Informační číselník Svazu zdravotních pojišťoven České republiky

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Informační číselník Svazu zdravotních pojišťoven ČR leden 2013 Kód Název Doplněk názvu DRZ ZEM LIM1 OME1 IND1 UHR1 MFC DNC Doplatek ZAP1 EKV1 EKV2 0147030 IOPAMIGITA 370 MG/ML INJ SOL ZAGK D D 6 552,93 6 907,19 354,26 0,00 1 037,55 30X20ML/7400MG 0147028 IOPAMIGITA 370 MG/ML INJ SOL ZAGK D D 8 191,16 8 643,06 451,90 0,00 1 037,55 10X75ML/27750MG 0052219 SCANLUX 370 MG/ML INJ SOL 10X200ML/37GM ASBA A D 21 843,20 22 577,63 734,43 0,00 1 037,55 0147022 IOPAMIGITA 300 MG/ML INJ SOL ZAGK D D 19 965,56 19 965,56 0,00 0,00 1 038,21 30X75ML/22500MG 0147021 IOPAMIGITA 300 MG/ML INJ SOL ZAGK D D 13 600,94 13 600,94 0,00 0,00 1 060,87 30X50ML/15000MG 0147019 IOPAMIGITA 300 MG/ML INJ SOL ZAGK D D 9 140,90 9 140,90 0,00 0,00 1 069,49 10X100ML/30000MG 0147025 IOPAMIGITA 300 MG/ML INJ SOL ZAGK D D 36 906,95 36 906,95 0,00 0,00 1 079,53 20X200ML/60000MG 0147020 IOPAMIGITA 300 MG/ML INJ SOL ZAGK D D 5 574,63 5 762,98 188,35 0,00 1 087,05 30X20ML/6000MG 0147017 IOPAMIGITA 300 MG/ML INJ SOL ZAGK D D 4 645,53 4 832,77 187,24 0,00 1 087,06 10X50ML/15000MG 0191747 IOPAMIGITA 300 MG/ML INJ SOL ZAGK D D 4 645,53 4 832,77 187,24 0,00 1 087,06 1X500ML/150000MG 0147024 IOPAMIGITA 300 MG/ML INJ SOL ZAGK D D 18 889,32 18 889,32 0,00 0,00 1 105,03 10X200ML/60000MG 0147018 IOPAMIGITA 300 MG/ML INJ SOL ZAGK D D 7 335,46 7 528,25 192,79 0,00 1 144,32 10X75ML/22500MG 0052204 SCANLUX 300 MG/ML INJ SOL 10X100ML/30GM ASBA A D 9 780,61 9 780,62 0,01 0,00 1 144,33 0147016 IOPAMIGITA 300 MG/ML INJ SOL ZAGK D D 1 956,12 2 122,43 166,31 0,00 1 144,33 10X20ML/6000MG 0052201 SCANLUX 300 MG/ML INJ SOL 10X50ML/15GM ASBA A D 4 890,31 5 182,85 292,54 0,00 1 144,33 0052207 SCANLUX 300 MG/ML INJ SOL 10X200ML/60GM ASBA A D 19 561,23 20 245,49 684,26 0,00 1 144,33 V08AB05 parent. Jopromid 0093626 ULTRAVIST 370 INJ SOL 1X200ML ABZB D D 2 184,32 2 347,55 163,23 0,00 1 037,53 0077018 ULTRAVIST 370 INJ SOL 10X50ML ABZB D D 5 460,80 7 883,23 2 422,43 0,00 1 037,54 0077019 ULTRAVIST 370 INJ SOL 10X100ML ABZB D D 10 921,60 13 195,34 2 273,74 0,00 1 037,55 0093625 ULTRAVIST 370 INJ SOL 1X100ML ABZB D D 1 092,16 1 305,88 213,72 0,00 1 037,58 0052591 ULTRAVIST 300 INJ SOL 1X200ML ABZB D D 1 956,12 2 298,59 342,47 0,00 1 144,33 0077024 ULTRAVIST 300 INJ SOL 10X20ML ABZB D D 1 956,12 