
SOL. INJ.
ISLANDA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML CONC. PT. SOL. PERF./INJ. S
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 3 ML CONC. PT. SOL. PERF./INJ. S
ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ. PR
IRLANDA CUTIE X BLISTER DIN POLIAMIDA/AL/PVC X 1 CAPSULA MOALE PRF
IRLANDA CUTIE X 1 FLAC. DIN STICLA X 5 ML SOL. INJ. P-RF
AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ.
AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ.
AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ. P-RF/R
CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF
LUXEMBURG CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. FILM. PRF
4000UI/0,3ml
5000UI/0,3ml
CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF
CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R

S/P-RF/R
S/P-RF/R
S/P-RF/R
PR
2000UI/0,6ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR
40000UI/1,0ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. PR
100mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R
150mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE, A 1 ML X 0,3 ML P-RF/R
300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML P-RF/R
500mcg/ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 1 ML P-RF/R
50mg
BAYER PHARMA AG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-RF
0,5mg
CN UNIFARM S.A.
ROMANIA CUTIE CU 10 BLISTERE X 10 COMPRIMATE PRF
4mg/ml
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF
4mg/ml
4mg/ml
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 100 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ.
PRF
Pagina 10 din 39
cant.
UT/
Pret de
aj
(RON)
10
10
10
10
10
10
5
5
5
1
1
6
6
1
6
1
1
6
6
6
6
1
6
6
1
1
1
1
1
1
1
1
1
4
4
4
4
1
4
4
1
4
4
4
50
100
10
25
100
11,747000
12,136000
14,096400
14,096400
24,501000
28,198000
14,580000
33,974000
28,870000
288,130000
329,720000
21,785000
45,386666
488,460000
68,290000
912,804000
760,670000
87,998333
107,725000
280,040000
59,898333
999,550000
108,236666
154,340000
228,050000
51,940000
533,260000
73,980000
693,880000
98,650000
123,300000
140,320000
196,010000
647,495000
78,342500
962,400000
143,647500
1.960,260000
206,655000
269,612500
3.219,860000
321,740000
395,560000
521,557500
2,250800
0,190800
0,832000
0,816800
0,736400

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
11,747000
12,136000
14,096400
14,096400
24,501000
28,198000
14,580000
33,974000
28,870000
288,130000
329,720000
21,785000
45,386666
488,460000
68,290000
912,804000
760,670000
87,998333
107,725000
280,040000
59,898333
999,550000
108,236666
154,340000
228,050000
51,940000
533,260000
73,980000
693,880000
98,650000
123,300000
140,320000
196,010000
647,495000
78,342500
962,400000
143,647500
1.960,260000
206,655000
269,612500
3.219,860000
321,740000
395,560000
521,557500
2,250800
0,190800
0,832000
0,816800
0,736400
0,000000
0,000000
4,408600
3,092600
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
99,806000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
COD ATC
DCI
H02AB02
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
ITRACONAZOLUM
ITRACONAZOLUM
ITRACONAZOLUM
ITRACONAZOLUM
ITRACONAZOLUM
ITRACONAZOLUM
VORICONAZOLUM**
VORICONAZOLUM**
VORICONAZOLUM**
VORICONAZOLUM**
POSACONAZOLUM**
POSACONAZOLUM**
CASPOFUNGINUM**
CASPOFUNGINUM**
ANAGRELIDUM***
ANAGRELIDUM***
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
J02AC02
J02AC02
J02AC02
J02AC02
J02AC02
J02AC02
J02AC03
J02AC03
J02AC03
J02AC03
J02AC04
J02AC04
J02AX04
J02AX04
L01XX35
L01XX35
L04AD01
L04AD01
L04AD01
L04AD01
L04AD01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA05
N02AA05
N02AA05
N02AA05
N02AA05
N02AA05
100 N02AA05
101 N02AA05
102 N02AA05
103 N02AA05
104 N02AA05
Denumire Comerciala
forma farm.
SOL. INJ.
DEXAMETAZONA ROMPHARM 4 mg/ml SOL. INJ.
DEXAMETAZONA ROMPHARM 4 mg/ml SOL. INJ.
DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ.
DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ.
DEXAMED
SOL. INJ.
ORUNGAL
CAPS.
ITRACONAZOL 100 mg
CAPS.
OMICRAL 100 mg
CAPS.
MICOGAL 100 mg
CAPS.
ITRACONAZOL ARENA 100 mg CAPS.
OMICRAL 100 mg
CAPS.
VFEND 200mg
COMPR. FILM.
VFEND 50mg
COMPR. FILM.
VFEND 200mg
VFEND 40 mg/ml
NOXAFIL 100mg
CAPS. GASTROREZ.
NOXAFIL 40mg/ml
SUSP. ORALA
CANCIDAS 50 mg
PULB. PT. CONC. PT. SOL. PERF.
CANCIDAS 70 mg
THROMBOREDUCTIN
CAPS.
THROMBOREDUCTIN
CAPS.
EQUORAL 100 mg
CAPS. MOI
SANDIMMUN NEORAL (R)
CAPS. MOI
EQUORAL 25 mg
CAPS. MOI
CAPS. MOI
EQUORAL 50 mg
CAPS. MOI
MST CONTINUS 100 mg
COMPR. ELIB. MODIF.
MST CONTINUS 10 mg
COMPR. ELIB. MODIF.
MST CONTINUS 200 mg
COMPR. ELIB. MODIF.
MST CONTINUS 30 mg
COMPR. ELIB. MODIF.
MST CONTINUS 60 mg
COMPR. ELIB. MODIF.
SEVREDOL 10 mg
COMPR. FILM.
SEVREDOL 20 mg
COMPR. FILM.
VENDAL (R) RETARD 100 mg COMPR. FILM. ELIB. PREL.
MORFINA ZENTIVA 20 mg/ml SOL. INJ.
OXYCONTIN 10 mg
OXYCONTIN 20 mg
OXYCONTIN 40 mg
OXYCONTIN 80 mg
RELTEBON 10 mg
RELTEBON 20 mg
CLORHIDRAT DE OXICODONA TORRENT 20 mg COMPR. CU ELIB. PREL.
RELTEBON 40 mg
RELTEBON 80 mg
concentratie
4mg/ml
4mg/ml
4mg/ml
8mg
8mg
8mg/2ml
100mg
100mg
100mg
100mg
100mg
100mg
200mg
50mg
200mg
40mg/ml
100mg
40mg/ml
50mg
70mg
0,5mg
0,5mg
100mg
25mg
25mg
50mg
50mg
100mg
10mg
200mg
30mg
60mg
10mg
20mg
100mg
30mg
60mg
20mg/ml
10 mg
20 mg
40 mg
80mg
10mg
20mg
20mg
40mg
40mg
80mg
80mg
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 25 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF
PRF
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF
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
SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF
MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS.
P-RF
ROMPHARM COMPANY SRL ROMANIA CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF
PHARMASWISS CESKA REPUBLIKA S.R.O.
REPUBLICA CEHA CUTIE X 3 BLIST. AL/AL X 5 CAPS.
P-RF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML
P-RF
PFIZER LIMITED
MAREA BRITANIE
P-RF
MERCK SHARP & DOHME LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/PCTF/AL X 24 COMPRIMATE GASTROREZISTENTE PR
CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR
MERCK SHARP & DOHME
MAREA BRITANIE
CUTIE X 1 FLAC. X 105ML SUSP. ORALA
MERCK SHARP & DOHME
MAREA BRITANIE
CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF.
MERCK SHARP & DOHME
MAREA BRITANIE
CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF.
AUSTRIA CUTIE X 1 FLAC. DIN PE X 42 CAPS.

AUSTRIA CUTIE X 1 FLAC. DIN PE X 100 CAPS.
TEVA CZECH INDUSTRIES S.R.O. CEHIA
CUTIE X 5 BLIST. X 10 CAPS. MOI
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD.
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM.
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM.
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.
ZENTIVA S.A.
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.
TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL.
P-RF/R
S
S
ORPHA-DEVEL HANDELS UND VERTRIEBS GMBH
P-RF
ORPHA-DEVEL HANDELS UND VERTRIEBS GMBH
P-RF/S
Pagina 11 din 39
S/P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
P-TS
P-TS
P-TS
P-TS
P-TS
P-TS
P-TS
P-TS
P-TS
P-TS
P-TS
PS
PS
PS
PS
PR, PS
PR, PS
PR, PS
PR, PS
PR, PS
PR, PS
PR, PS
cant.
UT/
Pret de
aj
(RON)
10
25
100
100
5
10
15
15
15
15
15
15
28
28
1
1
24
1
1
1
42
100
50
50
50
50
50
60
60
60
60
60
60
60
30
30
30
5
60
60
60
60
60
60
60
60
60
60
60
1,387000
1,327200
1,246200
1,256100
1,380000
1,425000
2,573599
2,144666
2,144666
2,144666
2,144666
2,144666
132,002857
36,496071
512,920000
2.266,130000
147,492083
2.660,080000
1.396,750000
1.801,340000
16,829761
14,483900
6,232400
1,784400
1,487000
3,040560
2,533800
2,910799
0,626333
6,769666
0,925599
1,944000
0,751599
1,219500
2,425666
0,771333
1,620000
1,720000
0,815599
1,440199
2,331999
3,964399
0,679666
1,200166
1,200166
1,943333
1,943333
3,303666
3,304000

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
1,387000
1,327200
1,246200
1,256100
1,380000
1,425000
2,573599
2,144666
2,144666
2,144666
2,144666
2,144666
132,002857
36,496071
512,920000
2.266,130000
147,492083
2.660,080000
1.396,750000
1.801,340000
16,829761
14,483900
6,232400
1,784400
1,487000
3,040560
2,533800
2,910799
0,626333
6,769666
0,925599
1,944000
0,751599
1,219500
2,425666
0,771333
1,620000
1,720000
0,815599
1,440199
2,331999
3,964399
0,679666
1,200166
1,200166
1,943333
1,943333
3,303666
3,304000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,620401
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,574000
0,000000
0,788040
0,000000
0,628367
0,000000
0,000000
0,184234
0,300333
0,114734
0,000000
0,000000
0,000000
0,000000
0,000000
0,230234
0,406134
0,503334
1,118434
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
DCI
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
DIHYDROCODEINUM
DIHYDROCODEINUM
DIHYDROCODEINUM
PETHIDINUM
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
106 N02AA05
107 N02AA05
108 N02AA05
109 N02AA05
110 N02AA05
111 N02AA05
112 N02AA08
113 N02AA08
114 N02AA08
115 N02AB02
116 N02AB03
117 N02AB03
118 N02AB03
119 N02AB03
120 N02AB03
121 N02AB03
122 N02AB03
123 N02AB03
124 N02AB03
125 N02AB03
126 N02AB03
127 N02AB03
128 N02AB03
129 N02AB03
130 N02AB03
131 N02AB03
132 N02AB03
133 N02AB03
134 N02AB03
135 N02AB03
136 N02AB03
137 N02AX02
138 N02AX02
139 N02AX02
140 N02AX02
141 N02AX02
142 N02AX02
143 N02AX02
144 N02AX02
145 N02AX02
146 N02AX02
147 N02AX02
148 N02AX02
149 N02AX02
150 N02AX02
151 N02AX02
152 N02AX02
153 N02AX02
Denumire Comerciala
forma farm.
OXIDOLOR 10 mg
OXIDOLOR 20 mg
OXIDOLOR 40 mg
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.
FENTANYL TTS SANDOZ 100 mcg/h
PLASTURE TRANSDERMIC
FENTANYL ACTAVIS 100micrograme/h
100micrograme/h
ALGOGESIC 100 micrograme/ora
100micrograme/ora
DOLFORIN 100 g/ORA
100g/ora
25mcg/h
COMPR. ELIB. PREL.

COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
SOL. INJ.
concentratie
10mg
20mg
40mg
40mg
60mg
80mg
80mg
120mg
60mg
90mg
50mg/ml
COMPR. SUBLING. 100micrograme

100mcg/h
FENTANYL ACTAVIS 25micrograme/h PLASTURE TRANSDERMIC 25micrograme/h
25micrograme/ora
DOLFORIN 25 g/ORA
25g/ora
50mcg/h
FENTANYL ACTAVIS 50micrograme/h PLASTURE TRANSDERMIC 50micrograme/h
50micrograme/ora
DOLFORIN 50 g/ORA
50g/ora
75mcg/h
75micrograme/ora
DOLFORIN 75 g/ORA
TRAMADOL
K-ALMA (R)
TRAMADOL ARENA
TRAMACALM
TRAMAG 50
TRAMADOL EEL
75g/ora
50mg
50mg
50mg
50mg
50mg
50mg
50mg
100mg
100mg
100mg
100mg
100mg
100mg
150mg
150mg
150mg
150mg
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR.
COMPR.
COMPR. ELIB. PREL.
TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL.

COMPR. ELIB. PREL.

COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
TRAMADOL SR ZENTIVA 150 mg COMPR. ELIB. PREL.

COMPR. ELIB. PREL.

COMPR. ELIB. PREL.
DETINATOR APP
AUSTRIA
SANDOZ S.R.L.
ROMANIA
SANDOZ S.R.L.
ROMANIA
SANDOZ S.R.L.
ROMANIA
MUNDIPHARMA GES.M.B.H AUSTRIA
ZENTIVA SA
ROMANIA
GEDEON RICHTER PLC. UNGARIA
SANDOZ S.R.L.
ROMANIA
ZENTIVA K.S.
REPUBLICA CEHA
SANDOZ S.R.L.
ROMANIA
ZENTIVA K.S.
REPUBLICA CEHA
SANDOZ S.R.L.
ROMANIA
ZENTIVA K.S.
REPUBLICA CEHA
SANDOZ S.R.L.
ROMANIA
ZENTIVA K.S.
REPUBLICA CEHA
KRKA D.D.
SLOVENIA
ANTIBIOTICE SA
ROMANIA
A.C. HELCOR PHARMA S.R.L. ROMANIA
ZENTIVA A.S.
SLOVACIA
MAGISTRA C & C
ROMANIA
BIO EEL SRL
ROMANIA
AMBALAJ
Prescriptie
COD ATC
105 N02AA05
NR.CRT
TARA
DET. APP
CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL.
P-TS
P-TS
P-TS
PS
PS
P-TS
CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL.
PS
PS
PS
PS
CUTIE X 5 FIOLE DIN STICLA X 2 ML
P-TS

CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE
PRF
PRF
PRF
PRF
PRF
PRF
CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS
CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC
PS
PS
CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC
P-TS
CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC
PS
PS
P-TS
PS
PS
P-TS

PS
P-TS

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.
SLOVACIA
CIPRU
CIPRU
CIPRU
CIPRU
ZENTIVA AS
SLOVACIA
Pagina 12 din 39
P-RF
P-RF
P-RF

PRF
PRF
CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
PRF
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF

PRF
PRF
cant.
UT/
Pret de
aj
(RON)
60
60
60
20
20
60
20
56
56
56
5
10
10
10
10
10
10
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
20
20
20
10
20
20
20
30
30
10
30
10
30
30
30
10
30
0,679666
1,200166
1,943333
2,046000
7,230000
3,303666
3,546500
2,159107
0,543750
1,462142
1,942000
29,404000
27,380000
27,968000
27,968000
27,968000
27,968000
31,884000
26,570000
31,884000
31,884000
10,538400
8,782000
10,538400
10,538400
16,424000
15,444000
18,532800
18,532800
30,532000
32,076000
32,076000
0,299500
0,341400
0,341400
0,341400
0,284500
0,341400
0,341400
0,632400
0,630333
0,527000
0,528000
0,527000
0,528000
0,949599
0,904333
0,792000
0,791333

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,679666
1,200166
1,943333
2,046000
7,230000
3,303666
3,546500
2,159107
0,543750
1,462142
1,942000
29,404000
27,380000
27,968000
27,968000
27,968000
27,968000
31,884000
26,570000
31,884000
31,884000
10,538400
8,782000
10,538400
10,538400
16,424000
15,444000
18,532800
18,532800
30,532000
32,076000
32,076000
0,299500
0,341400
0,341400
0,341400
0,284500
0,341400
0,341400
0,632400
0,630333
0,527000
0,528000
0,527000
0,528000
0,949599
0,904333
0,792000
0,791333
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
2,056000
0,000000
7,800000
7,800000
1,231600
0,000000
1,813600
3,653600
0,000000
0,000000
4,927200
6,529200
0,000000
0,000000
0,000000
0,000000
0,057100
0,125600
0,043600
0,000000
0,057100
0,042100
0,021266
0,000000
0,000000
0,000000
0,000000
0,000000
0,168401
0,000000
0,000000
0,000000
DCI
COD ATC
154 N02AX02
155 N02AX02
156 N02AX02
157 N02AX02
158 N02AX02
159 N02AX02
160 N02AX02
161 N02AX02
162 N02AX02
163 N02AX02
164 N02AX02
165 N02AX02
166 N02AX02
167 N02AX02
168 N02AX02
169 N02AX02
170 N02AX02
171 N07BC02
172 N07BC02
173 R05DA04
174 R05DA04
175 R05DA04
176 R05DA04
177 R05DA04
178 R05DA04
179 V03AC01
180 V03AC03
181 V03AC03
182 V03AC03
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
METHADONUM
METHADONUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
DEFEROXAMINUM**3)
DEFERASIROXUM***
DEFERASIROXUM***
DEFERASIROXUM***
Denumire Comerciala
forma farm.

TRADOLAN 50 mg
MABRON
MABRON
TRAMADOL
TRAMADOL
TRAMADOL
SINTALGON 2,5 mg
METADON BIOEEL 5 mg
FOSFAT DE CODEINA 15 mg
CODEINA FOSFORICA
FARMACOD
CODEINA FOSFAT
CODEINA FOSFAT LPH 15 mg
COMPR. ELIB. PREL.

COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. FILM.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SUPOZ.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
CODEINA FOSFAT MCC 15 mg COMPR.
DESFERAL
EXJADE 125mg
COMPR. DISP.
EXJADE 250mg
COMPR. DISP.
EXJADE 500mg
COMPR. DISP.
concentratie
DETINATOR APP
AMBALAJ
150mg
150mg
200mg
200mg
200mg
200mg
200mg
50mg
150mg
200mg
50mg
50mg
100mg
100mg
50mg/ml
50mg/ml
100mg
2,5mg
5mg
15mg
15mg
15mg
15mg
15mg
15mg
500mg
125mg
250mg
500mg

100 mg
100mg
100mg
100 mg/ml
100mg
250mg/5ml
200mg
200mg
200mg
200mg
200mg
200mg
200mg
200mg
400mg
ZENTIVA SA
SC ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 10 COMPR.
Prescriptie
NR.CRT
TARA
DET. APP
PRF
PRF
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
PRF
PRF
PRF
PRF
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-RF
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
ZENTIVA, A.S.
ZENTIVA, A.S.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
KRKA D.D.
KRKA D.D.
KRKA D.D.
ZENTIVA S.A.
BIO EEL SRL
SINTOFARM SA
BIO EEL SRL
FARMACOM SA
SLAVIA PHARM SRL
REPUBLICA SLOVACA
CIPRU
CIPRU
CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE
PRF
S/P-RF
S/P-RF

SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ.
S/P-RF
S/P-RF
P-RF
P-TS
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
MAGISTRA C & C SRL ROMANIA
CUTIE X 5 BLIST. AL/PVC-PVDC X 10 COMPR. P-TS
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)

P-RF
P-RF

P-RF
P-RF
P-RF
P-RF
PR
PR
PR
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
10
30
30
10
30
10
30
30
30
30
10
10
5
100
5
5
5
50
50
30
25
20
20
20
20
10
28
28
28
0,792000
0,791333
1,170666
1,055000
1,055333
1,055000
1,055333
0,330333
0,949599
1,266000
0,341400
0,341400
1,675320
1,396100
1,024000
1,675320
1,158000
0,506400
0,326000
0,181200
0,181200
0,151000
0,173500
0,165500
0,181200
13,266000
27,555357
52,592500
95,897142
0,792000
0,791333
1,170666
1,055000
1,055333
1,055000
1,055333
0,330333
0,949599
1,266000
0,341400
0,341400
1,675320
1,396100
1,024000
1,675320
1,158000
0,506400
0,326000
0,181200
0,181200
0,151000
0,173500
0,165500
0,181200
13,266000
27,555357
52,592500
95,897142
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,335734
0,430000
0,056600
0,056600
0,200680
0,000000
0,000000
1,042680
0,000000
0,000000
0,000000
0,019133
0,024000
0,000000
0,000000
0,000000
0,008300
0,000000
0,000000
0,000000
0,000000
25
10
30
5
20
5
50
60
50
50
50
20
20
20
50
0,142800
0,119000
0,142800
2,274000
0,144000
14,054000
0,168000
0,141833
0,141800
0,141800
0,141800
0,140000
0,142000
0,142000
0,392200
0,142800
0,119000
0,142800
2,274000
0,144000
14,054000
0,168000
0,141833
0,141800
0,141800
0,141800
0,140000
0,142000
0,142000
0,392200
0,039600
0,000000
0,044200
0,000000
0,000000
0,000000
0,050200
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
Tratamentul se iniiaz de ctre medicul n specialitatea oncologie sau hematologie.

9. EPILEPSIE - G11
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
N03AA02
N03AA02
N03AA02
N03AA02
N03AB02
N03AB02
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
PHENOBARBITALUM
PHENOBARBITALUM
PHENOBARBITALUM
PHENOBARBITALUM
PHENYTOINUM
PHENYTOINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
FENOBARBITAL ZENTIVA 100 mg COMPR.

FENOBARBITAL ARENA 100mg COMPR.
FENOBARBITAL ARENA 100mg COMPR.
SOL. INJ.
FENITOINA RICHTER 100 mg COMPR.
PHENHYDAN 250 mg/5 ml
SOL. INJ.
TEGRETOL (R) 200
COMPR.
CARBAMAZEPINA LPH (R) 200 mg COMPR.
CARBAMAZEPINA LPH 200 mg COMPR.
CARBAVIM
COMPR.
CARBEPSIL 200mg
COMPR.
CARBAMAZEPIN
COMPR.
CARBAMAZEPIN EEL
COMPR.
CARBAMAZEPINA ARENA 200 mg COMPR.
CARBEPSIL 400mg
COMPR.
FENOBARBITAL ZENTIVA 100 mg/ml
P-RF
P-RF
ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLISTERE DIN PVC/AL A CTE 10 COMPRIMATE P-RF
ZENTIVA S.A
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF
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
P-6L

BIO EEL SRL
ROMANIA
Pagina 13 din 39
P-6L

P-6L
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
COD ATC
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF02
N03AF02
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
DCI
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
OXCARBAZEPINUM
OXCARBAZEPINUM
ACIDUM VALPROICUM + SARURI
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
Denumire Comerciala
CARBAMAZEPINA ARENA 400 mg

NEUROTOP (R) RETARD 300 mg
NEUROTOP (R) RETARD 600 mg
TEGRETOL CR 200
TEGRETOL CR 400
TIMONIL SIROP
TRILEPTAL (R) 300 mg
TRILEPTAL (R) 600 mg
ORFIRIL LONG 150 mg
CONVULEX (R) 150 mg
CONVULEX 150 mg
CONVULEX (R) 300 mg
CONVULEX 300 mg
CONVULEX (R) 500 mg
CONVULEX 500 mg
DEPAKINE CHRONO 300 mg
DEPAKINE (R) CHRONO 500 mg
DEPAKINE 200 mg
ORFIRIL LONG 1000 mg
DEPAKINE
DEPAKINE
LAMOTRIX 100 mg
PLEXXO (R) 100 mg
LAMICTAL 100 mg
LAMOTRIX 200 mg
LAMICTAL 25 mg
LAMOTRIX 50 mg
LAMOTRIN 100 mg
LAMOTRIN 50 mg
LAMICTAL 2 mg
LAMICTAL 5 mg
TOPRAN 100 mg
TOPIRAMAT TEVA 100 mg
TOPIRAMAT ACTAVIS 100 mg
LUSITRAX 100mg
TORLEPTA 100 mg
NEXTOP 100 mg
TOPAMAX 100 mg
TOPILEX 100 mg
NEXTOP 200 mg
TOPRAN 25 mg
LUSITRAX 25 mg
TORLEPTA 25 mg
forma farm.
COMPR.
concentratie
400mg
COMPR. CU ELIB. PRELUNGITA 150mg
COMPR. CU ELIBERARE PRELUNGITA 300mg
COMPR. CU ELIBERARE PRELUNGITA 600mg
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
COMPR.
100mg
COMPR.
100mg
COMPR.
200mg
COMPR.
25mg
COMPR.
50mg
COMPR. DISP.
100mg
COMPR. DISP.
50mg
COMPR. DISP./MAST. 2mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
200mg
COMPR. FILM.
200mg
COMPR. FILM.
25mg
COMPR. FILM.
25mg
COMPR. FILM.
25mg
COMPR. FILM.
25mg
COMPR. FILM.
25mg
DETINATOR APP
AMBALAJ
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR.

