Anexă · Ministerul Sănătății Casa Națională de Asigurări de Sănătate

Anexa din 30 iunie 2015

privind Lista denumirilor comerciale și a prețurilor de decontare ale medicamentelor prevăzute la art. 2 alin. (4) din Anexa la Ordinul ministrului sănătății nr. 75/2009 pentru aprobarea Normelor privind modul de calcul al prețurilor la medicamentele de uz uman, cu modificările și completările ulterioare (Anexa nr. 2)

prezumat în vigoare

Data actului: 30 iunie 2015
Emitent: Ministerul Sănătății Casa Națională de Asigurări de Sănătate
Publicat în: Monitorul Oficial nr. 480 bis din 1 iulie 2015
Citează: 4 acte
Structură: 0 articole · 711.567 caractere
Sursă: legislatie.just.ro

Legături cu alte acte

Ce face acest act

Anexă la 1

Ordinul nr. 75/2009 30 ianuarie 2009 pentru aprobarea Normelor privind modul de calcul al prețurilor la medicamentele de uz uma…

Are ca temei 1

Ordinul nr. 1605/2014 privind aprobarea modului de calcul, a listei denumirilor comerciale și a prețurilor de de…

Textul nu are o structură pe articole recunoscută și este afișat ca atare.

ANEXA 1

SECȚIUNEA C2 - LISTA denumirilor comerciale și a preturilor de decontare a medicamentelor care se acordă bolnavilor cuprinși in cadrul programele nationale de sănătate, in tratamentul ambulatoriu si spitalicesc, corespunzătoare denumirilor comune internaționale cuprinse în sec țiunea C2 a sublistei C

din HG nr. 720/2008, cu modificările și completările ulterioare, elaborată în temeiul Ordinului MS/CNAS nr. 1605/875/2014, cu modificarile si competarile ulterioare, VALABILĂ ÎNCEPÂND CU 01 IULIE 2015

P1: PROGRAMUL NATIONAL DE BOLI TRANSMISIBILE

A) SUBPROGRAMUL DE TRATAMENT SI MONITORIZARE A PERSOANELOR CU INFECTIE HIV/SIDA si TRATAMENTUL POSTEXPUNERE 1 W05444001 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 12 COMPR. FILM. P-RF 12 1,942500 2,625833 0,000000 2 W05444002 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE X 3 BLIST. AL/PVC A CATE 12 COMPR. FILM. P-RF 36 1,908611 2,413333 0,000000 3 W05445001 A07AA11 RIFAXIMINUM NORMIX 200mg/10ml GRAN. PT. SUSP. ORALA 200mg/10 ml ALFA WASSERMANN SPA ITALIA CUTIE X 1 FLAC. GRAN. PT. 60 ML SUSP. ORALA + 1 MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML P-RF 1 14,660000 19,810000 0,000000 4 W13742001 D01AC02 MICONAZOLUM MICONAZOL NITRAT 2% CREMA 2% SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 5,190000 7,010000 0,000000 5 W00040001 D06BB03 ACICLOVIRUM ZOVIRAX CREMA 5% THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 TUB X 5G CREMA P-RF 1 4,584000 6,192000 15,658000 6 W55641001 D06BB03 ACICLOVIRUM ACICLOVIR 50mg/g CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 5 G CREMA P-RF 1 3,820000 5,160000 0,000000 7 W55641002 D06BB03 ACICLOVIRUM ACICLOVIR 50mg/g CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 15 G CREMA P-RF 1 4,176000 5,640000 2,250000 8 W55128002 D06BB03 ACICLOVIRUM ACICLOVIR SLAVIA 50 mg/g CREMA 50mg/g SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 1 TUB AL X 5 G CREMA P-RF 1 4,140000 5,590000 0,000000 9 W58038001 D06BB03 ACICLOVIRUM ACICLOVIR TERAPIA 50 mg/g CREMA 50mg/g TERAPIA S.A. ROMANIA CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF 1 4,176000 5,640000 1,320000 10 W60557001 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 5 G CREMA PRF 1 3,820000 5,160000 0,000000 11 W60557002 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA PRF 1 4,176000 5,640000 2,250000 12 W52146002 D06BB03 ACICLOVIRUM ACICLOVIR HYPERION CREMA 50mg/g HYPERION S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 4,176000 5,640000 1,690000 13 W53041001 D06BB03 ACICLOVIRUM ACICLOVIR TIS 50mg/g CREMA 50mg/g TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB DIN PEJD X 15 G CREMA P-RF 1 3,480000 4,700000 0,000000 14 W55128001 D06BB03 ACICLOVIRUM ACICLOVIR SLAVIA 50 mg/g CREMA 50mg/g SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA P-RF 1 4,176000 5,640000 1,320000 15 W51339001 G01AF04 MICONAZOLUM GYNOZOL 200 CAPS. VAG. 200mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. X 3 CAPS. VAG. MOI P-RF 6 0,763333 1,031666 0,000000 16 W51340001 G01AF04 MICONAZOLUM GYNOZOL 400 CAPS. VAG. 400mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 CAPS. VAG. MOI P-RF 3 1,463333 1,976666 0,000000 17 W04675003 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 0,251650 0,307220 0,000000 18 W11729001 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,289500 0,368664 0,022836 19 W04675002 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,272500 0,368500 0,000000 20 W43090001 J01CF04 OXACILLINUM OXACILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,296000 0,368664 0,031336 21 W13743001 J01CF04 OXACILLINUM OXACILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,468216 0,571608 0,071392 22 W43092001 J01CF04 OXACILLINUM OXACILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,468216 0,571608 0,158392 23 W12910002 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 50 BLIST. AL/PVC X 10 CAPS. P-RF/S 500 0,390180 0,476340 0,000000 24 W12910001 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,413000 0,558500 0,000000 25 W07274001 J01CF04 OXACILLINUM OXACILINA 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0,468216 0,571608 0,206392 26 W60469001 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 1 4,090000 5,530000 0,000000 27 W60469003 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 100 3,890600 4,622300 0,000000 28 W60468003 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 100 3,612900 4,319600 0,000000 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 29 W60468001 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 1 3,770000 5,100000 0,000000 30 W04684004 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 500 mg PULB. PT. SOL. INJ./PERF. I.M./I.V. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF 1 3,770000 5,100000 0,000000 31 W04684002 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 500 mg PULB. PT. SOL. INJ./PERF. I.M./I.V. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF/S 100 3,612900 4,319600 0,000000 32 W04682003 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 1 g PULB. PT. SOL. INJ./PERF.I. M./I.V. 1g ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF 1 4,090000 5,530000 0,000000 33 W04682002 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 1 g PULB. PT. SOL. INJ./PERF.I. M./I.V. 1g ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF/S 100 3,890600 4,622300 0,000000 34 W58901002 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS 1000 mg/500 mg PULB. PT. SOL. INJ./PERF. 1000mg/5 00mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. PR, PRF 50 13,129000 15,073600 0,000000 35 W55354004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN SR 1000 mg/62,5 mg COMPR. ELIB. PREL. 1000mg/6 2,5mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE CU 7 BLIST. AL/PVC-AL X 4 COMPR. ELIB. PREL. P-RF 28 1,256071 1,642857 0,000000 36 W00400003 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 1000 mg COMPR. FILM. 1000mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. AL/AL X 7 COMPR.FILM. P-RF 14 0,712142 0,962142 0,000000 37 W57628002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 500 mg/125mg COMPR. FILM. 500 mg/125 mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 4 FOLII AL-PEJD X 7 COMPR. FILM. P-RF 28 0,437142 0,591071 0,000000 38 W54453002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 500/125 mg COMPR. FILM. 500/125m g ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 0,437142 0,590714 0,000000 39 W54971008 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 500 mg/125 mg COMPR. FILM. 500mg/12 5mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 0,437142 0,590714 0,000000 40 W55163002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 500 mg/125 mg COMPR. FILM. 500mg/12 5mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 2 BLISTERE PVC-PVDC/AL X 7 COMPRIMATE FILMATE, FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOARE DIN AL LAMINAT, CONTINAND UN DESICANT P-RF 14 0,524570 0,708857 0,200428 41 W00401004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 625 mg COMPR. FILM. 625mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 14 COMPR. FILM. P-RF 14 0,437142 0,590714 0,000000 42 W55164001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 875 mg/125 mg COMPR. FILM. 875mg/12 5mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 2 BLISTERE PVC-PVDC/AL X 7 COMPRIMATE FILMATE, FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOARE DIN AL LAMINAT, CONTINAND UN DESICANT P-RF 14 0,854570 1,154570 0,324715 43 W55401002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 875 mg/125 mg COMPR. FILM. 875mg/12 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 0,712142 0,962142 0,000000 44 W54972008 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 875 mg/125 mg COMPR. FILM. 875mg/12 5mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 0,712142 0,962142 0,000000 45 W51992004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 1000 mg COMPR. PT. DISPERSIE ORALA/OR ODISPERS ABILE 1000mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 0,854570 1,154570 0,703287 46 W51991002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 625 mg COMPR. PT. DISPERSIE ORALA/OR ODISPERS ABILE 625mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 0,524570 0,708857 0,516143 47 W59739002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 1000 mg/200 mg PULB. PT. SOL. INJ./PERF. 1000mg/2 00mg ANTIBIOTICE SA ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA CARE CONTINE PULB. PT. SOL. INJ. / PERF. PRF 50 7,344200 8,768200 0,000000 48 W00399001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 156,25mg/5ml PULB. PT. SUSP. ORALA 156,25mg /5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 MG PULB. PT. 100 ML SUSP. ORALA P-RF 1 8,010000 10,820000 0,000000 49 W08783001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2x PULB. PT. SUSP. ORALA 400mg+5 7mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 35 ML SUSP.ORALA + SERINGA DOZATOARE P-RF 1 4,960000 6,700000 0,000000 4 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 50 W08783002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2x PULB. PT. SUSP. ORALA 400mg+5 7mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 70 ML SUSP.ORALA + SERINGA DOZATOARE P-RF 1 9,920000 13,410000 0,000000 51 W55355002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57 mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 70 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 11,904000 16,092000 4,538000 52 W59180001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57 mg/5ml AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 FLAC. PEID CARE CONTINE PULB. PT. SUSP. ORALA PT. OBTINEREA A 35 ML SUSP. RECONSTITUITA + 1 SERINGA DE POLISTIREN CU GRADATII LA INTERVALE DE 0,5 ML PRF 1 4,960000 6,700000 0,000000 53 W55355004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57 mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 5,952000 8,040000 2,280000 54 W55355001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57 mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + 1 SERINGA PT. ADM. ORALA P-RF 1 5,952000 8,040000 2,280000 55 W55342003 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN (R) ES PULB. PT. SUSP. ORALA 600 mg/42,9m g/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA CU PULB. PT. 100 ML SUSP. ORALA + 1 MASURA DOZATOARE P-RF 1 27,200000 35,580000 0,000000 56 W00402001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 312,5mg/5ml PULB. PT.SUSP. ORALA 312,5mg/ 5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 G PULB. PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 14,060000 19,000000 0,000000 57 W55629002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 12 4,044000 5,472000 22,543000 58 W54763001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CU PULB. PT. SOL. INJ./PERF. S 1 3,370000 4,560000 0,000000 59 W55369001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 60 W55629001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 61 W55423001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 62 W55424001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 63 W55370001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 64 W55630001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 65 W55630002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 12 21,346800 26,060400 20,445433 66 W54765001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 10,049600 67 W53595006 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 2g/0,25 g PULB. PT. SOL. PERF. 2g/0,25g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 4,044000 5,472000 10,127000 68 W53596003 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 4g/0.5g PULB. PT. SOL. PERF. 4g/0,5g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE CU 10 FLAC DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 17,789000 21,717000 0,000000 69 W55618001 J01DD04 CEFTRIAXONUM OFRAMAX 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg TERAPIA SA ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 15 ML CU PULB. PT. SOL. INJ./PERF. S 50 4,826400 6,313200 4,739400 70 W13949006 J01DD04 CEFTRIAXONUM CEFORT 1 g PULB. PT. SOL. INJ./PERF. 1g ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 10 ML CU PULB. PT. SOL. INJ./PERF. PR 10 4,826400 6,313200 10,025800 71 W13949009 J01DD04 CEFTRIAXONUM CEFORT 1 g PULB. PT. SOL. INJ./PERF. 1g ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 30 ML CU PULB. PT. SOL. INJ./PERF. PR 10 4,826400 6,313200 10,025800 72 W13949012 J01DD04 CEFTRIAXONUM CEFORT 1 g PULB. PT. SOL. INJ./PERF. 1g ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 15 ML CU PULB. PT. SOL. INJ./PERF. PR 10 4,826400 6,313200 10,025800 73 W13949003 J01DD04 CEFTRIAXONUM CEFORT 1 g PULB. PT. SOL. INJ./PERF. 1g ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 17 ML CU PULB. PT. SOL. INJ./PERF. S/P-RF 10 4,826400 6,313200 10,025800 5 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 74 W59397002 J01DD04 CEFTRIAXONUM CEFTRIAXONA-MIP 1 g PULB. PT. SOL. INJ./PERF. 1g MIP PHARMA GMBH GERMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 50 ML CONTINAND PULB. PT. SOL. INJ./PERF. PR 10 4,022000 5,261000 0,000000 75 W53779001 J01DD04 CEFTRIAXONUM SEFTRION 1 g PULB. PT. SOL. INJ./PERF. 1g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERFZ. S/P-RF 1 4,826400 6,313200 7,416800 76 W13948008 J01DD04 CEFTRIAXONUM CEFORT 250 mg PULB. PT. SOL. INJ./PERF. 250mg ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 15 ML CU PULB. PT. SOL. INJ. PERF. PR 10 5,668000 7,167000 0,000000 77 W13948004 J01DD04 CEFTRIAXONUM CEFORT 250 mg PULB. PT. SOL. INJ./PERF. 250mg ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 10 ML CU PULB. PT. SOL. INJ. PERF. S/P-RF 10 5,668000 7,167000 0,000000 78 W55619001 J01DD04 CEFTRIAXONUM OFRAMAX 250 mg PULB. PT. SOL. INJ./PERF. 250mg TERAPIA SA ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 5 ML CU PULB. PT. SOL. INJ./PERF. S 50 5,105400 6,232600 0,000000 79 W13891008 J01DD04 CEFTRIAXONUM CEFORT 2 g PULB. PT. SOL. INJ./PERF. 2g ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 30 ML CU PULB. PT. SOL. INJ./PERF. PR 10 8,888400 11,238000 17,698000 80 W59398002 J01DD04 CEFTRIAXONUM CEFTRIAXONA-MIP 2 g PULB. PT. SOL. INJ./PERF. 2g MIP PHARMA GMBH GERMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 50 ML CONTINAND PULB. PT. SOL. INJ./PERF. PR 10 7,407000 9,365000 0,000000 81 W13891004 J01DD04 CEFTRIAXONUM CEFORT 2 g PULB. PT. SOL. INJ./PERF. 2g ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 50 ML, CU PULB. PT. SOL. INJ./PERF. S/P-RF 10 8,888400 11,238000 17,698000 82 W42544001 J01DD04 CEFTRIAXONUM MEDAXONE 2 g PULB. PT. SOL. INJ./PERF. 2g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLACOANE X 2 G PULB. PT. SOL. INJ./PERF. S/P-RF 10 8,888400 11,238000 15,471000 83 W53778001 J01DD04 CEFTRIAXONUM SEFTRION 500 mg PULB. PT. SOL. INJ./PERF. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERFZ. S/P-RF 1 6,370000 8,610000 0,000000 84 W56096001 J01DD04 CEFTRIAXONUM SEFTRION 2 g PULB. PT. SOL. PERF. 2g EIPICO MED SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. P-RF 1 8,888400 11,238000 6,252000 85 W51335001 J01DD04 CEFTRIAXONUM ROCEPHIN (R) PULB. PT. SOL. PERF. 2g ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPCITATEA DE 50ML CONTINAND PULB. PT. SOL. PERFUZ. S/P-RF 1 8,888400 11,238000 42,222000 86 W57455001 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 1,655000 2,237000 0,000000 87 W13701001 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 2,759000 3,609000 0,000000 88 W60256001 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATE PRF 5 7,660000 10,020000 0,000000 89 W60256003 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU 2 BLISTERE PVC-PVDC/AL A CATE 5 COMPRIMATE FILMATE PRF 10 7,526000 9,516000 0,000000 90 W13676001 J01DD12 CEFOPERAZONUM MEDOCEF 1 g PULB. PT. SOL. INJ. 1g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 8,412000 11,376000 6,538000 91 W13677001 J01DD12 CEFOPERAZONUM MEDOCEF 2 g PULB. PT. SOL. INJ. 2g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 12,576000 16,992000 6,670000 92 W44045001 J01DD12 CEFOPERAZONUM CEFOZON 500 mg PULB. PT. SOL. INJ. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. S/P-RF 1 3,190000 4,310000 0,000000 93 W52795001 J01DD12 CEFOPERAZONUM CEFOZON 2 g PULB. PT. SOL. INJ./PERF. I.M./I.V. 2g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA A 20 ML CU PULB. PT. SOL. INJ./PERF. I.M./I.V. S/P-RF 1 10,480000 14,160000 0,000000 94 W44061001 J01DD12 CEFOPERAZONUM CEFOZON 1 g PULB. PT. SOL. INJ./PERF.I. M./I.V. 1g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 15 ML CU PULB. PT. SOL. INJ. I.M./PERF. I.V. S/P-RF 1 7,010000 9,480000 0,000000 95 W53787001 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1 000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 1 19,370000 23,076840 3,103160 96 W53787004 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1 000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S 100 17,292800 19,230700 0,000000 97 W53787003 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1 000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 50 17,592800 19,939200 0,000000 98 W53787002 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1 000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 10 18,691000 22,818000 0,000000 99 W60705002 J01DH02 MEROPENEMUM MEROPENEM ZENTIVA 1000 mg PULB. PT. SOL. INJ. SAU PERF. 1000 mg ZENTIVA, K.S. REPUBLIC A CEHA CUTIE CU 10 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 20 ML PR 10 27,211200 33,219600 44,763400 6 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 100 W60703002 J01DH02 MEROPENEMUM MEROPENEM ZENTIVA 500 mg PULB. PT. SOL. INJ. SAU PERF. 500 mg ZENTIVA, K.S. REPUBLIC A CEHA CUTIE CU 10 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 20 ML PR 10 16,826400 20,541600 22,648400 101 W56827001 J01DH02 MEROPENEMUM LODITER 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg TERAPIA S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 40 ML CONTINAND PULB. PT. SOL. INJ./PERF. PR 1 27,211200 33,219600 62,340400 102 W58974002 J01DH02 MEROPENEMUM MEROPENEM ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 20 ML SAU 30 ML CU DOP DIN CAUCIUC, SIGILAT CU CAPSA DIN ALUMINIU PREVAZUTA CU DISC DIN MATERIAL PLASTIC PRF 10 27,211200 33,219600 47,425400 103 W61143002 J01DH02 MEROPENEMUM ARCHIFAR 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA, CAPACITATEA 30 ML, DOP DIN CAUCIUC BROMOBUTILIC SIGILAT CU CAPSA AL CU PULB.PT.SOL.INJ./PERF. PR 10 27,211200 33,219600 29,959400 104 W56125002 J01DH02 MEROPENEMUM MEROPENEM KABI 1 g PULB. PT. SOL. INJ./PERF. 1g FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 10 27,211200 33,219600 16,867400 105 W56331002 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 1 g PULB. PT. SOL. INJ./PERF. 1g HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 10 22,676000 27,683000 0,000000 106 W56826001 J01DH02 MEROPENEMUM LODITER 500 mg PULB. PT. SOL. INJ./PERF. 500mg TERAPIA S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CONTINAND PULB. PT. SOL. INJ./PERF. PR 1 16,826400 20,541600 30,708400 107 W56124002 J01DH02 MEROPENEMUM MEROPENEM KABI 500 mg PULB. PT. SOL. INJ./PERF. 500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. PR 10 16,826400 20,541600 6,620400 108 W56330002 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 500 mg PULB. PT. SOL. INJ./PERF. 500mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 10 14,022000 17,118000 0,000000 109 W61142002 J01DH02 MEROPENEMUM ARCHIFAR 500 mg PULB. PT. SOL. INJ./PERF. 500mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA, CAPACITATEA 20 ML, DOP DIN CAUCIUC BROMOBUTILIC SIGILAT CU CAPSA AL CU PULB.PT.SOL.INJ./PERF. PR 10 16,826400 20,541600 24,002400 110 W58973002 J01DH02 MEROPENEMUM MEROPENEM ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 20 ML CU DOP DIN CAUCIUC, SIGILAT CU CAPSA DIN ALUMINIU PREVAZUTA CU DISC DIN MATERIAL PLASTIC PRF 10 16,826400 20,541600 24,004400 111 W59077002 J01DH51 IMIPENEMUM + CILASTATINUM TIENAM I.V. 500 mg/500 mg PULB. PT. SOL. PERF. 500mg/50 0mg MERCK SHARP & DOHME ROMANIA TAVA CU 10 FLAC. DIN STICLA INCOLORA A 20 ML CU PULB. PT. SOL. PERF. PR 10 22,297200 27,220800 7,679200 112 W54471006 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF. S/P-RF 10 22,297200 27,220800 9,677200 113 W54471009 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 30 ML PULB. PT. SOL. PERF. S/P-RF 10 22,297200 27,220800 6,801200 114 W61198003 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN ATB 500 mg/500 mg PULB. PT. SOL. PERF. 500mg/50 0mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA TIP III, CU CAPACITATEA DE 20 ML, CONTINANAD PULB. PT. SOL. PERF. PR 10 18,582000 22,685000 0,000000 115 W54471007 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 30 ML PULB. PT. SOL. PERF. S/P-RF 1 22,297200 27,220800 10,559200 116 W54471008 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 30 ML PULB. PT. SOL. PERF. S/P-RF 5 22,297200 27,220800 6,803200 117 W54471002 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF. S/P-RF 5 18,922000 23,924000 0,000000 118 W54471003 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF. S/P-RF 10 18,582000 22,685000 0,000000 119 W54471005 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF. S/P-RF 5 22,297200 27,220800 9,829200 120 W54532001 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN KABI 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. S/P-RF 10 18,581000 22,684000 0,000000 121 W53671001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM BITRIM 400mg/80mg COMPR. 400mg/80 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,296500 0,400500 0,000000 122 W12479001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM CO - TRIM ELL COMPR. 400mg/80 mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,270000 0,365000 0,000000 123 W05738001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM COMPR. 400mg/80 mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,257500 0,348000 0,000000 124 W05741001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80 mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,296500 0,400500 0,000000 7 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 125 W44046001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM EPITRIM SUSP. ORALA 200mg/40 mg /5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA BRUNA CU MASURA DOZATOARE X 100 ML P-RF 1 3,480000 4,710000 0,000000 126 W05739001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SUSP. ORALA 25mg/5m g/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 7,300000 9,860000 0,000000 127 W05561001 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 0,472500 0,638750 0,000000 128 W13604002 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 1,933000 2,613000 0,000000 129 W13604003 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 1,933000 2,613000 0,000000 130 W58242002 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 1,458000 1,970570 0,463715 131 W59000002 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. ELIB. PREL. 500mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR. ELIB. PREL. PRF 6 1,458000 1,970570 0,464430 132 W44093001 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 0,672000 0,907714 0,179428 133 W08490001 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 0,672000 0,907714 0,328000 134 W14043001 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 0,672000 0,907714 0,264428 135 W60253004 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF 14 0,622857 0,842142 0,000000 136 W61223003 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 0,560000 0,756428 0,000000 137 W01326002 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT S.R.L. ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 0,672000 0,907714 1,039428 138 W58998015 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 250 mg COMPR. FILM. 250mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR) PRF 14 0,622142 0,840714 0,000000 139 W44087001 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 1,458000 1,970570 0,068715 140 W54044001 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 1,458000 1,970570 0,277930 141 W60254003 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 1,414285 1,911428 0,000000 142 W56269001 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF 20 1,458000 1,970570 0,385430 143 W61224003 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 1,215000 1,642142 0,000000 144 W14044001 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 1,414285 1,911428 0,000000 145 W08491001 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 1,421428 1,921428 0,000000 146 W58999014 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. FILM. 500mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR) PRF 14 1,350000 1,825000 0,000000 147 W44088001 J01FA09 CLARITHROMYCINUM KLABAX MR 500 mg COMPR. FILM. ELIB. MODIF. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC/PVDC-AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 1,458000 1,970570 0,463715 148 W41838002 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 1,458000 1,970570 0,463715 149 W13607002 J01FA09 CLARITHROMYCINUM KLACID SR COMPR. FILM. ELIB. PREL. 500mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 5 COMPR. FILM. ELIB. PREL. P-RF 5 1,458000 1,970570 1,777430 150 W01327001 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5 ml ABBOTT S.R.L. ITALIA CUTIE X 1 FLACON PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML P-RF 1 22,180000 29,980000 0,000000 151 W01327002 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5 ml ABBOTT S.R.L. ITALIA CUTIE X 1 FLACON PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML P-RF 1 11,388000 15,384000 4,336000 152 W44092001 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 9,490000 12,820000 0,000000 153 W42258001 J01FA09 CLARITHROMYCINUM LEKOKLAR 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5 ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 9,490000 12,820000 0,000000 8 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 154 W44091001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 24,320000 32,870000 0,000000 155 W44091002 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 40,530000 53,010000 0,000000 156 W58393002 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5 ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA PRF 1 22,090000 29,860000 0,000000 157 W01329001 J01FA09 CLARITHROMYCINUM KLACID I.V. LIOF. PT. SOL. PERF. 500mg ABBOTT LABORATORIES LTD. FRANTA CUTIE X 1 FLAC. LIOF. PT. SOL. PERF. S/P-RF 1 30,230000 39,540000 0,000000 158 W42271001 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. P-RF 6 2,435000 3,291666 0,000000 159 W00517001 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 2,922000 3,949999 1,116667 160 W00518001 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 3,068333 4,146666 0,000000 161 W42879004 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 2,435000 3,291666 0,000000 162 W52838002 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 2,435000 3,291666 0,000000 163 W52838001 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 2,435000 3,291666 0,000000 164 W57032001 J01FA10 AZITHROMYCINUM AZITROX (R) 500 COMPR. FILM. 500mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 3,607999 4,876000 0,700666 165 W52840002 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM. P-RF 3 3,607999 4,876000 0,700666 166 W42878001 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 500 mg COMPRIMATE FILMATE COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 COMPR. FILM. P-RF 3 3,006666 4,063333 0,000000 167 W60019004 J01FA10 AZITHROMYCINUM AZATRIL 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-PVC-AL/AL X 3 COMPR. FILM. PRF 3 3,607999 4,876000 0,254000 168 W52840001 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF 3 3,607999 4,876000 0,700666 169 W00519001 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 3,607999 4,876000 3,707333 170 W60406001 J01FA10 AZITHROMYCINUM AZITROMICINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 3 COMPR. FILM. PRF 3 3,607999 4,876000 0,700666 171 W43486001 J01FA10 AZITHROMYCINUM AZIBIOT 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 3,607999 4,876000 0,440666 172 W52841002 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 11,793333 15,426666 0,000000 173 W52841001 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 11,793333 15,426666 0,000000 174 W53281001 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5 ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLACON DIN PE CU PULBERE PENTRU 15ML SUSPENSIE ORALA RECONSTITUITA + FLACON CU SOLVENT X 7.5ML SOLVENT + 1 SERINGA PENTRU ADMINISTRAREA ORALA + O LINGURITA DOZATOARE P-RF 1 10,710000 14,470000 0,000000 175 W42901001 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5 ml SANDOZ SRL ROMANIA CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (400 MG) SUSP. ORALA P-RF 1 14,310000 19,340000 0,000000 176 W42877002 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (800 MG) SUSP. ORALA P-RF 1 21,260000 28,740000 0,000000 177 W00520001 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5 ml PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE P-RF 1 30,340000 39,680000 0,000000 178 W00520002 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5 ml PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT.15 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE P-RF 1 12,852000 17,364000 4,896000 179 W00520003 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5 ml PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 37,5 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE P-RF 1 46,150000 60,360000 0,000000 180 W03308001 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 40mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 10 0,547000 0,740000 0,000000 181 W03309002 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 80mg/2ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 50 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF/S 50 0,658000 0,860600 0,000000 182 W03309001 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 80mg/2ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF 10 0,735000 0,994000 0,000000 183 W53277001 J01GB06 AMIKACINUM AMIKOZIT (R) 500 mg/2 ml SOL. INJ. 500mg/2 ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA X 2 ML P-RF 1 5,350000 7,230000 0,000000 184 W07914001 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,872000 1,179000 0,000000 9 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 185 W56957001 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,046400 1,414800 0,662200 186 W54037002 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 2,692000 3,404000 0,000000 187 W54037001 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 2,959000 3,871000 0,000000 188 W54038002 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 0,472000 0,638000 0,000000 189 W01288001 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 0,505000 0,683000 0,000000 190 W01271002 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 0,525000 0,709000 0,000000 191 W07862001 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 0,533000 0,720000 0,000000 192 W44077004 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 0,505000 0,683000 0,000000 193 W01273001 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 0,523000 0,707000 0,000000 194 W54038001 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 0,504000 0,681000 0,000000 195 W54039002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,630500 0,852000 0,000000 196 W01289001 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 0,756600 1,022400 0,299600 197 W07863001 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 500mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 0,674000 0,911000 0,000000 198 W12545001 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,756600 1,022400 0,348600 199 W44076001 J01MA02 CIPROFLOXACINUM CIPROCIN 500 mg COMPR. FILM. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 0,681000 0,920000 0,000000 200 W01272001 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 0,756600 1,022400 0,348600 201 W54039001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,708000 0,957000 0,000000 202 W01274001 J01MA02 CIPROFLOXACINUM CIPRINOL 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,756600 1,022400 0,160600 203 W54040001 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 0,915600 1,237200 2,633800 204 W42772001 J01MA02 CIPROFLOXACINUM CIPRINOL 750 mg COMPR. FILM. 750mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,763000 1,031000 0,000000 205 W57948001 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 9,928571 12,554285 0,000000 206 W57949001 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 0,756600 1,022400 8,530933 207 W60268001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ZENTIVA 10 mg/ml CONC. PT. SOL. PERF. 100mg/10 ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA PREVAZUTE CU INEL DE RUPERE X 10 ML S/P-RF 5 2,580000 3,400560 0,085440 208 W01275001 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10 ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 10 ML S/P-RF 5 2,570000 3,400560 0,073440 209 W01275002 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10 ml KRKA D.D. SLOVENIA CUTIE X 50 FIOLE X 10 ML S 50 2,321200 2,833800 0,000000 210 W61489001 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 10 PUNGI DIN PVC PLASTICIZAT A CÂTE 100 ML SOL. PERF. PR 10 6,972000 8,815000 0,000000 211 W61489002 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 50 PUNGI DIN PVC PLASTICIZAT A CÂTE 100 ML SOL. PERF. PR 50 6,617800 7,976400 0,000000 212 W61489003 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 10 PUNGI DIN PVC PLASTICIZAT A CÂTE 200 ML SOL. PERF. PR 10 13,125000 16,023000 0,000000 213 W61489004 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 30 PUNGI DIN PVC PLASTICIZAT A CÂTE 200 ML SOL. PERF. PR 30 12,828000 15,254333 0,000000 214 W53353002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 100ML S 10 6,972000 8,815000 0,000000 215 W53353003 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 200ML S 10 13,125000 16,023000 0,000000 216 W52445001 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 2,139000 2,891000 0,000000 217 W58303001 J01MA06 NORFLOXACINUM NORFLOXACIN HELCOR 400 mg COMPR. FILM. 400mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,651000 0,880000 0,000000 10 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 218 W07984001 J01MA06 NORFLOXACINUM NOLICIN 400 mg COMPR. FILM. 400mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,586000 0,792000 0,000000 219 W41800001 J01MA06 NORFLOXACINUM NORFLOXACINA LPH 400 mg COMPR. FILM. 400mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,603500 0,816000 0,000000 220 W55699003 J01MA12 LEVOFLOXACINUM TAVANIC 250 mg COMPR. FILM. 250mg TERAPIA S.A. ROMANIA CUTIE X1 BLIST. PVC/AL. X 7 COMPR. FILM. P-RF 7 1,381714 1,866857 1,984571 221 W56992002 J01MA12 LEVOFLOXACINUM LEVOTOR 250 mg COMPR. FILM. 250mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-RF 7 1,151428 1,555714 0,000000 222 W52786004 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 250 mg COMPR. FILM. 250mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-RF 7 1,151428 1,555714 0,000000 223 W56939002 J01MA12 LEVOFLOXACINUM FLERADAY 500 mg COMPR. FILM. 500 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/PVDC - AL X 7 COMPR. FILM. PRF 7 2,866285 3,874285 0,552857 224 W56993002 J01MA12 LEVOFLOXACINUM LEVOTOR 500 mg COMPR. FILM. 500mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-RF 7 2,388571 3,228571 0,000000 225 W55700002 J01MA12 LEVOFLOXACINUM TAVANIC 500 mg COMPR. FILM. 500mg TERAPIA S.A. ROMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF 7 2,866285 3,874285 2,717143 226 W52787004 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-RF 7 2,427142 3,280000 0,000000 227 W55815004 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 5 mg/ml SOL. PERF. 5mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA X 100 ML SOL. PERF. S 1 33,144000 43,356000 11,304000 228 W55456001 J01MA12 LEVOFLOXACINUM EVOLOX 5 mg/ml SOL. PERF. 5mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 20,890000 28,240000 0,000000 229 W54108003 J01MA12 LEVOFLOXACINUM LEVOFLOXACIN KABI 5 mg/ml SOL. PERF. 5mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEJD KABIPAC X 100 ML CONTINAD 100 ML SOL. PERF. (500MG LEVOFLOXACINA) S 1 33,144000 43,356000 11,304000 230 W55702001 J01MA12 LEVOFLOXACINUM TAVANIC I.V. 500 mg SOL. PERF. 5mg/ml TERAPIA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML SOL. PERF. P-RF/S 1 33,144000 43,356000 36,514000 231 W55456003 J01MA12 LEVOFLOXACINUM EVOLOX 5 mg/ml SOL. PERF. 5mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 27,620000 36,130000 0,000000 232 W57939001 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 6,612000 8,647200 2,436800 233 W60311001 J01MA14 MOXIFLOXACINUM MOFINACIN 400 mg COMPR. FILM. 400mg ALVOGEN IPCO S.A.R.L LUXEMBUR G CUTIE CU BLIST. OPA-AL-PVC/AL X 5 COMPR. FILM PRF 5 5,510000 7,206000 0,000000 234 W60943001 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 5,510000 7,206000 0,000000 235 W60545001 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 5,510000 7,206000 0,000000 236 W59332001 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 5,510000 7,206000 0,000000 237 W57938004 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg/250 ml SOL. PERF. 400mg/25 0ml BAYER PHARMA AG GERMANIA CUTIE X 5 FLACOANE DIN STICLA X 250 ML S 5 69,648000 88,056000 13,026000 238 W60727001 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA KABI 400 mg/250 ml SOL. PERF. 400mg/25 0ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPACK) A 250 ML SOL. PERF. (400 MG MOXIFLOXACINA) PR 1 58,040000 73,380000 0,000000 239 W43348001 J01XA01 VANCOMYCINUM VANCOMYCIN TEVA LIOF. PT. SOL. PERF. 1g TEVA PHARM. WORKS PRIVATE LTD. COMPANY UNGARIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 25,308000 34,212000 20,538000 240 W43347001 J01XA01 VANCOMYCINUM VANCOMYCIN TEVA LIOF. PT. SOL. PERF. 500mg TEVA PHARM. WORKS PRIVATE LTD. COMPANY UNGARIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 20,930000 25,840800 2,449200 241 W56449002 J01XA01 VANCOMYCINUM VANCOMICINA PHARMASWISS 1000 mg PULB. PT. SOL. PERF. 1000mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLIC A CEHA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR 10 25,308000 34,212000 10,904000 242 W56448002 J01XA01 VANCOMYCINUM VANCOMICINA PHARMASWISS 500 mg PULB. PT. SOL. PERF. 500mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLIC A CEHA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR 10 17,639000 21,534000 0,000000 243 W57042001 J01XA01 VANCOMYCINUM