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ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator...

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Page 1: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)
Page 2: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)
Page 3: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

ANEXA 2a

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

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din pretul de referinta)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 90% din pretul de

referinta)

SE ELIMINA

43 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 0,788600 0,000000 0,709740 0,078860132 C03BA11 INDAPAMIDUM INDAPAGAMMA 1,5 mg COMPR. ELIB. PREL. 1,5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. ELIB. PREL. P6L 30 0,280664 0,069002 0,252597 0,097069382 C09AA03 LISINOPRILUM LISIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,148799 0,149201 0,133919 0,164081391 C09AA03 LISINOPRILUM LISIGAMMA 20 mg COMPR. 20mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,297599 0,149734 0,267839 0,179494398 C09AA03 LISINOPRILUM LISIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,074399 0,150601 0,066959 0,158041

SE MODIFICA

41 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 1,152400 0,000000 1,037160 0,11524042 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 1,152400 0,061000 1,037160 0,17624045 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L 100 2,304800 0,376900 2,074320 0,60738046 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PPP6L 1 57,620055 39,869945 51,858049 45,63195171 B01AC05 TICLOPIDINUM 1) TICLODIN COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 0,267267 1,509233 0,240540 1,53596072 B01AC05 TICLOPIDINUM 1) IPATON COMPR. FILM. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/ PVC X 10 COMPR.FILM. P-RF 20 0,267267 0,420733 0,240540 0,447460115 C02AC01 CLONIDINUM CLONIDINA SINTOFARM 0,15 mg COMPR. 0,15mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,202254 0,037746 0,182028 0,057972116 C02AC01 CLONIDINUM CLONIDINA ARENA 0,15 mg COMPR. 0,15mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 0,202254 0,053746 0,182028 0,073972117 C02AC01 CLONIDINUM CLONIDINA ARENA 0,15 mg COMPR. 0,15mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. P6L 50 0,202254 0,053546 0,182028 0,073772119 C03BA11 INDAPAMIDUM SERDIMID 1,5 mg COMPR. CU ELIB. PREL. 1,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. P6L 30 0,279809 0,069857 0,251828 0,097838120 C03BA11 INDAPAMIDUM INDAPAMIDA SOPHARMA 1,5 mg COMPR. CU ELIB. PREL. 1,5mg SOPHARMA PLC BULGARIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 30 0,279809 0,042191 0,251828 0,070172121 C03BA11 INDAPAMIDUM SERDIMID 2,5 mg COMPR. CU ELIB. PREL. 2,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. CU ELIB. PREL. P6L 30 0,466349 0,054984 0,419714 0,101619122 C03BA11 INDAPAMIDUM INDAPAMIDA TERAPIA 1,5 mg COMPR. CU ELIB. PRELUNGITA 1,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. CU ELIB. PREL. P-6L 30 0,279809 0,069857 0,251828 0,097838123 C03BA11 INDAPAMIDUM INDAPAMIDA TERAPIA 2,5mg COMPR. CU ELIB. PRELUNGITA 2,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10COMPR. CU ELIB. PREL. P-6L 30 0,466349 0,048651 0,419714 0,095286124 C03BA11 INDAPAMIDUM INDAPAMID SR ZENTIVA 1,5 mgCOMPR. ELIB. PREL 1,5 mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P6L 30 0,279809 0,069857 0,251828 0,097838126 C03BA11 INDAPAMIDUM TERTENSIF SR 1,5 mg COMPR. ELIB. PREL. 1,5mg LES LAB. SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-6L 30 0,279809 0,258524 0,251828 0,286505127 C03BA11 INDAPAMIDUM INDAPAMID MCC 1,5 mg COMPR. ELIB. PREL. 1,5mg MAGISTRA C&C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 30 0,279809 0,069857 0,251828 0,097838128 C03BA11 INDAPAMIDUM IDUREN SR 1,5 mg COMPR. ELIB. PREL. 1,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0,279809 0,069857 0,251828 0,097838129 C03BA11 INDAPAMIDUM DIUREMID SR 1,5 mg COMPR. ELIB. PREL. 1,5mg GLENMARK PHARMACEUTICALS SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. P-6L 30 0,279809 0,069857 0,251828 0,097838131 C03BA11 INDAPAMIDUM INDAPAMIDA SR TORRENT 1,5 mgCOMPR. ELIB. PREL. 1,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 30 0,279809 0,069857 0,251828 0,097838133 C03BA11 INDAPAMIDUM INDAPAMID LPH (R) 2,5 mg COMPR. FILM. 2,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,466349 0,054984 0,419714 0,101619134 C03BA11 INDAPAMIDUM INDAPAMID SR 1,5 mg LAROPHARM COMPR. FILM. ELIB. PREL. 1,5 mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,279809 0,070191 0,251828 0,098172135 C03BA11 INDAPAMIDUM INDAPAMID LPH (R) 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 0,279809 0,069857 0,251828 0,097838137 C03BA11 INDAPAMIDUM IMPAMID SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. FILM. ELIB. PREL. P-6L 30 0,279809 0,069857 0,251828 0,097838181 C07AB02 METOPROLOLUM BETAPROL 100 mg COMPR. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,218924 0,077409 0,197031 0,099302182 C07AB02 METOPROLOLUM EGILOK 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X, 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 0,218924 0,077576 0,197031 0,099469183 C07AB02 METOPROLOLUM METOPROLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,218924 0,027076 0,197031 0,048969184 C07AB02 METOPROLOLUM METOPROLOL LAROPHARM 100 mg COMPR. 100mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,218924 0,077576 0,197031 0,099469185 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,218924 0,077409 0,197031 0,099302186 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,218924 0,077409 0,197031 0,099302187 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 100 mg COMPR. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,218924 0,077576 0,197031 0,099469188 C07AB02 METOPROLOLUM METOPROLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,218924 0,023409 0,197031 0,045302189 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,218924 0,071576 0,197031 0,093469190 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 0,218924 0,077409 0,197031 0,099302191 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 100 mg COMPR. 100mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L 30 0,218924 0,077409 0,197031 0,099302192 C07AB02 METOPROLOLUM EGILOK 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 0,054731 0,043769 0,049257 0,049243

SUBLISTA A - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 90% DIN PRETUL DE REFERINTA CONFORMDENUMIRILOR 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 DECEMBRIE 2015

Pagina 1 din 6

Page 4: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

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

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din pretul de referinta)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 90% din pretul de

referinta)193 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,054731 0,043769 0,049257 0,049243194 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,054731 0,043935 0,049257 0,049409195 C07AB02 METOPROLOLUM METOPROLOL ARENA 25 MG COMPR. 25mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,054731 0,043935 0,049257 0,049409196 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-6L 60 0,054731 0,043602 0,049257 0,049076197 C07AB02 METOPROLOLUM METOPROLOL LAROPHARM 50 mg COMPR. 50mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,109462 0,073038 0,098515 0,083985198 C07AB02 METOPROLOLUM BETAPROL 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,109462 0,072871 0,098515 0,083818199 C07AB02 METOPROLOLUM EGILOK 50 mg COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 0,109462 0,073038 0,098515 0,083985200 C07AB02 METOPROLOLUM METOPROLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,109462 0,054871 0,098515 0,065818201 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,109462 0,072871 0,098515 0,083818202 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,109462 0,134538 0,098515 0,145485203 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 50 mg COMPR. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,109462 0,063038 0,098515 0,073985204 C07AB02 METOPROLOLUM METOPROLOL ARENA 50 MG COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,109462 0,072871 0,098515 0,083818205 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,109462 0,073038 0,098515 0,083985206 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 0,109462 0,042204 0,098515 0,053151207 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 50 mg COMPR. 50mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L 30 0,109462 0,072871 0,098515 0,083818208 C07AB02 METOPROLOLUM METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L 20 0,218924 0,077576 0,197031 0,099469209 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 100 mg COMPR. FILM. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,218924 0,077409 0,197031 0,099302210 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,109462 0,071871 0,098515 0,082818211 C07AB02 METOPROLOLUM BETALOC (R) ZOK 100 mg COMPR. FILM. ELIB. PREL. 100mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 0,218924 0,237076 0,197031 0,258969212 C07AB02 METOPROLOLUM BETALOC (R) ZOK 50 mg COMPR. FILM. ELIB. PREL. 50mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 0,109462 0,270538 0,098515 0,281485213 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mg COMPR.FILM.ELIB.MOD. 190mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,415957 0,088043 0,374361 0,129639214 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,103989 0,111677 0,093590 0,122076215 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,207978 0,150355 0,187180 0,171153222 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.FILM.P-6L 28 0,328387 0,027684 0,295548 0,060523223 C07AB07 BISOPROLOLUM BISOPROLOL LPH 10mg COMPR. 10mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,328387 0,245279 0,295548 0,278118225 C07AB07 BISOPROLOLUM BISOPROLOL LPH 5mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,164193 0,088473 0,147773 0,104893227 C07AB07 BISOPROLOLUM BOREZ 10 mg COMPR. FILM. 10 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 0,328387 0,034613 0,295548 0,067452228 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM.P-6L 30 0,328387 0,554613 0,295548 0,587452229 C07AB07 BISOPROLOLUM BISOGAMMA (R) 10 COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L/S 100 0,328387 0,172813 0,295548 0,205652230 C07AB07 BISOPROLOLUM BISOGAMMA (R) 10 COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 0,328387 0,032279 0,295548 0,065118231 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,328387 0,756946 0,295548 0,789785232 C07AB07 BISOPROLOLUM BISOTENS 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,328387 0,018279 0,295548 0,051118233 C07AB07 BISOPROLOLUM BISOPROLOL FUMARAT AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L 30 0,328387 0,144279 0,295548 0,177118234 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,328387 0,756946 0,295548 0,789785235 C07AB07 BISOPROLOLUM SOBYC 10 mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,328387 0,018946 0,295548 0,051785236 C07AB07 BISOPROLOLUM BOREZ 2,5 mg COMPR. FILM. 2,5 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 0,082096 0,161237 0,073886 0,169447237 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,082096 0,292237 0,073886 0,300447238 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,082096 0,292237 0,073886 0,300447239 C07AB07 BISOPROLOLUM SOBYC 2,5 mg COMPR. FILM. 2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,082096 0,126904 0,073886 0,135114240 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM.P-6L 30 0,164193 0,350807 0,147773 0,367227242 C07AB07 BISOPROLOLUM BISOGAMMA (R) 5 COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM. P-6L 100 0,164193 0,004707 0,147773 0,021127243 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. FILM. P-6L 30 0,164193 0,225140 0,147773 0,241560244 C07AB07 BISOPROLOLUM BISOTENS 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,164193 0,042140 0,147773 0,058560245 C07AB07 BISOPROLOLUM BISOPROLOL FUMARAT AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L 30 0,164193 0,108140 0,147773 0,124560246 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,164193 0,225140 0,147773 0,241560247 C07AB07 BISOPROLOLUM SOBYC 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,164193 0,042140 0,147773 0,058560248 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 12,5 mg COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,246149 0,031184 0,221534 0,055799249 C07AG02 CARVEDILOLUM DILATREND (R) 12,5 mg COMPR. 12,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L 28 0,246149 0,588136 0,221534 0,612751250 C07AG02 CARVEDILOLUM CORYOL 12,5 mg COMPR. 12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0,246149 0,013136 0,221534 0,037751251 C07AG02 CARVEDILOLUM TALLITON (R) 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0,246149 0,034851 0,221534 0,059466252 C07AG02 CARVEDILOLUM CARVEDILOL LPH 12,5 mg COMPR. 12,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,246149 0,216184 0,221534 0,240799253 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 12,5mg COMPR. 12,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,246149 0,089851 0,221534 0,114466254 C07AG02 CARVEDILOLUM GLADYCOR 12,5 mg COMPR. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,246149 0,139184 0,221534 0,163799255 C07AG02 CARVEDILOLUM MIOCARVIL 12,5 mg COMPR. 12,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,246149 0,216184 0,221534 0,240799256 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,2 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,246149 0,205851 0,221534 0,230466257 C07AG02 CARVEDILOLUM DILATREND (R) 25 mg COMPR. 25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L 28 0,492299 0,434486 0,443069 0,483716259 C07AG02 CARVEDILOLUM TALLITON (R) 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0,492299 0,031034 0,443069 0,080264

