ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay...

157

Transcript of ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay...

Page 1: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000
Page 2: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000
Page 3: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

ANEXA 1

Nr crt. codifatc den_internationala denumire formaF concentratie Firma detinatoare tara forma ambalare prescriere cant/ambalaj

Pret amanuntul maximal/ambalaj (RON)

Pret amanuntul maximal/UT (RON)

Val suportata de CNAS/UT (RON)Legea nr. 95/2006 art 213 alin.1 lit. a) si f)

Val suportata CNAS/UT (RON) pt. Adulti

1 A02BA02 RANITIDINUM ULCORAN CAPS. 150mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-6L 20 6.13 0.306500 0.306500 0.2758502 A02BA02 RANITIDINUM RANITIDIN ARENA 150mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 6.26 0.313000 0.252000 0.2268003 A02BA02 RANITIDINUM RANITIDINA 150 mg COMPR. 150mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6.52 0.326000 0.252000 0.2268004 A02BA02 RANITIDINUM RANITIDIN COMPR. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 5.04 0.252000 0.252000 0.2268005 A02BA02 RANITIDINUM ZANTAC 150 mg COMPR. FILM. 150mg GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/AL X 10 COMPR. FILM. P-6L 20 10.02 0.501000 0.222000 0.1998006 A02BA02 RANITIDINUM RANITIDINA ANTIBIOTICE 150 mg COMPR. FILM. 150mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 6.50 0.325000 0.222000 0.1998007 A02BA02 RANITIDINUM RANITIDINA 150 mg COMPR. FILM. 150mg FILDAS TRADING SRL ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL-VMCH X 10 COMPR. FILM. P-6L 20 4.44 0.222000 0.222000 0.1998008 A02BA02 RANITIDINUM RANITIDIN 150 mg COMPR. FILM. 150mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 7.18 0.359000 0.222000 0.1998009 A02BA02 RANITIDINUM RANITIDINA LAROPHARM 150 mg COMPR. FILM. 150mg ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 20 5.70 0.285000 0.222000 0.199800

10 A02BA02 RANITIDINUM RANITIDINA LPH 150 mg COMPR. FILM. 150mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 6.61 0.330500 0.222000 0.19980011 A02BA02 RANITIDINUM RANITIDIN 300 mg COMPR. FILM. 300mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 10 6.07 0.607000 0.541333 0.48719912 A02BA02 RANITIDINUM RANITIDINA LPH 300 mg COMPR. FILM. 300mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 16.24 0.541333 0.541333 0.48719913 A02BA02 RANITIDINUM ARNETIN SOL. INJ. 25mg/ml MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE X 2 ML P-RF 5 11.90 2.380000 2.380000 2.14200014 A02BA02 RANITIDINUM ZANTAC SOLUTIE INJECTABILA SOL. INJ. 25mg/ml GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 5 FIOLE X 2 ML SOL. INJ. P-RF 5 14.02 2.804000 2.380000 2.14200015 A02BA03 FAMOTIDINUM QUAMATEL (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER PLC. UNGARIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 8.88 0.317142 0.070000 0.06300016 A02BA03 FAMOTIDINUM FAMODIN 20 COMPR. FILM. 20mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 8.34 0.278000 0.070000 0.06300017 A02BA03 FAMOTIDINUM FAMOTIDINA ZENTIVA 20mg COMPR. FILM. 20mg ZENTIVA S.A ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 2.10 0.070000 0.070000 0.06300018 A02BA03 FAMOTIDINUM QUAMATEL (R) 40 mg COMPR. FILM. 40mg GEDEON RICHTER PLC UNGARIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-6L 14 8.88 0.634285 0.128333 0.11549919 A02BA03 FAMOTIDINUM FAMOTIDINA ZENTIVA 40 mg COMPR. FILM. 40mg ZENTIVA S.A ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 3.85 0.128333 0.128333 0.11549920 A02BA03 FAMOTIDINUM FAMODIN 40 COMPR. FILM. 40mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 11.57 0.385666 0.128333 0.11549921 A02BA03 FAMOTIDINUM QUAMATEL (R) 20 mg LIOF. + SOLV. PT. SOL. INJ. 20mg GEDEON RICHTER LTD. UNGARIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. + 5 FIOLE X 5 ML SOLV. P-RF 5 23.13 4.626000 4.626000 4.16340022 A02BA04 NIZATIDINUM NIZATIDIN VIM SPECTRUM 150 mg CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 17.12 0.856000 0.856000 0.77040023 A02BC01 OMEPRAZOLUM RISEK CAPS. ENTER. 20mg GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 1 FLAC. X 14 CAPS. ENTER. P-6L 14 51.85 3.703571 0.541428 0.48728524 A02BC01 OMEPRAZOLUM ORTANOL S 10 mg CAPS. GASTROREZ. 10mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L 14 8.38 0.598571 0.598571 0.53871325 A02BC01 OMEPRAZOLUM OMEZ CAPS. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ. P-6L 30 20.11 0.670333 0.541428 0.48728526 A02BC01 OMEPRAZOLUM ORTANOL (R) 20 mg CAPS. GASTROREZ. 20mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. AL/AL X 14 CAPS. GASTROREZ. P-6L 14 7.58 0.541428 0.541428 0.487285

LISTA DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU CONTRIBUTIE PERSONALA CONFOR HG NR. 720/2008 VALABILA INCEPAND CU 1 APRILIE 2009