VANCOMICINA KABI 1000 mg PULB. PT.CONC. PT.SOL. PERF. 1000mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CARE CONTINE PULB. PT. CONC. PT. SOL. P PR 1 21,090000 28,510000 0,000000 244 W57041001 J01XA01 VANCOMYCINUM VANCOMICINA KABI 500 mg PULB. PT.CONC. PT.SOL. PERF. 500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. P PR 1 19,630000 25,840800 0,689200 245 W06051001 J01XA01 VANCOMYCINUM EDICIN PULB.LIOF. PT.SOL.PE RF./INJ 1g LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. LIOF. PT. SOL. PERF./INJ. S/P-RF 1 25,308000 34,212000 16,888000 246 W13105001 J01XA02 TEICOPLANINUM TARGOCID (R) 400 mg LIOF. + SOLV. PT. SOL. INJ. 400mg AVENTIS PHARMA LTD. MAREA BRITANIE CUTIE X 1 FLAC. LIOF. + O FIOLA SOLV. P-RF 1 106,430000 129,930000 0,000000 247 W52501003 J01XB01 COLISTINUM COLISTINA ANTIBIOTICE 1000000 UI PULB. PT. SOL. INJ./PERF. 1000000u i ANTIBIOTICE SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S 10 18,000000 21,974000 0,000000 11 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 248 W53689002 J01XD01 METRONIDAZOLUM METRONIDAZOL ARENA 250 mg (J01XD01) COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,176666 0,238666 0,000000 249 W08257001 J01XD01 METRONIDAZOLUM FLAGYL ( vezi J01XD01) COMPR. FILM. 250mg LABORATOIRE AVENTIS FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,211999 0,286399 0,081101 250 W42139001 J01XD01 METRONIDAZOLUM METRONIDAZOL A 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML S/P-RF 1 6,990000 9,450000 0,000000 251 W42139002 J01XD01 METRONIDAZOLUM METRONIDAZOL A 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML S/P-RF 12 6,855000 8,667500 0,000000 252 W42138002 J01XD01 METRONIDAZOLUM METRONIDAZOL B 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML S/P-RF 12 6,721666 8,499166 0,000000 253 W42138001 J01XD01 METRONIDAZOLUM METRONIDAZOL B 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML S/P-RF 1 6,840000 9,240000 0,000000 254 W08927002 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN PEJD X 100 ML SOL. PERF. S/P-RF 10 3,828000 5,007000 0,000000 255 W08927001 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S/P-RF 10 3,828000 5,007000 0,000000 256 W08927003 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. DIN PEJD X 100 ML SOL. PERF. S/P-RF 20 3,761000 4,755500 0,000000 257 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 163,000000 181,485000 0,000000 258 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5 ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 911,260000 1.031,420000 0,000000 259 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBUR G CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINÂND 300 ML SOL. PERF. PR 1 112,480000 137,320000 0,000000 260 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF. PR 1 116,710000 142,262400 0,217600 261 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 126,315600 142,262400 42,337600 262 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPATA CU UN CONECTOR (DIN RASINA PE BAZA DE POLIOEFINE)SI CU O SUPRA-PUNGA (DIN COPOLIMER POLIESTER/PROPILENA) PRF 10 105,263000 118,552000 0,000000 263 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 1,998750 2,614500 3,788000 264 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,998750 2,614500 0,805500 265 W42371002 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 1,665625 2,178750 0,000000 266 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,998750 2,614500 2,056928 267 W52224001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,870000 6,580000 0,000000 268 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,680000 6,320000 0,000000 269 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLIC A CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 270 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 271 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 272 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS. PRF 1 4,620000 6,240000 0,000000 273 W56446001 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 274 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 275 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,544000 7,488000 3,542000 276 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 277 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 278 W43288001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 279 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 12 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 280 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 281 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 4,460000 5,834285 0,000000 282 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,356000 1,832570 0,133144 283 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,265714 1,710000 0,000000 284 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 285 W57238001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 1,356000 1,832570 0,947430 286 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 287 W43287001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,130000 1,527142 0,000000 288 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,560287 289 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,946001 290 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 291 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 2,444572 292 W58322001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON PEID DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 LINGURITA DOZATOARE A 5ML, CU PULB. PENTRU 35 ML SUSP. ORALA PRF 1 21,880000 29,570000 0,000000 293 W55502017 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 1 36,250000 47,420000 0,000000 294 W55502009 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 1 18,130000 24,500000 0,000000 295 W12072001 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML S/PR-F 1 21,516000 26,266800 21,183200 296 W55502001 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 1 9,060000 12,250000 0,000000 297 W58456003 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 200 ML SOL. PERF. PR 10 43,500000 56,904000 32,740000 298 W58456002 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 100 ML SOL. PERF. PR 20 21,516000 26,266800 11,204200 299 W60056005 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLIC A CEHA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 17,930000 21,889000 0,000000 300 W57368003 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 21,516000 26,266800 28,873200 301 W58456001 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 50 ML SOL. PERF. PR 20 10,872000 14,700000 6,937500 302 W43051001 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 1,586666 2,144666 0,000000 303 W03837002 J02AC02 ITRACONAZOLUM ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 1,903999 2,573599 0,620401 304 W53958001 J02AC02 ITRACONAZOLUM MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF 15 1,586666 2,144666 0,000000 305 W52343006 J02AC02 ITRACONAZOLUM OMICRAL 100 mg CAPS. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 1,586666 2,144666 0,000000 306 W59235001 J02AC02 ITRACONAZOLUM ITRACONAZOL ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 1,586666 2,144666 0,000000 307 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 119,853214 132,002857 0,000000 308 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 32,232500 36,496071 0,000000 309 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 435,570000 512,920000 0,000000 310 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 2.044,020000 2.266,130000 0,000000 311 W60913001 J02AC04 POSACONAZOLUM** NOXAFIL 100mg CAPS. GASTROR EZ. 100mg MERCK SHARP & DOHME LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/PCTF/AL X 24 COMPRIMATE GASTROREZISTENTE PR 24 133,855416 147,492083 0,000000 13 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 312 W58194001 J02AC04 POSACONAZOLUM** NOXAFIL 40mg/ml SUSP. ORALA 40mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. X 105ML SUSP. ORALA P-RF/R 1 2.405,440000 2.660,080000 0,000000 313 W06665001 J02AX04 CASPOFUNGINUM** CANCIDAS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.246,420000 1.396,750000 0,000000 314 W06670001 J02AX04 CASPOFUNGINUM** CANCIDAS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.617,600000 1.801,340000 0,000000 315 W55841001 J02AX06 ANIDULAFUNGINUM ECALTA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1FLAC.DIN STICLA A 30ML X 100MG PULB. S 1 1.377,370000 1.539,480000 0,000000 316 W58576002 J04AC01 ISONIAZIDUM IZONIAZIDA ATB 100 mg COMPR. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 150 BLIST. PVC/AL X 10 COMPR. PR 1500 0,110333 0,134693 0,000000 317 W58577002 J04AC01 ISONIAZIDUM IZONIAZIDA ATB 300 mg COMPR. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. PVC/AL X 10 COMPR. S/P-RF 1500 0,272473 0,322426 0,000000 318 W60582001 J04AC01 ISONIAZIDUM ISONIAZID SIROP 100mg/5 ml CN UNIFARM S.A. ROMANIA CUTIE X 1 FLAC. X 200 ML SIROP PR 1 30,110000 39,380000 0,000000 319 W60594001 J04AC01 ISONIAZIDUM BITUB SOL INJ. 100mg/ml CN UNIFARM S.A. ROMANIA CUTIE CU 10 FIOLE A 5ML PR 10 1,469000 1,986000 0,000000 320 W60213002 J04AK01 PYRAZINAMIDUM PIRAZINAMIDA ATB 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 150 BLIST. PVC/AL X 10 COMPR. PR 1500 0,299853 0,352273 0,000000 321 W53682002 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,184000 0,249000 0,000000 322 W59648001 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF 20 0,287500 0,388500 0,000000 323 W59648003 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN PE X 50 CAPS. PRF 50 0,284600 0,384600 0,000000 324 W42943002 J04AK02 ETHAMBUTOLUM ETAMBUTOL 250 mg COMPR. FILM. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1500 0,217573 0,262586 0,000000 325 W42861002 J04AK02 ETHAMBUTOLUM ETAMBUTOL 400 mg COMPR. FILM. 400mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1500 0,334726 0,390286 0,000000 326 W60583001 J04AK02 ETHAMBUTOLUM INBUTOL SOL INJ. 100mg/ml CN UNIFARM S.A. ROMANIA FLAC. X 10 ML SOL. INJ PR 1 16,130000 21,800000 0,000000 327 W14071002 J04AM02 COMBINATII (RIFAMPICINUM+IZONIAZIDUM) SINERDOL ISO CAPS. 300mg+1 50mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. S 1000 0,600660 0,692870 0,000000 328 W56038001 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0,636000 0,859800 0,211200 329 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,636000 0,859800 0,188700 330 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,636000 0,859800 0,251200 331 W53675003 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 0,636000 0,833260 0,000000 332 W53676001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 1,495000 2,020000 0,000000 333 W13972001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,636000 0,859800 0,033700 334 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,636000 0,859800 0,030200 335 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,636000 0,859800 0,033700 336 W06667003 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 20 0,530000 0,716500 0,000000 337 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,636000 0,859800 0,033700 338 W06668003 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 10 1,794000 2,424000 0,334000 339 W00058001 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL. INJ./PERF. S/P-RF 5 38,600000 47,124000 0,000000 340 W60057003 J05AB04 RIBAVIRINUM REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 6,981214 7,882071 0,000000 341 W53326004 J05AB04 RIBAVIRINUM COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168 6,945654 7,797857 0,000000 342 W51337001 J05AB06 GANCICLOVIRUM CYMEVENE LIOF. PT. SOL. INJ. 500mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. S 1 90,440000 114,350000 0,000000 343 W61213001 J05AB06 GANCICLOVIRUM CYMEVENE 500 mg PULB. PT. SOL. PERF. 500mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLAC. MULTIDOZA DIN STICLA INCOLORA CONTINAND 10 ML PULB. PT. SOL. PERF. PR 1 90,440000 114,350000 0,000000 14 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 344 W58707001 J05AB11 VALACYCLOVIRUM VALTREX 500 mg COMPR. FILM. 500 mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM. PRF 10 2,780400 3,757200 0,903800 345 W60087001 J05AB11 VALACYCLOVIRUM VALACICLOVIR ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC ALB OPAC/AL X 10 COMPR. FILM. PRF 10 2,317000 3,131000 0,000000 346 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 59,167800 65,256000 23,726166 347 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM. PRF 60 49,306500 54,380000 0,000000 348 W12651002 J05AB15 BRIVUDINUM BRIVAL 125mg COMPR. 125mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 BLIST. PVC/AL X 7 COMPR. P-RF 7 39,321428 48,002857 0,000000 349 W42514001 J05AE01 SAQUINAVIRUM INVIRASE 500 mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 120 COMPR. FILM. P-RF/R 120 8,449166 9,527500 0,000000 350 W59955001 J05AE03 RITONAVIRUM** NORVIR 100 mg COMPR. FILM. 100mg ABBVIE LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 30 COMPR.FILM. P-RF/R 30 3,187666 4,030666 0,000000 351 W59948001 J05AE06 LOPINAVIRUM+RITONAVIRUM** KALETRA 200mg/50mg COMPR. FILM. 200mg/50 mg ABBVIE LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 120 COMPR. FILM. PR 120 11,833666 13,216666 0,000000 352 W59947002 J05AE06 LOPINAVIRUM+RITONAVIRUM** KALETRA 80mg/ml+20mg/ml SOL. ORALA 80mg/ml+ 20mg/ml ABBVIE LTD. MAREA BRITANIE CUTIE X 5 FLAC. MULTIDOZA DIN TPE X 60 ML + 5 SERINGI GRADATE A 5 ML PR 5 243,736000 273,302000 0,000000 353 W41772001 J05AE07 FOSAMPRENAVIRUM** TELZIR 700mg COMPR. FILM. 700mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN HDPE X 60 COMPR. FILM. PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII P-RF/R 60 20,084000 22,527500 0,000000 354 W41773001 J05AE07 FOSAMPRENAVIRUM** TELZIR 50mg/ml SUSP. ORALA 50mg/ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLACON HDPE X 225 ML SUSP. ORALA PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII + 1SERINGA PT. ADMINISTRARE ORALA DIN POLIPROPILENA X10ML +1ADAPTOR DIN POLIETILENA P-RF/R 1 371,490000 443,070000 0,000000 355 W14087002 J05AE08 ATAZANAVIRUM REYATAZ 150 mg CAPS. 150mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 60 CAPS. (BLIST. AL/AL 6X1) P-RF/R 60 25,246833 28,155000 0,000000 356 W53181001 J05AE08 ATAZANAVIRUM REYATAZ 300 mg CAPS. 300mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID X 30 CAPS. P-RF/R 30 46,935666 52,431666 0,000000 357 W53878001 J05AE10 DARUNAVIRUM** PREZISTA 400mg COMPR. FILM. 400mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 26,035166 29,014166 0,000000 358 W53877001 J05AE10 DARUNAVIRUM** PREZISTA 600mg COMPR. FILM. 600mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 38,805000 42,933333 0,000000 359 W06151002 J05AF01 ZIDOVUDINUM RETROVIR (R) CAPS. 100mg VIIV HEALTHCARE UK LIMITED UK CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-RF 100 3,663800 4,375000 0,000000 360 W60312001 J05AF01 ZIDOVUDINUM RETROVIR 10 mg/ml SOL. ORALA 10mg/ml VIIV HEALTHCARE UK LIMITED MAREA BRITANIE CUTIE CU 1 FLACON DIN STICLA BRUNA X 200 ML SOL. ORALA + 1 ADAPTOR DE DOZARE + 1 SERINGA PT. ADM. ORALA DE 10 ML PRF 1 44,500000 58,200000 0,000000 361 W10724001 J05AF02 DIDANOSINUM VIDEX EC 250 mg CAPS. GASTROR EZ. 250mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. S/P-RF 30 11,946000 14,292666 0,000000 362 W10725001 J05AF02 DIDANOSINUM VIDEX EC 400 mg CAPS. GASTROR EZ. 400mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. S/P-RF 30 18,512666 21,450333 0,000000 363 W12057001 J05AF04 STAVUDINUM ZERIT 30 mg CAPS. 30mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 4 BLIST. ACLAR/AL X 14 CAPS. P-RF/R 56 9,010714 10,502857 0,000000 364 W12056001 J05AF04 STAVUDINUM ZERIT 40 mg CAPS. 40mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 4 BLIST. ACLAR/AL X 14 CAPS. P-RF/R 56 9,262142 10,776964 0,000000 365 W59320003 J05AF05 LAMIVUDINUM LAMIVUDINA AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 FLAC. PVC-ACLAR/AL X 60 COMPR. FILM. PR 60 3,304500 4,034166 0,000000 366 W03923002 J05AF05 LAMIVUDINUM EPIVIR 150mg COMPR. FILM. 150mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILM. P-RF/R 60 3,965400 4,840999 1,336334 367 W55474002 J05AF05 LAMIVUDINUM LAMIVUDINE TEVA PHARMA B.V. 300 mg COMPR. FILM. 300 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 8,751666 10,684000 0,000000 368 W03924002 J05AF05 LAMIVUDINUM EPIVIR 10mg/ml SOL. ORALA 10mg/ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLACON PEID X 240ML SOL. ORALA + 1 SERINGA DOZATOARE + 1 ADAPTOR P-RF/R 1 82,820000 104,720000 0,000000 369 W12820001 J05AF06 ABACAVIRUM ZIAGEN 300 mg COMPR. FILM. 300mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 60 COMPR. FILM. P-RF/R 60 13,505833 15,357166 0,000000 370 W07524001 J05AF06 ABACAVIRUM ZIAGEN 20 mg/ml SOL. ORALA 20mg/ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLACON PEID X 240 ML SOL. ORALA + SERINGA DOZATOARE PP X 10 ML + ADAPTOR PE P-RF/R 1 217,800000 265,890000 0,000000 371 W60828015 J05AF07 TENOFOVIRUM DISOPROXIL FUMARATE TENOFOVIR DISOPROXIL TEVA 245 mg COMPR. FILM. 245mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEÎD CU CAPAC CAPAC PREVAZUT CU SISTEM SECURIZAT PENTRU COPII DIN PP SI RECIPIENT CU DESICANT, A 30 COMPR. FILM. PR 30 24,040000 27,475333 0,000000 372 W51800001 J05AF07 TENOFOVIRUM DISOPROXIL FUMARATE VIREAD 245mg COMPR. FILM. 245mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM P-RF/R 30 28,848000 32,970400 8,027266 373 W51482001 J05AF09 EMTRICITABINUM EMTRIVA 200mg CAPS. 200mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 CAPS. P-RF/R 30 20,593333 23,718333 0,000000 374 W59595001 J05AG01 NEVIRAPINUM NEVIRAPINA TEVA 200mg COMPR. 200mg TEVA PHARMA B.V. OLANDA BLISTERE DIN PVC/PE/PVDC - AL X 60 COMP. P-RF/R 60 5,649333 6,793666 0,000000 375 W59667002 J05AG01 NEVIRAPINUM NEVIRAPINA SANDOZ 200 mg COMPR. 200mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. PR 60 5,649000 6,793166 0,000000 15 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 376 W57323001 J05AG01 NEVIRAPINUM VIRAMUNE 400mg COMPR. ELIB. PREL. 400mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU UN FLACON DIN PEID X 30 COMPR. CU ELIB. PRELUNGITA PR 30 16,663000 19,434333 0,000000 377 W13091001 J05AG01 NEVIRAPINUM VIRAMUNE 50mg/5ml SUSP. ORALA 50mg/5ml BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 FLACON PEID X 240 ML + O SERINGA X 5 ML + UN DISPOZITIV DE ADAPTARE A SERINGII LA FLACON PR 1 100,440000 122,620000 0,000000 378 W12025001 J05AG03 EFAVIRENZUM STOCRIN 600 mg COMPR. FILM. 600mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PREVAZUT CU UN SIST. DE INCHIDERE SECURIZAT PT. COPII P-RF/R 30 2,332666 2,949333 0,000000 379 W53549001 J05AG04 ETRAVIRINUM INTELENCE COMPR. 100mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. PEID X 120 COMPR. P-RF/R 120 12,478333 13,919333 0,000000 380 W56750001 J05AR01 COMBINATII (LAMIVUDINUM+ZIDOVUDINUM)** LAMIVUDINA/ZIDOVUDINA TEVA COMPR. FILM. 150 mg/300 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN OPA/AL/PVC X 60 COMPRIMATE FILMATE P-RF 60 5,436166 6,561333 0,000000 381 W02028001 J05AR01 COMBINATII (LAMIVUDINUM+ZIDOVUDINUM)** COMBIVIR 150mg/300mg COMPR. FILM. 150mg/30 0mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 6 BLIST. X 10 COMPR. FILM. P-RF/R 60 6,523399 7,873600 1,594733 382 W59832001 J05AR01 COMBINATII (LAMIVUDINUM+ZIDOVUDINUM)** LAMIVUDINA/ZIDOVUDINA AUROBINDO 150 mg/300 mg COMPR. FILM. 150mg/30 0mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. PR 60 5,436166 6,561333 0,000000 383 W42301001 J05AR02 ABACAVIRUM+LAMIVUDINUM** KIVEXA 600mg/300mg COMPR. FILM. 600mg/30 0mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 30 COMPR. FILM.( BLIST.ALB-OPAC PVC-PVDC/AL ) P-RF/R 30 45,918333 51,322666 0,000000 384 W08336004 J05AR04 ABACAVIRUM+LAMIVUDINUM+ZIDOVUDIN UM** TRIZIVIR 300mg/150mg/300mg COMPR. FILM. 300mg/15 0mg/300 mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 60 COMPR. FILM. (BLIST. OPACE DIN PVC/ACLAR) P-RF/R 60 27,912833 31,060833 0,000000 385 W08336001 J05AR04 ABACAVIRUM+LAMIVUDINUM+ZIDOVUDIN UM** TRIZIVIR 300mg/150mg/300mg COMPR. FILM. 300mg/15 0mg/300 mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X, 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 27,912833 31,060833 0,000000 386 W13961001 J05AX07 ENFUVIRTIDUM** FUZEON 90mg/ml PULB. + SOLV. PT. SOL. INJ. 90mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 60 FLAC. PULB. PT. SOL. INJ. + 60 FLAC. SOLV. + 60 SERINGI X 3 ML + 60 SERINGI X 1 ML, 180 TAMPOANE CU ALCOOL P-RF/R 60 101,513000 111,285166 0,000000 387 W52764001 J05AX08 RALTEGRAVIRUM ISENTRESS 400mg COMPR. FILM. 400 mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILMATE P-RF/R 60 40,691833 44,990000 0,000000 388 W61477003 J05AX09 MARAVIROCUM CELSENTRI 150mg COMPR. FILM. 150mg VIIV HEALTHCARE UK LIMITED MAREA BRITANIE CUTIE X 60 COMPR. FILM.( BLIST. PVC/AL) PR 60 43,135833 47,654000 0,000000 389 W61478003 J05AX09 MARAVIROCUM CELSENTRI 300mg COMPR. FILM. 300mg VIIV HEALTHCARE UK LIMITED MAREA BRITANIE CUTIE X 60 COMPR. FILM.( BLIST. PVC/AL) PR 60 43,135833 47,654000 0,000000 390 W60635001 J05AX12 DOLUTEGRAVIRUM** TIVICAY 50mg COMPR. FILM. 50mg VIIV HEALTHCARE UK LIMITED MAREA BRITANIE FLACOANE PEID X 30 COMPRIMATE FILMATE, INCHISE CU CAPAC CU FILET DIN POLIPROPILENA SI SIGILIU CU LINIE DE INDUCTIE CU O FATA DIN POLIETILENA PR 30 81,414000 90,013000 0,000000 391 W54752001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 391,580000 464,970000 0,000000 392 W54752002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 870,210000 986,680000 0,000000 393 W54752003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 1.710,420000 1.902,510000 0,000000 394 W54752004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA, CU CAPACITATE DE 250ML, A 200ML SOLUTIE PERFUZABILA S 1 3.390,820000 3.734,150000 0,000000 395 W51530001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL. PERF.(1G/10ML) S 1 190,360000 232,390000 0,000000 396 W51530006 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL. PERF.(30G/300ML) S 1 5.766,650000 6.323,810000 0,000000 397 W51530003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL. PERF.(5G/50ML) S 1 912,190000 1.032,440000 0,000000 398 W51530004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL. PERF.(10G/100ML) S 1 1.847,580000 2.059,644000 78,286000 399 W51530005 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL. PERF.(20G/200ML) S 1 3.736,820000 4.111,290000 0,000000 400 W43965001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.539,650000 1.716,370000 0,000000 401 W43962001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 204,810000 250,030000 0,000000 402 W43963001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 407,410000 482,230000 0,000000 403 W59114003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 100 ML SOL. PERF. PRF 1 894,400000 1.013,050000 0,000000 404 W59114001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 20 ML SOL. PERF. PRF 1 190,170000 232,160000 0,000000 405 W59114004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 200 ML SOL. PERF. PRF 1 1.758,800000 1.955,240000 0,000000 406 W59114002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 50 ML SOL. PERF. PRF 1 462,170000 541,920000 0,000000 407 W13462002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 100 ML S 1 894,000000 1.012,610000 0,000000 408 W13462003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S 1 1.837,780000 2.041,330000 0,000000 16 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 409 W13462001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S 1 481,950000 563,480000 0,000000 410 W43964001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 784,820000 893,600000 0,000000 411 W59944001 J06BB16 PALIVIZUMABUM** SYNAGIS 50 mg PULB. + SOLV. PT. SOL. INJ. 50mg ABBVIE LTD. MAREA BRITANIE CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + FIOLA X 1 ML SOLV. P-RF 1 1.837,910000 2.041,470000 0,000000 412 W53892001 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLU TA 60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 87,690000 110,870000 0,000000 413 W53893001 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLU TA 96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 139,560000 170,380000 0,000000 414 W53520001 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300mcg/0, 5ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF. S/P-RF/R 1 105,228000 127,437600 34,512400 415 W55757002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300μg/0,5 ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 90,430000 106,198000 0,000000 416 W53523001 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480mcg/0, 8ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML SOL. INJ. SAU PERF. S/P-RF/R 1 167,472000 195,360000 72,090000 417 W55758002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480μg/0,5 ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 142,358000 162,800000 0,000000 418 W54015001 P01BC02 MEFLOQUINUM4) ELOQUINE 250 mg COMPR. 250mg CN UNIFARM ROMANIA CUTIE X 10 BLIST. X 10 COMPR. X 100 1,458600 1,780700 0,000000 419 W12757001 S01AA23 NETILMICINUM NETTACIN (R) PIC. OFT., SOL 0,3% S.I.F.I. SPA ITALIA CUTIE X 1 FLACON X 5ML P-RF 1 10,880000 14,710000 0,000000 420 W41510001 S01AA23 NETILMICINUM NETTACIN (R) PICATURI OFT.-SOL. 0,3% S.I.F.I. SPA ITALIA CUTIE X 3 FOLII TERMOSUDATE X 5 FLACOANE UNIDOZA DIN POLIETILENA X 0,3 ML P-RF 15 1,480666 2,001333 0,000000 421 W43512001 S01AA23 NETILMICINUM NETTAVISC 3mg/g UNG. OFT. 3mg/g S.I.F.I. SPA ITALIA CUTIE X 1 TUB DIN AL X 5 G UNGUENT OFTALMIC, PREV. CU APLICATOR P-RF 1 13,056000 17,652000 16,058000 422 W55950001 S01BA01 DEXAMETHASONUM OZURDEX IMPLANT 700 microgram e ALLERGAN PHARMACEUTICALS IRELAND IRLANDA CUTIE X 1 IMPLANT STERIL DE TIP FILAMENT CU ELIBERARE PRELUNGITA X 700MCG DEXAMETAZONA DISPUS IN ACUL (OTEL INOXIDABIL) UNUI APLICATOR DE UNICA FOLOSINTA P-RF 1 4.163,000000 4.575,830000 0,000000 423 W55648002 S01BA01 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 1mg/ml PIC. OFT. SUSP. 1mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. DIN PEID X 10 ML PIC. OFT., SUSPENSIE P-RF 1 7,490000 10,120000 0,000000 424 W55648001 S01BA01 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 1mg/ml PIC. OFT. SUSP. 1mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. DIN PEID X 5 ML PIC. OFT., SUSPENSIE P-RF 1 4,060000 5,490000 0,000000 425 W02427001 S01BA01 DEXAMETHASONUM MAXIDEX (R) PICATURI OFT.- SUSP. 0,1% ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON PICURATOR DIN PE X 5 ML P-RF 1 4,872000 6,588000 1,852000 426 W51513001 S03AAN2 NORFLOXACINUM NORFLOX PICATURI OFT./AURI C.-SOL. 0,3% CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 FLACON PEJD X 5 ML P-RF 1 3,660000 4,950000 0,000000 P1: PROGRAMUL NATIONAL DE BOLI TRANSMISIBILE 17 B) SUBPROGRAMUL DE TRATAMENT AL BOLNAVILOR CU TUBERCULOZA 1 W42822001 A11HA02 PYRIDOXINUM VITAMINA B6 250 mg COMPR. 250 mg ARENA GROUP SA ROMANIA CUTIE X 1 FLACON DIN PE X 20 COMPR. P-6L 20 0,349500 0,472500 0,000000 2 W56760001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg COMPR. 250mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 0,349500 0,472500 0,000000 3 W56758001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg/5 ml SOL. INJ. 250mg/5 ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF 5 1,586000 2,144000 0,000000 4 W56757001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 50 mg/2ml SOL. INJ. 50mg/2ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1,072000 1,448000 0,000000 5 W05242001 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,055320 0,072360 0,064640 6 W53341001 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,055320 0,072360 0,061140 7 W13686002 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,055320 0,072360 0,051306 8 W12565003 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR. P-RF/S 1000 0,046100 0,060300 0,000000 9 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,055320 0,072360 0,017973 10 W58242002 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 1,458000 1,970570 0,463715 11 W59000002 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. ELIB. PREL. 500mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR. ELIB. PREL. PRF 6 1,458000 1,970570 0,464430 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 12 W44093001 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 0,672000 0,907714 0,179428 13 W08490001 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 0,672000 0,907714 0,328000 14 W14043001 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 0,672000 0,907714 0,264428 15 W60253004 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF 14 0,622857 0,842142 0,000000 16 W61223003 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 0,560000 0,756428 0,000000 17 W01326002 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT S.R.L. ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 0,672000 0,907714 1,039428 18 W58998015 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 250 mg COMPR. FILM. 250mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR) PRF 14 0,622142 0,840714 0,000000 19 W44087001 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 1,458000 1,970570 0,068715 20 W54044001 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 1,458000 1,970570 0,277930 21 W60254003 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 1,414285 1,911428 0,000000 22 W56269001 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF 20 1,458000 1,970570 0,385430 23 W61224003 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 1,215000 1,642142 0,000000 24 W14044001 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 1,414285 1,911428 0,000000 25 W08491001 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 1,421428 1,921428 0,000000 26 W58999014 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. FILM. 500mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR) PRF 14 1,350000 1,825000 0,000000 27 W44088001 J01FA09 CLARITHROMYCINUM KLABAX MR 500 mg COMPR. FILM. ELIB. MODIF. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC/PVDC-AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 1,458000 1,970570 0,463715 28 W41838002 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 1,458000 1,970570 0,463715 29 W13607002 J01FA09 CLARITHROMYCINUM KLACID SR COMPR. FILM. ELIB. PREL. 500mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 5 COMPR. FILM. ELIB. PREL. P-RF 5 1,458000 1,970570 1,777430 30 W01327001 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5 ml ABBOTT S.R.L. ITALIA CUTIE X 1 FLACON PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML P-RF 1 22,180000 29,980000 0,000000 31 W01327002 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5 ml ABBOTT S.R.L. ITALIA CUTIE X 1 FLACON PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML P-RF 1 11,388000 15,384000 4,336000 32 W44092001 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 9,490000 12,820000 0,000000 33 W42258001 J01FA09 CLARITHROMYCINUM LEKOKLAR 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5 ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 9,490000 12,820000 0,000000 34 W44091001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 24,320000 32,870000 0,000000 35 W44091002 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 40,530000 53,010000 0,000000 36 W58393002 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5 ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA PRF 1 22,090000 29,860000 0,000000 37 W01329001 J01FA09 CLARITHROMYCINUM KLACID I.V. LIOF. PT. SOL. PERF. 500mg ABBOTT LABORATORIES LTD. FRANTA CUTIE X 1 FLAC. LIOF. PT. SOL. PERF. S/P-RF 1 30,230000 39,540000 0,000000 38 W57336001 J01GA01 STREPTOMYCINUM STREPTOMICINA SULFAT BP PULB. PT. SOL. INJ. 1g ANTIBIOTICE S.A. ROMANIA CUTIE X 50 FL.PULB.PT. SOL.INJ. A 1 G PRF 50 2,899400 3,539600 0,000000 39 W14119005 J01GA01 STREPTOMYCINUM STREVITAL 1 g PULB. PT. SOL. INJ. 1g ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CONTINAND PULB. PT. SOL. INJ. S 100 2,883400 3,520100 0,000000 18 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 40 W14119004 J01GA01 STREPTOMYCINUM STREVITAL 1 g PULB. PT. SOL. INJ. 1g ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. DIN STICLA CONTINAND PULB. PT. SOL. INJ. S 50 2,899400 3,539600 0,000000 41 W08827001 J01GB04 KANAMYCINUM PAN - KANAMYCINE PULB. PT. SOL. INJ. 1g LAB. PANPHARMA FRANTA CUTIE X 50 FLAC. X 1 G P-RF/S 50 1,683200 2,128200 0,000000 42 W53277001 J01GB06 AMIKACINUM AMIKOZIT (R) 500 mg/2 ml SOL. INJ. 500mg/2 ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA X 2 ML P-RF 1 5,350000 7,230000 0,000000 43 W07914001 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,872000 1,179000 0,000000 44 W56957001 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,046400 1,414800 0,662200 45 W54037002 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 2,692000 3,404000 0,000000 46 W54037001 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 2,959000 3,871000 0,000000 47 W54038002 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 0,472000 0,638000 0,000000 48 W01288001 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 0,505000 0,683000 0,000000 49 W01271002 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 0,525000 0,709000 0,000000 50 W07862001 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 0,533000 0,720000 0,000000 51 W44077004 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 0,505000 0,683000 0,000000 52 W01273001 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 0,523000 0,707000 0,000000 53 W54038001 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 0,504000 0,681000 0,000000 54 W54039002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,630500 0,852000 0,000000 55 W01289001 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 0,756600 1,022400 0,299600 56 W07863001 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 500mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 0,674000 0,911000 0,000000 57 W12545001 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,756600 1,022400 0,348600 58 W44076001 J01MA02 CIPROFLOXACINUM CIPROCIN 500 mg COMPR. FILM. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 0,681000 0,920000 0,000000 59 W01272001 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 0,756600 1,022400 0,348600 60 W54039001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,708000 0,957000 0,000000 61 W01274001 J01MA02 CIPROFLOXACINUM CIPRINOL 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,756600 1,022400 0,160600 62 W54040001 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 0,915600 1,237200 2,633800 63 W42772001 J01MA02 CIPROFLOXACINUM CIPRINOL 750 mg COMPR. FILM. 750mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,763000 1,031000 0,000000 64 W57948001 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 9,928571 12,554285 0,000000 65 W57949001 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 0,756600 1,022400 8,530933 66 W60268001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ZENTIVA 10 mg/ml CONC. PT. SOL. PERF. 100mg/10 ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA PREVAZUTE CU INEL DE RUPERE X 10 ML S/P-RF 5 2,580000 3,400560 0,085440 67 W01275001 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10 ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 10 ML S/P-RF 5 2,570000 3,400560 0,073440 68 W01275002 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10 ml KRKA D.D. SLOVENIA CUTIE X 50 FIOLE X 10 ML S 50 2,321200 2,833800 0,000000 69 W61489001 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 10 PUNGI DIN PVC PLASTICIZAT A CÂTE 100 ML SOL. PERF. PR 10 6,972000 8,815000 0,000000 70 W61489002 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 50 PUNGI DIN PVC PLASTICIZAT A CÂTE 100 ML SOL. PERF. PR 50 6,617800 7,976400 0,000000 71 W61489003 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 10 PUNGI DIN PVC PLASTICIZAT A CÂTE 200 ML SOL. PERF. PR 10 13,125000 16,023000 0,000000 72 W61489004 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 30 PUNGI DIN PVC PLASTICIZAT A CÂTE 200 ML SOL. PERF. PR 30 12,828000 15,254333 0,000000 19 Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 73 W53353002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 100ML S 10 6,972000 8,815000 0,000000 74 W53353003 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 200ML S 10 13,125000 16,023000 0,000000 75 W57939001 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 6,612000 8,647200 2,436800 76 W60311001 J01MA14 MOXIFLOXACINUM MOFINACIN 400 mg COMPR. FILM. 400mg ALVOGEN IPCO S.A.R.L LUXEMBUR G CUTIE CU BLIST. OPA-AL-PVC/AL X 5 COMPR. FILM PRF 5 5,510000 7,206000 0,000000 77 W60943001 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 5,510000 7,206000 0,000000 78 W60545001 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 5,510000 7,206000 0,000000 79 W59332001 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 5,510000 7,206000 0,000000 80 W57938004 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg/250 ml SOL. PERF. 400mg/25 0ml BAYER PHARMA AG GERMANIA CUTIE X 5 FLACOANE DIN STICLA X 250 ML S 5 69,648000 88,056000 13,026000 81 W60727001 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA KABI 400 mg/250 ml SOL. PERF. 400mg/25 0ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPACK) A 250 ML SOL. PERF. (400 MG MOXIFLOXACINA) PR 1 58,040000 73,380000 0,000000 82 W52079002 J04AB01 CICLOSERINUM CICLOSERINA ANTIBIOTICE 250 mg CAPS. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 10 FOLII TERMOSUDATE DIN AL/AL X 10 CAPS. P-RF 100 4,399000 5,176400 0,000000 83 W41998002 J04AB02 RIFAMPICINUM SINERDOL 150 mg CAPS. 150mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. S 1000 0,169650 0,207110 0,000000 84 W41999002 J04AB02 RIFAMPICINUM SINERDOL 300 mg CAPS. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR. S 1000 0,548780 0,636320 0,000000 85 W58576002 J04AC01 ISONIAZIDUM IZONIAZIDA ATB 100 mg COMPR. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 150 BLIST. PVC/AL X 10 COMPR. PR 1500 0,110333 0,134693 0,000000 86 W58577002 J04AC01 ISONIAZIDUM IZONIAZIDA ATB 300 mg COMPR. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. PVC/AL X 10 COMPR. S/P-RF 1500 0,272473 0,322426 0,000000 87 W60582001 J04AC01 ISONIAZIDUM ISONIAZID SIROP 100mg/5 ml CN UNIFARM S.A. ROMANIA CUTIE X 1 FLAC. X 200 ML SIROP PR 1 30,110000 39,380000 0,000000 88 W60594001 J04AC01 ISONIAZIDUM BITUB SOL INJ. 100mg/ml CN UNIFARM S.A. ROMANIA CUTIE CU 10 FIOLE A 5ML PR 10 1,469000 1,986000 0,000000 89 W55916001 J04AD01 PROTIONAMIDUM PETEHA 250 mg COMPR. FILM. 250 mg ANTIBIOTICE SA ROMANIA CUTIE X 10 BLISTERE X 10 COMPRIMATE FILMATE PR 100 1,022700 1,248500 0,000000 90 W60213002 J04AK01 PYRAZINAMIDUM PIRAZINAMIDA ATB 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 150 BLIST. PVC/AL X 10 COMPR. PR 1500 0,299853 0,352273 0,000000 91 W53682002 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,184000 0,249000 0,000000 92 W59648001 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF 20 0,287500 0,388500 0,000000 93 W59648003 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN PE X 50 CAPS. PRF 50 0,284600 0,384600 0,000000 94 W42943002 J04AK02 ETHAMBUTOLUM ETAMBUTOL 250 mg COMPR. FILM. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1500 0,217573 0,262586 0,000000 95 W42861002 J04AK02 ETHAMBUTOLUM ETAMBUTOL 400 mg COMPR. FILM. 400mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1500 0,334726 0,390286 0,000000 96 W60583001 J04AK02 ETHAMBUTOLUM INBUTOL SOL INJ. 100mg/ml CN UNIFARM S.A. ROMANIA FLAC. X 10 ML SOL. INJ PR 1 16,130000 21,800000 0,000000 97 W14071002 J04AM02 COMBINATII (RIFAMPICINUM+IZONIAZIDUM) SINERDOL ISO CAPS. 300mg+1 50mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. S 1000 0,600660 0,692870 0,000000 20 P1: PROGRAMUL NATIONAL DE BOLI TRANSMISIBILE C) SUBPROGRAMUL DE SUPRAVEGHERE SI CONTROL AL BOLILOR TRANSMISIBILE PRIORITATRE PREV-TRAT GRIPEI