Pagina 2 din 6

Page 5: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

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

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din pretul de referinta)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 90% din pretul de

referinta)260 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,492299 0,109701 0,443069 0,158931261 C07AG02 CARVEDILOLUM GLADYCOR 25 mg COMPR. 25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,492299 0,031701 0,443069 0,080931262 C07AG02 CARVEDILOLUM MIOCARVIL 25 mg COMPR. 25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,492299 0,108701 0,443069 0,157931263 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,492299 0,110201 0,443069 0,159431265 C07AG02 CARVEDILOLUM DILATREND (R) 6,25 mg COMPR. 6,25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L 28 0,123074 0,266568 0,110766 0,278876266 C07AG02 CARVEDILOLUM CORYOL (R) COMPR. 6,25mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0,123074 0,075140 0,110766 0,087448267 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0,123074 0,061926 0,110766 0,074234268 C07AG02 CARVEDILOLUM CARVEDILOL LPH 6,25 mg COMPR. 6,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 0,123074 0,115259 0,110766 0,127567269 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 6,25 mg COMPR. 6,25mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,123074 0,104926 0,110766 0,117234270 C07AG02 CARVEDILOLUM GLADYCOR 6,25 mg COMPR. 6,25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,123074 0,061926 0,110766 0,074234271 C07AG02 CARVEDILOLUM MIOCARVIL 6,25 mg COMPR. 6,25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L 30 0,123074 0,115259 0,110766 0,127567272 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 6,25 mg COMPR. 6,25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,123074 0,057259 0,110766 0,069567273 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 12,5mg COMPR. FILM. 12,5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,246149 0,010993 0,221534 0,035608275 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 6,25mg COMPR. FILM. 6,25mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,123074 0,056926 0,110766 0,069234295 C08CA01 AMLODIPINUM ALMACOR 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,132149 0,098851 0,118934 0,112066335 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 12,5 mg COMPR. 12,5mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 0,037198 0,080468 0,033478 0,084188336 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,074396 0,067270 0,066956 0,074710337 C09AA01 CAPTOPRILUM CAPTOPRIL 25 EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,074396 0,076604 0,066956 0,084044338 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,074396 0,044104 0,066956 0,051544339 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,074396 0,043604 0,066956 0,051044340 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,074396 0,043604 0,066956 0,051044341 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,074396 0,080270 0,066956 0,087710342 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,074396 0,044104 0,066956 0,051544344 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148792 0,081874 0,133912 0,096754345 C09AA01 CAPTOPRILUM CAPTOPRIL 50 EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,148792 0,044708 0,133912 0,059588347 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148792 0,006874 0,133912 0,021754349 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,148792 0,050708 0,133912 0,065588350 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,148792 0,050541 0,133912 0,065421351 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 0,148792 0,050208 0,133912 0,065088352 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,148792 0,050708 0,133912 0,065588353 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 0,148792 0,041708 0,133912 0,056588354 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,148792 0,157636 0,133912 0,172516355 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 0,148792 0,050708 0,133912 0,065588356 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 0,148792 0,050541 0,133912 0,065421357 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC, X 10 COMPR. P-6L 50 0,148792 0,050608 0,133912 0,065488358 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC, X 10 COMPR. P-6L 100 0,148792 0,050408 0,133912 0,065288359 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 0,148792 0,050708 0,133912 0,065588360 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,148792 0,050208 0,133912 0,0650881.129 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0,148792 0,050708 0,133912 0,065588361 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,297584 0,032916 0,267825 0,062675362 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 0,297584 0,032916 0,267825 0,062675363 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,297584 0,032916 0,267825 0,062675364 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,297584 0,211344 0,267825 0,241103365 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 0,297584 0,032916 0,267825 0,062675366 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,297584 0,033082 0,267825 0,062841367 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. P-6L 50 0,297584 0,033016 0,267825 0,062775368 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 20 mg COMPR. 20mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,297584 0,032916 0,267825 0,062675369 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,297584 0,032916 0,267825 0,0626751.130 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0,297584 0,032916 0,267825 0,062675370 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,074396 0,018604 0,066956 0,026044371 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,074396 0,019604 0,066956 0,027044372 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,074396 0,069889 0,066956 0,077329373 C09AA02 ENALAPRILUM ENALAPRIL LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 0,074396 0,018604 0,066956 0,026044374 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 0,074396 0,018604 0,066956 0,026044375 C09AA02 ENALAPRILUM ENALAPRIL ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,074396 0,018937 0,066956 0,026377376 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 5 mg COMPR. 5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,074396 0,015604 0,066956 0,023044377 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0,074396 0,015604 0,066956 0,023044

Pagina 3 din 6

Page 6: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

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

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din pretul de referinta)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 90% din pretul de

referinta)1.131 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC- X 10 COMPRIMATE (2 ANI) P6L 20 0,074396 0,018604 0,066956 0,026044379 C09AA03 LISINOPRILUM RANOLIP COMPR. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,148792 0,369541 0,133912 0,384421380 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,148792 0,388208 0,133912 0,403088381 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148792 0,121208 0,133912 0,136088383 C09AA03 LISINOPRILUM LISINOPRIL 10 MEDO COMPR. 10mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148792 0,105541 0,133912 0,120421384 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,148792 0,121208 0,133912 0,136088385 C09AA03 LISINOPRILUM LISINOPRIL ATB 10 MG COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148792 0,264541 0,133912 0,279421386 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,148792 0,237636 0,133912 0,252516387 C09AA03 LISINOPRILUM TONOLYSIN 2,5 mg COMPR. 2,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,037198 0,273873 0,033478 0,277593388 C09AA03 LISINOPRILUM RANOLIP COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,297584 0,501749 0,267825 0,531508389 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,297584 0,484916 0,267825 0,514675390 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,297584 0,081416 0,267825 0,111175392 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 20 mg COMPR. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,297584 0,081416 0,267825 0,111175393 C09AA03 LISINOPRILUM LISINOPRIL ATB 20 MG COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,297584 0,514416 0,267825 0,544175394 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,297584 0,351344 0,267825 0,381103395 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR. P-6L 20 0,297584 0,130916 0,267825 0,160675396 C09AA03 LISINOPRILUM LISINOPRIL ATB 40 MG COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,595169 0,764164 0,535652 0,823681397 C09AA03 LISINOPRILUM RANOLIP COMPR. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,074396 0,190270 0,066956 0,197710399 C09AA03 LISINOPRILUM LISINOPRIL 5 MEDO COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,074396 0,118270 0,066956 0,125710400 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,074396 0,118604 0,066956 0,126044401 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,074396 0,188818 0,066956 0,196258413 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR. P-6L 28 0,148792 0,000850 0,133912 0,015730414 C09AA05 RAMIPRILUM PIRAMIL 2,5 mg COMPR. 2,5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 0,148792 0,023350 0,133912 0,038230415 C09AA05 RAMIPRILUM RAMIPRIL-AC 2,5 mg COMPR. 2,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148792 0,019541 0,133912 0,034421416 C09AA05 RAMIPRILUM AMPRIL 2,5 mg COMPR. 2,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,148792 0,023208 0,133912 0,038088417 C09AA05 RAMIPRILUM ZENRA 2,5 COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,148792 0,017279 0,133912 0,032159418 C09AA05 RAMIPRILUM TRITACE(R) 2,5 COMPR. 2,5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,148792 0,115850 0,133912 0,130730419 C09AA05 RAMIPRILUM AMPRIGEN 2,5 mg COMPR. 2,5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 0,148792 0,023208 0,133912 0,038088420 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. 2,5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,148792 0,023208 0,133912 0,038088421 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. 2,5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,148792 0,023208 0,133912 0,038088427 C09AA05 RAMIPRILUM TRITACE® 5 COMPR. 5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,297584 0,084201 0,267825 0,113960433 C09AA06 QUINAPRILUM ACCUPRO 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL/PA X 10 COMPR. FILM.P-6L 30 0,099194 0,302472 0,089274 0,312392434 C09AA06 QUINAPRILUM ACCUPRO (R) 20 COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 0,198389 0,378277 0,178550 0,398116435 C09AA06 QUINAPRILUM ACCUPRO (R) 5 COMPR. FILM. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 0,049597 0,142403 0,044637 0,147363436 C09AA09 FOSINOPRILUM MONOPRIL 10 mg COMPR. 10mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 0,099194 0,486163 0,089274 0,496083437 C09AA09 FOSINOPRILUM FOSYPRIL 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. P-6L 30 0,099194 0,281472 0,089274 0,291392438 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 0,099194 0,281472 0,089274 0,291392439 C09AA09 FOSINOPRILUM MONOPRIL 10 mg COMPR. 10mg PHARMASWISS CESKÁ REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 0,099194 0,486163 0,089274 0,496083440 C09AA09 FOSINOPRILUM MONOPRIL 20 mg COMPR. 20mg BRISTOL-MYERS SQUIBB UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 0,198389 0,650539 0,178550 0,670378441 C09AA09 FOSINOPRILUM FOSYPRIL 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL, X 10 COMPR. P-6L 30 0,198389 0,353611 0,178550 0,373450442 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 20 mg COMPR. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 0,198389 0,353611 0,178550 0,373450443 C09AA09 FOSINOPRILUM MONOPRIL 20 mg COMPR. 20mg PHARMASWISS CESKÁ REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 0,198389 0,650539 0,178550 0,670378451 C09CA01 LOSARTANUM LODIAL 100mg COMPR. FILM. 100 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 2 BLIST. DIN PVC/AL X 15 COMPR. FILM. P6L 30 0,694927 0,529739 0,625434 0,599232452 C09CA01 LOSARTANUM TALOSAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 0,694927 0,423073 0,625434 0,492566453 C09CA01 LOSARTANUM TALOSAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 0,694927 0,423073 0,625434 0,492566461 C09CA01 LOSARTANUM COZAAR 50 mg COMPR. FILM. 50mg MERCK SHARP & DOHME ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,347463 0,167179 0,312716 0,201926464 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 10 mg COMPR. FILM. 10 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0,121524 0,202761 0,109371 0,214914465 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 10 mg COMPR. FILM. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,121524 0,025809 0,109371 0,037962466 C10AA01 SIMVASTATINUM ZEPLAN (R) 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILMP-6L 28 0,121524 0,082047 0,109371 0,094200467 C10AA01 SIMVASTATINUM SINTENAL 10 mg COMPR. FILM. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,121524 0,190142 0,109371 0,202295468 C10AA01 SIMVASTATINUM VASILIP 10 mg COMPR. FILM. 10mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L 28 0,121524 0,202047 0,109371 0,214200469 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,121524 0,202476 0,109371 0,214629470 C10AA01 SIMVASTATINUM SIMVASTATINA SUN 10 mg COMPR. FILM. 10mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,121524 0,020618 0,109371 0,032771471 C10AA01 SIMVASTATINUM SIMVACARD 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,121524 0,027047 0,109371 0,039200472 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,121524 0,026476 0,109371 0,038629473 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,121524 0,025809 0,109371 0,037962474 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,121524 0,183142 0,109371 0,195295