SUBLISTA A - MEDICAMENTE CU NIVEL DE COMPENSARE 90% DIN PRETUL DE REFERINTA

Pagina 1 din 34

Page 4: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

27 A02BC01 OMEPRAZOLUM OMEPRAZOL BIOFARM 20 mg CAPS. GASTROREZ. 20mg BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. PEID X 28 CAPS. GASTROREZ. P-6L 28 19.31 0.689642 0.541428 0.48728528 A02BC01 OMEPRAZOLUM OMEPRAZOL BIOFARM 20 mg CAPS. GASTROREZ. 20mg BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. PEID X 14 CAPS. GASTROREZ. P-6L 14 10.18 0.727142 0.541428 0.48728529 A02BC01 OMEPRAZOLUM ULTOP CAPS. GASTROREZ. 20mg KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PE X 14 CAPS. GASTROREZ. P-6L 14 13.57 0.969285 0.541428 0.48728530 A02BC01 OMEPRAZOLUM OMEPRAZOL 20 mg CAPS. GASTROREZ. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-AL-PA/AL X 7 CAPS. GASTROREZ. P-6L 14 13.57 0.969285 0.541428 0.48728531 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 20 12.02 0.601000 0.541428 0.48728532 A02BC01 OMEPRAZOLUM HELICID 20 CAPS. GASTROREZ. 20mg ZENTIVA AS CEHIA CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ. P-6L 28 19.52 0.697142 0.541428 0.48728533 A02BC01 OMEPRAZOLUM HELICID 20 CAPS. GASTROREZ. 20mg ZENTIVA AS CEHIA CUTIE X 1 FLAC. DIN STICLA X 14 CAPS. GASTROREZ. P-6L 14 9.45 0.675000 0.541428 0.48728534 A02BC01 OMEPRAZOLUM OMERAN 20 CAPS. GASTROREZ. 20mg EUROPHARM SA ROMANIA CUTIE X 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L 28 26.78 0.956428 0.541428 0.48728535 A02BC01 OMEPRAZOLUM OMERAN 20 CAPS. GASTROREZ. 20mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L 14 13.39 0.956428 0.541428 0.48728536 A02BC01 OMEPRAZOLUM OMEPRAZOL 20 mg CAPS. GASTROREZ. 20mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 21.31 0.710333 0.541428 0.48728537 A02BC01 OMEPRAZOLUM OMEPRAZOL TERAPIA 20 mg CAPS. GASTROREZ. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 21.16 0.705333 0.541428 0.48728538 A02BC01 OMEPRAZOLUM OMEPRAZOL ARENA 20 mg CAPS. GASTROREZ. 20mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 20.66 0.688666 0.541428 0.48728539 A02BC01 OMEPRAZOLUM OMEPRAZOL FARMEX 20 mg CAPS. GASTROREZ. 20mg FARMEX COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 19.58 0.652666 0.541428 0.48728540 A02BC01 OMEPRAZOLUM OMEPRAZOL OZONE 20 mg CAPS. GASTROREZ. 20mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 28 CAPS. GASTROREZ. P-6L 28 17.44 0.622857 0.541428 0.48728541 A02BC01 OMEPRAZOLUM OMEPRAZOL RPH 20 mg CAPS. GASTROREZ. 20mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 20.80 0.693333 0.541428 0.48728542 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. PVC/AL X 10CAPS. GASTROREZ P-6L 10 6.09 0.609000 0.541428 0.48728543 A02BC01 OMEPRAZOLUM ORTANOL 40 mg CAPS. GASTROREZ. 40mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L 7 7.53 1.075714 1.075714 0.96814244 A02BC01 OMEPRAZOLUM OMERAN 40 CAPS. GASTROREZ. 40mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. AL/AL X 7 CAPSULE GASTROREZ. P-6L 14 24.56 1.754285 1.075714 0.96814245 A02BC01 OMEPRAZOLUM LOSEC MUPS 10 mg COMPR. FILM. GASTROREZ. 10mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 14 COMPR. FILM. GASTROREZ. P-6L 14 31.17 2.226428 2.226428 2.00378546 A02BC01 OMEPRAZOLUM LOSEC MUPS 20 mg COMPR. FILM. GASTROREZ. 20mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 7 COMPR. FILM. GASTROREZ. P-6L 7 23.44 3.348571 1.595000 1.43550047 A02BC01 OMEPRAZOLUM OMEDAR (R) COMPR. FILM. GASTROREZ. 20mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. DE STICLA BRUNA X 14 COMPR. FILM. GASTROREZ. P-6L 14 22.33 1.595000 1.595000 1.43550048 A02BC03 LANSOPRAZOLUM LEVANT 15 mg CAPS. GASTROREZ. 15mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L 14 6.16 0.440000 0.440000 0.39600049 A02BC03 LANSOPRAZOLUM LANZUL CAPS. GASTROREZ. 30mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 7 CAPS. GASTROREZ. P-6L 14 12.33 0.880714 0.761428 0.68528550 A02BC03 LANSOPRAZOLUM LEVANT 30 mg CAPS. GASTROREZ. 30mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L 14 10.66 0.761428 0.761428 0.68528551 A02BC03 LANSOPRAZOLUM LANZAP 30mg CAPS. GASTROREZ. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L 20 15.64 0.782000 0.761428 0.68528552 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg SOLVAY PHARMACEUTICALS BV OLANDA CUTIE X 3 BLIST. X 10 CAPS. ELIB. PREL. P-6L 30 26.07 0.869000 0.869000 0.78210053 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg SOLVAY PHARMACEUTICALS BV OLANDA CUTIE X 2 BLIST. X 15 CAPS. ELIB. PREL. P-6L 30 26.07 0.869000 0.869000 0.78210054 A03AA04 MEBEVERINUM COLOSPASMIN DRAJ. 100mg E.I.P.I.CO. MED SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ. P-6L 20 8.49 0.424500 0.424500 0.38205055 A03AA05 TRIMEBUTINUM PROMEBUTIN (R) 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 13.04 0.652000 0.348666 0.31379956 A03AA05 TRIMEBUTINUM TRIMEBUTIN 100 COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10.46 0.348666 0.348666 0.31379957 A03AA05 TRIMEBUTINUM COLPERIN 100 mg COMPR. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 15.08 0.502666 0.348666 0.31379958 A03AA05 TRIMEBUTINUM DEBRIDAT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 16.09 0.536333 0.536333 0.48269959 A03AA05 TRIMEBUTINUM IBUTIN (R) 300 mg COMPR. FILM. ELIB. PREL. 300mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 33.82 1.691000 1.691000 1.52190060 A03AA05 TRIMEBUTINUM DEBRIDAT GRAN. PT. SUSP. ORALA 24mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 152,5 G GRANULE PT. 250ML SUSP. + MASURA DOZATOARE P-6L 1 11.31 11.310000 11.310000 10.17900061 A03AD01 PAPAVERINI HYDROCHLORIDUM PAPAVERINA 100 mg COMPR. 100mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3.28 0.109333 0.109333 0.09839962 A03AD01 PAPAVERINI HYDROCHLORIDUM PAPAVERINA LAROPHARM 100 mg COMPR. 100mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.19 0.109500 0.109333 0.09839963 A03AD01 PAPAVERINI HYDROCHLORIDUM PAPAVERINA COMPR. 200mg FARMACOM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 5.05 0.252500 0.252500 0.22725064 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 10 mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 40 COMPR. P-6L 40 1.31 0.032750 0.027250 0.02452565 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 1.09 0.027250 0.027250 0.02452566 A03FA01 METOCLOPRAMIDUM N - METOCLOPRAMID COMPR. 10mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. PE X 40 COMPR. P-6L 40 1.28 0.032000 0.027250 0.02452567 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 2.13 0.053250 0.027250 0.02452568 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID PIC. ORALE-SOL. 7mg/ml BIOFARM SA ROMANIA CUTIE X 1 FLACON DIN STICLA X 20 ML PIC. ORALE.,SOLUTIE, PREVAZUT CU PICURATOR P-RF 1 2.68 2.680000 2.680000 2.41200069 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID BIOFARM 1mg/5ml SIROP 1mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA X 100 ML SIROP + MASURA DOZATOARE P-RF 1 8.15 8.150000 8.150000 7.33500070 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 10 mg SOL. INJ. 5mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF 5 4.30 0.860000 0.860000 0.77400071 A03FA03 DOMPERIDONUM MOTILIUM 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 11.57 1.157000 1.157000 1.04130072 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P-6L/S 100 116.69 1.166900 1.166900 1.05021073 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 68.32 1.366400 1.166900 1.050210

Pagina 2 din 34

Page 5: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

74 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 64.58 1.291600 1.166900 1.05021075 A06AD11 LACTULOSUM DUPHALAC (R) LICHID ORAL 66,7% SOLVAY PHARMACEUTICALS BV OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P-RF 1 10.29 10.290000 10.290000 9.26100076 A06AD11 LACTULOSUM LACTULOSE AL SIROP SIROP 66,7% ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 FLACON DIN TFPE BRUNA X 200 ML SIROP + MASURA GRADATA X 20 ML P-RF 1 11.77 11.770000 10.290000 9.26100077 A06AD11 LACTULOSUM LAEVOLAC 670mg/ml SOL. ORALA 670mg/ml FRESENIUS KABI AUSTRIA GMBH AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SOL. ORALA + DISPOZITIV DE CURGERE + MASURA CU GRADATII D P-RF 1 7.15 7.150000 7.150000 6.43500078 A07AA02 NYSTATINUM NISTATINA COMPR. FILM. 500.000ui ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 4.35 0.217500 0.217500 0.19575079 A07EC01 SULFASALAZINUM SULFASALAZIN EN COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 26.50 0.530000 0.293400 0.26406080 A07EC01 SULFASALAZINUM SALAZOPYRIN EN COMPR. FILM. GASTROREZ. 500mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. GASTROREZ. P-6L 100 29.34 0.293400 0.293400 0.26406081 A07EC02 MESALAZINUM** SALOFALK 250 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 100 65.31 0.653100 0.653100 0.58779082 A07EC02 MESALAZINUM** SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 100 113.56 1.135600 1.135600 1.02204083 A07EC02 MESALAZINUM** SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 50 70.59 1.411800 1.135600 1.02204084 A07EC02 MESALAZINUM** SALOFALK (R) 250 mg SUPOZ. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 30.02 3.002000 3.002000 2.70180085 A07EC02 MESALAZINUM** SALOFALK (R) 500 mg SUPOZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 47.89 4.789000 4.789000 4.31010086 A07EC02 MESALAZINUM** SALOFALK 4 g/ 60 ml SUSP. RECTALA 4g/60ml DR. FALK PHARMA GMBH GERMANIA CUTIE X 7 BLIST. AL/PE CONTINAND FIECARE CATE 1 FLACON UNIDOZA X 60 ML SUSPENSIE RECTALA + APLICA P-6L 7 159.27 22.752857 22.752857 20.47757187 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.94 0.098000 0.098000 0.08820088 B01AA07 ACENOCUMAROLUM SINTROM (R) COMPR. 4mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 6.35 0.317500 0.317500 0.28575089 B01AC05 TICLOPIDINUM1 TICLODIN COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 33.36 1.668000 0.448000 0.40320090 B01AC05 TICLOPIDINUM1 IPATON COMPR. FILM. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/ PVC X 10 COMPR.FILM. P-RF 20 32.39 1.619500 0.448000 0.40320091 B01AC05 TICLOPIDINUM1