2 960,19 1 004,07 0,00 1 144,33 0077016 ULTRAVIST 300 INJ SOL 10X50ML ABZB D D 4 890,31 7 138,95 2 248,64 0,00 1 144,33 0077017 ULTRAVIST 300 INJ SOL 10X100ML ABZB D D 9 780,61 13 278,14 3 497,53 0,00 1 144,33 V08AB07 parent. Joversol 0014770 OPTIRAY 350 INJ SOL 10X50ML(A) ACDN D D 4 740,39 6 343,23 1 602,84 0,00 948,08 0014763 OPTIRAY 350 INJ SOL 10X100ML(A) ACDN D D 9 480,78 11 705,17 2 224,39 0,00 948,08 0014764 OPTIRAY 350 INJ SOL 10X200ML(A) ACDN D D 18 961,57 22 710,41 3 748,84 0,00 948,08 Úhrada Vysvětlivky: UHR1 – úhrada, MFC – konečná cena, Doplatek – maximální doplatek, ZAP1 – započitatelný doplatek, DNC – dohodnutá nejvyšší cena, Úhrada EKV1, EKV2 – vypočtená úhrada za 1 ODTD nebo 1 DDD, k datu sestavení číselníku neúčtovaný LP pojišťovnám, LP bez doplatku pacienta Stránka 298 z 301
Informační číselník Svazu zdravotních pojišťoven ČR leden 2013 Kód Název Doplněk názvu DRZ ZEM LIM1 OME1 IND1 UHR1 MFC DNC Doplatek ZAP1 EKV1 EKV2 0014767 OPTIRAY 350 INJ SOL 10X100ML(C) ACDN D D 9 480,78 14 640,35 5 159,57 0,00 948,08 0187722 OPTIRAY 350 INJ SOL 5X500ML(A) ZCDN D D 23 701,95 29 096,10 5 394,15 0,00 948,08 0014768 OPTIRAY 350 INJ SOL 10X125ML(C) ACDN D D 11 850,98 18 082,51 6 231,53 0,00 948,08 0014749 OPTIRAY 300 INJ SOL 10X100ML(A) ACDN D D 9 780,61 10 131,24 350,63 0,00 1 144,33 0014747 OPTIRAY 300 INJ SOL 10X50ML(A) ACDN D D 4 890,31 5 437,13 546,82 0,00 1 144,33 0014753 OPTIRAY 300 INJ SOL 10X50ML(B) ACDN D D 4 890,31 5 727,07 836,76 0,00 1 144,33 0014751 OPTIRAY 300 INJ SOL 10X200ML(A) ACDN D D 19 561,23 20 533,82 972,59 0,00 1 144,33 0014746 OPTIRAY 300 INJ SOL 10X20ML(A) ACDN D D 1 956,12 3 154,19 1 198,07 0,00 1 144,33 0014755 OPTIRAY 300 INJ SOL 10X100ML(C) ACDN D D 9 780,61 12 269,85 2 489,24 0,00 1 144,33 0014756 OPTIRAY 300 INJ SOL 10X125ML(C) ACDN D D 12 225,77 15 132,64 2 906,87 0,00 1 144,33 0014752 OPTIRAY 300 INJ SOL 10X30ML(B) ACDN D D 2 934,19 3 508,93 574,74 0,00 1 144,34 0014758 OPTIRAY 320 INJ SOL 10X50ML(B) ACDN D D 6 506,54 6 945,33 438,79 0,00 1 444,45 V08AB09 parent. Jodixanol 0042439 VISIPAQUE 320 MG I/ML INJ SOL 10X200ML-PP AGHO N D 20 478,60 20 478,60 0,00 0,00 1 136,56 0042433 VISIPAQUE 320 MG I/ML INJ SOL 10X100ML-PP AGHO N D 10 337,41 10 337,41 0,00 0,00 1 147,45 0045125 VISIPAQUE 320 MG I/ML INJ SOL 6X200ML-SKL AGHO N D 13 056,20 13 056,20 0,00 0,00 1 207,70 0042411 VISIPAQUE 270 MG I/ML INJ SOL 