Pagina 4 din 6

Page 7: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

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

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din pretul de referinta)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 90% din pretul de

referinta)475 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 20 mg COMPR. FILM. 20 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0,243049 0,190165 0,218744 0,214470476 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 20 mg COMPR. FILM. 20mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,243049 0,097617 0,218744 0,121922477 C10AA01 SIMVASTATINUM ZEPLAN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILMP-6L 28 0,243049 0,190165 0,218744 0,214470478 C10AA01 SIMVASTATINUM ZOCOR 20 mg COMPR. FILM. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 28 0,243049 0,423379 0,218744 0,447684479 C10AA01 SIMVASTATINUM SINTENAL 20 mg COMPR. FILM. 20mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,243049 0,189951 0,218744 0,214256480 C10AA01 SIMVASTATINUM VASILIP 20 mg COMPR. FILM. 20mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L 28 0,243049 0,190165 0,218744 0,214470481 C10AA01 SIMVASTATINUM SIMCOR 20 mg COMPR. FILM. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,243049 0,189951 0,218744 0,214256482 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,243049 0,189951 0,218744 0,214256484 C10AA01 SIMVASTATINUM SIMVACARD 20 mg COMPR. FILM. 20mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,243049 0,002308 0,218744 0,026613485 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,243049 0,002951 0,218744 0,027256487 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,243049 0,189951 0,218744 0,214256488 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 30 mg COMPR. FILM. 30mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,364574 0,118759 0,328116 0,155217489 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 40 mg COMPR. FILM. 40 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0,486099 0,621043 0,437489 0,669653490 C10AA01 SIMVASTATINUM VASILIP (R) 40 mg COMPR. FILM. 40mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 7 COMPR. FILM P-6L 28 0,486099 0,465329 0,437489 0,513939491 C10AA01 SIMVASTATINUM ZEPLAN (R) 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 0,486099 0,064258 0,437489 0,112868492 C10AA01 SIMVASTATINUM SINTENAL 40 mg COMPR. FILM. 40mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,486099 0,580234 0,437489 0,628844493 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 40 mg COMPR. FILM. 40mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,486099 0,140567 0,437489 0,189177494 C10AA01 SIMVASTATINUM SIMCOR 40 mg COMPR. FILM. 40mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,486099 0,620234 0,437489 0,668844495 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 40 mg COMPR. FILM. 40mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,486099 0,620234 0,437489 0,668844500 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,486099 0,405901 0,437489 0,454511501 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. X 10 COMPR. P-6L 10 0,162033 0,362967 0,145829 0,379171502 C10AA02 LOVASTATINUM LOVASTATINA ARENA 20 mg COMPR. 20mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,162033 0,732633 0,145829 0,748837503 C10AA03 PRAVASTATINUM PRAVATOR 20 mg COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR.P-6L 28 0,243049 0,589093 0,218744 0,613398504 C10AA03 PRAVASTATINUM PRAVATOR 40 mg COMPR. 40mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PE-AL-PVC/AL X 7 COMPR.P-6L 28 0,486099 0,829972 0,437489 0,878582509 D01AC02 MICONAZOLUM MICONAZOL NITRAT 2% CREMA 2% SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 4,636666 2,373334 4,172999 2,837001670 J01FA01 ERYTHROMYCINUM ERITROMICINA 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,373435 0,124065 0,336091 0,161409671 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR. 200mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,373435 0,048565 0,336091 0,085909672 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,373435 0,124065 0,336091 0,161409673 J01FA09 CLARITHROMYCINUM CLAXIRIT 500 mg COMPR. CU ELIB. PREL. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/PVDC//AL X 7 COMPR. CU ELIB. PREL. PRF 7 1,867178 0,567107 1,680460 0,753825674 J01FA09 CLARITHROMYCINUM KLACID SR COMPR. ELIB. PREL. 500mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 5 COMPR. ELIB. PREL. P-RF 5 1,867178 1,880822 1,680460 2,067540675 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mgCOMPR. ELIB. PREL. 500mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR. ELIB. PREL. PRF 6 1,867178 0,567822 1,680460 0,754540676 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT S.R.L. ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 0,933589 1,013553 0,840230 1,106912677 J01FA09 CLARITHROMYCINUM KLERIMED (R) 250 COMPR. FILM. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM. P-RF 14 0,933589 0,238553 0,840230 0,331912678 J01FA09 CLARITHROMYCINUM KLABAX 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 0,933589 0,153553 0,840230 0,246912679 J01FA09 CLARITHROMYCINUM FROMILID 250 COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. P-RF 14 0,933589 0,302125 0,840230 0,395484683 J01FA09 CLARITHROMYCINUM KLERIMED (R) 500 COMPR. FILM. 500mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM. P-RF 14 1,867178 0,044250 1,680460 0,230968684 J01FA09 CLARITHROMYCINUM KLABAX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 1,867178 0,172107 1,680460 0,358825685 J01FA09 CLARITHROMYCINUM FROMILID 500 COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. P-RF 14 1,867178 0,054250 1,680460 0,240968686 J01FA09 CLARITHROMYCINUM ROCLARIN 500 mg COMPR. FILM. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 1,849000 0,000000 1,664100 0,184900687 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF 20 1,867178 0,488822 1,680460 0,675540689 J01FA09 CLARITHROMYCINUM LEKOKLAR 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF 14 1,867178 0,044250 1,680460 0,230968691 J01FA09 CLARITHROMYCINUM FROMILID (R) UNO COMPR. FILM. ELIB. PREL. 500mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 1,867178 0,567107 1,680460 0,753825701 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,226700 0,850300 1,104030 0,972970702 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,245340 3,625660 0,220806 3,650194703 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,245340 3,158660 0,220806 3,183194704 J01MA02 CIPROFLOXACINUM CIPROCIN 250 mg COMPR. FILM. 250mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,613350 0,069650 0,552015 0,130985705 J01MA02 CIPROFLOXACINUM CIPRINOL 250 mg COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,613350 0,093650 0,552015 0,154985706 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 250 mg COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,613350 0,069650 0,552015 0,130985707 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,613350 0,095650 0,552015 0,156985708 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 0,613350 0,106650 0,552015 0,167985709 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,613350 0,067650 0,552015 0,128985710 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,613350 0,024650 0,552015 0,085985713 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 500 mg COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,226700 0,095300 1,104030 0,217970714 J01MA02 CIPROFLOXACINUM CUMINOL 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,226700 0,144300 1,104030 0,266970716 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,226700 0,144300 1,104030 0,266970720 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 750 mg COMPR. FILM. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,840050 2,030950 1,656045 2,214955721 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 2,453400 10,100885 2,208060 10,346225

Pagina 5 din 6

Page 8: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

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

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din pretul de referinta)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 90% din pretul de

referinta)722 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 1,226700 8,326633 1,104030 8,449303723 J01MA03 PEFLOXACINUM PEFLOXACIN LAROPHARM COMPR. FILM. 400mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,226700 1,664300 1,104030 1,786970915 N03AX12 GABAPENTINUM GABAGAMMA 100 mg CAPS. 100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,155860 0,038240 0,140274 0,053826916 N03AX12 GABAPENTINUM GRIMODIN 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,155860 0,420640 0,140274 0,436226917 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L 50 0,155860 0,311940 0,140274 0,327526918 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L 100 0,155860 0,296840 0,140274 0,312426919 N03AX12 GABAPENTINUM GABAPENTIN ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,155860 0,251473 0,140274 0,267059921 N03AX12 GABAPENTINUM GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,467583 0,288517 0,420824 0,335276922 N03AX12 GABAPENTINUM GABARAN 300 mg CAPS. 300mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 0,467583 0,879017 0,420824 0,925776923 N03AX12 GABAPENTINUM GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,467583 0,052117 0,420824 0,098876924 N03AX12 GABAPENTINUM GRIMODIN 300 mg CAPS. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,467583 0,107917 0,420824 0,154676927 N03AX12 GABAPENTINUM GABAPENTIN ARENA 300 mg CAPS. 300mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,467583 0,429750 0,420824 0,476509929 N03AX12 GABAPENTINUM GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,623445 0,569655 0,561100 0,632000930 N03AX12 GABAPENTINUM GABARAN 400 mg CAPS. 400mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 0,623445 0,885555 0,561100 0,947900931 N03AX12 GABAPENTINUM GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,623445 0,069055 0,561100 0,131400932 N03AX12 GABAPENTINUM GRIMODIN 400 mg CAPS. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,623445 0,405888 0,561100 0,468233935 N03AX12 GABAPENTINUM GABAPENTIN ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,623445 0,498221 0,561100 0,560566936 N03AX12 GABAPENTINUM GABARAN 600 mg COMPR. FILM. 600mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 0,935168 1,244832 0,841651 1,338349937 N03AX12 GABAPENTINUM GRIMODIN 600 mg COMPR. FILM. 600mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 0,935168 0,932665 0,841651 1,026182938 N03AX12 GABAPENTINUM GABARAN 800 mg COMPR. FILM. 800mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 1,246891 2,358109 1,122201 2,4827991.035 N06AX11 MIRTAZAPINUM* REMERON SOLTAB 30 mg COMPR. DISP. 30mg NV ORGANON OLANDA CUTIE X 5 BLIST. AL/PVC-PA-POLIESTER PERFORAT PT. ELIB. UNEI UNIT. DOZATE X 6 COMPR. DISP. P-RF 30 0,490166 1,695167 0,441149 1,7441841.036 N06AX11 MIRTAZAPINUM* MIRTAZAPIN ARENA 15 mg COMPR. FILM. 15mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM.PRF 30 0,245083 0,606583 0,220574 0,6310921.038 N06AX11 MIRTAZAPINUM* PHARMATAZ 30 mg COMPR. FILM. 30mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL, X 10 COMPR. FILM. P-RF 30 0,490166 0,327500 0,441149 0,3765171.040 N06AX11 MIRTAZAPINUM* MIRTAZAPIN ARENA 45 mg COMPR. FILM. 45mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM.PRF 30 0,735249 1,388417 0,661724 1,4619421.041 N06AX11 MIRTAZAPINUM* MIRTAZAPINA AUROBINDO 15 mg COMPR. ORODISPERSABILE 15mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE P-RF 30 0,245083 0,605583 0,220574 0,6300921.042 N06AX11 MIRTAZAPINUM* MIRZATEN Q-TAB 30 mg COMPR. ORODISPERSABILE 30mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 30 COMPR. ORODISPERSABILE P-RF 30 0,490166 0,004834 0,441149 0,0538511.043 N06AX11 MIRTAZAPINUM* MIRTAZAPINA AUROBINDO 30 mg COMPR. ORODISPERSABILE 30mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE P-RF 30 0,490166 0,385500 0,441149 0,4345171.044 N06AX11 MIRTAZAPINUM* ZULIN 30 mg COMPR. ORODISPERSABILE 30mg ANTIBIOTICE S.A. ROMANIA CUTIE X 5 BLIST. AL/AL X 6 COMPR. ORODISPERSABILE P-RF 30 0,485333 0,000000 0,436799 0,0485341.045 N06AX11 MIRTAZAPINUM* MIRTAZAPINA AUROBINDO 45 mg COMPR. ORODISPERSABILE 45mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE P-RF 30 0,735249 0,522751 0,661724 0,596276

Pagina 6 din 6

Page 9: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

ANEXA 2b

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

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 50% din pretul de referinta)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 50% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 90% din pretul de referinta)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 90% din pretul de

referinta)