1 W08867001 J05AH01 ZANAMIVIRUM RELENZA 5 mg PULB. UNIDOZA DE INHALAT 5mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 5 BLIST. TIP ROTADISK X 4 DOZE + DISPOZITIV DE ADMINISTRARE DISKHALER P-RF 5 10,228000 12,932000 0,000000 2 W52316001 J05AH02 OSELTAMIVIRUM TAMIFLU 30mg CAPS. 30mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1BLISTER PVC/PE/PVDC/ALX 10 CAPSULE P-RF 10 3,328000 4,353000 0,000000 3 W13633001 J05AH02 OSELTAMIVIRUM TAMIFLU 75 mg CAPS. 75mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1BLISTER PVC/PE/PVDC/AL X 10 CAPSULE P-RF 10 6,050000 7,649000 0,000000

P3: PROGRAMUL NATIONAL DE ONCOLOGIE

1 W58800001 G03HA01 CYPROTERONUM ANDROCUR COMPR. 50mg BAYER PHARMA AG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-RF 50 1,780200 2,250800 0,000000 2 W12490001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 0,401400 0,542400 0,000000 3 W52215001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 200 mg PULB. PT. SOL. PERF./INJ. I.V. 200mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ S 1 11,760000 15,890000 0,000000 4 W58866002 L01AA02 CHLORAMBUCILUM LEUKERAN COMPR. FILM. 2mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 1 FLAC. X 25 COMPR. FILM. P-RF 25 9,680000 11,817200 0,000000 5 W58865001 L01AA03 MELPHALANUM ALKERAN 2 mg COMPR. FILM. 2mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 25 COMPR. FILM. P-RF 25 10,116400 12,350000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 6 W60631001 L01AA03 MELPHALANUM ALKERAN 50 mg PULB+SOL V. PT. SOL. INJ./PERF. 50mg CN UNIFARM S.A. ROMANIA CUTIE CU 1 FIOLA PULB.+ 1 FIOLA SOLVENT PR 1 630,000000 724,850000 0,000000 7 W12497001 L01AA06 IFOSFAMIDUM HOLOXAN 1 g PULB. PT. SOL. PERF. 1g BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. PERF. S 1 95,760000 121,080000 0,000000 8 W51454001 L01AB01 BUSULFANUM BUSILVEX 6mg/ml CONC. PT. SOL. PERF. 6mg/ml PIERRE FABRE MEDICAMENT FRANTA CUTIE X 8 FLAC. X 10 ML CONC. PT. SOL. INJ. S 8 1.007,503750 1.102,948750 0,000000 9 W59709001 L01AD02 LOMUSTINUM4) CECENU CAPS. 40mg CN UNIFARM S.A. ROMANIA CUTIE X 1 FLACON X 20 CAPSULE PR 20 96,375500 106,957000 0,000000 10 W55335001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE TEVA 100 mg CAPS. 100mg TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS. P-RF/R 5 37,248000 45,472000 0,000000 11 W61245001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 100 mg CAPS. 100mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 37,248000 45,472000 0,000000 12 W61245002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 100 mg CAPS. 100mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS. PR 5 37,248000 45,472000 0,000000 13 W59699001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA GLENMARK 100 mg CAPS. 100mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 37,248000 45,472000 0,000000 14 W59614003 L01AX03 TEMOZOLOMIDUM** TEMODAL 100 mg CAPS. 100mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 5 CAPS. AMBALATE INDIVIDUAL IN PLICURI P-RF/R 5 44,697600 54,566400 15,389600 15 W59451001 L01AX03 TEMOZOLOMIDUM** BLASTOMAT 100 mg CAPS. 100mg ALVOGEN IPCO S.AR.L. LUXEMBUR G CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 37,248000 45,472000 0,000000 16 W59705002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 100 mg CAPS. 100mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS. PR 5 37,248000 45,472000 0,000000 17 W56780001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 100 mg CAPS. 100mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 37,248000 45,472000 0,000000 18 W59506001 L01AX03 TEMOZOLOMIDUM** NOGRON 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 37,248000 45,472000 0,000000 19 W59705001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 100 mg CAPS. 100mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 37,248000 45,472000 0,000000 20 W59507001 L01AX03 TEMOZOLOMIDUM** NOGRON 140 mg CAPS. 140mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 78,164000 92,828000 0,000000 21 W59706001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 140 mg CAPS. 140mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 78,164000 92,828000 0,000000 22 W59706002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 140 mg CAPS. 140mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS. PR 5 78,164000 92,828000 0,000000 23 W59615003 L01AX03 TEMOZOLOMIDUM** TEMODAL 140mg CAPS. 140mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 5 CAPS. AMBALATE INDIVIDUAL IN PLICURI P-RF/R 5 93,796800 111,393600 23,790400 24 W56781001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 140 mg CAPS. 140mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 78,164000 92,828000 0,000000 25 W56782001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 180 mg CAPS. 180mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 97,764000 114,192000 0,000000 26 W59508001 L01AX03 TEMOZOLOMIDUM** NOGRON 180 mg CAPS. 180mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 97,764000 114,192000 0,000000 27 W59616003 L01AX03 TEMOZOLOMIDUM** TEMODAL 180 mg CAPS. 180mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 5 CAPS. AMBALATE INDIVIDUAL IN PLICURI P-RF/R 5 117,316800 137,030400 31,019600 28 W61244001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 20 mg CAPS. 20mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 7,966000 10,420000 0,000000 29 W61244002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 20 mg CAPS. 20mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS. PR 5 7,966000 10,420000 0,000000 30 W55334001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE TEVA 20 mg CAPS. 20mg TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS. P-RF/R 5 7,966000 10,420000 0,000000 31 W59617003 L01AX03 TEMOZOLOMIDUM** TEMODAL 20 mg CAPS. 20mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 5 CAPS. AMBALATE INDIVIDUAL IN PLICURI P-RF/R 5 9,559200 12,504000 2,720000 32 W59698001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA GLENMARK 20 mg CAPS. 20mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 7,966000 10,420000 0,000000 33 W59450001 L01AX03 TEMOZOLOMIDUM** BLASTOMAT 20 mg CAPS. 20mg ALVOGEN IPCO S.AR.L. LUXEMBUR G CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 7,966000 10,420000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 34 W59505001 L01AX03 TEMOZOLOMIDUM** NOGRON 20 mg CAPS. 20mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 7,966000 10,420000 0,000000 35 W59704001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 20 mg CAPS. 20mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 7,966000 10,420000 0,000000 36 W59704002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 20 mg CAPS. 20mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS. PR 5 7,966000 10,420000 0,000000 37 W56779001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 20 mg CAPS. 20mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 7,966000 10,420000 0,000000 38 W59454001 L01AX03 TEMOZOLOMIDUM** BLASTOMAT 250 mg CAPS. 250mg ALVOGEN IPCO S.AR.L. LUXEMBUR G CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 233,776800 263,973600 13,432400 39 W59702001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA GLENMARK 250 mg CAPS. 250mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 233,776800 263,973600 13,432400 40 W60017001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 250 mg CAPS. 250mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 233,776800 263,973600 95,694400 41 W61248001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 250 mg CAPS. 250mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 233,776800 263,973600 95,694400 42 W61248002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 250 mg CAPS. 250mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS. PR 5 233,776800 263,973600 95,694400 43 W56783001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 250 mg CAPS. 250mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 233,776800 263,973600 35,660400 44 W55336001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE TEVA 250 mg CAPS. 250mg TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS. P-RF/R 5 194,814000 219,978000 0,000000 45 W60017002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 250 mg CAPS. 250mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS. PR 5 233,776800 263,973600 95,694400 46 W59613001 L01AX03 TEMOZOLOMIDUM** TEMODAL 2,5mg/ml PULB. PT. SOL. PERF. 2,5mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PT. SOL. PERF. P-RF/R 1 602,770000 695,170000 0,000000 47 W56549001 L01AX04 DACARBAZINUM DACARBAZINE MEDAC 500 mg PULB. PT. SOL. INJ. 500mg CN UNIFARM S.A. ROMANIA CUTIE CU 1 FLAC.X 500MG PULB. PT. SOL. INJ. PR 1 69,450000 87,810000 0,000000 48 W58779001 L01AX04 DACARBAZINUM DACARBAZINA LIPOMED 200 mg PULB. PT. SOL. INJ./PERF. 200 mg LIPOMED GMBH GERMANIA CUTIE CU 10 FLACOANE MONODOZA DIN STICLA BRUNA CU DOP DIN CAUCIUC BROMOBUTILIC CU SIGILIU DIN AL TIP FLIP-OFF CU CAPAC DIN PLASTIC DE CULOARE ROSIE CARE CONTIN PULB. PENTRU SOL. INJ. SAU PERF. PR 10 75,731000 86,362000 0,000000 49 W59710001 L01AX04 DACARBAZINUM DACARBAZIN MEDAC 200mg PULB. PT. SOL. INJ./PERF. 200mg CN UNIFARM S.A. ROMANIA CUTIE X 10 FLACOANE PR 10 82,419000 93,652000 0,000000 50 W58569001 L01BA01 METHOTREXATUM METHOTREXATE PCH 10mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10COMPR. P6L 10 2,211000 2,989000 0,000000 51 W58568001 L01BA01 METHOTREXATUM METHOTREXATE PCH 2,5mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X30 COMPRIMATE P6L 30 0,553333 0,747666 0,000000 52 W12733003 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S 1 65,640000 82,990000 0,000000 53 W12735001 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 308,200000 374,090000 0,000000 54 W58316010 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 93,336000 118,008000 9,082000 55 W58316004 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 35,730000 46,730000 0,000000 56 W58316007 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 63,030000 79,700000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 57 W58316001 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ PR 1 47,310000 61,880000 0,000000 58 W53758021 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÃ„PARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 87,540000 110,680000 0,000000 59 W53758016 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÃ„PARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 77,780000 98,340000 0,000000 60 W53758006 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÃ„PARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 42,876000 56,076000 13,944000 61 W42003001 L01BA04 PEMETREXEDUM**** ALIMTA 500mg PULB. PT. CONC. PT. SOL. PERF. 500mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. S 1 3.745,950000 4.121,240000 0,000000 62 W58868001 L01BB02 MERCAPTOPURINUM PURI - NETHOL COMPR. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 25 COMPR. P-RF 25 10,648800 13,000000 0,000000 63 W58869001 L01BB03 TIOGUANINUM LANVIS COMPR. 40mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 1 FLAC. X 25 COMPR. P-RF 25 25,200000 28,994000 0,000000 64 W60721001 L01BB03 TIOGUANINUM THIOGUANIN ASPEN 40 mg COMPR. 40mg CN UNIFARM S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU 25 COMPR. PR 25 23,650000 27,304400 0,000000 65 W44114001 L01BB04 CLADRIBINUM LITAK 2 mg/ml SOL. INJ. 2mg/ml LIPOMED GMBH GERMANIA CUTIE X 1 FLACON X 5 ML S 1 1.309,390000 1.465,390000 0,000000 66 W56210002 L01BB05 FLUDARABINUM**** FLUDARA ORAL 10 mg COMPR. FILM. 10mg GENZYME EUROPE B.V. OLANDA CUTIE X 1 FLAC. DIN PE X 4 BLIST. AL/AL X 5 COMPR. FILM. P-RF/S 20 53,287000 59,990500 0,000000 67 W56211001 L01BB05 FLUDARABINUM FLUDARA LIOF. PT. SOL. INJ./PERF. 50mg GENZYME EUROPE B.V. OLANDA CUTIE X 5 FLAC. CU LIOF. PT. SOL. INJ./PERF. S 5 81,444000 102,984000 12,802000 68 W53700001 L01BB05 FLUDARABINUM FLUDARABINA ACTAVIS 25 mg/ml PULB. PT. SOL. INJ./PERF. 25mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA (CAPACITATE 5ML) CU PULB. PT. SOL. INJ/PERF CONTINAND 50MG FLUDA S 1 67,870000 85,820000 0,000000 69 W53291005 L01BB06 CLOFARABINUM**** EVOLTRA 1mg/ml CONC. PT. SOL. PERF. 1mg/ml GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. CU CONC. PT. SOL. PERF. PR 1 6.027,070000 6.607,660000 0,000000 70 W52264001 L01BB07 NELARABINUM**** ATRIANCE SOL. PERF. 5mg/ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 6 FLAC. X 50 ML S 6 1.193,418333 1.307,186666 0,000000 71 W13946007 L01BC01 CYTARABINUM ALEXAN 20mg/ml SOL. INJ. 20mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FLACOANE DIN STICLA X 5 ML SOL. INJ. S 10 9,173000 11,598000 0,000000 72 W42933004 L01BC01 CYTARABINUM ALEXAN 50mg/ml SOL. INJ. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 20 ML. SOL. INJ. S 1 49,464000 64,704000 31,816000 73 W59016003 L01BC01 CYTARABINUM CITARABINA KABI 100 mg/ml SOL. INJ. SAU PERF. 100mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC BROMBUTILIC CU CAPSA DETASABILA DIN AL DE CULOARE ROSIE X 10 ML SOL. INJ. SAU PERF. PR 1 41,220000 53,920000 0,000000 74 W59016004 L01BC01 CYTARABINUM CITARABINA KABI 100 mg/ml SOL. INJ. SAU PERF. 100mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC BROMBUTILIC CU CAPSA DETASABILA DIN AL DE CULOARE GALBENA X 20 ML SOL. INJ. SAU PERF. PR 1 98,560000 124,620000 0,000000 75 W53814001 L01BC01 CYTARABINUM DEPOCYTE 50mg SUSP. INJ. 50mg PACIRA LIMITED MAREA BRITANIE CUTIE X 1 FLAC. X 50MG SUSP.INJ. (MONODOZA 5ML) S 1 6.172,500000 6.766,180000 0,000000 76 W43451005 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 12,550000 16,960000 0,000000 77 W43451001 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 5 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 2,970000 4,020000 0,000000 78 W43451003 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 5,960000 8,060000 0,000000 79 W43451006 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 56,540000 71,490000 0,000000 80 W59510002 L01BC05 GEMCITABINUM** GEMCITABINA KABI 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA, PREVAZUT CU SIGILIU CU CAPSA DETASABILA DIN AL DE CULOARE ALBASTRA, CU DISC DIN PP, A 1000 MG/25 ML CONC. PT. SOL. PERF. PR 1 97,536000 123,324000 103,466000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 81 W56425001 L01BC05 GEMCITABINUM** GITRABIN 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 5 ML X 200 MG GEMCITABINA PR 1 21,540000 29,120000 0,000000 82 W56425002 L01BC05 GEMCITABINUM** GITRABIN 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 25 ML X 1 G GEMCITABINA PR 1 97,536000 123,324000 5,886000 83 W59510001 L01BC05 GEMCITABINUM** GEMCITABINA KABI 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA, PREVAZUT CU SIGILIU CU CAPSA DETASABILA DIN AL DE CULOARE VERDE, CU DISC DIN PP, A 200 MG/5 ML CONC. PT. SOL. PERF. PR 1 25,848000 34,944000 19,396000 84 W59510003 L01BC05 GEMCITABINUM** GEMCITABINA KABI 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA, PREVAZUT CU SIGILIU CU CAPSA DETASABILA DIN AL DE CULOARE VIOLET, CU DISC DIN PP, A 2000 MG/50 ML CONC. PT. SOL. PERF. PR 1 187,104000 228,420000 223,340000 85 W56425003 L01BC05 GEMCITABINUM** GITRABIN 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML X 2 G GEMCITABINA PR 1 187,104000 228,420000 25,380000 86 W59316002 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 25 ML X 1 G GEMCITABINA PR 1 97,536000 123,324000 110,526000 87 W59316003 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML X 2 G GEMCITABINA PR 1 187,104000 228,420000 222,080000 88 W56246001 L01BC05 GEMCITABINUM** GEMZAR 1000 mg PULB. PT. SOL. PERF. 1000 mg LILLY FRANCE SAS FRANTA CUTIE X 1FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. S 1 97,536000 123,324000 225,586000 89 W55552001 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 1000 mg PULB. PT. SOL. PERF. 1000mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 1000 MG PULB. PT. SOL. PERF. S 1 97,536000 123,324000 87,966000 90 W56371001 L01BC05 GEMCITABINUM** GEMCITABINA ATB 1000 mg PULB. PT. SOL. PERF. 1000mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML PULB. PT. SOL. PERF. PR 1 97,536000 123,324000 103,466000 91 W56150001 L01BC05 GEMCITABINUM** DAPLAX 1 g PULB. PT. SOL. PERF. 1g DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. CONTINAND 1000MG GEMCITABINA S 1 97,536000 123,324000 103,466000 92 W55553001 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 2000 mg PULB. PT. SOL. PERF. 2000mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 2000 MG PULB. PT. SOL. PERF. S 1 187,104000 228,420000 141,810000 93 W03290001 L01BC05 GEMCITABINUM** GEMZAR (R) 200 mg PULB. PT. SOL. PERF. 200mg LILLY FRANCE SAS FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. PERF. S 1 25,848000 34,944000 44,446000 94 W56149001 L01BC05 GEMCITABINUM** DAPLAX 200 mg PULB. PT. SOL. PERF. 200mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. CONTINAND 200MG GEMCITABINA S 1 25,848000 34,944000 19,396000 95 W56370001 L01BC05 GEMCITABINUM** GEMCITABINA ATB 200 mg PULB. PT. SOL. PERF. 200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 10 ML PULB. PT. SOL. PERF. PR 1 25,848000 34,944000 19,396000 96 W55551001 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 200 mg PULB. PT. SOL. PERF. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 MG PULB. PT. SOL. PERF. S 1 25,848000 34,944000 18,516000 97 W55531003 L01BC05 GEMCITABINUM** GITRABIN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 FLAC. STICLA INCOLORA CU PULB. PT SOL. PERF. CARE CONTINE 1000MG GEMCITABINA S 1 97,536000 123,324000 43,336000 98 W55531004 L01BC05 GEMCITABINUM** GITRABIN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 FLAC. STICLA INCOLORA CU PULB. PT SOL. PERF. CARE CONTINE 2000MG GEMCITABINA S 1 187,104000 228,420000 199,610000 99 W54381001 L01BC05 GEMCITABINUM** GEMCIRENA 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML CU PULB. PT. SOL. PERF. CARE CONTINE 200MG GEMCITABINA S 1 23,270000 31,450000 0,000000 100 W55531002 L01BC05 GEMCITABINUM** GITRABIN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 FLAC. STICLA INCOLORA CU PULB. PT SOL. PERF. CARE CONTINE 200MG GEMCITABINA S 1 25,800000 33,740000 0,000000 101 W54381002 L01BC05 GEMCITABINUM** GEMCIRENA 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. CARE CONTINE 1000MG GEMCITABINA S 1 81,280000 102,770000 0,000000 102 W54381004 L01BC05 GEMCITABINUM** GEMCIRENA 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML CU PULB. PT. SOL. PERF. CARE CONTINE 2000MG GEMCITABINA S 1 155,920000 190,350000 0,000000 103 W58925005 L01BC06 CAPECITABINUM CAPECITABINA GLENMARK 150 mg COMPR. FILM. 150mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE CU 6 BLIST. PVC/PVDC-AL X 60 (6X10) COMPR. FILM. PR 60 0,905500 1,145000 0,000000 104 W08338001 L01BC06 CAPECITABINUM XELODA 150 mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 BLIST. DIN PVC/PE/PVDC X 10 COMPR. FILM. P-RF/R 60 1,086600 1,374000 2,827500 105 W60217002 L01BC06 CAPECITABINUM ECANSYA 150mg COMPR. FILM. 150mg KRKA D.D. SLOVENIA CUTIE CU BLIST. AL/AL X 60 COMPRIMATE FILMATE PR 60 0,905500 1,145000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 106 W59654001 L01BC06 CAPECITABINUM ARXEDA 150 mg COMPR. FILM. 150mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. PRF 60 0,905500 1,145000 0,000000 107 W59086001 L01BC06 CAPECITABINUM CAPECITABINA FRESENIUS KABI 150 mg COMPR. FILM. 150mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 6 BLIST. CU PERFORATIE DIN PVC-PVDC/AL X 10 COMPR. FILM. PR 60 0,905500 1,145000 0,000000 108 W60278001 L01BC06 CAPECITABINUM CAPECITABINE TEVA 150 mg COMPR. FILM. 150mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PE/PVDC/AL X 60 COMPR. FILM. PR 60 0,905500 1,145000 0,000000 109 W59654002 L01BC06 CAPECITABINUM ARXEDA 150 mg COMPR. FILM. 150mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 60 COMPR. FILM. PRF 60 0,905500 1,145000 0,000000 110 W59427002 L01BC06 CAPECITABINUM CAPECITABINA ZENTIVA 150 mg COMPR. FILM. 150mg ZENTIVA, K.S. REPUBLIC A CEHA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PR 60 0,905500 1,145000 0,000000 111 W60217005 L01BC06 CAPECITABINUM ECANSYA 150mg COMPR. FILM. 150mg KRKA D.D. SLOVENIA CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPRIMATE FILMATE PR 60 0,905500 1,145000 0,000000 112 W59385001 L01BC06 CAPECITABINUM XALVOBIN 150 mg COMPR. FILM. 150mg ALVOGEN IPCO S.AR.L. LUXEMBUR G CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. PR 60 0,905500 1,145000 0,000000 113 W59427001 L01BC06 CAPECITABINUM CAPECITABINA ZENTIVA 150 mg COMPR. FILM. 150mg ZENTIVA, K.S. REPUBLIC A CEHA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PR 60 0,905500 1,145000 0,000000 114 W58925002 L01BC06 CAPECITABINUM CAPECITABINA GLENMARK 150 mg COMPR. FILM. 150mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE CU 6 BLIST. AL-AL X 60 (6X10) COMPR. FILM. PR 60 0,905500 1,145000 0,000000 115 W59385002 L01BC06 CAPECITABINUM XALVOBIN 150 mg COMPR. FILM. 150mg ALVOGEN IPCO S.AR.L. LUXEMBUR G CUTIE CU BLIST. PVC-PE-PVDC/AL X 60 COMPR. FILM. PR 60 0,905500 1,145000 0,000000 116 W60218005 L01BC06 CAPECITABINUM ECANSYA 300mg COMPR. FILM. 300mg KRKA D.D. SLOVENIA CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPRIMATE FILMATE PR 60 5,327000 6,442333 0,000000 117 W60218002 L01BC06 CAPECITABINUM ECANSYA 300mg COMPR. FILM. 300mg KRKA D.D. SLOVENIA CUTIE CU BLIST. AL/AL X 60 COMPRIMATE FILMATE PR 60 5,327000 6,442333 0,000000 118 W59428001 L01BC06 CAPECITABINUM CAPECITABINA ZENTIVA 500 mg COMPR. FILM. 500mg ZENTIVA, K.S. REPUBLIC A CEHA CUTIE CU 12 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PR 120 1,844100 2,251300 0,000033 119 W59428002 L01BC06 CAPECITABINUM CAPECITABINA ZENTIVA 500 mg COMPR. FILM. 500mg ZENTIVA, K.S. REPUBLIC A CEHA CUTIE CU 12 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PR 120 1,844100 2,251300 0,000033 120 W08339001 L01BC06 CAPECITABINUM XELODA 500 mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 12 BLIST. DIN PVC/PE/PVDC X 10 COMPR. FILM. P-RF/R 120 1,844100 2,251300 9,651616 121 W60219006 L01BC06 CAPECITABINUM ECANSYA 500mg COMPR. FILM. 500mg KRKA D.D. SLOVENIA CUTIE CU BLIST. PVC/PVDC/AL X 120 COMPRIMATE FILMATE PR 120 1,844100 2,251300 0,000033 122 W59386002 L01BC06 CAPECITABINUM XALVOBIN 500 mg COMPR. FILM. 500mg ALVOGEN IPCO S.AR.L. LUXEMBUR G CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 1,844100 2,251300 1,225366 123 W60219003 L01BC06 CAPECITABINUM ECANSYA 500mg COMPR. FILM. 500mg KRKA D.D. SLOVENIA CUTIE CU BLIST. AL/AL X 120 COMPRIMATE FILMATE PR 120 1,844100 2,251300 0,000033 124 W60255001 L01BC06 CAPECITABINUM CAPECITABINA DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLISTERE PVC-PE-PVDC/AL-PET-HARTIE X 120 COMPRIMATE FILMATE PR 120 1,844100 2,251300 0,000033 125 W58926003 L01BC06 CAPECITABINUM CAPECITABINA GLENMARK 500 mg COMPR. FILM. 500mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE CU 12 BLIST. AL-AL X 120 (12X10) COMPR. FILM. PR 120 1,844100 2,251300 1,225366 126 W59655002 L01BC06 CAPECITABINUM ARXEDA 500 mg COMPR. FILM. 500mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PRF 120 1,844100 2,251300 1,225366 127 W59424001 L01BC06 CAPECITABINUM CEREX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 120 (12X10) COMPR. FILM. PR 120 1,844100 2,251300 1,225366 128 W59655001 L01BC06 CAPECITABINUM ARXEDA 500 mg COMPR. FILM. 500mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 120 COMPR. FILM. PRF 120 1,844100 2,251300 1,225366 129 W59059003 L01BC06 CAPECITABINUM COLOXET 500 mg COMPR. FILM. 500mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 12 BLIST. AL/AL X 10 COMPR. FILM. PR 120 1,844100 2,251300 1,225366 130 W59087001 L01BC06 CAPECITABINUM CAPECITABINA FRESENIUS KABI 500 mg COMPR. FILM. 500mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 12 BLIST. CU PERFORATIE DIN PVC-PVDC/AL X 10 COMPR. FILM. PR 120 1,844100 2,251300 1,225366 131 W60279001 L01BC06 CAPECITABINUM CAPECITABINE TEVA 500 mg COMPR. FILM. 500mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PE/PVDC/AL X 120 COMPR. FILM. PR 120 1,844100 2,251300 1,225366 132 W59424002 L01BC06 CAPECITABINUM CEREX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 (12X10) COMPR. FILM. PR 120 1,844100 2,251300 1,225366 133 W59059006 L01BC06 CAPECITABINUM COLOXET 500 mg COMPR. FILM. 500mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 12 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PR 120 1,844100 2,251300 1,225366 134 W59367001 L01BC06 CAPECITABINUM CAPECITABINA ACTAVIS 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 120 COMPR. FILM. PR 120 1,536750 1,876083 0,000000 135 W59386001 L01BC06 CAPECITABINUM XALVOBIN 500 mg COMPR. FILM. 500mg ALVOGEN IPCO S.AR.L. LUXEMBUR G CUTIE CU BLIST. PVC-PVDC/AL X 120 COMPR. FILM. PR 120 1,844100 2,251300 1,225366 136 W59587001 L01BC08 DECITABINUM**** DACOGEN PULB. PT. CONC. PT. SOL. PERF. 50mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 FL. DIN STICLA CE CONTINE 50MG DECITABINA PR 1 4.936,540000 5.418,990000 0,000000 137 W59211001 L01CA01 VINBLASTINUM4) VINBLASTINA TEVA 1 mg/ml SOL INJ. 1mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 10 ML SOL. INJ. PR 1 30,750000 40,220000 0,000000 138 W52220001 L01CA02 VINCRISTINUM SINDOVIN 1 mg PULB. PT. SOL. INJ./PERF. 1mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. INJ./PERF. I.V. S 1 26,490000 34,650000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 139 W42512002 L01CA04 VINORELBINUM NAVELBINE 20 mg CAPS. MOI 20mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE X 1 BLIST. PVC-PVDC/AL-PETP X 1 CAPS. MOALE P-RF 1 186,710000 227,940000 0,000000 140 W42513002 L01CA04 VINORELBINUM NAVELBINE 30 mg CAPS. MOI 30mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE X 1 BLIST. PVC-PVDC/AL-PETP X 1 CAPS. MOALE P-RF 1 280,060000 341,900000 0,000000 141 W43735002 L01CA04 VINORELBINUM VINORELBIN EBEWE 10 mg/ ml CONC. PT. SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLAC. X 5 ML CONC. PT. SOL. INJ/PERF. S 1 136,180000 166,250000 0,000000 142 W43735001 L01CA04 VINORELBINUM VINORELBIN EBEWE 10 mg/ ml CONC. PT. SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLAC. X 1 ML CONC. PT. SOL. INJ/PERF. S 1 31,740000 41,510000 0,000000 143 W52194002 L01CA04 VINORELBINUM VINORELBIN ACTAVIS 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 5 ML CONC. PT. SOL. PERF. S 1 124,280000 151,720000 0,000000 144 W52194001 L01CA04 VINORELBINUM VINORELBIN ACTAVIS 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 1 ML CONC. PT. SOL. PERF. S 1 36,880000 48,240000 0,000000 145 W08035001 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 100mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 1 BLIST. PVC/A0-PVC-PVDC X 10 CAPS. P-RF 10 21,796000 26,609000 0,000000 146 W08036001 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 50mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 2 BLIST. PVC/AL-PVC-PVDC X 10 CAPS. P-RF 20 10,952500 13,371000 0,000000 147 W52210001 L01CB01 ETOPOSIDUM SINTOPOZID 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5 ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 17,960000 24,270000 0,000000 148 W03065001 L01CB01 ETOPOSIDUM ETOPOSID "EBEWE" 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5 ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 21,552000 29,124000 3,236000 149 W52574002 L01CB01 ETOPOSIDUM ETOPOSIDE - TEVA CONC. PT. SOL. PERF. 20mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 10 ML CONC. PT. SOL. PERF. S 1 54,800000 69,290000 0,000000 150 W52574001 L01CB01 ETOPOSIDUM ETOPOSIDE - TEVA CONC. PT. SOL. PERF. 20mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 5 ML CONC. PT. SOL. PERF. S 1 21,552000 29,124000 3,846000 151 W60599002 L01CB01 ETOPOSIDUM ETOPOZIDA KABI 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU UN FLAC. DIN STICLA INCOLORA TIP I, CU CAPACITATEA DE 10 ML ÎNCHIS CU DOP DIN CAUCIUC BROMOBUTIL SI SIGILAT CU CAPSE DETASABILE DIN AL DE CULOARE ALBASTRA CONTINÂND 10 ML CONC. PENTRU SOL. PERF. PR 1 63,290000 80,030000 0,000000 152 W54068003 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 16,7 ML CONC. PT. SOL. PERF. S 1 57,620000 72,860000 0,000000 153 W54068007 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 25 ML CONC. PT. SOL. PERF. S 1 82,320000 104,090000 0,000000 154 W43372004 L01CD01 PACLITAXELUM** PACLITAXEL EBEWE 6mg/ml CONC. PT. SOL. PERF. 6mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 50 ML CONC. PT. SOL. PERF. S 1 194,040000 236,880000 221,080000 155 W43372002 L01CD01 PACLITAXELUM** PACLITAXEL EBEWE 6mg/ml CONC. PT. SOL. PERF. 6mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 16,6 ML CONC. PT. SOL. PERF. S 1 69,144000 87,432000 60,418000 156 W43372001 L01CD01 PACLITAXELUM** PACLITAXEL EBEWE 6mg/ml CONC. PT. SOL. PERF. 6mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 32,550000 42,570000 0,000000 157 W54068005 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML CONC. PT. SOL. PERF. S 1 161,700000 197,400000 0,000000 158 W54978004 L01CD01 PACLITAXELUM** PACLITAXEL ARCHIE SAMUEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ARCHIE SAMUEL S.R.O. REPUBLIC A CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 300 MG CONC. PT. SOL. PERF. S 1 194,040000 236,880000 1.044,810000 159 W54978003 L01CD01 PACLITAXELUM** PACLITAXEL ARCHIE SAMUEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ARCHIE SAMUEL S.R.O. REPUBLIC A CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 150 MG CONC. PT. SOL. PERF. S 1 98,784000 124,908000 544,552000 160 W52212001 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 32,550000 42,570000 0,000000 161 W52212005 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 43,33 ML CONC. PT. SOL. PERF. S 1 850,040000 964,700000 0,000000 162 W54978001 L01CD01 PACLITAXELUM** PACLITAXEL ARCHIE SAMUEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ARCHIE SAMUEL S.R.O. REPUBLIC A CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 30 MG CONC. PT. SOL. PERF. S 1 39,060000 51,084000 94,486000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 163 W54068001 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 32,550000 42,570000 0,000000 164 W52212002 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 16,67 ML CONC. PT. SOL. PERF. S 1 69,144000 87,432000 45,228000 165 W52212004 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML CONC. PT. SOL. PERF. S 1 194,040000 236,880000 144,960000 166 W52212003 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X, 25 ML CONC. PT. SOL. PERF. S 1 98,784000 124,908000 544,672000 167 W54978002 L01CD01 PACLITAXELUM** PACLITAXEL ARCHIE SAMUEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ARCHIE SAMUEL S.R.O. REPUBLIC A CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 MG CONC. PT. SOL. PERF. S 1 69,144000 87,432000 353,188000 168 W43372003 L01CD01 PACLITAXELUM** PACLITAXEL EBEWE 6mg/ml CONC. PT. SOL. PERF. 6mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 25 ML CONC. PT. SOL. PERF. S 1 98,784000 124,908000 157,092000 169 W55670001 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 20 mg/0,5 ml CONC. + SOLV. PT. SOL. PERF. 20mg/0,5 ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLISTER DIN POLIESTER TERMOFORMAT X 1 FLACON DIN STICLA INCOLORA X 0,5ML CONCENTRAT PT. SOL. PERFUZABILA + 1 FLACON DIN STICLA INCOLORA X 1,5ML SOLVENT PT. CONCENTRAT PT. SOL. PERFUZABILA S 1 58,116000 76,008000 373,462000 170 W55671001 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 80 mg/2 ml CONC. + SOLV. PT. SOL. PERF. 80mg/2ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLISTER DIN POLIESTER TERMOFORMAT X 1 FLACON DIN STICLA INCOLORA X 2ML CONCENTRAT PT. SOLUTIE PERFUZABILA + 1 FLACON DIN STICLA INCOLORA X 6ML SOLVENT PT. CONCENTRAT PT. SOLUTIE PERFUZABILA S 1 185,136000 226,008000 1.359,682000 171 W55307003 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml HOSPIRA UK LTD MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 8 ML CONC. PT. SOL. PERF. S/P-RF 1 154,280000 188,340000 0,000000 172 W57028001 L01CD02 DOCETAXELUM** DOCETAXEL EBEWE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 2 ML CONC. PT. SOL. PERF. P-RF/R 1 58,116000 76,008000 46,802000 173 W59128003 L01CD02 DOCETAXELUM** DOCETAXEL PFIZER 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. DIN PP DE UNICA FOLOSINTA A 13 ML CONC. PT. SOL. PERF. PR 1 1.636,040000 1.821,440000 0,000000 174 W59128001 L01CD02 DOCETAXELUM** DOCETAXEL PFIZER 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. DIN PP DE UNICA FOLOSINTA A 2 ML CONC. PT. SOL. PERF. PR 1 58,116000 76,008000 255,792000 175 W59128004 L01CD02 DOCETAXELUM** DOCETAXEL PFIZER 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. DIN PP DE UNICA FOLOSINTA A 20 ML CONC. PT. SOL. PERF. PR 1 2.500,840000 2.764,070000 0,000000 176 W59128002 L01CD02 DOCETAXELUM** DOCETAXEL PFIZER 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. DIN PP DE UNICA FOLOSINTA A 8 ML CONC. PT. SOL. PERF. PR 1 185,136000 226,008000 856,342000 177 W55307005 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml HOSPIRA UK LTD MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 16 ML CONC. PT. SOL. PERF. S/P-RF 1 466,500000 546,640000 0,000000 178 W55307001 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml HOSPIRA UK LTD MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 2 ML CONC. PT. SOL. PERF. S/P-RF 1 48,430000 63,340000 0,000000 179 W57028007 L01CD02 DOCETAXELUM** DOCETAXEL EBEWE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 8 ML CONC. PT. SOL. PERF. P-RF/R 1 185,136000 226,008000 262,112000 180 W57028016 L01CD02 DOCETAXELUM** DOCETAXEL EBEWE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU FOLIE PROTECTOARE DIN PLASTIC ONCO-SAFE X 16 ML CONC. PT. SO P-RF/R 1 559,800000 655,968000 525,052000 181 W57271001 L01CD02 DOCETAXELUM** TAXOTERE 160 mg/8ml CONC. PT. SOL. PERF. 160 mg/8 ml AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON DIN STICLA CU 8 ML CONC. PT. SOL. PERF.X 160MG PR 1 559,800000 655,968000 1.109,592000 182 W59570001 L01CD02 DOCETAXELUM** DOCETAXEL KABI 120 mg/6 ml CONC. PT. SOL. PERF. 20 mg/1 ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FL DIN STICLA INCOLORA X 6 ML CONCENTRAT PENTRU SOL. PERFUZABILA PR 1 892,210000 1.010,660000 0,000000 183 W55044001 L01CD02 DOCETAXELUM** TAXOTERE 20 mg/1ml CONC. PT. SOL. PERF. 20mg/1ml AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON X 1 ML CONC. PT. SOL. PERF. PR 1 58,116000 76,008000 146,752000 184 W61077003 L01CD02 DOCETAXELUM** DOCETAXEL TEVA 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU 1 FLAC. UNIDOZA X 7 ML CONC. PT. SOL. PERF. PR 1 914,280000 1.034,720000 0,000000 185 W59826001 L01CD02 DOCETAXELUM** DOCETAXEL KABI 20mg/ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA X 1ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA X 20MG DOCETAXEL PR 1 58,116000 76,008000 48,742000 186 W55902001 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU 1 ML CONC. PT. SOL. PERF. CARE CONTINE 20 MG DOCETAX PR 1 58,116000 76,008000 19,812000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 187 W59877002 L01CD02 DOCETAXELUM** TOLNEXA 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 1 FLAC. DIN STICLA, DE CAPACITATE 5 ML, PREVAZUT CU SIGILIU DIN AL CU CAPSA TIP FLIP-OFF DE CULOARE ROSIE, A 4 ML CONC. PT. SOL. PERF. CARE CONTINE 80 MG DOCETAXEL PR 1 185,136000 226,008000 58,602000 188 W59573001 L01CD02 DOCETAXELUM** DOCETAXEL KABI 80 mg/4 ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FL DIN STICLA INCOLORA X 4 ML CONCENTRAT CE CONTINE 80 MG DOCETAXEL PR 1 185,136000 226,008000 258,202000 189 W59877001 L01CD02 DOCETAXELUM** TOLNEXA 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 1 FLAC. DIN STICLA, DE CAPACITATE 5 ML, PREVAZUT CU SIGILIU DIN AL CU CAPSA TIP FLIP-OFF DE CULOARE PORTOCALIE, A 1 ML CONC. PT. SOL. PERF. CARE CONTINE 20 MG DOCETAXEL PR 1 52,400000 66,260000 0,000000 190 W55902003 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU 7 ML CONC. PT. SOL. PERF. CARE CONTINE 140 MG DOCETA PR 1 1.084,200000 1.219,930000 0,000000 191 W55902002 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU 4 ML CONC. PT. SOL. PERF. CARE CONTINE 80 MG DOCETAX PR 1 154,630000 188,770000 0,000000 192 W59877003 L01CD02 DOCETAXELUM** TOLNEXA 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 1 FLAC. DIN STICLA, DE CAPACITATE 5 ML, PREVAZUT CU SIGILIU DIN AL CU CAPSA TIP FLIP-OFF DE CULOARE PORTOCALIE, A 8 ML CONC. PT. SOL. PERF. CARE CONTINE 160 MG DOCETAXEL PR 1 559,800000 655,968000 2,252000 193 W55045001 L01CD02 DOCETAXELUM** TAXOTERE 80 mg/4ml CONC. PT. SOL. PERF. 80mg/4ml AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON DIN STICLA X 4 ML CONC. PT. SOL. PERF. PR 1 185,136000 226,008000 569,692000 194 W52365001 L01CX01 TRABECTEDINUM**** YONDELIS 0,25mg PULB. PT.CONC. PT.SOL. PERF. 0,25mg PHARMA MAR S.A. SPANIA CUTIE X 1 FLAC. CU PULB. PT. CONC. PT. SOL. PERF. S 1 1.893,750000 2.102,340000 0,000000 195 W52366001 L01CX01 TRABECTEDINUM**** YONDELIS 1mg PULB. PT.CONC. PT.SOL. PERF. 1mg PHARMA MAR S.A. SPANIA CUTIE X 1 FLAC. CU PULB. PT. CONC. PT. SOL. PERF. S 1 7.298,630000 7.993,670000 0,000000 196 W58172008 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. A 100 ML CONC. PT. SOL. PERF. CARE CONTINE 200 MG DOXORUBICINA PR 1 265,470000 324,090000 0,000000 197 W58172003 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. A 10 ML CONC. PT. SOL. PERF. CARE CONTINE 20 MG DOXORUBICINA PR 1 43,536000 56,940000 24,830000 198 W42736002 L01DB01 DOXORUBICINUM DOXORUBICIN "EBEWE" 2mg/ml CONC. PT. SOL. PERF. 2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 25 ML CONC. PT. SOL. PERF. (50 MG DOXORUBICINA) S 1 47,880000 62,630000 0,000000 199 W58172005 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. A 25 ML CONC. PT. SOL. PERF. CARE CONTINE 50 MG DOXORUBICINA PR 1 57,456000 75,156000 10,294000 200 W58172006 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. A 50 ML CONC. PT. SOL. PERF. CARE CONTINE 100 MG DOXORUBICINA PR 1 132,740000 162,050000 0,000000 201 W58172007 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. A 75 ML CONC. PT. SOL. PERF. CARE CONTINE 150 MG DOXORUBICINA PR 1 271,400000 331,320000 0,000000 202 W58281001 L01DB01 DOXORUBICINUM CAELYX 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE X 1 FLACON DIN STICLA X 10 ML S 1 1.424,810000 1.591,200000 0,000000 203 W42736001 L01DB01 DOXORUBICINUM DOXORUBICIN "EBEWE" 2mg/ml CONC. PT. SOL. PERF. 2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML CONC. PT. SOL. PERF. (10 MG DOXORUBICINA) S 1 9,570000 12,940000 0,000000 204 W58172001 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. A 5 ML CONC. PT. SOL. PERF. CARE CONTINE 10 MG DOXORUBICINA PR 1 11,484000 15,528000 3,052000 205 W57533002 L01DB01 DOXORUBICINUM DOXORUBICINA TEVA 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLACON X 10ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA CONTINAND 20MG CLORHIDRAT DE DOXORUBICINA PR 1 36,280000 47,450000 0,000000 206 W57533003 L01DB01 DOXORUBICINUM DOXORUBICINA TEVA 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLACON X 25ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA CONTINAND 50MG CLORHIDRAT DE DOXORUBICINA PR 1 57,456000 75,156000 41,904000 207 W60643001 L01DB01 DOXORUBICINUM DHARUXO 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. PR 1 11,484000 15,528000 21,672000 208 W60643002 L01DB01 DOXORUBICINUM DHARUXO 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 10 ML CONC. PT. SOL. PERF. PR 1 43,536000 56,940000 29,940000 209 W60643003 L01DB01 DOXORUBICINUM DHARUXO 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 25 ML CONC. PT. SOL. PERF. PR 1 57,456000 75,156000 52,824000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 210 W60636001 L01DB01 DOXORUBICINUM MYOCET 50mg PULB. + AMESTC. PT. CONC. PT.DISP.LI POZOM.PT. PERF 50mg TEVA PHARMA B.V. OLANDA CUTIE X 2 SETURI X 3 FLAC. (1 FLAC PULB. + 1 FLAC.LIPOZOMI +1 FLAC. SOL.TAMP.) S 2 1.945,425000 2.139,590000 0,000000 211 W52903001 L01DB01 DOXORUBICINUM SINDROXOCIN 2mg/ml PULB. PT. SOL. PERF. 2mg/ml ACTAVIS S.R.L ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 8 ML CONTINAND 10 MG CLORHIDRAT DE DOXORUBICIN S 1 11,484000 15,528000 21,362000 212 W52903002 L01DB01 DOXORUBICINUM SINDROXOCIN 2mg/ml PULB. PT. SOL. PERF. 2mg/ml ACTAVIS S.R.L ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML X 50 MG CLORHIDRAT DE DOXORUBICINA S 1 57,456000 75,156000 58,674000 213 W52209001 L01DB03 EPIRUBICINUM EPISINDAN 10 mg PULB. PT. SOL. INJ. 10mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON STICLA INCOLORA TIPI, CAPACITATE DE UMPLERE 8ML CU PULBERE PENTRU SOLUTIE PERFUZABILA INTRAVENOASA X 10MG CLORHIDRAT DE EPIRUBICINA S 1 23,940000 32,352000 25,648000 214 W52208001 L01DB03 EPIRUBICINUM EPISINDAN 50 mg PULB. PT. SOL. INJ. 50mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON STICLA INCOLORA TIPI, CAPACITATE DE UMPLERE 50ML CU PULBERE PENTRU SOLUTIE PERFUZABILA INTRAVENOASA X 50MG CLORHIDRAT DE EPIRUBICINA S 1 105,456000 133,344000 3,176000 215 W60072004 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 50 ML SOL. INJ./PERF. X 100 MG EPIRUBICINA S 1 255,576000 312,012000 11,478000 216 W53325002 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 10 ML SOL. INJ. X 20MG (20MG/10ML) S 1 45,450000 59,450000 0,000000 217 W53325003 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 25 ML SOL. INJ. X 50MG (50MG/25ML) S 1 87,880000 111,120000 0,000000 218 W53325004 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 50 ML SOL. INJ. X 100MG (100MG/50ML) S 1 212,980000 260,010000 0,000000 219 W53325005 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 100ML SOL. INJ. X 200MG (200MG/100ML) S 1 390,530000 463,830000 0,000000 220 W60072001 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 5 ML SOL. INJ./PERF. X 10 MG EPIRUBICINA S 1 21,320000 28,810000 0,000000 221 W53325001 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 5 ML SOL. INJ. X 10MG (10MG/5ML) S 1 19,950000 26,960000 0,000000 222 W60072005 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 100 ML SOL. INJ./PERF. X 200 MG EPIRUBICINA S 1 468,636000 556,596000 353,124000 223 W60072002 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 10 ML SOL. INJ./PERF. X 20 MG EPIRUBICINA S 1 54,540000 71,340000 34,700000 224 W53860003 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 25 ML SOL. INJ. /PERFZ. S 1 105,456000 133,344000 0,156000 225 W53860004 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 75 ML SOL. INJ. /PERFZ. S 1 328,920000 396,670000 0,000000 226 W53860005 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 100 ML SOL. INJ. /PERFZ. S 1 441,160000 519,010000 0,000000 227 W53860002 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 10 ML SOL. INJ. /PERFZ. S 1 45,450000 59,450000 0,000000 228 W60072003 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 25 ML SOL. INJ./PERF. X 50 MG EPIRUBICINA S 1 105,456000 133,344000 31,216000 229 W53860001 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 5 ML SOL. INJ. /PERFZ. S 1 23,940000 32,352000 9,358000 230 W03575001 L01DB06 IDARUBICINUM ZAVEDOS CAPS. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 188,210000 229,770000 0,000000 231 W03581001 L01DB06 IDARUBICINUM ZAVEDOS 5 mg PULB. PT. SOL. INJ. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. S 1 109,250000 133,370000 0,000000 232 W42735002 L01DB07 MITOXANTRONUM** ONKOTRONE CONC. PT. SOL. INJ. 2mg/ml BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 1 FLACON X 10 ML CONC. PT. SOL. INJ. S 1 474,870000 555,760000 0,000000 233 W58249002 L01DC01 BLEOMYCINUM SULFAS BLEOMYCIN MEDAC 15000 UI PULB. PT. SOL. INJ. 15000UI MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÃ„PARATE GERMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML CU PULB. PT. SOL. INJ. PR 1 99,230000 125,470000 0,000000 234 W56664001 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 20 ML CONC. PT. SOL. PERF. PR 1 10,350000 13,990000 0,000000 235 W56664003 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 100 ML CONC. PT. SOL. PERF. PR 1 24,048000 32,508000 15,522000 236 W56664002 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 50 ML CONC. PT. SOL. PERF. PR 1 20,490000 27,700000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 237 W56665002 L01XA01 CISPLATINUM PLATOSIN 1 mg/ml CONC. PT. SOL. PERF. 1 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 50 ML CONC. PT. SOL. PERF. PR 1 20,040000 27,090000 0,000000 238 W56665003 L01XA01 CISPLATINUM PLATOSIN 1 mg/ml CONC. PT. SOL. PERF. 1 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 100 ML CONC. PT. SOL. PERF. PR 1 70,460000 89,090000 0,000000 239 W52187002 L01XA01 CISPLATINUM SINPLATIN 1 mg/1 ml CONC. PT. SOL. PERF. 1mg/1ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 50 ML X 50 MG CONC. SOL. PERF. S 1 23,940000 32,360000 0,000000 240 W52187001 L01XA01 CISPLATINUM SINPLATIN 1 mg/1 ml CONC. PT. SOL. PERF. 1mg/1ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 10 ML X 10 MG CONC. SOL. PERF. S 1 9,940000 13,440000 0,000000 241 W01317001 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 50 mg/100 ml CONC. PT. SOL. PERF. 50mg/100 ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 100 ML CONC. PT. SOL. PERF. S 1 24,048000 32,508000 8,792000 242 W53000002 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 15 ML CONC. PT. SOL. PERF. S 1 45,350000 59,320000 0,000000 243 W53000003 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 45 ML CONC. PT. SOL. PERF. S 1 134,430000 164,110000 0,000000 244 W53000001 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 15,480000 20,920000 0,000000 245 W58740001 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE VERDE X 5 ML CON. PT. SOL. PERF. X 50 MG CARBOPLATINA PR 1 18,576000 25,104000 0,136000 246 W58740002 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE ALBASTRA X 15 ML CONC. PT. SOL. PERF. X 150 MG CARBOPLATINA PR 1 49,170000 64,310000 0,000000 247 W58740003 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE ROSIE X 45 ML CON. PT. SOL. PERF. X 450 MG CARBOPLATINA PR 1 136,890000 167,110000 0,000000 248 W52579003 L01XA02 CARBOPLATINUM CARBOPLATIN TEVA 10mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 45 ML CONC. PT. SOL. PERF. S 1 137,790000 168,220000 0,000000 249 W52579002 L01XA02 CARBOPLATINUM CARBOPLATIN TEVA 10mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 15 ML CONC. PT. SOL. PERF. S 1 49,230000 64,390000 0,000000 250 W58740004 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE GALBENA X 60 ML CONC. PT. SOL. PERF. X 600 MG CARBOPLATINA PR 1 181,360000 221,410000 0,000000 251 W57278002 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml CONC. PT. SOL. PERF. 5 mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU INVELIS DE PROTECTIE (ONCO-SAFE) X 10 ML CONC. PT. SOL. PERF PR 1 38,604000 50,496000 85,684000 252 W57278008 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml CONC. PT. SOL. PERF. 5 mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU INVELIS DE PROTECTIE (ONCO-SAFE) X 20 ML CONC. PT. SOL. PERF PR 1 74,064000 93,648000 185,992000 253 W57278010 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml CONC. PT. SOL. PERF. 5 mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU INVELIS DE PROTECTIE (ONCO-SAFE) X 40 ML CONC. PT. SOL. PERF PR 1 148,992000 181,896000 358,384000 254 W54318002 L01XA03 OXALIPLATINUM OXALIPLATINA TEVA 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML CONC. PT. SOL. PERF. PR 1 38,604000 50,496000 4,304000 255 W54318003 L01XA03 OXALIPLATINUM OXALIPLATINA TEVA 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 20 ML CONC. PT. SOL. PERF. PR 1 74,064000 93,648000 3,002000 256 W42983002 L01XA03 OXALIPLATINUM ELOXATIN 5mg/ml CONC. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS FRANCE FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA 20 ML, CU SUPORT DIN PE, CONTINAND OXALIPLATINA 100 MG/20 ML CONC. PT. SOL. PERF. S 1 74,064000 93,648000 325,002000 257 W56696005 L01XA03 OXALIPLATINUM OXALIPLATIN KABI 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU FOLIE PROTECTOARE DIN PLASTIC A 40 ML CONC. PT. SOL. PERF. CONTINAND 200 MG OXALIPLATINA PR 1 124,160000 151,580000 0,000000 258 W42983003 L01XA03 OXALIPLATINUM ELOXATIN 5mg/ml CONC. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 200 MG/40 ML CONC. PT. SOL. PERF. S 1 148,992000 181,896000 584,504000 259 W57175002 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 20 ML CONC. PT. SOL. PERF. CARE CONTINE 100 MG OXALIPLATINA PR 1 74,064000 93,648000 184,862000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 260 W57175001 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CONC. PT. SOL. PERF. CARE CONTINE 50 MG OXALIPLATINA PR 1 38,604000 50,496000 88,744000 261 W42983001 L01XA03 OXALIPLATINUM ELOXATIN 5mg/ml CONC. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS FRANCE FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA 15 ML, CU SUPORT DIN PE, CONTINAND OXALIPLATINA 50 MG/10 ML CONC. PT. SOL. PERF. S 1 38,604000 50,496000 163,724000 262 W57175003 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 40 ML CONC. PT. SOL. PERF. CARE CONTINE 200 MG OXALIPLATINA PR 1 148,992000 181,896000 341,064000 263 W56696001 L01XA03 OXALIPLATINUM OXALIPLATIN KABI 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU FOLIE PROTECTOARE DIN PLASTIC A 10 ML CONC. PT. SOL. PERF. CONTINAND 50 MG OXALIPLATINA PR 1 32,170000 42,080000 0,000000 264 W56696002 L01XA03 OXALIPLATINUM OXALIPLATIN KABI 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU FOLIE PROTECTOARE DIN PLASTIC A 20 ML CONC. PT. SOL. PERF. CONTINAND 100 MG OXALIPLATINA PR 1 61,720000 78,040000 0,000000 265 W52195002 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml LIOF. PT. SOL. PERF. 5mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 MG LIOF. PT. SOL. PERF. S 1 74,064000 93,648000 192,092000 266 W52195001 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml LIOF. PT. SOL. PERF. 5mg/ml ACTAVIS S.R.L. ROMANIA CUTIE 1 FLAC. X 50 MG LIOF. PT. SOL. PERF. S 1 38,604000 50,496000 84,424000 267 W52468001 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml PULB. PT. SOL. PERF. 5mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU SUPORT TRANSPARENT DIN PLASTIC (ONKO-SAFE) X 50 MG OXALIPLATI PR 1 38,604000 50,496000 418,414000 268 W52977002 L01XA03 OXALIPLATINUM OXALIPLATIN STADA 5 mg/ml PULB. PT. SOL. PERF. 5mg/ml STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 MG OXALIPLATINA PR 1 74,064000 93,648000 196,712000 269 W52468002 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml PULB. PT. SOL. PERF. 5mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU SUPORT TRANSPARENT DIN PLASTIC (ONKO-SAFE) X 100 MG OXALIPLAT PR 1 74,064000 93,648000 773,312000 270 W52977001 L01XA03 OXALIPLATINUM OXALIPLATIN STADA 5 mg/ml PULB. PT. SOL. PERF. 5mg/ml STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 MG OXALIPLATINA PR 1 38,604000 50,496000 86,434000 271 W52468003 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml PULB. PT. SOL. PERF. 5mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU SUPORT TRANSPARENT DIN PLASTIC (ONKO-SAFE) X 150 MG OXALIPLAT PR 1 1.668,360000 1.856,660000 0,000000 272 W59766001 L01XB01 PROCARBAZINUM4) NATULAN CAPS. 50 mg CN UNIFARM S.A. ROMANIA CUTIE X 50CAPSULE PRF 50 13,860000 15,870400 0,000000 273 W07199001 L01XC02 RITUXIMABUM**** MABTHERA 100 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 2 FLACOANE X 10 ML S 2 929,765000 1.032,520000 0,000000 274 W07200001 L01XC02 RITUXIMABUM**** MABTHERA 500 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML(500MG RITUXIMAB IN 50ML- 10MG/ML) S 1 4.632,930000 5.088,050000 0,000000 275 W07881001 L01XC03 TRASTUZUMABUM**** HERCEPTIN 150mg PULB. PT. CONC. PT. SOL. PERF. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. PR 1 2.138,340000 2.368,940000 0,000000 276 W60341001 L01XC03 TRASTUZUMABUM**** HERCEPTIN 600mg/5ml SOL. INJ. 600mg/5 ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE CU UN FLACON DE 6 ML DIN STICLA TRANSPARENTA CU DOP CONTINAND 5ML SOLUTIE (600 MG TRASTUZUMAB) S 1 6.199,870000 6.796,020000 0,000000 277 W52549002 L01XC06 CETUXIMABUM**** ERBITUX 5mg/ml SOL. PERF. 5mg/ml MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN STICLA X 20 ML SOL. PERF. S 1 730,430000 834,320000 0,000000 278 W42165001 L01XC07 BEVACIZUMABUM**** AVASTIN 25mg/ml CONC. PT. SOL. PERF. 25mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA X 4 ML CONC. PT. SOL. PERF. S 1 1.130,890000 1.270,820000 0,000000 279 W42165002 L01XC07 BEVACIZUMABUM**** AVASTIN 25mg/ml CONC. PT. SOL. PERF. 25mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA X 16 ML CONC. PT. SOL. PERF. S 1 4.372,950000 4.804,670000 0,000000 280 W57375001 L01XC10 OFATUMUMAB**** ARZERRA 1000mg CONC. PT. SOL. PERF. 20mg/ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE CU 1 FLACON DIN STICLA X 50 ML CONCENTRAT PT. SOL. PERF. (1000MG OFATUMUMAB)+2 SETURI DE EXTEN S 1 9.006,440000 9.855,180000 0,000000 281 W06844004 L01XE01 IMATINIBUM**** GLIVEC 100 mg CAPS. 100mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 120 CAPS. PR 120 30,750000 33,898999 42,447751 282 W59827004 L01XE01 IMATINIBUM**** IMATINIB ACTAVIS 100 mg CAPS. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTER DIN AL/PVC/ACLAR X 120 CAPSULE PR 120 25,625000 28,249166 0,000000 283 W59679004 L01XE01 IMATINIBUM**** NIBIX 100 mg CAPS. 100mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 120 CAPS. PR 120 30,750000 33,898999 15,933084 284 W59881004 L01XE01 IMATINIBUM**** EGITINID 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PA-AL-PVC/AL X 120 CAPS. PR 120 30,750000 33,898999 15,933084 285 W59541007 L01XE01 IMATINIBUM**** IMATINIB GLENMARK 100 mg COMPR. FILM. 100mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 30,750000 33,898999 15,933084