10X100ML-PP AGHO N D 9 562,61 9 562,61 0,00 0,00 1 243,14 0045124 VISIPAQUE 320 MG I/ML INJ SOL 10X100ML-SK AGHO N D 11 523,42 11 523,42 0,00 0,00 1 279,10 0045122 VISIPAQUE 320 MG I/ML INJ SOL 10X20ML-SKL AGHO N D 2 333,70 2 333,70 0,00 0,00 1 295,20 0045119 VISIPAQUE 270 MG I/ML INJ SOL 10X50ML-SKL AGHO N D 5 310,77 6 920,05 1 609,28 0,00 1 380,78 0017038 VISIPAQUE 270 MG I/ML INJ SOL 10X50ML-PP AGHO N D 5 310,77 6 920,05 1 609,28 0,00 1 380,78 0045123 VISIPAQUE 320 MG I/ML INJ SOL 10X50ML-SKL AGHO N D 6 506,54 7 666,21 1 159,67 0,00 1 444,45 0017039 VISIPAQUE 320 MG I/ML INJ SOL 10X50ML-PP AGHO N D 6 506,54 7 666,21 1 159,67 0,00 1 444,45 0045118 VISIPAQUE 270 MG I/ML INJ SOL 10X20ML-SKL AGHO N D 2 352,51 3 961,39 1 608,88 0,00 1 529,09 V08AB10 parent. Jomeprol 0022081 IOMERON 400 INJ SOL 1X50ML ABDK D D 494,51 728,53 234,02 0,00 870,31 0022075 IOMERON 400 INJ SOL 1X100ML ABDK D D 989,03 1 350,12 361,09 0,00 870,32 0137480 IOMERON 400 INJ SOL 1X500ML ABDK D D 4 945,11 8 203,78 3 258,67 0,00 870,34 0122995 IOMERON 400 INJ SOL 1X200ML ZPGK GR D 1 978,04 2 543,49 565,45 0,00 870,35 0022077 IOMERON 400 INJ SOL 1X200ML ABDK D D 1 978,04 2 543,49 565,45 0,00 870,35 0022058 IOMERON 350 INJ SOL 1X100ML ABDK D D 948,07 1 227,08 279,01 0,00 948,07 0022064 IOMERON 350 INJ SOL 1X50ML ABDK D D 474,04 658,13 184,09 0,00 948,08 0022061 IOMERON 350 INJ SOL 1X200ML ABDK D D 1 896,16 2 304,41 408,25 0,00 948,08 0137481 IOMERON 350 INJ SOL 1X500ML ABDK D D 4 740,39 5 766,00 1 025,61 0,00 948,08 0107455 IOMERON 350 INJ SOL 1X20ML ABDK D D 189,62 286,68 97,06 0,00 948,10 0022048 IOMERON 300 INJ SOL 1X50ML ABDK D D 489,03 577,63 88,60 0,00 1 144,20 0022043 IOMERON 300 INJ SOL 1X200ML ABDK D D 1 956,12 2 037,95 81,83 0,00 1 144,33 0022040 IOMERON 300 INJ SOL 1X100ML ABDK D D 978,06 1 085,83 107,77 0,00 1 144,33 0107453 IOMERON 300 INJ SOL 1X20ML ABDK D D 195,61 262,16 66,55 0,00 1 144,59 Vysvětlivky: UHR1 – úhrada, MFC – konečná cena, Doplatek – maximální doplatek, ZAP1 – započitatelný doplatek, DNC – dohodnutá nejvyšší cena, Úhrada EKV1, EKV2 – vypočtená úhrada za 1 ODTD nebo 1 DDD, k datu sestavení číselníku neúčtovaný LP pojišťovnám, LP bez doplatku pacienta Úhrada Stránka 299 z 301
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Informační číselník Svazu zdravotních pojišťoven České republiky

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