TICLOPIDIN SANDOZ COMPR. FILM. 250mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PDVC/AL X 10 COMPR. P-RF 30 13.44 0.448000 0.448000 0.40320092 B01AC05 TICLOPIDINUM1 TICLID (R) 250 mg COMPR. FILM. 250mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST PVC TRANSPARENT/AL X 10 COMPR. FILM. P-RF 20 12.03 0.601500 0.448000 0.40320093 B02BA01 PHYTOMENADIONUM FITOMENADION 10 mg/ml SOL. INJ. 10mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE PREVAZUTE CU PUNCT DE RUPERE X 1 ML S/P-RF 5 5.33 1.066000 1.066000 0.95940094 B03AA07 FERROSI SULFAS FERRO-GRADUMET COMPR.FILM.ELIB.PREL 329,724mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. CU ELIB. PREL. P-6L 30 7.33 0.244333 0.244333 0.21989995 B03AA07 FERROSI SULFAS TARDYFERON 80 mg DRAJ. ELIB. PREL. 80mg LAB. PIERRE FABRE FRANTA CUTIE X 3 BLIST. AL/PVDC-PE-PVC X 10 DRAJ. ELIB. PREL. P-6L 30 11.34 0.378000 0.378000 0.340200

96 B03AB05

COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT MALTOFER COMPR. MAST. 100mg VIFOR FRANCE S.A. FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MASTIC. P-6L 30 20.18 0.672666 0.672666 0.605399

97 B03AB05

COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT PHARMA-FERRUM (R) PICATURI ORALE-SOL. 5% TERAPIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 50 ML P-6L 1 12.85 12.850000 11.060000 9.954000

98 B03AB05

COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT PHARMA-FERRUM (R) PICATURI ORALE-SOL. 5% TERAPIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 30 ML P-6L 1 11.06 11.060000 11.060000 9.954000

99 B03AB05

COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERRUM HAUSMANN (R) PICATURI ORALE-SOL. 50mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 1 FLACON CU PICURATOR X 30 ML P-6L 1 12.70 12.700000 11.060000 9.954000

100 B03AB05

COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERRUM HAUSMANN (R) SIROP 10mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 1 FLACON X 150 ML + O MASURA DOZATOARE P-6L 1 14.44 14.440000 14.440000 12.996000

101 B03AB05

COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERGLUROM 50mg/5ml SIROP 50mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SIROP + MASURA DOZATOARE GRADATA DE LA 2,5 - 20 ML P-6L 1 9.45 9.450000 9.450000 8.505000

Pagina 3 din 34

Page 6: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

102 B03AEN1

COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM) SORBIFER DURULES COMPR. FILM. FARA CONCENTRATIE EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. FILM. P-6L 50 13.94 0.278800 0.278800 0.250920

103 B03BB01 ACIDUM FOLICUM ACIFOL 5 mg COMPR. FILM. 5mg ZENTIVA S.A. ROMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. P-6L 30 1.14 0.038000 0.038000 0.034200104 C01AA05 DIGOXINUM DIGOXIN 0,25 mg COMPR. 0,25mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 1.80 0.072000 0.072000 0.064800105 C01AA05 DIGOXINUM DIGOXIN 0,5 mg/2 ml SOL. INJ. 0,5mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. S/P-RF 5 4.25 0.850000 0.850000 0.765000106 C01AA05 DIGOXINUM LANOXIN SOLUTIE ORALA SOL. ORALA 0,05mg/ml THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA BRUNA X 60 ML SOL. ORALA + PIPETA X 1 ML P-RF 1 10.42 10.420000 10.420000 9.378000107 C01BA01 CHINIDINI SULFAS CHINIDINA SULFAT 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. PEID X 20 COMPR. P-RF 20 11.63 0.581500 0.225000 0.202500108 C01BA01 CHINIDINI SULFAS CHINIDINA LAROPHARM 200 mg COMPR. 200mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 4.50 0.225000 0.225000 0.202500109 C01BC03 PROPAFENONUM PROPAFENONA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-RF 20 46.93 2.346500 2.346500 2.111850110 C01BC03 PROPAFENONUM RYTMONORM (R) COMPR. FILM. 150mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 50 30.08 0.601600 0.328000 0.295200111 C01BC03 PROPAFENONUM PROPAFENON AL 150 COMPR. FILM. 150mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. X 25 COMPR. FILM. P-RF 50 17.57 0.351400 0.328000 0.295200112 C01BC03 PROPAFENONUM PROPAFENON AL 150 COMPR. FILM. 150mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 BLIST. X 20 COMPR. FILM. P-RF 20 7.03 0.351500 0.328000 0.295200113 C01BC03 PROPAFENONUM PROPAFENON AL 150 COMPR. FILM. 150mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM. P-RF 100 32.80 0.328000 0.328000 0.295200114 C01BC03 PROPAFENONUM PROPAFENON SANDOZ 150 mg COMPR. FILM. 150mg HEXAL AG GERMANIA CUTIE X 5 BLIST. AL/PP X 10 COMPR. FILM. P-RF 50 16.98 0.339600 0.328000 0.295200115 C01BC03 PROPAFENONUM RYTMONORM SOL. INJ. 70mg/20ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 20 ML SOL. INJ. P-RF 5 34.53 6.906000 6.906000 6.215400116 C01BD01 AMIODARONUM SEDACORON (R) COMPR. 200mg EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 13.00 0.650000 0.353000 0.317700117 C01BD01 AMIODARONUM SEDACORON (R) COMPR. 200mg EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 26.87 0.537400 0.353000 0.317700118 C01BD01 AMIODARONUM AMIODARONA LPH 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 10.59 0.353000 0.353000 0.317700119 C01BD01 AMIODARONUM DARITMIN (R) 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 11.51 0.383666 0.353000 0.317700120 C01BD01 AMIODARONUM AMIODARONA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 10.60 0.353333 0.353000 0.317700121 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. DIVIZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ. P-RF 30 15.87 0.529000 0.529000 0.476100122 C01DA02 NITROGLYCERINUM NITROMINT 2,6 mg COMPR. ELIB. PREL. 2,6mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 60 COMPR. ELIB. PREL. P-6L 60 9.26 0.154333 0.154333 0.138899123 C01DA02 NITROGLYCERINUM NITROGLICERINA 0,5 mg COMPR. SUBLING. 0,5mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. SUBLINGUALE P-6L 20 3.62 0.181000 0.181000 0.162900124 C01DA02 NITROGLYCERINUM NITRODERM (R) TTS 5 SIST. TERAP. TRANSDERM. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 PLICURI X 1 SIST. TERAPEUTIC TRANSDERMIC P-6L 10 17.35 1.735000 1.735000 1.561500125 C01DA02 NITROGLYCERINUM NITROMINT SPRAY SUBLINGUAL 0,4mg/doza EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON X 10G (180 DOZE) SPRAY SUBLINGUAL P-6L 1 14.36 14.360000 14.360000 12.924000126 C01DA08 ISOSORBIDI DINITRAS DINITER SR 20 mg CAPS. ELIB. PREL. 20mg TERAPIA SA ROMANIA CUTIEX 2 BLIST. X 10 CAPS. ELIB. PREL. P-6L 20 5.12 0.256000 0.256000 0.230400127 C01DA08 ISOSORBIDI DINITRAS DINITER SR 40 mg CAPS. ELIB. PREL. 40mg TERAPIA SA ROMANIA CUTIEX 2 BLIST. X 10 CAPS. ELIB. PREL. P-6L 20 8.49 0.424500 0.424500 0.382050128 C01DA08 ISOSORBIDI DINITRAS ISOSORBIDE DINITRATE 10 mg COMPR. 10mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-6L 60 2.00 0.033333 0.033333 0.029999129 C01DA08 ISOSORBIDI DINITRAS ISODINIT (R) RETARD COMPR. ELIB. PREL. 20mg BALKAN PHARMA DUPNITZA AD BULGARIA CUTIE X 6 BLIST. X 10 COMPR. ELIB. PREL. P-6L 60 3.70 0.061666 0.061666 0.055499130 C01DA14 ISOSORBIDI MONONITRAS OLICARD 40 mg RETARD CAPS. ELIB. PREL. 40mg SOLVAY PHARMACEUTICALS BV GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 20 11.28 0.564000 0.564000 0.507600131 C01DA14 ISOSORBIDI MONONITRAS OLICARD 60 mg RETARD CAPS. ELIB. PREL. 60mg SOLVAY PHARMACEUTICALS BV GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 20 18.00 0.900000 0.900000 0.810000132 C01DA14 ISOSORBIDI MONONITRAS MONONITRON (R) EP 60 mg COMPR. FILM. ELIB. PREL. 60mg ZENTIVA S.A ROMANIA CUTIE X 4 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 40 34.19 0.854750 0.854750 0.769275133 C01EA01 ALPROSTADILUM PRIDAX 20mcg CONC. PT. SOL. PERF. 20mcg GEBRO PHARMA GMBH AUSTRIA CUTIE X 5 FLAC. X 1 ML CONC. PT. SOL. PERF S/P-RF 5 308.86 61.772000 49.363000 44.426700134 C01EA01 ALPROSTADILUM VASAPROSTAN 20 LIOF. PT. SOL. PERF. 20mcg SCHWARZ PHARMA AG GERMANIA CUTIE X 10 FIOLE X 5 ML LIOF. PT. SOL. PERF. S/P-RF 10 493.63 49.363000 49.363000 44.426700135 C01EB15 TRIMETAZIDINUM TRIMETAZIDIN VIM SPECTRUM 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 CAPS. P-6L 30 13.59 0.453000 0.453000 0.407700136 C01EB15 TRIMETAZIDINUM PREDUCTAL (R) COMPR. FILM. 20mg LES LAB. SERVIER IND. FRANTA CUTIE X 2 BLIST. X 30 COMPR. FILM. P-6L 60 22.00 0.366666 0.366666 0.329999137 C01EB15 TRIMETAZIDINUM MODUXIN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 13.71 0.457000 0.366666 0.329999138 C01EB15 TRIMETAZIDINUM DILATAN 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 30 13.71 0.457000 0.366666 0.329999139 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH (R) 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. FILM. P-6L 60 24.88 0.414666 0.366666 0.329999140 C01EB15 TRIMETAZIDINUM PREDUCTAL MR 35 mg COMPR. FILM. ELIB. MODIF. 35mg LES LAB. SERVIER IND. FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. FILM. ELIB. MODIF. P-6L 60 46.70 0.778333 0.690666 0.621599141 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH (R) 35 mg COMPR. FILM. ELIB. MODIF. 35mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. MODIF. P-6L 60 44.52 0.742000 0.690666 0.621599142 C01EB15 TRIMETAZIDINUM MODUXIN MR 35 mg COMPR. FILM. ELIB. PREL. 35mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 20.72 0.690666 0.690666 0.621599143 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA 20 mg DRAJ. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-6L 30 13.59 0.453000 0.453000 0.407700144 C02AB01 METHYLDOPUM DOPEGYT COMPR. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 11.90 0.238000 0.238000 0.214200145 C02AC01 CLONIDINUM CLONIDINA 0,15 mg COMPR. 0,15mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 2.13 0.042600 0.040600 0.036540