Prescriptie
NR.CRT
TARA
DET. APP
P-6L
P6L
GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L
GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L
GERMANIA
AUSTRIA
AUSTRIA
CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIB. PRELUNGITA
CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL
P-6L
CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL.
P-6L
CUTIE X 5 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL.
P-6L
CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL.
P-6L
GERMANIA
CUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE
P-6L

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
SANOFI-AVENTIS FRANCE
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
CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. 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.
P-6L
FRANTA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA

SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE
DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR.
P-6L

P-6L
SANOFI - AVENTIS FRANCE
THE WELLCOME FOUNDATION LTD. MAREA BRITANIE


ACTAVIS GROUP HF. ISLANDA
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L

THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. DISP./MAST.
P-6L
THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. DISP./MAST.
P-6L
TERAPIA SA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
REPUBLICA CEHA
P-RF
ROMANIA
P-6L
JOHNSON & JOHNSON D.O.O.
SLOVENIA

P6L
P6L
P-RF
P-6L
AUSTRIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
REPUBLICA CEHA
ACTAVIS S.R.L.
TERAPIA SA
ACTAVIS S.R.L.
Pagina 14 din 39
CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L

P-RF
CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF

CUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM. P-RF

P-RF

P-RF
cant.
UT/
Pret de
aj
(RON)
20
50
50
50
50
50
50
30
1
50
50
50
100
100
100
100
100
100
100
30
40
50
1
1
30
30
28
30
28
30
30
30
30
30
60
30
60
30
30
30
28
30
30
30
60
30
60
30
30
0,392000
0,303800
0,412600
0,731600
0,356000
0,686000
0,168000
0,470400
23,360000
0,887000
1,372200
0,227760
0,189800
0,189800
0,234500
0,234500
0,304800
0,304800
0,281400
0,365760
0,277250
1,924200
18,430000
18,430000
0,903600
0,849666
0,903600
1,768000
0,149285
0,409999
0,753000
0,341666
0,009333
0,026333
0,632400
0,632400
0,632400
0,632400
0,632400
0,527000
0,632400
0,632400
2,972333
3,566799
0,242799
0,242799
0,242799
0,242799
0,242799

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,392000
0,303800
0,412600
0,731600
0,356000
0,686000
0,168000
0,470400
23,360000
0,887000
1,372200
0,227760
0,189800
0,189800
0,234500
0,234500
0,304800
0,304800
0,281400
0,365760
0,277250
1,924200
18,430000
18,430000
0,903600
0,849666
0,903600
1,768000
0,149285
0,409999
0,753000
0,341666
0,009333
0,026333
0,632400
0,632400
0,632400
0,632400
0,632400
0,527000
0,632400
0,632400
2,972333
3,566799
0,242799
0,242799
0,242799
0,242799
0,242799
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,179400
0,133600
0,000000
0,000000
0,000000
0,127840
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,067700
0,103240
0,000000
0,000000
0,000000
0,000000
0,028066
0,000000
0,501757
0,000000
0,000000
0,086667
0,000000
0,000000
0,000000
0,000000
0,350266
0,345933
0,347433
0,382933
0,382933
0,000000
0,879385
0,381933
0,000000
1,601534
0,147534
0,133534
0,147367
0,148201
0,147534
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
COD ATC
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
100 N03AX12
101 N03AX14
102 N03AX14
103 N03AX14
104 N03AX14
105 N03AX14
106 N03AX14
107 N03AX14
108 N03AX14
109 N03AX14
110 N03AX14
111 N03AX14
112 N03AX14
113 N03AX14
DCI
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
Denumire Comerciala
NEXTOP 25 mg
TOPAMAX 25 mg
TOPILEX 25 mg
TOPRAN 50 mg
LUSITRAX 50 mg
TORLEPTA 50 mg
NEXTOP 50 mg
TOPAMAX 50 mg
TOPILEX 50 mg
GABAPENTIN AUROBINDO 100 mg
GABAGAMMA 100 mg
GRIMODIN 100 mg
GABAPENTINA PFIZER 100 mg
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

GABARAN 600 mg
GRIMODIN 600 mg
GABARAN 800 mg
LEVETIRACETAM TORRENT 1000 mg
LEVETIRACETAM TERAPIA 1000 mg
KEPPRA 1000 mg
LEVETIRACETAM ACTAVIS 1000mg
LEVETIRACETAM TEVA 1000mg
TRUND 1000 mg
EPILETAM 1000 mg
LEVETIRACETAM AUROBINDO 1000 mg
MYAKELL 1000 mg
NORMEG 1000 mg
LEVELANZ 1000 mg
LEVELANZ 1000 mg
LEVETIRACETAM TEVA 250 mg
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
concentratie
25mg
25mg
25mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
100 mg
100mg
100mg
100mg
100mg
100mg
300 mg
300mg
300mg
300mg
300mg
300mg
300mg
300mg
400 mg
400mg
400mg
400mg
400mg
400mg
400mg
400mg
600mg
600mg
800mg
1000 mg
1000 mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
250 mg
Prescriptie
NR.CRT
DETINATOR APP
TARA
DET. APP
ROMANIA
P-6L
SLOVENIA

P6L
P6L
AMBALAJ
AUSTRIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
REPUBLICA CEHA
P-RF
ROMANIA
P-6L
SLOVENIA
P6L
AUSTRIA
P6L
MAREA BRITANIE CUTIE CU BLIST. DIIN POLIAMIDA/AL/PVC-AL X 50 CAPS.
GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L
TERAPIA SA
ACTAVIS S.R.L.

UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS.
MAREA BRITANIE
MAREA BRITANIE
P6L
P-6L

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

MAREA BRITANIE
MAREA BRITANIE

UNGARIA
TERAPIA S.A.
ROMANIA
UCB PHARMA SA
BELGIA
TEVA PHARMA
OLANDA
P-6L

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

CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L
P-RF
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMP.FILM. PRF
CUTIE X 30 COMPR. FILM.1 (BLIST. AL/PVC)
P-RF
CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM. PRF

CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM. PRF
CUTIE CU 6 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM.
PRF
UNGARIA
ROMASTRU TRADING SRL ROMANIA
ZENTIVA, K.S.
REPUBLICA CEHA
PRF
PRF
CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM.
PRF
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.FILM.
PRF
ABBOTT LABORATORIES LTD.
MAREA BRITANIE
PRF
MAREA BRITANIE
TEVA PHARMA
OLANDA
CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM. PRF
REPUBLICA CEHA
Pagina 15 din 39
cant.
UT/
Pret de
aj
(RON)
30
28
30
60
30
60
30
30
30
28
30
50
100
60
50
100
60
50
100
50
100
60
50
100
60
50
100
50
100
60
50
100
60
30
60
30
30
30
30
30
30
60
30
30
30
30
28
28
30
0,202333
0,242799
0,242799
0,413599
0,413599
0,413599
0,413599
0,413599
0,344666
0,413599
0,413599
0,149200
0,179040
0,179040
0,179040
0,179040
0,179040
0,447800
0,519600
0,519600
0,519600
0,519600
0,447400
0,433000
0,519600
0,597600
0,692520
0,692520
0,692520
0,692520
0,596200
0,577100
0,692520
2,180000
1,867833
3,605000
1,878799
1,878799
1,878799
1,864000
1,878799
1,784333
1,878799
1,878799
1,878799
1,565666
1,878799
1,878799
0,472666

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,202333
0,242799
0,242799
0,413599
0,413599
0,413599
0,413599
0,413599
0,344666
0,413599
0,413599
0,149200
0,179040
0,179040
0,179040
0,179040
0,179040
0,447800
0,519600
0,519600
0,519600
0,519600
0,447400
0,433000
0,519600
0,597600
0,692520
0,692520
0,692520
0,692520
0,596200
0,577100
0,692520
2,180000
1,867833
3,605000
1,878799
1,878799
1,878799
1,864000
1,878799
1,784333
1,878799
1,878799
1,878799
1,565666
1,878799
1,878799
0,472666
0,000000
0,358272
0,146867
0,229067
0,226734
0,212401
0,250401
0,233067
0,000000
0,608186
0,233401
0,000000
0,015060
0,397460
0,288760
0,273660
0,228293
0,000000
0,236500
0,827000
0,836700
0,055900
0,000000
0,000000
0,377733
0,000000
0,500580
0,816480
1,062580
0,336813
0,000000
0,000000
0,429146
0,000000
0,000000
0,000000
1,285867
1,635201
3,247534
0,000000
0,050201
0,000000
1,635201
1,502534
1,635201
0,000000
1,634772
1,634772
0,000000
COD ATC
114 N03AX14
115 N03AX14
116 N03AX14
117 N03AX14
118 N03AX14
119 N03AX14
120 N03AX14
121 N03AX14
122 N03AX14
123 N03AX14
124 N03AX14
125 N03AX14
126 N03AX14
127 N03AX14
128 N03AX14
129 N03AX14
130 N03AX14
131 N03AX14
132 N03AX14
133 N03AX14
134 N03AX14
135 N03AX14
136 N03AX14
137 N03AX14
138 N03AX14
139 N03AX14
140 N03AX14
141 N03AX14
142 N03AX14
143 N03AX14
144 N03AX14
145 N03AX14
146 N03AX16
147 N03AX16
148 N03AX16
149 N03AX16
150 N03AX16
151 N03AX16
152 N03AX17
153 N03AX17
154 N03AX17
155 N03AX17
DCI
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
STIRIPENTOLUM**
STIRIPENTOLUM**
STIRIPENTOLUM**
STIRIPENTOLUM**
Denumire Comerciala
forma farm.
COMPR. FILM.
LEVETIRACETAM TERAPIA 250 mg COMPR. FILM.
KEPPRA 250 mg
COMPR. FILM.
LEVETIRACETAM ACTAVIS 250mg COMPR. FILM.
TRUND 250 mg
COMPR. FILM.
EPILETAM 250 mg
COMPR. FILM.
LEVETIRACETAM AUROBINDO 250 mg COMPR. FILM.
MYAKELL 250 mg
COMPR. FILM.
LEVELANZ 250 mg
COMPR. FILM.
LEVELANZ 250 mg
COMPR. FILM.
LEVETIRACETAM TORRENT 500 mg COMPR. FILM.
LEVETIRACETAM TERAPIA 500 mg COMPR. FILM.
KEPPRA 500 mg
COMPR. FILM.
LEVETIRACETAM ACTAVIS 500mg COMPR. FILM.
LEVETIRACETAM TEVA 500 mg COMPR. FILM.
TRUND 500 mg
COMPR. FILM.
EPILETAM 500 mg
COMPR. FILM.
LEVETIRACETAM AUROBINDO 500 mg COMPR. FILM.
MYAKELL 500 mg
COMPR. FILM.
NORMEG 500 mg
COMPR. FILM.
LEVELANZ 500 mg
COMPR. FILM.
LEVELANZ 500 mg
COMPR. FILM.
LEVETIRACETAM TORRENT 750 mg COMPR. FILM.
MYAKELL 750 mg
COMPR. FILM.
LEVETIRACETAM TORRENT 250 mg
LEVETIRACETAM DESITIN 1000 mg
GRANULE ACOPERITE, IN PLIC UNIDOZA
LEVETIRACETAM ACTAVIS GROUP 100mg/ml
KEPPRA 100 mg/ml

TRUND 100 mg/ml
LEVETIRACETAM RATIOPHARM 100mg/ml
LYRICA 150 mg
LYRICA 150 mg
LYRICA 300 mg
LYRICA 300 mg
LYRICA 75 mg
LYRICA 75 mg
DIACOMIT 250mg
DIACOMIT 500mg
DIACOMIT 250mg
DIACOMIT 500mg
SOL. ORALA
SOL. ORALA
SOL. ORALA
SOL. ORALA
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
concentratie
250 mg
250 mg
250mg
250mg
250mg
250mg
250mg
250mg
250mg
250mg
500 mg
500 mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
750 mg
750mg
1000mg
250mg
500mg
750mg
100 mg/ml
100mg/ml
100mg/ml
100mg/ml
150mg
150mg
300mg
300mg
75mg
75mg
250mg
500mg
250mg
500mg
DETINATOR APP
Prescriptie
NR.CRT
TARA
DET. APP
AMBALAJ
ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF

ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.FILM. PRF
BELGIA CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF
ISLANDA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM. PRF
REPUBLICA CEHA
TERAPIA S.A.
UCB PHARMA SA
PRF
UNGARIA
PRF
PRF
PRF
MAREA BRITANIE
PRF
MAREA BRITANIE
P-RF
TEVA PHARMA
ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM.

ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.FILM.
BELGIA CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC)
ISLANDA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM.
OLANDA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM.
REPUBLICA CEHA
PRF
UNGARIA
ZENTIVA, K.S.
REPUBLICA CEHA
PRF
PRF
PRF
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.FILM.
PRF
MAREA BRITANIE
PRF
MAREA BRITANIE
ROMANIA
ROMANIA
PRF
ROMASTRU TRADING SRL
PRF
GERMANIA
CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE
PRF
GERMANIA
PRF
GERMANIA
PRF
GERMANIA
PRF
UCB PHARMA SA
ISLANDA
BELGIA
REPUBLICA CEHA
RATIOPHARM GMBH
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
BIOCODEX
BIOCODEX
BIOCODEX
BIOCODEX
GERMANIA
TERAPIA S.A.
UCB PHARMA SA
Tratamentul se iniiaz de ctre medicul n specialitatea neurologie i neurologie pediatric.
10. BOALA PARKINSON - G12
Pagina 16 din 39
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
FRANTA
FRANTA
FRANTA
FRANTA
PRF
PRF
PRF
PRF
PRF
CUTIE X 1 FLACON DIN STICLA BRUNA A 300ML PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 SERINGA PENTRU ADMINISTRARE ORALA A 10ML
CUTIE X 1 FLACON X 300 ML SOL. ORALA + SERINGA PT. ADMIN. ORALA
P-RF
CUTIE X 1 FLACON DIN STICLA BRUNA X 300ML SOLUTIE ORALA, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII DIN PP + O SERINGA DOZATAOARE (PP, PE) DE 10ML SI UN ADAPTOR PT. SERINGA PE
CUTIE CU UN FLACON DIN STICLA BRUNA A 300 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + O SERINGA PENTRU ADMINISTRARE ORALA GRADATA A 10ML
CUTIE X 14 CAPS., (BLIST. PVC/AL)

CUTIE X 56 CAPS. (BLIST. PVC/AL)
CUTIE X 14 CAPS. (BLIST. PVC/AL)
CUTIE X 1 FLAC. DIN PP X 60 CAPS.
CUTIE X 1 FLAC. DIN PP X 60 CAPS.
CUTIE X 60 PLICURI HARTIE/AL/PE
CUTIE X 60 PLICURI HARTIE/AL/PE
PRF
PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF/R
P-RF/R
P-RF/R
P-RF/R
cant.
UT/
Pret de
aj
(RON)
30
30
30
30
60
30
30
30
28
28
30
30
30
30
30
60
30
30
30
30
28
28
30
30
30
30
30
60
1
1
1
1
14
56
56
14
14
56
60
60
60
60
0,525999
0,525999
0,525999
0,477666
0,438333
0,525999
0,525999
0,525999
0,525999
0,525999
0,673599
0,673599
0,673599
0,645000
0,561333
0,673599
0,673599
0,673599
0,673599
0,673599
0,673599
0,673599
2,362000
2,834400
1,878799
0,525999
0,673599
2,834400
61,270000
73,524000
61,270000
61,270000
4,380714
3,896250
5,731785
6,045000
2,632857
2,413928
12,749333
25,643166
12,749333
25,643166

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,525999
0,525999
0,525999
0,477666
0,438333
0,525999
0,525999
0,525999
0,525999
0,525999
0,673599
0,673599
0,673599
0,645000
0,561333
0,673599
0,673599
0,673599
0,673599
0,673599
0,673599
0,673599
2,362000
2,834400
1,878799
0,525999
0,673599
2,834400
61,270000
73,524000
61,270000
61,270000
4,380714
3,896250
5,731785
6,045000
2,632857
2,413928
12,749333
25,643166
12,749333
25,643166
0,204001
0,430334
0,897667
0,000000
0,000000
0,430334
0,224334
0,430334
0,425429
0,425429
0,660067
1,076067
1,882401
0,000000
0,000000
0,228067
1,076067
0,709067
1,076067
0,135401
1,075686
1,075686
0,000000
0,423600
1,635201
0,362667
1,076067
0,042766
0,000000
15,986000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
COD ATC
N04AA01
N04BA02
N04BA02
N04BA02
N04BA02
DCI
Denumire Comerciala
TRIHEXYPHENIDYLUM
ROMPARKIN (R) 2 mg
COMBINATII (LEVODOPUM+BENSERAZIDUM)** MADOPAR HBS
COMBINATII (LEVODOPUM+BENSERAZIDUM)** MADOPAR 200mg/50mg
COMBINATII (LEVODOPUM+CARBIDOPUM)** ISICOM 250 mg/25 mg
COMBINATII (LEVODOPUM+CARBIDOPUM)** DUODOPA
N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)***
STALEVO 100 mg/25 mg/200 mg
STALEVO 125 mg/31,25 mg/200 mg

STALEVO 200 mg/50 mg/200 mg
N04BB01
N04BC01
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
AMANTADINUM**
BROMOCRIPTINUM
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
VIREGYT (R)- K
BROCRIPTIN (N04BC01)
ROPINIROL TEVA 2 mg
REQUIP-MODUTAB 2 mg
ROPINIROL TEVA 4 mg
REQUIP-MODUTAB 4 mg
ROPINIROL TEVA 8 mg
REQUIP-MODUTAB 8 mg
ROLPRYNA EP 2 mg
ROLPRYNA EP 4 mg
ROLPRYNA EP 8 mg
ROPINIROL AUROBINDO 2 mg
ROPINIROL ACTAVIS 2 mg
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
forma farm.
COMPR.
concentratie
2mg
DETINATOR APP
TERAPIA SA
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP

CAPS. ELIB. MODIF. 100mg+25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 CAPS. CU ELIB. MODIF. P-6L
COMPR.
200mg+50mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L
COMPR.
250mg/25mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 10 BLIST. PP/AL X 10 COMPR. P-6L
GEL INT.
FARA CONCENTRATIE ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE X 7 CASETE BRUNE TRANSPARENTE X 100 GEL INT. IN PUNGA PVC S/P-RF
COMPR. FILM.
100mg/25mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF
COMPR. FILM.
125mg/31,25mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF
COMPR. FILM.
150mg/37,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF
COMPR. FILM.
200mg/50mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF
COMPR. FILM.
50mg/12,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF
COMPR. FILM.
75mg/18,75mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF
CAPS.
100mg
P-6L
DRAJ.
2,5mg
BIOFARM SA
ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 DRAJ. P-RF
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG. PRF
SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 COMPR. CU ELIB. PREL. P-RF
COMPR. CU ELIBERARE PRELUNGITA 2 mg
KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA - AL - PVC/AL X 28 COMPR. ELIB. PREL. PRF
COMPR. ELIB. PREL. 2 mg
CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL.
PRF
PRF
PRF
COMPR.
0,088mg
KRKA D.D.
COMPR.
0,18 mg
ZENTIVA, K.S.
COMPR.
0,18mg
KRKA D.D.
COMPR.
0,18mg
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
COMPR.
0,18mg
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF
COMPR.
0,18mg
COMPR.
0,18mg
COMPR.
0,18mg
COMPR.
0,7 mg
COMPR.
0,7 mg
ZENTIVA, K.S.
COMPR.
0,7mg
KRKA D.D.
COMPR.
0,7mg
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
COMPR.
0,7mg
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF
COMPR.
0,7mg
COMPR.
0,7mg
STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. OPA-AL -PVC/AL X 10 COMPR. P-RF
COMPR.
0,7mg
GERMANIA CUTIE CU 1 BLIST.OPA-AL-PVC/AL X 10 COMPR. P-RF
KRKA D.D.
SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF
GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR. P-RF
KRKA D.D.
SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF
Pagina 17 din 39
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
50
0,562400
100
0,588700
30
0,786333
100
0,773600
7 452,308571
100
2,742400
100
2,742400
100
2,847700
100
3,069200
100
2,532700
100
2,840600
50
0,354400
40
0,549000
30
0,916333
28
1,099285
30
1,773000
28
2,127428
30
3,044666
28
3,653570
28
0,916071
28
1,772857
28
3,044642
28
0,916071
28
0,916071
28
1,772857
28
1,772857
28
3,044642
28
3,044642
30
0,530000
30
0,386666
30
0,387199
30
0,387199
30
0,322666
30
0,387199
30
0,387199
30
0,387199
30
1,889333
30
2,109000
30
2,028000
30
2,034333
30
2,256666
30
2,267199
30
2,027333
30
2,267199
10
0,763200
30
0,636000
10
0,636000
30
1,679599
30
1,399666
0,562400
0,588700
0,786333
0,773600
452,308571
2,742400
2,742400
2,847700
3,069200
2,532700
2,840600
0,354400
0,549000
0,916333
1,099285
1,773000
2,127428
3,044666
3,653570
0,916071
1,772857
3,044642
0,916071
0,916071
1,772857
1,772857
3,044642
3,044642
0,530000
0,386666
0,387199
0,387199
0,322666
0,387199
0,387199
0,387199
1,889333
2,109000
2,028000
2,034333
2,256666
2,267199
2,027333
2,267199
0,763200
0,636000
0,636000
1,679599
1,399666
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,265000
0,000000
0,462929
0,000000
0,869287
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,039467
0,264134
0,000000
0,203467
0,136134
0,126801
0,000000
0,000000
0,000000
0,000000
0,000000
0,170801
0,000000
0,180467
0,755800
0,000000
0,000000
0,473734
0,000000
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
COD ATC
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC09
N04BC09
N04BC09
N04BC09
N04BD01
N04BD01
N04BD02
N04BX02
N04BX02
N04BX02
N04BX02
N04BX02
N05AH02
N05AH02
DCI
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
ROTIGOTINUM***
ROTIGOTINUM***
ROTIGOTINUM***
ROTIGOTINUM***
SELEGILINUM
SELEGILINUM
RASAGILINUM***
ENTACAPONUM***
ENTACAPONUM***
ENTACAPONUM***
ENTACAPONUM***
ENTACAPONUM***
CLOZAPINUM**
CLOZAPINUM**
Denumire Comerciala
CALMOLAN 0,52 mg
MIRAPEXIN 1,05 mg
OPRYMEA 1,05mg
OPRYMEA 1,57mg
OPRYMEA 2,10mg
MIRAPEXIN 2,1 mg
CALMOLAN 2,1 mg
MIRAPEXIN 3,15 mg
NEUPRO 2mg/24h
NEUPRO 4mg/24h
NEUPRO 6mg/24h
NEUPRO 8mg/24h
SELEGOS
SELEGOS
AZILECT 1mg
COMTAN 200mg
ENTACAPONE TEVA
ENCAPIA 200 mg
ENCAPIA 200 mg
ENCAPIA 200 mg
LEPONEX (R) 100 mg
LEPONEX (R) 25 mg
forma farm.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
concentratie
0,52mg
1,05mg
1,05mg
1,57mg
2,10mg
2,1mg
2,1mg
3,15mg
2mg/24h
4mg/24h
6mg/24h
8mg/24h
5mg
5mg
1mg
200mg
200mg
200mg
200mg
200mg
100mg
25mg
DETINATOR APP
G.L. PHARMA GMBH AUSTRIA
Prescriptie
NR.CRT
TARA
DET. APP
AMBALAJ
CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL.
PRF
P-RF
KRKA D.D.
KRKA D.D.
KRKA D.D.
SLOVENIA
SLOVENIA
SLOVENIA
P-RF
P-RF
P-RF
G.L. PHARMA GMBH AUSTRIA

P-RF
CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL.
PRF
P-RF
IRLANDA
IRLANDA
UCB MANUFACTURING IRELAND LTD. IRLANDA
UCB MANUFACTURING IRELAND LTD. IRLANDA
UCB MANUFACTURING IRELAND LTD.
UCB MANUFACTURING IRELAND LTD.
CUTIE X 28 PLASTURI TRANSDERMICI

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

CUTIE X 10 BLIST. DIN AL/PVC X 10 COMPR. P-6L
TEVA PHARMA GMBH GERMANIA CUTIE X 30 COMPR.(BLIST. AL/AL)
P-RF
MAREA BRITANIE
CUTIE X 1 FLAC. DIN STICLA BRUNA CU SISTEM DE INCHIDERE SECURIZAT X 100 COMPR. FILM.
P-RF
TEVA PHARMA B.V.

MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
OLANDA
CIPRU
CIPRU
CIPRU
CUTIE X 1 FLAC. DIN PEID X 100 COMPR. FILM PRF


GERMANIA CUTIE X 5 BLIST. X 10 COMPR.
PRF
P-RF
P-RF

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
1,399666
2,550000
2,125000
5,049333
4,722333
5,666799
4,722333
11,950000
7,975714
11,431428
14,614285
17,376071
0,725200
0,701100
14,349333
1,922280
1,601900
1,779000
1,689166
1,601900
1,274200
0,386200
1,399666
2,550000
2,125000
5,049333
4,722333
5,666799
4,722333
11,950000
7,975714
11,431428
14,614285
17,376071
0,725200
0,701100
14,349333
1,922280
1,601900
1,779000
1,689166
1,601900
1,274200
0,386200
0,000000
1,552000
0,000000
0,000000
0,000000
1,598201
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,542220
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
20
0,108399
30
0,090333
30
0,108399
20
0,108399
10
2,989000
30
0,747666
1 374,090000
1 82,990000
1 61,880000
1 118,008000
1 46,730000
1 79,700000
1 98,340000
1 56,076000
1 110,680000
100
0,702300
100
0,702300
100
0,788900
20
0,712000
20
0,618500
0,108399
0,090333
0,108399
0,108399
2,989000
0,747666
374,090000
82,990000
61,880000
118,008000
46,730000
79,700000
98,340000
56,076000
110,680000
0,702300
0,702300
0,788900
0,712000
0,618500
0,028601
0,000000
0,015267
0,025101
0,000000
0,000000
0,000000
0,000000
0,000000
9,082000
0,000000
0,000000
0,000000
13,944000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
cant.
UT/
Pret de
aj
(RON)
30
30
30
30
30
30
30
30
28
28
28
28
50
100
30
100
100
30
60
100
50
50
Tratamentul se initiaza de catre medicul in specialitatea neurologie
11. MIASTENIA GRAVIS - G13

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
H02AB07
H02AB07
H02AB07
H02AB07
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L04AX01
L04AX01
L04AX01
N07AA01
N07AA02
PREDNISONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM
NEOSTIGMINI BROMIDUM
PYRIDOSTIGMINI BROMIDUM
PREDNISON MCC 5 mg
PREDNISON 5 mg
PREDNISON - RICHTER 5 mg
METHOTREXATE PCH 10mg
METHOTREXATE PCH 2,5mg
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
METHOTREXAT "EBEWE" 5000 mg
CONC. PT. SOL. INJ./PERF.
METOTREXAT EBEWE 10 mg/ml

METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
IMURAN
IMURAN
IMMUNOPRIN 75 mg
NEOSTIGMINA LPH 15 mg
MESTINON 60 mg

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
DRAJ.
5mg
5mg
5mg
5mg
10mg
2,5mg
100mg/ml
100mg/ml
10mg/ml
10mg/ml
10mg/ml
10mg/ml
50mg/ml
50mg/ml
50mg/ml
50mg
50mg
75mg
15mg
60mg
MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

SINTOFARM SA
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR.
P-RF
P-RF
P-RF
P-RF
ROMANIA CUTIE X 10COMPR.

P6L
ROMANIA CUTIE X30 COMPRIMATE
P6L
AUSTRIA CUTIE X 1 FLACON X 50 ML
S
AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S
AUSTRIA
PR
AUSTRIA
PR
AUSTRIA
PR
AUSTRIA
PR
MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE
GERMANIA
CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL
GERMANIA
GERMANIA

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ
CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE
P-RF
P-RF
P-RF
S/P-RF
IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF

AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PR
MEDA AB
SUEDIA CUTIE X 1 FLAC. X 20 DRAJ.
S/P-RF

Pagina 18 din 39
COD ATC
DCI
Denumire Comerciala
forma farm.
concentratie
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
MAREA BRITANIE
P-RF
MAREA BRITANIE
MAREA BRITANIE

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,543200
1,234000
20,480000
8,810000
31,020000
0,108399
0,090333
0,108399
0,108399
2,989000
0,747666
374,090000
82,990000
61,880000
118,008000
46,730000
79,700000
98,340000
56,076000
110,680000
555,760000
0,702300
0,702300
0,788900
0,543200
1,234000
20,480000
8,810000
31,020000
0,108399
0,090333
0,108399
0,108399
2,989000
0,747666
374,090000
82,990000
61,880000
118,008000
46,730000
79,700000
98,340000
56,076000
110,680000
555,760000
0,702300
0,702300
0,788900
0,000000
0,000000
0,000000
0,000000
0,000000
0,028601
0,000000
0,015267
0,025101
0,000000
0,000000
0,000000
0,000000
0,000000
9,082000
0,000000
0,000000
0,000000
13,944000
0,000000
0,000000
0,000000
0,000000
0,000000
0,227760
0,189800
0,189800
0,234500
0,234500
0,304800
0,304800
0,281400
0,365760
0,277250
1,924200
18,430000
0,227760
0,189800
0,189800
0,234500
0,234500
0,304800
0,304800
0,281400
0,365760
0,277250
1,924200
18,430000
0,127840
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,067700
0,103240
0,000000
0,000000
0,000000
cant.
UT/
Pret de
aj
(RON)
Tratamentul se initiaza de catre medicul in specialitatea neurologie
12. SCLEROZA MULTIPLA - G14

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
H02AB04
H02AB04
H02AB04
H02AB04
H02AB04
H02AB07
H02AB07
H02AB07
H02AB07
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01DB07
L04AX01
L04AX01
L04AX01
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
MITOXANTRONUM***
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM
MEDROL A 16
MEDROL 32
LEMOD SOLU 125 mg
LEMOD SOLU 500 mg
PREDNISON MCC 5 mg
PREDNISON 5 mg

METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
ONKOTRONE
IMURAN
IMURAN
IMMUNOPRIN 75 mg
COMPR.
COMPR.
16mg
32mg
LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml
PULB+SOLV. PT. SOL. INJ./PERF. 125mg
PULB+SOLV. PT. SOL. INJ./PERF. 500mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
10mg
COMPR.
2,5mg
CONC. PT. SOL. INJ./PERF. 100mg/ml
CONC. PT. SOL. INJ./PERF. 100mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml
CONC. PT. SOL. INJ. 2mg/ml
COMPR. FILM.
50mg
COMPR. FILM.
50mg
COMPR. FILM.
75mg
ROMANIA
SINTOFARM SA
ROMANIA
EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA
P-RF
S/P-RF
S/P-RF

CUTIE X 2 BLIST. AL./PVC X 10 COMPR.
P-RF
CUTIE X 10COMPR.
CUTIE X30 COMPRIMATE
CUTIE X 1 FLACON X 50 ML
P6L
P6L
CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML

P-RF
P-RF
P-RF
S
S
PR
PR
PR
PR
GERMANIA
GERMANIA
GERMANIA
P-RF
P-RF
P-RF
BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 1 FLACON X 10 ML CONC. PT. SOL. INJ.
S/P-RF

IRLANDA
AUSTRIA
S/P-RF
PR
50
20
1
1
1
20
30
30
20
10
30
1
1
1
1
1
1
1
1
1
1
100
100
100
Tratamentul se iniiaz de ctre medicul din specialitatea neurologie.
13. BOLI PSIHICE (SCHIZOFRENIE, TULBURARI SCHIZOTIPALE SI DELIRANTE, TULBURARI AFECTIVE MAJORE, TULBURARI PSIHOTICE ACUTE SI BOLI PSIHICE COPII, AUTISM) - G15
1
2
3
4
5
6
7
8
9
10
11
12
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01

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 COMPR. ELIB. PREL.
DEPAKINE 200 mg
ORFIRIL LONG 1000 mg
DEPAKINE
COMPR. GASTROREZ.
MINICOMPR. ELIB. PREL.
SIROP
150mg
150mg
150mg
300mg
300mg
500mg
500mg
300mg
500mg
200mg
1000mg
57,64mg/ml
GERMANIA
CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PRELUNG. P-6L
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
FRANTA
FRANTA
FRANTA
GERMANIA
CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG.
P-6L
FRANTA
CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA
P-6L


Pagina 19 din 39
P-6L
P6L
P-6L
P6L
CUTIE X 10 BLIST. AL/PVDC-PVCX 10 CAPS. MOI GASTROREZ.
P-6L
CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L
P-6L
CUTIE X 1 FLAC. PP X 30 COMPR. FILM. ELIB. PREL.
P-RF
CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L
50
100
100
100
100
100
100
100
30
40
50
1
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
COD ATC
N03AG01
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N04AA01
N05AD01
N05AD01
N05AD01
N05AD01
N05AD01
N05AD01
N05AD01
N05AD01
N05AE03
N05AE03
N05AE04
N05AE04
N05AE04
N05AE04
N05AE04
N05AE04
N05AF01
N05AF05
N05AF05
N05AF05
N05AF05
N05AF05
N05AH02
N05AH02
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
DCI

LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
TRIHEXYPHENIDYLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
SERTINDOL**
SERTINDOL**
ZIPRASIDONUM**
ZIPRASIDONUM**
ZIPRASIDONUM**
ZIPRASIDONUM**
ZIPRASIDONUM**
ZIPRASIDONUM**
FLUPENTIXOLUM**
ZUCLOPENTHIXOLUM**
ZUCLOPENTHIXOLUM**
ZUCLOPENTHIXOLUM**
ZUCLOPENTHIXOLUM**
ZUCLOPENTHIXOLUM**
CLOZAPINUM**
CLOZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
Denumire Comerciala
DEPAKINE
LAMOTRIX 100 mg
PLEXXO (R) 100 mg
LAMICTAL 100 mg
LAMOTRIX 200 mg
LAMICTAL 25 mg
LAMOTRIX 50 mg
LAMOTRIN 100 mg
LAMOTRIN 50 mg
LAMICTAL 2 mg
LAMICTAL 5 mg
ROMPARKIN (R) 2 mg
forma farm.
SIROP
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. DISP.
COMPR. DISP.
concentratie
57,64mg/ml
100mg
100mg
100mg
200mg
25mg
50mg
100mg
50mg
COMPR.
2mg
HALOPERIDOL LAROPHARM 0,5 mg COMPR.
0,5mg
1mg
2mg
HALDOL
COMPR.
5mg
HALOPERIDOL ROMPHARM 2 mg/ml PIC. ORALE, SOL. 2 mg/ml
HALOPERIDOL 2 mg/ml
HALOPERIDOL DECANOAT SOL. INJ.
50mg/ml
HALOPERIDOL RICHTER 5 mg/ml SOL. INJ.
5mg/ml
SERDOLECT 16 mg
COMPR. FILM.
16mg
SERDOLECT 4 mg
COMPR. FILM.
4mg
ZIXADOX 40 mg
CAPS.
40mg
ZYPSILA 40 mg
CAPS.
40mg
ZIXADOX 60 mg
CAPS.
60mg
ZYPSILA 60 mg
CAPS.
60mg
ZIXADOX 80 mg
CAPS.
80mg
ZYPSILA 80 mg
CAPS.
80mg
FLUANXOL DEPOT
SOL. INJ.
20mg/ml
CLOPIXOL 10 mg
COMPR. FILM.
10mg
CLOPIXOL 25 mg
COMPR. FILM.
25mg
CLOPIXOL 20 mg/ml
CLOPIXOL (R) DEPOT
SOL. INJ.
200mg/ml
CLOPIXOL ACUPHASE (R)
SOL. INJ.
50mg/ml
LEPONEX (R) 100 mg
COMPR.
100mg
LEPONEX (R) 25 mg
COMPR.
25mg
ZALASTA 10mg
COMPR.
10mg
OLAZAX 10 mg
COMPR.
10mg
ZALASTA 5mg
COMPR.
5mg
OLAZAX 5 mg
COMPR.
5mg
ZYPREXA 10 mg
COMPR. FILM.
10mg
LAPOZAN 10 mg
COMPR. FILM.
10mg
LAPOZAN 10 mg
COMPR. FILM.
10mg
OLANZAPINA ACTAVIS 10 mg COMPR. FILM.
10mg
BLOONIS 10 mg
COMPR. FILM.
10mg
OLANZAPINA DR. REDDY'S 10 mg COMPR. FILM.
10mg
LAPOZAN 15 mg
COMPR. FILM.
15mg
EGOLANZA 15 mg
COMPR. FILM.
15mg
EGOLANZA 20 mg
COMPR. FILM.
20mg
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
FRANTA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE

DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR.
P-6L

P-6L


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

THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. DISP./MAST.
P-6L
THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. DISP./MAST.
P-6L
TERAPIA SA
LAROPHARM S.R.L.
ARENA GROUP S.A.
ARENA GROUP S.A.

ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF
ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATE PRF
CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLACON PEJD CU PICURATOR PEJD X 10 ML PIC. OFT., SOL. PRF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 10ML PICATURI ORALE-SOLUTIE P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE X 1 ML
P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.
P-RF
H. LUNDBECK A/S
DANEMARCA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF
H. LUNDBECK A/S
DANEMARCA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS.
ZENTIVA K.S.
REPUBLICA CEHA
ZENTIVA K.S.
REPUBLICA CEHA
P-RF
CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. P-RF

P-RF
CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. P-RF
P-RF
H. LUNDBECK A/S
H. LUNDBECK A/S
H. LUNDBECK A/S
H. LUNDBECK A/S
H. LUNDBECK A/S
H. LUNDBECK A/S
DANEMARCA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.
P-RF
DANEMARCA
CUTIE X 1 FLAC. DIN PEJD X 50 COMPR. FILM., INCHIS CU CAPAC CU FILET, PREVAZUT CU SISTEM DE INCHIDER
P-RF
DANEMARCA
CUTIE X 1 FLAC. DIN PEJD X 50 COMPR. FILM., INCHIS CU CAPAC CU FILET, PREVAZUT CU SISTEM DE INCHIDER
P-RF
DANEMARCA CUTIE X 1 FLAC. + CAPAC SECURIZAT PT. COPII X 20 ML
P-RF
DANEMARCA CUTIE X 5 FIOLE X 1 ML
P-RF

DANEMARCA
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR., (BLISTER OPA/AL/PVC/AL)

REPUBLICA CEHA
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR., (BLISTER OPA/AL/PVC/AL)

REPUBLICA CEHA
OLANDA
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA
UNGARIA
UNGARIA
ELI LILLY NEDERLAND BV
Pagina 20 din 39
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
P-RF
P-RF
P-RF
P-RF
cant.
UT/
Pret de
aj
(RON)
1
30
30
28
30
28
30
30
30
30
30
50
20
30
30
25
1
1
5
5
28
30
56
60
56
60
56
60
10
50
50
1
10
5
50
50
28
28
28
28
28
28
30
30
28
35
28
28
28
18,430000
0,903600
0,849666
0,903600
1,768000
0,149285
0,409999
0,753000
0,341666
0,009333
0,026333
0,562400
0,168000
0,267000
0,373333
0,299600
5,390000
6,468000
8,452000
2,206000
14,899285
3,767000
2,787500
2,787333
4,212321
4,212166
4,713750
4,330833
7,118000
0,358800
0,568000
29,290000
12,456000
9,058000
1,274200
0,386200
0,671428
0,671570
0,440357
0,446400
0,671570
0,671570
0,671570
0,563000
0,671428
0,671570
2,440713
2,440713
2,764285

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
18,430000
0,903600
0,849666
0,903600
1,768000
0,149285
0,409999
0,753000
0,341666
0,009333
0,026333
0,562400
0,168000
0,267000
0,373333
0,299600
5,390000
6,468000
8,452000
2,206000
14,899285
3,767000
2,787500
2,787333
4,212321
4,212166
4,713750
4,330833
7,118000
0,358800
0,568000
29,290000
12,456000
9,058000
1,274200
0,386200
0,671428
0,671570
0,440357
0,446400
0,671570
0,671570
0,671570
0,563000
0,671428
0,671570
2,440713
2,440713
2,764285
0,000000
0,028066
0,000000
0,501757
0,000000
0,000000
0,086667
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,432000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,070215
0,000000
0,107885
6,514858
2,413430
2,413763
0,000000
0,000000
3,746144
4,871787
5,162501
6,115000
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
DCI
COD ATC
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
100 N05AH03
101 N05AH03
102 N05AH03
103 N05AH03
104 N05AH03
105 N05AH03
106 N05AH03
107 N05AH03
108 N05AH03
109 N05AH03
110 N05AH03
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
Denumire Comerciala
ZYPREXA 5 mg
LAPOZAN 5 mg
LAPOZAN 5 mg
OLANZAPINA ACTAVIS 5 mg
BLOONIS 5 mg
ZALASTA 10mg
OLANZAPINE TEVA 10mg
OLANZAPINA TERAPIA 10 mg
OLAZAX DISPERZI 10 mg
LAPOZAN 10 mg
LAPOZAN 10 mg
BLOONIS 10 mg
OLANZAPINA DR. REDDY'S 10 mg
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.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
OLANZAPINA AUROBINDO 15 mg COMPR. ORODISPERSABILE

OLANZAPINA POLPHARMA 20 mg COMPR. ORODISPERSABILE
ZALASTA 20mg
BLOONIS 20 mg
IRROPIA 20 mg
WRANELON 20 mg
OLANZAPINA AUROBINDO 20 mg
ZALASTA 5mg
OLANZAPINE TEVA 5mg
LAPOZAN 5 mg
LAPOZAN 5 mg
concentratie
5mg
5mg
5mg
5mg
5mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
20 mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
OLANDA CUTIE X 28 COMPR. FILM. ( BLIST.AL ABUTISATE LA RECE)

ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM.
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
P-RF
CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL)
P-RF
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. ORODISP.
P-RF
CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE
P-RF
CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE
P-RF
ELI LILLY NEDERLAND BV
TEVA PHARMA BV
TERAPIA S.A.
OLANDA
ROMANIA
REPUBLICA CEHA
P-RF
P-RF
P-RF
P-RF

P-RF
P-RF
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF
DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 35 COMPR. ORODISPERSABILE P-RF
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF
ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE PRF
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF
GALENICA S.A.
GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF
PRF
CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PED//AL-PE X 28 COMPR. ORODISPERSABILE
TEVA PHARMA BV
TERAPIA S.A.
OLANDA
ROMANIA
REPUBLICA CEHA
P-RF
P-RF
P-RF
P-RF

P-RF
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF
GALENICA S.A.
PRF
PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 28 COMPR. ORODISP.
PRF
TEVA PHARMA BV
TERAPIA S.A.
OLANDA
ROMANIA
REPUBLICA CEHA
P-RF
P-RF
P-RF
P-RF
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF

GALENICA S.A.
PRF
TEVA PHARMA BV
TERAPIA S.A.
OLANDA
ROMANIA
CUTIE X 30 COMPR. FILM. (BLIST. OPA-AL-PVC/AL) P-RF

P-RF
REPUBLICA CEHA
P-RF
P-RF
P-RF
CUTIE CU BLIST. OPA-AL-PVC/AL X 35 COMPR. ORODISPERSABILE
P-RF

Pagina 21 din 39
P-RF
cant.
UT/
Pret de
aj
(RON)
28
28
30
30
28
28
30
28
28
30
50
28
35
28
28
28
28
28
28
30
28
28
30
28
35
28
28
28
28
28
28
28
30
28
28
28
35
28
28
28
28
28
28
30
28
28
30
50
35
0,446400
0,446400
0,446400
0,372000
0,443928
0,586071
0,671570
0,671570
0,671570
0,671570
0,671570
0,671428
0,671570
0,559642
0,671570
0,671570
0,671570
0,671570
2,033928
2,440713
2,440713
2,440713
2,440713
2,440713
2,440713
2,435000
2,440713
2,440713
2,440713
2,440713
2,764285
2,303571
2,304000
2,764285
2,764285
2,764285
2,764285
2,749642
2,764285
2,764285
2,764285
2,764285
0,440357
0,443666
0,446400
0,446400
0,446400
0,446400
0,446400