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 286 W59500004 L01XE01 IMATINIBUM**** IMATINIB ZENTIVA 100 mg COMPR. FILM. 100mg ZENTIVA, K.S. REPUBLIC A CEHA CUTIE CU 12 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PR 120 30,750000 33,898999 0,000001 287 W59486006 L01XE01 IMATINIBUM**** IMAKREBIN 100 mg COMPR. FILM. 100mg ALVOGEN IPCO S.AR.L. LUXEMBUR G CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 30,750000 33,898999 8,689001 288 W61215006 L01XE01 IMATINIBUM**** NEOXELL 100 mg COMPR. FILM. 100mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 30,750000 33,898999 15,933084 289 W59852005 L01XE01 IMATINIBUM**** MEAXIN 100 mg COMPR. FILM. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 120 COMPR. FILM. PR 120 30,750000 33,898999 0,001001 290 W59852011 L01XE01 IMATINIBUM**** MEAXIN 100 mg COMPR. FILM. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 30,750000 33,898999 0,001001 291 W59589001 L01XE01 IMATINIBUM**** IMATINIB TEVA 100 mg COMPR. FILM. 100mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. OPA/AL/PVC/AL A CATE 120 X 1 COMPRIMAT PR 120 30,750000 33,898999 14,289501 292 W59937006 L01XE01 IMATINIBUM**** NEOXELL 100 mg COMPR. FILM. 100mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 30,750000 33,898999 15,933084 293 W59590001 L01XE01 IMATINIBUM**** IMATINIB TEVA 400 mg COMPR. FILM. 400 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. OPA/AL/PVC/AL A CATE 30 X 1 COMPRIMAT PR 30 167,100000 183,665200 16,239800 294 W59542002 L01XE01 IMATINIBUM**** IMATINIB GLENMARK 400 mg COMPR. FILM. 400mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 167,100000 183,665200 16,239800 295 W61216006 L01XE01 IMATINIBUM**** NEOXELL 400 mg COMPR. FILM. 400mg NEOLA PHARMA SRL ROMANIA CUTIE X BLISTERE PVC-PE-PVDC/AL X 30 COMPRIMATE FILMATE PR 30 167,100000 183,665200 16,239800 296 W59487003 L01XE01 IMATINIBUM**** IMAKREBIN 400 mg COMPR. FILM. 400mg ALVOGEN IPCO S.AR.L. LUXEMBUR G CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 155,119333 170,352000 0,000000 297 W59853002 L01XE01 IMATINIBUM**** MEAXIN 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 139,250000 153,054333 0,000000 298 W59853006 L01XE01 IMATINIBUM**** MEAXIN 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 139,250000 153,054333 0,000000 299 W59936003 L01XE01 IMATINIBUM**** NEOXELL 400 mg COMPR. FILM. 400mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 167,100000 183,665200 16,239800 300 W42501001 L01XE03 ERLOTINIBUM**** TARCEVA 100 mg COMPR. FILM. 100mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 30 COMPR. FILM., (BLIST. AL/PVC) P-RF/R 30 194,839000 213,646333 0,000000 301 W42502001 L01XE03 ERLOTINIBUM**** TARCEVA 150 mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF/R 30 240,123000 263,006000 0,000000 302 W43546001 L01XE04 SUNITINIBUM**** SUTENT 12,5 mg CAPS. 12,5mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 CAPS. P-RF/R 30 151,764333 166,695000 0,000000 303 W43556001 L01XE04 SUNITINIBUM**** SUTENT 25mg CAPS. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 CAPS. P-RF/R 30 302,400666 330,889000 0,000000 304 W43557001 L01XE04 SUNITINIBUM**** SUTENT 50 mg CAPS. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 CAPS. P-RF/R 30 602,737666 658,256666 0,000000 305 W61565001 L01XE05 SORAFENIBUM**** NEXAVAR 200 mg COMPR. FILM. 200mg BAYER PHARMA AG GERMANIA CUTIE X 4 BLIST. PP/ AL X 28 COMPR.FILM. PR 112 114,015089 124,617232 0,000000 306 W54613001 L01XE06 DASATINIBUM**** SPRYCEL 100mg COMPR. FILM. 100 mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. P-RF/R 30 448,689333 490,343666 0,000000 307 W51768001 L01XE06 DASATINIBUM**** SPRYCEL 20mg COMPR. FILM. 20 mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 91,303500 100,156833 0,000000 308 W51769001 L01XE06 DASATINIBUM**** SPRYCEL 50mg COMPR. FILM. 50 mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 211,415666 231,079166 0,000000 309 W51770001 L01XE06 DASATINIBUM**** SPRYCEL 70mg COMPR. FILM. 70 mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 211,415666 231,079166 0,000000 310 W56489001 L01XE08 NILOTINIBUM**** TASIGNA CAPS. 150mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 CAPS.(BLIST. PVC/PVDC/AL) P-RF/R 28 85,802142 94,887142 0,000000 311 W56489002 L01XE08 NILOTINIBUM**** TASIGNA CAPS. 150mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE 4 CUTII X 28 CAPS.(BLIST. PVC/PVDC/AL) P-RF/R 112 84,998660 92,989285 0,000000 312 W52708002 L01XE08 NILOTINIBUM**** TASIGNA CAPS. 200mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE 4 CUTII X 28 CAPS.(BLIST. PVC/PVDC/AL) PR 112 113,242142 123,774732 0,000000 313 W52708003 L01XE08 NILOTINIBUM**** TASIGNA CAPS. 200mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 CAPS.(BLIST. PVC/PVDC/AL) PR 28 114,046071 125,672857 0,000000 314 W52721001 L01XE09 TEMSIROLIMUSUM TORISEL 25mg/ml CONC. + SOLV. PT. SOL. PERF. 25mg/ml WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 1 FLAC. X 1,2ML CONCENTRAT + 1 FLAC. X 1,8 SOLVENT S 1 3.116,840000 3.435,510000 0,000000 315 W59310001 L01XE18 RUXOLITINIBUM**** JAKAVI COMPR. 15 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE FLACON DIN PEÎD, CU GARNITURA ETANSA SI SISTEM DE ÎNCHIDERE SECURIZAT PENTRU COPII, CONTINÂND 60 COMPRIMATE PR 60 275,400833 300,823166 0,000000 316 W59311001 L01XE18 RUXOLITINIBUM**** JAKAVI COMPR. 20 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE FLACON DIN PEÎD, CU GARNITURA ETANSA SI SISTEM DE ÎNCHIDERE SECURIZAT PENTRU COPII, CONTINÂND 60 COMPRIMATE PR 60 275,400833 300,823166 0,000000 317 W59309001 L01XE18 RUXOLITINIBUM**** JAKAVI COMPR. 5 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE FLACON DIN PEÎD, CU GARNITURA ETANSA SI SISTEM DE ÎNCHIDERE SECURIZAT PENTRU COPII, CONTINÂND 60 COMPRIMATE PR 60 138,219666 151,295500 0,000000 318 W03542001 L01XX05 HYDROXYCARBAMIDUM HYDREA CAPS. 500mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 CAPS. P-RF 100 0,681700 0,861900 0,000000 319 W53177001 L01XX17 TOPOTECAMUM HYCAMTIN 1 mg CAPS. 1mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X BLIST. PVC/PCTFE/AL X 10 CAPS. P-RF 10 112,482000 126,421000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 320 W54750001 L01XX17 TOPOTECAMUM TOPOTECAN TEVA 1 mg/1ml CONC. PT. SOL. PERF. 1mg/1ml TEVA PHARMA B.V. OLANDA CUTIE X 1 FLACON DIN STICLA TRANSPARENTA A 1ML P-RF/R 1 173,250000 211,500000 0,000000 321 W56261007 L01XX17 TOPOTECAMUM TOPOTECAN EBEWE 1 mg/ml CONC. PT. SOL. PERF. 1mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 4 ML CONC. PT. SOL. PERF. PR 1 177,204000 216,324000 98,216000 322 W54751001 L01XX17 TOPOTECAMUM TOPOTECAN TEVA 4 mg/4ml CONC. PT. SOL. PERF. 4mg/4ml TEVA PHARMA B.V. OLANDA CUTIE X 1 FLACON DIN STICLA TRANSPARENTA A 4ML P-RF/R 1 177,204000 216,324000 98,216000 323 W57231001 L01XX17 TOPOTECAMUM TOPOTECAN ATB 1 mg PULB. PT. CONC. PT. SOL. PERF. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML X 1 MG TOPOTECAN PR 1 176,650000 215,650000 0,000000 324 W57232001 L01XX17 TOPOTECAMUM TOPOTECAN ATB 4 mg PULB. PT. CONC. PT. SOL. PERF. 4mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML X 4 MG TOPOTECAN PR 1 177,204000 216,324000 98,216000 325 W56744001 L01XX17 TOPOTECAMUM POTACTASOL 4mg PULB. PT. CONC. PT. SOL. PERF. 4mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1FL DIN STICLA X 4 MG PULBERE PENTRU CONCENTRAT PENTRU SOLU_IE PERFUZABILA PR 1 147,670000 180,270000 0,000000 326 W52206001 L01XX19 IRINOTECANUM IRINOTESIN 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 2 ML CONC. PT. SOL. INJ. S 1 43,430000 56,810000 0,000000 327 W52206004 L01XX19 IRINOTECANUM IRINOTESIN 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 15 ML CONC. PT. SOL.PERF. S 1 325,716000 397,632000 205,328000 328 W52206003 L01XX19 IRINOTECANUM IRINOTESIN 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 25 ML CONC. PT. SOL. INJ. S 1 518,170000 602,960000 0,000000 329 W55816015 L01XX19 IRINOTECANUM IRINOTECAN EBEWE 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA, CU DOP DIN CAUCIUC FARA PLASTIC DE PROTECTIE TIP "ONCO-SAFE", A 5ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA CARE CONTINE 100MG CLORHIDRAT DE IRINOTECAN TRIHIDRAT S 1 88,200000 111,520000 0,000000 330 W58369002 L01XX19 IRINOTECANUM IRINOTECAN ATB 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 5 ML X 5 ML CONC. PT. SOL. PERF. INCHIS CU DOP DIN CAUCIUC SI SIGILAT CU CAPSA DIN AL TIP FLIP-OFF PR 1 105,840000 133,824000 84,676000 331 W52206002 L01XX19 IRINOTECANUM IRINOTESIN 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 ML CONC. PT. SOL. INJ. S 1 105,840000 130,250000 0,000000 332 W54854002 L01XX19 IRINOTECANUM IRINOTECAN STADA 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA A 5 ML CONC. PT. SOL. PERF. X 100 MG S 1 105,840000 133,824000 55,626000 333 W55816021 L01XX19 IRINOTECANUM IRINOTECAN EBEWE 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA, CU DOP CAUCIUC FARA PLASTIC DE PROTECTIE TIP ONCO-SAFE A 15ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA CARE CONTINE 300MG CLORHIDRAT DE IRINOTECAN TRIHIDRAT S 1 271,430000 331,360000 0,000000 334 W51535001 L01XX23 MITOTANUM LYSODREN 500mg COMPR. 500mg LABORATOIRE HRA PHARMA FRANTA CUTIE X 1 FLAC. DIN PEID X 100 COMPR. P-RF/R 100 21,756200 24,095800 0,000000 335 W42249001 L01XX32 BORTEZOMIBUM**** VELCADE 3,5 mg PULB. PT. SOL. INJ. 3,5mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. X 10ML X 3,5 MG PULB. PT. SOL. INJ., INTRODUS INTR-UN BLISTER TRANSPARENT P-RF/R 1 3.942,570000 4.335,560000 0,000000 336 W52184001 L02AB01 MEGESTROLUM MEGESIN 160 mg COMPR. 160mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-RF 30 2,838000 3,588333 0,000000 337 W43179004 L02AE02 LEUPRORELINUM** ELIGARD 22,5 mg PULB+SOL V.PT.SOL.I NJ 22,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 SET X 2 SERINGI DIN PP/COPOLIMER ACID OLEFINIC CICLIC PREUMPLUTE (O SERINGA A SI O SERINGA B) IN TAVI TERMOFORMATE S 1 762,710000 869,510000 0,000000 338 W52321002 L02AE02 LEUPRORELINUM** ELIGARD 45 mg PULB+SOL V.PT.SOL.I NJ 45mg ASTELLAS PHARMA EUROPE BV OLANDA O CUTIE X 1 SET X 2 TAVITE TERMOFORMATE CE CONTIN 2 SERINGI PREUMPLUTE (O SERINGA A SI O SERINGA B) S 1 1.542,370000 1.719,340000 0,000000 339 W43178003 L02AE02 LEUPRORELINUM** ELIGARD 7,5 mg PULB+SOL V.PT.SOL.I NJ 7,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 SET X 2 SERINGI DIN PP/COPOLIMER ACID OLEFINIC CICLIC PREUMPLUTE (O SERINGA A SI O SERINGA B) IN TAVI TERMOFORMATE S 1 267,520000 326,590000 0,000000 340 W60959002 L02AE02 LEUPRORELINUM** LUCRIN DEPOT 11,25mg PULB. PT. SUSP. INJ. CU ELIB. PREL. 11,25mg ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE CU1 KIT CU 1 FLAC. DIN STICLA INCOLORA,O FIOLA DIN STICLA INCOLORA CU PUNCT DE RUPERE A 2 ML SOLV,O SERINGA STERILA,APIROGENA DE UNICA FOLOSINTA A 2,5 ML,2 ACE(23G 1½)STERILE,DE UNICA FOLOSINTA SI 1 TAMPON IMBIBAT CU ALCOOL IZOPROPILIC 70%. PR/PRF 1 543,600000 630,670000 0,000000 341 W60960002 L02AE02 LEUPRORELINUM** LUCRIN DEPOT 3,75mg PULB. PT. SUSP. INJ. CU ELIB. PREL. 3,75mg ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE CU1 KIT CU 1 FLAC. DIN STICLA INCOLORA,O FIOLA DIN STICLA INCOLORA CU PUNCT DE RUPERE A 2 ML SOLV,O SERINGA STERILA,APIROGENA DE UNICA FOLOSINTA A 2,5 ML,2 ACE(22G 1½)STERILE,DE UNICA FOLOSINTA SI 1 TAMPON IMBIBAT CU ALCOOL IZOPROPILIC 70%. PR/PRF 1 202,270000 246,930000 0,000000 342 W10731001 L02AE03 GOSERELINUM** ZOLADEX LA 10,8 mg IMPLANT 10,8 mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 1 PLIC DIN PET-AL-PE X 1 SERINGA PREUMPLUTA CU 10,8 MG IMPLANT+AC DIN INOX CU SIST. DE PROT S 1 782,140000 890,680000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 343 W10173001 L02AE03 GOSERELINUM** ZOLADEX (R) IMPLANT 3,6mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 1 PLIC X 1 SERINGA PRE-UMPLUTA X 3,6 MG S/P-RF 1 248,330000 303,160000 0,000000 344 W55725001 L02AE04 TRIPTORELINUM** DIPHERELINE 0,1 mg LIOF. + SOLV. PT. SOL. INJ. 0,1mg IPSEN PHARMA FRANTA CUTIE X 7 FLAC. CU LIOF. PT. SOL. INJ. + 7 FIOLE X 1 ML SOLV. S/P-RF 7 10,820000 13,681428 0,000000 345 W55726001 L02AE04 TRIPTORELINUM** DIPHERELINE PR 11,25 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 11,25mg IPSEN PHARMA FRANTA CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV. + 1 BLIST. CU 1 SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE S/P-RF 1 778,650000 886,880000 0,000000 346 W55727001 L02AE04 TRIPTORELINUM** DIPHERELINE 3,75 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 3,75mg IPSEN PHARMA FRANTA CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV. + 1 BLIST. CU O SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE S/P-RF 1 306,070000 371,770000 0,000000 347 W58059002 L02AE04 TRIPTORELINUM** GONAPEPTYL ZILNIC 0,1 mg/ml SOL. INJ. 0,1mg/ml FERRING GMBH GERMANIA CUTIE X 28 SERINGI PREUMPLUTE DIN STICLA INCOLORA X 1 ML SOL. INJ S/P-RF 28 12,984000 16,417714 5,755143 348 W53654002 L02BA01 TAMOXIFENUM TAMOXIFEN SANDOZ 10 mg COMPR. FILM. 10mg HEXAL AG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-RF/S 100 0,397800 0,520300 0,000000 349 W51514001 L02BA03 FULVESTRANTUM** FASLODEX 250mg SOL. INJ. 250mg/5 ml ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 5 ML + 1 AC P-RF 1 1.090,780000 1.227,100000 0,000000 350 W03217002 L02BB01 FLUTAMIDUM FLUTAN COMPR. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-RF 100 1,113199 1,443500 0,000000 351 W52204001 L02BB01 FLUTAMIDUM FLUTASIN 250 mg COMPR. 250mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA BRUNA X 30 COMPR. P-RF 30 0,927666 1,213333 0,000000 352 W54719007 L02BB03 BICALUTAMIDUM BICALUTAMIDA SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU BLISTERE PVC-ACLAR/AL X 30 COMPR. FILM. P-6L 30 10,178000 12,365666 0,000000 353 W12048001 L02BB03 BICALUTAMIDUM CASODEX 150 mg COMPR. FILM. 150mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 10,291285 12,563570 3,040715 354 W61109001 L02BB03 BICALUTAMIDUM YONISTIB 150 mg COMPR. FILM. 150mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 8,576071 10,469642 0,000000 355 W53572001 L02BB03 BICALUTAMIDUM BICALUTAMID TERAPIA 150 mg COMPR. FILM. 150mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 8,576071 10,469642 0,000000 356 W58040001 L02BB03 BICALUTAMIDUM BICALUTAMIDA ALVOGEN 150 mg COMPR. FILM. 150mg ALVOGEN ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM P6L 28 8,576071 10,469642 0,000000 357 W55157001 L02BB03 BICALUTAMIDUM YONISTIB 150 mg COMPR. FILM. 150mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 8,576071 10,469642 0,000000 358 W56707002 L02BB03 BICALUTAMIDUM BICALUTAMIDA KABI 50 mg COMPR. FILM. 50 mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 (2X14) COMPR. FILM. P6L 28 2,910714 3,680357 0,000000 359 W58725009 L02BB03 BICALUTAMIDUM BICALUTAMIDA RANBAXY 50 mg COMPR. FILM. 50 mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID CU CAPAC PP X 28 COMPR.FILM. P6L 28 2,910714 3,680357 0,000000 360 W58725001 L02BB03 BICALUTAMIDUM BICALUTAMIDA RANBAXY 50 mg COMPR. FILM. 50 mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR.FILM. P6L 28 2,910714 3,680357 0,000000 361 W58039001 L02BB03 BICALUTAMIDUM BICALUTAMIDA ALVOGEN 50 mg COMPR. FILM. 50mg ALVOGEN ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM P6L 28 2,910714 3,680357 0,000000 362 W55156001 L02BB03 BICALUTAMIDUM YONISTIB 50 mg COMPR. FILM. 50mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 2,910714 3,680357 0,000000 363 W10174001 L02BB03 BICALUTAMIDUM CASODEX 50 mg COMPR. FILM. 50mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. TIP CALENDAR AL/PVC X 14 COMPR. FILM. P-6L 28 3,492400 4,416000 0,953642 364 W61108001 L02BB03 BICALUTAMIDUM YONISTIB 50 mg COMPR. FILM. 50mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 2,910714 3,680357 0,000000 365 W54851001 L02BB03 BICALUTAMIDUM CALUMID COMPR. FILM. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVDC-PVC X 15 COMPR. FILM. P-6L 30 2,910333 3,680000 0,000000 366 W56520001 L02BB03 BICALUTAMIDUM BICALUTAMIDA ATB 50 mg COMPR. FILM. 50mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PR 30 2,911000 3,680666 0,000000 367 W53339003 L02BB03 BICALUTAMIDUM BICALUTAMIDA SANDOZ 50 mg COMPR. FILM. 50mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 3,492400 4,416000 0,506666 368 W57886001 L02BG03 ANASTROZOLUM ANASTROZOL KABI 1 mg COMPR. FILM. 1mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 14 (1X14) COMPR. FILM. P6L 14 1,315999 1,721200 1,058800 369 W53147001 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 20 COMPR. FILM. P6L 20 1,315999 1,721200 1,058800 370 W53147005 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 84 COMPR. FILM. P6L 84 1,315999 1,721200 0,782966 371 W53147006 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 98 COMPR. FILM. P6L 98 1,315999 1,721200 0,782677 372 W53147002 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM. P6L 28 1,315999 1,721200 0,919514 373 W53147003 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 1,315999 1,721200 0,919466 374 W00468001 L02BG03 ANASTROZOLUM ARIMIDEX 1 mg COMPR. FILM. 1mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. TIP CALENDAR AL/PVC X 14 COMPR. FILM. P-6L 28 1,315999 1,721200 2,341657 375 W56267005 L02BG03 ANASTROZOLUM ANASTROZOL TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 1,315999 1,721200 0,774800

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 376 W58828003 L02BG03 ANASTROZOLUM ELOZA 1 mg COMPR. FILM. 1mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE X BLIST. PVC/AL X 30 COMPR. FILM. PR 30 1,096666 1,434333 0,000000 377 W55859001 L02BG03 ANASTROZOLUM KYARESTA 1 mg COMPR. FILM. 1mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 14 COMPR. FILM. P-6L 28 1,315999 1,721200 0,919514 378 W53245005 L02BG03 ANASTROZOLUM ENZAMIDEX 1mg COMPR. FILM. 1mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 1,315999 1,721200 0,919466 379 W53147007 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 100 COMPR. FILM. P6L 100 1,315999 1,721200 0,782700 380 W53266010 L02BG03 ANASTROZOLUM EGISTROZOL 1 mg COMPR. FILM. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU, BLIST. PVC-PE- PVDC/AL X 90 COMPR.FILM. PR 90 1,315999 1,721200 0,782800 381 W61107001 L02BG03 ANASTROZOLUM KYARESTA 1 mg COMPR. FILM. 1mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL A CATE 14 COMPR. FILM. P-6L 28 1,315999 1,721200 0,919514 382 W56083001 L02BG03 ANASTROZOLUM ANASTROZOL ATB 1 mg COMPR. FILM. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P -6L 30 1,315999 1,721200 0,919466 383 W53147004 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 50 COMPR. FILM. P6L 50 1,315999 1,721200 0,828200 384 W53266005 L02BG03 ANASTROZOLUM EGISTROZOL 1 mg COMPR. FILM. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU, BLIST. PVC-PE- PVDC/AL X 30 COMPR.FILM. PR 30 1,315999 1,721200 0,919466 385 W56262002 L02BG03 ANASTROZOLUM OZOLAN 1 mg COMPR. FILM. 1mg ALVOGEN IPCO S.A.R.L LUXEMBUR G CUTIE X BLIST. PVC/AL X 28 COMPR. FILM. P-6L 28 1,315999 1,721200 0,919514 386 W53147008 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 300 COMPR. FILM. P6L 300 1,315999 1,721200 0,547433 387 W56632005 L02BG04 LETROZOLUM LETROZOL TERAPIA 2,5 mg COMPR. FILM. 2,5 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/PE/PVDC - AL X 30 COMPR. FILM. P6L 30 1,928000 2,437666 0,000000 388 W55679004 L02BG04 LETROZOLUM LETROZOL SANOFI-AVENTIS 2,5 mg COMPR. FILM. 2,5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P-6L 30 1,928000 2,437666 0,000000 389 W53124002 L02BG04 LETROZOLUM LETROZOL TEVA 2,5 mg COMPR. FILM. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 1,928000 2,437666 0,000000 390 W55367002 L02BG04 LETROZOLUM ZEQUIPRA 2,5 mg COMPR. FILM. 2,5mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. AL-PVC/PVC-PE-PVDC X 30 COMPR. FILM. P-6L 30 1,928000 2,437666 0,000000 391 W51409001 L02BG04 LETROZOLUM FEMARA 2,5 mg COMPR. FILM. 2,5mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 2,271960 2,773680 0,976320 392 W55646003 L02BG04 LETROZOLUM LETROZOL ALVOGEN 2,5 mg COMPR. FILM. 2,5mg ALVOGEN IPCO S.A.R.L LUXEMBUR G CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P-6L 30 1,928000 2,437666 0,000000 393 W58106004 L02BG04 LETROZOLUM TROZEL 2,5 mg COMPR. FILM. 2,5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 1,928000 2,437666 0,000000 394 W57606001 L02BG04 LETROZOLUM LETROZOL KABI 2,5 mg COMPR. FILM. 2,5mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P6L 10 1,962000 2,652000 0,000000 395 W55787007 L02BG04 LETROZOLUM ELOZORA 2,5 mg COMPR. FILM. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 1,928000 2,437666 0,000000 396 W56911001 L02BG04 LETROZOLUM LETROZOL ATB 2,5 mg COMPR. FILM. 2,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVDC-PE-PVC/AL X 10 COMPR. FILM. P6L 30 1,928000 2,437666 0,000000 397 W59547004 L02BG04 LETROZOLUM LORTANDA 2,5 mg COMPR. FILM. 2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 1,928000 2,437666 0,000000 398 W56502003 L02BG04 LETROZOLUM LETROZOL STADA 2,5 mg COMPR. FILM. 2,5mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU BLIST. PVC/AL X 100 (10X10) COMPR. FILM. P6L 100 1,893300 2,311400 0,000000 399 W53743003 L02BG04 LETROZOLUM ETRUZIL 2,5 mg COMPR. FILM. 2,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. DIN PVC/AL X 30 COMPR. FILM. P-6L 30 1,928000 2,437666 0,000000 400 W55449003 L02BG04 LETROZOLUM LEZRA 2,5 mg COMPR. FILM. 2,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P-6L 30 1,928000 2,437666 0,000000 401 W55874002 L02BG06 EXEMESTANUM EXEMESTAN GLENMARK 25mg COMPR. FILM. 25mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 2,778000 3,512400 0,036266 402 W55664004 L02BG06 EXEMESTANUM EXEMESTAN TEVA 25 mg COMPR. FILM. 25mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM P-RF 30 2,778000 3,512400 0,036266 403 W57409001 L02BG06 EXEMESTANUM XANEPRA 25 mg COMPR. FILM. 25mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM PRF 30 2,778000 3,512400 0,036266 404 W57409002 L02BG06 EXEMESTANUM XANEPRA 25 mg COMPR. FILM. 25mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM PRF 30 2,778000 3,512400 0,036266 405 W61219001 L02BG06 EXEMESTANUM XANEPRA 25 mg COMPR. FILM. 25mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM PRF 30 2,778000 3,512400 0,036266 406 W57687007 L02BG06 EXEMESTANUM INPLAVIA 25 mg COMPR. FILM. 25mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. UNIDOZA PVC-PVDC/AL X 30 (30X1) COMPR. FILM. PRF 30 2,778000 3,512400 2,054600 407 W56479002 L02BG06 EXEMESTANUM EXEMESTAN ALVOGEN 25 mg COMPR. FILM. 25mg ALVOGEN IPCO S.A.R.L LUXEMBUR G CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 2,777666 3,512000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 408 W61219002 L02BG06 EXEMESTANUM XANEPRA 25 mg COMPR. FILM. 25mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM PRF 30 2,778000 3,512400 0,036266 409 W57021003 L02BG06 EXEMESTANUM EXEMESTAN TERAPIA 25 mg COMPR. FILM. 25mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM. PRF 30 2,778000 3,512400 4,318933 410 W59268003 L02BG06 EXEMESTANUM ESCEPRAN 25 mg COMPR. FILM. 25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 2,315000 2,927000 0,000000 411 W08074001 L02BG06 EXEMESTANUM AROMASIN 25 mg DRAJ. 25mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/PVC-AL X 15 DRAJ. P-RF 30 2,778000 3,512400 4,805266 412 W53892001 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLU TA 60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 87,690000 110,870000 0,000000 413 W53893001 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLU TA 96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 139,560000 170,380000 0,000000 414 W53520001 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300mcg/0, 5ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF. S/P-RF/R 1 105,228000 127,437600 34,512400 415 W55757002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300μg/0,5 ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 90,430000 106,198000 0,000000 416 W53523001 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480mcg/0, 8ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML SOL. INJ. SAU PERF. S/P-RF/R 1 167,472000 195,360000 72,090000 417 W55758002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480μg/0,5 ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 142,358000 162,800000 0,000000 418 W51563003 L03AA13 PEGFILGRASTIMUM*** NEULASTA 6mg SOL. INJ. 6 mg AMGEN EUROPE B.V. OLANDA CUTIE CU 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. IN BLISTER, CU PROTECTIE A ACULUI PR 1 3.112,790000 3.431,100000 0,000000 419 W51563001 L03AA13 PEGFILGRASTIMUM*** NEULASTA 6mg SOL. INJ. 6mg AMGEN EUROPE B.V. OLANDA CUTIE X BLISTER X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR 1 3.242,710000 3.572,710000 0,000000 420 W51327001 L03AB04 INTERFERONUM ALFA 2A*** ROFERON A SOL. INJ. 3Mui/0,5m l ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML + AC STERIL PR 1 69,150000 87,430000 0,000000 421 W51329001 L03AB04 INTERFERONUM ALFA 2A*** ROFERON A SOL. INJ. 9Mui/0,5m l ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC STERIL PR 1 146,130000 178,400000 0,000000 422 W59599002 L03AB05 INTERFERONUM ALFA 2B*** INTRON A 18 milioane U.I. SOL. INJ. PEN MULTIDOZ A 18 milioane U.I. MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML SOL. INJ. + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 323,080000 390,310000 0,000000 423 W59600001 L03AB05 INTERFERONUM ALFA 2B*** INTRON A 30 milioane U.I. SOL. INJ. PEN MULTIDOZ A 30 milioane U.I. MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 519,500000 604,410000 0,000000 424 W57665001 M05BA02 ACIDUM CLODRONICUM** BONEFOS® 800 mg COMPR. FILM. 800mg BAYER OY FINLANDA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 60 6,140000 7,328500 0,000000 425 W52199001 M05BA02 ACIDUM CLODRONICUM** SINDRONAT (R) 300 mg/5 ml CONC. PT. SOL. PERF. 300mg/5 ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA X 5 ML S 1 20,750000 28,040000 0,000000 426 W58123006 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE X 1 FIOLA PE X 2 ML S/P-RF 1 139,390000 170,170000 0,000000 427 W58123005 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE X 1 FIOLA PE X 1 ML S/P-RF 1 82,206000 100,356000 25,364000 428 W58123007 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE X 1 FIOLA PE X 4 ML S/P-RF 1 267,560000 326,640000 0,000000 429 W07918001 M05BA03 ACIDUM PAMIDRONICUM** AREDIA (R) 15 mg LIOF.+ SOLV. PT. SOL. PERF. 15mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 FLAC. DIN STICLA X 15 MG LIOF. PT. SOL. PERF. + 4 FIOLE DIN STICLA X 5 ML SOLV. S/P-RF 4 68,505000 83,630000 0,000000 430 W57926001 M05BA03 ACIDUM PAMIDRONICUM** PAMIRED 30mg pulbere pentru solutie perfuzabila PULB. PT. SOL. PERF. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 MG LIOF. PT. SOL. PERF. I.V. PR 1 158,620000 193,640000 0,000000 431 W57925001 M05BA03 ACIDUM PAMIDRONICUM** PAMIRED 60mg pulbere pentru solutie perfuzabila PULB. PT. SOL.PERF. 60mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 60 MG LIOF. PT. SOL. PERF. I.V. PR 1 246,750000 301,230000 0,000000 432 W60664001 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 26,790000 35,040000 0,000000 433 W57730004 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC SANDOZ 50 mg COMPR. FILM. 50 mg SANDOZ PHARMACEUTICALS GMBH GERMANIA CUTIE CU BLIST. DIN PA/AL/PVC/AL CU 28 COMPRIMATE FILMATE PR 28 8,696428 10,616785 0,000000 434 W56748001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 50 mg COMPR. FILM. 50 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 28 COMPRIMATE FILMATE PR 28 9,973571 12,175714 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 435 W41499001 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 50mg COMPR. FILM. 50mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X BLIST. AL/PVC X 28 COMPR. FILM. S 28 10,435714 12,740142 26,152715 436 W56932004 M05BA06 ACIDUM IBANDRONICUM** IASIBON 50 mg COMPR. FILM. 50mg PHARMATHEN S.A. GRECIA CUTIE CU BLIST. PA/ALL/PVC/ALU X 28 COMPR. FILM PR 28 9,973571 12,175714 0,000000 437 W59829025 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC GLENMARK 50 mg COMPR. FILM. 50mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE CU BLIST. PVC/PVDC-AL X 28 COMPR. FILM. PR 28 10,435714 12,740142 11,278072 438 W57712001 M05BA06 ACIDUM IBANDRONICUM** HOLMEVIS 50 mg COMPR. FILM. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. PR 28 9,973571 12,175714 0,000000 439 W58937001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 6 mg CONC. PT. SOL. PERF. 6mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC SI CAPSA DE CULOARE TURCOAZ (ALBASTRU VERZUI) X 6 ML CONC. PT. SOL. PERF. PR 1 302,410000 367,780000 0,000000 440 W56933001 M05BA06 ACIDUM IBANDRONICUM** IASIBON 6mg/6ml CONC. PT. SOL. PERF. 6mg/6ml PHARMATHEN S.A. GRECIA CUTIE CU 1 FLAC. DIN STICLA X 6ML CONC. PT. SOL. PERF. PR 1 263,810000 322,060000 0,000000 441 W41498001 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 6mg/6ml CONC. PT. SOL. PERF. 6mg/6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLACON X 6 ML CONC. PT. SOL. PERF. S 1 316,572000 386,472000 634,168000 442 W59137001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC SANDOZ 4 mg/100 ml CONC. PT. SOL. PERF. 4mg/100 ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR, DIN COPOLIMER CICLOOLEFINIC PREVAZUT CUC CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" X 100 ML CONC. PT. SOL. PERF. PR 1 87,516000 106,839000 232,201000 443 W59136001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC SANDOZ 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR, DIN COPOLIMER CICLOOLEFINIC PREVAZUT CUC CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" X 5 ML CONC. PT. SOL. PERF. PR 1 87,516000 106,839000 125,811000 444 W59191004 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC TERAPIA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml TERAPIA SA ROMANIA CUTIE CU 1 FLAC. TRANSPARENT DIN STICLA CU CAPACITATEA DE 6 ML INCHIS CU DOP DIN CAUCIUC DE CULOARE GRI SI SIGILAT CU CAPAC DIN AL, TIP "FLIP OFF" DE CULOARE GRI CARE CONTINE CONC. PT. SOL. PERF. PR 1 87,516000 106,839000 266,421000 445 W59914001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC PFIZER 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. DIN PP PREVAZUT CU CAPSA FLIP-OFF DIN AL CU CONC. PT. SOL. PERF. PR 1 87,516000 106,839000 266,421000 446 W59840001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC HOSPIRA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON CU CAPACITATE DE 5ML DIN PLASTIC CU DOP BROMOBUTIL, ACOPERIT CU UN STRAT DE FLUOROPOLIMER SI CAPAC DIN AL CU COMPONENTA "FLIP-OFF" PR 1 87,516000 106,839000 266,421000 447 W59090002 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC FRESENIUS KABI 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 4 FLAC. DIN PP INCOLORA, INCHIS X 4 MG/5 ML CONC. PT. SOL. PERF. PR 4 72,930000 89,032500 0,000000 448 W60989001 M05BA08 ACIDUM ZOLEDRONICUM** ZYOLIX 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml NEOLA PHARMA SRL ROMANIA CUTIE CU 1 FLAC. DIN COPOLIMER COCLOOLEFINIC, TRANSPARENT, INCOLOR, INCHIS CU DOP DIN CAUCIUC BROMOBUTILIC, SIGILAT CU CAPSA DIN AL SI CAPAC TIP FLIP-OFF DIN PP CARE CONTINE 4 MG/5 ML CONC. PT. SOL. PERF. PR 1 87,516000 106,839000 266,421000 449 W59520001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC DR. REDDY'S 4mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 1 FLAC. DIN STICLA CU CAPACITATEA DE 5 ML CU CONC. PT. SOL. PERF. PR 1 87,516000 106,839000 266,421000 450 W58886001 M05BA08 ACIDUM ZOLEDRONICUM** DESINOBON 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml ALVOGEN IPCO S.A.R.L LUXEMBOU RG CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR DE 5 ML DIN COPOLIMER CICLOOLEFINIC CU DOP DE CAUCIUC SI CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" CARE CONTINE CONC. PT. SOL. PERF. PR 1 87,516000 106,839000 74,401000 451 W59588001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC ACTAVIS 4mg/5ml CONC. PT. SOL. PERF. 4mg/5ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 FLACON PLASTIC TRANSPARENT, INCOLOR CU CAPACITATEA DE 5 ML CARE CONTINE CONC. PT. SOL. PER PR 1 87,516000 106,839000 62,361000 452 W58621001 M05BA08 ACIDUM ZOLEDRONICUM** ZYOLIX 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml ROMASTRU TRADING S.R.L. ROMANIA CUTIE X 1 FLACON DIN COPOLIMER COCLOOLEFINIC, TRANSPARENT, INCOLOR, INCHIS CU DOP DE CAUCIUC BROMOBUTILIC, SIGILAT CU CAPSA DIN AL SI CAPAC TIP FLIP-OFF DIN PP CARE CONTINE 4MG/5ML CONC. SOL. PERF. PR 1 87,516000 106,839000 266,421000 453 W08426001 M05BA08 ACIDUM ZOLEDRONICUM** ZOMETA 4 mg PULB. + SOLV. SOL. PERF. 4mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. 4MG PULB. PT. SOL. PERF. + 1 FIOLA X 5 ML SOLV. PR 1 87,516000 106,839000 432,691000 454 W60382001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC HOSPIRA 4 mg/100 ml SOL. PERF. 4 mg/100 ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 PUNGA DIN POLIPROPILENA DE 100ML CU UN PORT "TWIST-OFF" DIN POLIPROPILENA CU CAPAC SI CU UN INVELIS DIN POLIESTER/POLIPROPILENA PR 1 87,516000 106,839000 232,201000 455 W60980001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC DR. REDDY'S 4mg/100 ml SOL. PERF. 4mg/100 ml DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 1 FLAC. DIN STICLA CU DOP DIN CAUCIUC CLOROBUTILIC, SIGILAT CU CAPSA DIN AL TIP "FLIP-OFF"A 100 ML SOL. PERF. PR 1 87,516000 106,839000 267,201000 456 W60543001 M05BA08 ACIDUM ZOLEDRONICUM** ZERLINDA 4 mg/100 ml SOL. PERF. 4mg/100 ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 PUNGA A 100 ML SOL. PERF. PR 1 87,516000 106,839000 266,421000 457 W59355001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC ZENTIVA 4 mg/5 ml SOL. PERF. 4mg/5ml ZENTIVA, K.S. REPUBLIC A CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CARE CONTINE CONC. PT. SOL. PERF. PR 1 87,516000 106,839000 118,761000 458 W04133001 V03AF01 MESNUM UROMITEXAN (R) 400 mg SOL. INJ. 400mg/4 ml BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 3 SUPORTURI TERMOFORMATE DIN PLASTIC X 5 FIOLE DE STICLA INCOLORA X 4 ML S 15 3,104000 4,060000 0,000000