Pagina 4 din 34

Page 7: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

146 C02AC01 CLONIDINUM CLONIDINA SINTOFARM 0,15 mg COMPR. 0,15mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 2.03 0.040600 0.040600 0.036540147 C02CA04 DOXAZOSINUM DOXAZOSIN SANDOZ 2 mg (vezi C02CA04) COMPR. 2mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 30 13.87 0.462333 0.411000 0.369900148 C02CA04 DOXAZOSINUM ANIPROSIN 2 mg (vezi C02CA04) COMPR. 2mg OZONE LABORATORIES BV OLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 12.33 0.411000 0.411000 0.369900149 C02CA04 DOXAZOSINUM KAMIREN XL 4 mg (vezi C02CA04) COMPR. FILM. ELIB. PREL. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. CU ELIB. PREL. P-6L 30 35.07 1.169000 1.169000 1.052100150 C03AA03 HYDROCHLOROTHIAZIDUM NEFRIX 25 mg COMPR. 25mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L 25 0.99 0.039600 0.039600 0.035640151 C03BA11 INDAPAMIDUM IMPAMID (R) 2,5 mg COMPR. 2,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 15 COMPR. P-6L 30 14.24 0.474666 0.474666 0.427199152 C03BA11 INDAPAMIDUM INDAPAMID MCC 1,5 mg COMPR. ELIB. PREL. 1,5mg MAGISTRA C&C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 30 12.85 0.428333 0.400666 0.360599153 C03BA11 INDAPAMIDUM IDUREN SR 1,5 mg COMPR. ELIB. PREL. 1,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 12.02 0.400666 0.400666 0.360599154 C03BA11 INDAPAMIDUM INDAPAMID LPH (R) 2,5 mg COMPR. FILM. 2,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 14.16 0.472000 0.160333 0.144299155 C03BA11 INDAPAMIDUM INDATER (R) 2,5 mg COMPR. FILM. 2,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 13.99 0.466333 0.160333 0.144299156 C03BA11 INDAPAMIDUM INDAPAMIDE 2,5 mg COMPR. FILM. 2,5mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 4.81 0.160333 0.160333 0.144299157 C03BA11 INDAPAMIDUM INDAPAMID SR 1,5 mg LAROPHARM COMPR. FILM. ELIB. PREL. 1,5 mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 12.45 0.622500 0.366333 0.329699158 C03BA11 INDAPAMIDUM TERTENSIF (R) SR COMPR. FILM. ELIB. PREL. 1,5mg LES LAB. SERVIER IND. FRANTA CUTIE X 2 BLIST. X 15 COMPR. FILM. ELIB. PREL. P-6L 30 19.77 0.659000 0.366333 0.329699159 C03BA11 INDAPAMIDUM INDAPAMID LPH (R) 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 19.61 0.653666 0.366333 0.329699160 C03BA11 INDAPAMIDUM INDATER SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.ELIB. PREL. P-6L 30 18.37 0.612333 0.366333 0.329699161 C03BA11 INDAPAMIDUM RAWEL SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 10.99 0.366333 0.366333 0.329699162 C03BA11 INDAPAMIDUM IMPAMID SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. FILM. ELIB. PREL. P-6L 30 12.36 0.412000 0.366333 0.329699163 C03BA11 INDAPAMIDUM INDAPAMID SR OZONE 1,5mg COMPR. FILM. ELIB. PREL. 1,5mg OZONE LABORATORIES BV OLANDA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 7.37 0.368500 0.366333 0.329699164 C03BA11 INDAPAMIDUM REDITENS SR 1.5 mg COMPR. FILM. ELIB. PREL. 1,5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 12.85 0.428333 0.366333 0.329699165 C03BA11 INDAPAMIDUM INDAPAMIDA ACTAVIS 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. CU ELIB. PRELUNGITA P-6L 30 17.75 0.591666 0.366333 0.329699166 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 1.53 0.076500 0.075500 0.067950167 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.13 0.106500 0.075500 0.067950168 C03CA01 FUROSEMIDUM FUROSEMID EEL COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 1.83 0.091500 0.075500 0.067950169 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 1.53 0.076500 0.075500 0.067950170 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.88 0.144000 0.075500 0.067950171 C03CA01 FUROSEMIDUM FUROSEMID ARENA 40 mg COMPR. 40mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 1.51 0.075500 0.075500 0.067950172 C03CA01 FUROSEMIDUM FUROSEMID 20 mg/2 ml SOL. INJ. 10mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 3.14 0.628000 0.628000 0.565200173 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER PLC UNGARIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 26.75 0.891666 0.891666 0.802499174 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER PLC UNGARIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 15.69 0.523000 0.523000 0.470700175 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA EEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4.05 0.202500 0.202500 0.182250176 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA OZONE 25 mg COMPR. 25mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 10.14 0.202800 0.202500 0.182250177 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 12.68 0.253600 0.202500 0.182250178 C03DA01 SPIRONOLACTONUM ALSPIRON 25 mg COMPR. FILM. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 4.05 0.202500 0.202500 0.182250179 C03DA01 SPIRONOLACTONUM ALSPIRON 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 12.91 0.645500 0.645500 0.580950

180 C03EB01

COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUREX 50 CAPS. 50mg/20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 14.71 0.735500 0.735500 0.661950

181 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 13.13 0.656500 0.596400 0.536760182 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 32.36 0.647200 0.596400 0.536760183 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 100 59.64 0.596400 0.596400 0.536760184 C04AD03 PENTOXIFYLLINUM ANGIOPENT 400 mg COMPR. FILM. ELIB. PREL. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 14.71 0.735500 0.398400 0.358560185 C04AD03 PENTOXIFYLLINUM PENTOXI RETARD 400 mg COMPR. FILM. ELIB. PREL. 400mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 40 21.06 0.526500 0.398400 0.358560186 C04AD03 PENTOXIFYLLINUM PENTOXI RETARD 400 mg COMPR. FILM. ELIB. PREL. 400mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 20 16.15 0.807500 0.398400 0.358560187 C04AD03 PENTOXIFYLLINUM OXIFLUX 400 mg COMPR. FILM. ELIB. PREL. 400mg LABORMED PHARMA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL P-6L 20 10.17 0.508500 0.398400 0.358560188 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 9.61 0.480500 0.398400 0.358560189 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 24.04 0.480800 0.398400 0.358560