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,446400
0,446400
0,446400
0,372000
0,443928
0,586071
0,671570
0,671570
0,671570
0,671570
0,671570
0,671428
0,671570
0,559642
0,671570
0,671570
0,671570
0,671570
2,033928
2,440713
2,440713
2,440713
2,440713
2,440713
2,440713
2,435000
2,440713
2,440713
2,440713
2,440713
2,764285
2,303571
2,304000
2,764285
2,764285
2,764285
2,764285
2,749642
2,764285
2,764285
2,764285
2,764285
0,440357
0,443666
0,446400
0,446400
0,446400
0,446400
0,446400
3,342885
0,846100
2,016600
0,000000
0,000000
0,000000
0,062430
4,084501
0,358430
2,412430
2,252630
0,000000
3,746144
0,000000
0,361287
3,776644
0,362001
0,362001
0,000000
0,586953
3,426787
3,426787
3,426287
0,000001
3,426429
0,000000
0,129644
3,426787
2,030358
1,757144
6,508215
0,000000
0,000000
6,577857
3,458215
0,000357
5,624857
0,000000
3,457143
3,245000
2,111786
2,421072
0,000000
0,000000
2,060742
0,107885
0,845933
0,845800
2,016457
DCI
COD ATC
111 N05AH03
112 N05AH03
113 N05AH03
114 N05AH03
115 N05AH03
116 N05AH03
117 N05AH03
118 N05AH03
119 N05AH03
120 N05AH03
121 N05AH04
122 N05AH04
123 N05AH04
124 N05AH04
125 N05AH04
126 N05AH04
127 N05AH04
128 N05AH04
129 N05AH04
130 N05AH04
131 N05AH04
132 N05AH04
133 N05AH04
134 N05AH04
135 N05AH04
136 N05AH04
137 N05AH04
138 N05AH04
139 N05AH04
140 N05AH04
141 N05AH04
142 N05AH04
143 N05AH04
144 N05AH04
145 N05AH04
146 N05AH04
147 N05AH04
148 N05AH04
149 N05AH04
150 N05AL01
151 N05AL01
152 N05AL01
153 N05AL05
154 N05AL05
155 N05AL05
156 N05AL05
157 N05AX08
158 N05AX08
159 N05AX08
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
SULPIRIDUM
SULPIRIDUM
SULPIRIDUM
AMISULPRIDUM**
AMISULPRIDUM**
AMISULPRIDUM**
AMISULPRIDUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
Denumire Comerciala
IRROPIA 5 mg
WRANELON 5 mg
forma farm.
concentratie
5mg
OLANZAPINA AUROBINDO 5 mg COMPR. ORODISPERSABILE 5mg
OLANZAPINA TORRENT 7,5 mg COMPR. ORODISPERSABILE 7,5mg
ZYPADHERA 210mg
210mg
ZYPADHERA 300mg
300mg
ZYPADHERA 405mg
405mg
ZYPREXA 10 mg
SEROQUEL XR 150 mg
QUETIAPINA TEVA 150 mg COMPR. ELIB. PREL. 150mg
KETILEPT 100 mg
COMPR. FILM.
100mg
QUETIAPINE TEVA 100 mg COMPR. FILM.
100mg
KVENTIAX 100 mg
COMPR. FILM.
100mg
QUETROP 100 mg
COMPR. FILM.
100mg
Q MIND 100 mg
COMPR. FILM.
100mg
KATHIRA 100 mg
COMPR. FILM.
100mg
KATHIRA 150 mg
COMPR. FILM.
150mg
KETILEPT 200 mg
COMPR. FILM.
200mg
200mg
KVENTIAX 200 mg
COMPR. FILM.
200mg
QUETROP 200 mg
COMPR. FILM.
200mg
Q MIND 200 mg
COMPR. FILM.
200mg
KATHIRA 200 mg
COMPR. FILM.
200mg
KATHIRA 25 mg
COMPR. FILM.
25mg
KETILEPT 300 mg
COMPR. FILM.
300mg
300mg
KVENTIAX 300 mg
COMPR. FILM.
300mg
QUETROP 300 mg
COMPR. FILM.
300mg
Q MIND 300 mg
COMPR. FILM.
300mg
KATHIRA 300 mg
COMPR. FILM.
300mg
SEROQUEL XR 200 mg
SEROQUEL XR 300 mg
SEROQUEL XR 400 mg
SEROQUEL XR 50 mg
EGLONYL (R) 50 mg
CAPS.
50mg
EGLONYL 50 mg
CAPS.
50mg
EGLONYL (R) 200 mg
COMPR.
200mg
AMISULPRIDA LPH 200 mg COMPR.
200mg
MIDORA 200 mg
COMPR.
200mg
SOLIAN 200 mg
COMPR. DIVIZ. 200mg
SOLIAN 400 mg
COMPR. FILM.
400mg
RISPERIDONE TEVA 1 mg
COMPR. FILM.
1mg
SPRING 1 mg
COMPR. FILM.
1mg
RONYDAL 1 mg
COMPR. FILM.
1mg
DETINATOR APP
AMBALAJ
ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE

ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE
GALENICA S.A.
GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (2X14) COMPR. ORODISPERSABILE
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE
ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 210MG PULB. + 1 FLAC. X 3ML SOLVENT
ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC. X 10 MG PULB.PT.SOL.INJ.
ASTRAZENECA UK LIMITED
MAREA BRITANIE CUTIE CU 6 BLIST. PVC-PCTFE/AL X 10 COMPR. ELIB. PREL.
ROMANIA
UNGARIA
TEVA PHARMACEUTICAL S.R.L. ROMANIA
Prescriptie
NR.CRT
TARA
DET. APP
P-RF
PRF
P-RF
PRF
PRF
P-RF
P-RF/R
P-RF/R
P-RF/R
P-RF
P-RF
CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. FILM.
PRF
CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL.
PRF
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
ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF

NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF
UNGARIA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-RF
TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 60 COMPR. FILM. P-RF/S
REPUBLICA CEHA

UNGARIA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-RF
TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 60 COMPR. FILM. P-RF/S
REPUBLICA CEHA

ASTRAZENECA UK LTD.
MAREA BRITANIE CUTIE X 6 BLIST. OPACE AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL.
P-RF
ASTRAZENECA UK LTD.
MAREA BRITANIE CUTIE X 6 BLIST. OPACE AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL.
P-RF
ASTRAZENECA UK LIMITED
MAREA BRITANIE CUTIE X 6 BLIST. PVC-PCTFE/AL X 10 COMPR. CU ELIB. PREL.
P-RF
ASTRAZENECA UK LTD.
MAREA BRITANIE CUTIE X 6 BLIST. OPACE DIN AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL.
P-RF
FRANTA
SANOFI-SYNTHELABO FRANCE FRANTA
SANOFI-SYNTHELABO FRANCE FRANTA
TERAPIA S.A.
ROMANIA
SANOFI-AVENTIS FRANCE FRANTA
SANOFI-AVENTIS FRANCE FRANTA
TEVA PHARMACEUTICAL S.R.L. ROMANIA
ANTIBIOTICE S.A.
ROMANIA
SANOFI-SYNTHELABO FRANCE
Pagina 22 din 39
P-RF
PRF
P-RF
CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-RF
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
cant.
UT/
Pret de
aj
(RON)
28
0,446400
28
0,446400
28
0,446400
28
0,446400
28
0,446400
28
3,313571
1 650,040000
1 916,710000
1 1.223,460000
1 20,710000
60
2,451199
60
2,042666
60
2,675000
60
3,791833
60
4,493500
60
0,426799
60
0,355666
60
0,355666
60
0,426799
60
0,426799
60
0,426799
60
1,492666
60
0,602799
60
0,504833
60
0,502333
60
0,602799
60
0,602799
60
0,602799
60
0,588000
60
1,256799
60
1,051166
60
1,047333
60
1,256799
60
1,256799
60
1,256799
60
3,210000
60
4,550199
60
5,392200
60
1,104333
30
0,274333
30
0,274333
12
0,698333
30
1,522000
30
1,522000
30
1,826400
30
3,672000
60
0,303833
30
0,364599
60
0,364599

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,446400
0,446400
0,446400
0,446400
0,446400
3,313571
650,040000
916,710000
1.223,460000
20,710000
2,451199
2,042666
2,675000
3,791833
4,493500
0,426799
0,355666
0,355666
0,426799
0,426799
0,426799
1,492666
0,602799
0,504833
0,502333
0,602799
0,602799
0,602799
0,588000
1,256799
1,051166
1,047333
1,256799
1,256799
1,256799
3,210000
4,550199
5,392200
1,104333
0,274333
0,274333
0,698333
1,522000
1,522000
1,826400
3,672000
0,303833
0,364599
0,364599
0,015742
0,107885
1,598600
0,107885
0,107885
0,000000
0,000000
0,000000
0,000000
0,000000
0,635134
0,000000
0,000000
0,000000
0,000000
0,538701
0,000000
0,000000
1,033701
0,418201
0,473367
0,000000
0,347367
0,000000
0,000000
1,275034
0,813367
0,889867
0,000000
0,352867
0,000000
0,000000
1,445534
0,489701
0,700034
0,905333
1,596967
2,469300
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,437266
0,000000
0,000000
0,150401
0,050901
COD ATC
160 N05AX08
161 N05AX08
162 N05AX08
163 N05AX08
164 N05AX08
165 N05AX08
166 N05AX08
167 N05AX08
168 N05AX08
169 N05AX08
170 N05AX08
171 N05AX08
172 N05AX08
173 N05AX08
174 N05AX08
175 N05AX08
176 N05AX08
177 N05AX08
178 N05AX08
179 N05AX08
180 N05AX08
181 N05AX08
182 N05AX08
183 N05AX08
184 N05AX08
185 N05AX08
186 N05AX08
187 N05AX08
188 N05AX08
189 N05AX08
190 N05AX08
191 N05AX08
192 N05AX08
193 N05AX08
194 N05AX08
195 N05AX08
196 N05AX12
197 N05AX12
198 N05AX12
199 N05AX12
200 N05AX12
201 N05AX12
202 N05AX13
203 N05AX13
204 N05AX13
205 N05AX13
206 N05AX13
207 N05AX13
208 N05AX13
DCI
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
Denumire Comerciala
forma farm.
RISPEN 1
RISPERIDONA ARENA 1 mg
RONYDAL 1 mg
RISPEN 2
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
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
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
RISPOLEPT
SOL. ORALA
ABILIFY 10mg
COMPR.
ARYZALERA 10mg
COMPR.
ABILIFY 15mg
COMPR.
ARYZALERA 15mg
COMPR.
ABILIFY MAINTENA 400mg
ABILIFY 7,5mg/ml
SOL. INJ.
INVEGA 3mg
COMPR. ELIB. PREL.
INVEGA 6mg
COMPR. ELIB. PREL.
INVEGA 9mg
COMPR. ELIB. PREL.
XEPLION
SUSP. INJ. CU ELIB. PREL.
XEPLION
XEPLION
XEPLION
concentratie
1mg
1mg
1mg
2 mg
2mg
2mg
2mg
2mg
2mg
2mg
3mg
3mg
3mg
3mg
3mg
3mg
3mg
3mg
4 mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
1mg
1mg
2mg
2mg
3mg
25mg
37,5mg
50mg
1mg/ml
10mg
10mg
15mg
15mg
400mg
7,5mg/ml
3mg
6mg
9mg
100mg
150mg
50mg
75mg
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
ZENTIVA KS
CEHIA
ZENTIVA KS
CEHIA
ANTIBIOTICE S.A.
ROMANIA
ROMANIA
ANTIBIOTICE S.A.
ROMANIA
ZENTIVA KS
CEHIA
ZENTIVA KS
CEHIA
ACTAVIS GROUP HF.

ANTIBIOTICE S.A.
MEDOCHEMIE LTD.
ARENA GROUP S.A.
NEOLA PHARMA S.R.L.
ROMANIA
ISLANDA
ROMANIA
ROMANIA
CIPRU
ROMANIA
ROMANIA
CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM.
P-RF

P-RF

P-RF
P-RF

P-RF

P-RF

P-RF

P-RF

PRF
P-RF
CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE
P-RF
TERAPIA SA
ROMANIA
P-RF
P-RF
TERAPIA SA
TERAPIA SA
JANSSEN PHARMACEUTICA N.V.
ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF

ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF
BELGIA
S/P-RF
BELGIA
S/P-RF
BELGIA
S/P-RF
BELGIA CUTIE X 1 FLACON DIN STICLA BRUNA X 30 ML SOL. ORALA + 1 PIPETA P-RF
OTSUKA PHARMACEUTICAL EUROPE LTD.
MAREA BRITANIE CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 28 (X1) COMPR.

CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE
P-RF
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
MAREA BRITANIE CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 28 (X1) COMPR.
P-RF
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
MAREA BRITANIE
MAREA BRITANIE
BELGIA
JANSSEN-CILAG INTERNATIONAL NV BELGIA
JANSSEN-CILAG INTERNATIONAL NV BELGIA
JANSSEN CILAG INTERNATIONALL NV BELGIA
JANSSEN-CILAG INTERNATIONAL NV
Pagina 23 din 39
CUTIE CU UN FL.X 400 MG PULB., UN FL. DE 2 ML CU SOLV., O SERINGA LUER-LOCK DE 3 ML CU AC HIPODERMIC SECURIZAT, O SERINGA JETABILA DE 3 ML CU VRF LUER-LOCK, UN ADAPTOR PENTRU FLACON, UN AC HIPODERMIC SECURIZAT SI UN AC HIPODERMIC SECURIZAT PT OBEZI
PRF
CUTIE X 1FLAC. X 1,3ML SOL.INJ
P-RF
CUTIE X 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL)
P-RF
CUTIEX 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL)
P-RF
CUTIE X 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL)
P-RF
CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE
PR
PR
PR
PR

cant.
UT/
Pret de
aj
(RON)
50
20
60
50
60
20
30
60
20
60
30
60
20
30
60
50
20
60
50
30
60
20
30
60
20
20
60
30
30
30
30
30
1
1
1
1
28
30
28
30
1
1
30
30
30
1
1
1
1
0,359600
0,364599
0,364599
0,309000
0,309000
0,257500
0,309000
0,309000
0,309000
0,309000
0,507600
0,507600
0,423000
0,507600
0,507600
0,507600
0,507600
0,507600
0,309000
0,309000
0,309000
0,257500
0,309000
0,309000
0,309000
0,309000
0,309000
0,364599
0,364599
0,309000
0,309000
0,507600
374,930000
530,080000
635,690000
17,330000
8,750400
7,292000
8,956399
7,463666
1.163,560000
19,950000
15,777333
16,040000
17,477333
1.463,340000
2.055,980000
944,130000
1.202,120000

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,359600
0,364599
0,364599
0,309000
0,309000
0,257500
0,309000
0,309000
0,309000
0,309000
0,507600
0,507600
0,423000
0,507600
0,507600
0,507600
0,507600
0,507600
0,309000
0,309000
0,309000
0,257500
0,309000
0,309000
0,309000
0,309000
0,309000
0,364599
0,364599
0,309000
0,309000
0,507600
374,930000
530,080000
635,690000
17,330000
8,750400
7,292000
8,956399
7,463666
1.163,560000
19,950000
15,777333
16,040000
17,477333
1.463,340000
2.055,980000
944,130000
1.202,120000
0,000000
0,018901
0,050901
0,000000
0,222333
0,000000
0,564000
0,614333
0,530000
0,614333
0,687733
0,270066
0,000000
0,874066
0,919566
0,000000
0,851400
0,919566
0,000000
1,334333
0,795833
0,000000
1,579666
1,608833
1,503500
1,416000
1,608833
0,062067
0,070067
0,597000
0,619666
0,929733
0,000000
0,000000
0,000000
0,000000
2,732100
0,000000
2,526101
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
DCI
CITALOPRAMUM**
CITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TIANEPTINUM**
TIANEPTINUM**
TIANEPTINUM**
TIANEPTINUM**
TIANEPTINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
210 N06AB04
211 N06AB10
212 N06AB10
213 N06AB10
214 N06AB10
215 N06AB10
216 N06AB10
217 N06AB10
218 N06AB10
219 N06AB10
220 N06AB10
221 N06AB10
222 N06AB10
223 N06AB10
224 N06AB10
225 N06AB10
226 N06AB10
227 N06AB10
228 N06AB10
229 N06AB10
230 N06AB10
231 N06AB10
232 N06AB10
233 N06AB10
234 N06AB10
235 N06AB10
236 N06AB10
237 N06AB10
238 N06AB10
239 N06AB10
240 N06AX05
241 N06AX05
242 N06AX05
243 N06AX05
244 N06AX05
245 N06AX05
246 N06AX14
247 N06AX14
248 N06AX14
249 N06AX14
250 N06AX14
251 N06AX16
252 N06AX16
253 N06AX16
254 N06AX16
255 N06AX16
256 N06AX16
257 N06AX16
Denumire Comerciala
LINISAN 10 mg
LINISAN 20 mg
DEPRESINAL 10 mg
CIPRALEX 10 mg
ESCITIL 10 mg
LENUXIN 10 mg
ESLOREX 10 mg
SERODEPS 10mg
ESTAN 10 mg
ESTAN 10 mg
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
ESCITALOPRAM ACTAVIS 10 mg COMPR. FILM.
ELICEA 10 mg
COMPR. FILM.
ESCITALOPRAM AUROBINDO 10 mg COMPR. FILM.
ESCITALOPRAM ATB 10 mg COMPR. FILM.
ESCITALOPRAM TORRENT 10 mg COMPR. FILM.
ESCITALOPRAM-TEVA 15 mg COMPR. FILM.
ELICEA 15 mg
COMPR. FILM.
ESCITALOPRAM-TEVA 20 mg COMPR. FILM.
SERODEPS 20mg
COMPR. FILM.
ESCITALOPRAM TORRENT 20 mg COMPR. FILM.
ESCITALOPRAM ACTAVIS 20 mg COMPR. FILM.
ELICEA 20 mg
COMPR. FILM.
ELICEA Q-TAB 10 mg
ELICEA Q-TAB 10 mg
ESCITALOPRAM TEVA 10 mg COMPR. ORODISPERSABILE
ELICEA Q-TAB 15 mg
ELICEA Q-TAB 15 mg
ELICEA Q-TAB 20 mg
ELICEA Q-TAB 20 mg
ESCITALOPRAM TEVA 20 mg COMPR. ORODISPERSABILE
TRITTICO AC 150 mg
COMPR. ELIB. PREL.
TRITTICO AC 150 mg
COMPR. ELIB. PREL.
TRITTICO AC 150 mg
COMPR. ELIB. PREL.
TRITTICO AC 150 mg
COMPR. ELIB. PREL.
TRITTICO AC 75 mg
COMPR. ELIB. PREL.
TRITTICO AC 75 mg
COMPR. ELIB. PREL.
LYXIT 12,5 mg
COMPR. FILM.
LYXIT 12,5 mg
COMPR. FILM.
NOBIXAL 12,5 mg
COMPR. FILM.
NOBIXAL 12,5 mg
COMPR. FILM.
COAXIL (R)
DRAJ.
EFECTIN EP 150 mg
CAPS. ELIB. PREL.
ELIFY EP 150 mg
CAPS. ELIB. PREL.
IVRYX 150mg
CAPS. ELIB. PREL.
VELAXIN 150 mg
CAPS. ELIB. PREL.
ALVENTA 150mg
CAPS. ELIB. PREL.
concentratie
10mg
20mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
15mg
15mg
20mg
20mg
20mg
20mg
20mg
10mg
10mg
10mg
15mg
15mg
20mg
20mg
20mg
150mg
150mg
150mg
150mg
75mg
75mg
12,5 mg
12,5 mg
12,5mg
12,5mg
12,5mg
150 mg
150 mg
150 mg
150mg
150mg
DETINATOR APP
AMBALAJ

LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.
H. LUNDBECK A/S
DANEMARCA CUTIE X 2 BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 14 COMPR. FILM.
UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
ZENTIVA K.S.
CEHIA
TERAPIA SA
ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM.
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM.
Prescriptie
COD ATC
209 N06AB04
NR.CRT
TARA
DET. APP
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
PRF
P-RF
PRF
PRF
PRF
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF
MAREA BRITANIE
ANTIBIOTICE S.A.
ROMANIA
CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM.
PRF

PRF
ROMANIA
ROMANIA
TERAPIA SA
P-RF
PRF
CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM.
PRF
PRF
PRF
ROMANIA CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE PRF
PRF
PRF
PRF
PRF
ROMANIA CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE

ANGELINI FRANCESCO SPA ITALIA
CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL.
CUTIE X 2 BLIST. AL/PVCX 10 COMPR. ELIB. PREL.
ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM.
ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 90 COMPR. FILM.
ANTIBIOTICE S.A.
ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM.
ANTIBIOTICE S.A.
ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM.
LES LAB. SERVIER IND. FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ.
MAREA BRITANIE
CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL.
PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
PRF
PRF
PRF
PRF
P-RF
PRF

UNGARIA
CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL. PRF
ISLANDA
P-RF
CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL.
P-RF
Pagina 24 din 39
CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF

P-RF
cant.
UT/
Pret de
aj
(RON)
30
30
30
28
28
30
28
30
28
14
28
28
30
28
28
28
30
30
30
28
28
28
30
28
28
30
28
28
28
28
30
20
60
60
20
30
30
30
90
30
30
30
28
30
28
28
30
28
30
0,246000
1,368000
0,778666
0,918000
0,848928
0,776000
0,848928
0,780666
0,780357
0,848571
0,848928
0,778214
0,780666
0,778214
0,765000
0,848928
1,018713
1,018713
1,370000
1,359642
1,631570
1,399642
1,406000
0,780357
0,780357
0,918000
1,018713
1,018713
1,576785
1,576785
1,369000
1,264000
1,094833
1,094833
1,264000
0,644666
0,644666
0,460333
0,445222
0,460333
0,460333
0,534266
0,665599
0,665599
0,665599
0,665599
0,554666
0,665599
0,665599

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,246000
1,368000
0,778666
0,918000
0,848928
0,776000
0,848928
0,780666
0,780357
0,848571
0,848928
0,778214
0,780666
0,778214
0,765000
0,848928
1,018713
1,018713
1,370000
1,359642
1,631570
1,399642
1,406000
0,780357
0,780357
0,918000
1,018713
1,018713
1,576785
1,576785
1,369000
1,264000
1,094833
1,094833
1,264000
0,644666
0,644666
0,460333
0,445222
0,460333
0,460333
0,534266
0,665599
0,665599
0,665599
0,665599
0,554666
0,665599
0,665599
0,000000
0,000000
0,000000
0,346285
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,111620
0,350287
0,000000
0,000000
0,637001
0,000000
0,000000
0,000000
0,000000
0,015666
0,350572
0,332358
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,173400
1,347258
0,332734
0,195115
0,642972
0,000000
0,190829
0,643067
DCI
COD ATC
258 N06AX16
259 N06AX16
260 N06AX16
261 N06AX16
262 N06AX16
263 N06AX16
264 N06AX16
265 N06AX16
266 N06AX16
267 N06AX16
268 N06AX16
269 N06AX16
270 N06AX16
271 N06AX16
272 N06AX16
273 N06AX16
274 N06AX16
275 N06AX16
276 N06AX16
277 N06AX16
278 N06AX21
279 N06AX21
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
DULOXETINUM**
DULOXETINUM**
forma farm.
Denumire Comerciala
VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL.
FOBILESS 37,5 mg
CAPS. ELIB. PREL.
VENLAFAXINA ARENA EP 37,5 mg CAPS. ELIB. PREL.
EFECTIN EP 75 mg
CAPS. ELIB. PREL.
ELIFY EP 75 mg
CAPS. ELIB. PREL.
IVRYX 75mg
CAPS. ELIB. PREL.
IVRYX 75mg
CAPS. ELIB. PREL.
VELAXIN 75 mg
CAPS. ELIB. PREL.
ALVENTA 75 mg
CAPS. ELIB. PREL.
FOBILESS 75 mg
CAPS. ELIB. PREL.
VENLAFAXINA ACTAVIS 75 mg CAPS. ELIB. PREL.
VENLAFAXINA ARENA EP 75 mg CAPS. ELIB. PREL.
VENLAFAXINA ARENA 37,5 mg COMPR.