SE ADAUGA

1.059 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TORRENT 20 mg COMPR. GASTROREZ. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 56 COMPR. GASTROREZ. P6L 56 0,554642 0,000000 0,277321 0,277321 0,499177 0,0554651.060 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TORRENT 20 mg COMPR. GASTROREZ. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 90 COMPR. GASTROREZ. P6L 90 0,536777 0,000000 0,268388 0,268389 0,483099 0,0536781.061 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TORRENT 40 mg COMPR. GASTROREZ. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 56 COMPR. GASTROREZ. P6L 56 0,835000 0,000000 0,417500 0,417500 0,751500 0,0835001.062 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TORRENT 40 mg COMPR. GASTROREZ. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 90 COMPR. GASTROREZ. P6L 90 0,793000 0,000000 0,396500 0,396500 0,713700 0,0793001.063 C02AC05 MOXONIDINUM PHYSIOTENS 0,2 mg COMPR. FILM. 0,2mg ABBOTT LABORATORIES GMBH GERMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,809016 0,270626 0,404508 0,675134 0,728114 0,3515281.064 C02AC05 MOXONIDINUM PHYSIOTENS 0,4 mg COMPR. FILM. 0,4mg ABBOTT LABORATORIES GMBH GERMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 1,602857 0,000000 0,801428 0,801429 1,442571 0,1602861.065 C09AA04 PERINDOPRILUM ERNYOM 4 mg COMPR. 4mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0,297584 0,216082 0,148792 0,364874 0,267825 0,2458411.066 C09AA04 PERINDOPRILUM ERNYOM 8 mg COMPR. 8mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0,595169 0,164831 0,297584 0,462416 0,535652 0,2243481.067 C09CA03 VALSARTANUM VALSARTAN TORRENT 160 mg COMPR. FILM. 160mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 98 COMPR. FILM. P6L 98 0,462244 0,000000 0,231122 0,231122 0,416019 0,0462251.068 C09CA03 VALSARTANUM VALSACOR 320 mg COMPR. FILM. 320mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P-6L 30 1,129333 0,000000 0,564666 0,564667 1,016399 0,1129341.069 C09CA03 VALSARTANUM VALSARTAN TORRENT 80 mg COMPR. FILM. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 98 COMPR. FILM. P6L 98 0,292755 0,000000 0,146377 0,146378 0,263479 0,0292761.070 C09CA07 TELMISARTANUM TELMISARTAN TORRENT 40 mg COMPR. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL (OPA-AL-PVC/AL) X 56 COMPR. P6L 56 0,694927 0,115251 0,347463 0,462715 0,625434 0,1847441.071 C09CA07 TELMISARTANUM TELMISARTAN TORRENT 80 mg COMPR. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL (OPA-AL-PVC/AL) X 56 COMPR. P6L 56 0,939464 0,000000 0,469732 0,469732 0,845517 0,0939471.072 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM)CO - VALSACOR 160 mg/12,5 mg COMPR. FILM. 160 mg/12,5 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC - PE -PVDC/AL X 30 COMPR. FILM. P6L 30 0,693963 0,168037 0,346981 0,515019 0,624566 0,2374341.073 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM)CO - VALSACOR 160 mg/25 mg COMPR. FILM. 160 mg/25 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,693963 0,028703 0,346981 0,375685 0,624566 0,0981001.074 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM)CO - VALSACOR 320 mg/12,5 mg COMPR. FILM. 320 mg/12,5 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,693963 0,408370 0,346981 0,755352 0,624566 0,4777671.075 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM)CO - VALSACOR 320 mg/25 mg COMPR. FILM. 320 mg/25 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,693963 0,413037 0,346981 0,760019 0,624566 0,4824341.076 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM)CO - VALSACOR 80 mg/12,5 mg COMPR. FILM. 80 mg/12,5 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC - PE - PVDC/AL X 30 COMPR. FILM. P6L 30 0,489000 0,000000 0,244500 0,244500 0,440100 0,0489001.077 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANDESARTAN HIDROCLOROTIAZIDA TORRENT 16 mg/12,5 mg COMPR. 16mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 56 COMPR. P6L 56 0,641250 0,000000 0,320625 0,320625 0,577125 0,0641251.078 C10AA05 ATORVASTATINUM ATORIS 30 mg COMPR. FILM. 30mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,608000 0,000000 0,304000 0,304000 0,547200 0,0608001.079 C10AA05 ATORVASTATINUM ATORIS 60 mg COMPR. FILM. 60mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,001666 0,000000 0,500833 0,500833 0,901499 0,1001671.080 C10AA05 ATORVASTATINUM ATORIS 80 mg COMPR. FILM. 80mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,017333 0,000000 0,508666 0,508667 0,915599 0,1017341.081 D07AD01 CLOBETASOLUM* CLOBETAZOL ATB 0,5 mg/g UNGUENT 0,5mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 25 G UNGUENT PRF 1 5,860000 0,150000 2,930000 3,080000 5,274000 0,7360001.082 G03GA05 FOLLITROPINUM ALFA****# BEMFOLA 150 UI/0,25 ml SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 150UI/0,25ml FINOX BIOTECH AG LIECHTENSTEIN. CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF 1 207,100000 4,400000 103,550000 107,950000 186,390000 25,1100001.083 G03GA05 FOLLITROPINUM ALFA****# BEMFOLA 225 UI/0,375 ml SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 225UI/0,375ml FINOX BIOTECH AG LIECHTENSTEIN. CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF 1 310,650000 6,610000 155,325000 161,935000 279,585000 37,6750001.084 G03GA05 FOLLITROPINUM ALFA****# BEMFOLA 300 UI/0,50 ml SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 300UI/0,50ml FINOX BIOTECH AG LIECHTENSTEIN. CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF 1 414,200000 0,000000 207,100000 207,100000 372,780000 41,4200001.085 G03GA05 FOLLITROPINUM ALFA****# BEMFOLA 450 UI/0,75 ml SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 450UI/0,75ml FINOX BIOTECH AG LIECHTENSTEIN. CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF 1 584,410000 0,000000 292,205000 292,205000 525,969000 58,4410001.086 G03GA05 FOLLITROPINUM ALFA****# BEMFOLA 75 UI/0,125 ml SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 75UI/0,125ml FINOX BIOTECH AG LIECHTENSTEIN. CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF 1 103,550000 8,790000 51,775000 60,565000 93,195000 19,1450001.087 J01FA10 AZITHROMYCINUM AZIBIOT 250 mg COMPR. FILM. 250mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR.FILM.PRF 6 3,111962 0,179704 1,555981 1,735685 2,800765 0,4909011.088 J01MA12 LEVOFLOXACINUM LEVALOX 250 mg COMPR. FILM. 250mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 7 COMPR. FILM. PRF 7 2,453400 0,050885 1,226700 1,277585 2,208060 0,2962251.089 J01MA12 LEVOFLOXACINUM LEVALOX 500 mg COMPR. FILM. 500mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 7 COMPR. FILM. PRF 7 4,274285 0,000000 2,137142 2,137143 3,846856 0,4274291.090 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)* DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UI TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR., AMBALAJ TIP CALENDAR P6L 4 6,554250 0,748250 3,277125 4,025375 5,898825 1,4036751.091 N04BC05 PRAMIPEXOLUM* OPRYMEA 2,62 mg COMPR. ELIB. PREL. 2,62mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF 30 2,592117 5,834549 1,296058 7,130608 2,332905 6,0937611.092 N04BC05 PRAMIPEXOLUM* OPRYMEA 3,15 mg COMPR. ELIB. PREL. 3,15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF 30 3,116476 4,650857 1,558238 6,209095 2,804828 4,9625051.093 N06AX21 DULOXETINUM** DULSEVIA 30 mg CAPS. GASTROREZ. 30mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 90 CAPS. GASTROREZ. PRF 90 0,625054 0,045612 0,312527 0,358139 0,562548 0,1081181.094 N06AX21 DULOXETINUM** DULSEVIA 60 mg CAPS. GASTROREZ. 60mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 90 CAPS. GASTROREZ. PRF 90 0,976444 0,000000 0,488222 0,488222 0,878799 0,097645

SE ELIMINA

99 B01AC04 CLOPIDOGRELUM** CLOPIGAMMA 75 mg COMPR. FILM. 75mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,637142 0,000000 0,318571 0,318571 0,573427 0,063715100 B01AC04 CLOPIDOGRELUM** CLOPIGAMMA 75 mg COMPR. FILM. 75mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 0,637142 0,000000 0,318571 0,318571 0,573427 0,063715216 C09CA03 VALSARTANUM VALSARGAMMA 160 mg COMPR. FILM. 160mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,761333 0,000000 0,380666 0,380667 0,685199 0,076134229 C09CA03 VALSARTANUM VALSARGAMMA 80 mg COMPR. FILM. 80mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,611666 0,000000 0,305833 0,305833 0,550499 0,061167320 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IFIRMACOMBI 150mg/12,5mg COMPR. FILM. 150mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,370666 0,000000 0,185333 0,185333 0,333599 0,037067327 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IFIRMACOMBI 300mg/12,5mg COMPR. FILM. 300mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,684031 0,004302 0,342015 0,346318 0,615627 0,072706334 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IFIRMACOMBI 300mg/25mg COMPR. FILM. 300mg/25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,684031 0,064969 0,342015 0,406985 0,615627 0,133373340 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANDESARTAN HIDROCLOROTIAZIDA TORRENT 16 mg/12,5 mg COMPR. 16mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 0,661428 0,000000 0,330714 0,330714 0,595285 0,066143381 C10AA05 ATORVASTATINUM ATORGAMMA 10 mg COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,215666 0,000000 0,107833 0,107833 0,194099 0,021567396 C10AA05 ATORVASTATINUM ATORGAMMA 20 mg COMPR. FILM. 20mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,431333 0,000000 0,215666 0,215667 0,388199 0,043134412 C10AA05 ATORVASTATINUM ATORGAMMA 40 mg COMPR. FILM. 40mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,863000 0,000000 0,431500 0,431500 0,776700 0,086300

SE MODIFICA

SUBLISTA B - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 50% DIN PRETUL DE REFERINTA CONFORMDENUMIRILOR COMUNE INTERNATIONALE (DCI) ALE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU CONTRIBUTIE PERSONALA DIN HG NR. 720/2008 CU

MODIFICARILE SI COMPLETARILE ULTERIOARE VALABILA INCEPAND CU 01 DECEMBRIE 2015

Pagina 1 din 5

Page 10: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

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

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 50% din pretul de referinta)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 50% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 90% din pretul de referinta)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 90% din pretul de