Pagina 5 din 34

Page 8: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

190 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 100 39.84 0.398400 0.398400 0.358560191 C04AD03 PENTOXIFYLLINUM ANGIOPENT 600 mg COMPR. FILM. ELIB. PREL. 600mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 15.44 0.772000 0.772000 0.694800192 C04AD03 PENTOXIFYLLINUM TRENTAL (R) DRAJ. ELIB. PREL. 400mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ. ELIB. PREL. P-6L 20 8.88 0.444000 0.444000 0.399600193 C07AA05 PROPRANOLOLUM PROPRANOLOL COMPR. 10mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 25 COMPR. P-6L 50 3.07 0.061400 0.054800 0.049320194 C07AA05 PROPRANOLOLUM N - PROPRANOLOL 10 mg COMPR. 10mg SC MEDUMAN SA ROMANIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 3.04 0.060800 0.054800 0.049320195 C07AA05 PROPRANOLOLUM PROPRANOLOL 10 mg COMPR. 10mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 2.74 0.054800 0.054800 0.049320196 C07AA05 PROPRANOLOLUM PROPRANOLOL FABIOL 10 mg COMPR. 10mg FABIOL S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-6L 10 0.68 0.068000 0.054800 0.049320197 C07AA05 PROPRANOLOLUM PROPRANOLOL FABIOL 10 mg COMPR. 10mg FABIOL S.A. ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 2.74 0.054800 0.054800 0.049320198 C07AA05 PROPRANOLOLUM PROPRANOLOL EEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 3.07 0.061400 0.061400 0.055260199 C07AA05 PROPRANOLOLUM PROPRANOLOL 40 mg COMPR. 40mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 3.07 0.061400 0.061400 0.055260200 C07AA05 PROPRANOLOLUM PROPRANOLOL FABIOL 40 mg COMPR. 40mg FABIOL S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-6L 10 0.74 0.074000 0.061400 0.055260201 C07AA05 PROPRANOLOLUM PROPRANOLOL FABIOL 40 mg COMPR. 40mg FABIOL S.A. ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 3.07 0.061400 0.061400 0.055260202 C07AA05 PROPRANOLOLUM PROPRANOLOL ARENA 40 mg COMPR. 40mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 4.67 0.093400 0.061400 0.055260203 C07AA07 SOTALOLUM SOTAGAMMA 160 COMPR. 160mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 20 10.91 0.545500 0.505400 0.454860204 C07AA07 SOTALOLUM SOTAGAMMA 160 COMPR. 160mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 100 54.87 0.548700 0.505400 0.454860205 C07AA07 SOTALOLUM SOTALOL AL 160 COMPR. 160mg ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 10.48 0.524000 0.505400 0.454860206 C07AA07 SOTALOLUM SOTALOL AL 160 COMPR. 160mg ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 25.27 0.505400 0.505400 0.454860207 C07AA07 SOTALOLUM SOTALOL AL 160 COMPR. 160mg ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-6L 100 51.29 0.512900 0.505400 0.454860208 C07AA07 SOTALOLUM DAROB (R) 80 mg COMPR. 80mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. AL/PVP X 10 COMPR. P-6L 20 9.45 0.472500 0.369200 0.332280209 C07AA07 SOTALOLUM SOTAGAMMA 80 COMPR. 80mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 100 36.92 0.369200 0.369200 0.332280210 C07AA07 SOTALOLUM SOTAGAMMA 80 COMPR. 80mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 20 8.07 0.403500 0.369200 0.332280211 C07AB02 METOPROLOLUM BLOXAN COMPR. 100mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC/PVDC TRANSPARENT/AL X 10 COMPR. P-6L 30 13.19 0.439666 0.185500 0.166950212 C07AB02 METOPROLOLUM BETAPROL 100 mg COMPR. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10.28 0.342666 0.185500 0.166950213 C07AB02 METOPROLOLUM EGILOK 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 6.16 0.308000 0.185500 0.166950214 C07AB02 METOPROLOLUM METOPROLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10.11 0.337000 0.185500 0.166950215 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 8.57 0.285666 0.185500 0.166950216 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 100 18.55 0.185500 0.185500 0.166950217 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 50 12.20 0.244000 0.185500 0.166950218 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 7.60 0.380000 0.185500 0.166950219 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 8.24 0.274666 0.185500 0.166950220 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 12.68 0.422666 0.185500 0.166950221 C07AB02 METOPROLOLUM METOPROLOL MEDICO UNO 100 mg COMPR. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10.11 0.337000 0.185500 0.166950222 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 100 mg COMPR. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6.92 0.346000 0.185500 0.166950223 C07AB02 METOPROLOLUM EGILOK 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 1.79 0.089500 0.089333 0.080399224 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 2.74 0.137000 0.089333 0.080399225 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2.68 0.089333 0.089333 0.080399226 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2.68 0.089333 0.089333 0.080399227 C07AB02 METOPROLOLUM METOPROLOL MEDICO UNO 25 mg COMPR. 25mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.11 0.137000 0.089333 0.080399228 C07AB02 METOPROLOLUM BETAPROL 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 8.26 0.275333 0.078900 0.071010229 C07AB02 METOPROLOLUM EGILOK 50 mg COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 3.30 0.165000 0.078900 0.071010230 C07AB02 METOPROLOLUM METOPROLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7.94 0.264666 0.078900 0.071010231 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 5.98 0.199333 0.078900 0.071010232 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. DIN PVC-PVDC/ALX 10 COMPR P-6L 100 7.89 0.078900 0.078900 0.071010233 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 50 6.66 0.133200 0.078900 0.071010234 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.95 0.165000 0.078900 0.071010235 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3.30 0.165000 0.078900 0.071010236 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.95 0.165000 0.078900 0.071010