ARGOFAN 150 SR
COMPR. ELIB. PREL.
ARGOFAN 75 SR
COMPR. ELIB. PREL.
CYMBALTA 30mg
CAPS. GASTROREZ.
CYMBALTA 60mg
CAPS. GASTROREZ.
concentratie
DETINATOR APP
TERAPIA S.A.
TERAPIA S.A.
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
150mg
150mg
37,5mg
37,5mg
75 mg
75 mg
75 mg
75 mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
37,5mg
50mg
75mg
150mg
75mg
30mg
60mg
ROMANIA
ROMANIA
CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL.
PRF
PRF
P-RF
CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL.
PRF

UNGARIA
PRF
CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL
P-RF
P-RF
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
10 mg
10mg
10mg
MAREA BRITANIE
AUSTRIA
ISLANDA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ARENA GROUP S.A.

TERAPIA S.A.
TERAPIA S.A.
ARENA GROUP S.A.
ARENA GROUP S.A.
ARENA GROUP S.A.
ZENTIVA A.S.
SLOVACIA
ZENTIVA A.S.
SLOVACIA
ELI LILLY NEDERLAND BV OLANDA
ELI LILLY NEDERLAND BV OLANDA
CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF


P-RF
P-RF
CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL.
PRF
PRF
CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR.
P-RF
P-RF
P-RF
P-RF
P-RF
CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF

CUTIE, X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
30
30
30
30
28
30
28
28
28
30
30
28
30
30
30
30
30
30
30
30
28
28
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
2,940000
4,562857
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
2,940000
4,562857
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
0,000000
0,000000
28
30
30
30
28
28
28
30
28
28
28
30
30
30
28
28
30
28
28
28
28
1,251428
1,256570
1,256570
1,256570
1,256570
1,047142
1,256570
1,256570
1,256570
0,985000
1,158856
1,158856
1,158856
1,158856
0,965714
1,158856
1,158856
1,158856
1,251428
1,256570
1,187142
1,251428
1,256570
1,256570
1,256570
1,256570
1,047142
1,256570
1,256570
1,256570
0,985000
1,158856
1,158856
1,158856
1,158856
0,965714
1,158856
1,158856
1,158856
1,251428
1,256570
1,187142
0,000000
0,896763
0,896763
0,920096
1,063787
0,000000
0,477001
0,564096
1,059858
0,000000
0,552215
0,383810
0,383810
0,347144
0,000000
0,127215
0,100477
0,553286
0,000000
4,127001
0,000000
Tratamentul se iniiaz de ctre medicul n specialitatea psihiatrie i psihiatrie pediatric.
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
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***
YASNAL 10 mg
DAVIA 10 mg
DAVIA 10 mg
TUADIN 10 mg
PRIDIA 10 mg
DONECEPT 10 MG
COGNEZIL 10 mg
DONEPEZIL TORRENT 10 mg
XALINAT 10 mg
YASNAL 5 mg
ZILDON 5 mg
DAVIA 5 mg
DAVIA 5 mg
TUADIN 5 mg
DONECEPT 5 MG
COGNEZIL 5 mg
DONEPEZIL TORRENT 5 mg
XALINAT 5 mg
YASNAL 10 mg
ARICEPT EVESS
DONEPEZIL TEVA 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.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CUTIE CU, BLIST., DIN OPA-AL-PVC/AL CU 28 COMPR. FILM. P-RF
TERAPIA SA
TERAPIA SA
ANTIBIOTICE S.A.
ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.

ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM.
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.
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM.
P-RF
P-RF
P-RF
P-RF
P-RF
CUTIE X BLISTERE PVC/AL X 28 COMPRIMATE FILMATE P-RF
REPUBLICA CEHA
ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF

GRECIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF
GALENICA S.A.
SANDOZ S.R.L.
TERAPIA SA
TERAPIA SA
ANTIBIOTICE S.A.
CUTIE CU BLIST. DIN OPA-AL-PVC/AL CU 28 COMPR. FILM.
P-RF
ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM.

ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM.
ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM.
ISLANDA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM.
REPUBLICA CEHA
ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF

GRECIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF
GALENICA S.A.
KRKA D.D.
SLOVENIA
P-RF
P-RF
P-RF
P-RF
P-RF
CUTIE X BLISTERE PVC/AL X 28 COMPRIMATE FILMATE P-RF
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
ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 28 COMPR. ORODISP.P-RF
Pagina 25 din 39
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
66
67
68
69
70
COD ATC
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
DCI
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***
Denumire Comerciala
forma farm.
DARIZOL 10 mg
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
SOL. ORALA
MEMANTINA RATIOPHARM 10 mg COMPR. FILM.
EBIXA 10 mg
COMPR. FILM.
MEMANTINA TORRENT 10 mg COMPR. FILM.
NEMDATINE 10mg
COMPR. FILM.
MEMANTINA DR. REDDY'S 10 mg COMPR. FILM.
concentratie
DETINATOR APP
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
ROMANIA
STADA HEMOFARM SRL ROMANIA
STADA HEMOFARM SRL ROMANIA
Prescriptie
NR.CRT
TARA
DET. APP
AMBALAJ
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
KRKA D.D.
SLOVENIA
MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC-PVDC-PE-PVDC-PVC X 14 COMPR. ORODISPERSABILE
CUTIE CU BLIST. OPA/AL/PVC SI FOLIE PET-AL "PEEL-OPEN" A CATE 28 COMPR. ORODISP.
PRF
PRF
P-RF
ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 28 COMPR. ORODISP.P-RF

ROMANIA
PRF
STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ORODISPERSABILE PRF
STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE PRF
PRF
MAREA BRITANIE 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.
NEOLA PHARMA S.R.L.

NEOLA PHARMA S.R.L.

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

P-RF/R
P-RF/R
P-RF/R
P-RF/R
KRKA ,D.D., NOVO MESTO SLOVENIA
CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE P-RF/R
MAREA BRITANIE
CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC
MAREA BRITANIE
ZENTIVA, K.S.
REPUBLICA CEHA
MAREA BRITANIE
ZENTIVA, K.S.
REPUBLICA CEHA

PR
PR
PRF
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
PR
PRF
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
PRF
ROMANIA
PRF
ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 125 ML SOL. ORALA + 1 SERINGA DOZATOARE P-RF/R
CUTIE CU 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HRTIE/POLIETILENTEREFTALAT/AL/POLIACRILONITRIL CU CU SISTEM DE NCHIDERE SECURIZAT PENTRU COPII, A CTE 1 PLASTURE TRANSDERMIC PROTEJ. DE O FOLIE DIN FILM DIN TEREFTALAT DE POLIETILENA SILICONATA
CUTIE CU 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HRTIE/POLIETILENTEREFTALAT/AL/POLIACRILONITRIL CU CU SISTEM DE NCHIDERE SECURIZAT PENTRU COPII, A CTE 1 PLASTURE TRANSDERMIC PROTEJ. DE O FOLIE DIN FILM DIN TEREFTALAT DE POLIETILENA SILICONATA
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.
REPUBLICA CEHA
PRF
ZENTIVA, K.S.
REPUBLICA CEHA
PRF
ZENTIVA, K.S.
REPUBLICA CEHA
JANSSEN-PHARMACEUTICA NV
BELGIA
CUTIE X 1 FLACON X 100 ML + 1 PIPETA DOZATOARE P-RF
PRF
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
Pagina 26 din 39
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
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
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
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
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
DCI
COD ATC
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
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***
Denumire Comerciala
MIRVEDOL 10 mg
MEMANTINA AUROBINDO 10 mg
MEMANTINA TERAPIA 10 mg
MEMANTINA ATB 10 mg
MARIXINO 10mg
COGNOMEM 10 mg
MEMANTINA LANNACHER HEILMITTEL 10 mg
MANTOMED 10 mg
MANTOMED 10 mg
MEMANTINA RATIOPHARM 20 mg
MEMANTINA TORRENT 20 mg
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
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
10mg
20mg
5mg/doza
10 mg/ml
10mg/ml
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR

PR
TERAPIA SA
TERAPIA SA
ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PR
ANTIBIOTICE S.A.
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 PR
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 70 COMPR. FILM.
PR
CUTIE CU BLIST. TRANSPARENT PVC-PE-PVDC/AL X 56 COMPR. FILM. PRF
RATIOPHARM GMBH GERMANIA CUTIE X BLISTERE DIN FOLIE PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR
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
TERAPIA SA
TERAPIA SA
ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. PR
ANTIBIOTICE S.A.
ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PR
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR
CUTIE CU BLIST. TRANSPARENT PVC-PE-PVDC/AL X 56 COMPR. FILM. PRF
PR
PR
H LUNDBECK A/S
DANEMARCA CUTIE X 1 FLACON DIN STICLA BRUNA CU POMPA DOZATOARE X 50 ML SOLUTIE P-RF/R
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA + SERINGA DOZATOARE A 50 ML SOL. ORALA PR
TORRENT PHARMA SRL ROMANIA CUTIE CU 1 FLAC. A 100 ML SOL. SOL. ORALA SI O POMPA DOZATOARE PR
CUTIE CU BLIST. PT. ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. ORODISPERSABILE
CUTIE CU BLIST. PT. ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL X 28X1 COMPR. ORODISPERSABILE
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
56
0,650785
56
0,542321
56
0,650785
56
0,650785
56
0,650785
56
0,619821
56
0,650785
70
0,628428
56
0,650785
56
0,650785
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
56
0,650785
28
1,370357
1 115,980000
1 96,650000
1 183,300000
0,650785
0,542321
0,650785
0,650785
0,650785
0,619821
0,650785
0,628428
0,650785
0,650785
1,644428
1,644428
1,552500
1,644428
1,644428
1,491071
1,644285
1,644428
1,644428
0,650785
1,370357
115,980000
96,650000
183,300000
0,396179
0,000000
0,034393
0,034393
0,005286
0,000000
0,034393
0,000000
0,032965
0,032965
0,100572
0,373786
0,000000
0,449500
0,449500
0,000000
0,000000
0,419857
0,419857
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
H02AB04
H02AB04
L01AA01
L01AA01
L04AX01
L04AX01
L04AX01
P01BA02
METHYLPREDNISOLONUM5)
CYCLOPHOSPHAMIDUM
CYCLOPHOSPHAMIDUM
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM
HYDROXYCHLOROQUINUM
MEDROL A 16
MEDROL 32
ENDOXAN (R) 50 mg
ENDOXAN 200 mg
IMURAN
IMURAN
IMMUNOPRIN 75 mg
PLAQUENIL
COMPR.
COMPR.
DRAJ.
PULB. PT. SOL. PERF./INJ. I.V.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
16mg
32mg
50mg
200mg
50mg
50mg
75mg
200mg
MAREA BRITANIE
MAREA BRITANIE
P-RF
BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF
ACTAVIS S.R.L.
ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ S
S/P-RF
IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF

EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PR
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L
50
20
50
1
100
100
100
60
0,543200
1,234000
0,542400
15,890000
0,702300
0,702300
0,788900
0,542833
0,543200
1,234000
0,542400
15,890000
0,702300
0,702300
0,788900
0,542833
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.

MERCK SHARP & DOHME ROMANIA CUTIE X 5 FIOLE X 1 ML
P-6L
P6L
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
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
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
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
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
forma farm.
METHOTREXATE PCH 10mg COMPR.

METHOTREXATE PCH 2,5mg COMPR.

METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml

LEFLUNOMIDA SANDOZ 10 mg COMPR. FILM.

LEFLUNOMIDE WINTHROP 10mg COMPR. FILM.
LEFLON 10 mg
COMPR. FILM.
LEFLUNOMIDA SANDOZ 20 mg COMPR. FILM.

LEFLUNOMIDE WINTHROP 20mg COMPR. FILM.
LEFLON 20 mg
EQUORAL 100 mg
EQUORAL 25 mg
EQUORAL 50 mg
IMURAN
IMURAN
IMMUNOPRIN 75 mg
DICLOREUM 150 mg
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
VOLTAREN (R)
COMPR. FILM.
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
COMPR. ELIB. MODIF.

DRAJ.
DRAJ. GASTROREZ.
DRAJ. GASTROREZ.
DRAJ. GASTROREZ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ./PERF.
SUPOZ.
SUPOZ.
SUPOZ.
SUPOZ.
SUPOZ.
SUPOZ.
SUPOZ.
concentratie
10mg
2,5mg
100mg/ml
100mg/ml
10mg/ml
10mg/ml
10mg/ml
10mg/ml
50mg/ml
50mg/ml
50mg/ml
10 mg
10mg
10mg
20 mg
20mg
20mg
100mg
25mg
25mg
50mg
50mg
50mg
50mg
75mg
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
DETINATOR APP
Prescriptie
NR.CRT
TARA
DET. APP
AMBALAJ
ROMANIA CUTIE X 10COMPR.

P6L
ROMANIA CUTIE X30 COMPRIMATE
P6L
AUSTRIA CUTIE X 1 FLACON X 50 ML
S
AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S
AUSTRIA
PR
AUSTRIA
PR
AUSTRIA
PR
AUSTRIA
PR
GERMANIA
GERMANIA
GERMANIA

P-RF
P-RF
P-RF
SANDOZ S.R.L.
ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP CU 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
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
S/P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
ALFA WASSERMANN SPA

TERAPIA SA
HEXAL AG
IRLANDA
AUSTRIA
ITALIA
CEHIA
ROMANIA
S/P-RF
S/P-RF
PR
CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL.
P-6L
CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL.
P-6L
CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL
P-6L
ROMANIA
CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL.
P-6L
P-6L
CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L
TERAPIA SA
P-6L
P-6L
ROMANIA
ROMANIA
ARENA GROUP SA
ARENA GROUP SA
ARENA GROUP SA
ROMANIA
ROMANIA
ROMANIA
CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L

CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ.
P-6L
P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE 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
TERAPIA SA
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ.
SINTOFARM SA
MAGISTRA C & C
SINTOFARM S.A.
SINTOFARM S.A.
Pagina 28 din 39
P-6L
ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L

P-6L
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
10
2,989000
30
0,747666
1 374,090000
1 82,990000
1 61,880000
1 118,008000
1 46,730000
1 79,700000
1 98,340000
1 56,076000
1 110,680000
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
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
2,989000
0,747666
374,090000
82,990000
61,880000
118,008000
46,730000
79,700000
98,340000
56,076000
110,680000
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
2,474500
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
0,000000
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
0,574000
0,000000
0,788040
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
COD ATC
55
P01BA02
DCI
HYDROXYCHLOROQUINUM
forma farm.
Denumire Comerciala
PLAQUENIL
COMPR. FILM.
concentratie
200mg
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
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
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
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)
VOLTAREN (R)
TRATUL (R)
DICLOFENAC 75 mg
REFEN 75 mg
CLAFEN 100 mg
VOLTAREN (R)
DICLOFENAC 100 mg
DICLOFENAC SODIC 100 mg
VOLTAREN (R)
COMPR. GASTROREZ.
SUSP. INJ. I.M.

CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
COMPR. ELIB. MODIF.

DRAJ.
DRAJ. GASTROREZ.
DRAJ. GASTROREZ.
DRAJ. GASTROREZ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ./PERF.
SUPOZ.
SUPOZ.
SUPOZ.
SUPOZ.
SUPOZ.
SUPOZ.
SUPOZ.
500mg
500mg
7mg/ml
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
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
CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL.
P-6L
CEHIA
CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L
TERAPIA SA
ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL P-6L
HEXAL AG
ROMANIA
CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL.
P-6L
P-6L
CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L
TERAPIA SA
P-6L
P-6L
ROMANIA
ROMANIA
ARENA GROUP SA
ARENA GROUP SA
ARENA GROUP SA
ROMANIA
ROMANIA
ROMANIA
CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L

P-6L
P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE 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
TERAPIA SA
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ.
SINTOFARM SA
MAGISTRA C & C
SINTOFARM S.A.
SINTOFARM S.A.
P-6L
ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L

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 NEUROENDOCRINE) - G
1
2
3
4
5
G02CB03
G02CB03
H01AX01
H01AX01
H01BA02
CABERGOLINUM**
CABERGOLINUM**
PEGVISOMANTUM****
PEGVISOMANTUM****
DESMOPRESSINUM
DOSTINEX
COMPR.
DOSTINEX
COMPR.
SOMAVERT 10 mg
SOMAVERT 20 mg
DESMOPRESINA TEVA 0,2mg COMPR.
0,5mg
0,5mg
10mg
20mg
0,2mg
PFIZER EUROPE MA EEG
MAREA BRITANIE
PFIZER EUROPE MA EEG
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
PFIZER LIMITED
PFIZER LIMITED
TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL- PVC/AL X 30 COMPR.
Pagina 29 din 39
P-RF
P-RF
P-RF
2 10,795000
8
9,912500
30 270,534666
30 539,183333
30
2,499333
10,795000
9,912500
270,534666
539,183333
2,499333
0,000000
0,000000
0,000000
0,000000
0,000000
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
COD ATC
H01BA02
H01BA02
H01BA02
H01BA02
H01CB02
H01CB02
H01CB02
H01CB02
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
DESMOPRESSINUM
DESMOPRESSINUM
DESMOPRESSINUM
OCTREOTIDUM****
OCTREOTIDUM****
OCTREOTIDUM****
OCTREOTIDUM****
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 0,2 mg
MINIRIN MELT 120 mcg
MINIRIN MELT 60 mcg
MINIRIN MELT 60 mcg
SANDOSTATIN LAR 20 mg
SANDOSTATIN 0,1 mg/ml
SOMATULINE PR 30 mg
SOMATULINE AUTOGEL 120 mg
forma farm.
COMPR.
LIOF. ORAL
LIOF. ORAL
LIOF. ORAL
PULB. + SOLV. PT. SUSP. INJ. (I.M.) CU ELIB. PRELU
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.
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
0,2mg
120mcg
60mcg
60mcg
20mg
10mg
30mg
0,1mg/ml
30mg
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
FERRING GMBH
FERRING GMBH
FERRING GMBH
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
GERMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR.
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
GERMANIA
CUTIE X 3 BLIST AL/AL X 10 UNITATI DOZATE LIOF. ORAL
P-RF
CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE S/P-RF
CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE S/P-RF
CUTIE X 1 FLAC. PULB. + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACES/P-RF
PR
S
IPSEN PHARMA
IPSEN PHARMA
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
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR.
P-RF
CN UNIFARM
ROMANIA
ZENTIVA S.A.
ROMANIA
MERCK KGAA
GERMANIA
MERCK KGAA
GERMANIA
MERCK KGAA
GERMANIA
MERCK KGAA
GERMANIA
MERCK KGAA
GERMANIA
MERCK KGAA
GERMANIA
MERCK KGAA
GERMANIA
MERCK KGAA
GERMANIA
MERCK KGAA
GERMANIA
MERCK KGAA
GERMANIA
BIOFARM SA
ROMANIA
Tratamentul se initiaza de catre medicul in specialitatea endocrinologie sau oncologie
Pagina 30 din 39
CUTIE X 1 FLACON LIOF. + 1 FIOLA X 2 ML SOLV. + 1 SERINGA X 3 ML + 2 ACE
CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. CU ELIB. PREL., IN PUNGA AL/NYLON/PE + ACS/P-RF
PR
PR
PR
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
CUTIE X 4 BLIST. PP/AL X 25 COMPR.
P-6L
CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L
CUTIE X 4 BLIST. AL/PP X 25 COMPR.
P-6L
P-6L
P-6L
CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-RF

P-RF
P-RF
cant.
UT/
Pret de
aj
(RON)
30
30
10
30
1
1
1
5
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
2,999199
6,047000
3,337000
3,169333
2.919,710000
1.519,360000
4.344,140000
8,830000
1.611,250000
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

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
2,999199
6,047000
3,337000
3,169333
2.919,710000
1.519,360000
4.344,140000
8,830000
1.611,250000
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
0,846134
0,000000
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
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
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
FRANTA CUTIE X 5 FIOLE X 5 ML

S/P-RF
AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ.
AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ. P-RF/R
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
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
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
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
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
SOL. INJ./PERF. 20mg/ml

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
S/P-RF/R
S/P-RF/R
S/P-RF/R
SLOVENIA
CUTIE CU 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ.
S/P-RF
AUSTRIA
AUSTRIA
AUSTRIA
P-RF/R

10000UI/0,6ml
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
4000UI/0,3ml
5000UI/0,3ml

100mcg/0,5ml AMGEN EUROPE BV OLANDA
500mcg/ml AMGEN EUROPE BV OLANDA
CUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ.
MAREA BRITANIE
100mcg/0,3ml
120mcg/0,3ml
150mcg/0,3ml
200mcg/0,3ml
250mcg/0,3ml
30mcg/0,3ml

S/P-RF/R
S/P-RF/R
S/P-RF/R
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
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
MAREA BRITANIE
S/P-RF/R
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
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
COD ATC
DCI

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
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**
CYCLOPHOSPHAMIDUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM
COMBINATII (AMINOACIZI)**
Denumire Comerciala
MIRCERA 50 mcg/0,3ml
MIRCERA 75mcg/0,3ml
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
ZEMPLAR 1g
ZEMPLAR 2g
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.
DRAJ.
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
concentratie
360mcg/0,6ml
50 mcg/0,3ml
75mcg/0,3ml
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
5 g/ml
50mg
100mg
25mg
25mg
50mg
50mg
50mg
50mg
75mg
Prescriptie
NR.CRT
DETINATOR APP
TARA
DET. APP
MAREA BRITANIE
CUTIE X 1 SERINGA PREUMPLUTA, X 0,6ML SOL. INJ.
S/P-RF/R
MAREA BRITANIE
S/P-RF/R
MAREA BRITANIE
S/P-RF/R
MALTA
GALENICA S.A.
GRECIA
SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA
TERAPIA S.A.
ROMANIA
SANDOZ S.R.L.
ROMANIA
AMBALAJ

P6L

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

SANOFI-AVENTIS GROUPE FRANTA
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

P6L
CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.
P-6L
P6L

CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM.
P-6L
P-6L
P-6L
ROMANIA
SANOFI-AVENTIS GROUPE FRANTA
SANOFI CLIR SNC
FRANTA
SINTOFARM SA
ROMANIA
P6L

P6L

P6L
P6L

P-RF
CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. MOI
P-RF
P-RF
P-RF
P-RF
CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. P-RF
CUTIE X 5 FIOLE X 1 ML SOL. INJ.