P4: PROGRAMUL NATIONAL DE BOLI NEUROLOGICE

Subprogramul de tratament al sclerozei multiple

1 W42705001 L03AB07 INTERFERONUM BETA 1A**** AVONEX 30 mcg BIO-SET PULB. + SOLV. PT. SOL. INJ. 30mcg (6 mil. UI) BIOGEN IDEC LIMITED MAREA BRITANIE CUTIE X (1 FLAC. DIN STICLA X 30 G PULBERE + 1 SERINGA PRE- UMPLUTA + 1 ML SOLV. + 4 FIOLE PREVAZUTE CU DISPOZITIV BIO- SET + 4 SERINGI PRE-UMPLUTE) P-RF/R 4 671,897500 741,907500 0,000000 2 W08473003 L03AB07 INTERFERONUM BETA 1A**** REBIF 44 micrograme SOL. INJ. 44mcg MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 12 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. P-RF/R 12 287,010833 316,021666 0,000000 3 W53186002 L03AB08 INTERFERONUM BETA 1-B**** EXTAVIA 250 mcg/ ml PULB+SOL V.PT.SOL.I NJ 250mcg/m l NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 15 FLAC. CU PULBERE + 15 SERINGI PREUMPLUTE CU SOLVENT P-RF/R 15 117,106000 130,189333 0,000000 4 W52752007 L03AB08 INTERFERONUM BETA 1-B**** BETAFERON 250mcg/ml PULB. + SOLV. PT. SOL. INJ. 250mcg/m l BAYER SCHERING AG GERMANIA CUTIE X 15 AMBALAJE MULTIPLE CE CONTIN FIECARE CATE UN FLACON CU PULBERE, O SERINGA PREUMPLUTA CU SOLVENT + ADAPTOR CU AC SI 2 TAMPOANE CU ALCOOL P-RF/P 15 140,527200 156,227200 46,425466 5 W44044001 L03AX13 GLATIRAMER ACETAT**** COPAXONE SOL. INJ. 20mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 28 BLIST. PVC X 1 SERINGA PREUMPLUTA X 1 ML PREVAZUTA CU AC FIX S/P-RF 28 91,865000 101,495357 0,000000 6 W51764001 L04AA23 NATALIZUMABUM**** TYSABRI 300mg CONC. PT. SOL. PERF. 20mg/ml ELAN PHARMA INTERNATIONAL LTD IRLANDA CUTIE X 1 FLAC. X 15ML CONC. PT. SOL. PERF S 1 5.263,910000 5.775,820000 0,000000 7 W60846001 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 0,555400 0,702300 0,000000 8 W56928001 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 0,555400 0,702300 0,000000 9 W56508002 L04AX01 AZATHIOPRINUM* IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PR 100 0,623900 0,788900 0,000000

P5: PROGRAMUL NATIONAL DE DIABET ZAHARAT

Tratamentul medicamentos al bolnavilor cu diabet zaharat

1 W52999001 A10AB01 INSULINE UMANE HUMULIN R SOL. INJ. 100UI/ml LILLY FRANCE SAS FRANTA CUTIE X 1 FLAC. X 10 ML SOL. INJ. P-RF 1 43,320000 56,660000 0,000000 2 W52999002 A10AB01 INSULINE UMANE HUMULIN R SOL. INJ. 100UI/ml LILLY FRANCE SAS FRANTA CUTIE X 5 CARTUSE X 3 ML SOL. INJ. P-RF 5 16,940000 21,420000 0,000000 3 W08452003 A10AB01 INSULINE UMANE INSUMAN RAPID 100UI/ml SOL. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SOL. INJ. P-RF 5 16,486000 20,846000 0,000000 4 W08451001 A10AB01 INSULINE UMANE INSUMAN RAPID 100UI/ml SOL. INJ. IN FLACON 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA X 5 ML SOL. INJ. P-RF 5 21,138000 25,806000 0,000000 5 W53811003 A10AB01 INSULINE UMANE INSUMAN RAPID 100 UI/ml SoloStar SOL. INJ. IN STILOU INJECTOR PREUMPLU T 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE X 1 CARTUS DIN STICLA INCOLORA X 3 ML SOL. INJ. P-RF 5 16,486000 20,846000 0,000000 6 W53873001 A10AB04 INSULINUM LISPRO** HUMALOG KWIKPEN100U/ml SOL. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PRE-UMPLUTE X 3 ML SOL. INJ. P-RF 5 27,604000 33,700000 0,000000 7 W52601001 A10AB04 INSULINUM LISPRO** HUMALOG 100 U/ml SOL. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 CARTUSE X 3 ML SOL.INJ. P-RF 5 23,530000 28,726000 0,000000 8 W07268001 A10AB05 INSULINUM ASPART** NOVORAPID PENFILL 100 U/ml SOL. INJ. IN CARTUS 100U/ml NOVO NORDISK A/S DANEMAR CA CUTIE X 5 CARTUSE X 3 ML SOL. INJ. P-RF 5 23,536000 28,732000 0,000000 9 W41740004 A10AB06 INSULINUM GLULIZINA** APIDRA 100U/ml SOL. INJ. IN CARTUS 100U/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE X 3 ML SOL. INJ. P-RF 5 22,138000 27,026000 0,000000 10 W52538004 A10AB06 INSULINUM GLULIZINA** APIDRA 100U/ml SOL. INJ. IN STILOU INJECTOR PREUMPLU T 100U/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE (SOLOSTAR) X 3 ML SOL. INJ. P-RF 5 22,138000 27,026000 0,000000 11 W52986001 A10AC01 INSULINE UMANE HUMULIN N SUSP. INJ. 100UI/ml LILLY FRANCE SAS FRANTA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML SUSP. INJ. P-RF 1 43,320000 56,660000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 12 W52986002 A10AC01 INSULINE UMANE HUMULIN N SUSP. INJ. 100UI/ml LILLY FRANCE SAS FRANTA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 16,940000 21,420000 0,000000 13 W08444003 A10AC01 INSULINE UMANE INSUMAN BASAL 100UI/ml SUSP. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 16,486000 20,846000 0,000000 14 W08381002 A10AC01 INSULINE UMANE INSUMAN BASAL 100UI/ml SUSP. INJ. IN FLACON 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA X 5 ML SUSP. INJ. P-RF 5 22,094000 26,972000 0,000000 15 W53808003 A10AC01 INSULINE UMANE INSUMAN BASAL 100UI/ml SoloStar SUSP. INJ. IN STILOU INJECTOR PREUMPLU T 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE X 1 CARTUS DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 16,486000 20,846000 0,000000 16 W53876001 A10AC04 INSULINUM LISPRO** HUMALOG BASAL KWIKPEN 100U/ml SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) X 3 ML SUSP. INJ. P-RF 5 22,920000 27,980000 0,000000 17 W53106001 A10AD01 INSULINE UMANE HUMULIN M3 SUSP. INJ. 100ui/ml LILLY FRANCE S.A.S FRANTA CUTIE X 1 FLACON DIN STICLA INCOLORA X 10 ML SUSP. INJ. P-RF 1 43,320000 56,660000 0,000000 18 W53106002 A10AD01 INSULINE UMANE HUMULIN M3 SUSP. INJ. 100ui/ml LILLY FRANCE S.A.S FRANTA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 16,940000 21,420000 0,000000 19 W03703002 A10AD01 INSULINE UMANE MIXTARD 30 PENFILL 100 UI/ml SUSP. INJ. IN CARTUS 100UI/ml NOVO NORDISK A/S DANEMAR CA CUTIE X 5 CARTUSE X 3 ML SUSP. INJ. P-RF 5 19,530000 24,694000 0,000000 20 W08446003 A10AD01 INSULINE UMANE INSUMAN COMB 25 100UI/ml SUSP. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 16,486000 20,846000 0,000000 21 W08449003 A10AD01 INSULINE UMANE INSUMAN COMB 50 100UI/ml SUSP. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 16,486000 20,846000 0,000000 22 W08445002 A10AD01 INSULINE UMANE INSUMAN COMB 25 100UI/ml SUSP. INJ. IN FLACON 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA X 5 ML SUSP. INJ. P-RF 5 28,536000 34,836000 0,000000 23 W53810003 A10AD01 INSULINE UMANE INSUMAN COMB 25 100UI/ml SoloStar SUSP. INJ. IN STILOU INJECTOR PREUMPLU T 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE X 1 CARTUS, DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 16,486000 20,846000 0,000000 24 W52602001 A10AD04 INSULINUM LISPRO** HUMALOG MIX25 SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 CARTUSE X 3 ML SUSP.INJ. P-RF 5 24,672000 30,120000 0,000000 25 W03665001 A10AD04 INSULINUM LISPRO** HUMALOG MIX50 SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 CARTUSE X 3 ML SUSP. INJ. P-RF 5 23,908000 29,188000 0,000000 26 W53874001 A10AD04 INSULINUM LISPRO** HUMALOG MIX25 KWIKPEN 100U/ml SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 STILOURI INJECTOARE (PEN-URI), PREUMPLUTE X 3 ML, SUSP. INJ. P-RF 5 27,434000 33,492000 0,000000 27 W53875001 A10AD04 INSULINUM LISPRO** HUMALOG MIX50 KWIKPEN 100U/ml SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 STILOURI INJECTOARE (PEN-URI), PREUMPLUTE X 3 ML, SUSP. INJ. P-RF 5 27,434000 33,492000 0,000000 28 W08254001 A10AD05 INSULINUM ASPART** NOVOMIX 30 PENFILL 100 U/ml SUSP. INJ. IN CARTUS 100U/ml NOVO NORDISK A/S DANEMAR CA CUTIE X 5 CARTUSE X 3 ML SUSP. INJ. P-RF 5 25,190000 30,752000 0,000000 29 W08054002 A10AE04 INSULINUM GLARGINE** LANTUS 100UI/ml SOL. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA X 3 ML SOL. INJ. P-RF 5 40,890000 49,918000 0,000000 30 W10010005 A10AE04 INSULINUM GLARGINE** LANTUS 100UI/ml SOL. INJ. IN FLACON 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA X 10 ML SOL. INJ. P-RF 1 150,000000 183,120000 0,000000 31 W52628008 A10AE04 INSULINUM GLARGINE** LANTUS SoloStar SOL. INJ. IN STILOU INJECTOR PREUMPLU T 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE X 3 ML P-RF 5 40,292000 49,188000 0,000000 32 W41732002 A10AE05 INSULINUM DETEMIR** LEVEMIR PENFILL 100 U/ml SOL. INJ. IN CARTUS 100U/ml NOVO NORDISK A/S DANEMAR CA CUTIE X 5 CARTUSE X 3 ML P-RF 5 44,490000 54,314000 0,000000 33 W53953001 A10BA02 METFORMINUM METFORMIN ARENA 1000 MG COMPR. 1000mg ARENA GROUP S.A. ROMANIA CUTIE X 10 BLIST. AL/PVC X 5 COMPR. P-RF 50 0,130800 0,176800 0,000000 34 W53953002 A10BA02 METFORMINUM METFORMIN ARENA 1000 MG COMPR. 1000mg ARENA GROUP S.A. ROMANIA FLACON DIN PE X 200 COMPR. P-RF/S 200 0,130550 0,170750 0,000000 35 W53951003 A10BA02 METFORMINUM METFORMIN ARENA 500 MG COMPR. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. DIN PE X 60 COMPR. P-RF 60 0,061833 0,083666 0,000000 36 W53952001 A10BA02 METFORMINUM METFORMIN ARENA 850 MG COMPR. 850mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 COMPR. P-RF 15 0,084666 0,114000 0,000000 37 W43318002 A10BA02 METFORMINUM GLUCOPHAGE XR COMPR. ELIB. PREL. 500mg MERCK SANTE S.A.S. FRANTA CUTIE X 2 BLIST. AL/PVC-PVDC X 15 COMPR. ELIB. PREL. P-RF 30 0,074200 0,100399 0,356267

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 38 W43318001 A10BA02 METFORMINUM GLUCOPHAGE XR COMPR. ELIB. PREL. 500mg MERCK SANTE S.A.S. FRANTA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 COMPR. ELIB. PREL. P-RF 30 0,074200 0,100399 0,356267 39 W13583011 A10BA02 METFORMINUM GLUCOPHAGE 1000 mg COMPR. FILM. 1000mg MERCK SANTE FRANTA CUTIE CU BLIST. PVC/AL, X 60 COMPR. FILM. P-6L 60 0,156660 0,204900 0,079600 40 W56835003 A10BA02 METFORMINUM SERDENIS 1000 mg COMPR. FILM. 1000mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 9 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 90 0,136777 0,184888 0,000000 41 W43828002 A10BA02 METFORMINUM METFOGAMMA 1000mg COMPR. FILM. 1000mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 8 BLIST. AL/PVC X 15 COMPR. FILM P6L 120 0,136833 0,184916 0,000000 42 W42349002 A10BA02 METFORMINUM SIOFOR 1000 COMPR. FILM. 1000mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. PVC/AL X 15 COMPR. FILM. P-RF 60 0,136833 0,184833 0,000000 43 W56835001 A10BA02 METFORMINUM SERDENIS 1000 mg COMPR. FILM. 1000mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 30 0,137000 0,185000 0,000000 44 W56835002 A10BA02 METFORMINUM SERDENIS 1000 mg COMPR. FILM. 1000mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 60 0,136833 0,184833 0,000000 45 W59641002 A10BA02 METFORMINUM METFORMIN AUROBINDO 1000 mg COMPR. FILM. 1000mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,137000 0,185000 0,000000 46 W59639003 A10BA02 METFORMINUM METFORMIN AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,074200 0,100399 0,018601 47 W13955001 A10BA02 METFORMINUM MEGUAN (R) 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 20 0,074200 0,100399 0,127101 48 W13873005 A10BA02 METFORMINUM GLUCOPHAGE 850 mg COMPR. FILM. 850mg MERCK SANTE FRANTA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. FILM. P6L 100 0,101200 0,136800 0,038900 49 W56834002 A10BA02 METFORMINUM SERDENIS 850 mg COMPR. FILM. 850mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 60 0,084666 0,114333 0,000000 50 W14102001 A10BA02 METFORMINUM MEGUAN (R) 850 mg COMPR. FILM. 850mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 20 0,084500 0,114000 0,000000 51 W08499004 A10BA02 METFORMINUM METFOGAMMA 850 mg COMPR. FILM. 850mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 12 BLIST. AL/PVC X 10 COMPR. FILM. P6L 120 0,084500 0,114166 0,000000 52 W56834003 A10BA02 METFORMINUM SERDENIS 850 mg COMPR. FILM. 850mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 9 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 90 0,084555 0,114222 0,000000 53 W56834001 A10BA02 METFORMINUM SERDENIS 850 mg COMPR. FILM. 850mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 30 0,084333 0,114000 0,000000 54 W56197002 A10BA02 METFORMINUM SIOFOR 850 mg COMPR. FILM. 850mg BERLIN-CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE CU 4 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 60 0,084666 0,114333 0,000000 55 W59640003 A10BA02 METFORMINUM METFORMIN AUROBINDO 850 mg COMPR. FILM. 850mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,084333 0,114000 0,000000 56 W07202003 A10BB01 GLIBENCLAMIDUM MANINIL 1,75 mg COMPR. 1,75mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 FLAC. X 120 COMPR. P-RF/S 120 0,058800 0,077136 0,025030 57 W41858002 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 1,75 mg COMPR. 1,75mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. PEID X 100 COMPR. P-RF/S 100 0,049100 0,066400 0,000000 58 W41858004 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 1,75 mg COMPR. 1,75mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR. P-RF/S 1000 0,049140 0,064280 0,000000 59 W41858003 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 1,75 mg COMPR. 1,75mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,049000 0,066333 0,000000 60 W41859002 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 3,5 mg COMPR. 3,5mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. PEID X 100 COMPR. P-RF/S 100 0,035400 0,047900 0,000000 61 W41859004 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 3,5 mg COMPR. 3,5mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR. P-RF/S 1000 0,035440 0,046360 0,000000 62 W07206003 A10BB01 GLIBENCLAMIDUM MANINIL 3,5 mg COMPR. 3,5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 FLAC. X 120 COMPR. P-RF/S 120 0,042480 0,055632 0,018034 63 W41859003 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 3,5 mg COMPR. 3,5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,035666 0,048333 0,000000 64 W53679003 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,146666 0,198333 0,000000 65 W03348001 A10BB07 GLIPIZIDUM GLUCOTROL XL 10 mg COMPR. FILM. ELIB. MODIF. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII X 30 COMPR. FILM. CU E P-RF 30 1,222333 1,599000 0,000000 66 W03349001 A10BB07 GLIPIZIDUM GLUCOTROL XL 5mg COMPR. FILM. ELIB. MODIF. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII X 30 COMPR. FILM. CU EL P-RF 30 0,576000 0,778666 0,000000 67 W03352001 A10BB08 GLIQUIDONUM GLURENORM COMPR. 30mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-RF 60 0,306333 0,414000 0,000000 68 W42334001 A10BB09 GLICLAZIDUM ESQUEL (R) 80 mg COMPR. 80mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 15 COMPR. P6L 30 0,336000 0,454000 0,000000 69 W59674006 A10BB09 GLICLAZIDUM GLYCLADA 60 mg COMPR. CU ELIB. MODIF. 60mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. CU ELIB. MODIF. PRF 60 0,334500 0,452000 0,000000 70 W55137009 A10BB09 GLICLAZIDUM DIAPREL MR 60 mg COMPR. ELIB. MODIF. 60mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. P-RF 60 0,401066 0,524666 0,148000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 71 W61093002 A10BB09 GLICLAZIDUM GLICLAZIDA ZENTIVA 60 mg COMPR. ELIB. MODIF. 60mg ZENTIVA, K.S. REPUBLIC A CEHA CUTIE CU BLIST. PVC/AL X 90 COMPR. ELIB. MODIF. PRF 90 0,334222 0,437222 0,000000 72 W54001004 A10BB09 GLICLAZIDUM GLYCLADA 30 mg COMPR. ELIB. PREL. 30mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. P-6L 60 0,187000 0,252666 0,000000 73 W54001003 A10BB09 GLICLAZIDUM GLYCLADA 30 mg COMPR. ELIB. PREL. 30mg KRKA SLOVENIA CUTIE X 4 BLIST. PVC/AL X 15 COMPR. CU ELIB. PREL. P-6L 60 0,187000 0,252666 0,000000 74 W57489005 A10BB12 GLIMEPIRIDUM AMARYL 1mg COMPR. 1mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-RF 30 0,125666 0,170000 0,000000 75 W57490004 A10BB12 GLIMEPIRIDUM AMARYL 2 mg COMPR. 2mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-RF 30 0,164400 0,222400 0,062600 76 W44007003 A10BB12 GLIMEPIRIDUM GLIMEPIRIDE 2 mg COMPR. 2mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 0,137000 0,185333 0,000000 77 W44010003 A10BB12 GLIMEPIRIDUM GLIMEPIRIDE 3 mg COMPR. 3mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 0,252333 0,341000 0,000000 78 W57492004 A10BB12 GLIMEPIRIDUM AMARYL 3 mg COMPR. 3mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-RF 30 0,302800 0,409200 0,115133 79 W57494004 A10BB12 GLIMEPIRIDUM AMARYL 4 mg COMPR. 4mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-RF 30 0,396333 0,535666 0,000000 80 W57495004 A10BB12 GLIMEPIRIDUM AMARYL 6 mg COMPR. 6mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-RF 30 0,660000 0,892000 0,000000 81 W42117002 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) BIDIAB 400 mg/2,5 mg CAPS. 400mg+2, 5mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 5 CAPS. P-RF/S 500 0,182000 0,230120 0,000000 82 W42117001 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) BIDIAB 400 mg/2,5 mg CAPS. 400mg+2, 5mg ARENA GROUP SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 5 CAPS. P-RF 20 0,185500 0,250500 0,000000 83 W10546002 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLIBOMET (R) COMPR. FILM. 400mg/2, 5mg LAB. GUIDOTTI SPA ITALIA CUTIE X 3 BLIST. X 20 COMPR. FILM. P-RF 60 0,218400 0,276144 0,131356 84 W13594002 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLUCOVANCE (R) 500 mg/2,5 mg COMPR. FILM. 500mg/2, 5mg MERCK SANTE FRANTA CUTIE X 4 BLIST. X 15 COMPR. FILM. P6L 60 0,352000 0,475666 0,000000 85 W13594006 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLUCOVANCE® 500 mg/2,5 mg COMPR. FILM. 500mg/2, 5mg MERCK SANTE FRANTA CUTIE X 3 BLIST. PVC/AL X 20 COMPR. FILM. P6L 60 0,352000 0,475666 0,000000 86 W13595002 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLUCOVANCE (R) 500 mg/5 mg COMPR. FILM. 500mg/5 mg MERCK SANTE FRANTA CUTIE X 4 BLIST. X 15 COMPR. FILM. P6L 60 0,352000 0,475666 0,000000 87 W13595006 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLUCOVANCE® 500 mg/5 mg COMPR. FILM. 500mg/5 mg MERCK SANTE FRANTA CUTIE X 3 BLIST. PVC/AL X 20 COMPR. FILM. P6L 60 0,352000 0,475666 0,000000 88 W52765005 A10BD05 COMBINATII ( PIOGLITAZONUM + METFORMINUM)*** COMPETACT COMPR. FILM. 15mg/850 mg TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD MAREA BRITANIE CUTIE X 56 COMPR. FILM. ( BLIST. AL/AL ) P-RF 56 1,593750 2,015178 0,000000 89 W53295002 A10BD07 COMBINATII ( SITAGLIPTINUM+METFORMINUM)*** JANUMET 50 mg/1000 mg COMPR. FILM. 50mg/100 0mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X BLIST. PVC/PE/PVDC/AL X 28 COMPR. FILM. P-RF 28 2,569642 3,248928 0,000000 90 W58716003 A10BD10 COMBINATII ( SAXAGLIPTINUM + METFORMINUM)*** KOMBOGLYZE 2,5/1000mg COMPR. FILM. 2,5mg+10 00mg BRISTOL-MYERS SQUIBB/ASTRAZENECA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL NEPERFORATE CU 60 COMPR.FILM. P-RF 60 2,747166 3,353666 0,000000 91 W57947002 A10BF01 ACARBOSUM GLUCOBAY® 100 COMPR. 100mg BAYER PHARMA AG GERMANIA CUTIE X 8 BLIST. AL/PP X 15 COMPR. P-RF 120 0,438666 0,554666 0,000000 92 W57946002 A10BF01 ACARBOSUM GLUCOBAY® 50 COMPR. 50mg BAYER PHARMA AG GERMANIA CUTIE X 8 BLIST. AL/PP X 15 COMPR. P-RF 120 0,247416 0,323583 0,000000 93 W58030002 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA TORRENT 15 mg COMPR. 15mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-AL X 30 COMPR. PRF 30 1,024333 1,340000 0,000000 94 W08069002 A10BG03 PIOGLITAZONUM*** ACTOS 15mg COMPR. 15mg TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD MAREA BRITANIE CUTIE X 28 COMPR. (BLIST. AL/AL) P-RF 28 1,147600 1,501200 0,560942 95 W58686003 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA AUROBINDO 15 mg COMPR. 15mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. DIN POLIAMIDA/AL/PVC X 30 COMPR. PRF 30 0,956333 1,251000 0,000000 96 W58503002 A10BG03 PIOGLITAZONUM*** GLIDIPION 15 mg COMPR. 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. (BLIST. TIP CALENDAR) PRF 28 1,024642 1,340357 0,000000 97 W58504002 A10BG03 PIOGLITAZONUM*** GLIDIPION 30 mg COMPR. 30mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. (BLIST. TIP CALENDAR) PRF 28 1,440000 1,883571 0,000000 98 W08070003 A10BG03 PIOGLITAZONUM*** ACTOS 30mg COMPR. 30mg TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD MAREA BRITANIE CUTIE X 28 COMPR.(BLIST. AL/AL) P-RF 28 1,612800 2,109600 0,642185 99 W58687003 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA AUROBINDO 30 mg COMPR. 30mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. DIN POLIAMIDA/AL/PVC X 30 COMPR. PRF 30 1,344000 1,758000 0,000000 100 W58031002 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA TORRENT 30 mg COMPR. 30mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-AL X 30 COMPR. PRF 30 1,440000 1,883666 0,000000 101 W58688003 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA AUROBINDO 45 mg COMPR. 45mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. DIN POLIAMIDA/AL/PVC X 30 COMPR. PRF 30 2,065000 2,611000 0,000000 102 W58032002 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA TORRENT 45 mg COMPR. 45mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-AL X 30 COMPR. PRF 30 2,212333 2,797333 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.1: HEMOFILIE SI TALASEMIE

1 W56025001 B02BD02 FACTOR VIII DE COAGULARE** HAEMOCTIN SDH 1000 PULB+SOL V. PT. SOL. INJ. 100UI/ml BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 FLAC. DIN STICLA INCOLORA CU 10 ML SOLV. PT. SOL. INJ. + 1 SERINGA DE UNICA FOLOSINTA + 1 CANULA DUBLA CU DOUA FILTRE SI 1 CANULA TIP FLUTURE PR 1 1.485,636000 1.665,120000 332,850000 2 W56023001 B02BD02 FACTOR VIII DE COAGULARE** HAEMOCTIN SDH 250 PULB+SOL V. PT. SOL. INJ. 50UI/ml BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 FLAC. DIN STICLA INCOLORA CU 5 ML SOLV. PT. SOL. INJ. + 1 SERINGA DE UNICA FOLOSINTA + 1 CANULA DUBLA CU DOUA FILTRE SI 1 CANULA TIP FLUTURE PR 1 380,736000 460,788000 91,842000 3 W56024001 B02BD02 FACTOR VIII DE COAGULARE** HAEMOCTIN SDH 500 PULB+SOL V. PT. SOL. INJ. 50UI/ml BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 FLAC. DIN STICLA INCOLORA CU 10 ML SOLV. PT. SOL. INJ. + 1 SERINGA DE UNICA FOLOSINTA + 1 CANULA DUBLA CU DOUA FILTRE SI 1 CANULA TIP FLUTURE PR 1 613,716000 714,732000 319,678000 4 W56663001 B02BD02 FACTOR VIII DE COAGULARE** OCTANATE 100 UI/ml PULB. + SOLV. PT. SOL. INJ. 100 UI/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 1000 UI PULB. PT.SOL. INJ. + 1 FL. SOLVENT X 10ML + CUTIE CU SET DE RECONSTITUIRE PR 1 1.238,030000 1.387,600000 0,000000 5 W56662002 B02BD02 FACTOR VIII DE COAGULARE** OCTANATE 50 UI/ml PULB. + SOLV. PT. SOL. INJ. 50 UI/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLAC. CU 500 U.I. PULB. + 1 FL. SOLVENT X 10ML + CUTIE CU SET DE RECONSTITUIRE SI ADM. PR 1 511,430000 595,610000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 6 W56662001 B02BD02 FACTOR VIII DE COAGULARE** OCTANATE 50 UI/ml PULB. + SOLV. PT. SOL. INJ. 50 UI/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLAC. CU 250 U.I. PULB. + 1 FL.SOLVENT X 5ML+ CUTIE CU SET DE RECONSTITUIRE SI ADM. PR 1 317,280000 383,990000 0,000000 7 W61061001 B02BD02 MOROCTOCOG ALFA** REFACTO AF 1000UI PULB. + SOL. PT. SOL. INJ. 1000 UI PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STERIL DE PERF. + 1 PLASTURE + 1 TIFON PR 1 2.286,860000 2.530,830000 0,000000 8 W61062001 B02BD02 MOROCTOCOG ALFA** REFACTO AF 2000UI PULB. + SOL. PT. SOL. INJ. 2000 UI PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STERIL DE PERF. + 1 PLASTURE + 1 TIFON PR 1 5.034,530000 5.525,790000 0,000000 9 W61059001 B02BD02 MOROCTOCOG ALFA** REFACTO AF 250UI PULB. + SOL. PT. SOL. INJ. 250 UI PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STERIL DE PERF. + 1 PLASTURE + 1 TIFON PR 1 608,100000 700,980000 0,000000 10 W61060001 B02BD02 MOROCTOCOG ALFA** REFACTO AF 500UI PULB. + SOL. PT. SOL. INJ. 500 UI PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STERIL DE PERF. + 1 PLASTURE + 1 TIFON PR 1 1.179,150000 1.323,420000 0,000000 11 W54970001 B02BD02 OCTOCOG ALFA** RECOMBINATE 1000 UI PULB+SOL V. PT. SOL. INJ. 1000UI BAXTER AG AUSTRIA CUTIE CU 1 FLAC. PULB.+1 FLAC. SOLV.+DISPOZITIV PT. RECONST. (BAXJECT II) +1 SERINGA +1 SET MINI-PERF.+ 2 TAMP. ALCOOL+2 PLAST. S/P-RF 1 2.322,730000 2.569,930000 0,000000 12 W59904001 B02BD02 OCTOCOG ALFA** RECOMBINATE 1000 UI/5 ml PULB+SOL V. PT. SOL. INJ. 1000UI/5 ml BAXTER AG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ., 1 FLAC CU 5 ML SOLV., 1 SERINGA DIN PLASTIC DE UNICA FOLOSINTA, 1 DISPOZITIV PT. RECONSTITUIRE (BAXJECT II), UN SET DE MINI- PERFUZARE STERIL, 2 TAMPOANE CU ALCOOL MEDICINAL SI 2 PLASTURI PRF 1 2.427,620000 2.684,260000 0,000000 13 W54968001 B02BD02 OCTOCOG ALFA** RECOMBINATE 250 UI PULB+SOL V. PT. SOL. INJ. 250UI BAXTER AG AUSTRIA CUTIE CU 1 FLAC. PULB.+1 FLAC. SOLV.+DISPOZITIV PT. RECONST. (BAXJECT II) +1 SERINGA +1 SET MINI-PERF.+ 2 TAMP. ALCOOL+2 PLAST. S/P-RF 1 629,410000 724,210000 0,000000 14 W59902001 B02BD02 OCTOCOG ALFA** RECOMBINATE 250 UI/5 ml PULB+SOL V. PT. SOL. INJ. 250UI/5ml BAXTER AG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ., 1 FLAC CU 5 ML SOLV., 1 SERINGA DIN PLASTIC DE UNICA FOLOSINTA, 1 DISPOZITIV PT. RECONSTITUIRE (BAXJECT II), UN SET DE MINI- PERFUZARE STERIL, 2 TAMPOANE CU ALCOOL MEDICINAL SI 2 PLASTURI PRF 1 629,410000 724,210000 0,000000 15 W54969001 B02BD02 OCTOCOG ALFA** RECOMBINATE 500 UI PULB+SOL V. PT. SOL. INJ. 500UI BAXTER AG AUSTRIA CUTIE CU 1 FLAC. PULB.+1 FLAC. SOLV.+DISPOZITIV PT. RECONST. (BAXJECT II) +1 SERINGA +1 SET MINI-PERF.+ 2 TAMP. ALCOOL+2 PLAST. S/P-RF 1 1.176,370000 1.320,400000 0,000000 16 W51449001 B02BD02 OCTOCOG ALFA** ADVATE 1000UI PULB+SOL V.PT.SOL.I NJ 1000UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. CU PULB. + 1 FLAC. X 5 ML APA PT. SOL. INJ. + 1 DISPOZITIV BAXJECT II P-RF/R 1 2.574,460000 2.844,320000 0,000000 17 W61172001 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 1000UI PULB+SOL V.PT.SOL.I NJ 1000UI BAYER PHARMA AG GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 2,5ML SOL. + AMBALAJ SUPL. CE CONTINE O TRUSA DE ADM. PR 1 2.578,880000 2.849,130000 0,000000 18 W51450001 B02BD02 OCTOCOG ALFA** ADVATE 1500UI PULB+SOL V.PT.SOL.I NJ 1500UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. CU PULB. + 1 FLAC. X 5 ML APA PT. SOL. INJ. + 1 DISPOZITIV BAXJECT II P-RF/R 1 4.090,790000 4.497,120000 0,000000 19 W61175001 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 2000UI PULB+SOL V.PT.SOL.I NJ 2000UI BAYER PHARMA AG GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 5,0ML SOL. + AMBALAJ SUPL. CE CONTINE O TRUSA DE ADM. P-RF/R 1 5.127,750000 5.627,410000 0,000000 20 W61168001 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 250UI PULB+SOL V.PT.SOL.I NJ 250UI BAYER PHARMA AG GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 2,5ML SOL. + AMBALAJ SUPL. CE CONTINE O TRUSA DE ADM. P-RF/R 1 677,970000 777,140000 0,000000 21 W51448001 B02BD02 OCTOCOG ALFA** ADVATE 500UI PULB+SOL V.PT.SOL.I NJ 500 UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. CU PULB. + 1 FLAC. X 5 ML APA PT. SOL. INJ. + 1 DISPOZITIV BAXJECT II P-RF/R 1 1.314,110000 1.470,530000 0,000000 22 W61170001 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 500UI PULB+SOL V.PT.SOL.I NJ 500UI BAYER PHARMA AG GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 2,5ML SOL. + AMBALAJ SUPL. CE CONTINE O TRUSA DE ADM. P-RF/R 1 1.315,560000 1.472,110000 0,000000 23 W53183001 B02BD02 OCTOCOG ALFA** ADVATE 2000UI PULB+SOL V.PT.SOL.I NJ. 2000 UI BAXTER AG AUSTRIA CUTIE X 1 FLAC CU PULB. + 1 FLAC. X 5 ML SOLVENT + 1 DISPOZITIV BAXJECT II P-RF/R 1 5.444,400000 5.972,550000 0,000000 24 W51447001 B02BD02 OCTOCOG ALFA** ADVATE 250UI PULB+SOL V.PT.SOL.I NJ. 250 UI BAXTER AG AUSTRIA CUTIE X 1 FLAC CU PULB. + 1 FLAC. X 5 ML APA PT. SOL. INJ. + 1 DISPOZITIV BAXJECT II P-RF/R 1 706,800000 808,560000 0,000000 25 W53185001 B02BD02 OCTOCOG ALFA** ADVATE 3000UI PULB+SOL V.PT.SOL.I NJ. 3000 UI BAXTER AG AUSTRIA CUTIE X 1 FLAC CU PULB. + 1 FLAC. X 5 ML SOLVENT + 1 DISPOZITIV BAXJECT II P-RF/R 1 8.151,590000 8.923,390000 0,000000 26 W52173003 B02BD03 COMPLEX DE ANTIINHIBITORI AI COAGULARII** FEIBA NF 1000 U FEIBA PULB.+SOL V. PT. SOL. INJ. 1000 U BAXTER A.G. AUSTRIA CUTIE X 1 FLACON FEIBA NF 1000U FEIBA PULB. PT. SOL. INJ. + 1 FLAC. CU SOLV. +1 DISP. BAXJECT II HI-FLOW1- FARA ACE PT. TRANSF. SI AMEST. MED. DIN 2 FLAC. INTR-O SER. DE UNICA FOLOS. +1AC DE UNICA FOLOS+1AC FLUTURE CU OPRITOR (SET. PT. INJ.) PR 1 2.889,810000 3.188,050000 0,000000 27 W52172002 B02BD03 COMPLEX DE ANTIINHIBITORI AI COAGULARII** FEIBA NF 500 U FEIBA PULB.+SOL V. PT. SOL. INJ. 500 U BAXTER A.G. AUSTRIA CUTIE X 1 FLACON FEIBA NF 500U FEIBA PULB. PT. SOL. INJ. + 1 FLAC. CU SOLV. +1 DISP. BAXJECT II HI-FLOW1- FARA ACE PT. TRANSF. SI AMEST. MED. DIN 2 FLAC. INTR-O SER. DE UNICA FOLOS. +1AC DE UNICA FOLOS+1AC FLUTURE CU OPRITOR (SET. PT. INJ.) PR 1 1.459,220000 1.628,700000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 28 W56231001 B02BD04 FACTOR IX DE COAGULARE** OCTANINE F 1000 UI PULB. + SOLV. PT. SOL. PERF. 1000UI OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF. + 1 FLAC. DIN STICLA CU 10 ML SOLV. PT. SOL. PERF.+ DISPOZITIV PT. RECONSTITUIRE SI ADM. CU 1 SET TRANSFER MIX2VIAL TM +1 SET DE PERFUZARE+1 SERINGA+2 TAMP. CU ALCOOL S 1 1.513,140000 1.687,470000 0,000000 29 W56230001 B02BD04 FACTOR IX DE COAGULARE** OCTANINE F 500 UI PULB. + SOLV. SOL. PERF. 500 UI OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF. + 1 FLAC. DIN STICLA CU 5 ML SOLV. PT. SOL. PERF.+ DISPOZITIV PT. RECONSTITUIRE SI ADM. CU 1 AC CU CAP DUBLU+1 FILTRU PT. AC+1 SET DE PERFUZARE+1 SERINGA+2 TAMP. CU ALCOOL S 1 771,570000 879,160000 0,000000 30 W43970001 B02BD04 FACTOR IX DE COAGULARE** IMMUNINE 1200 UI PULB.+SOL V. PT. SOL. INJ./PERF. 1200UI BAXTER AG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA CU PULBERE PENTRU SOLUTIE INJECTABILA PERFUZABILA + 1 FLACON UNIDOZA DIN STICLA INCOLORA X 10ML SOLVENT + 1 AC TRANSFER + 1 AC AERARE +1 AC FILTRARE +1 AC UNICA FOLOSINTA + 1 SERIGA +1 SET TRANSFER S 1 1.719,910000 1.912,850000 0,000000 31 W60173002 B02BD04 NONACOG ALPHA (FACTOR IX DE COAGULARE)** BENEFIX 1000UI PULB+SOL V.PT.SOL.I NJ 1000UI PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA UMPLUTA. X 5ML SOL. INJ. + 1 SET STERIL DE PERF. + 2 TAMP. ALCOOL + 1 PLASTURE + 1 TAMP. TIFON PR 1 1.815,768000 2.024,964000 861,046000 32 W60172002 B02BD04 NONACOG ALPHA (FACTOR IX DE COAGULARE)** BENEFIX 2000UI PULB+SOL V.PT.SOL.I NJ 2000UI PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA UMPLUTA. X 5ML SOL. INJ. + 1 SET STERIL DE PERF. + 2 TAMP. ALCOOL + 1 PLASTURE + 1 TAMP. TIFON PR 1 5.195,480000 5.701,230000 0,000000 33 W60175002 B02BD04 NONACOG ALPHA (FACTOR IX DE COAGULARE)** BENEFIX 250UI PULB+SOL V.PT.SOL.I NJ 250UI PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA UMPLUTA. X 5ML SOL. INJ. + 1 SET STERIL DE PERF. + 2 TAMP. ALCOOL + 1 PLASTURE + 1 TAMP. TIFON PR 1 686,250000 786,160000 0,000000 34 W60174001 B02BD04 NONACOG ALPHA (FACTOR IX DE COAGULARE)** BENEFIX 500UI PULB+SOL V.PT.SOL.I NJ 500UI PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA UMPLUTA. X 5ML SOL. INJ. + 1 SET STERIL DE PERF. + 2 TAMP. ALCOOL + 1 PLASTURE + 1 TAMP. TIFON PR 1 925,884000 1.054,992000 395,638000 35 W58455001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** WILATE 1000 1000 UI FVIII/1000 UI FVW PULB+SOL V. PT. SOL. INJ 1000 UI FVIII/1000 UI FVW OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE CU 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FLAC. CU SOLV. PT. SOL. INJ. + 1 SET DE ADMINISTRARE (1 SERINGA DE UNICA FOLOSINTA, 1 SET TRANSFER (MIX2VIAL), 1 SET DE PERFUZARE SI 2 TAMPOANE CU ALCOOL MEDICINAL) PR 1 1.567,000000 1.746,180000 0,000000 36 W58454001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** WILATE 500 500 UI FVIII/500 UI FVW PULB+SOL V. PT. SOL. INJ 500 UI FVIII/500 UI FVW OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE CU 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FLAC. CU SOLV. PT. SOL. INJ. + 1 SET DE ADMINISTRARE (1 SERINGA DE UNICA FOLOSINTA, 1 SET TRANSFER (MIX2VIAL), 1 SET DE PERFUZARE SI 2 TAMPOANE CU ALCOOL MEDICINAL) PR 1 835,000000 948,300000 0,000000 37 W61007001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 1000 UI FVIII/750 UI FVW PULB.+SOL V. PT. SOL. INJ. 1000 UI /750 UI BAXTER AG AUSTRIA CUTIE CU 1 FLAC. MONODOZA CU PULB. PT. SOL. INJ. + 1 FLAC. MONODOZA CU SOLV. + 1 SET DE TRANSFER/FILTRU + 1 SERINGA DE UNICA FOLOSINTA (10ML) + 1 AC DE UNICA FOLOSINTA + 1 SET DE PERFUZIE PR 1 1.263,180000 1.415,020000 0,000000 38 W58406001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 1000 UI PULB.+SOL V. PT. SOL. INJ. 1000UI BAXTER AG AUSTRIA CUTIE CU 1 FLAC. MONODOZA CU PULB. PT. SOL. INJ. + 1 FLAC. MONODOZA CU SOLV. + 1 SET DE TRANSFER/FILTRU + 1 SERINGA DE UNICA FOLOSINTA (10ML) + 1 AC DE UNICA FOLOSINTA + 1 SET DE PERFUZIE PR 1 1.263,180000 1.415,020000 0,000000 39 W61005001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 250 UI FVIII/190 UI FVW PULB.+SOL V. PT. SOL. INJ. 250 UI /190 UI BAXTER AG AUSTRIA CUTIE CU 1 FLAC. MONODOZA CU PULB. PT. SOL. INJ. + 1 FLAC. MONODOZA CU SOLV. + 1 SET DE TRANSFER/FILTRU + 1 SERINGA DE UNICA FOLOSINTA (5ML) + 1 AC DE UNICA FOLOSINTA + 1 SET DE PERFUZIE PR 1 310,560000 376,660000 0,000000 40 W58404001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 250 UI PULB.+SOL V. PT. SOL. INJ. 250UI BAXTER AG AUSTRIA CUTIE CU 1 FLAC. MONODOZA CU PULB. PT. SOL. INJ. + 1 FLAC. MONODOZA CU SOLV. + 1 SET DE TRANSFER/FILTRU + 1 SERINGA DE UNICA FOLOSINTA (5ML) + 1 AC DE UNICA FOLOSINTA + 1 SET DE PERFUZIE PR 1 310,560000 376,660000 0,000000 41 W61006001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 500 UI FVIII/375 UI FVW PULB.+SOL V. PT. SOL. INJ. 500 UI /375 UI BAXTER AG AUSTRIA CUTIE CU 1 FLAC. MONODOZA CU PULB. PT. SOL. INJ. + 1 FLAC. MONODOZA CU SOLV. + 1 SET DE TRANSFER/FILTRU + 1 SERINGA DE UNICA FOLOSINTA (5ML) + 1 AC DE UNICA FOLOSINTA + 1 SET DE PERFUZIE PR 1 589,060000 680,230000 0,000000 42 W58405001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 500 UI PULB.+SOL V. PT. SOL. INJ. 500UI BAXTER AG AUSTRIA CUTIE CU 1 FLAC. MONODOZA CU PULB. PT. SOL. INJ. + 1 FLAC. MONODOZA CU SOLV. + 1 SET DE TRANSFER/FILTRU + 1 SERINGA DE UNICA FOLOSINTA (5ML) + 1 AC DE UNICA FOLOSINTA + 1 SET DE PERFUZIE PR 1 589,050000 680,210000 0,000000 43 W53034001 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 1mg (50 KUI) PULB. + SOLV. PT. SOL. INJ. 50 KIU NOVO NORDISK A/S DANEMAR CA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE P-RF/R 1 2.406,410000 2.661,140000 0,000000 44 W02408001 V03AC01 DEFEROXAMINUM**3) DESFERAL LIOF. PT. SOL. INJ./PERF. 500mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 FLAC. DIN STICLA X 500 MG LIOF. PT. SOL. INJ./PERF. S/P-RF 10 10,867000 13,266000 0,000000 45 W51484001 V03AC03 DEFERASIROXUM**** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL) PR 28 24,030000 27,555357 0,000000 46 W51485001 V03AC03 DEFERASIROXUM**** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 47,000000 52,592500 0,000000 47 W51486001 V03AC03 DEFERASIROXUM**** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 86,728928 95,897142 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.2: EPIDERMOLIZA BULOASA