Pagina 6 din 34

Page 9: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

237 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 9.48 0.316000 0.078900 0.071010238 C07AB02 METOPROLOLUM METOPROLOL MEDICO UNO 50 mg COMPR. 50mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6.26 0.208666 0.078900 0.071010239 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 50 mg COMPR. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6.22 0.311000 0.078900 0.071010240 C07AB02 METOPROLOLUM METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L 20 12.36 0.618000 0.618000 0.556200241 C07AB02 METOPROLOLUM VASOCARDIN (R) SR 200 COMPR. ELIB. PREL. 200mg ZENTIVA AS SLOVACIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 100 56.22 0.562200 0.562200 0.505980242 C07AB02 METOPROLOLUM VASOCARDIN (R) SR 200 COMPR. ELIB. PREL. 200mg ZENTIVA AS SLOVACIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 60 34.61 0.576833 0.562200 0.505980243 C07AB02 METOPROLOLUM VASOCARDIN (R) SR 200 COMPR. ELIB. PREL. 200mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 30 20.63 0.687666 0.562200 0.505980244 C07AB02 METOPROLOLUM BETALOC (R) ZOC 100 mg COMPR. FILM. ELIB. PREL. 100mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 24.13 0.804333 0.522333 0.470099245 C07AB02 METOPROLOLUM EMZOK 100 mg COMPR. FILM. ELIB. PREL. 100mg IVAX PHARMCEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. AL/PP X 10 COMPR. FILM. ELIB. PREL. P-6L 30 15.67 0.522333 0.522333 0.470099246 C07AB02 METOPROLOLUM BETALOC (R) ZOC 50 mg COMPR. FILM. ELIB. PREL. 50mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 14.73 0.491000 0.319333 0.287399247 C07AB02 METOPROLOLUM EMZOK 50 mg COMPR. FILM. ELIB. PREL. 50mg IVAX PHARMCEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. AL/PP X 10 COMPR. FILM. ELIB. PREL. P-6L 30 9.58 0.319333 0.319333 0.287399248 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mg COMPR.FILM.ELIB.MOD. 190mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 21.33 0.711000 0.711000 0.639900249 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 7.64 0.254666 0.254666 0.229199250 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 12.76 0.425333 0.425333 0.382799251 C07AB03 ATENOLOLUM ATENOCOR 100 mg COMPR. 100mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10.18 0.339333 0.293500 0.264150252 C07AB03 ATENOLOLUM ATENOLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6.61 0.330500 0.293500 0.264150253 C07AB03 ATENOLOLUM ATENOLOL 100 mg COMPR. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 5.87 0.293500 0.293500 0.264150254 C07AB03 ATENOLOLUM ATENOLOL 100 mg COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 5.87 0.293500 0.293500 0.264150255 C07AB03 ATENOLOLUM ATENOLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4.24 0.212000 0.166500 0.149850256 C07AB03 ATENOLOLUM ATENOLOL MEDUMAN 50mg COMPR. 50mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 3.47 0.173500 0.166500 0.149850257 C07AB03 ATENOLOLUM ATENOLOL 50 mg COMPR. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 4.24 0.212000 0.166500 0.149850258 C07AB03 ATENOLOLUM ATENOCOR 50 mg COMPR. 50mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5.02 0.167333 0.166500 0.149850259 C07AB03 ATENOLOLUM ATENOLOL 50 mg COMPR. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3.33 0.166500 0.166500 0.149850260 C07AB03 ATENOLOLUM ATENOLOL 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 6.46 0.323000 0.215500 0.193950261 C07AB03 ATENOLOLUM ATENOLOL 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 10.23 0.341000 0.215500 0.193950262 C07AB03 ATENOLOLUM ATENOLOL 100 mg MEDO COMPR. FILM. 100mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 4.31 0.215500 0.215500 0.193950263 C07AB03 ATENOLOLUM ATENOLOL 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. X 10 COMPR. FILM. P-6L 50 10.94 0.218800 0.208666 0.187799264 C07AB03 ATENOLOLUM ATENOLOL 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 6.26 0.208666 0.208666 0.187799265 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.FILM. P-6L 28 21.43 0.765357 0.715357 0.643821266 C07AB05 BETAXOLOLUM BETAC COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 4 BLIST. AL/PVC X 7 COMPR. FILM. P-6L 28 20.03 0.715357 0.715357 0.643821267 C07AB05 BETAXOLOLUM BETAC COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 25.79 0.859666 0.715357 0.643821268 C07AB05 BETAXOLOLUM BETAC COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 20.34 1.017000 0.715357 0.643821269 C07AB05 BETAXOLOLUM BETAC COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC X 7 COMPR. FILM. P-6L 14 14.18 1.012857 0.715357 0.643821270 C07AB07 BISOPROLOLUM BISOBLOCK 10 mg COMPR. 10mg KERI PHARMA GENERICS LTD. UNGARIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 15.53 0.517666 0.517666 0.465899271 C07AB07 BISOPROLOLUM BISOBLOCK 5 mg COMPR. 5mg KERI PHARMA GENERICS LTD. UNGARIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 7.09 0.236333 0.236333 0.212699272 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 29.89 0.996333 0.464000 0.417600273 C07AB07 BISOPROLOLUM BISOGAMMA (R) 10 COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L/S 100 46.40 0.464000 0.464000 0.417600274 C07AB07 BISOPROLOLUM BISOGAMMA (R) 10 COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. X 10 COMPR. FILM. P-6L 50 28.47 0.569400 0.464000 0.417600275 C07AB07 BISOPROLOLUM BISOGAMMA (R) 10 COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 17.01 0.567000 0.464000 0.417600276 C07AB07 BISOPROLOLUM BISOTENS 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 17.01 0.567000 0.464000 0.417600277 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 13.87 0.462333 0.462333 0.416099278 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 15.35 0.511666 0.234800 0.211320279 C07AB07 BISOPROLOLUM BISOGAMMA (R) 5 COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. X 25 COMPR. FILM. P-6L 50 13.68 0.273600 0.234800 0.211320280 C07AB07 BISOPROLOLUM BISOGAMMA (R) 5 COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 8.01 0.267000 0.234800 0.211320281 C07AB07 BISOPROLOLUM BISOGAMMA (R) 5 COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM. P-6L 100 23.48 0.234800 0.234800 0.211320282 C07AB07 BISOPROLOLUM BISOTENS 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 8.01 0.267000 0.234800 0.211320283 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8.20 0.273333 0.271333 0.244199

Pagina 7 din 34

Page 10: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

284 C07AG02 CARVEDILOLUM DILATREND (R) 12,5 mg COMPR. 12,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 28.10 1.003571 0.271333 0.244199285 C07AG02 CARVEDILOLUM CORYOL 12,5 mg COMPR. 12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 11.71 0.418214 0.271333 0.244199286 C07AG02 CARVEDILOLUM TALLITON (R) 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 12.48 0.416000 0.271333 0.244199287 C07AG02 CARVEDILOLUM ATRAM 12,5 COMPR. 12,5mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. P-6L 30 14.99 0.499666 0.271333 0.244199288 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,5 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 13.13 0.656500 0.271333 0.244199289 C07AG02 CARVEDILOLUM CARVEDILOL LPH 12,5 mg COMPR. 12,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 22.00 0.733333 0.271333 0.244199290 C07AG02 CARVEDILOLUM CARVEDILOL TEVA 12,5 mg COMPR. 12,5mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8.14 0.271333 0.271333 0.244199291 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 12,5mg COMPR. 12,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 19.06 0.953000 0.271333 0.244199292 C07AG02 CARVEDILOLUM DILATREND (R) 25 mg COMPR. 25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 32.45 1.158928 0.283666 0.255299293 C07AG02 CARVEDILOLUM CORYOL 25 mg COMPR. 25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. P-6L 28 20.69 0.738928 0.283666 0.255299294 C07AG02 CARVEDILOLUM TALLITON (R) 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 25.25 0.841666 0.283666 0.255299295 C07AG02 CARVEDILOLUM ATRAM 25 COMPR. 25mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 24.10 0.803333 0.283666 0.255299296 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 22.36 1.118000 0.283666 0.255299297 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 25mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8.63 0.287666 0.283666 0.255299298 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 32.71 1.090333 0.283666 0.255299299 C07AG02 CARVEDILOLUM CARVEDILOL TEVA 25 mg COMPR. 25mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8.51 0.283666 0.283666 0.255299300 C07AG02 CARVEDILOLUM DILATREND (R) 6,25 mg COMPR. 6,25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 15.44 0.551428 0.189000 0.170100301 C07AG02 CARVEDILOLUM CORYOL (R) COMPR. 6,25mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 6.04 0.215714 0.189000 0.170100302 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 8.69 0.289666 0.189000 0.170100303 C07AG02 CARVEDILOLUM ATRAM 6,25 COMPR. 6,25mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. P-6L 30 6.04 0.201333 0.189000 0.170100304 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 6,25mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 7.52 0.250666 0.189000 0.170100305 C07AG02 CARVEDILOLUM CARVEDILOL LPH 6,25 mg COMPR. 6,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 8.44 0.281333 0.189000 0.170100306 C07AG02 CARVEDILOLUM CARVEDILOL TEVA 6,25 mg COMPR. 6,25mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 5.67 0.189000 0.189000 0.170100307 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 6,25 mg COMPR. 6,25mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 8.61 0.430500 0.189000 0.170100308 C07AG02 CARVEDILOLUM CARVEDIGAMMA 12,5 mg COMPR. FILM. 12,5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 13.07 0.435666 0.435666 0.392099309 C07AG02 CARVEDILOLUM CARVEDIGAMMA 25 mg COMPR. FILM. 25mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 22.80 0.760000 0.760000 0.684000310 C07AG02 CARVEDILOLUM CARVEDIGAMMA 6,25 mg COMPR. FILM. 6,25mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 8.51 0.283666 0.283666 0.255299311 C08CA01 AMLODIPINUM NORVASC 10 mg COMPR. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 30 27.86 0.928666 0.160333 0.144299312 C08CA01 AMLODIPINUM AMLOHEXAL 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L 30 22.93 0.764333 0.160333 0.144299313 C08CA01 AMLODIPINUM TENOX (R) 10 COMPR. 10mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 20.15 0.671666 0.160333 0.144299314 C08CA01 AMLODIPINUM AMLODIPINE-TEVA 10 mg COMPR. 10mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR P-6L 30 4.81 0.160333 0.160333 0.144299315 C08CA01 AMLODIPINUM ALOZUR 10 mg COMPR. 10mg OZONE LABORATORIES BV OLANDA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 30 18.10 0.603333 0.160333 0.144299316 C08CA01 AMLODIPINUM STAMLO M 10 mg COMPR. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 14 COMPR. P-6L 28 13.77 0.491785 0.160333 0.144299317 C08CA01 AMLODIPINUM VASOREX 10 mg COMPR. 10mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 20.82 0.694000 0.160333 0.144299318 C08CA01 AMLODIPINUM AGEN 10 COMPR. 10mg ZENTIVA A.S. CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 21.14 0.704666 0.160333 0.144299319 C08CA01 AMLODIPINUM CARDILOPIN 10 mg COMPR. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 30 27.00 0.900000 0.160333 0.144299320 C08CA01 AMLODIPINUM AMLODIPINA BIOGALENICA 10 mg COMPR. 10mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 19.78 0.659333 0.160333 0.144299321 C08CA01 AMLODIPINUM AMLODIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC- PVDC/AL X 30 COMPR. P-6L 30 23.05 0.768333 0.160333 0.144299322 C08CA01 AMLODIPINUM AMLODIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC- PVDC/AL X 100 COMPR. P-6L/S 100 33.28 0.332800 0.160333 0.144299323 C08CA01 AMLODIPINUM ALMACOR 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 18.10 0.603333 0.160333 0.144299324 C08CA01 AMLODIPINUM AMLODIPINA ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P-6L 20 17.50 0.875000 0.160333 0.144299325 C08CA01 AMLODIPINUM AMLODIPIN VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. PVC-COC-PVDC/AL X 10 COMPR. P-6L 20 14.64 0.732000 0.160333 0.144299326 C08CA01 AMLODIPINUM NORVASC 5 mg COMPR. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 18.72 0.624000 0.080000 0.072000327 C08CA01 AMLODIPINUM AMLOHEXAL 5 mg COMPR. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L 30 10.68 0.356000 0.080000 0.072000328 C08CA01 AMLODIPINUM TENOX (R) 5 COMPR. 5mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 10.71 0.357000 0.080000 0.072000329 C08CA01 AMLODIPINUM AMLODIPINE-TEVA 5 mg COMPR. 5mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 3 BLIST PVC-PVDC/AL X 10 COMPR. P-6L 30 2.40 0.080000 0.080000 0.072000330 C08CA01 AMLODIPINUM ALOZUR 5 mg COMPR. 5mg OZONE LABORATORIES BV OLANDA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 30 10.35 0.345000 0.080000 0.072000