TEVA CZECH INDUSTRIES S.R.O.
CEHIA

CEHIA
GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI
CEHIA
S/P-RF
S/P-RF
S/P-RF


FARA CONCENTRATIE FRESENIUS KABI DEUTSCHLAND GMBH
Tratamentul se initiaza de catre medicul in specialitatea nefrologie.
Pagina 32 din 39
IRLANDA
AUSTRIA
S/P-RF
S/P-RF
S/P-RF
S/P-RF
PR
GERMANIA CUTIE X 5 BLIST. DIN PVC/AL X 20 COMPR. FILM.
P-RF
cant.
UT/
Pret de
aj
(RON)
1 2.768,720000
1 424,740000
1 601,690000
28
0,359199
28
0,516071
28
0,359199
28
0,359199
28
0,359199
28
0,359199
30
0,299333
28
0,359199
28
0,359199
28
0,359199
28
0,359199
30
0,359199
28
0,359199
28
0,359199
28
0,619285
28
0,576785
28
0,619285
28
0,619285
28
0,619285
28
0,619285
28
0,619285
28
0,619285
30
0,619285
28
0,619285
28
0,619285
28
0,856428
20
0,108399
30
0,090333
30
0,108399
20
0,108399
28 10,363571
28 17,300357
5 47,686000
50
0,542400
50
6,232400
50
1,784400
50
1,487000
50
3,040560
50
2,533800
100
0,702300
100
0,702300
100
0,788900
100
2,272200

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
2.768,720000
424,740000
601,690000
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
47,686000
0,542400
6,232400
1,784400
1,487000
3,040560
2,533800
0,702300
0,702300
0,788900
2,272200
0,000000
0,000000
0,000000
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
0,000000
0,574000
0,000000
0,788040
0,000000
0,000000
0,000000
0,000000
0,000000
DCI
COD ATC
Denumire Comerciala
forma farm.
concentratie
DETINATOR APP
Prescriptie
NR.CRT
TARA
DET. APP
AMBALAJ
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
21. GLAUCOM - G 26
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
S01EC03
S01EC03
S01EC04
S01ED01
S01ED01
S01ED01
S01ED01
S01ED02
S01ED02
S01ED02
S01ED05
S01ED51
S01ED51
S01ED51
S01ED51
S01ED51
S01ED51
S01ED51
S01ED51
S01EE01
S01EE01
S01EE01
S01EE01
S01EE01
S01EE01
S01EE03
S01EE03
S01EE04
S01EE04
S01EE04
S01EE04
DORZOLAMIDUM
DORZOLAMIDUM
BRINZOLAMIDUM
TIMOLOLUM
TIMOLOLUM
TIMOLOLUM
TIMOLOLUM
BETAXOLOLUM
BETAXOLOLUM
BETAXOLOLUM
CARTEOLOLUM
DORZOPT 20 mg/ml
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
PIC. OFT., SOL

SOL. OFT.
20mg/ml
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
UNILAT 50 micrograme/ml
PIC. OFT., SOL. 50micrograme/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
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
P-6L
1
1
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
14,530000
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
30,180000
1,874000
25,150000
30,180000
42,800000
74,460000
87,630000
33,440000
36,290000
40,128000
14,530000
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
30,180000
1,874000
25,150000
30,180000
42,800000
74,460000
87,630000
33,440000
36,290000
40,128000
0,000000
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
6,930000
0,000000
0,000000
7,260000
0,000000
0,000000
0,000000
0,000000
0,000000
15,712000
ROMANIA CUTIE CU 10 BLISTERE X 10 COMPRIMATE PRF

ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF
PRF
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 25 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF
PRF
100
10
25
100
10
25
100
100
5
0,190800
0,832000
0,816800
0,736400
1,387000
1,327200
1,246200
1,256100
1,380000
0,190800
0,832000
0,816800
0,736400
1,387000
1,327200
1,246200
1,256100
1,380000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
ROMANIA CUTIE X 1 FLAC. PEJD X 5 ML PIC. OFT., SOL P-RF

ROMANIA CUTIE X 1 FLACON TIP OCULOMETER PLUS X 5 ML SOL. OFT. P-6L
ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON, PEJD X 5 ML
P-6L
ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PICURATOR DIN PEID X 5 ML PIC. OFTALMICE, SOL.P-6L
ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PICURATOR DIN PEID X 5 ML PIC. OFTALMICE, SOL.P-6L
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON PEID, PREVAZUT CU PICURATOR X 5 ML P-6L
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON CU PICURATOR X 5 ML P-6L
ROMPHARM SRL
ROMANIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFTALMICE, SOL. P-6L
ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON DIN PEJD PREV. CU PICURATOR X 5 ML PIC.OFTALMICE, SOL. P-6L
ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON DIN PEJD X 5ML PIC. OFT.SUSP. P-6L
MERCK SHARP & DOHME
GERMANIA
ALCON LABORATORIES (UK) LTD. MAREA BRITANIE
CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC. OFTALMICE CU ELIB. PREL.
P-6L
CUTIE X 1 FLAC. X 5 ML SUSP. OFT.
P-RF
IRLANDA CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC.OFT.SOL. P-RF

ROMANIA CUTIE CU 1 FLAC. PE ALB, OPAC +PICURATOR PEID A 5 ML PIC. OFT. SOL. PRF
MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DE TIP OCUMETER PLUS X 5ML PIC. OFT., SOL. P-6L
P6L
P6L
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 2,5 ML
P-6L
ALLERGAN PHARMACEUTICALS IRELAND
OFTAFARMA ROMNIA S.R.L.
CUTIE X 1 FLACON DIN PEJD CU PICURATOR DIN PEJD INCHIS CU CAPAC DIN PEID X 2.5ML PICATURI OFTALMICE-
CUTIE CU 1 FLAC. TRANSPARENT PEJD + PICURATOR TRANSPARENT PEJD X 2,5 ML PIC. OFT., SOL.
ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PP X 2,5 ML PIC. OFTALMICE,SOLUTIE P-RF
NTC S.R.L.
ITALIA
ROMANIA
CUTIE CU 1 FLAC. DIN PEJD CU CAPAC DIN PEID X 2,5 ML PIC. OFT. PT. APROX. 80 PIC. SOL.
P6L
UNIMED PHARMA SPOL. S.R.O.
REPUBLICA SLOVACA
CUTIE CU 1 FLAC. PICURATOR PE X 2,5 ML PIC. OFT., SOL.
P-6L

ROMANIA
MAREA BRITANIE
ROMANIA
ALLERGAN PHARMACEUTICALS IRELAND IRLANDA
CUTIE CU 1 FLAC. PEJD X 2,5 ML PIC. OFT., SOL. P6L
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
ISLANDA
ZENTIVA, K.S.
REPUBLICA CEHA
ALCON LABORATORIES LTD.
MAREA BRITANIE
PRF
CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC. OFT. SOL. P-RF
ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 4ML PICATURI OFTALMICE, SOLUTIE
P6L
P6L
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
Tratamentul se iniiaz de ctre medicul n specialitatea oftalmologie.
22. PEMFIGUS - G 27
1
2
3
4
5
6
7
8
9
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMED
DEXAMETHASONE SODIUM PHOSPHATE
DEXAMETHASONE SODIUM PHOSPHATE
COMPR.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
0,5mg
4mg/ml
4mg/ml
4mg/ml
4mg/ml
4mg/ml
4mg/ml
8mg
8mg
CN UNIFARM S.A.
Pagina 33 din 39
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
DCI
COD ATC
H02AB02
H02AB04
H02AB04
H02AB04
H02AB04
H02AB04
H02AB07
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
DEXAMETHASONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
PREDNISONUM
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
DEXAMED
MEDROL A 16
MEDROL 32
LEMOD SOLU 125 mg
LEMOD SOLU 500 mg
PREDNISON MCC 5 mg
PREDNISON 5 mg
DISULONE
ENDOXAN (R) 50 mg
ENDOXAN 200 mg
forma farm.
SOL. INJ.
COMPR.
COMPR.
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
PULB. PT.CONC. PT.SOL. PERF.
400U
LIOF. SI SOLV.PT.SOL.INJ
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
DRAJ.
PULB. PT. SOL. PERF./INJ. I.V.
COMPR.
COMPR.

METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
EQUORAL 100 mg
EQUORAL 25 mg
EQUORAL 50 mg
IMURAN
IMURAN
IMMUNOPRIN 75 mg
concentratie
8mg/2ml
16mg
32mg
250mg/4ml
125mg
500mg
5mg
5mg
5mg
5mg
100mg
50mg
200mg
10mg
2,5mg
100mg/ml
100mg/ml
10mg/ml
10mg/ml
10mg/ml
10mg/ml
50mg/ml
50mg/ml
50mg/ml
100mg
25mg
25mg
50mg
50mg
50mg
50mg
75mg

DETINATOR APP
Prescriptie
NR.CRT
TARA
DET. APP
AMBALAJ
CUTIE X 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
1,425000
0,543200
1,234000
20,480000
8,810000
31,020000
0,108399
0,090333
0,108399
0,108399
0,489700
0,542400
15,890000
2,989000
0,747666
374,090000
82,990000
61,880000
118,008000
46,730000
79,700000
98,340000
56,076000
110,680000
6,232400
1,784400
1,487000
3,040560
2,533800
0,702300
0,702300
0,788900
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
0,000000
0,000000
0,000000
0,000000
0,000000
9,082000
0,000000
0,000000
0,000000
13,944000
0,000000
0,000000
0,574000
0,000000
0,788040
0,000000
0,000000
0,000000
0,000000
6.149,520000
0,000000
0,416000
0,363000
0,361000
0,000000
0,000000
0,000000
S/P-RF
PR
10
1,425000
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
100
0,489700
50
0,542400
1 15,890000
10
2,989000
30
0,747666
1 374,090000
1 82,990000
1 61,880000
1 118,008000
1 46,730000
1 79,700000
1 98,340000
1 56,076000
1 110,680000
50
6,232400
50
1,784400
50
1,487000
50
3,040560
50
2,533800
100
0,702300
100
0,702300
100
0,788900
GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. PR
1 6.149,520000
ROMANIA
SINTOFARM SA
ROMANIA
CN UNIFARM
ROMANIA
P-RF

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

P-RF
CUTIE X 100 COMPR.
P-RF
P-RF
P-RF
P-RF
ACTAVIS S.R.L.
CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ
CUTIE X 10COMPR.
CUTIE X30 COMPRIMATE
CUTIE X 1 FLACON X 50 ML
P6L
ROMANIA
ROMANIA
ROMANIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
GERMANIA
GERMANIA
GERMANIA
CEHIA



CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML

P-RF
P-RF

CEHIA
CEHIA
IRLANDA
AUSTRIA
S
S
PR
PR
PR
PR
P-RF

P6L
S/P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
Tratamentul se iniiaz de ctre medicul n specialitatea dermatologie.
23. BOALA GAUCHER - G 29

1
A16AB02
IMIGLUCERASUM****
CEREZYME 400U
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
J01AA02
J01AA02
J01AA02
DOXYCYCLINUM
DOXYCYCLINUM
DOXYCYCLINUM
DOXICICLINA ATB 100 mg

DOXICICLINA ARENA
CAPS.
CAPS.
DOXICICLINA SANDOZ 100 mg CAPS.
100 mg
100mg
100mg
ANTIBIOTICE S.A.
ARENA GROUP SA
SANDOZ SRL
Pagina 34 din 39

ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF
10
20
10
0,416000
0,363000
0,361000
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
COD ATC
J01AA07
J01AA07
J01CE01
J01CE01
J01CE01
J01CE01
J01CE01
J01CE01
J01CE02
J01CE02
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
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
DCI
TETRACYCLINUM
TETRACYCLINUM
BENZYLPENICILLINUM
BENZYLPENICILLINUM
BENZYLPENICILLINUM
BENZYLPENICILLINUM
BENZYLPENICILLINUM
BENZYLPENICILLINUM
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
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
Denumire Comerciala
forma farm.
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.
OSPEN (R) 500
COMPR. FILM.
OSPEN 400.000 U.I./5 ml
SUSP. ORALA
MOLDAMIN 1200000 UI
PULB. PT. SUSP. INJ.
MOLDAMIN 1200000 UI
PULB. PT. SUSP. INJ.
EFICEF 100 mg
CAPS.
EFICEF (R) 200 mg
CAPS.
XIFIA 400mg
COMPR. FILM.
XIFIA 400mg
COMPR. FILM.
ERITROMAGIS 200 mg
COMPR.
ERITROMICINA 200 mg
COMPR.
ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR.
ERITROMICINA ATB 200 mg COMPR.
AZATRIL 250 mg
CAPS.
SUMAMED 250 mg
CAPS.
SUMAMED 125 mg
COMPR. FILM.
AZITROMICINA SANDOZ 250 mg COMPRIMATE FILMATE COMPR. FILM.
AZITROMICINA TERAPIA 250 mg COMPR. FILM.
SUMAMED 500 mg
COMPR. FILM.
AZITROMICINA SANDOZ 500 mg COMPRIMATE FILMATE COMPR. FILM.
AZIBIOT 500 mg
COMPR. FILM.
AZITROX (R) 500
COMPR. FILM.
AZATRIL 500 mg
COMPR. FILM.
AZITROMICINA ARENA 500 mg COMPR. FILM.
AZITROX 200 mg/5 ml
PULB. + SOLV. SUSP. ORALA
TETRACICLINA ARENA 250 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.
CIPROFLOXACINA ARENA 100 mg
concentratie
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
250mg
250mg
1 000 000ui
1 000 000ui
1000000ui
1000000ui
400 000ui
400 000ui
1000000ui
1500000ui
500000ui
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 CAPS. P-RF

ANTIBIOTICE S.A.
ANTIBIOTICE SA
ROMANIA CUTIE X 100 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF/S
ANTIBIOTICE SA
ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF
ANTIBIOTICE SA
ANTIBIOTICE SA
ANTIBIOTICE SA
ANTIBIOTICE SA
SANDOZ GMBH
AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF
SANDOZ GMBH
SANDOZ GMBH
400.000U.I./5ml SANDOZ GMBH
AUSTRIA
P-RF
1200000UI ANTIBIOTICE S.A.
ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M. P-RF
1200000UI ANTIBIOTICE S.A.
ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M. S/P-RF
100mg
ANTIBIOTICE S.A.
200mg
ANTIBIOTICE SA
400mg
INN-FARM D.O.O.
SLOVENIA CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATEPRF
400mg
INN-FARM D.O.O.
SLOVENIA CUTIE CU 2 BLISTERE PVC-PVDC/AL A CATE 5 COMPRIMATE FILMATE PRF
200mg
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-RF
200mg
ANTIBIOTICE SA
P-RF
200mg
SANDOZ S.R.L.
P-RF
200mg
ANTIBIOTICE SA
ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF
250mg
BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. P-RF
250mg
PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS. P-RF
125mg
PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 6 COMPR. FILM. P-RF
250mg
SANDOZ S.R.L.
ROMANIA CUTIE X 1 BLIST. X 6 COMPR. FILM. P-RF
250mg
TERAPIA SA
250mg
TERAPIA SA
500mg
PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF
500mg
SANDOZ S.R.L.
ROMANIA CUTIE X 1 BLIST. X 3 COMPR. FILM. P-RF
500mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF
500mg
TERAPIA SA
500mg
TERAPIA SA
500mg
ZENTIVA K.S.
CEHIA
500mg
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-PVC-AL/AL X 3 COMPR. FILM. PRF
500mg
ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 3 COMPR. FILM. PRF
600mg
TERAPIA SA
600mg
TERAPIA SA
200mg/5ml ZENTIVA S.A.
ROMANIA
P-RF
100mg/5ml SANDOZ SRL
ROMANIA
P-RF
200 mg/5 ml SANDOZ SRL
ROMANIA
P-RF
200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA
P-RF
P-RF
P-RF
100mg
100mg
250mg
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF
250mg
250mg
AC HELCOR SRL
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML SUSP. ORALA CU CAPAC SI LINGURITA DOZATOARE
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
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
Pagina 35 din 39
cant.
UT/
Pret de
aj
(RON)
20
20
100
1
1
100
100
1
12
12
12
1
1
100
10
10
5
10
20
20
20
20
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
0,155000
0,186000
4,141700
4,850000
4,840000
4,141700
2,848000
3,270000
0,299166
0,527500
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
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

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0,155000
0,186000
4,141700
4,850000
4,840000
4,141700
2,848000
3,270000
0,299166
0,527500
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
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
0,000000
0,150000
0,000000
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
0,056500
0,000000
0,056500
0,000000
1,116667
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
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
COD ATC
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
DCI
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
forma farm.
Denumire Comerciala
CUMINOL 250 mg
CIFRAN
COMPR. FILM.
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.
CIPRINOL 750 mg
COMPR. FILM.
CIPROBAY XR 1000 mg
CIPROBAY XR 500 mg
CIPRINOL (R)
CIPRINOL (R)
CIPROFLOXACINA ZENTIVA 10 mg/ml CONC. PT. SOL. PERF.
CIPROFLOXACINA INFOMED 2 mg/ml
CIPROFLOXACINA INFOMED 2 mg/ml
SOL. PERF.
SOL. PERF.
Prescriptie
NR.CRT
TARA
DET. APP
concentratie
DETINATOR APP
250mg
250mg
250mg
250mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
750mg
750mg
1000 mg
500 mg
100mg/10ml
100mg/10ml
100mg/10ml
2mg/ml
2mg/ml
RANBAXY UK LIMITED
MAREA BRITANIE

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

AC HELCOR SRL
RANBAXY UK LIMITED
P-RF
P-RF
P-RF
MAREA BRITANIE
ANTIBIOTICE SA
ROMANIA

ARENA GROUP S.A.

BAYER PHARMA AG
BAYER PHARMA AG
KRKA D.D.
KRKA D.D.
ZENTIVA S.A.
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/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
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
10
10
10
20
10
10
10
10
10
10
10
20
10
10
7
3
50
5
5
10
10
0,709000
0,720000
0,681000
0,638000
1,022400
0,920000
1,022400
1,022400
0,911000
1,022400
0,957000
0,852000
1,031000
1,237200
12,554285
1,022400
2,833800
3,400560
3,400560
8,815000
16,023000
0,709000
0,720000
0,681000
0,638000
1,022400
0,920000
1,022400
1,022400
0,911000
1,022400
0,957000
0,852000
1,031000
1,237200
12,554285
1,022400
2,833800
3,400560
3,400560
8,815000
16,023000
0,000000
0,000000
0,000000
0,000000
0,160600
0,000000
0,299600
0,348600
0,000000
0,348600
0,000000
0,000000
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
OLANDA
HOSPIRA UK LIMITED MAREA BRITANIE
CELLTRION HEALTHCARE HUNGARY KFT.
UNGARIA
ABBVIE LTD.
MAREA BRITANIE
JANSSEN BIOLOGICS B.V.
Tratamentul se iniiaz de ctre medicul n specialitatea gastro-enterologie i medicin intern.
Pagina 36 din 39
CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.
PR
PR
PR
CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL
P-RF/R
COD ATC
DCI
DETINATOR APP
MAREA BRITANIE
MAREA BRITANIE CUTIE X 1 FLACON X 50 ML(500MG RITUXIMAB IN 50ML- 10MG/ML)
BRISTOL-MYERS SQUIBB
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
forma farm.
Denumire Comerciala
concentratie
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
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
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
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****
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
10mg/ml
10mg/ml
PULB. PT.CONC. PT.SOL. PERF. 250mg
SOL INJ. IN SERINGA PRE-UMPLUTA 125mg/ml
PULB+SOLV. PT. SOL. INJ. 10mg
PULB. + SOLV. PT. SOL. INJ. 25mg
SOL. INJ. (INSERINGA PREUMPLUTA) 25mg
50mg
PULB. PT. CONC. PT. SOL. PERF. 100mg
SOL. INJ. IN SERINGA PREUMPLUTA 40mg
SOL. INJ. IN SERINGA PREUMPLUTA 200 mg
SOL. INJ. IN PEN PRE-UMPLUT 50mg/0,5ml
SOL. INJ. IN SERINGA PREUMPLUTA 50mg/0,5ml
CONC. PT. SOL. PERF. 20mg/ml
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
CUTIE X 2 FLACOANE X 10 ML
S
S
S
PR
PR
P-RF/R
MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R

MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R
OLANDA CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR
HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR
UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR
ABBVIE LTD.
MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL
P-RF/R
UCB PHARMA SA
BELGIA
P-RF/R
JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 STILOU INJECTOR PREUMPLUT (PEN) X 0,5ML
PR
JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML PR
ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 4 ML CONC. PT. SOL. PERF. S
CUTIE X 2 SERINGI PREUMPLUTE DIN STICLA CU PISTON A 1 ML + 2 TAMPOANE CU ALCOOL
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
4
4
4
4
4
3
3
1
2
1
1
209,250000
496,610000
496,277500
975,780000
975,780000
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
50mg
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
MAREA BRITANIE
MAREA BRITANIE
PR
P-RF/R

ABBVIE LTD.
P-RF/R
PR
Tratamentul se iniiaz de ctre medicul n specialitatea reumatologie i reabilitare medical.
28. SPONDILITA ANKILOZANTA - G 31d

Pagina 37 din 39
1.902,410000
1.628,203333
1.593,040000
1.956,550000
3.988,470000
3.988,470000
1
2
3
4
5
6
7
8
9
10
11
COD ATC
DCI
L04AB01
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
INFLIXIMABUM****
INFLIXIMABUM****
INFLIXIMABUM****
ADALIMUMABUM****
GOLIMUMAB****
GOLIMUMAB****
L04AB01
L04AB01
L04AB01
L04AB01
L04AB02
L04AB02
L04AB02
L04AB04
L04AB06
L04AB06
Denumire Comerciala

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
forma farm.
concentratie
10mg
25mg
50mg
DETINATOR APP
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
AMBALAJ
MAREA BRITANIE
MAREA BRITANIE
Prescriptie
NR.CRT
TARA
DET. APP
PR
P-RF/R

ABBVIE LTD.
P-RF/R
PR
Tratamentul se iniiaz de ctre medicul n specialitatea reumatologie, medicin intern i reabilitare medical.
Pagina 38 din 39
cant.
UT/
Pret de
aj
(RON)
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

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
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
COD ATC
DCI
Denumire Comerciala
DETINATOR APP
PULB. PT.CONC. PT.SOL. PERF.
MAREA BRITANIE
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
forma farm.
concentratie
AMBALAJ
Prescriptie
NR.CRT
TARA
DET. APP
cant.
UT/
Pret de
aj
(RON)

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
1.434,080000
209,250000
496,610000
496,277500
975,780000
975,780000
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
29. ARTRITA JUVENILA - G 31e

1
2
3
4
5
6
L04AA24
L04AB01
L04AB01
L04AB01
L04AB01
L04AB01
ABATACEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ORENCIA
ENBREL 25mg
ENBREL 25mg
ENBREL 50mg
ENBREL 50mg
250mg
10mg
PULB. + SOLV. PT. SOL. INJ. 25mg
50mg
CUTIE X 1 FLAC. X 250 MG PULB. + 1 SERINGA
MAREA BRITANIE
MAREA BRITANIE
S
PR
P-RF/R

1
4
4
4
4
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
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
50mg
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
MAREA BRITANIE
MAREA BRITANIE