referinta)93 B01AC04 CLOPIDOGRELUM** PLAVIX 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA) P-RF 30 4,276281 5,066052 2,138140 7,204193 3,848652 5,49368194 B01AC04 CLOPIDOGRELUM** PLAVIX 300mg COMPR. FILM. 300mg SANOFI CLIR SNC FRANTA CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA) P-RF 30 4,276281 5,066052 2,138140 7,204193 3,848652 5,49368196 B01AC04 CLOPIDOGRELUM** PLAVIX 75mg COMPR. FILM. 75mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-RF 28 1,069070 0,578787 0,534535 1,113322 0,962163 0,68569498 B01AC04 CLOPIDOGRELUM** TROGRAN 75 mg COMPR. FILM. 75mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 1,069070 0,037715 0,534535 0,572250 0,962163 0,144622103 B01AC04 CLOPIDOGRELUM** DEFROZYP 75 mg COMPR. FILM. 75mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVDC/AL X 28 COMPR. FILM. P-RF 28 1,069070 0,037715 0,534535 0,572250 0,962163 0,144622105 B01AC04 CLOPIDOGRELUM** CLOPIDOGREL DR. REDDY'S 75 mg COMPR. FILM. 75mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 1,069070 0,037263 0,534535 0,571798 0,962163 0,144170106 B01AC04 CLOPIDOGRELUM** CLOPIDOGREL TERAPIA 75 mg COMPR. FILM. 75mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 30 1,069070 0,037263 0,534535 0,571798 0,962163 0,144170111 B01AC04 CLOPIDOGRELUM** PLAVIX 75mg COMPR. FILM. 75mg SANOFI CLIR SNC FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 28 1,069070 0,578787 0,534535 1,113322 0,962163 0,685694112 B01AC18 TRIFLUSALUM PLATROX 300 mg CAPS. 300 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 5 BLIST. AL-PVC/PVDC X 10 CAPS. PRF 50 0,534535 0,163065 0,267267 0,430333 0,481081 0,216519113 B01AC18 TRIFLUSALUM AFLEN (R) CAPS. 300mg GALENICA S.A. GRECIA CUTIE X 5 BLIST. X 10 CAPS. P-RF 50 0,534535 0,538465 0,267267 0,805733 0,481081 0,591919125 C02AC05 MOXONIDINUM PHYSIOTENS 0,2 COMPR. FILM. 0,2mg ABBOTT PRODUCTS GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR.FILM. P-6L 28 0,809016 0,270626 0,404508 0,675134 0,728114 0,351528130 C02AC05 MOXONIDINUM PHYSIOTENS 0,4 COMPR. FILM. 0,4mg ABBOTT PRODUCTS GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR.FILM. P-6L 28 1,602857 0,000000 0,801428 0,801429 1,442571 0,160286163 C09AA04 PERINDOPRILUM PRENESSA 2 mg COMPR. 2mg KRKA POLSKA SP. Z.O.O. POLONIA CUTIE CU 1 BLIST. DIN PVC-PE-PVDC/AL X 30 COMPR. P-6L 30 0,148792 0,224208 0,074396 0,298604 0,133912 0,239088164 C09AA04 PERINDOPRILUM PERINDOPRIL TEVA 4 mg COMPR. 4mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 PUNGA DIN AL X 1 BLIST. PVC/VMCH-AL X 30 COMPR. P-6L 30 0,297584 0,342416 0,148792 0,491208 0,267825 0,372175165 C09AA04 PERINDOPRILUM VIDOTIN 4 mg COMPR. 4mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,297584 0,080082 0,148792 0,228874 0,267825 0,109841166 C09AA04 PERINDOPRILUM STOPRESS 4 mg COMPR. 4mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. ACLAR-PVC/AL X 30 COMPR. FILM.P-6L 30 0,297584 0,217082 0,148792 0,365874 0,267825 0,246841167 C09AA04 PERINDOPRILUM TREZEN 4 mg COMPR. 4mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,297584 0,597082 0,148792 0,745874 0,267825 0,626841168 C09AA04 PERINDOPRILUM TREZEN 4 mg COMPR. 4mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,297584 0,597082 0,148792 0,745874 0,267825 0,626841169 C09AA04 PERINDOPRILUM PRENESSA 4 mg COMPR. 4mg KRKA POLSKA SP. Z.O.O. POLONIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L 30 0,297584 0,190416 0,148792 0,339208 0,267825 0,220175170 C09AA04 PERINDOPRILUM PRINDEX 4 mg COMPR. 4mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L 30 0,297584 0,097416 0,148792 0,246208 0,267825 0,127175171 C09AA04 PERINDOPRILUM PERINDOPRIL TEVA 8 mg COMPR. 8mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 PUNGA DIN AL X 1 BLIST PVC/VMCH-AL X 30 COMPR. P-6L 30 0,595169 0,221831 0,297584 0,519416 0,535652 0,281348172 C09AA04 PERINDOPRILUM VIDOTIN 8 mg COMPR. 8mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,595169 0,095164 0,297584 0,392749 0,535652 0,154681173 C09AA04 PERINDOPRILUM STOPRESS 8 mg COMPR. 8mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. ACLAR-PVC/AL X 30 COMPR. FILM.P-6L 30 0,595169 0,315497 0,297584 0,613082 0,535652 0,375014174 C09AA04 PERINDOPRILUM TREZEN 8 mg COMPR. 8mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,595169 1,103831 0,297584 1,401416 0,535652 1,163348175 C09AA04 PERINDOPRILUM TREZEN 8 mg COMPR. 8mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,595169 1,103831 0,297584 1,401416 0,535652 1,163348176 C09AA04 PERINDOPRILUM PRINDEX 8 mg COMPR. 8mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L 30 0,595169 0,029497 0,297584 0,327082 0,535652 0,089014177 C09AA04 PERINDOPRILUM PRENESSA 8 mg COMPR. 8mg KRKA POLSKA SP Z O.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 0,595169 0,214831 0,297584 0,512416 0,535652 0,274348178 C09AA04 PERINDOPRILUM PRESTARIUM 10 mg COMPR. FILM. 10 mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L 30 0,743961 0,951039 0,371980 1,323020 0,669564 1,025436179 C09AA04 PERINDOPRILUM PERINDOPRIL TOSILAT TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L 30 0,743961 0,121039 0,371980 0,493020 0,669564 0,195436180 C09AA04 PERINDOPRILUM PRESTARIUM 5 mg COMPR. FILM. 5mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L 30 0,371980 0,617686 0,185990 0,803676 0,334782 0,654884181 C09AA04 PERINDOPRILUM PERINDOPRIL TOSILAT TEVA 5 mg COMPR. FILM. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L 30 0,371980 0,271686 0,185990 0,457676 0,334782 0,308884182 C09AA07 BENAZEPRILUM CIBACEN (R) 20 mg COMPR. FILM. 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 0,793558 1,325013 0,396779 1,721792 0,714202 1,404369183 C09AA07 BENAZEPRILUM CIBACEN (R) 5 mg COMPR. FILM. 5mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 0,198389 0,584825 0,099194 0,684020 0,178550 0,604664184 C09AA10 TRANDOLAPRILUM GOPTEN (R) 0,5 mg CAPS. 0,5mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 10 CAPS. P-6L 20 0,074396 0,310104 0,037198 0,347302 0,066956 0,317544185 C09AA10 TRANDOLAPRILUM GOPTEN (R) 2 mg CAPS. 2mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0,297584 0,315273 0,148792 0,464065 0,267825 0,345032186 C09AA10 TRANDOLAPRILUM GOPTEN (R) 4 mg CAPS. 4mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0,595169 0,581973 0,297584 0,879558 0,535652 0,641490187 C09AA15 ZOFENOPRILUM ZOMEN (R) 30 mg COMPR. FILM. 30mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBURG CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,297584 1,250987 0,148792 1,399779 0,267825 1,280746188 C09AA15 ZOFENOPRILUM ZOMEN (R) 7,5 mg COMPR. FILM. 7,5mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBURG CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,074396 0,655246 0,037198 0,692444 0,066956 0,662686209 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/2 mg COMPR. CU ELIB. MODIF. 240mg/2mg ABBOTT GMBH & CO.KG GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF. P6L 28 1,941963 0,112679 0,970981 1,083661 1,747766 0,306876210 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/4 mg COMPR. CU ELIB. MODIF. 240mg/4mg ABBOTT GMBH & CO.KG GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF. P6L 28 1,941963 0,751608 0,970981 1,722590 1,747766 0,945805217 C09CA03 VALSARTANUM DIOVAN 160 mg COMPR. FILM. 160mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 1,389855 0,204073 0,694927 0,899001 1,250869 0,343059223 C09CA03 VALSARTANUM DIOVAN 40 mg COMPR. FILM. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM. P6L 28 0,347463 2,220751 0,173731 2,394483 0,312716 2,255498224 C09CA03 VALSARTANUM AVASSAN 40 mg COMPR. FILM. 40mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,347463 1,232179 0,173731 1,405911 0,312716 1,266926225 C09CA03 VALSARTANUM VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,347463 0,065751 0,173731 0,239483 0,312716 0,100498226 C09CA03 VALSARTANUM VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM.P6L 28 0,347463 0,065751 0,173731 0,239483 0,312716 0,100498227 C09CA03 VALSARTANUM WENZELL 80 mg COMPR. FILM. 80mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 28 COMPR. FILM. P-6L 28 0,694927 0,107930 0,347463 0,455394 0,625434 0,177423228 C09CA03 VALSARTANUM WENZELL 80 mg COMPR. FILM. 80mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 30 COMPR. FILM. P-6L 30 0,694927 0,107739 0,347463 0,455203 0,625434 0,177232230 C09CA03 VALSARTANUM DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM. P6L 28 0,694927 0,500073 0,347463 0,847537 0,625434 0,569566232 C09CA03 VALSARTANUM AVASSAN 80 mg COMPR. FILM. 80mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,694927 0,107930 0,347463 0,455394 0,625434 0,177423236 C09CA03 VALSARTANUM DIOVAN 3 mg/ml SOL. ORALA 3mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML ) P-6L 1 4,169566 37,250434 2,084783 39,335217 3,752609 37,667391240 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,694927 0,510787 0,347463 0,858251 0,625434 0,580280241 C09CA04 IRBESARTANUM IRBESARTAN TERAPIA 150 mg COMPR. FILM. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L 28 0,694927 0,088644 0,347463 0,436108 0,625434 0,158137246 C09CA04 IRBESARTANUM ATOKKEN 150 mg COMPR. FILM. 150mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 0,694927 0,088644 0,347463 0,436108 0,625434 0,158137248 C09CA04 IRBESARTANUM IRBESARTAN HF 150 mg COMPR. FILM. 150mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,694927 0,065073 0,347463 0,412537 0,625434 0,134566249 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,694927 0,510787 0,347463 0,858251 0,625434 0,580280250 C09CA04 IRBESARTANUM ATOKKEN 150 mg COMPR. FILM. 150mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 0,694927 0,088644 0,347463 0,436108 0,625434 0,158137253 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 1,389855 0,210859 0,694927 0,905787 1,250869 0,349845260 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 1,389855 0,210859 0,694927 0,905787 1,250869 0,349845262 C09CA04 IRBESARTANUM ATOKKEN 75 mg COMPR. FILM. 75mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 0,347463 0,508965 0,173731 0,682697 0,312716 0,543712263 C09CA06 CANDESARTANUM CILEXETIL ATACAND COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 1,389855 0,191930 0,694927 0,886858 1,250869 0,330916268 C09CA06 CANDESARTANUM CILEXETIL ATACAND 16mg COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 1,389855 0,191930 0,694927 0,886858 1,250869 0,330916281 C09CA06 CANDESARTANUM CILEXETIL ATACAND COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 0,694927 0,122215 0,347463 0,469679 0,625434 0,191708286 C09CA06 CANDESARTANUM CILEXETIL ATACAND 8mg COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0,694927 0,122215 0,347463 0,469679 0,625434 0,191708295 C09CA07 TELMISARTANUM TELMISARTAN TEVA 40 mg COMPR. 40mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE 30X1 P6L 30 0,694927 0,107739 0,347463 0,455203 0,625434 0,177232296 C09CA07 TELMISARTANUM TELMISARTAN RANBAXY 40 mg COMPR. 40mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. P6L 28 0,694927 0,766858 0,347463 1,114322 0,625434 0,836351298 C09CA07 TELMISARTANUM MICARDIS 80 mg COMPR. 80mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 1,389855 0,064073 0,694927 0,759001 1,250869 0,203059

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Page 11: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