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.3: HIPERTENSIUNE PULMONARA

1 W43049001 C02KX01 BOSENTANUM** TRACLEER 125 mg COMPR. FILM. 125mg ACTELION REGISTRATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 14 COMPR. FILM. P-RF/R 56 142,585000 156,099107 0,000000 2 W43048002 C02KX01 BOSENTANUM** TRACLEER 62,5 mg COMPR. FILM. 62,5mg ACTELION REGISTRATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 14 COMPR. FILM. P-RF/R 56 142,324464 155,815178 0,000000 3 W42831001 G04BE03 SILDENAFILUM** REVATIO 20 mg COMPR. FILM. 20mg PFIZER LIMITED MAREA BRITANIE CUTIE X 6 BLIST. AL/PVC X 15 COMPR. FILM. PR 90 20,212555 22,455555 0,000000 4 W60083001 G04BE03 SILDENAFILUM** REVATIO 10mg/ml SUSP. ORALA 10mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE CU UN FLACON DIN STICLA BRUNA CE CONTINE 32,27 G DE PULBERE PENTRU SUSP. ORALA PR 1 1.045,450000 1.177,690000 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.4: MUCOVISCIDOZA

1 W56031002 A09AA02 PANCREATINUM** KREON 40000 CAPS. GASTROR EZ. 400mg ABBOTT LABORATORIES GMBH GERMANIA CUTIE X UN FLACON DIN PEID CU 50 CAPS. GASTROREZ. P-6L 50 1,684200 2,129600 0,000000 2 W58242002 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 1,458000 1,970570 0,463715 3 W59000002 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. ELIB. PREL. 500mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR. ELIB. PREL. PRF 6 1,458000 1,970570 0,464430 4 W44093001 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 0,672000 0,907714 0,179428 5 W08490001 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 0,672000 0,907714 0,328000 6 W14043001 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 0,672000 0,907714 0,264428 7 W60253004 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF 14 0,622857 0,842142 0,000000 8 W61223003 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 0,560000 0,756428 0,000000 9 W01326002 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT S.R.L. ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 0,672000 0,907714 1,039428

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 10 W58998015 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 250 mg COMPR. FILM. 250mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR) PRF 14 0,622142 0,840714 0,000000 11 W44087001 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 1,458000 1,970570 0,068715 12 W54044001 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 1,458000 1,970570 0,277930 13 W60254003 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 1,414285 1,911428 0,000000 14 W56269001 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF 20 1,458000 1,970570 0,385430 15 W61224003 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 1,215000 1,642142 0,000000 16 W14044001 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 1,414285 1,911428 0,000000 17 W08491001 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 1,421428 1,921428 0,000000 18 W58999014 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. FILM. 500mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR) PRF 14 1,350000 1,825000 0,000000 19 W44088001 J01FA09 CLARITHROMYCINUM KLABAX MR 500 mg COMPR. FILM. ELIB. MODIF. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC/PVDC-AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 1,458000 1,970570 0,463715 20 W41838002 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 1,458000 1,970570 0,463715 21 W13607002 J01FA09 CLARITHROMYCINUM KLACID SR COMPR. FILM. ELIB. PREL. 500mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 5 COMPR. FILM. ELIB. PREL. P-RF 5 1,458000 1,970570 1,777430 22 W01327001 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5 ml ABBOTT S.R.L. ITALIA CUTIE X 1 FLACON PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML P-RF 1 22,180000 29,980000 0,000000 23 W01327002 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5 ml ABBOTT S.R.L. ITALIA CUTIE X 1 FLACON PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML P-RF 1 11,388000 15,384000 4,336000 24 W44092001 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 9,490000 12,820000 0,000000 25 W42258001 J01FA09 CLARITHROMYCINUM LEKOKLAR 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5 ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 9,490000 12,820000 0,000000 26 W44091001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 24,320000 32,870000 0,000000 27 W44091002 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 40,530000 53,010000 0,000000 28 W58393002 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5 ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA PRF 1 22,090000 29,860000 0,000000 29 W01329001 J01FA09 CLARITHROMYCINUM KLACID I.V. LIOF. PT. SOL. PERF. 500mg ABBOTT LABORATORIES LTD. FRANTA CUTIE X 1 FLAC. LIOF. PT. SOL. PERF. S/P-RF 1 30,230000 39,540000 0,000000 30 W52060001 J01GB01 TOBRAMYCINUM** TOBI (R) SOL. INHAL. 300mg/5 ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 PLICURI DIN AL; FIECARE PLIC CONTINE 7 FIOLE GEMENE DIN PEJD X 5 ML SOL. DE INHALAT PRIN N P-RF 56 89,066785 97,764107 0,000000 31 W61214001 R05CB13 DORNAZA ALFA** PULMOZYME 2500 U/2,5 ml SOL. DE INHALAT PRIN NEBULIZAT OR 2500U/2,5 ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE CU 6 FIOLE UNIDOZA, MONOBLOC, DIN PE X 2,5 ML SOL. INHAL. PRIN NEBULIZATOR, INTRODUSE INTR-O PUNGA DIN AL PR 6 71,111666 83,870000 0,000000 32 W51323001 R05CB13 DORNAZA ALFA** PULMOZYME SOL. INHAL. 1mg/ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 6 FIOLE UNIDOZA PE X 2,5 ML SOL. INHAL. PRIN NEBULIZATOR, INTRODUSE IN PUNGA AL S/P-RF 6 71,111666 83,870000 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.5: BOLI NEUROLOGICE DEGENERATIVE/INFLAMATOR-IMUNE

P6.5.1: TRATAMENTUL MEDICAMENTOS AL BOLNAVILOR CU BOLI NEUROLOGICE INFLAMATOR-IMUNE

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.5: BOLI NEUROLOGICE DEGENERATIVE/INFLAMATOR-IMUNE

P6.5.2: TRATAMENTUL MEDICAMENTOS AL BOLNAVILOR CU BOLI NEUROLOGICE DEGENERATIVE-SCLEROZA LATERALA AMIOTROFICA

1 W12590001 N07XX02 RILUZOLUM** RILUTEK 50 mg COMPR. FILM. 50mg AVENTIS PHARMA SA FRANTA CUTIE X 4 BLIST. X 14 COMPR. PR 56 5,805178 7,008928 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.5: BOLI NEUROLOGICE DEGENERATIVE/INFLAMATOR-IMUNE

P6.5.3: Tratamentul medicamentos al bolnavilor cu polineuropatie familială amiloidă cu transtiretină

1 W59336001 N07XX08 TAFAMIDIS** VYNDAQEL CAPS. MOI 20mg PFIZER LIMITED MAREA BRITANIE CUTIE CU 2 BLIST. PVC/AL A CATE 15 CAPSULE MOI PR 30 1.635,525333 1.783,996666 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.6: OSTEOGENEZA IMPERFECTA

1 W58123006 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE X 1 FIOLA PE X 2 ML S/P-RF 1 139,390000 170,170000 0,000000 2 W58123005 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE X 1 FIOLA PE X 1 ML S/P-RF 1 82,206000 100,356000 25,364000 3 W58123007 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE X 1 FIOLA PE X 4 ML S/P-RF 1 267,560000 326,640000 0,000000 4 W07918001 M05BA03 ACIDUM PAMIDRONICUM AREDIA (R) 15 mg LIOF.+ SOLV. PT. SOL. PERF. 15mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 FLAC. DIN STICLA X 15 MG LIOF. PT. SOL. PERF. + 4 FIOLE DIN STICLA X 5 ML SOLV. S/P-RF 4 68,505000 83,630000 0,000000 5 W57926001 M05BA03 ACIDUM PAMIDRONICUM PAMIRED 30mg pulbere pentru solutie perfuzabila PULB. PT. SOL. PERF. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 MG LIOF. PT. SOL. PERF. I.V. PR 1 158,620000 193,640000 0,000000 6 W57925001 M05BA03 ACIDUM PAMIDRONICUM PAMIRED 60mg pulbere pentru solutie perfuzabila PULB. PT. SOL.PERF. 60mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 60 MG LIOF. PT. SOL. PERF. I.V. PR 1 246,750000 301,230000 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.7: SINDROM PRADER WILLI

1 W05539002 H01AC01 SOMATROPINUM** GENOTROPIN 16 UI/ml (5,3 mg/ml) PULB. + SOLV. PT. SOL. INJ. 16UI/ml (5,3mg/ml ) PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 CARTUS BICAMERAL MULTIDOZA CU PULB. SI SOLV. PT. SOL. INJ. P-RF 1 391,110000 464,460000 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.8: BOALA FABRY

1 W08961001 A16AB04 AGALSIDASUM BETA** FABRAZYME 35 mg PULB. PT. CONC. PT. SOL. PERF. 35mg GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. CU PULB. PT. CONC. PT. SOL. PERF. PR 1 11.604,190000 12.686,730000 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.9: BOALA POMPE

1 W51536001 A16AB07 ALGLUCOSIDASUM ALPHA** MYOZYME 50mg PULB. PT. CONC. PT. SOL. PERF. 50mg GENZYME EUROPE B.V. OLANDA CUTIE X 1 FLAC. CU 50MG PULB. PT. CONC. PT. SOL. PERF. PR 1 1.869,590000 2.076,010000 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.10: TIROZINEMIE

1 W51629001 A16AX04 NITISINONUM ORFADIN 10mg CAPS. 10mg SWEDISH ORPHAN INTERNATIONAL AB SUEDIA CUTIE X 1 FLAC. DIN PEID X 60 CAPS. P-RF/R 60 214,180833 234,093333 0,000000 2 W51622001 A16AX04 NITISINONUM ORFADIN 2mg CAPS. 2mg SWEDISH ORPHAN INTERNATIONAL AB SUEDIA CUTIE X 1 FLAC. DIN PEID X 60 CAPS. P-RF/R 60 50,905666 56,123166 0,000000 3 W51627001 A16AX04 NITISINONUM ORFADIN 5mg CAPS. 5mg SWEDISH ORPHAN INTERNATIONAL AB SUEDIA CUTIE X 1 FLAC. DIN PEID X 60 CAPS. P-RF/R 60 101,523666 111,296833 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.12: MUCOPOLIZAHARIDOZĂ TIP II (SINDROM HUNTER)

1 W51481002 A16AB09 IDURSULFASUM** ELAPRASE 2mg/ml CONC. PT. SOL. PERF. 2mg/ml SHIRE HUMAN GENETIC THERAPIES AB SUEDIA CUTIE X 4 FLAC. X 3 ML CONC. PT. SOL. PERF. S 4 10.948,927500 11.943,885000 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.13: MUCOPOLIZAHARIDOZĂ TIP I (SINDROM HURLER)

1 W42203001 A16AB05 LARONIDAZUM** ALDURAZYME 100UI/ml CONC. PT. SOL. PERF. 100UI/ml GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. X 5 ML S 1 2.077,500000 2.302,630000 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.15: Sindrom de imunodeficiență primară

1 W54752001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 391,580000 464,970000 0,000000 2 W54752002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 870,210000 986,680000 0,000000 3 W54752003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 1.710,420000 1.902,510000 0,000000 4 W54752004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA, CU CAPACITATE DE 250ML, A 200ML SOLUTIE PERFUZABILA S 1 3.390,820000 3.734,150000 0,000000 5 W51530001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL. PERF.(1G/10ML) S 1 190,360000 232,390000 0,000000 6 W51530006 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL. PERF.(30G/300ML) S 1 5.766,650000 6.323,810000 0,000000 7 W51530003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL. PERF.(5G/50ML) S 1 912,190000 1.032,440000 0,000000 8 W51530004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL. PERF.(10G/100ML) S 1 1.847,580000 2.059,644000 78,286000 9 W51530005 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL. PERF.(20G/200ML) S 1 3.736,820000 4.111,290000 0,000000 10 W43965001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.539,650000 1.716,370000 0,000000 11 W43962001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 204,810000 250,030000 0,000000 12 W43963001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 407,410000 482,230000 0,000000 13 W59114003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 100 ML SOL. PERF. PRF 1 894,400000 1.013,050000 0,000000 14 W59114001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 20 ML SOL. PERF. PRF 1 190,170000 232,160000 0,000000 15 W59114004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 200 ML SOL. PERF. PRF 1 1.758,800000 1.955,240000 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.16: Scleroza sistemică și ulcere digitale evolutive

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.17: Purpura trombocitopenică imună cronică la adulții splenectomizați și nesplenectomizați

1 W53894001 B02BX04 ROMIPLOSTIMUM**** NPLATE 250mcg PULB. PT. SOL. INJ. 250mcg AMGEN EUROPE B.V. OLANDA CUTIE X 1 FLAC X 250MCG PULB. PT. SOL. INJ. S 1 2.312,930000 2.559,250000 0,000000 2 W53895001 B02BX04 ROMIPLOSTIMUM**** NPLATE 500mcg PULB. PT. SOL. INJ. 500mcg AMGEN EUROPE B.V. OLANDA CUTIE X 1 FLAC X 500MCG PULB. PT. SOL. INJ. S 1 4.721,020000 5.184,070000 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.18: Pacienți adulți și copii cu hiperfenilalaninemie diagnosticați cu fenilcetonurie sau deficit de tetrahidrobiopterină (BH4)

1 W57418002 A16AX07 SAPROPTERINUM**** KUVAN COMPR. SOLUBILE 100 mg MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X FLAC. PEID X 120 COMPR. SOLUBILE PR 120 91,061083 99,574666 0,000000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.19: Scleroză tuberoasă

1 W57284002 L01XE10 EVEROLIMUS**** VOTUBIA COMPR. 2,5 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. PA/AL/PVC X 30 COMPR. PR 30 184,291333 202,149333 0,000000 2 W57285001 L01XE10 EVEROLIMUS**** VOTUBIA COMPR. 5mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. PA/AL/PVC X 30 COMPR. PR 30 356,861333 390,251000 0,000000

P7: PROGRAM NATIONAL DE BOLI ENDOCRINE

Tratamentul medicamentos al bolnavilor cu osteoporoza, gusa datorata carentei de iod si proliferarii maligne

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 16 W08307001 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg PULB+SOL V. PT. SOL. INJ./PERF. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 6,520000 8,810000 0,000000 17 W08310001 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg PULB+SOL V. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 22,950000 31,020000 0,000000 18 W57399001 H03AA01 LEVOTHYROXINUM EUTHYROX 100mcg COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 0,089800 0,121400 0,000000 19 W57399003 H03AA01 LEVOTHYROXINUM EUTHYROX 100μg COMPR. 100μg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 0,089800 0,121400 0,000000 20 W57395001 H03AA01 LEVOTHYROXINUM EUTHYROX 200mcg COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-6L 100 0,185300 0,250500 0,000000 21 W57395002 H03AA01 LEVOTHYROXINUM EUTHYROX 200μg COMPR. 200μg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-6L 100 0,185300 0,250500 0,000000 22 W57396001 H03AA01 LEVOTHYROXINUM EUTHYROX 25mcg COMPR. 25mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 0,063500 0,085800 0,000000 23 W57396003 H03AA01 LEVOTHYROXINUM EUTHYROX 25μg COMPR. 25μg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 0,063500 0,085800 0,000000 24 W57398001 H03AA01 LEVOTHYROXINUM EUTHYROX 50mcg COMPR. 50mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 0,063500 0,085800 0,000000 25 W57398002 H03AA01 LEVOTHYROXINUM EUTHYROX 50μg COMPR. 50μg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 0,063500 0,085800 0,000000 26 W54546003 H03BB02 THIAMAZOLUM THYROZOL 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 0,317400 0,429000 0,000000 27 W54545003 H03BB02 THIAMAZOLUM THYROZOL 20mg COMPR. FILM. 20mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 0,391600 0,529400 0,000000 28 W54547004 H03BB02 THIAMAZOLUM THYROZOL 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P6L 100 0,236900 0,320200 0,000000 29 W03843004 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-RF 100 0,094200 0,127300 0,000000 30 W03843003 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-RF 100 0,094200 0,127300 0,000000 31 W55488001 H05AA02 TERIPARATIDUM** FORSTEO 20μg/80μl SOL. INJ. 20μg/80μl ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 2,4 ML (28 DOZE X 20 MCG/80MCL) P-RF 1 1.291,980000 1.446,410000 0,000000 32 W08119001 H05BA01 CALCITONINUM (SOMON) NYLEX (R) SOL. INJ. 100UI/ml PROEL E.P. CORONIS SA GRECIA CUTIE X 5 FIOLE X 1ML P-RF 5 4,968000 6,714000 0,000000 33 W00756001 H05BA01 CALCITONINUM (SOMON) MIACALCIC (R) SOL. INJ. 50ui/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML P-RF 5 4,388000 5,932000 0,000000 34 W54297001 M05BA04 ACIDUM ALENDRONICUM** TEVANAT 70 mg COMPR. 70 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-AL-OPA/AL X 4 COMPR. P-6L 4 2,002500 2,705000 0,000000 35 W60296004 M05BA04 ACIDUM ALENDRONICUM** FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L 2 2,208000 2,985000 10,635000 36 W58352002 M05BA04 ACIDUM ALENDRONICUM** ACID ALENDRONIC AUROBINDO 70 mg COMPR. 70mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. TRANSPARENTE PVC-ACLAR/AL X 4 COMPR. P6L 4 1,840000 2,487500 0,000000 37 W56763001 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 2,208000 2,985000 5,150833 38 W56763002 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 2,208000 2,985000 5,865000 39 W56763003 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 2,208000 2,985000 5,582500 40 W52948001 M05BA04 ACIDUM ALENDRONICUM** ALENDRONAT SANDOZ 70 mg COMPR. FILM. 70mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 2 COMPR. FILM P-6L 2 2,208000 2,985000 1,905000 41 W56749001 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 27,060000 35,400000 0,000000 42 W56947001 M05BA06 ACIDUM IBANDRONICUM** QUODIXOR 150 mg COMPR. FILM. 150mg ALVOGEN IPCO S.AR.L LUXEMBUR G CUTIE CU BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P-6L 1 27,270000 35,670000 0,000000 43 W57485004 M05BA06 ACIDUM IBANDRONICUM** OSAGRAND 150 mg COMPR. FILM. 150mg ZENTIVA K.S. REPUBLIC A CEHA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 COMPR. FILM. P6L 1 27,280000 35,680000 0,000000 44 W58574001 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 27,280000 35,680000 0,000000 45 W42716001 M05BA06 ACIDUM IBANDRONICUM** BONVIVA 150mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 COMPR. FILM.( BLIST. AL/AL) P-6L 1 32,148000 42,048000 47,692000 46 W60664001 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 26,790000 35,040000 0,000000 47 W55441001 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 28,490000 37,260000 0,000000 48 W57730004 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC SANDOZ 50 mg COMPR. FILM. 50 mg SANDOZ PHARMACEUTICALS GMBH GERMANIA CUTIE CU BLIST. DIN PA/AL/PVC/AL CU 28 COMPRIMATE FILMATE PR 28 8,696428 10,616785 0,000000 49 W56748001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 50 mg COMPR. FILM. 50 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 28 COMPRIMATE FILMATE PR 28 9,973571 12,175714 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 50 W41499001 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 50mg COMPR. FILM. 50mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X BLIST. AL/PVC X 28 COMPR. FILM. S 28 10,435714 12,740142 26,152715 51 W56932004 M05BA06 ACIDUM IBANDRONICUM** IASIBON 50 mg COMPR. FILM. 50mg PHARMATHEN S.A. GRECIA CUTIE CU BLIST. PA/ALL/PVC/ALU X 28 COMPR. FILM PR 28 9,973571 12,175714 0,000000 52 W59829025 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC GLENMARK 50 mg COMPR. FILM. 50mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLIC A CEHA CUTIE CU BLIST. PVC/PVDC-AL X 28 COMPR. FILM. PR 28 10,435714 12,740142 11,278072 53 W57712001 M05BA06 ACIDUM IBANDRONICUM** HOLMEVIS 50 mg COMPR. FILM. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. PR 28 9,973571 12,175714 0,000000 54 W58937001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 6 mg CONC. PT. SOL. PERF. 6mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC SI CAPSA DE CULOARE TURCOAZ (ALBASTRU VERZUI) X 6 ML CONC. PT. SOL. PERF. PR 1 302,410000 367,780000 0,000000 55 W56933001 M05BA06 ACIDUM IBANDRONICUM** IASIBON 6mg/6ml CONC. PT. SOL. PERF. 6mg/6ml PHARMATHEN S.A. GRECIA CUTIE CU 1 FLAC. DIN STICLA X 6ML CONC. PT. SOL. PERF. PR 1 263,810000 322,060000 0,000000 56 W41498001 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 6mg/6ml CONC. PT. SOL. PERF. 6mg/6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLACON X 6 ML CONC. PT. SOL. PERF. S 1 316,572000 386,472000 634,168000 57 W57932001 M05BA06 ACIDUM IBANDRONICUM** OSSICA 3 mg SOL INJ. IN SERINGA PREUMPLU TA 3mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. + 1 AC PT. INJECTIE P6L 1 82,280000 104,030000 0,000000 58 W58935001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 3 mg SOL INJ. IN SERINGA PREUMPLU TA 3mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. SI UN AC DE INJECTARE P6L 1 79,750000 100,840000 0,000000 59 W57484001 M05BA06 ACIDUM IBANDRONICUM** OSAGRAND 3 mg/3 ml SOL. INJ. 3mg/3ml ZENTIVA K.S. REPUBLIC A CEHA CUTIE CU 1 FIOLA DIN STICLA INCOLORA X 3 ML SOL. INJ. P6L 1 82,890000 104,810000 0,000000 60 W43328001 M05BA06 ACIDUM IBANDRONICUM** BONVIVA 3mg/3ml SOL. INJ. IN SERINGA PREUMPLU TA 1mg/1ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA DIN STICLA X 3 ML SOL. INJ. + 1 AC P-6L 1 95,700000 121,008000 31,892000 61 W59460003 M05BA07 ACIDUM RISEDRONICUM** RISEDRONAT AUROBINDO 35 mg COMPR. FILM. 35mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 4 COMPR. FILM. P6L 4 1,971000 2,664000 1,048500 62 W53578003 M05BA07 ACIDUM RISEDRONICUM** RISEDRONAT TEVA 35 mg COMPR. FILM. 35mg TEVA PHARMACEUTICALS SRL ROMANIA CUTIE X BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L 4 1,642500 2,220000 0,000000 63 W55565003 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 1,971000 2,664000 4,558500 64 W54377002 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 1,971000 2,664000 4,558500 65 W60074002 M05BA07 ACIDUM RISEDRONICUM** RISEDRONAT SODIC ZENTIVA 35mg COMPR. FILM. 35mg ZENTIVA KS REPUBLIC A CEHA CUTIE X 1 BLISTER OPA-AL-PVC/AL X 4 COMPRIMATE FILMATE P-6L 4 1,971000 2,664000 1,048500 66 W61163003 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 1,971000 2,664000 8,086000 67 W61164001 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 26,255000 33,195000 0,000000 68 W59137001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC SANDOZ 4 mg/100 ml CONC. PT. SOL. PERF. 4mg/100 ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR, DIN COPOLIMER CICLOOLEFINIC PREVAZUT CUC CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" X 100 ML CONC. PT. SOL. PERF. PR 1 87,516000 106,839000 232,201000 69 W59136001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC SANDOZ 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR, DIN COPOLIMER CICLOOLEFINIC PREVAZUT CUC CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" X 5 ML CONC. PT. SOL. PERF. PR 1 87,516000 106,839000 125,811000 70 W59191004 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC TERAPIA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml TERAPIA SA ROMANIA CUTIE CU 1 FLAC. TRANSPARENT DIN STICLA CU CAPACITATEA DE 6 ML INCHIS CU DOP DIN CAUCIUC DE CULOARE GRI SI SIGILAT CU CAPAC DIN AL, TIP "FLIP OFF" DE CULOARE GRI CARE CONTINE CONC. PT. SOL. PERF. PR 1 87,516000 106,839000 266,421000 71 W59914001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC PFIZER 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. DIN PP PREVAZUT CU CAPSA FLIP-OFF DIN AL CU CONC. PT. SOL. PERF. PR 1 87,516000 106,839000 266,421000 72 W59840001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC HOSPIRA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON CU CAPACITATE DE 5ML DIN PLASTIC CU DOP BROMOBUTIL, ACOPERIT CU UN STRAT DE FLUOROPOLIMER SI CAPAC DIN AL CU COMPONENTA "FLIP-OFF" PR 1 87,516000 106,839000 266,421000 73 W59090002 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC FRESENIUS KABI 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 4 FLAC. DIN PP INCOLORA, INCHIS X 4 MG/5 ML CONC. PT. SOL. PERF. PR 4 72,930000 89,032500 0,000000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA

P9.1: TRANSPLANT MEDULAR

1 W56153001 A04AA01 ONDANSETRONUM** OSETRON 4 mg COMPR. FILM. 4mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X 10 COMPR. FILM. P-RF 10 1,461000 1,975000 0,000000 2 W56154001 A04AA01 ONDANSETRONUM** OSETRON 8 mg COMPR. FILM. 8mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X 10 COMPR. FILM. P-RF 10 2,557000 3,345000 0,000000 3 W57423001 A04AA01 ONDANSETRONUM** OSETRON 4 mg SOLUTIE INJECTABILA SOL. INJ. 2mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE 1 BLIST. AL/PVC X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 3,652000 4,936000 0,000000 4 W57424001 A04AA01 ONDANSETRONUM** OSETRON 8 mg SOLUTIE INJECTABILA SOL. INJ. 2mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 5 FIOLE X 4 ML SOL. INJ. S/P-RF 5 6,940000 9,078000 0,000000 5 W51504002 A04AA01 ONDANSETRONUM** EMESET 4 mg/2 ml SOL. INJ./PERF. 2mg/ml CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 5 FIOLE STICLA + INEL RUPERE X 2ML SOL. INJ/ PERF. S/P-RF 5 3,652000 4,936000 0,000000 6 W51505002 A04AA01 ONDANSETRONUM** EMESET 8 mg/4 ml SOL. INJ./PERF. 2mg/ml CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 5 FIOLE STICLA + INEL RUPERE X 4ML SOL. INJ. / PERF. S/P-RF 5 6,938000 9,074000 0,000000 7 W00188001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 0,603000 0,788600 0,000000 8 W59934001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6L 60 0,602833 0,788500 0,000000 9 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 0,723400 0,946200 0,267200 10 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 0,723400 0,946200 0,206200 11 W58710002 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 2,196700 2,681700 0,000000 12 W58363001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5 ml DR. FALK PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP P6L 1 77,100000 97,490000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 13 W54011001 B02AA02 ACIDUM TRANEXAMICUM4) EXACYL SOL. INJ. 500mg/5 ml CN UNIFARM ROMANIA CUTIE X 5 FIOLE X 5ML SOL. INJ. X 5 1,890000 2,554000 0,000000 14 W53034001 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 1mg (50 KUI) PULB. + SOLV. PT. SOL. INJ. 50 KIU NOVO NORDISK A/S DANEMAR CA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE P-RF/R 1 2.406,410000 2.661,140000 0,000000 15 W55629002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 12 4,044000 5,472000 22,543000 16 W54763001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CU PULB. PT. SOL. INJ./PERF. S 1 3,370000 4,560000 0,000000 17 W55369001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 18 W55629001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 19 W55423001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 20 W55424001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 21 W55370001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 22 W55630001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 23 W55630002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 12 21,346800 26,060400 20,445433 24 W54765001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 10,049600 25 W53595006 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 2g/0,25 g PULB. PT. SOL. PERF. 2g/0,25g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 4,044000 5,472000 10,127000 26 W53596003 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 4g/0.5g PULB. PT. SOL. PERF. 4g/0,5g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE CU 10 FLAC DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 17,789000 21,717000 0,000000 27 W60705002 J01DH02 MEROPENEMUM MEROPENEM ZENTIVA 1000 mg PULB. PT. SOL. INJ. SAU PERF. 1000 mg ZENTIVA, K.S. REPUBLIC A CEHA CUTIE CU 10 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 20 ML PR 10 27,211200 33,219600 44,763400 28 W60703002 J01DH02 MEROPENEMUM MEROPENEM ZENTIVA 500 mg PULB. PT. SOL. INJ. SAU PERF. 500 mg ZENTIVA, K.S. REPUBLIC A CEHA CUTIE CU 10 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 20 ML PR 10 16,826400 20,541600 22,648400 29 W56827001 J01DH02 MEROPENEMUM LODITER 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg TERAPIA S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 40 ML CONTINAND PULB. PT. SOL. INJ./PERF. PR 1 27,211200 33,219600 62,340400 30 W58974002 J01DH02 MEROPENEMUM MEROPENEM ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 20 ML SAU 30 ML CU DOP DIN CAUCIUC, SIGILAT CU CAPSA DIN ALUMINIU PREVAZUTA CU DISC DIN MATERIAL PLASTIC PRF 10 27,211200 33,219600 47,425400 31 W61143002 J01DH02 MEROPENEMUM ARCHIFAR 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA, CAPACITATEA 30 ML, DOP DIN CAUCIUC BROMOBUTILIC SIGILAT CU CAPSA AL CU PULB.PT.SOL.INJ./PERF. PR 10 27,211200 33,219600 29,959400 32 W56125002 J01DH02 MEROPENEMUM MEROPENEM KABI 1 g PULB. PT. SOL. INJ./PERF. 1g FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 10 27,211200 33,219600 16,867400 33 W56331002 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 1 g PULB. PT. SOL. INJ./PERF. 1g HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 10 22,676000 27,683000 0,000000 34 W56826001 J01DH02 MEROPENEMUM LODITER 500 mg PULB. PT. SOL. INJ./PERF. 500mg TERAPIA S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CONTINAND PULB. PT. SOL. INJ./PERF. PR 1 16,826400 20,541600 30,708400 35 W56124002 J01DH02 MEROPENEMUM MEROPENEM KABI 500 mg PULB. PT. SOL. INJ./PERF. 500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. PR 10 16,826400 20,541600 6,620400 36 W56330002 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 500 mg PULB. PT. SOL. INJ./PERF. 500mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 10 14,022000 17,118000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 37 W61142002 J01DH02 MEROPENEMUM ARCHIFAR 500 mg PULB. PT. SOL. INJ./PERF. 500mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA, CAPACITATEA 20 ML, DOP DIN CAUCIUC BROMOBUTILIC SIGILAT CU CAPSA AL CU PULB.PT.SOL.INJ./PERF. PR 10 16,826400 20,541600 24,002400 38 W58973002 J01DH02 MEROPENEMUM MEROPENEM ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 20 ML CU DOP DIN CAUCIUC, SIGILAT CU CAPSA DIN ALUMINIU PREVAZUTA CU DISC DIN MATERIAL PLASTIC PRF 10 16,826400 20,541600 24,004400 39 W59077002 J01DH51 IMIPENEMUM + CILASTATINUM TIENAM I.V. 500 mg/500 mg PULB. PT. SOL. PERF. 500mg/50 0mg MERCK SHARP & DOHME ROMANIA TAVA CU 10 FLAC. DIN STICLA INCOLORA A 20 ML CU PULB. PT. SOL. PERF. PR 10 22,297200 27,220800 7,679200 40 W54471006 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF. S/P-RF 10 22,297200 27,220800 9,677200 41 W54471009 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 30 ML PULB. PT. SOL. PERF. S/P-RF 10 22,297200 27,220800 6,801200 42 W61198003 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN ATB 500 mg/500 mg PULB. PT. SOL. PERF. 500mg/50 0mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA TIP III, CU CAPACITATEA DE 20 ML, CONTINANAD PULB. PT. SOL. PERF. PR 10 18,582000 22,685000 0,000000 43 W54471007 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 30 ML PULB. PT. SOL. PERF. S/P-RF 1 22,297200 27,220800 10,559200 44 W54471008 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 30 ML PULB. PT. SOL. PERF. S/P-RF 5 22,297200 27,220800 6,803200 45 W54471002 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF. S/P-RF 5 18,922000 23,924000 0,000000 46 W54471003 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF. S/P-RF 10 18,582000 22,685000 0,000000 47 W54471005 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF. S/P-RF 5 22,297200 27,220800 9,829200 48 W54532001 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN KABI 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. S/P-RF 10 18,581000 22,684000 0,000000 49 W43348001 J01XA01 VANCOMYCINUM VANCOMYCIN TEVA LIOF. PT. SOL. PERF. 1g TEVA PHARM. WORKS PRIVATE LTD. COMPANY UNGARIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 25,308000 34,212000 20,538000 50 W43347001 J01XA01 VANCOMYCINUM VANCOMYCIN TEVA LIOF. PT. SOL. PERF. 500mg TEVA PHARM. WORKS PRIVATE LTD. COMPANY UNGARIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 20,930000 25,840800 2,449200 51 W56449002 J01XA01 VANCOMYCINUM VANCOMICINA PHARMASWISS 1000 mg PULB. PT. SOL. PERF. 1000mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLIC A CEHA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR 10 25,308000 34,212000 10,904000 52 W56448002 J01XA01 VANCOMYCINUM VANCOMICINA PHARMASWISS 500 mg PULB. PT. SOL. PERF. 500mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLIC A CEHA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR 10 17,639000 21,534000 0,000000 53 W57042001 J01XA01 VANCOMYCINUM VANCOMICINA KABI 1000 mg PULB. PT.CONC. PT.SOL. PERF. 1000mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CARE CONTINE PULB. PT. CONC. PT. SOL. P PR 1 21,090000 28,510000 0,000000 54 W57041001 J01XA01 VANCOMYCINUM VANCOMICINA KABI 500 mg PULB. PT.CONC. PT.SOL. PERF. 500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. P PR 1 19,630000 25,840800 0,689200 55 W06051001 J01XA01 VANCOMYCINUM EDICIN PULB.LIOF. PT.SOL.PE RF./INJ 1g LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. LIOF. PT. SOL. PERF./INJ. S/P-RF 1 25,308000 34,212000 16,888000 56 W13105001 J01XA02 TEICOPLANINUM TARGOCID (R) 400 mg LIOF. + SOLV. PT. SOL. INJ. 400mg AVENTIS PHARMA LTD. MAREA BRITANIE CUTIE X 1 FLAC. LIOF. + O FIOLA SOLV. P-RF 1 106,430000 129,930000 0,000000 57 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 163,000000 181,485000 0,000000 58 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5 ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 911,260000 1.031,420000 0,000000 59 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBUR G CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINÂND 300 ML SOL. PERF. PR 1 112,480000 137,320000 0,000000 60 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF. PR 1 116,710000 142,262400 0,217600