Pagina 8 din 34

Page 11: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

331 C08CA01 AMLODIPINUM STAMLO M 5 mg COMPR. 5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 14 COMPR. P-6L 28 8.21 0.293214 0.080000 0.072000332 C08CA01 AMLODIPINUM VASOREX 5 mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10.74 0.358000 0.080000 0.072000333 C08CA01 AMLODIPINUM AGEN 5 COMPR. 5mg ZENTIVA A.S. CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 10.55 0.351666 0.080000 0.072000334 C08CA01 AMLODIPINUM CARDILOPIN 5 mg COMPR. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 30 13.42 0.447333 0.080000 0.072000335 C08CA01 AMLODIPINUM AMLODIPINA BIOGALENICA 5 mg COMPR. 5mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 7.41 0.247000 0.080000 0.072000336 C08CA01 AMLODIPINUM AMLODIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30COMPR. P-6L 30 11.83 0.394333 0.080000 0.072000337 C08CA01 AMLODIPINUM AMLODIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100COMPR. P-6L/S 100 23.54 0.235400 0.080000 0.072000338 C08CA01 AMLODIPINUM ALMACOR 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 10.66 0.355333 0.080000 0.072000339 C08CA01 AMLODIPINUM AMLODIPINA ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P-6L 20 10.97 0.548500 0.080000 0.072000340 C08CA01 AMLODIPINUM AMLODIPIN VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. PVC-COC-PVDC/AL X 10 COMPR. P-6L 20 7.75 0.387500 0.080000 0.072000341 C08CA02 FELODIPINUM FELODIPIN AL 10 RETARD COMPR. ELIB. MODIF. 10mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. X 10 COMPR. ELIB. MODIF. P-6L 50 69.19 1.383800 1.312700 1.181430342 C08CA02 FELODIPINUM FELODIPIN AL 10 RETARD COMPR. ELIB. MODIF. 10mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. ELIB. MODIF. P-6L/S 100 131.27 1.312700 1.312700 1.181430343 C08CA02 FELODIPINUM FELODIPIN AL 10 RETARD COMPR. ELIB. MODIF. 10mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. ELIB. MODIF. P-6L 30 42.94 1.431333 1.312700 1.181430344 C08CA02 FELODIPINUM FELODIPIN AL 10 RETARD COMPR. ELIB. MODIF. 10mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. X 10 COMPR. ELIB. MODIF. P-6L 20 29.58 1.479000 1.312700 1.181430345 C08CA02 FELODIPINUM FELODIPIN AL 2,5 RETARD COMPR. ELIB. MODIF. 2,5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. ELIB. MODIF. P-6L 30 19.41 0.647000 0.626300 0.563670346 C08CA02 FELODIPINUM FELODIPIN AL 2,5 RETARD COMPR. ELIB. MODIF. 2,5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. X 10 COMPR. ELIB. MODIF. P-6L 50 32.36 0.647200 0.626300 0.563670347 C08CA02 FELODIPINUM FELODIPIN AL 2,5 RETARD COMPR. ELIB. MODIF. 2,5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. ELIB. MODIF. P-6L/S 100 62.63 0.626300 0.626300 0.563670348 C08CA02 FELODIPINUM FELODIPIN AL 2,5 RETARD COMPR. ELIB. MODIF. 2,5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. X 10 COMPR. ELIB. MODIF. P-6L 20 12.94 0.647000 0.626300 0.563670349 C08CA02 FELODIPINUM FELODIPIN AL 5 RETARD COMPR. ELIB. MODIF. 5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. ELIB. MODIF. P-6L 30 27.73 0.924333 0.849700 0.764730350 C08CA02 FELODIPINUM FELODIPIN AL 5 RETARD COMPR. ELIB. MODIF. 5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. X 10 COMPR. ELIB. MODIF. P-6L 20 19.11 0.955500 0.849700 0.764730351 C08CA02 FELODIPINUM FELODIPIN AL 5 RETARD COMPR. ELIB. MODIF. 5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. ELIB. MODIF. P-6L/S 100 84.97 0.849700 0.849700 0.764730352 C08CA02 FELODIPINUM FELODIPIN AL 5 RETARD COMPR. ELIB. MODIF. 5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. X 10 COMPR. ELIB. MODIF. P-6L 50 44.73 0.894600 0.849700 0.764730353 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 10mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL. P-6L 30 47.13 1.571000 0.952333 0.857099354 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 2,5mg ASTRAZENECA AB SUEDIA CUTIE 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL. P-6L 30 20.91 0.697000 0.269000 0.242100355 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 5mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL. P-6L 30 26.63 0.887666 0.491000 0.441900356 C08CA02 FELODIPINUM SISTAR 10 mg COMPR. FILM. ELIB. MODIF. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 28.57 0.952333 0.952333 0.857099357 C08CA02 FELODIPINUM SISTAR 2,5 mg COMPR. FILM. ELIB. MODIF. 2,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 15.45 0.515000 0.269000 0.242100358 C08CA02 FELODIPINUM SISTAR 5 mg COMPR. FILM. ELIB. MODIF. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 21.23 0.707666 0.491000 0.441900359 C08CA02 FELODIPINUM AURONAL 10 mg COMPR. FILM. ELIB. PREL. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 39.96 1.332000 0.952333 0.857099360 C08CA02 FELODIPINUM PRESID (R) 10 mg COMPR. FILM. ELIB. PREL. 10mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 30 31.49 1.049666 0.952333 0.857099361 C08CA02 FELODIPINUM MIVARA 10 mg COMPR. FILM. ELIB. PREL. 10mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 10 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L/S 100 110.46 1.104600 0.952333 0.857099362 C08CA02 FELODIPINUM MIVARA 10 mg COMPR. FILM. ELIB. PREL. 10mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 34.89 1.163000 0.952333 0.857099363 C08CA02 FELODIPINUM MIVARA 10 mg COMPR. FILM. ELIB. PREL. 10mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 58.17 1.163400 0.952333 0.857099364 C08CA02 FELODIPINUM FELODIPIN SANDOZ 10 mg COMPR. FILM. ELIB. PREL. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 28.67 0.955666 0.952333 0.857099365 C08CA02 FELODIPINUM AURONAL 2,5 mg COMPR. FILM. ELIB. PREL. 2,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 15.45 0.515000 0.269000 0.242100366 C08CA02 FELODIPINUM PRESID (R) 2,5 mg COMPR. FILM. ELIB. PREL. 2,5mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 30 8.07 0.269000 0.269000 0.242100367 C08CA02 FELODIPINUM AURONAL 5 mg COMPR. FILM. ELIB. PREL. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 25.02 0.834000 0.491000 0.441900368 C08CA02 FELODIPINUM PRESID (R) 5 mg COMPR. FILM. ELIB. PREL. 5mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 30 16.15 0.538333 0.491000 0.441900369 C08CA02 FELODIPINUM MIVARA 5 mg COMPR. FILM. ELIB. PREL. 5mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 36.38 0.727600 0.491000 0.441900370 C08CA02 FELODIPINUM MIVARA 5 mg COMPR. FILM. ELIB. PREL. 5mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 22.56 0.752000 0.491000 0.441900371 C08CA02 FELODIPINUM MIVARA 5 mg COMPR. FILM. ELIB. PREL. 5mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 10 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L/S 100 70.34 0.703400 0.491000 0.441900372 C08CA02 FELODIPINUM FELODIPIN SANDOZ 5 mg COMPR. FILM. ELIB. PREL. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 14.73 0.491000 0.491000 0.441900373 C08CA05 NIFEDIPINUM ADALAT CR 30 COMPR. ELIB. MODIF. 30mg BAYER HEALTHCARE AG GERMANIA CUTIE X 2 BLIST. AL/PP X 14 COMPR. ELIB. MODIF. P-6L 28 28.04 1.001428 1.001428 0.901285374 C08CA05 NIFEDIPINUM NIFEDIPIN RETARD TERAPIA 20 mg COMPR. FILM. ELIB. PREL. 20mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 4.13 0.082600 0.082600 0.074340375 C08CA05 NIFEDIPINUM EPILAT RETARD DRAJ. 20mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 2 FOLII X 10 DRAJ. P-6L 20 4.51 0.225500 0.225500 0.202950376 C08DA01 VERAPAMILUM VERAPAMIL AL 40 COMPR. FILM. 40mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. X 10 COMPR. FILM. P-6L 50 5.86 0.117200 0.111600 0.100440377 C08DA01 VERAPAMILUM VERAPAMIL AL 40 COMPR. FILM. 40mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L 100 11.16 0.111600 0.111600 0.100440