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

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 50% din pretul de referinta)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 50% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 90% din pretul de referinta)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 90% din pretul de

referinta)304 C09CA07 TELMISARTANUM TANYDON 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,694927 0,397406 0,347463 0,744870 0,625434 0,466899306 C09CA07 TELMISARTANUM TELMOTENS 40mg COMPR. FILM. 40mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 3 BLIST. NYLON-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0,694927 0,714073 0,347463 1,061537 0,625434 0,783566313 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM)VALSARTAN HIDROCLOROTIAZIDA TORRENT 160 mg/12,5 mg COMPR. FILM. 160mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,693963 2,366037 0,346981 2,713019 0,624566 2,435434314 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM)VALSARTAN HIDROCLOROTIAZIDA TORRENT 80 mg/12,5 mg COMPR. FILM. 80mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,693963 1,943537 0,346981 2,290519 0,624566 2,012934315 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg COMPR. 150mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 0,693963 0,492465 0,346981 0,839447 0,624566 0,561862316 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/12,5mg COMPR. 300mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 0,693963 0,756037 0,346981 1,103019 0,624566 0,825434318 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5mg COMPR. FILM 300mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM. P-6L 28 0,693963 0,279965 0,346981 0,626947 0,624566 0,349362321 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mgCOMPR. FILM. 150mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,077108 0,346981 0,424090 0,624566 0,146505322 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mgCOMPR. FILM. 150mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM.P6L 28 0,693963 0,077108 0,346981 0,424090 0,624566 0,146505323 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg COMPR. FILM. 150mg/12,5mg SANOFI CLIR SNC FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,693963 0,492465 0,346981 0,839447 0,624566 0,561862324 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,077108 0,346981 0,424090 0,624566 0,146505325 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,077108 0,346981 0,424090 0,624566 0,146505326 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN/ HYDROCHLOROTHIAZIDE TEVA 300 mg/12,5 mgCOMPR. FILM. 300 mg/12,5mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 0,693963 0,279965 0,346981 0,626947 0,624566 0,349362328 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/12,5 mgCOMPR. FILM. 300mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,279965 0,346981 0,626947 0,624566 0,349362329 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/12,5 mgCOMPR. FILM. 300mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM.P6L 28 0,693963 0,279965 0,346981 0,626947 0,624566 0,349362330 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/12,5mg COMPR. FILM. 300mg/12,5mg SANOFI CLIR SNC FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,693963 0,756037 0,346981 1,103019 0,624566 0,825434331 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/12,5 mg COMPR. FILM. 300mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,279965 0,346981 0,626947 0,624566 0,349362332 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/12,5 mg COMPR. FILM. 300mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,279965 0,346981 0,626947 0,624566 0,349362333 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/25mg COMPR. FILM. 300mg/25mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,693963 0,758179 0,346981 1,105161 0,624566 0,827576335 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mg COMPR. FILM. 300mg/25mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,281751 0,346981 0,628733 0,624566 0,351148336 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mg COMPR. FILM. 300mg/25mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM.P6L 28 0,693963 0,281751 0,346981 0,628733 0,624566 0,351148337 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/25mg COMPR. FILM. 300mg/25mg SANOFI CLIR SNC FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,693963 0,758179 0,346981 1,105161 0,624566 0,827576338 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/25 mg COMPR. FILM. 300mg/25mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,281037 0,346981 0,628019 0,624566 0,350434339 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/25 mg COMPR. FILM. 300mg/25mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,281037 0,346981 0,628019 0,624566 0,350434341 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANZENO HCT 16mg/12,5mg COMPR. 16mg/12,5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,693963 0,041037 0,346981 0,388019 0,624566 0,110434345 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) ACTELSAR HCT 80 mg/12,5 mg COMPR. 80 mg/12,5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATE PRF 28 0,693963 0,400679 0,346981 0,747661 0,624566 0,470076346 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TOLUCOMBI 80 mg/12,5mg COMPR. 80 mg/12,5mg KRKA D.D. SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE PRF 30 0,693963 0,314370 0,346981 0,661352 0,624566 0,383767347 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TOLUCOMBI 80 mg/25mg COMPR. 80 mg/25mg KRKA D.D. SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE PRF 30 0,693963 0,314370 0,346981 0,661352 0,624566 0,383767348 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) ACTELSAR HCT 80 mg/25mg COMPR. 80 mg/25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATE PRF 28 0,693963 0,403894 0,346981 0,750876 0,624566 0,473291349 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/12,5mg COMPR. 80/12,5mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 0,693963 0,941037 0,346981 1,288019 0,624566 1,010434350 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/25mg COMPR. 80/25mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28 COMPR. (BLIST. PA/AL/PVC/AL SAU PA/PA/AL/PVC/AL) P-6L 28 0,693963 0,941037 0,346981 1,288019 0,624566 1,010434351 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TANYDON HCT 80 mg/12,5 mg COMPR. 80mg/12,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L 30 0,693963 0,314370 0,346981 0,661352 0,624566 0,383767352 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA EGIS 80 mg/12,5 mg COMPR. 80mg/12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 0,693963 0,395679 0,346981 0,742661 0,624566 0,465076353 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TEZEO HCT 80 mg/12,5 mg COMPR. 80mg/12,5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,690333 0,000000 0,345166 0,345167 0,621299 0,069034354 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMARK PLUS 80mg/12,5mg COMPR. 80mg/12,5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATE P-6L 30 0,693963 0,402703 0,346981 0,749685 0,624566 0,472100355 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mg COMPR. 80mg/12,5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 0,693963 0,404251 0,346981 0,751233 0,624566 0,473648356 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mg COMPR. 80mg/12,5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28X1 COMPR. P6L 28 0,693963 0,404251 0,346981 0,751233 0,624566 0,473648357 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TANYDON HCT 80 mg/25 mg COMPR. 80mg/25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L 30 0,693963 0,314370 0,346981 0,661352 0,624566 0,383767358 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TEZEO HCT 80 mg/25 mg COMPR. 80mg/25mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,693963 0,403037 0,346981 0,750019 0,624566 0,472434359 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMARK PLUS 80mg/25mg COMPR. 80mg/25mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATE P-6L 30 0,693963 0,404703 0,346981 0,751685 0,624566 0,474100360 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mg COMPR. 80mg/25mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 0,693963 0,404251 0,346981 0,751233 0,624566 0,473648361 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mg COMPR. 80mg/25mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28X1 COMPR. P6L 28 0,693963 0,404251 0,346981 0,751233 0,624566 0,473648372 C10AA04 FLUVASTATINUM LESCOL 20 mg CAPS. 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/AL X 7 CAPS. P-6L 28 0,243049 0,349093 0,121524 0,470618 0,218744 0,373398373 C10AA04 FLUVASTATINUM LESCOL 40 mg CAPS. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/AL X 7 CAPS. P-6L 28 0,486099 0,484615 0,243049 0,727665 0,437489 0,533225376 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 0,364574 0,722759 0,182287 0,905046 0,328116 0,759217378 C10AA05 ATORVASTATINUM ATORIS 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM. P-6L 30 0,364574 0,001092 0,182287 0,183379 0,328116 0,037550379 C10AA05 ATORVASTATINUM GLETOR 10 mg COMPR. FILM. 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,364574 0,141759 0,182287 0,324046 0,328116 0,178217380 C10AA05 ATORVASTATINUM ASCORD 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 0,364574 0,342092 0,182287 0,524379 0,328116 0,378550382 C10AA05 ATORVASTATINUM TORVAZIN 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,364574 0,284759 0,182287 0,467046 0,328116 0,321217383 C10AA05 ATORVASTATINUM XAMARA 10 mg COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,364574 0,342092 0,182287 0,524379 0,328116 0,378550384 C10AA05 ATORVASTATINUM VOREDANIN 10 mg COMPR. FILM. 10mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,364574 0,307092 0,182287 0,489379 0,328116 0,343550387 C10AA05 ATORVASTATINUM STAVRA 10 mg COMPR. FILM. 10mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,364574 0,342092 0,182287 0,524379 0,328116 0,378550388 C10AA05 ATORVASTATINUM ATORVASTATINA TORRENT 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,364574 0,342092 0,182287 0,524379 0,328116 0,378550391 C10AA05 ATORVASTATINUM SORTIS 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 0,729149 0,637184 0,364574 1,001759 0,656234 0,710099395 C10AA05 ATORVASTATINUM ASCORD 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 0,729149 0,188517 0,364574 0,553092 0,656234 0,261432398 C10AA05 ATORVASTATINUM XAMARA 20 mg COMPR. FILM. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,729149 0,188517 0,364574 0,553092 0,656234 0,261432399 C10AA05 ATORVASTATINUM VOREDANIN 20 mg COMPR. FILM. 20mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,729149 0,188184 0,364574 0,552759 0,656234 0,261099402 C10AA05 ATORVASTATINUM STAVRA 20 mg COMPR. FILM. 20mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,729149 0,188517 0,364574 0,553092 0,656234 0,261432403 C10AA05 ATORVASTATINUM ATORVASTATINA TORRENT 20 mg COMPR. FILM. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,729149 0,188517 0,364574 0,553092 0,656234 0,261432406 C10AA05 ATORVASTATINUM SORTIS 40 mg COMPR. FILM. 40mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 1,458299 0,237415 0,729149 0,966565 1,312469 0,383245429 C10AA07 ROSUVASTATINUM CRESTOR 10 mg COMPR. FILM. 10mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 0,729149 2,597279 0,364574 2,961854 0,656234 2,670194430 C10AA07 ROSUVASTATINUM ROSUCARD 10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,729149 0,103851 0,364574 0,468426 0,656234 0,176766434 C10AA07 ROSUVASTATINUM ROSTAT 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,729149 0,024851 0,364574 0,389426 0,656234 0,097766436 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,729149 0,512636 0,364574 0,877211 0,656234 0,585551437 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 0,729149 0,512636 0,364574 0,877211 0,656234 0,585551438 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,729149 0,476517 0,364574 0,841092 0,656234 0,549432

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Page 12: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

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

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 50% din pretul de referinta)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 50% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 90% din pretul de referinta)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 90% din pretul de