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 61 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 126,315600 142,262400 42,337600 62 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPATA CU UN CONECTOR (DIN RASINA PE BAZA DE POLIOEFINE)SI CU O SUPRA-PUNGA (DIN COPOLIMER POLIESTER/PROPILENA) PRF 10 105,263000 118,552000 0,000000 63 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 1,998750 2,614500 3,788000 64 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,998750 2,614500 0,805500 65 W42371002 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 1,665625 2,178750 0,000000 66 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,998750 2,614500 2,056928 67 W52224001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,870000 6,580000 0,000000 68 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,680000 6,320000 0,000000 69 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLIC A CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 70 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 71 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 72 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS. PRF 1 4,620000 6,240000 0,000000 73 W56446001 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 74 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 75 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,544000 7,488000 3,542000 76 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 77 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 78 W43288001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 79 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 80 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 81 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 4,460000 5,834285 0,000000 82 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,356000 1,832570 0,133144 83 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,265714 1,710000 0,000000 84 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 85 W57238001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 1,356000 1,832570 0,947430 86 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 87 W43287001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,130000 1,527142 0,000000 88 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,560287 89 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,946001 90 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 91 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 2,444572 92 W58322001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON PEID DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 LINGURITA DOZATOARE A 5ML, CU PULB. PENTRU 35 ML SUSP. ORALA PRF 1 21,880000 29,570000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 93 W55502017 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 1 36,250000 47,420000 0,000000 94 W55502009 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 1 18,130000 24,500000 0,000000 95 W12072001 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML S/PR-F 1 21,516000 26,266800 21,183200 96 W55502001 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 1 9,060000 12,250000 0,000000 97 W58456003 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 200 ML SOL. PERF. PR 10 43,500000 56,904000 32,740000 98 W58456002 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 100 ML SOL. PERF. PR 20 21,516000 26,266800 11,204200 99 W60056005 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLIC A CEHA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 17,930000 21,889000 0,000000 100 W57368003 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 21,516000 26,266800 28,873200 101 W58456001 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 50 ML SOL. PERF. PR 20 10,872000 14,700000 6,937500 102 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 119,853214 132,002857 0,000000 103 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 32,232500 36,496071 0,000000 104 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 435,570000 512,920000 0,000000 105 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 2.044,020000 2.266,130000 0,000000 106 W60913001 J02AC04 POSACONAZOLUM** NOXAFIL 100mg CAPS. GASTROR EZ. 100mg MERCK SHARP & DOHME LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/PCTF/AL X 24 COMPRIMATE GASTROREZISTENTE PR 24 133,855416 147,492083 0,000000 107 W58194001 J02AC04 POSACONAZOLUM** NOXAFIL 40mg/ml SUSP. ORALA 40mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. X 105ML SUSP. ORALA P-RF/R 1 2.405,440000 2.660,080000 0,000000 108 W06665001 J02AX04 CASPOFUNGINUM** CANCIDAS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.246,420000 1.396,750000 0,000000 109 W06670001 J02AX04 CASPOFUNGINUM** CANCIDAS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.617,600000 1.801,340000 0,000000 110 W56038001 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0,636000 0,859800 0,211200 111 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,636000 0,859800 0,188700 112 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,636000 0,859800 0,251200 113 W53675003 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 0,636000 0,833260 0,000000 114 W53676001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 1,495000 2,020000 0,000000 115 W13972001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,636000 0,859800 0,033700 116 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,636000 0,859800 0,030200 117 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,636000 0,859800 0,033700 118 W06667003 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 20 0,530000 0,716500 0,000000 119 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,636000 0,859800 0,033700 120 W06668003 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 10 1,794000 2,424000 0,334000 121 W00058001 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL. INJ./PERF. S/P-RF 5 38,600000 47,124000 0,000000 122 W58707001 J05AB11 VALACYCLOVIRUM VALTREX 500 mg COMPR. FILM. 500 mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM. PRF 10 2,780400 3,757200 0,903800

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 123 W60087001 J05AB11 VALACYCLOVIRUM VALACICLOVIR ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC ALB OPAC/AL X 10 COMPR. FILM. PRF 10 2,317000 3,131000 0,000000 124 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 59,167800 65,256000 23,726166 125 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM. PRF 60 49,306500 54,380000 0,000000 126 W54752001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 391,580000 464,970000 0,000000 127 W54752002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 870,210000 986,680000 0,000000 128 W54752003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 1.710,420000 1.902,510000 0,000000 129 W54752004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA, CU CAPACITATE DE 250ML, A 200ML SOLUTIE PERFUZABILA S 1 3.390,820000 3.734,150000 0,000000 130 W51530001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL. PERF.(1G/10ML) S 1 190,360000 232,390000 0,000000 131 W51530006 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL. PERF.(30G/300ML) S 1 5.766,650000 6.323,810000 0,000000 132 W51530003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL. PERF.(5G/50ML) S 1 912,190000 1.032,440000 0,000000 133 W51530004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL. PERF.(10G/100ML) S 1 1.847,580000 2.059,644000 78,286000 134 W51530005 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL. PERF.(20G/200ML) S 1 3.736,820000 4.111,290000 0,000000 135 W43965001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.539,650000 1.716,370000 0,000000 136 W43962001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 204,810000 250,030000 0,000000 137 W43963001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 407,410000 482,230000 0,000000 138 W59114003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 100 ML SOL. PERF. PRF 1 894,400000 1.013,050000 0,000000 139 W59114001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 20 ML SOL. PERF. PRF 1 190,170000 232,160000 0,000000 140 W59114004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 200 ML SOL. PERF. PRF 1 1.758,800000 1.955,240000 0,000000 141 W59114002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 50 ML SOL. PERF. PRF 1 462,170000 541,920000 0,000000 142 W13462002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 100 ML S 1 894,000000 1.012,610000 0,000000 143 W13462003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S 1 1.837,780000 2.041,330000 0,000000 144 W13462001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S 1 481,950000 563,480000 0,000000 145 W43964001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 784,820000 893,600000 0,000000 146 W12490001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 0,401400 0,542400 0,000000 147 W52215001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 200 mg PULB. PT. SOL. PERF./INJ. I.V. 200mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ S 1 11,760000 15,890000 0,000000 148 W58865001 L01AA03 MELPHALANUM ALKERAN 2 mg COMPR. FILM. 2mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 25 COMPR. FILM. P-RF 25 10,116400 12,350000 0,000000 149 W60631001 L01AA03 MELPHALANUM ALKERAN 50 mg PULB+SOL V. PT. SOL. INJ./PERF. 50mg CN UNIFARM S.A. ROMANIA CUTIE CU 1 FIOLA PULB.+ 1 FIOLA SOLVENT PR 1 630,000000 724,850000 0,000000 150 W12497001 L01AA06 IFOSFAMIDUM HOLOXAN 1 g PULB. PT. SOL. PERF. 1g BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. PERF. S 1 95,760000 121,080000 0,000000 151 W51454001 L01AB01 BUSULFANUM BUSILVEX 6mg/ml CONC. PT. SOL. PERF. 6mg/ml PIERRE FABRE MEDICAMENT FRANTA CUTIE X 8 FLAC. X 10 ML CONC. PT. SOL. INJ. S 8 1.007,503750 1.102,948750 0,000000 152 W58569001 L01BA01 METHOTREXATUM METHOTREXATE PCH 10mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10COMPR. P6L 10 2,211000 2,989000 0,000000 153 W58568001 L01BA01 METHOTREXATUM METHOTREXATE PCH 2,5mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X30 COMPRIMATE P6L 30 0,553333 0,747666 0,000000 154 W12733003 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S 1 65,640000 82,990000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 155 W12735001 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 308,200000 374,090000 0,000000 156 W58316010 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 93,336000 118,008000 9,082000 157 W58316004 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 35,730000 46,730000 0,000000 158 W58316007 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 63,030000 79,700000 0,000000 159 W58316001 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ PR 1 47,310000 61,880000 0,000000 160 W53758021 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÃ„PARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 87,540000 110,680000 0,000000 161 W53758016 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÃ„PARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 77,780000 98,340000 0,000000 162 W53758006 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLU TA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÃ„PARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 42,876000 56,076000 13,944000 163 W56210002 L01BB05 FLUDARABINUM FLUDARA ORAL 10 mg COMPR. FILM. 10mg GENZYME EUROPE B.V. OLANDA CUTIE X 1 FLAC. DIN PE X 4 BLIST. AL/AL X 5 COMPR. FILM. P-RF/S 20 53,287000 59,990500 0,000000 164 W56211001 L01BB05 FLUDARABINUM FLUDARA LIOF. PT. SOL. INJ./PERF. 50mg GENZYME EUROPE B.V. OLANDA CUTIE X 5 FLAC. CU LIOF. PT. SOL. INJ./PERF. S 5 81,444000 102,984000 12,802000 165 W53700001 L01BB05 FLUDARABINUM FLUDARABINA ACTAVIS 25 mg/ml PULB. PT. SOL. INJ./PERF. 25mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA (CAPACITATE 5ML) CU PULB. PT. SOL. INJ/PERF CONTINAND 50MG FLUDA S 1 67,870000 85,820000 0,000000 166 W08035001 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 100mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 1 BLIST. PVC/A0-PVC-PVDC X 10 CAPS. P-RF 10 21,796000 26,609000 0,000000 167 W08036001 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 50mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 2 BLIST. PVC/AL-PVC-PVDC X 10 CAPS. P-RF 20 10,952500 13,371000 0,000000 168 W52210001 L01CB01 ETOPOSIDUM SINTOPOZID 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5 ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 17,960000 24,270000 0,000000 169 W03065001 L01CB01 ETOPOSIDUM ETOPOSID "EBEWE" 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5 ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 21,552000 29,124000 3,236000 170 W52574002 L01CB01 ETOPOSIDUM ETOPOSIDE - TEVA CONC. PT. SOL. PERF. 20mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 10 ML CONC. PT. SOL. PERF. S 1 54,800000 69,290000 0,000000 171 W52574001 L01CB01 ETOPOSIDUM ETOPOSIDE - TEVA CONC. PT. SOL. PERF. 20mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 5 ML CONC. PT. SOL. PERF. S 1 21,552000 29,124000 3,846000 172 W60599002 L01CB01 ETOPOSIDUM ETOPOZIDA KABI 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU UN FLAC. DIN STICLA INCOLORA TIP I, CU CAPACITATEA DE 10 ML ÎNCHIS CU DOP DIN CAUCIUC BROMOBUTIL SI SIGILAT CU CAPSE DETASABILE DIN AL DE CULOARE ALBASTRA CONTINÂND 10 ML CONC. PENTRU SOL. PERF. PR 1 63,290000 80,030000 0,000000 173 W03575001 L01DB06 IDARUBICINUM ZAVEDOS CAPS. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 188,210000 229,770000 0,000000 174 W03581001 L01DB06 IDARUBICINUM ZAVEDOS 5 mg PULB. PT. SOL. INJ. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. S 1 109,250000 133,370000 0,000000 175 W42735002 L01DB07 MITOXANTRONUM** ONKOTRONE CONC. PT. SOL. INJ. 2mg/ml BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 1 FLACON X 10 ML CONC. PT. SOL. INJ. S 1 474,870000 555,760000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 176 W56664001 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 20 ML CONC. PT. SOL. PERF. PR 1 10,350000 13,990000 0,000000 177 W56664003 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 100 ML CONC. PT. SOL. PERF. PR 1 24,048000 32,508000 15,522000 178 W56664002 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 50 ML CONC. PT. SOL. PERF. PR 1 20,490000 27,700000 0,000000 179 W56665002 L01XA01 CISPLATINUM PLATOSIN 1 mg/ml CONC. PT. SOL. PERF. 1 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 50 ML CONC. PT. SOL. PERF. PR 1 20,040000 27,090000 0,000000 180 W56665003 L01XA01 CISPLATINUM PLATOSIN 1 mg/ml CONC. PT. SOL. PERF. 1 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 100 ML CONC. PT. SOL. PERF. PR 1 70,460000 89,090000 0,000000 181 W52187002 L01XA01 CISPLATINUM SINPLATIN 1 mg/1 ml CONC. PT. SOL. PERF. 1mg/1ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 50 ML X 50 MG CONC. SOL. PERF. S 1 23,940000 32,360000 0,000000 182 W52187001 L01XA01 CISPLATINUM SINPLATIN 1 mg/1 ml CONC. PT. SOL. PERF. 1mg/1ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 10 ML X 10 MG CONC. SOL. PERF. S 1 9,940000 13,440000 0,000000 183 W01317001 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 50 mg/100 ml CONC. PT. SOL. PERF. 50mg/100 ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 100 ML CONC. PT. SOL. PERF. S 1 24,048000 32,508000 8,792000 184 W53000002 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 15 ML CONC. PT. SOL. PERF. S 1 45,350000 59,320000 0,000000 185 W53000003 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 45 ML CONC. PT. SOL. PERF. S 1 134,430000 164,110000 0,000000 186 W53000001 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 15,480000 20,920000 0,000000 187 W58740001 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE VERDE X 5 ML CON. PT. SOL. PERF. X 50 MG CARBOPLATINA PR 1 18,576000 25,104000 0,136000 188 W58740002 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE ALBASTRA X 15 ML CONC. PT. SOL. PERF. X 150 MG CARBOPLATINA PR 1 49,170000 64,310000 0,000000 189 W58740003 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE ROSIE X 45 ML CON. PT. SOL. PERF. X 450 MG CARBOPLATINA PR 1 136,890000 167,110000 0,000000 190 W52579003 L01XA02 CARBOPLATINUM CARBOPLATIN TEVA 10mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 45 ML CONC. PT. SOL. PERF. S 1 137,790000 168,220000 0,000000 191 W52579002 L01XA02 CARBOPLATINUM CARBOPLATIN TEVA 10mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 15 ML CONC. PT. SOL. PERF. S 1 49,230000 64,390000 0,000000 192 W58740004 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE GALBENA X 60 ML CONC. PT. SOL. PERF. X 600 MG CARBOPLATINA PR 1 181,360000 221,410000 0,000000 193 W07199001 L01XC02 RITUXIMABUM** MABTHERA 100 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 2 FLACOANE X 10 ML S 2 929,765000 1.032,520000 0,000000 194 W07200001 L01XC02 RITUXIMABUM** MABTHERA 500 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML(500MG RITUXIMAB IN 50ML- 10MG/ML) S 1 4.632,930000 5.088,050000 0,000000 195 W53892001 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLU TA 60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 87,690000 110,870000 0,000000 196 W53893001 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLU TA 96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 139,560000 170,380000 0,000000 197 W53520001 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300mcg/0, 5ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF. S/P-RF/R 1 105,228000 127,437600 34,512400 198 W55757002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300μg/0,5 ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 90,430000 106,198000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 199 W53523001 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480mcg/0, 8ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML SOL. INJ. SAU PERF. S/P-RF/R 1 167,472000 195,360000 72,090000 200 W55758002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480μg/0,5 ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 142,358000 162,800000 0,000000 201 W54580001 L03AX16 PLERIXAFOR** MOZOBIL 20mg/ml SOL. INJ. 20 mg/ml GENZYME EUROPE B.V. OLANDA FLACON CU 1,2 ML SOL. X 20 MG/ML S 1 21.644,390000 23.630,570000 0,000000 202 W04406001 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 1,706500 2,083300 0,000000 203 W04407001 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 3,228200 3,941000 0,000000 204 W42264003 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROR EZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 3,078833 3,673833 0,000000 205 W42265003 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROR EZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 6,008166 6,866833 0,000000 206 W56657001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 1,109300 1,354200 0,000000 207 W56643001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PRF 100 1,109300 1,354200 0,000000 208 W52877001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS. P-RF/R 100 1,109300 1,354200 0,000000 209 W58520001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 100 1,109300 1,354200 0,000000 210 W56644001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. PRF 50 2,136400 2,608200 0,000000 211 W55987001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF 50 2,136400 2,608200 0,000000 212 W58523001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 50 2,136400 2,608200 0,000000 213 W52876001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM. P-RF/R 50 2,136400 2,608200 0,000000 214 W56003001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM. P-RF 50 3,003000 3,666000 0,000000 215 W10576001 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR) P-RF/R 30 15,282333 17,929333 0,000000 216 W58975001 L04AB01 ETANERCEPTUM** ENBREL 10mg de uz pediatric PULB+SOL V. PT. SOL. INJ. 10mg PFIZER LIMITED MAREA BRITANIE CUTIE CU 4 FLACOANE CU PULBERE + 4 SERINGI PRE-UMPLUTE X 1ML APA + 4 ACE CU INJECTOARE DIN OTEL INOXIDABIL + 4 ADAPTOARE PENTRU FLACON + 8 TAMPOANE CU ALCOOL MEDICNAL PR 4 183,222500 209,250000 0,000000 217 W61297001 L04AB01 ETANERCEPTUM** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 446,855000 496,610000 0,000000 218 W61299001 L04AB01 ETANERCEPTUM** ENBREL 25mg SOL. INJ. (INSERING A PREUMPLU TA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 446,550000 496,277500 0,000000 219 W61300002 L04AB01 ETANERCEPTUM** ENBREL 50mg SOL. INJ. (INSERING A PREUMPLU TA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 886,460000 975,780000 0,000000 220 W61303002 L04AB01 ETANERCEPTUM** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLU T 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 886,460000 975,780000 0,000000 221 W58368003 L04AD01 CICLOSPORINUM EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 5,105200 6,232400 0,000000 222 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 1,865200 2,358400 0,000000 223 W58149003 L04AD01 CICLOSPORINUM EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 1,176000 1,487000 0,000000 224 W58367003 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 2,075600 2,533800 0,000000 225 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 3,136200 3,828600 0,000000 226 W56579003 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 1,235600 1,562200 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 227 W53729001 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 1,900800 2,403400 0,000000 228 W55262007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 1,235600 1,562200 0,000000 229 W56580003 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 2,427400 2,963400 0,000000 230 W55263007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 2,427400 2,963400 0,000000 231 W53730001 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 3,734800 4,559400 0,000000 232 W53731001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 17,573400 19,918000 0,000000 233 W51974002 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 2,652600 3,238400 0,000000 234 W57352002 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 4,662600 5,692200 0,000000 235 W51976002 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE, X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 20,683000 23,307600 0,000000 236 W53732001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 10 FIOLE X 1 ML S 10 148,802000 166,009000 0,000000 237 W52049001 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,252600 0,341400 0,125600 238 W12691002 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,221500 0,299500 0,000000 239 W60291001 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0,252600 0,341400 0,043600 240 W60238002 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,210500 0,284500 0,000000 241 W41593001 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,252600 0,341400 0,057100 242 W42957001 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,252600 0,341400 0,042100 243 W42440001 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,252600 0,341400 0,057100 244 W58072001 N02AX02 TRAMADOLUM TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. PRF 30 0,483666 0,653666 0,000000 245 W60236002 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 0,466333 0,630333 0,000000 246 W58893002 N02AX02 TRAMADOLUM TRADOLAN RETARD 150 mg COMPR. ELIB. PREL. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,802800 1,085200 0,032800 247 W60237002 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 150 mg COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 0,669000 0,904333 0,000000 248 W58894002 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,895000 1,170666 0,000000 249 W07784001 N02AX02 TRAMADOLUM TRADOLAN 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-RF 30 0,244333 0,330333 0,000000 250 W43360001 N02AX02 TRAMADOLUM TRAMADOL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-RF 30 0,802800 1,085200 0,200133 251 W43361001 N02AX02 TRAMADOLUM TRAMADOL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR., FILM. ELIB. PREL. P-RF 30 1,074000 1,404799 0,291201 252 W60239003 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPE RSABILE 50mg ZENTIVA, A.S. REPUBLIC A SLOVACA CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE PRF 10 0,252600 0,341400 0,056600 253 W60239001 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPE RSABILE 50mg ZENTIVA, A.S. REPUBLIC A SLOVACA CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE PRF 10 0,252600 0,341400 0,056600 254 W05961002 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 100 1,143600 1,396100 0,000000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA

P9.2: TRANSPLANT DE CORD

1 W02947001 C01CA24 EPINEPHRINUM ADRENALINA 1 mg SOL. INJ. 1mg/ml TERAPIA SA ROMANIA CUTIE X 100 FIOLE X 1 ML S 100 1,569300 1,915800 0,000000 2 W60389001 C01CA24 EPINEPHRINUM EPIPEN 150 micrograme SOL. INJ. IN STILOU PREUMPLU T 150mcg MEDA PHARMA GMBH & CO KG GERMANIA CUTIE CU 1 STILOU AUTOINJECTOR PREUMPLUT CU 2ML PENTRU O DOZA UNICA DE 0,3ML PR 1 146,100000 178,360000 0,000000 3 W60390001 C01CA24 EPINEPHRINUM EPIPEN 300 micrograme SOL. INJ. IN STILOU PREUMPLU T 300mcg MEDA PHARMA GMBH & CO KG GERMANIA CUTIE CU 1 STILOU AUTOINJECTOR PREUMPLUT CU 2ML PENTRU O DOZA UNICA DE 0,3ML PR 1 146,100000 178,360000 0,000000 4 W55629002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 12 4,044000 5,472000 22,543000 5 W54763001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CU PULB. PT. SOL. INJ./PERF. S 1 3,370000 4,560000 0,000000 6 W55369001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 7 W55629001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 8 W55423001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 9 W55424001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 10 W55370001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 11 W55630001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 12 W55630002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 12 21,346800 26,060400 20,445433 13 W54765001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 10,049600 14 W53595006 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 2g/0,25 g PULB. PT. SOL. PERF. 2g/0,25g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 4,044000 5,472000 10,127000 15 W53596003 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 4g/0.5g PULB. PT. SOL. PERF. 4g/0,5g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE CU 10 FLAC DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 17,789000 21,717000 0,000000 16 W13676001 J01DD12 CEFOPERAZONUM MEDOCEF 1 g PULB. PT. SOL. INJ. 1g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 8,412000 11,376000 6,538000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 17 W13677001 J01DD12 CEFOPERAZONUM MEDOCEF 2 g PULB. PT. SOL. INJ. 2g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 12,576000 16,992000 6,670000 18 W44045001 J01DD12 CEFOPERAZONUM CEFOZON 500 mg PULB. PT. SOL. INJ. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. S/P-RF 1 3,190000 4,310000 0,000000 19 W52795001 J01DD12 CEFOPERAZONUM CEFOZON 2 g PULB. PT. SOL. INJ./PERF. I.M./I.V. 2g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA A 20 ML CU PULB. PT. SOL. INJ./PERF. I.M./I.V. S/P-RF 1 10,480000 14,160000 0,000000 20 W44061001 J01DD12 CEFOPERAZONUM CEFOZON 1 g PULB. PT. SOL. INJ./PERF.I. M./I.V. 1g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 15 ML CU PULB. PT. SOL. INJ. I.M./PERF. I.V. S/P-RF 1 7,010000 9,480000 0,000000 21 W59077002 J01DH51 IMIPENEMUM + CILASTATINUM TIENAM I.V. 500 mg/500 mg PULB. PT. SOL. PERF. 500mg/50 0mg MERCK SHARP & DOHME ROMANIA TAVA CU 10 FLAC. DIN STICLA INCOLORA A 20 ML CU PULB. PT. SOL. PERF. PR 10 22,297200 27,220800 7,679200 22 W54471006 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF. S/P-RF 10 22,297200 27,220800 9,677200 23 W54471009 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 30 ML PULB. PT. SOL. PERF. S/P-RF 10 22,297200 27,220800 6,801200 24 W61198003 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN ATB 500 mg/500 mg PULB. PT. SOL. PERF. 500mg/50 0mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA TIP III, CU CAPACITATEA DE 20 ML, CONTINANAD PULB. PT. SOL. PERF. PR 10 18,582000 22,685000 0,000000 25 W54471007 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 30 ML PULB. PT. SOL. PERF. S/P-RF 1 22,297200 27,220800 10,559200 26 W54471008 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 30 ML PULB. PT. SOL. PERF. S/P-RF 5 22,297200 27,220800 6,803200 27 W54471002 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF. S/P-RF 5 18,922000 23,924000 0,000000 28 W54471003 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF. S/P-RF 10 18,582000 22,685000 0,000000 29 W54471005 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF. S/P-RF 5 22,297200 27,220800 9,829200 30 W54532001 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN KABI 500mg/500mg PULB. PT. SOL. PERF. 500mg/50 0mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. S/P-RF 10 18,581000 22,684000 0,000000 31 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 163,000000 181,485000 0,000000 32 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5 ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 911,260000 1.031,420000 0,000000 33 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBUR G CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINÂND 300 ML SOL. PERF. PR 1 112,480000 137,320000 0,000000 34 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF. PR 1 116,710000 142,262400 0,217600 35 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 126,315600 142,262400 42,337600 36 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPATA CU UN CONECTOR (DIN RASINA PE BAZA DE POLIOEFINE)SI CU O SUPRA-PUNGA (DIN COPOLIMER POLIESTER/PROPILENA) PRF 10 105,263000 118,552000 0,000000 37 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 1,998750 2,614500 3,788000 38 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,998750 2,614500 0,805500 39 W42371002 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 1,665625 2,178750 0,000000 40 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,998750 2,614500 2,056928 41 W52224001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,870000 6,580000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 42 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,680000 6,320000 0,000000 43 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLIC A CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 44 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 45 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 46 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS. PRF 1 4,620000 6,240000 0,000000 47 W56446001 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 48 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 49 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,544000 7,488000 3,542000 50 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 51 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 52 W43288001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 53 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 54 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 55 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 4,460000 5,834285 0,000000 56 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,356000 1,832570 0,133144 57 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,265714 1,710000 0,000000 58 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 59 W57238001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 1,356000 1,832570 0,947430 60 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 61 W43287001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,130000 1,527142 0,000000 62 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,560287 63 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,946001 64 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 65 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 2,444572 66 W58322001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON PEID DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 LINGURITA DOZATOARE A 5ML, CU PULB. PENTRU 35 ML SUSP. ORALA PRF 1 21,880000 29,570000 0,000000 67 W55502017 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 1 36,250000 47,420000 0,000000 68 W55502009 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 1 18,130000 24,500000 0,000000 69 W12072001 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML S/PR-F 1 21,516000 26,266800 21,183200 70 W55502001 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 1 9,060000 12,250000 0,000000 71 W58456003 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 200 ML SOL. PERF. PR 10 43,500000 56,904000 32,740000 72 W58456002 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 100 ML SOL. PERF. PR 20 21,516000 26,266800 11,204200 73 W60056005 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLIC A CEHA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 17,930000 21,889000 0,000000 74 W57368003 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 21,516000 26,266800 28,873200

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 75 W58456001 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 50 ML SOL. PERF. PR 20 10,872000 14,700000 6,937500 76 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 119,853214 132,002857 0,000000 77 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 32,232500 36,496071 0,000000 78 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 435,570000 512,920000 0,000000 79 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 2.044,020000 2.266,130000 0,000000 80 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 59,167800 65,256000 23,726166 81 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM. PRF 60 49,306500 54,380000 0,000000 82 W04406001 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 1,706500 2,083300 0,000000 83 W04407001 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 3,228200 3,941000 0,000000 84 W42264003 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROR EZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 3,078833 3,673833 0,000000 85 W42265003 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROR EZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 6,008166 6,866833 0,000000 86 W56657001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 1,109300 1,354200 0,000000 87 W56643001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PRF 100 1,109300 1,354200 0,000000 88 W52877001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS. P-RF/R 100 1,109300 1,354200 0,000000 89 W58520001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 100 1,109300 1,354200 0,000000 90 W56644001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. PRF 50 2,136400 2,608200 0,000000 91 W55987001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF 50 2,136400 2,608200 0,000000 92 W58523001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 50 2,136400 2,608200 0,000000 93 W52876001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM. P-RF/R 50 2,136400 2,608200 0,000000 94 W56003001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM. P-RF 50 3,003000 3,666000 0,000000 95 W58368003 L04AD01 CICLOSPORINUM EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 5,105200 6,232400 0,000000 96 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 1,865200 2,358400 0,000000 97 W58149003 L04AD01 CICLOSPORINUM EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 1,176000 1,487000 0,000000 98 W58367003 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 2,075600 2,533800 0,000000 99 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 3,136200 3,828600 0,000000 100 W56579003 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 1,235600 1,562200 0,000000 101 W53729001 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 1,900800 2,403400 0,000000 102 W55262007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 1,235600 1,562200 0,000000 103 W56580003 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 2,427400 2,963400 0,000000 104 W55263007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 2,427400 2,963400 0,000000 105 W53730001 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 3,734800 4,559400 0,000000 106 W53731001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 17,573400 19,918000 0,000000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA

P9.3: TRANSPLANT HEPATIC

1 W00188001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 0,603000 0,788600 0,000000 2 W59934001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6L 60 0,602833 0,788500 0,000000 3 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 0,723400 0,946200 0,267200 4 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 0,723400 0,946200 0,206200 5 W58710002 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 2,196700 2,681700 0,000000 6 W58363001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5 ml DR. FALK PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP P6L 1 77,100000 97,490000 0,000000 7 W13613002 B01AB05 ENOXAPARINUM CLEXANE 2000ui anti-Xa/0,2ml SOL. INJ. 2000ui anti- Xa/0,2ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML SOL. INJ. PR/PRF 10 5,083000 6,427000 0,000000 8 W13612002 B01AB05 ENOXAPARINUM CLEXANE 4000ui anti-Xa/0,4ml SOL. INJ. 4000ui anti- Xa/0,4ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML SOL. INJ. PR/PRF 10 9,222000 11,660000 0,000000 9 W13611002 B01AB05 ENOXAPARINUM CLEXANE 6000ui anti-Xa/0,6ml SOL. INJ. 6000ui anti- Xa/0,6ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. PR/PRF 10 12,277000 14,988000 0,000000 10 W13610002 B01AB05 ENOXAPARINUM CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti- Xa/0,8ml LABORATOIRE AVENTIS FRANTA CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,8 ML SOL INJ. PR/PRF 6 15,641666 19,778333 0,000000 11 W58879001 B01AC11 ILOPROSTUM** ILOMEDIN 20 CONC. PT. SOL. PERF. 20μg/ml BAYER PHARMA AG GERMANIA CUTIE X 5 FIOLE STICLA INCOLORA X 1 ML CONC. PT. SOL. PERF. S/P-RF 5 131,884000 151,384000 0,000000 12 W61568004 B01AC11 ILOPROSTUM** VENTAVIS 10μg/ml SOL. DE INHALAT PRIN NEBULIZ. 10μg/ml BAYER PHARMA AG GERMANIA CUTIE X 30 FIOLE X 1 ML SOL. DE INHALAT PRIN NEBULIZ. PR 30 54,208000 60,358333 0,000000 13 W00257001 B01AD02 ALTEPLASUM** ACTILYSE PULB+SOL V. PT. SOL. INJ 50mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1 FLACON SOLV. + CANULA DE TRANSFER S 1 1.490,890000 1.663,220000 0,000000 14 W54011001 B02AA02 ACIDUM TRANEXAMICUM4) EXACYL SOL. INJ. 500mg/5 ml CN UNIFARM ROMANIA CUTIE X 5 FIOLE X 5ML SOL. INJ. X 5 1,890000 2,554000 0,000000 15 W53034001 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 1mg (50 KUI) PULB. + SOLV. PT. SOL. INJ. 50 KIU NOVO NORDISK A/S DANEMAR CA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE P-RF/R 1 2.406,410000 2.661,140000 0,000000 16 W58726003 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUROCARD 50 mg/20 mg CAPS. 50mg/20 mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 0,805666 1,089000 0,000000 17 W07005001 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUREX 50 CAPS. 50mg/20 mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 0,895000 1,209500 0,000000 18 W60585001 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIOCOR 50 mg/20 mg CAPS. 50mg/20 mg SANIENCE S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P6L 20 0,862500 1,165500 0,000000 19 W60585002 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIOCOR 50 mg/20 mg CAPS. 50mg/20 mg SANIENCE S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 0,776333 1,049333 0,000000 20 W53989001 H01BA02 DESMOPRESSINUM MINIRIN 0,2 mg COMPR. 0,2mg FERRING GMBH GERMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF 30 2,371999 2,999200 0,846133 21 W53832002 H01BA02 DESMOPRESSINUM DESMOPRESINA TEVA 0,2mg COMPR. 0,2mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL- PVC/AL X 30 COMPR. P-RF 30 1,976666 2,499333 0,000000 22 W53992002 H01BA02 DESMOPRESSINUM MINIRIN MELT 120 mcg LIOF. ORAL 120mcg FERRING GMBH GERMANIA CUTIE X 3 BLIST. AL/AL X 10 UNITATI DOZATE LIOF. ORAL P-RF 30 4,953333 6,047000 0,000000 23 W53991001 H01BA02 DESMOPRESSINUM MINIRIN MELT 60 mcg LIOF. ORAL 60mcg FERRING GMBH GERMANIA CUTIE X 1 BLIST AL/AL X 10 UNITATI DOZATE LIOF. ORAL P-RF 10 2,551000 3,337000 0,000000 24 W53991002 H01BA02 DESMOPRESSINUM MINIRIN MELT 60 mcg LIOF. ORAL 60mcg FERRING GMBH GERMANIA CUTIE X 3 BLIST AL/AL X 10 UNITATI DOZATE LIOF. ORAL P-RF 30 2,506666 3,169333 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 25 W55629002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 12 4,044000 5,472000 22,543000 26 W54763001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CU PULB. PT. SOL. INJ./PERF. S 1 3,370000 4,560000 0,000000 27 W55369001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 28 W55629001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 29 W55423001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 30 W55424001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 31 W55370001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 32 W55630001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 33 W55630002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 12 21,346800 26,060400 20,445433 34 W54765001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 10,049600 35 W53595006 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 2g/0,25 g PULB. PT. SOL. PERF. 2g/0,25g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 4,044000 5,472000 10,127000 36 W53596003 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 4g/0.5g PULB. PT. SOL. PERF. 4g/0,5g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE CU 10 FLAC DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 17,789000 21,717000 0,000000 37 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 163,000000 181,485000 0,000000 38 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5 ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 911,260000 1.031,420000 0,000000 39 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBUR G CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINÂND 300 ML SOL. PERF. PR 1 112,480000 137,320000 0,000000 40 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF. PR 1 116,710000 142,262400 0,217600 41 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 126,315600 142,262400 42,337600 42 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPATA CU UN CONECTOR (DIN RASINA PE BAZA DE POLIOEFINE)SI CU O SUPRA-PUNGA (DIN COPOLIMER POLIESTER/PROPILENA) PRF 10 105,263000 118,552000 0,000000 43 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 119,853214 132,002857 0,000000 44 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 32,232500 36,496071 0,000000 45 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 435,570000 512,920000 0,000000 46 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 2.044,020000 2.266,130000 0,000000 47 W06665001 J02AX04 CASPOFUNGINUM** CANCIDAS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.246,420000 1.396,750000 0,000000 48 W06670001 J02AX04 CASPOFUNGINUM** CANCIDAS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.617,600000 1.801,340000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 49 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 59,167800 65,256000 23,726166 50 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM. PRF 60 49,306500 54,380000 0,000000 51 W54188003 J06BB04 IMUNOGLOBULINA ANTI-HEPATITICA B** HEPATECT CP 50 UI/ml SOL. PERF. 50 UI/ ml BIOTEST PHARMA GMBH GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 40 ML SOL. PERF. (2000UI) PR 1 3.044,440000 3.356,590000 0,000000 52 W53892001 L03AA02 FILGRASTIMUM (G-CSF) ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLU TA 60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 87,690000 110,870000 0,000000 53 W53893001 L03AA02 FILGRASTIMUM (G-CSF) ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLU TA 96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 139,560000 170,380000 0,000000 54 W53520001 L03AA02 FILGRASTIMUM (G-CSF) TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300mcg/0, 5ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF. S/P-RF/R 1 105,228000 127,437600 34,512400 55 W55757002 L03AA02 FILGRASTIMUM (G-CSF) NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300μg/0,5 ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 90,430000 106,198000 0,000000 56 W53523001 L03AA02 FILGRASTIMUM (G-CSF) TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480mcg/0, 8ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML SOL. INJ. SAU PERF. S/P-RF/R 1 167,472000 195,360000 72,090000 57 W55758002 L03AA02 FILGRASTIMUM (G-CSF) NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480μg/0,5 ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 142,358000 162,800000 0,000000 58 W04406001 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 1,706500 2,083300 0,000000 59 W04407001 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 3,228200 3,941000 0,000000 60 W42264003 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROR EZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 3,078833 3,673833 0,000000 61 W42265003 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROR EZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 6,008166 6,866833 0,000000 62 W56657001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 1,109300 1,354200 0,000000 63 W56643001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PRF 100 1,109300 1,354200 0,000000 64 W52877001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS. P-RF/R 100 1,109300 1,354200 0,000000 65 W58520001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 100 1,109300 1,354200 0,000000 66 W56644001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. PRF 50 2,136400 2,608200 0,000000 67 W55987001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF 50 2,136400 2,608200 0,000000 68 W58523001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 50 2,136400 2,608200 0,000000 69 W52876001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM. P-RF/R 50 2,136400 2,608200 0,000000 70 W56003001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM. P-RF 50 3,003000 3,666000 0,000000 71 W10576001 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR) P-RF/R 30 15,282333 17,929333 0,000000 72 W58368003 L04AD01 CICLOSPORINUM EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 5,105200 6,232400 0,000000 73 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 1,865200 2,358400 0,000000 74 W58149003 L04AD01 CICLOSPORINUM EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 1,176000 1,487000 0,000000 75 W58367003 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 2,075600 2,533800 0,000000 76 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 3,136200 3,828600 0,000000 77 W56579003 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 1,235600 1,562200 0,000000 78 W53729001 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 1,900800 2,403400 0,000000 79 W55262007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 1,235600 1,562200 0,000000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA

P9.4: TRANSPLANT RENAL combinat RINICHI si PANCREAS

1 W00188001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 0,603000 0,788600 0,000000 2 W59934001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6L 60 0,602833 0,788500 0,000000 3 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 0,723400 0,946200 0,267200 4 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 0,723400 0,946200 0,206200 5 W58710002 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 2,196700 2,681700 0,000000 6 W58363001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5 ml DR. FALK PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP P6L 1 77,100000 97,490000 0,000000 7 W00231001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,25 mcg CAPS. MOI 0,25mcg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN PPID X 50 CAPS. MOI P-RF 50 0,435800 0,589000 0,000000 8 W58167002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,25 mcg CAPS. MOI 0,25μg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF 30 0,522960 0,706800 0,058866 9 W44042001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,50 mcg CAPS. MOI 0,50mcg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 30 CAPS. MOI P-RF 30 0,803666 1,086333 0,000000 10 W58168002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,5 mcg CAPS. MOI 0,5μg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF 30 0,866666 1,133666 0,000000 11 W55847002 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2microgra me/ml LEO PHARMA A/S DANEMAR CA CUTIE CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. S 10 21,144000 25,813000 0,000000 12 W55847001 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2microgra me/ml LEO PHARMA A/S DANEMAR CA CUTIE CU 10 FIOLE DIN STICLA BRUNA X 0,5 ML SOL. INJ. S 10 11,086000 13,534000 0,000000 13 W43774001 B01AB04 DALTEPARINUM FRAGMIN 10000 UI/0,4 ml SOL. INJ. 10000UI/0 ,4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 5 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,4 ML SOLUTIE INJECTABILA S/P-RF 5 14,576000 18,430000 0,000000 14 W43775001 B01AB04 DALTEPARINUM FRAGMIN 12500 UI/0,5 ml SOL. INJ. 12500 UI/0,5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 5 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,5 ML SOLUTIE INJECTABILA S/P-RF 5 18,506000 23,398000 0,000000 15 W52805003 B01AB04 DALTEPARINUM FRAGMIN15000 UI/0,6 ml SOL. INJ. 15000ui/0 ,6ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 5 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,6 ML SOLUTIE INJECTABILA S/P-RF 5 22,400000 27,346000 0,000000 16 W43776001 B01AB04 DALTEPARINUM FRAGMIN 18000 UI/0,72 ml SOL. INJ. 18000 UI/0,72ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 5 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,72 ML SOLUTIE INJECTABILA S/P-RF 5 27,466000 33,530000 0,000000 17 W52809004 B01AB04 DALTEPARINUM FRAGMIN 2500 UI/0,2 ml SOL. INJ. 2500ui/0, 2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA FARA SISTEM DE BLOCARE A ACULUI NEEDLE- TRAP X 0,2 ML SOLUTIE INJECTABILA S/P-RF 10 4,739000 6,199000 0,000000 18 W52808004 B01AB04 DALTEPARINUM FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000ui/0, 2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 10 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,2 ML SOLUTIE INJECTABILA S/P-RF 10 9,056000 11,451000 0,000000 19 W52807002 B01AB04 DALTEPARINUM FRAGMIN 7500 UI/0,3 ml SOL. INJ. 7500ui/0, 3ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 10 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,3 ML SOLUTIE INJECTABILA S/P-RF 10 11,200000 13,673000 0,000000 20 W13613002 B01AB05 ENOXAPARINUM CLEXANE 2000ui anti-Xa/0,2ml SOL. INJ. 2000ui anti- Xa/0,2ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML SOL. INJ. PR/PRF 10 5,083000 6,427000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 21 W13612002 B01AB05 ENOXAPARINUM CLEXANE 4000ui anti-Xa/0,4ml SOL. INJ. 4000ui anti- Xa/0,4ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML SOL. INJ. PR/PRF 10 9,222000 11,660000 0,000000 22 W13611002 B01AB05 ENOXAPARINUM CLEXANE 6000ui anti-Xa/0,6ml SOL. INJ. 6000ui anti- Xa/0,6ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. PR/PRF 10 12,277000 14,988000 0,000000 23 W13610002 B01AB05 ENOXAPARINUM CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti- Xa/0,8ml LABORATOIRE AVENTIS FRANTA CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,8 ML SOL INJ. PR/PRF 6 15,641666 19,778333 0,000000 24 W42955001 H01CB02 OCTREOTIDUM** SANDOSTATIN LAR 20 mg PULB. + SOLV. PT. SUSP. INJ. (I.M.) CU ELIB. PRELU 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE S/P-RF 1 2.643,630000 2.919,710000 0,000000 25 W42954001 H01CB02 OCTREOTIDUM** SANDOSTATIN LAR 10 mg PULB.+SOL V.PT.SUSP. INJ. (I.M.) CU ELIB. PRELUNG. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE S/P-RF 1 1.358,910000 1.519,360000 0,000000 26 W42956001 H01CB02 OCTREOTIDUM** SANDOSTATIN LAR 30 mg PULB.+SOL V.PT.SUSP. INJ. (I.M.) CU ELIB. PRELUNG. 30mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULB. + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE S/P-RF 1 3.950,440000 4.344,140000 0,000000 27 W59079001 H01CB02 OCTREOTIDUM** SANDOSTATIN 0,1 mg/ml SOL. INJ. 0,1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. PR 5 6,750000 8,830000 0,000000 28 W55629002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 12 4,044000 5,472000 22,543000 29 W54763001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CU PULB. PT. SOL. INJ./PERF. S 1 3,370000 4,560000 0,000000 30 W55369001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 31 W55629001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 32 W55423001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 33 W55424001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 34 W55370001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 35 W55630001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 36 W55630002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 12 21,346800 26,060400 20,445433 37 W54765001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 10,049600 38 W53595006 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 2g/0,25 g PULB. PT. SOL. PERF. 2g/0,25g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 4,044000 5,472000 10,127000 39 W53596003 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 4g/0.5g PULB. PT. SOL. PERF. 4g/0,5g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE CU 10 FLAC DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 17,789000 21,717000 0,000000 40 W13105001 J01XA02 TEICOPLANINUM TARGOCID (R) 400 mg LIOF. + SOLV. PT. SOL. INJ. 400mg AVENTIS PHARMA LTD. MAREA BRITANIE CUTIE X 1 FLAC. LIOF. + O FIOLA SOLV. P-RF 1 106,430000 129,930000 0,000000 41 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 163,000000 181,485000 0,000000 42 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5 ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 911,260000 1.031,420000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 43 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBUR G CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINÂND 300 ML SOL. PERF. PR 1 112,480000 137,320000 0,000000 44 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF. PR 1 116,710000 142,262400 0,217600 45 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 126,315600 142,262400 42,337600 46 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPATA CU UN CONECTOR (DIN RASINA PE BAZA DE POLIOEFINE)SI CU O SUPRA-PUNGA (DIN COPOLIMER POLIESTER/PROPILENA) PRF 10 105,263000 118,552000 0,000000 47 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 1,998750 2,614500 3,788000 48 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,998750 2,614500 0,805500 49 W42371002 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 1,665625 2,178750 0,000000 50 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,998750 2,614500 2,056928 51 W52224001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,870000 6,580000 0,000000 52 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,680000 6,320000 0,000000 53 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLIC A CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 54 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 55 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 56 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS. PRF 1 4,620000 6,240000 0,000000 57 W56446001 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 58 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 59 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,544000 7,488000 3,542000 60 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 61 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 62 W43288001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 63 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 64 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 65 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 4,460000 5,834285 0,000000 66 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,356000 1,832570 0,133144 67 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,265714 1,710000 0,000000 68 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 69 W57238001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 1,356000 1,832570 0,947430 70 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 71 W43287001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,130000 1,527142 0,000000 72 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,560287 73 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,946001

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 74 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 75 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 2,444572 76 W58322001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON PEID DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 LINGURITA DOZATOARE A 5ML, CU PULB. PENTRU 35 ML SUSP. ORALA PRF 1 21,880000 29,570000 0,000000 77 W55502017 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 1 36,250000 47,420000 0,000000 78 W55502009 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 1 18,130000 24,500000 0,000000 79 W12072001 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML S/PR-F 1 21,516000 26,266800 21,183200 80 W55502001 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 1 9,060000 12,250000 0,000000 81 W58456003 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 200 ML SOL. PERF. PR 10 43,500000 56,904000 32,740000 82 W58456002 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 100 ML SOL. PERF. PR 20 21,516000 26,266800 11,204200 83 W60056005 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLIC A CEHA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 17,930000 21,889000 0,000000 84 W57368003 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 21,516000 26,266800 28,873200 85 W58456001 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 50 ML SOL. PERF. PR 20 10,872000 14,700000 6,937500 86 W43051001 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 1,586666 2,144666 0,000000 87 W03837002 J02AC02 ITRACONAZOLUM ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 1,903999 2,573599 0,620401 88 W53958001 J02AC02 ITRACONAZOLUM MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF 15 1,586666 2,144666 0,000000 89 W52343006 J02AC02 ITRACONAZOLUM OMICRAL 100 mg CAPS. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 1,586666 2,144666 0,000000 90 W59235001 J02AC02 ITRACONAZOLUM ITRACONAZOL ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 1,586666 2,144666 0,000000 91 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 119,853214 132,002857 0,000000 92 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 32,232500 36,496071 0,000000 93 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 435,570000 512,920000 0,000000 94 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 2.044,020000 2.266,130000 0,000000 95 W06665001 J02AX04 CASPOFUNGINUM** CANCIDAS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.246,420000 1.396,750000 0,000000 96 W06670001 J02AX04 CASPOFUNGINUM** CANCIDAS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.617,600000 1.801,340000 0,000000 97 W56038001 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0,636000 0,859800 0,211200 98 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,636000 0,859800 0,188700 99 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,636000 0,859800 0,251200 100 W53675003 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 0,636000 0,833260 0,000000 101 W53676001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 1,495000 2,020000 0,000000 102 W13972001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,636000 0,859800 0,033700 103 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,636000 0,859800 0,030200 104 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,636000 0,859800 0,033700

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 105 W06667003 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 20 0,530000 0,716500 0,000000 106 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,636000 0,859800 0,033700 107 W06668003 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 10 1,794000 2,424000 0,334000 108 W00058001 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL. INJ./PERF. S/P-RF 5 38,600000 47,124000 0,000000 109 W58707001 J05AB11 VALACYCLOVIRUM VALTREX 500 mg COMPR. FILM. 500 mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM. PRF 10 2,780400 3,757200 0,903800 110 W60087001 J05AB11 VALACYCLOVIRUM VALACICLOVIR ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC ALB OPAC/AL X 10 COMPR. FILM. PRF 10 2,317000 3,131000 0,000000 111 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 59,167800 65,256000 23,726166 112 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM. PRF 60 49,306500 54,380000 0,000000 113 W54752001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 391,580000 464,970000 0,000000 114 W54752002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 870,210000 986,680000 0,000000 115 W54752003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 1.710,420000 1.902,510000 0,000000 116 W54752004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA, CU CAPACITATE DE 250ML, A 200ML SOLUTIE PERFUZABILA S 1 3.390,820000 3.734,150000 0,000000 117 W51530001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL. PERF.(1G/10ML) S 1 190,360000 232,390000 0,000000 118 W51530006 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL. PERF.(30G/300ML) S 1 5.766,650000 6.323,810000 0,000000 119 W51530003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL. PERF.(5G/50ML) S 1 912,190000 1.032,440000 0,000000 120 W51530004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL. PERF.(10G/100ML) S 1 1.847,580000 2.059,644000 78,286000 121 W51530005 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL. PERF.(20G/200ML) S 1 3.736,820000 4.111,290000 0,000000 122 W43965001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.539,650000 1.716,370000 0,000000 123 W43962001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 204,810000 250,030000 0,000000 124 W43963001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 407,410000 482,230000 0,000000 125 W59114003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 100 ML SOL. PERF. PRF 1 894,400000 1.013,050000 0,000000 126 W59114001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 20 ML SOL. PERF. PRF 1 190,170000 232,160000 0,000000 127 W59114004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 200 ML SOL. PERF. PRF 1 1.758,800000 1.955,240000 0,000000 128 W59114002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 50 ML SOL. PERF. PRF 1 462,170000 541,920000 0,000000 129 W13462002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 100 ML S 1 894,000000 1.012,610000 0,000000 130 W13462003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S 1 1.837,780000 2.041,330000 0,000000 131 W13462001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S 1 481,950000 563,480000 0,000000 132 W43964001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 784,820000 893,600000 0,000000 133 W12490001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 0,401400 0,542400 0,000000 134 W52215001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 200 mg PULB. PT. SOL. PERF./INJ. I.V. 200mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ S 1 11,760000 15,890000 0,000000 135 W53892001 L03AA02 FILGRASTIMUM (G-CSF) ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLU TA 60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 87,690000 110,870000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 136 W53893001 L03AA02 FILGRASTIMUM (G-CSF) ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLU TA 96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 139,560000 170,380000 0,000000 137 W53520001 L03AA02 FILGRASTIMUM (G-CSF) TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300mcg/0, 5ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF. S/P-RF/R 1 105,228000 127,437600 34,512400 138 W55757002 L03AA02 FILGRASTIMUM (G-CSF) NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300μg/0,5 ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 90,430000 106,198000 0,000000 139 W53523001 L03AA02 FILGRASTIMUM (G-CSF) TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480mcg/0, 8ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML SOL. INJ. SAU PERF. S/P-RF/R 1 167,472000 195,360000 72,090000 140 W55758002 L03AA02 FILGRASTIMUM (G-CSF) NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480μg/0,5 ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 142,358000 162,800000 0,000000 141 W04406001 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 1,706500 2,083300 0,000000 142 W04407001 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 3,228200 3,941000 0,000000 143 W42264003 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROR EZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 3,078833 3,673833 0,000000 144 W42265003 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROR EZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 6,008166 6,866833 0,000000 145 W56657001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 1,109300 1,354200 0,000000 146 W56643001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PRF 100 1,109300 1,354200 0,000000 147 W52877001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS. P-RF/R 100 1,109300 1,354200 0,000000 148 W58520001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 100 1,109300 1,354200 0,000000 149 W56644001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. PRF 50 2,136400 2,608200 0,000000 150 W55987001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF 50 2,136400 2,608200 0,000000 151 W58523001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 50 2,136400 2,608200 0,000000 152 W52876001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM. P-RF/R 50 2,136400 2,608200 0,000000 153 W56003001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM. P-RF 50 3,003000 3,666000 0,000000 154 W10576001 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR) P-RF/R 30 15,282333 17,929333 0,000000 155 W13098001 L04AC02 BASILIXIMABUM** SIMULECT 20 mg LIOF. + SOLV. PT. SOL. INJ./PERF. 20mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. CU LIOF.+ 1 FIOLA SOLV. APA PT. PREP. INJ. S 1 4.015,330000 4.414,870000 0,000000 156 W58368003 L04AD01 CICLOSPORINUM EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 5,105200 6,232400 0,000000 157 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 1,865200 2,358400 0,000000 158 W58149003 L04AD01 CICLOSPORINUM EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 1,176000 1,487000 0,000000 159 W58367003 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 2,075600 2,533800 0,000000 160 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 3,136200 3,828600 0,000000 161 W56579003 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 1,235600 1,562200 0,000000 162 W53729001 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 1,900800 2,403400 0,000000 163 W55262007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 1,235600 1,562200 0,000000 164 W56580003 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 2,427400 2,963400 0,000000 165 W55263007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 2,427400 2,963400 0,000000 166 W53730001 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 3,734800 4,559400 0,000000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA

P9.5: TRANSPLANT CELULE PANCREATICE

1 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 163,000000 181,485000 0,000000 2 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5 ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 911,260000 1.031,420000 0,000000 3 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBUR G CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINÂND 300 ML SOL. PERF. PR 1 112,480000 137,320000 0,000000 4 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF. PR 1 116,710000 142,262400 0,217600 5 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 126,315600 142,262400 42,337600 6 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPATA CU UN CONECTOR (DIN RASINA PE BAZA DE POLIOEFINE)SI CU O SUPRA-PUNGA (DIN COPOLIMER POLIESTER/PROPILENA) PRF 10 105,263000 118,552000 0,000000 7 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 119,853214 132,002857 0,000000 8 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 32,232500 36,496071 0,000000 9 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 435,570000 512,920000 0,000000 10 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 2.044,020000 2.266,130000 0,000000 11 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 59,167800 65,256000 23,726166 12 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM. PRF 60 49,306500 54,380000 0,000000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA

P9.6: TRANSPLANT PULMONAR

1 W13613002 B01AB05 ENOXAPARINUM CLEXANE 2000ui anti-Xa/0,2ml SOL. INJ. 2000ui anti- Xa/0,2ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML SOL. INJ. PR/PRF 10 5,083000 6,427000 0,000000 2 W13612002 B01AB05 ENOXAPARINUM CLEXANE 4000ui anti-Xa/0,4ml SOL. INJ. 4000ui anti- Xa/0,4ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML SOL. INJ. PR/PRF 10 9,222000 11,660000 0,000000 3 W13611002 B01AB05 ENOXAPARINUM CLEXANE 6000ui anti-Xa/0,6ml SOL. INJ. 6000ui anti- Xa/0,6ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. PR/PRF 10 12,277000 14,988000 0,000000 4 W13610002 B01AB05 ENOXAPARINUM CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti- Xa/0,8ml LABORATOIRE AVENTIS FRANTA CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,8 ML SOL INJ. PR/PRF 6 15,641666 19,778333 0,000000 5 W54011001 B02AA02 ACIDUM TRANEXAMICUM4) EXACYL SOL. INJ. 500mg/5 ml CN UNIFARM ROMANIA CUTIE X 5 FIOLE X 5ML SOL. INJ. X 5 1,890000 2,554000 0,000000 6 W02947001 C01CA24 EPINEPHRINUM ADRENALINA 1 mg SOL. INJ. 1mg/ml TERAPIA SA ROMANIA CUTIE X 100 FIOLE X 1 ML S 100 1,569300 1,915800 0,000000 7 W60389001 C01CA24 EPINEPHRINUM EPIPEN 150 micrograme SOL. INJ. IN STILOU PREUMPLU T 150mcg MEDA PHARMA GMBH & CO KG GERMANIA CUTIE CU 1 STILOU AUTOINJECTOR PREUMPLUT CU 2ML PENTRU O DOZA UNICA DE 0,3ML PR 1 146,100000 178,360000 0,000000 8 W60390001 C01CA24 EPINEPHRINUM EPIPEN 300 micrograme SOL. INJ. IN STILOU PREUMPLU T 300mcg MEDA PHARMA GMBH & CO KG GERMANIA CUTIE CU 1 STILOU AUTOINJECTOR PREUMPLUT CU 2ML PENTRU O DOZA UNICA DE 0,3ML PR 1 146,100000 178,360000 0,000000 9 W55629002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 12 4,044000 5,472000 22,543000 10 W54763001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CU PULB. PT. SOL. INJ./PERF. S 1 3,370000 4,560000 0,000000 11 W55369001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 12 W55629001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 13 W55423001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 4,044000 5,472000 26,688000 14 W55424001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 15 W55370001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 16 W55630001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 29,479600 17 W55630002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 12 21,346800 26,060400 20,445433 18 W54765001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 21,346800 26,060400 10,049600 19 W53595006 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 2g/0,25 g PULB. PT. SOL. PERF. 2g/0,25g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 4,044000 5,472000 10,127000 20 W53596003 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 4g/0.5g PULB. PT. SOL. PERF. 4g/0,5g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE CU 10 FLAC DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 17,789000 21,717000 0,000000 21 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 163,000000 181,485000 0,000000 22 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5 ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 911,260000 1.031,420000 0,000000 23 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBUR G CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINÂND 300 ML SOL. PERF. PR 1 112,480000 137,320000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 24 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF. PR 1 116,710000 142,262400 0,217600 25 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 126,315600 142,262400 42,337600 26 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPATA CU UN CONECTOR (DIN RASINA PE BAZA DE POLIOEFINE)SI CU O SUPRA-PUNGA (DIN COPOLIMER POLIESTER/PROPILENA) PRF 10 105,263000 118,552000 0,000000 27 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 1,998750 2,614500 3,788000 28 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,998750 2,614500 0,805500 29 W42371002 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 1,665625 2,178750 0,000000 30 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,998750 2,614500 2,056928 31 W52224001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,870000 6,580000 0,000000 32 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,680000 6,320000 0,000000 33 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLIC A CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 34 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 35 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 36 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS. PRF 1 4,620000 6,240000 0,000000 37 W56446001 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 38 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 39 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,544000 7,488000 3,542000 40 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 41 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 42 W43288001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 43 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 44 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 45 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 4,460000 5,834285 0,000000 46 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,356000 1,832570 0,133144 47 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,265714 1,710000 0,000000 48 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 49 W57238001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 1,356000 1,832570 0,947430 50 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 51 W43287001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,130000 1,527142 0,000000 52 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,560287 53 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,946001 54 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 55 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 2,444572

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 56 W58322001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON PEID DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 LINGURITA DOZATOARE A 5ML, CU PULB. PENTRU 35 ML SUSP. ORALA PRF 1 21,880000 29,570000 0,000000 57 W55502017 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 1 36,250000 47,420000 0,000000 58 W55502009 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 1 18,130000 24,500000 0,000000 59 W12072001 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML S/PR-F 1 21,516000 26,266800 21,183200 60 W55502001 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 1 9,060000 12,250000 0,000000 61 W58456003 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 200 ML SOL. PERF. PR 10 43,500000 56,904000 32,740000 62 W58456002 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 100 ML SOL. PERF. PR 20 21,516000 26,266800 11,204200 63 W60056005 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLIC A CEHA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 17,930000 21,889000 0,000000 64 W57368003 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 21,516000 26,266800 28,873200 65 W58456001 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 50 ML SOL. PERF. PR 20 10,872000 14,700000 6,937500 66 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 119,853214 132,002857 0,000000 67 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 32,232500 36,496071 0,000000 68 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 435,570000 512,920000 0,000000 69 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 2.044,020000 2.266,130000 0,000000 70 W56038001 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0,636000 0,859800 0,211200 71 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,636000 0,859800 0,188700 72 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,636000 0,859800 0,251200 73 W53675003 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 0,636000 0,833260 0,000000 74 W53676001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 1,495000 2,020000 0,000000 75 W13972001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,636000 0,859800 0,033700 76 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,636000 0,859800 0,030200 77 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,636000 0,859800 0,033700 78 W06667003 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 20 0,530000 0,716500 0,000000 79 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,636000 0,859800 0,033700 80 W06668003 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 10 1,794000 2,424000 0,334000 81 W00058001 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL. INJ./PERF. S/P-RF 5 38,600000 47,124000 0,000000 82 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 59,167800 65,256000 23,726166 83 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM. PRF 60 49,306500 54,380000 0,000000 84 W04406001 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 1,706500 2,083300 0,000000 85 W04407001 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 3,228200 3,941000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 86 W42264003 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROR EZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 3,078833 3,673833 0,000000 87 W42265003 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROR EZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 6,008166 6,866833 0,000000 88 W56657001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 1,109300 1,354200 0,000000 89 W56643001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PRF 100 1,109300 1,354200 0,000000 90 W52877001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS. P-RF/R 100 1,109300 1,354200 0,000000 91 W58520001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 100 1,109300 1,354200 0,000000 92 W56644001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. PRF 50 2,136400 2,608200 0,000000 93 W55987001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF 50 2,136400 2,608200 0,000000 94 W58523001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 50 2,136400 2,608200 0,000000 95 W52876001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM. P-RF/R 50 2,136400 2,608200 0,000000 96 W56003001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM. P-RF 50 3,003000 3,666000 0,000000 97 W13098001 L04AC02 BASILIXIMABUM** SIMULECT 20 mg LIOF. + SOLV. PT. SOL. INJ./PERF. 20mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. CU LIOF.+ 1 FIOLA SOLV. APA PT. PREP. INJ. S 1 4.015,330000 4.414,870000 0,000000 98 W58368003 L04AD01 CICLOSPORINUM EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 5,105200 6,232400 0,000000 99 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 1,865200 2,358400 0,000000 100 W58149003 L04AD01 CICLOSPORINUM EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 1,176000 1,487000 0,000000 101 W58367003 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 2,075600 2,533800 0,000000 102 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 3,136200 3,828600 0,000000 103 W60846001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 0,555400 0,702300 0,000000 104 W56928001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 0,555400 0,702300 0,000000 105 W56508002 L04AX01 AZATHIOPRINUM IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PR 100 0,623900 0,788900 0,000000 106 W52049001 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,252600 0,341400 0,125600 107 W12691002 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,221500 0,299500 0,000000 108 W60291001 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0,252600 0,341400 0,043600 109 W60238002 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,210500 0,284500 0,000000 110 W41593001 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,252600 0,341400 0,057100 111 W42957001 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,252600 0,341400 0,042100 112 W42440001 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,252600 0,341400 0,057100 113 W58072001 N02AX02 TRAMADOLUM TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. PRF 30 0,483666 0,653666 0,000000 114 W60236002 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 0,466333 0,630333 0,000000 115 W58893002 N02AX02 TRAMADOLUM TRADOLAN RETARD 150 mg COMPR. ELIB. PREL. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,802800 1,085200 0,032800 116 W60237002 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 150 mg COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 0,669000 0,904333 0,000000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA

P9.7: TRATAMENTUL STARII POSTTRANSPLANT IN AMBULATORIU A PACIENTILOR TRANSPLANTATI

1 W00188001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 0,603000 0,788600 0,000000 2 W59934001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6L 60 0,602833 0,788500 0,000000 3 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 0,723400 0,946200 0,267200 4 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 0,723400 0,946200 0,206200 5 W58710002 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 2,196700 2,681700 0,000000 6 W58363001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5 ml DR. FALK PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP P6L 1 77,100000 97,490000 0,000000 7 W04224001 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,401800 0,543200 0,000000 8 W04222001 H02AB04 METHYLPREDNISOLONUM MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 0,913000 1,234000 0,000000 9 W04237001 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.S OL.INJ 250mg/4 ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV P-RF 1 15,150000 20,480000 0,000000 10 W08307001 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg PULB+SOL V. PT. SOL. INJ./PERF. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 6,520000 8,810000 0,000000 11 W08310001 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg PULB+SOL V. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 22,950000 31,020000 0,000000 12 W05242001 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,055320 0,072360 0,064640 13 W53341001 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,055320 0,072360 0,061140 14 W13686002 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,055320 0,072360 0,051306 15 W12565003 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR. P-RF/S 1000 0,046100 0,060300 0,000000 16 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,055320 0,072360 0,017973 17 W53671001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM BITRIM 400mg/80mg COMPR. 400mg/80 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,296500 0,400500 0,000000 18 W12479001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM CO - TRIM ELL COMPR. 400mg/80 mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,270000 0,365000 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 19 W05738001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM COMPR. 400mg/80 mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,257500 0,348000 0,000000 20 W05741001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80 mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,296500 0,400500 0,000000 21 W44046001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM EPITRIM SUSP. ORALA 200mg/40 mg /5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA BRUNA CU MASURA DOZATOARE X 100 ML P-RF 1 3,480000 4,710000 0,000000 22 W05739001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SUSP. ORALA 25mg/5m g/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 7,300000 9,860000 0,000000 23 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 1,998750 2,614500 3,788000 24 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,998750 2,614500 0,805500 25 W42371002 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 1,665625 2,178750 0,000000 26 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,998750 2,614500 2,056928 27 W52224001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,870000 6,580000 0,000000 28 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,680000 6,320000 0,000000 29 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLIC A CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 30 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 31 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 32 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS. PRF 1 4,620000 6,240000 0,000000 33 W56446001 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PRF 1 5,300000 7,160000 0,000000 34 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 35 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,544000 7,488000 3,542000 36 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 37 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 38 W43288001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 39 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 40 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 5,300000 7,160000 0,000000 41 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 4,460000 5,834285 0,000000 42 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,356000 1,832570 0,133144 43 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,265714 1,710000 0,000000 44 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 45 W57238001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 1,356000 1,832570 0,947430 46 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 47 W43287001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,130000 1,527142 0,000000 48 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,560287 49 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,946001 50 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 0,947430 51 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,356000 1,832570 2,444572

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 52 W58322001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON PEID DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 LINGURITA DOZATOARE A 5ML, CU PULB. PENTRU 35 ML SUSP. ORALA PRF 1 21,880000 29,570000 0,000000 53 W55502017 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 1 36,250000 47,420000 0,000000 54 W55502009 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 1 18,130000 24,500000 0,000000 55 W12072001 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML S/PR-F 1 21,516000 26,266800 21,183200 56 W55502001 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 1 9,060000 12,250000 0,000000 57 W58456003 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 200 ML SOL. PERF. PR 10 43,500000 56,904000 32,740000 58 W58456002 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 100 ML SOL. PERF. PR 20 21,516000 26,266800 11,204200 59 W60056005 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLIC A CEHA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 17,930000 21,889000 0,000000 60 W57368003 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 21,516000 26,266800 28,873200 61 W58456001 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 50 ML SOL. PERF. PR 20 10,872000 14,700000 6,937500 62 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 119,853214 132,002857 0,000000 63 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 32,232500 36,496071 0,000000 64 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 435,570000 512,920000 0,000000 65 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 2.044,020000 2.266,130000 0,000000 66 W60913001 J02AC04 POSACONAZOLUM** NOXAFIL 100mg CAPS. GASTROR EZ. 100mg MERCK SHARP & DOHME LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/PCTF/AL X 24 COMPRIMATE GASTROREZISTENTE PR 24 133,855416 147,492083 0,000000 67 W58194001 J02AC04 POSACONAZOLUM** NOXAFIL 40mg/ml SUSP. ORALA 40mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. X 105ML SUSP. ORALA P-RF/R 1 2.405,440000 2.660,080000 0,000000 68 W56038001 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0,636000 0,859800 0,211200 69 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,636000 0,859800 0,188700 70 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,636000 0,859800 0,251200 71 W53675003 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 0,636000 0,833260 0,000000 72 W53676001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 1,495000 2,020000 0,000000 73 W13972001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,636000 0,859800 0,033700 74 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,636000 0,859800 0,030200 75 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,636000 0,859800 0,033700 76 W06667003 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 20 0,530000 0,716500 0,000000 77 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,636000 0,859800 0,033700 78 W06668003 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 10 1,794000 2,424000 0,334000 79 W00058001 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL. INJ./PERF. S/P-RF 5 38,600000 47,124000 0,000000 80 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 59,167800 65,256000 23,726166 81 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM. PRF 60 49,306500 54,380000 0,000000 82 W55472002 J05AF05 LAMIVUDINUM LAMIVUDINE TEVA 100 mg COMPR. FILM. 100 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 2,243333 2,836666 0,000000

Nr. crt Cod CIM Grupa terapeutica Denumire generica Denumire comerciala Forma farmaceutic a Concentr atie / U.T. Firma Tara Ambalaj Prescriptie cant /am balaj Pret cu ridicata maximal de decontare / U.T. Pret de decontare / U.T. contribuție maximă asigurat / U.T. - farmacii comunitare 83 W07518002 J05AF05 LAMIVUDINUM ZEFFIX 100 mg COMPR. FILM. 100mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R 28 2,692000 3,403999 0,959572 84 W59320003 J05AF05 LAMIVUDINUM LAMIVUDINA AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 FLAC. PVC-ACLAR/AL X 60 COMPR. FILM. PR 60 3,304500 4,034166 0,000000 85 W03923002 J05AF05 LAMIVUDINUM EPIVIR 150mg COMPR. FILM. 150mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILM. P-RF/R 60 3,965400 4,840999 1,336334 86 W55474002 J05AF05 LAMIVUDINUM LAMIVUDINE TEVA PHARMA B.V. 300 mg COMPR. FILM. 300 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 8,751666 10,684000 0,000000 87 W03924002 J05AF05 LAMIVUDINUM EPIVIR 10mg/ml SOL. ORALA 10mg/ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLACON PEID X 240ML SOL. ORALA + 1 SERINGA DOZATOARE + 1 ADAPTOR P-RF/R 1 82,820000 104,720000 0,000000 88 W04406001 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 1,706500 2,083300 0,000000 89 W04407001 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 3,228200 3,941000 0,000000 90 W42264003 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROR EZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 3,078833 3,673833 0,000000 91 W42265003 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROR EZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 6,008166 6,866833 0,000000 92 W56657001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 1,109300 1,354200 0,000000 93 W56643001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PRF 100 1,109300 1,354200 0,000000 94 W52877001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS. P-RF/R 100 1,109300 1,354200 0,000000 95 W58520001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 100 1,109300 1,354200 0,000000 96 W56644001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. PRF 50 2,136400 2,608200 0,000000 97 W55987001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF 50 2,136400 2,608200 0,000000 98 W58523001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 50 2,136400 2,608200 0,000000 99 W52876001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM. P-RF/R 50 2,136400 2,608200 0,000000 100 W56003001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM. P-RF 50 3,003000 3,666000 0,000000 101 W10576001 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR) P-RF/R 30 15,282333 17,929333 0,000000 102 W58368003 L04AD01 CICLOSPORINUM EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 5,105200 6,232400 0,000000 103 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 1,865200 2,358400 0,000000 104 W58149003 L04AD01 CICLOSPORINUM EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 1,176000 1,487000 0,000000 105 W58367003 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 2,075600 2,533800 0,000000 106 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 3,136200 3,828600 0,000000 107 W56579003 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 1,235600 1,562200 0,000000 108 W53729001 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 1,900800 2,403400 0,000000 109 W55262007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 1,235600 1,562200 0,000000 110 W56580003 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 2,427400 2,963400 0,000000 111 W55263007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 2,427400 2,963400 0,000000 112 W53730001 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 3,734800 4,559400 0,000000 113 W53731001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 17,573400 19,918000 0,000000 114 W51974002 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 2,652600 3,238400 0,000000 115 W57352002 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 4,662600 5,692200 0,000000

Pentru următoarele DCI-uri: VORICONAZOLUM si VALGANCICLOVIRUM prescrierea și eliberarea medicamentelor se fac numai cu aprobarea Agenției Naționale de Transplant

P10: PROGRAM NATIONAL DE SUPLEERE A FUNCTIEI RENALE LA BOLNAVII CU INSUFICIENTA RENALA CRONICA

1 W00231001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,25 mcg CAPS. MOI 0,25mcg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN PPID X 50 CAPS. MOI P-RF 50 0,435800 0,589000 0,000000 2 W58167002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,25 mcg CAPS. MOI 0,25μg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF 30 0,522960 0,706800 0,058866 3 W44042001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,50 mcg CAPS. MOI 0,50mcg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 30 CAPS. MOI P-RF 30 0,803666 1,086333 0,000000 4 W58168002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,5 mcg CAPS. MOI 0,5μg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF 30 0,866666 1,133666 0,000000 5 W55847002 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2microgra me/ml LEO PHARMA A/S DANEMAR CA CUTIE CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. S 10 21,144000 25,813000 0,000000 6 W55847001 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2microgra me/ml LEO PHARMA A/S DANEMAR CA CUTIE CU 10 FIOLE DIN STICLA BRUNA X 0,5 ML SOL. INJ. S 10 11,086000 13,534000 0,000000 7 W51334002 A11CC04 CALCITRIOLUM** ROCALTROL CAPS. MOI 0,25mcg ROCHE ROMANIA S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC X 20 CAPS. MOI. P-RF 100 0,546500 0,691000 0,000000 8 W03447001 B01AB01 HEPARINUM** HEPARINE SODIQUE PANPHARMA SOL. INJ. 5000ui/ml LAB. PANPHARMA FRANTA CUTIE X 10 FLACOANE DIN STICLA INCOLORA X 5 ML SOL. INJ. S 10 10,891000 13,296000 0,000000 9 W13613002 B01AB05 ENOXAPARINUM** CLEXANE 2000ui anti-Xa/0,2ml SOL. INJ. 2000ui anti- Xa/0,2ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML SOL. INJ. PR/PRF 10 5,083000 6,427000 0,000000 10 W13612002 B01AB05 ENOXAPARINUM** CLEXANE 4000ui anti-Xa/0,4ml SOL. INJ. 4000ui anti- Xa/0,4ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML SOL. INJ. PR/PRF 10 9,222000 11,660000 0,000000 11 W13611002 B01AB05 ENOXAPARINUM** CLEXANE 6000ui anti-Xa/0,6ml SOL. INJ. 6000ui anti- Xa/0,6ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. PR/PRF 10 12,277000 14,988000 0,000000 12 W13610002 B01AB05 ENOXAPARINUM** CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti- Xa/0,8ml LABORATOIRE AVENTIS FRANTA CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,8 ML SOL INJ. PR/PRF 6 15,641666 19,778333 0,000000 13 W55557001 B01AB06 NADROPARINUM** FRAXIPARINE 2850 UI anti-factor Xa/0,3 ml SOL. INJ. 2850 ui AFXa/0,3 ml GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,3 ML SOL. INJ. S/P-RF 10 5,097000 6,445000 0,000000 14 W61290001 B01AB06 NADROPARINUM** FRAXIPARINE 2850 UI anti-factor Xa/0,3 ml SOL. INJ. 2850 ui AFXa/0,3 ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,3 ML SOL. INJ. S/P-RF 10 5,097000 6,445000 0,000000 15 W61293001 B01AB06 NADROPARINUM** FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4 ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ. S/P-RF 10 6,720000 8,497000 0,000000 16 W55558001 B01AB06 NADROPARINUM** FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4 ml GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ. S/P-RF 10 6,720000 8,497000 0,000000 17 W55559001 B01AB06 NADROPARINUM** FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6 ml GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ. S/P-RF 10 10,800000 13,185000 0,000000 18 W61291001 B01AB06 NADROPARINUM** FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6 ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ. S/P-RF 10 10,800000 13,185000 0,000000 19 W61292001 B01AB06 NADROPARINUM** FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AFXa/0,8 ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ. S/P-RF 10 13,121000 16,018000 0,000000 20 W55560001 B01AB06 NADROPARINUM** FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AFXa/0,8 ml GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ. S/P-RF 10 13,121000 16,018000 0,000000 21 W55414002 B01AB06 NADROPARINUM** FRAXIPARINE 9500 UI anti-factor Xa/1 ml multidoza SOL. INJ. 9500 UI AFXa/1 ml GLAXO GROUP LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA INCOLORA, MULTIDOZA X 5 ML SOL. INJ. S 10 78,696000 89,594000 0,000000

P11: PROGRAM NATIONAL DE SANATATE MINTALA

SUBPROGRAMUL TRATAMENTUL TOXICODEPENDENTELOR

1 W60453003 N07BB04 NALTREXONUM NALTREXONA TORREX 50 mg COMPR. FILM. 50mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. PRF 28 7,700000 9,400000 0,000000 2 W51921003 N07BC02 METHADONUM SINTALGON 2,5 mg COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-TS 50 0,374600 0,506400 0,000000 3 W55532002 N07BC02 METHADONUM METADON BIOEEL 20 mg COMPR. 20mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC-PVDC X 10 COMPR. P-TS 50 0,965800 1,263200 0,000000 4 W55533002 N07BC02 METHADONUM METADON BIOEEL 5 mg COMPR. 5mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC-PVDC X 10 COMPR. P-TS 50 0,241200 0,326000 0,000000 5 W58160001 N07BC51 COMBINATII ( BUPRENORPHINUM + NALAXONE) SUBOXONE 2mg/0,5mg COMPR. SUBLING. 2mg/0,5m g RECKITT BENCKISER HEALTHCARE INTERNATIONAL LTD. MAREA BRITANIE CUTIE X 7 COMPR. SUBLING. ( BLIST.NYLON/AL/PVC) P-TS; S 7 2,664285 3,601428 0,000000 6 W58161001 N07BC51 COMBINATII ( BUPRENORPHINUM + NALAXONE) SUBOXONE 8mg/2mg COMPR. SUBLING. 8mg/2mg RECKITT BENCKISER HEALTHCARE INTERNATIONAL LTD. MAREA BRITANIE CUTIE X 7 COMPR. SUBLING. ( BLIST.NYLON/AL/PVC) P-TS; S 7 8,084285 10,221428 0,000000

NOTA:

- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (*) se inițiaza de medicul de specialitate in limita competenței și poate fi prescris în continuare de medicul de familie pe baza scrisorii medicale emise de medicul de specialitate; - Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS; - Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS si cu aprobarea comisiilor de la nivelul Caselor udetene de Asi urari de Sanatate; - Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (****) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS si cu aprobarea comisiilor de la nivelul Casei Nationale de Asi urari de Sanatate; Medicamentul corespunzator DCI-ului notat cu ( 3 ) se livreaza impreuna cu solvent;

Medicamentele corespunzatoare DCI-urilor notate cu 4 () se importa cu avizul Ministerului Sanatatii;

Medicamentele din această sublistă se eliberează atât prin farmacii cu circuit închis câtși prin farmacii cu circuit deschis pe bază de prescripție medicală cu reținere în farmacie (P-RF).

SECȚIUNEA C2 - LISTA denumirilor comerciale și a prețurilor de decontare ale medicamentelor prevăzute la art. 2 alin. (4) din Anexa la Ordinul ministrului sănătății nr. 75/2009 pentru aprobarea Normelor privind modul de calcul al prețurilor la medicamentele de uz uman, cu modificările și completările ulterioare

VALABILĂ ÎNCEPÂND CU 01 IULIE 2015

ANEXA 2

Grupa

Denumire

Forma

Concentratie /

Pret cu ridicata

Pret de

contribuție maximă

Nr.crt

Prescriptie

Cod CIM

Denumire generica

terapeutica comerciala

farmaceutica

U.T. Firma Tara Ambalaj

cant/ambalaj

maximal de decontare / U.T.

decontare / U.T.

asigurat / U.T. - farmacii comunitare

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER

P6.4: MUCOVISCIDOZA

1 W58656002 A09AA02 PANCREATINUM** KREON 10000 CAPS. GASTROREZ. 150mg ABBOTT LABORATORIES GMBH GERMANIA FLACON DIN PEID CU 20 CAPS. GASTROREZ. OTC 20 0,446000 0,603000 0,000000 Mucoviscidoza 2 W59801002 A09AA02 PANCREATINUM** KREON 25000 CAPS. GASTROREZ. 300mg ABBOTT LABORATORIES GMBH GERMANIA FLACON DIN PEID CU 20 CAPS. GASTROREZ. OTC 20 0,906500 1,225500 0,000000 Mucoviscidoza

Conținută de Ordinul ministrului sănătății și al președintelui Casei Naționale de Asigurări de Sănătate nr. 815/468/2015 , publicat în Monitorul Oficial, Partea I, nr. 480 din 1 iulie 2015.

Textul este prelucrat automat din sursa indicată; numerotarea și legăturile pot conține erori. Referințele subliniate duc la actele citate, așa cum au fost identificate de noi.