OLANDA
HOSPIRA UK LIMITED MAREA BRITANIE
UNGARIA
ABBVIE LTD.
MAREA BRITANIE
PR
P-RF/R
PR
PR
PR
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 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;
3
- Medicamentul corespunzator DCI-ului notat cu ( ) se livreaza impreuna cu solventul;
- Medicamentele corespunztoare DCI-urilor notate cu (4) se import cu avizul Ageniei Naionale a Medicamentului i a Dispozitivelor Medicale.
5
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu () se utilizeaza numai pentru cazurile fara raspuns terapeutic la prednisonum.
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
cod
ATC
A03AD02
A03BA01
A03BB01
A03DA02
A03DA02
A03DA02
A05BAN3
A06AD65
A06AD65
A07AX03
A11CA01
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
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
VITAMIN A 50000 ui
CAPS. MOI
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.
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 OCTOMBRIE 2015
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
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%
compensare 100% din
din pretul de
aj
(RON)
referinta)
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
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
PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 12 CAPS. MOI P-6L
24
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
P-RF
5
50mg/2ml
ZENTIVA SA
P-RF
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
Pagina 1 din 5
CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 1 ML SOL. INJ.
1,016800
1,606000
0,672000
0,375000
0,375000
2,540000
3,253000
5,656666
6,787999
0,422500
0,072500
0,087000
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
1,016800
1,606000
0,672000
0,375000
0,375000
2,540000
3,253000
5,656666
6,787999
0,422500
0,072500
0,087000
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
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
3,127001
0,000000
0,000000
0,103666
0,000000
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
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
cod
ATC
A16AXN1
A16AXN1
A16AXN1
B02BX01
B02BX02
B03AA03
B03AD02
B03AD02
B03AD03
B03AD04
B03AE01
B03AE10
B03BA01
C01EA01
C05AA01
C05AA01
C05AA08
C05AA08
C05AD01
C05BX01
C05CA54
C07NAN1
C08CA06
C08CA06
D01AC05
D01AC05
D01AC08
D01AC08
D01AC08
D01AC08
D05AXN1
D07AC04
D07CB01
D07CC02
D07CC02
D07XB02
D07XC01
D07XC01
D07XC01
D07XC04
D07XC04
D10AF02
D10AF02
D10AF52
D11AH02
G01AF01
G01AX12
G01BDN1
G03DB04
G03GA01
DCI
DIVERSE
DIVERSE
DIVERSE
ETAMSYLATUM
CARBAZOCHROMI SALICYLAS
FERROSI GLUCONAS
COMBINATII
COMBINATII
COMBINATII
COMBINATII
COMBINATII
COMBINATII
CYANOCOBALAMINUM
ALPROSTADILUM**
COMBINATII
COMBINATII
COMBINATII
COMBINATII
COMBINATII
CALCII DOBESILAS
TROXERUTINUM (COMBINATII)
COMBINATII
NIMODIPINUM
NIMODIPINUM
ISOCONAZOLUM
ISOCONAZOLUM
KETOCONAZOLUM
KETOCONAZOLUM
KETOCONAZOLUM
KETOCONAZOLUM
COMBINATII
FLUOCINOLONI ACETONIDUM
COMBINATII
COMBINATII
COMBINATII
COMBINATII
COMBINATII
COMBINATII
Denumire Comerciala
ACTOVEGIN 200 mg
ACTOVEGIN (R)
ACTOVEGIN 200 mg/5 ml
forma farm.
DRAJ.
SOL. INJ.
SOL. INJ.
ETAMSILAT ZENTIVA 250mg SOL. INJ.
ADRENOSTAZIN
SOL. INJ.
ASCOFER
COMPR.
FERRETAB (R)
CAPS. ELIB. PREL.
FERRETAB (R)
CAPS. ELIB. PREL.
TARDYFERON FOL (R)
DRAJ. ELIB. PREL.
MALTOFER FOL
COMPR. MAST.
FERRO - FOLGAMMA (R)
CAPS. MOI
TOT'HEMA
SOL. ORALA
VITAMINA B12 ZENTIVA 50g/ml SOL. INJ.
ALPROSTADIL "REMEDIA" 500 g
HEMORZON
HEMORZON
SUPOZ.
UNGUENT
ULTRAPROCT SUPOZITOARE SUPOZ.
concentratie
200mg
200mg/5ml
200mg/5ml
250mg/2ml
0,3mg/ml
FARA CONCENTRATIE
FARA CONCENTRATIE
FARA CONCENTRATIE
FARA CONCENTRATIE
FARA CONCENTRATIE
FARA CONCENTRATIE
FARA CONCENTRATIE
50g/ml
500g
FARA CONCENTRATIE
FARA CONCENTRATIE
FARA CONCENTRATIE
ULTRAPROCT UNGUENT RECTAL
UNGUENT RECTAL
FARA CONCENTRATIE
DOXIPROCT
DOXILEK
GINKOR FORT
DISTONOCALM (R)
NIMOTOP 30 mg
NIMOTOP
TRAVOGEN
TRAVOGEN 10mg/g
KETOCONAZOL
KETOCONAZOL CREMA
KETOCONAZOL CREMA
NIZORAL 20 mg/g
ASORIAN
UNGUENT RECTAL
FARA CONCENTRATIE
CAPS.
CAPS.
FARA CONCENTRATIE
500mg
COMPR. FILM. FARA CONCENTRATIE

COMPR. FILM. 30mg
SOL. PERF.
CREMA
CREMA
CREMA
CREMA
CREMA
CREMA
SOL. CUT.
FLUOCINOLON ACETONID 0,025% UNGUENT
NIDOFLOR
CREMA
FLUOCINOLON N
UNGUENT
FLUOCINOLON N ATB 0,25 mg/5 mg/g UNGUENT
TRIAMCINOLON S
CREMA
DIPROSALIC
SOL. CUT.
DIPROSALIC
UNGUENT
COMBINATII (BETAMETHASONUM+ACIDUM SALICYLICUM) SAL-EKARZIN 0,50 mg/30 mg pe gram UNGUENT
COMBINATII
TRAVOCORT
CREMA
COMBINATII
TRAVOCORT
CREMA
ERYTHROMYCINUM
ERYFLUID
SOL. CUT.
ERYTHROMYCINUM
ERYFLUID
SOL. CUT.
COMBINATII
ZINERYT
PULB. + SOLV. SOL. CUT.
PIMECROLIMUS
ELIDEL 1% (10mg/g)
CREMA
METRONIDAZOLUM
FLAGYL
OVULE
CICLOPIROXUM
DAFNEGIN
OVULE
COMBINATII
TERGYNAN
COMPR. VAG.
NOMEGESTROLUM
LUTENYL (R)
COMPR.
GONADOTROPHINUM CHORIONICUM PREGNYL 5000
10mg/50ml
10mg/1g
10mg/g
2%
20mg/g
20mg/g
20mg/g
FARA CONCENTRATIE
0,025%
FARA CONCENTRATIE
0,25mg/5mg/g
0,25mg/5mg/g
FARA CONCENTRATIE
FARA CONCENTRATIE
FARA CONCENTRATIE
0,50mg/30mg pe gram
10mg/1mg/1g
10mg/1mg/1g
4g/30ml
4g/30ml
40mg/12mg/ml
10mg/g
500mg
100mg
FARA CONCENTRATIE
5mg
5000ui/ml
Prescriptie
Nr. crt
Tara det.
APP

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
compensare 100% din
din pretul de
aj
(RON)
referinta)
Ambalaj
AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 50 DRAJ. P6L
50
2,901600
NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 5 FIOLE PUNCT DE RUPERE X 5 ML P-RF
5 21,744000
TAKEDA AUSTRIA GMBH AUSTRIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA CU PUNCT DE RUPERE X 5 ML SOL. INJ. PR
5 21,744000
ZENTIVA S.A
ROMANIA CUTIE X 5 FIOLE X 2 ML SOL. INJ.
P-RF
5
1,396000
TERAPIA SA
P-RF
5
2,638000
ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 20 COMPR.
P-6L
20
0,400500
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. AL/PVC X 20 CAPS. ELIB. PREL. P-6L
100
0,286000
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L
30
0,343200
LAB. PIERRE FABRE FRANTA CUTIE X 3 BLIST. AL/PVDC-PE-PVC X 10 DRAJ. ELIB. PREL. P-6L
30
0,463333
VIFOR FRANCE S.A. FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MAST. P-6L
30
0,617333
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. X 10 CAPS. MOI
P-RF
50
0,497000
LABORATOIRE INNOTECH INTERNATIONAL FRANTA
P-6L
20
0,886500
ZENTIVA SA
P-RF
5
1,448000
FARMACEUTICA REMEDIA S.A. ROMANIA CUTIE X 5 FLAC. X 1 ML CONC. PT. SOL. PERF. S
5 332,144000
ANTIBIOTICE SA
ROMANIA CUTIE CU 2 FOLII TERMOFORMATE PVC X 3 SUPOZ. P-6L
6
1,210000
ANTIBIOTICE SA
P-6L
1 12,960000
INTENDIS GMBH
GERMANIA CUTIE X 2 FOLII X 5 SUPOZ.
P-RF
10
1,342000
INTENDIS GMBH
GERMANIA CUTIE X 1 TUB AL X 30 G + 1 CANULA PEJD P-RF
1 32,060000
OM PHARMA S.A.
PORTUGALIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT RECTAL + CANULA APLICATOARE
P-6L
1 21,660000
LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC. X 10 CAPS.
P-6L
30
0,742000
IPSEN PHARMA
FRANTA CUTIE X 3 BLIST. AL/PVC X 10 CAPS.
P-6L
30
0,890000
ZENTIVA S.A.
30
0,245666
BAYER PHARMA AG GERMANIA CUTIE CU 10 BLIST. AL/PP X 10 COMPR. FILM. P-RF 100
0,713400
BAYER PHARMA AG GERMANIA
S
5 29,144000
INTENDIS GMBH
GERMANIA CUTIE X 1 TUB, DIN AL X 20 G CREMA
P-RF
1 11,630000
BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 20 G CREMA
PRF
1 11,630000
TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB PEJD X 15 G
P-RF
1
3,470000
SC HYPERION SA ROMANIA CUTIE X 1 TUB DIN AL X 20 G CREMA
P-RF
1
4,640000
SC HYPERION SA ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA
P-RF
1
3,470000
CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF
1
4,164000
BIOFARM SA
ROMANIA CUTIE X 1 FLACON X 100 ML
P-RF
1 10,550000
LAROPHARM SRL ROMANIA CUTIE X 1 TUB AL X 20 G
P-RF
1
7,670000
ANTIBIOTICE SA
P-RF
1 10,370000
ANTIBIOTICE SA
P-RF
1
8,510000
ANTIBIOTICE SA
ROMANIA CUTIE CU 1 TUB DIN AL X 18 G UNG.
PRF
1
8,510000
ANTIBIOTICE SA
P-RF
1
9,340000
MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DIN PEID X 30 ML SOL. CUT., PREVAZUT CU PICURATOR P-RF
1
6,270000
MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF
1
3,420000
ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 TUB AL X 15 G UNGUENT
P-RF
1
7,260000
INTENDIS GMBH
P-RF
1 26,150000
BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA
P-RF
1 26,150000
FRANTA CUTIE X 1 FLACON X 100 ML SOL. CUT. P-RF
1 21,790000
FRANTA CUTIE X 1 FLACON X 30 ML SOL. CUT. P-RF
1
8,400000
ASTELLAS PHARMA EUROPE BV OLANDA
P-RF
1 27,380000
MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 TUB AL X 30 G CREMA
P-RF
1 124,050000
LAB. AVENTIS
FRANTA CUTIE X 2 BLIST. X 5 OVULE
P-RF
10
0,884000
POLICHEM SA
LUXEMBURG CUTIE X 1 FOLIE. TERMOSUDATA DIN PVC/PE X 6 OVULE + 6 APLICATOARE DIN PE
P-6L
6
6,000000
LAB. BOUCHARA-RECORDATI FRANTA CUTIE X 1 FOLIE HARTIE/PE/AL/PE X 10 COMPR. VAG. P-RF
10
2,613000
LAB. THERAMEX
MONACO CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P6L
10
1,943000
NV ORGANON
OLANDA
S/P-RF
1 15,180000
Detinator APP
TAKEDA AUSTRIA GMBH
CUTIE X 5 CUTII X 1 FLACON DIN STICLA DE CULOARE BRUNA X 50 ML + 1 PERFUZOR DIN POLIETILENA
CUTIE X 1 FLAC. DIN PEID PULB. PT. SOL. CUTANATA + APLICATOR DIN PP CU SOLV. PT 30 ML SOL. CUTANATA
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.
Pagina 2 din 5
2,901600
21,744000
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
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
0,000000
0,000000
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
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
92
93
94
95
96
97
98
99
cod
ATC
G03GA02
G04BCN1
H03AA03
J01DB04
DCI
MENOTROPINUM
COMBINATII
COMBINATII
CEFAZOLINUM
J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM)

100 J01EB05
101 J01GB03
102 J01GB03
103 J01GB03
104 J01XB01
105 J02AC03
106 J02AC03
107 J02AC03
108 M01AA01
109 M01AB55
110 M01AB55
111 M01AB55
112 M01AB55
113 M01AB55
114 M01AB55
115 M01AB55
116 M01AE01
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 M01AE02
130 M01AE02
131 M01AE02
132 M01AE02
133 M01AE02
134 M01AE02
135 M01AG01
136 M01AH04
137 M01AH04
138 M03BB03
139 M03BB03
140 M03BB03
141 M03BX04
SULFAFURAZOLUM
GENTAMICINUM
GENTAMICINUM
GENTAMICINUM
COLISTINUM
VORICONAZOLUM**
VORICONAZOLUM**
VORICONAZOLUM**
PHENYLBUTAZONUM
COMBINATII
COMBINATII
COMBINATII
COMBINATII
Denumire Comerciala
MENOPUR
URALYT-U
NOVOTHYRAL (R) 100
LYZOLIN 1g
SULCEF 1000 mg/1000 mg
forma farm.
concentratie
FARA CONCENTRATIE
GRANULE
COMPR.
FARA CONCENTRATIE
100mcg+20mcg
PULB. PT. SOL. INJ.
1g
1000mg/1000mg
1000mg/1000mg
1000mg/1000mg
1000mg/1000mg
FERRING GMBH
MADAUS GMBH
MERCK KGAA
SC ANSAMED SRL
MEDOCHEMIE S.R.L.
MEDOCHEMIE S.R.L.
MEDOCHEMIE S.R.L.
MEDOCHEMIE S.R.L.
Tara det.
APP
Ambalaj
GERMANIA
CUTIE X 10 FLAC. DIN STICLA INCOLORA CU LIOF. + 10 FIOLE X 1 ML SOLV. PT. SOL. INJ. S/P-RF
GERMANIA
CUTIE X 1 FLAC. PP X 280 G GRANULE + 1 LINGURITA DOZATOARE + 1 CALENDAR DE CONTROL + HARTIE INDICATO
P-6L
GERMANIA
CUTIE X 4 BLIST. AL/PP X 25 COMPR.
P-6L
ROMANIA CUTIE X 1 FLACON

PR
ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF
ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF.
S
SULFAFURAZOL ARENA 500 mg COMPR.
ARENA GROUP SA
GENTAMICIN KRKA
GENTAMICIN KRKA
GENTAMICIN KRKA
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF
COLISTINA ANTIBIOTICE 1000000 UI
VFEND 200mg
VFEND 50mg
VFEND 40 mg/ml
FENILBUTAZONA 250 mg
TRATUL PLUS
TRATUL PLUS
NEODOLPASSE 0,30 mg+0,12 mg/ml
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 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
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
500mg
40mg/ml
80mg/2ml
80mg/2ml
1000000ui
COMPR. FILM. 200mg
COMPR. FILM. 50mg
40mg/ml
SUPOZ.
250mg
Detinator APP
Prescriptie
Nr. crt
SOL. INJ.
SOL. INJ.
SOL. INJ.
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.
SOL. PERF.
SUPOZ.
0,30mg+0,12mg/ml FRESENIUS KABI AUSTRIA GMBH
CAPS. ELIB. MODIF.

CAPS. ELIB. MODIF.
75mg/20mg
75mg/20mg
COMPR. GASTROREZ.
75mg+0,200mg PFIZER EUROPE MA EEIG
CAPS. ELIB. PREL.
300mg
400mg
400mg
400mg
400mg
400mg
600mg
600mg
600mg
100mg/5ml
100mg/5ml
100mg/5ml
100mg/5ml
250mg
500mg
275mg
275mg
550mg
550mg
500mg
40mg
40mg
250mg
250mg
250mg
150mg
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
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
PULB. PT. SOL. INJ.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
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
ANTIBIOTICE SA
ROMANIA
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. 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
S
P-RF
P-RF
P-RF
AUSTRIA
AUSTRIA
AUSTRIA
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
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
P6L
REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 CAPS. ELIB. MODIFICATA
P6L
MAREA BRITANIE
CUTIE X 2 BLIST. AL X 10 COMPR. GASTROREZ.
P-6L
TERAPIA SA
ROMANIA CUTIE X 1 BLIST. X 10 CAPS. ELIB. PREL. P-6L

ABBOTT SCANDINAVIA AB SUEDIA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L
ABBOTT SCANDINAVIA AB SUEDIA CUTIE CU BLIST. AL/PVC X 60 COMPR. FILM. P-6L
ABBOTT SCANDINAVIA AB
ABBOTT SCANDINAVIA AB
SUEDIA
SUEDIA

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

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

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
compensare 100% din
din pretul de
aj
(RON)
referinta)
10 78,451000
1 59,060000
100
0,300300
1
7,410000
1 23,076840
10 22,818000
50 19,939200
100 19,230700
20
0,655500
10
0,740000
50
0,860600
10
0,994000
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
0,234000
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
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
78,451000
59,060000
0,300300
7,410000
23,076840
22,818000
19,939200
19,230700
0,655500
0,740000
0,860600
0,994000
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
0,234000
0,234000
0,234000
0,234000
0,195000
0,380000
0,456000
0,456000
6,920000
6,920000
6,920000
6,920000
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
0,000000
0,000000
3,103160
0,000000
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
0,065333
0,065666
0,065333
0,065666
0,000000
0,000000
0,429333
0,088500
0,000000
0,000000
0,000000
0,000000
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
142 M03BX04
143 M03BX04
DCI
TOLPERISONUM
TOLPERISONUM
ACIDUM HIALURONICUM
Denumire Comerciala
MYDOCALM
MYDOCALM
HYALGAN (R)
ULTRACOD 500 mg/30 mg
PARADOREN 500mg/30mg
PARADOREN 500mg/60mg
ALGOCALMIN (R) 500 mg
ALINDOR
SINTOCALMIN
NOVOCALMIN

COMPR. FILM. 150mg
COMPR. FILM. 50mg
181 R01AD07
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
MIDAZOLAMUM
MIDAZOLAMUM
MIDAZOLAMUM
CINOLAZEPAMUM
METHYLFENIDATUM***
METHYLFENIDATUM***
METHYLFENIDATUM***
ATOMOXETINUM***
ATOMOXETINUM***
ATOMOXETINUM***
ATOMOXETINUM***
ATOMOXETINUM***
ATOMOXETINUM***
PYRITINOLUM
PYRITINOLUM
PYRITINOLUM
PYRITINOLUM
CINNARIZINUM
CINNARIZINUM
CINNARIZINUM
TENONITROZOLUM
PYRANTELUM
TIXOCORTOLUM
182 R01ADN1
COMBINATII (BETAMETHASONUM+TETRYZOLINUM)
SOL. INJ.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
METAMIZOL FARMACOM 500 mg COMPR.
ALGOBLOCK
COMPR.
ALGOZONE 500mg
COMPR.
ALVOTOR 500 mg/ml
PIC. ORALE, SOL.
ALGOCALMIN (R) 1 g/2 ml SOL. INJ.
SINTOCALMIN 300 mg
SUPOZ.
NOVOCALMIN 300 mg
SUPOZ.
DORMICUM (R)
COMPR. FILM.
DORMICUM (R)
SOL. INJ.
MIDAZOLAM TORREX 1 mg/ml SOL. INJ.
GERODORM (R)
COMPR.
CONCERTA 18 mg
CONCERTA 36 mg
CONCERTA 54 mg
STRATTERA 10 mg
CAPS.
STRATTERA 18 mg
CAPS.
STRATTERA 25 mg
CAPS.
STRATTERA 40 mg
CAPS.
STRATTERA 60 mg
CAPS.
STRATTERA 80 mg
CAPS.
PIRITINOL ARENA 100 mg DRAJ.
ENCEPHABOL 100 mg
DRAJ.
ENCEPHABOL 200 mg
DRAJ.
ENCEPHABOL 80,5 mg/5 ml SUSP. ORALA
CINARIZINA ARENA 25 mg CAPS.
STUGERON 25 mg
COMPR.
CINARIZIN 25 mg
COMPR.
ATRICAN 250 mg
HELMINTOX (R)
SUSP. ORALA
PIVALONE 0,9mg/pulverizare SPRAY NAZAL SUSPENSIE
BIORINIL
SPRAY NAZ.,SUSP.
183 R01BA52
COMBINATII (DESLORATADINUM+ PSEUDOEPHEDRINE)
AERINAZE (vezi R06AX27) 2,5mg/120mg
184 R01BA52
COMBINATII (LORATADINUM+PSEUDOEFEDRINUM)
185 R02AB03
FUSAFUNGINUM
144 M09AX01
145 N02AA59 COMBINATII ( PARACETAMOLUM + CODEINUM)

146 N02AA59 COMBINATII ( PARACETAMOLUM+CODEINUM)
147 N02AA59 COMBINATII ( PARACETAMOLUM+CODEINUM)
148 N02BB02
149 N02BB02
150 N02BB02
151 N02BB02
152 N02BB02
153 N02BB02
154 N02BB02
155 N02BB02
156 N02BB02
157 N02BB02
158 N02BB02
159 N05CD08
160 N05CD08
161 N05CD08
162 N05CD13
163 N06BA04
164 N06BA04
165 N06BA04
166 N06BA09
167 N06BA09
168 N06BA09
169 N06BA09
170 N06BA09
171 N06BA09
172 N06BX02
173 N06BX02
174 N06BX02
175 N06BX02
176 N07CA02
177 N07CA02
178 N07CA02
179 P01AX08
180 P02CC01
186 R03CA02
187 R03CA02
188 R03CA02
189 R03DX05
190 R03DX05
191 R05CB01
CLARINASE 5 mg/120 mg
BIOPAROX
EPHEDRINI HYDROCHLORIDUM EFEDRINA ARENA
EPHEDRINI HYDROCHLORIDUM EFEDRINA 50 mg/ ml
COMPR. ELIB. MODIF.

SPRAY BUCOFARINGIAN SI NAZAL-SOL.
COMPR.
SOL. INJ.
EPHEDRINI HYDROCHLORIDUM EFEDRINA ZENTIVA 50 mg/ ml SOL. INJ.
OMALIZUMABUM**
XOLAIR 150 mg
SOL INJ.
OMALIZUMABUM**
XOLAIR 75 mg
SOL INJ.
ACETYLCYSTEINUM
ACC INJECT 300mg/3ml
SOL. INJ./ SOL. PT. INHALAT PRIN NEBULIZATOR
20mg/2ml
Detinator APP
CSC PHARMACEUTICALS HANDELS GMBH
500 mg/30 mg ZENIVA K.S.

500mg+30mg ARENA GROUP S.A.
500mg+60mg ARENA GROUP S.A.
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg/ml
1g/2ml
300mg
300mg
7,5mg
1mg/ml
1mg/ml
40mg
18mg
36mg
54mg
10mg
18mg
25mg
40mg
60mg
80mg
100mg
100mg
200mg
80,5mg/5ml
25mg
25mg
25mg
250mg
125mg/2,5ml
ZENTIVA S.A.
LAROPHARM SRL
SINTOFARM SA
ANTIBIOTICE SA
FARMACOM SA
BIOFARM S.A.
ZENTIVA S.A.
SINTOFARM SA
ANTIBIOTICE S.A.
ROCHE ROMANIA S.R.L.
ROCHE ROMANIA S.R.L.
ELI LILLY AND COMPANY LTD.
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
ARENA GROUP S.A.

MERCK KGAA
MERCK KGAA
MERCK KGAA
ARENA GROUP SA
TERAPIA SA
LAROPHARM SRL
LAB. INNOTECH INT.
LAB. INNOTECH INT.
ROMANIA CUTIE X 3 BLIST. X 10 DRAJ.
P-6L
CUTIE CU 5 BLIST. PVC/AL X 10 DRAJ.

GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 DRAJ.
P6L
P6L
P6L

THEA FARMA SPA
2,5mg/120mg MERCK SHARP & DOHME
5mg/120mg
50mg/10ml
50mg
50mg/ml
50mg/ml
150mg
75mg
300mg/3ml
Tara det.
APP
Ambalaj
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.FILM. P-6L
AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 2 ML P-RF
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR.
PRF
P-RF
P-RF
ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF
P-RF
ROMANIA CUTIE X 2 BLIST., PVC/AL X 10 COMPR. P-RF
ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF
ROMANIA CUTIE X 2 BLIST.PVC-PVDC/AL A CATE 10 COMPR. P-RF
ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, PREVAZUT CU PICURATOR DIN PEJD A 100 ML PIC. ORALE, SOL. P6L
ROMANIA CUTIE X 2 BLIST. PVC/PE X 3 SUPOZ.
P-RF
ROMANIA CUTIE CU 2 FOLII TERMOSUDATE, OPACE DIN PVC X 6 SUPOZ. PRF
ROMANIA CUTIE X 1 BLIST. PVC/PVDC/AL X 10 COMPR. FILM. P-RF
S/P-RF
AUSTRIA CUTIE X 10 FIOLE X 5 ML SOL. INJ.