referinta)441 C10AA07 ROSUVASTATINUM ROZUCOR 10 mg COMPR. FILM. 10mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,729149 0,836517 0,364574 1,201092 0,656234 0,909432442 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0,729149 0,118184 0,364574 0,482759 0,656234 0,191099444 C10AA07 ROSUVASTATINUM CRESTOR 20 mg COMPR. FILM. 20mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 1,458299 3,406701 0,729149 4,135851 1,312469 3,552531452 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,458299 0,326343 0,729149 1,055493 1,312469 0,472173453 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 1,458299 0,326343 0,729149 1,055493 1,312469 0,472173454 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 1,458299 0,326701 0,729149 1,055851 1,312469 0,472531457 C10AA07 ROSUVASTATINUM ROZUCOR 20 mg COMPR. FILM. 20mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,458299 0,554701 0,729149 1,283851 1,312469 0,700531458 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 20 mg COMPR. FILM. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 1,001666 0,000000 0,500833 0,500833 0,901499 0,100167471 C10AA07 ROSUVASTATINUM CRESTOR 5 mg COMPR. FILM. 5mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/AL X 14 COMPR. FILM. P-6L 28 0,364574 2,271497 0,182287 2,453784 0,328116 2,307955472 C10AA07 ROSUVASTATINUM ROXARDIO 5 mg COMPR. FILM. 5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 0,364574 0,838997 0,182287 1,021284 0,328116 0,875455474 C10AA07 ROSUVASTATINUM ROSTAT 5 mg COMPR. FILM. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,364574 0,407759 0,182287 0,590046 0,328116 0,444217475 C10AA07 ROSUVASTATINUM TINTAROS 5 mg COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. P6L 28 0,364574 0,018997 0,182287 0,201284 0,328116 0,055455476 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,364574 1,439711 0,182287 1,621998 0,328116 1,476169477 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 0,364574 1,439711 0,182287 1,621998 0,328116 1,476169478 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,364574 0,663092 0,182287 0,845379 0,328116 0,699550479 C10AA07 ROSUVASTATINUM ROVASTAMED 5mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,364574 0,661854 0,182287 0,844141 0,328116 0,698312480 C10AA07 ROSUVASTATINUM STARCREST 5 mg COMPR. FILM. 5mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 0,364574 0,323997 0,182287 0,506284 0,328116 0,360455481 C10AA07 ROSUVASTATINUM ROZUCOR 5 mg COMPR. FILM. 5mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,364574 1,052092 0,182287 1,234379 0,328116 1,088550482 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0,364574 0,405759 0,182287 0,588046 0,328116 0,442217530 D07AD01 CLOBETASOLUM* DERMOVATE 0,5 mg/g CREMA 0,5mg/g GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 TUB AL X 25 G CREMA P-RF 1 5,860000 6,610000 2,930000 9,540000 5,274000 7,196000532 D07AD01 CLOBETASOLUM* DERMOVATE 0,5 mg/g UNGUENT 0,5mg/g GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 TUB AL X 25 G UNGUENT P-RF 1 5,860000 3,380000 2,930000 6,310000 5,274000 3,966000576 G03GA05 FOLLITROPINUM ALFA****# GONAL - f 75 UI (5,5 µg) PULB. + SOLV. PT. SOL. INJ. 75UI MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV.P-RF/R 1 103,550000 28,980000 51,775000 80,755000 93,195000 39,335000577 G03GA05 FOLLITROPINUM ALFA****# GONAL-f 300 UI/0,5 ml ( 22 µg/0,5 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 300UI/0,5ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 8 ACE PT. ADM. P-RF/R 1 414,200000 91,450000 207,100000 298,550000 372,780000 132,870000578 G03GA05 FOLLITROPINUM ALFA****# GONAL-f 450 UI/0,75 ml (33 µg/0,75 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 450UI/0,75ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 12 ACE PT. ADM. SUBCUTANATA P-RF/R 1 621,300000 114,480000 310,650000 425,130000 559,170000 176,610000579 G03GA05 FOLLITROPINUM ALFA****# GONAL-f 900 UI/1,5ml (66 µg/1,5 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 900UI/1,5ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1,5 ML SOL. INJ. + 20 ACE PT. ADM. SUBCUTANATA P-RF/R 1 1.242,600000 141,820000 621,300000 763,120000 1.118,340000 266,080000582 G03GA06 FOLLITROPINUM BETA****# PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml N. V. ORGANON OLANDA CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1.242,102960 38,157040 621,051480 659,208520 1.117,892664 162,367336583 G03GA06 FOLLITROPINUM BETA****# PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1.242,102960 38,157040 621,051480 659,208520 1.117,892664 162,367336628 J01FA02 SPIRAMYCINUM ROVAMYCINE (R) 1,5 Mil. UI COMPR. FILM. 1,5 M ui LAB. AVENTIS FRANTA CUTIE X 2 BLIST. AL/PVC X 8 COMPR. FILM. P-RF 16 0,622390 0,016360 0,311195 0,327555 0,560151 0,078599629 J01FA02 SPIRAMYCINUM ROVAMYCINE (R) 3 Mil. UI COMPR. FILM. 3M ui LAB. AVENTIS FRANTA CUTIE X 2 BLIST. AL/PVC X 5 COMPR. FILM. P-RF 10 1,244784 1,368216 0,622392 1,990608 1,120305 1,492695630 J01FA02 SPIRAMYCINUM ROVAMYCINE 3 Mil. UI COMPR. FILM. 3MilU.I. LABORATOIRES AVENTIS FRANTA CUTIE CU 1 BLIST. AL/PVC X 10 COMPR. FILM. PRF 10 1,244784 1,368216 0,622392 1,990608 1,120305 1,492695631 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. P-RF 6 3,111962 0,179704 1,555981 1,735685 2,800765 0,490901632 J01FA10 AZITHROMYCINUM SUMAMED 250 mg CAPS. 250mg PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS. P-RF 6 3,111962 1,954704 1,555981 3,510685 2,800765 2,265901633 J01FA10 AZITHROMYCINUM SUMAMED 125 mg COMPR. FILM. 125mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 6 COMPR. FILM. P-RF 6 1,555979 2,590687 0,777989 3,368677 1,400381 2,746285634 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 250 mg COMPRIMATE FILMATE COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. X 6 COMPR. FILM. P-RF 6 3,111962 0,179704 1,555981 1,735685 2,800765 0,490901635 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 6 COMPR. FILM. P-RF 6 3,111962 0,179704 1,555981 1,735685 2,800765 0,490901636 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 6 COMPR. FILM. P-RF 6 3,111962 0,179704 1,555981 1,735685 2,800765 0,490901637 J01FA10 AZITHROMYCINUM SUMAMED 500 mg COMPR. FILM. 500mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 6,223925 2,359408 3,111962 5,471371 5,601532 2,981801645 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 600 mg COMPR. FILM. 600mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF 3 7,468713 7,957953 3,734356 11,692310 6,721841 8,704825646 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 600 mg COMPR. FILM. 600mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM. P-RF 3 7,468713 7,957953 3,734356 11,692310 6,721841 8,704825660 J01MA12 LEVOFLOXACINUM TAVANIC 250 mg COMPR. FILM. 250mg TERAPIA S.A. ROMANIA CUTIE X1 BLIST. PVC/AL. X 7 COMPR. FILM. P-RF 7 2,453400 1,398028 1,226700 2,624728 2,208060 1,643368664 J01MA12 LEVOFLOXACINUM TAVANIC 500 mg COMPR. FILM. 500mg TERAPIA S.A. ROMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF 7 4,906800 1,684628 2,453400 4,138028 4,416120 2,175308666 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg COMPR. FILM. 400mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. TRANSPARENT PP/AL X 5 COMPR. FILM. P-RF 5 4,906800 6,177200 2,453400 8,630600 4,416120 6,667880667 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA AUROBINDO 400 mg COMPR. FILM. 400mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR. FILM. PRF 5 4,906800 2,299200 2,453400 4,752600 4,416120 2,789880668 J01MA14 MOXIFLOXACINUM MOFINACIN 400 mg COMPR. FILM. 400mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. OPA-AL-PVC/AL X 5 COMPR. FILM PRF 5 4,906800 2,299200 2,453400 4,752600 4,416120 2,789880669 J01MA14 MOXIFLOXACINUM MOFIL 400 mg COMPR. FILM. 400mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 5 COMPR. FILM. PRF 5 4,906800 2,299200 2,453400 4,752600 4,416120 2,789880670 J01MA14 MOXIFLOXACINUM MOFLAXA 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONAINÂND 5 COMPRIMATE FILMATE PRF 5 4,906800 2,299200 2,453400 4,752600 4,416120 2,789880726 M05BA04 ACIDUM ALENDRONICUM* FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L 2 6,554250 7,065750 3,277125 10,342875 5,898825 7,721175728 M05BA04 ACIDUM ALENDRONICUM* ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR. FILM. P-6L 12 6,554250 1,581583 3,277125 4,858708 5,898825 2,237008729 M05BA04 ACIDUM ALENDRONICUM* ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 COMPR. FILM. P-6L 2 6,554250 2,295750 3,277125 5,572875 5,898825 2,951175730 M05BA04 ACIDUM ALENDRONICUM* ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L 4 6,554250 2,013250 3,277125 5,290375 5,898825 2,668675732 M05BA07 ACIDUM RISEDRONICUM* LORINE 35mg COMPR. FILM. 35mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1BLIST. PVC- PVDC/AL X 4 COMPR. FILM. P-6L 4 6,554250 0,668250 3,277125 3,945375 5,898825 1,323675733 M05BA07 ACIDUM RISEDRONICUM* OSODENS 35 mg COMPR. FILM. 35mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR. FILM. P-6L 4 6,554250 0,668250 3,277125 3,945375 5,898825 1,323675736 M05BA07 ACIDUM RISEDRONICUM* ACTONEL SAPTAMANAL 35 mg COMPR. FILM. 35mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 4 COMPR. FILM. P-6L 4 6,554250 4,195750 3,277125 7,472875 5,898825 4,851175737 M05BA07 ACIDUM RISEDRONICUM* ACTONEL 75 mg COMPR. FILM. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L 2 14,044821 19,150179 7,022410 26,172590 12,640338 20,554662738 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)* FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UI MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.) P-6L 4 6,554250 11,935750 3,277125 15,212875 5,898825 12,591175739 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)* FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UI MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 2 COMPR. (1 PLIANT CU BLIST. AL/AL X 2 COMPR.) P-6L 2 6,554250 11,120750 3,277125 14,397875 5,898825 11,776175740 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)* FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UI MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.) P-6L 4 6,554250 10,533250 3,277125 13,810375 5,898825 11,188675775 N03AX16 PREGABALINUM**# LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF 14 2,805509 1,575205 1,402754 2,977960 2,524958 1,855756776 N03AX16 PREGABALINUM**# LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF 56 2,805509 1,090741 1,402754 2,493496 2,524958 1,371292777 N03AX16 PREGABALINUM**# LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 5,611019 0,120766 2,805509 2,926276 5,049917 0,681868778 N03AX16 PREGABALINUM**# LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 5,611019 0,433981 2,805509 3,239491 5,049917 0,995083779 N03AX16 PREGABALINUM**# LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF 14 1,402754 1,230103 0,701377 1,931480 1,262478 1,370379780 N03AX16 PREGABALINUM**# LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF 56 1,402754 1,011174 0,701377 1,712551 1,262478 1,151450855 N06AX21 DULOXETINUM** CYMBALTA 30mg CAPS. GASTROREZ. 30mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 0,625054 2,314946 0,312527 2,627473 0,562548 2,377452856 N06AX21 DULOXETINUM** CYMBALTA 60mg CAPS. GASTROREZ. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE, X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 1,250109 3,312748 0,625054 3,937803 1,125098 3,437759930 R03BB04 TIOTROPIUM* SPIRIVA 18 micrograme CAPS. CU PULB. INHAL. 18micrograme BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. AL/PVC/AL X 10 CAPS. CU PULB. DE INHALAT + 1 DISPOZITIV HANDIHALER PRF 30 5,127666 0,236334 2,563833 2,800167 4,614899 0,749101

Pagina 4 din 5

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

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 50% din pretul de referinta)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 50% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 90% din pretul de referinta)

Co-plata maxima a asiguratului / UT (pt.

asiguratii care beneficiaza de

compensare 90% din pretul de

referinta)931 R03BB04 TIOTROPIUM* SPIRIVA RESPIMAT 2,5 micrograme SOL. DE INHALAT 2,5micrograme BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 1 AMBALAJ UNIC CU UN INHALATOR RESPIMAT SI UN CARTUS CARE FURNIZEAZA 60 PUFURI (30 DOZE MEDICINALE) SOL. PT. INHALAT PRF 1 153,829999 4,250001 76,914999 81,165001 138,446999 19,633001

Pagina 5 din 5

Page 14: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

ANEXA 2c

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

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 100% din

pretul de referinta)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

SE ADAUGA

265 C09CA03 VALSARTANUM** VALSARTAN TORRENT 160 mg COMPR. FILM. 160mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 98 COMPR. FILM. P6L 98 0,462244 0,462244 0,000000266 C09CA03 VALSARTANUM** VALSACOR 320 mg COMPR. FILM. 320mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P-6L 30 1,129333 1,129333 0,000000267 C09CA03 VALSARTANUM** VALSARTAN TORRENT 80 mg COMPR. FILM. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 98 COMPR. FILM. P6L 98 0,292755 0,292755 0,000000

SE ELIMINA

157 C09AA03 LISINOPRILUM LISIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,298000 0,298000 0,000000166 C09AA03 LISINOPRILUM LISIGAMMA 20 mg COMPR. 20mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,447333 0,447333 0,000000173 C09AA03 LISINOPRILUM LISIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,225000 0,225000 0,000000212 C09CA03 VALSARTANUM** VALSARGAMMA 160 mg COMPR. FILM. 160mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,551570 0,551570 0,209763225 C09CA03 VALSARTANUM** VALSARGAMMA 80 mg COMPR. FILM. 80mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,462856 0,462856 0,148810

SE MODIFICA

88 C07AG02 CARVEDILOLUM GLADYCOR 12,5 mg COMPR. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,308570 0,308570 0,07676395 C07AG02 CARVEDILOLUM GLADYCOR 25 mg COMPR. 25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,342856 0,342856 0,181144104 C07AG02 CARVEDILOLUM GLADYCOR 6,25 mg COMPR. 6,25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,185000 0,185000 0,000000209 C09CA03 VALSARTANUM** VALSARTAN TEVA 80 mg CAPS. 80mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. P-6L 28 0,351306 0,351306 0,057979223 C09CA03 VALSARTANUM** WENZELL 80 mg COMPR. FILM. 80mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 28 COMPR. FILM. P-6L 28 0,351306 0,351306 0,451551224 C09CA03 VALSARTANUM** WENZELL 80 mg COMPR. FILM. 80mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 30 COMPR. FILM. P-6L 30 0,351306 0,351306 0,451360226 C09CA03 VALSARTANUM** DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM. P6L 28 0,351306 0,351306 0,843694227 C09CA03 VALSARTANUM** VALSACOR 80 mg COMPR. FILM. 80mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,351306 0,351306 0,086551228 C09CA03 VALSARTANUM** AVASSAN 80 mg COMPR. FILM. 80mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,351306 0,351306 0,451551229 C09CA03 VALSARTANUM** VALSARTAN ZENTIVA 80 mg COMPR. FILM. 80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM.P-6L 28 0,351306 0,351306 0,171551230 C09CA03 VALSARTANUM** VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,351306 0,351306 0,034408231 C09CA03 VALSARTANUM** VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,351306 0,351306 0,034408

