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207 C09AA03 LISINOPRILUM LISIGAMMA 20 mg COMPR. 20mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 20.38 0.68 0.35 0.35
208 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 10.26 0.51 0.35 0.35
209 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 20 mg COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-6L 10 5.3 0.53 0.35 0.35
210 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 20 mg COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 15.63 0.52 0.35 0.35
211 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 40 mg COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 27.03 0.9 0.9 0.9
212 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 40 mg COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-6L 10 9.17 0.92 0.9 0.9
213 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER LTD. UNGARIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 12.08 0.43 0.15 0.15
214 C09AA03 LISINOPRILUM RANOLIP COMPR. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 7.67 0.26 0.15 0.15
215 C09AA03 LISINOPRILUM MEDAPRIL 5 COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 6.9 0.23 0.15 0.15
216 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 5 mg COMPR. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 8.23 0.27 0.15 0.15
217 C09AA03 LISINOPRILUM LISIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 7.4 0.25 0.15 0.15
218 C09AA03 LISINOPRILUM LISIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 100 14.57 0.15 0.15 0.15
219 C09AA03 LISINOPRILUM LISINOPRIL 5 MEDO COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6.32 0.21 0.15 0.15
2. BOLNAVI CU PROTEZE VALVULARE ŞI VASCULARE - G 2
1 B01AA07 ACENOCOUMAROLUM* TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.31 0.08 0.08 0.08
2 B01AA07 ACENOCOUMAROLUM* SINTROM (R) COMPR. 4mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 6.36 0.32 0.32 0.32
*) La indicatia medicului în specialitatea cardiologie
3. BOLNAVI CU PROCEDURI INTERVENTIONALE PERCUTANE, NUMAI DUPĂ IMPLANTAREA UNEI PROTEZE ENDOVASCULARE (STENT) - G 3
1 B01AC04 CLOPIDOGRELUM* PLAVIX (R) COMPR. FILM. 75mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 28 240.32 8.58 8.58 8.58
*) La indicatia medicului în specialitatea cardiologie sau neurologie cu aprobarea comisiilor de la nivelul caselor de asigurări de sănătate
4. HEPATITELE CRONICE DE ETIOLOGIE VIRALA B, C, D cu probe biologice de activitate, markeri de replicare virala, criterii histologice si varsta sub 65 ani, fiind necesară
îndeplinirea tuturor criteriilor conform protocoalelor de practică - G 4
1 J05AB04 RIBAVIRINUM* REBETOL 200 mg CAPS. 200mg SP EUROPE BELGIA CUTIE X 14 BLIST. PVC/PE/PVDC X 10 CAPS. P-RF/R 140 618.35 4.42 4.42 4.42
2 J05AB04 RIBAVIRINUM* COPEGUS (R) COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 168 COMPR. FILM. P-RF 168 2834.3 16.87 16.87 16.87
3 J05AF05 LAMIVUDINUM* ZEFFIX 100 mg COMPR. FILM. 100mg GLAXO GROUP LTD. U.K. CUTIE X 2 BLIST. PVC-AL/PVC-AL X 14 COMPR. FILM. S/P-RF 28 196.9 7.03 7.03 7.03
4 J05AF05 LAMIVUDINUM* EPIVIR COMPR. FILM. 150mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILM. P-RF/R 60 284.91 4.75 4.75 4.75
5 J05AF05 LAMIVUDINUM* EPIVIR 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 75.94 75.94 75.94 75.94
6 J05AF05 LAMIVUDINUM* ZEFFIX 5 mg/ml SOL. ORALA 5mg/ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLACON HDPE X 240 ML + 1 SERINGA DOZATOARE PP + 1 ADAPTOR PE P-RF/R 1 88.1 88.1 88.1 88.1
7 L03AB04 INTERFERONUM ALFA 2A* ROFERON A SOL. INJ. 18Mui/0.6ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 CARTUS MULTIDOZA X 0,6 ML SOL. INJ. S/P-RF 1 295.96 296 295.96 296
8 L03AB04 INTERFERONUM ALFA 2A* ROFERON A SOL. INJ. 3Mui/0.5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.5 ML + AC STERIL S/P-RF 1 68.53 68.53 68.53 68.53
9 L03AB04 INTERFERONUM ALFA 2A* ROFERON A SOL. INJ. 4.5Mui/0.5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.5ML SOL. INJ. + AC STERIL S/P-RF 1 95.42 95.42 95.42 95.42
10 L03AB04 INTERFERONUM ALFA 2A* ROFERON A SOL. INJ. 9Mui/0.5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.5 ML SOL. INJ. + AC STERIL S/P-RF 1 171.3 171.3 171.3 171.3
11 L03AB05 INTERFERONUM ALFA 2B* INTRON A 18 milioane U.I. SOL. INJ. PEN MULTIDOZA 18 milioane U.I. SP EUROPE BELGIA CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML SOL. INJ. + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 371.16 371.2 371.16 371.2
12 L03AB05 INTERFERONUM ALFA 2B* INTRON A 30 milioane U.I. SOL. INJ. PEN MULTIDOZA 60 milioane U.I. SP EUROPE BELGIA CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 618.6 618.6 618.6 618.6
13 L03AB10 PEGINTERFERON ALFA-2B* PEGINTRON 100 ug PULB. + SOLV. PT. SOL. INJ. 100µg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 849.86 849.9 849.86 849.9
14 L03AB10 PEGINTERFERON ALFA-2B* PEGINTRON 120 ug PULB. + SOLV. PT. SOL. INJ. 120µg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 1045 1045 1045 1045
15 L03AB10 PEGINTERFERON ALFA-2B* PEGINTRON 150 ug PULB. + SOLV. PT. SOL. INJ. 150µg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 1274.9 1275 1274.9 1275
16 L03AB10 PEGINTERFERON ALFA-2B* PEGINTRON 50 ug PULB. + SOLV. PT. SOL. INJ. 50µg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 424.92 424.9 424.92 424.9
17 L03AB11 PEGINTERFERON ALFA-2A* PEGASYS (R) 135 ag SOL. INJ. 135µg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE
Pagina 6 din 40
CUTIE X 1 FLAC. SOL. INJ. P-RF/R 1 778.53 778.5 778.53 778.5