AUSTRIA CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR.
BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL.
CHIESI PHARMACEUTICALS GMBH
0,9mg/pulverizare PFIZER EUROPE MA EEG
0,5 mg/1 mg/ ml
Prescriptie
Nr. crt
CUTIE X 1 BLIST. PVC-PE-PCTFE/AL X 7 CAPS.

CUTIE X 4 BLIST. PCTFE-PE-PVC/AL X 7 CAPS.
GERMANIA
GERMANIA
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

P-RF
PR, PS
PR, PS
PR, PS
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF/R
P-6L
P-6L
P-6L
FRANTA
FRANTA
CUTIE X 1 FLACON X 15 ML + LINGURITA DOZATOARE X 2,5 ML
P-RF
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
CUTIE X 1 BLIST. AL/PVC X 8 CAPS. MOI GASTROREZ. P-RF
MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 COMPR. ELIB. MODIF.
S/P-RF
FRANTA
CUTIE X 1 FLACON PRESURIZAT DIN AL X 10 ML SOL. + 3 APLIC. DIN PE: 1 APLIC. BUCAL (ALB) + 2 APLIC.
P-6L
P-RF

ZENTIVA S.A.
ROMANIA CUTIE X 5 FIOLE CU INEL DE RUPERE X 1ML SOL. INJ S
ZENTIVA S.A.
ROMANIA CUTIE X 5 FIOLE CU INEL DE RUPERE X 1ML SOL. INJ S
NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA X 1ML SOLUTIE INJECTABILA
PR
NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA X 0.5ML SOLUTIE INJECTABILA PR
HEXAL AG
GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. S/P-RF
Pagina 4 din 5

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
compensare 100% din
din pretul de
aj
(RON)
referinta)
20
0,509000
30
0,252666
1 127,790000
30
0,793200
20
0,661000
20
1,028500
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
2,124000
10
1,770000
30
0,797000
30
2,966666
30
4,681333
30
6,082000
7 13,407142
7 13,491428
28 12,654285
28 12,654285
28 12,654285
28 15,916785
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
1 1.536,080000
1 855,380000
5
1,566000
0,509000
0,252666
127,790000
0,793200
0,661000
1,028500
0,384600
0,384600
0,342000
0,384600
0,326000
0,320500
0,353000
28,460000
1,226000
1,261666
1,253333
0,578000
2,124000
1,770000
0,797000
2,966666
4,681333
6,082000
13,407142
13,491428
12,654285
12,654285
12,654285
15,916785
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
1.536,080000
855,380000
1,566000
0,000000
0,000000
0,000000
0,333466
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
0,790000
0,000000
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
cod
ATC
192 R05CB01
193 R05CB01
194 R05CB03
195 R05CB03
196 R05CB03
197 R06AD02
198 R06AE05
199 R06AX02
200 R06AX02
201 R06AX13
202 R06AX13
203 R06AX13
204 S01AA01
205 S01AA13
206 S01AA24
207 S01AA30
208 S01BA07
209 S01BC01
210 S02CA05
211 S02CA05
DCI
ACETYLCYSTEINUM
ACETYLCYSTEINUM
CARBOCISTEINUM
CARBOCISTEINUM
CARBOCISTEINUM
PROMETHAZINUM
MECLOZINUM
CYPROHEPTADINUM
CYPROHEPTADINUM
LORATADINUM
LORATADINUM
LORATADINUM
CHLORAMPHENICOLUM
ACIDUM FUSIDICUM
KANAMYCINUM
COMBINATII
FLUOROMETHOLONUM
INDOMETACINUM
COMBINATII
COMBINATII
Denumire Comerciala
forma farm.
FLUIMUCIL 2% PEDIATRIC SOL. ORALA
FLUIMUCIL
RHINATHIOL 100mg/5ml pentru copii SIROP
RHINATHIOL 2% pentru copii si sugari SIROP
FLUIDOL 100mg/5ml
SOL. ORALA
ROMERGAN
SIROP
EMETOSTOP
COMPR.
PERITOL
COMPR.
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.
SOL.INJ./INHAL.NEBULIZ./INSTILATIE ENDOTRAHEOBRON.
SOLUTIE AURICULARA CU CLORAMFENICOL SI FLUOCINOLON
SOL. AURICULARA
concentratie
2%
300mg/3ml
100 mg/5 ml
2%
100mg/5ml
5mg/5ml
30mg
4mg
4mg
1mg/ml
5mg/5ml
5mg/5ml
4mg/ml
10mg/g
1%
FARA CONCENTRATIE
2mg/ml
0,1%
FARA CONCENTRATIE
FARA CONCENTRATIE
Detinator APP
Tara det.
APP
ZAMBON S.P.A.
ZAMBON S.P.A.
ITALIA
ITALIA
SANOFI-AVENTIS OTC FRANTA
SANOFI-AVENTIS OTC FRANTA
TIS FARMACEUTIC SA ROMANIA
BIOFARM S.A.
ROMANIA
Ambalaj
Prescriptie
Nr. crt
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 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
SPECIFAR SA
GRECIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR.

UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
P-RF
P-6L
P-6L
MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON X 120 ML + LINGURITA DOZATOARE P-6L
BIOFARM S.A.
ROMANIA
LEK PHARMACEUTICALS D.D.
SLOVENIA
S.I.F.I. SPA
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
CUTIE X 1 FLACON DIN STICLA BRUNA X 120 ML SUSP. ORALA + LINGURITA DOZATOARE
P-RF
P-6L
ITALIA
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
S.I.F.I. SPA
ITALIA
CUTIE X 1 FLACON X 5 ML SOLV. + PLIC REZERVOR PULBERE + DISP. PICURARE
THEA FARMA SPA ITALIA
CUTIE X 1 FLACON PEJD X 10ML PIC. OFT. SUSP.
LAB. CHAUVIN
FRANTA CUTIE X 1 FLACON PICURATOR DIN POLIETILENA X 5 ML
P-RF
TIS FARMACEUTIC SA ROMANIA

BIOFARM SA
ROMANIA
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
CUTIE X 1 FLAC. STICLA BRUNA X 5 ML SOLV. + O PUNGA X UN REZERVOR CU PULB. + UN PICURATOR
P-6L
P-RF
P-RF
P-RF
P-6L
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

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
compensare 100% din
din pretul de
aj
(RON)
referinta)
1
5
1
1
1
1
10
20
30
1
1
1
1
1
1
1
1
1
1
1
13,620000
1,710000
9,520000
9,520000
4,160000
2,910000
0,373000
0,168500
0,169333
12,756000
7,350000
10,630000
20,030000
13,980000
6,640000
33,280000
33,220000
14,500000
4,212000
3,510000
13,620000
1,710000
9,520000
9,520000
4,160000
2,910000
0,373000
0,168500
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
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
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.
cod ATC
DCI
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
A02BA02
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
TRIMETAZIDINUM
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
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
C01EB15
C04AE02
C04AE02
C04AE02
C04AE02
C04AE02
C04AE02
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
FAMOTIDINA ZENTIVA 40 mg
FAMODIN 40 mg
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 ATB 35 mg
PREDUCTAL MR 35 mg
TRIMELUZINE 35 mg
MODUXIN MR 35 mg
TRIMETAZIDINA TEVA 35 mg
MODUXIN (R) 20 mg
SOL. INJ.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
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. ELIB. PREL.
COMPR. FILM.
TRIMETAZIDINA LPH (R) 20 mg COMPR. FILM.
PREDUCTAL 20 mg
COMPR. FILM.
DILATAN 20 mg
COMPR. FILM.
TRIMETAZIDINA LPH (R) 35 mg COMPR. FILM. ELIB. MODIF.
PREDUTRIM 20 mg/ml
NICERIUM (R) 15
NICERIUM (R) 30 UNO
NICERGOLINA LPH 10 mg
GRALIN 10 mg
SERMION
NICERGOLINA LPH 30 mg
PIC. ORALE, SOL.

CAPS. ELIB. MODIF.
CAPS. ELIB. MODIF.
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
35mg
20mg/ml
15mg
30mg
10mg
10mg
30mg
30mg
tara det.
APP
Detinator APP
Ambalaj
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS.

ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR.
SLAVIA PHARM SRL 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 OCTOMBRIE 2015
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
ROMANIA
ROMANIA
ZENTIVA S.A
ROMANIA
ZENTIVA S.A
ROMANIA
KRKA D.D.
SLOVENIA
ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA
ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA
E.I.P.I.CO. MED SRL ROMANIA
MAGISTRA C & C
ROMANIA
MAREA BRITANIE
MAREA BRITANIE
P-6L
CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L

CUTIE CU 3 BLISTERE DIN FOLIE PVC-PVDC/AL X 10 COMPR. FILM. P-6L
P-RF

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

CUTIE X 3 BLIST. X 10 CAPS. ELIB. PREL.
CUTIE X 2 BLIST. X 15 CAPS. ELIB. PREL.
CUTIE X 2 BLIST., AL/PVC X 10 DRAJ.
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

CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L
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 CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. ORODISP.
P6L
ANTIBIOTICE S.A.
ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. CU ELIB. PREL. P6L
FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. FILM. ELIB. MODIF. P-6L
SANDOZ S.R.L.
ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 60 COMPR. ELIB. PREL. P6L
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. CU ELIB. PRELUNG. P6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL.
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. P-6L
TERAPIA SA
LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. MODIF. P-6L
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID + APLICATOR PT. PICURARE DIN PEJD X 50 ML PIC. ORALEP6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. PP/AL X 10 CAPS. ELIB. MODIF. P-6L
HEXAL AG
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
MAREA BRITANIE
CUTIE X 2 BLIST. PVC-PVDC/AL-PVC X 15 COMPR. FILM
P-6L
Pagina 1 din 3
cant.
Pret de
UT/
(RON)
aj
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
30
60
60
30
60
30
60
60
30
60
1
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
0,401000
0,401166
0,380333
0,401000
0,401166
0,229238
0,229238
0,229238
0,229238
0,401166
11,461900
0,450166
0,900333
0,300111
0,300111
0,900333
0,900333
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 20% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 20%
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
0,000000
0,196334
0,000000
0,000000
0,000167
0,034095
0,034262
0,175928
0,034095
0,000167
0,868100
0,514500
0,000000
0,165222
0,162555
0,440333
0,000000
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
0,080200
0,080233
0,076066
0,080200
0,080233
0,045847
0,045847
0,045847
0,045847
0,080233
2,292380
0,090033
0,180066
0,060022
0,060022
0,180066
0,180066
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
0,320800
0,517267
0,304267
0,320800
0,321100
0,217486
0,217653
0,359319
0,217486
0,321100
10,037620
0,874633
0,720267
0,405311
0,402644
1,160600
0,720267
cod ATC
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
C04AE02
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
M01AC01
M01AX17
M01AX17
M01AX17
M01AX17
M01AX17
M01AX17
M01AX17
M01AX17
M05BA06
M05BA06
M05BA06
M05BA06
M05BA06
M05BA06
M05BA06
M05BA06
100 M05BA06
101 M05BA06
102 M05BA06
103 M05BX03
104 N03AE01
105 N03AE01
DCI
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
VINCAMINUM
VINCAMINUM
DIOSMINUM (COMBINATII)**
Denumire Comerciala
Prescriptie
Nr crt.
cant.
UT/
Pret de
tara det.
(RON)
aj
Detinator APP
APP
Ambalaj
COMPR. FILM. 30mg
30
0,900333
COMPR. FILM. 5mg
30
0,150055
GRALIN 30 mg
GRALIN 5 mg
NICERIUM (R) 10
DRAJ.
SINERGOLIN 30
DRAJ.
SINERGOLIN 30
DRAJ.
OXYBRAL SR 30 mg
CAPS. ELIB. PREL.
VINCAMINA
DRAJ.
DETRALEX ( R )
COMPR. FILM.
ACID OMEGA-3-ESTERI ETILICI 90** TEVOCOR 1000 mg
CAPS. MOI
ACID OMEGA-3-ESTERI ETILICI 90** OMACOR (R)
CAPS. MOI
ACICLOVIRUM
ZOVIRAX
CREMA
ACICLOVIRUM
ACICLOVIR 50mg/g
CREMA
ACICLOVIRUM
ACICLOVIR 50mg/g
CREMA
ACICLOVIRUM
ACICLOVIR SLAVIA 50 mg/g CREMA
ACICLOVIRUM
ACICLOVIR-RICHTER 50mg/g CREMA
ACICLOVIRUM
ACICLOVIR HYPERION
CREMA
ACICLOVIRUM
ACICLOVIR TIS 50mg/g
CREMA
ACICLOVIRUM
ACICLOVIR SLAVIA 50 mg/g CREMA
ACICLOVIRUM
ACICLOVIR TERAPIA 50 mg/g CREMA
ACICLOVIRUM
ACICLOVIR-RICHTER 50mg/g CREMA
CALCITONINUM (SOMON)
NYLEX (R)
SOL. INJ.
CALCITONINUM (SOMON)
MIACALCIC (R)
SOL. INJ.
PIROXICAMUM
PIROXSAL 20 mg
COMPR.
PIROXICAMUM
FLAMEXIN
COMPR.
PIROXICAMUM
FLAMEXIN
COMPR.
PIROXICAMUM
PIROXICAM ARENA 20 MG COMPR.
PIROXICAMUM
PIROXICAM HELCOR 20 mg COMPR.
PIROXICAMUM
FLAMEXIN
COMPR. EFF.
PIROXICAMUM
FLAMEXIN
COMPR. EFF.
PIROXICAMUM
FLAMEXIN
COMPR. EFF.
PIROXICAMUM
FLAMEXIN (R)
PIROXICAMUM
HOTEMIN
SOL. INJ.
PIROXICAMUM
PIROXICAM ATB 20 mg
SUPOZ.
PIROXICAMUM
PIROXICAM ATB 20 mg
SUPOZ.
PIROXICAMUM
PIROXICAM SINTOFARM 20 mg SUPOZ.
NIMESULIDUM
LEMESIL
COMPR.
NIMESULIDUM
NIMESULID 100 mg
COMPR.
NIMESULIDUM
NIMESULID SLAVIA
COMPR.
NIMESULIDUM
APONIL
COMPR.
NIMESULIDUM
APONIL
COMPR.
NIMESULIDUM
NIMESULID ARENA 100 mg COMPR.
NIMESULIDUM
NIMELID 100 mg/plic
GRANULE PT. SUSP. ORALA
NIMESULIDUM
NIMELID 100 mg/plic
GRANULE PT. SUSP. ORALA
ACIDUM IBANDRONICUM**
ACID IBANDRONIC TEVA 150 mg COMPR. FILM.
BONVIVA 150mg
COMPR. FILM.
OSSICA 150 mg
COMPR. FILM.
QUODIXOR 150 mg
COMPR. FILM.
OSAGRAND 150 mg
COMPR. FILM.
ACID IBANDRONIC SANDOZ 150 mg COMPR. FILM.
ACID IBANDRONIC AUROBINDO 150 mg COMPR. FILM.
OSSICA 3 mg
ACID IBANDRONIC TEVA 3 mg
OSAGRAND 3 mg/3 ml
SOL. INJ.
BONVIVA 3mg/3ml
STRONTIUM RANELATUM
OSSEOR 2 g
CLONAZEPAMUM
RIVOTRIL
COMPR.
CLONAZEPAMUM
RIVOTRIL 2 mg
COMPR.
SOL INJ. IN SERINGA PREUMPLUTA
SOL INJ. IN SERINGA PREUMPLUTA
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
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
150mg
3mg
3mg
3mg/3ml
3mg/3ml
2g
0,5mg
2mg
HEXAL AG
SINTOFARM SA
SINTOFARM SA
GERMANIA CUTIE X 1 BLIST. AL/PVC X 25 DRAJ.
P-6L

P-6L
ROMANIA
ROMANIA
GLAXOSMITHKLINE (GSK) SRL ROMANIA
BIOFARM SA
ROMANIA
FRANTA
PRONOVA BIOPHARMA NORGE A.S.

SLAVIA PHARM S.R.L.

HYPERION S.A.
TIS FARMACEUTIC SA
SLAVIA PHARM S.R.L.
TERAPIA S.A.
PROEL E.P. CORONIS SA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
GRECIA

ITALIA
AC HELCOR PHARMA S.R.L. ROMANIA
ANTIBIOTICE S.A.
ROMANIA
ANTIBIOTICE S.A.
ROMANIA
SINTOFARM SA
ROMANIA
MAGISTRA C & C
ROMANIA
P-6L

CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. PRF
NORVEGIA FALC. DIN PEID X 28 CAPS. MOI
P-6L
CUTIE X 1 BLIST. AL/PVC-PVDC X 10 CAPS. CU ELIB. PREL. P-6L
P-RF
CUTIE X 1 TUB X 5G CREMA

P-RF
CUTIE X 1 TUB X 5 G CREMA
P-RF
CUTIE X 1 TUB X 15 G CREMA
P-RF
P-RF
PRF
P-RF
CUTIE X 1 TUB DIN PEJD X 15 G CREMA P-RF
P-RF
CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF
PRF
CUTIE X 5 FIOLE X 1ML
P-RF
P-RF
CUTIE X 2 BLIST.PVC/ AL X 10 COMPR. P-6L
CUTIE X 3 BLIST. PVC-PDVC/AL-LAC PVDC X 10 COMPR. P-6L
CUTIE X 1 BLIST. PVC-PDVC/AL-LAC PVDC X 10 COMPR. P-6L

P-6L
CUTIE X 1 BLIST. AL-PE/AL X 10 COMPR. EFF.

P-6L
P6L
P-6L
P-6L
CUTIE X 20 PLICURI DUBLU COMPARTIMENTAT X 3 G PULB. PT. SOL. ORALAP-6L
CUTIE X 1 BLIST. C-PET/PE X 5 FIOLE X 1 ML SOL. INJ.
P-RF
CUTIE CU 2 FOLII TERMOSUDATE PVC X 3 SUPOZ. P6L
P6L
CUTIE X 2 FOLII TERMOSUDATE X 5 SUPOZ. P-6L
CUTIE CU 1 FOLIE TERMOSUDATA PVC X 6 SUPOZ.

P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
PRF
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
CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 1 COMPRIMAT FILMAT
P6L
CUTIE X 1 COMPR. FILM.( BLIST. AL/AL)
P-6L
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.
MAREA BRITANIE
REPUBLICA CEHA
ROMANIA
ZENTIVA K.S.
REPUBLICA CEHA
LES LAB. SERVIER
P6L
P6L
CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. + 1 AC PT. INJECTIE
P6L
CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. SI UN AC DE INJECTARE
P6L
CUTIE CU 1 FIOLA DIN STICLA INCOLORA X 3 ML SOL. INJ. P6L
CUTIE CU 1 BLIST. PA-AL-PVC/AL X 1 COMPR. FILM.
MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA DIN STICLA X 3 ML SOL. INJ. + 1 AC
FRANTA
P-6L
P-6L
CUTIE X 28 PLICURI HARTI-PE-AL/PE GRAN. PT. SUSP. ORALA P-RF
P-RF
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 30 COMPR.
P-RF
Pagina 2 din 3
25
30
20
10
20
30
30
28
1
1
1
1
1
1
1
1
1
1
5
5
20
30
10
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
1
28
50
30
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
0,324000
0,128000
0,222000
0,324000
0,324000
0,324000
0,324000
1,768500
0,759249
0,759249
0,732000
0,356400
0,356400
0,356400
0,356400
0,356400
0,356400
0,356400
0,356400
28,261766
28,261766
28,261766
28,261766
28,261766
28,261766
28,261766
104,030000
100,840000
104,810000
141,268500
5,203214
0,069873
0,225000
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)

beneficiaza de
compensare 20% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 20%
din pretul de
referinta)
0,000000
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
0,818000
0,000000
0,000000
1,231000
1,230500
1,181000
1,031000
0,441500
0,009084
0,009084
0,000000
0,040600
0,039600
0,039600
0,039600
0,039600
0,039600
0,039600
0,039600
7,138234
61,478234
7,418234
7,408234
7,418234
7,418234
6,778234
0,000000
0,000000
0,000000
11,631500
0,000000
0,071927
0,000000
0,180066
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
0,064800
0,025600
0,044400
0,064800
0,064800
0,064800
0,064800
0,353700
0,151849
0,151849
0,146400
0,071280
0,071280
0,071280
0,071280
0,071280
0,071280
0,071280
0,071280
5,652353
5,652353
5,652353
5,652353
5,652353
5,652353
5,652353
20,806000
20,168000
20,962000
28,253700
1,040642
0,013974
0,045000
0,720267
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
1,077200
0,102400
0,177600
1,490200
1,489700
1,440200
1,290200
1,856300
0,616484
0,616484
0,585600
0,325720
0,324720
0,324720
0,324720
0,324720
0,324720
0,324720
0,324720
29,747647
84,087647
30,027647
30,017647
30,027647
30,027647
29,387647
83,224000
80,672000
83,848000
124,646300
4,162572
0,127826
0,180000
cod ATC
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 N06BX03
123 N06BX03
124 N06BX03
125 R05CB15
126 R05CB15
127 R05CB15
DCI
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
ERDOSTEINUM**
ERDOSTEINUM**
ERDOSTEINUM**
Denumire Comerciala
PIRACETAM ARENA 400 mg

PIRACETAM SLAVIA 400 mg
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
Prescriptie
Nr crt.
tara det.
Detinator APP
APP
CAPS.
400mg
COMPR.
400mg
COMPR.
400mg
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
CUTIE X 4 BLIST. DIN PVC/AL X 10 COMPR. P-6L

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

CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ.
AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS.

CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE CU 20 PLICURI UNIDOZA DIN HARTIE AL/PE
CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA
CSC PHARMACEUTICALS HANDELS GMBH
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.
Pret de
UT/
(RON)
aj
30
40
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
0,099674
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)

beneficiaza de
compensare 20% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 20%
din pretul de
referinta)
0,265992
0,019326
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
0,019934
0,019934
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
0,345732
0,099066
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

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ANEXA 2a

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

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

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

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

LEK PHARMACEUTICALS D.D. SLOVENIA

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

Val. maxima suportata de

MESALAZINA SOFARFARM 400 mg

B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

FERGLUROM FORTE 50 mg/ml

B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

FERRUM HAUSMANN (R)

B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM)

PROPAFENONA ARENA 150 mg

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

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

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

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

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

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

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

Val. maxima suportata de

ISOSORBID DINITRAT 10 mg COMPR.

ABBOTT LABORATORIES GMBH

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

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

KRKA D.D. NOVO MESTO SLOVENIA

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

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

GEDEON RICHTER ROMANIA SA

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

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

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

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

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

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

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

Val. maxima suportata de

AC HELCOR PHARMA SRL

BIO EEL S.R.L.

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

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

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

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

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

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

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

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

WORWAG PHARMA GMBH & CO. KG

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

EGIS PHARMACEUTICALS P.L.C.

Val. maxima suportata de

CARVEDILOL SANDOZ 12,5 mg COMPR.

DILATREND (R) 12,5 mg

CARVEDILOL AUROBINDO 12,5mg COMPR. FILM.

ACTAVIS GROUP PTC EHF.

LABORMED PHARMA S.A.