SE ELIMINA

7 B01AC04 CLOPIDOGRELUM*** CLOPIGAMMA 75 mg COMPR. FILM. 75mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,506570 0,506570 0,130572

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

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

SECŢIUNEA C1 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% DIN PREŢUL DE REFERINŢĂ CONFORMDCI-urilor UTILIZATE ÎN TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOLI

DIN H.G. NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE;MEDICAMENTELE DIN ACEASTĂ SUBLISTĂ SE ELIBEREAZĂ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZĂ DE PRESCRIPŢIE MEDICALĂ CU REŢINERE ÎN FARMACIE

VALABILĂ ÎNCEPÂND CU 01 DECEMBRIE 2015

Pagina 1 din 3

Page 15: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

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

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 100% din

pretul de referinta)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)8 B01AC04 CLOPIDOGRELUM*** CLOPIGAMMA 75 mg COMPR. FILM. 75mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 0,506570 0,506570 0,130572

SE ELIMINA

3 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 0,788600 0,788600 0,000000

SE ADAUGA

184 N07BC02 METHADONUM MISYO 10 mg/ml CONC. PT. SOL. ORALA 10mg/ml INN-FARM D.O.O. SLOVENIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPAC DIN PP 28 CU SIGILIU DIN PE A 1000 ML CONC. PT. SOL. ORAL PS 1 387,080000 387,080000 0,000000185 N07BC02 METHADONUM MISYO 10 mg/ml CONC. PT. SOL. ORALA 10mg/ml INN-FARM D.O.O. SLOVENIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPAC DIN PP 28 PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII, A 1000 ML CONC. PT. SOL. ORALA PS 1 387,080000 387,080000 0,000000

SE MODIFICA

85 N03AX12 GABAPENTINUM*** GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,519600 0,519600 0,00010093 N03AX12 GABAPENTINUM*** GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,692500 0,692500 0,000000

10. BOALA PARKINSON - G12

SE ADAUGA

75 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1,782500 1,782500 0,00000076 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 125 mg/31,25 mg/200 mg COMPR. FILM. 125mg/31,25mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1,782500 1,782500 0,00000077 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1,851000 1,851000 0,00000078 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1,995000 1,995000 0,00000079 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1,646200 1,646200 0,00000080 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,75mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1,262600 1,262600 0,00000081 N04BC05 PRAMIPEXOLUM** OPRYMEA 2,62 mg COMPR. ELIB. PREL. 2,62mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF 30 8,426666 8,426666 0,00000082 N04BC05 PRAMIPEXOLUM** OPRYMEA 3,15 mg COMPR. ELIB. PREL. 3,15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF 30 7,767333 7,767333 0,000000

SE MODIFICA

6 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 2,139000 2,139000 0,6034007 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 125 mg/31,25 mg/200 mg COMPR. FILM. 125mg/31,25mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF 100 2,139000 2,139000 0,6034008 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 2,221200 2,221200 0,6265009 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 2,394000 2,394000 0,675200

10 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 1,975440 1,975440 0,55726011 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,75mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF 100 1,515120 1,515120 1,325480

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

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

9. EPILEPSIE - G11

Pagina 2 din 3

Page 16: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

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

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 100% din

pretul de referinta)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)57 N04BC05 PRAMIPEXOLUM** MIRAPEXIN 3,15 mg COMPR. ELIB. PREL. 3,15mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR. P-RF 30 9,320799 9,320799 2,629201

SE ADAUGA

288 N05AH04 QUETIAPINUM** QUETIAPINA TEVA 50 mg COMPR. ELIB. PREL. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 0,742500 0,742500 0,000000289 N05AX12 ARIPIPRAZOLUM** ARIPIPRAZOL TEVA 10 mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 7,463666 7,463666 0,000000290 N05AX12 ARIPIPRAZOLUM** ARIPIPRAZOL TEVA 15 mg COMPR. 15mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 7,463666 7,463666 0,000000291 N05AX12 ARIPIPRAZOLUM** ARIPIPRAZOL TEVA 20 mg COMPR. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 12,270000 12,270000 0,000000292 N05AX12 ARIPIPRAZOLUM** ARIPIPRAZOL TEVA 30 mg COMPR. 30mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 12,270000 12,270000 0,000000293 N06AX21 DULOXETINUM** DULSEVIA 30 mg CAPS. GASTROREZ. 30mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 90 CAPS. GASTROREZ. PRF 90 0,670666 0,670666 0,000000294 N06AX21 DULOXETINUM** DULSEVIA 60 mg CAPS. GASTROREZ. 60mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 90 CAPS. GASTROREZ. PRF 90 0,976444 0,976444 0,000000

SE MODIFICA

121 N05AH04 QUETIAPINUM** SEROQUEL XR 150 mg COMPR. ELIB. PREL. 150mg ASTRAZENECA UK LIMITED MAREA BRITANIE CUTIE CU 6 BLIST. PVC-PCTFE/AL X 10 COMPR. ELIB. PREL. P-RF 60 1,770199 1,770199 1,316134122 N05AH04 QUETIAPINUM** QUETIAPINA TEVA 150 mg COMPR. ELIB. PREL. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. FILM. PRF 60 1,475166 1,475166 0,000000123 N05AH04 QUETIAPINUM** QUETIAPINA TEVA 200 mg COMPR. ELIB. PREL. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 1,953500 1,953500 0,000000146 N05AH04 QUETIAPINUM** SEROQUEL XR 200 mg COMPR. FILM. ELIB. PREL. 200mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. OPACE AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL. P-RF 60 2,344200 2,344200 1,771133149 N05AH04 QUETIAPINUM** SEROQUEL XR 50 mg COMPR. FILM. ELIB. PREL. 50mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. OPACE DIN AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL. P-RF 60 0,891000 0,891000 0,213333278 N06AX21 DULOXETINUM** CYMBALTA 30mg CAPS. GASTROREZ. 30mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 0,804799 0,804799 2,135201279 N06AX21 DULOXETINUM** CYMBALTA 60mg CAPS. GASTROREZ. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE, X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 1,171732 1,171732 3,391125

SE MODIFICA

4 N06DA02 DONEPEZILUM*** TUADIN 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 1,237666 1,237666 0,000000

SE ADAUGA

40 H01CB02 OCTREOTIDUM**** SANDOSTATIN LAR 10 mg PULB.+SOLV. PT. SOL. INJ. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2 ML SOLVENT + ADAPTOR PT FLACON+1 AC PR 1 1.495,280000 1.495,280000 0,00000041 H01CB02 OCTREOTIDUM**** SANDOSTATIN LAR 20 mg PULB.+SOLV. PT. SOL. INJ. 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2 ML SOLVENT + ADAPTOR PT FLACON+1 AC PR 1 2.919,710000 2.919,710000 0,00000042 H01CB03 LANREOTIDUM**** SOMATULINE AUTOGEL 120 mg SOL. INJ. IN SERINGA PREUMPLUTA 120mg IPSEN PHARMA FRANTA CUTIE CU 1 SERINGA PREUMPLUTA PE TEREFTALAT/AL/PE LAMINATA X 0,5 ML PREVAZUTA CU SIST. DE SIGURANTA AUTOMAT SI 1 AC DIN OTEL (1,2MMX20MM), TEACA DIN PLASTIC PT. AC (PEID) SI 1 OPRITOR PT. PISTON (BROMOBUTIL CAUCIUC) PR 1 4.667,070000 4.667,070000 0,000000

SE ADAUGA

74 J01FA10 AZITHROMYCINUM AZIBIOT 250 mg COMPR. FILM. 250mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR.FILM. PRF 6 3,291666 3,291666 0,000000

18. BOLI ENDOCRINE (GUSA ENDEMICA, INSUFICIENTA SUPRARENALA CRONICA, DIABETUL INSIPID, MIXEDEMUL ADULTULUI, TUMORI HIPOFIZARE CU EXPANSIUNE SUPRASELARA SI TUMORI NEUROENDOCRINE) - G

13. BOLI PSIHICE (SCHIZOFRENIE, TULBURĂRI SCHIZOTIPALE ŞI DELIRANTE, TULBURĂRI AFECTIVE MAJORE, TULBURĂRI PSIHOTICE ACUTE ŞI BOLI PSIHICE COPII, AUTISM, TULBURĂRI CU DEFICIT DE ATENŢIE/HIPERREACTIVITATE) - G15

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

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

Pagina 3 din 3

Page 17: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

ANEXA 2d

Nr. crt

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP

Tara det. APP Ambalaj Pr

escr

iptie cant.

UT/ ambal

aj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 100% din

pretul de referinta)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

SE ADAUGA

216 D01AC05 ISOCONAZOLUM TRAVOGEN CREMA 10mg/1g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA PRF 1 17,470000 17,470000 0,000000

SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% - CONFORM DCI-URILOR DIN CANAMED, ALTELE DECÂT CELE DIN SUBLISTELE A, B, C1, C2, INDICATE PENTRU COPII PÂNĂ LA 18 ANI, TINERI DE LA 18 LA 26 DE ANI DACA SUNT ELEVI, STUDENŢI SAU UCENICI DACĂ NU REALIZEAZĂ VENITURI, PRECUM ŞI

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

VALABILĂ ÎNCEPÂND CU 01 DECEMBRIE 2015

Pagina 1 din 1

Page 18: ANEXA 2a - casan.ro · Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Ambalaj Prescriptie cant. UT/ ambal aj Pret de referinta / UT (RON)

ANEXA 2e

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

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de

referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 20% din pretul de referinta)

Co-plata maxima a asiguratului / UT

(pt. asiguratii care beneficiaza de

compensare 20% din pretul de

referinta)

SE MODIFICA

92 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 150 mg COMPR. FILM. 150 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 1 COMPRIMAT FILMAT P6L 1 28,089642 7,310358 5,617928 29,78207293 M05BA06 ACIDUM IBANDRONICUM** BONVIVA 150mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 COMPR. FILM.( BLIST. AL/AL) P-6L 1 28,089642 61,650358 5,617928 84,12207294 M05BA06 ACIDUM IBANDRONICUM** OSSICA 150 mg COMPR. FILM. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P-6L 1 28,089642 7,590358 5,617928 30,06207295 M05BA06 ACIDUM IBANDRONICUM** QUODIXOR 150 mg COMPR. FILM. 150mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P-6L 1 28,089642 7,580358 5,617928 30,05207296 M05BA06 ACIDUM IBANDRONICUM** OSAGRAND 150 mg COMPR. FILM. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 COMPR. FILM. P6L 1 28,089642 7,590358 5,617928 30,06207297 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P6L 1 28,089642 7,590358 5,617928 30,06207298 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P6L 1 28,089642 6,950358 5,617928 29,422072102 M05BA06 ACIDUM IBANDRONICUM** BONVIVA 3mg/3ml SOL. INJ. IN SERINGA PREUMPLUTA 3mg/3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA DIN STICLA X 3 ML SOL. INJ. + 1 AC P-6L 1 133,791750 19,108250 26,758350 126,141650

SUBLISTA D - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 20% DIN PRETUL DE REFERINTA CONFORMDENUMIRILOR 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 DECEMBRIE 2015

Pagina 1 din 1


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