Pagina 9 din 34

Page 12: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

378 C08DA01 VERAPAMILUM ISOPTIN (R) 40 mg COMPR. FILM. 40mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 20 COMPR. FILM. P-6L 100 16.04 0.160400 0.111600 0.100440379 C08DA01 VERAPAMILUM VERAPAMIL AL 80 COMPR. FILM. 80mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L 100 19.74 0.197400 0.197200 0.177480380 C08DA01 VERAPAMILUM VERAPAMIL AL 80 COMPR. FILM. 80mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. X 10 COMPR. FILM. P-6L 50 9.86 0.197200 0.197200 0.177480381 C08DA01 VERAPAMILUM ISOPTIN (R) 80 mg COMPR. FILM. 80mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 14.36 0.287200 0.197200 0.177480382 C08DA01 VERAPAMILUM VEROGALID (R) ER 240 mg COMPR. FILM. ELIB. PREL. 240mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 10 10.06 1.006000 0.691666 0.622499383 C08DA01 VERAPAMILUM VEROGALID (R) ER 240 mg COMPR. FILM. ELIB. PREL. 240mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 30 21.23 0.707666 0.691666 0.622499384 C08DA01 VERAPAMILUM VEROGALID (R) ER 240 mg COMPR. FILM. ELIB. PREL. 240mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 20.75 0.691666 0.691666 0.622499385 C08DA01 VERAPAMILUM ISOPTIN RR COMPR. FILM. ELIB. PREL. 240mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 18.69 0.934500 0.691666 0.622499386 C08DA01 VERAPAMILUM VERAPAMIL 40 mg DRAJ. 40mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 DRAJ. P-6L 50 11.09 0.221800 0.221800 0.199620387 C08DA01 VERAPAMILUM VERAPAMIL 80 mg DRAJ. 80mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 DRAJ. P-6L 50 16.27 0.325400 0.325400 0.292860388 C08DB01 DILTIAZEMUM DILZEM 60 mg COMPR. 60mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 11.66 0.388666 0.252500 0.227250389 C08DB01 DILTIAZEMUM DILTIAZEM EIPICO 60 mg COMPR. 60mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 5.05 0.252500 0.252500 0.227250390 C08DB01 DILTIAZEMUM DILTIAZEM LPH 60 mg COMPR. 60mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6.35 0.317500 0.252500 0.227250391 C08DB01 DILTIAZEMUM DILTIAZEM ARENA 60 mg COMPR. 60mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. DIN AL/ PVC X 10COMPR. P-6L 20 7.10 0.355000 0.252500 0.227250392 C08DB01 DILTIAZEMUM DILTIAZEM ARENA 60 mg COMPR. 60mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. DIN AL/ PVC X 10COMPR. P-6L 50 14.45 0.289000 0.252500 0.227250393 C08DB01 DILTIAZEMUM CORZEM 120 COMPR. FILM. 120mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 10 12.05 1.205000 1.205000 1.084500394 C08DB01 DILTIAZEMUM DILZEM 90 mg RETARD COMPR. FILM. ELIB. PREL. 90mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 14.42 0.480666 0.480666 0.432599395 C09AA01 CAPTOPRILUM CAPTOPRIL 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 30 2.77 0.092333 0.092333 0.083099396 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 12,5 mg COMPR. 12,5mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2.77 0.092333 0.092333 0.083099397 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 30 3.20 0.106666 0.106500 0.095850398 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3.20 0.106666 0.106500 0.095850399 C09AA01 CAPTOPRILUM CAPTOPRIL 25 EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.84 0.142000 0.106500 0.095850400 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.13 0.106500 0.106500 0.095850401 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3.20 0.106666 0.106500 0.095850402 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.13 0.137666 0.106500 0.095850403 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3.24 0.108000 0.106500 0.095850404 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.13 0.106500 0.106500 0.095850405 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 50 mg COMPR. 50 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.51 0.125500 0.122666 0.110399406 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 20 4.18 0.209000 0.122666 0.110399407 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.25 0.141666 0.122666 0.110399408 C09AA01 CAPTOPRILUM CAPTOPRIL 50 EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3.62 0.181000 0.122666 0.110399409 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.51 0.125500 0.122666 0.110399410 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.24 0.141333 0.122666 0.110399411 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3.68 0.122666 0.122666 0.110399412 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 FOLII X 10 COMPR. P-6L 20 4.59 0.229500 0.124500 0.112050413 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 4.59 0.229500 0.124500 0.112050414 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 10 mg COMPR. 10mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3.71 0.185500 0.124500 0.112050415 C09AA02 ENALAPRILUM EDNYT (R) 10 mg COMPR. 10mg GEDEON RICHTER LTD. UNGARIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 9.57 0.319000 0.124500 0.112050416 C09AA02 ENALAPRILUM ENALAP COMPR. 10mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 4.13 0.206500 0.124500 0.112050417 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 7.24 0.362000 0.124500 0.112050418 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 4.13 0.206500 0.124500 0.112050419 C09AA02 ENALAPRILUM ENALAPRIL FABIOL 10 mg COMPR. 10mg FABIOL SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6.29 0.314500 0.124500 0.112050420 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 6.19 0.309500 0.124500 0.112050421 C09AA02 ENALAPRILUM ENALAPRIL AL 10 COMPR. 10mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 7.95 0.265000 0.124500 0.112050422 C09AA02 ENALAPRILUM ENALAPRIL AL 10 COMPR. 10mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 50 9.80 0.196000 0.124500 0.112050423 C09AA02 ENALAPRILUM ENALAPRIL AL 10 COMPR. 10mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 100 12.45 0.124500 0.124500 0.112050424 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 9.88 0.352857 0.124500 0.112050

Pagina 10 din 34

Page 13: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

425 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 7.73 0.386500 0.124500 0.112050426 C09AA02 ENALAPRILUM ENAM 10 mg COMPR. 10mg REPREZENTANTA DR. REDDY'S LABORATORIES LTD. ROMANIA CUTIE X 2 BLIST. AL-PEJD/AL X10 COMPR. P-6L 20 5.55 0.277500 0.124500 0.112050427 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 6.84 0.342000 0.124500 0.112050428 C09AA02 ENALAPRILUM MUNEVER 10 mg COMPR. 10mg REPREZENTANTA DR. REDDY'S LABORATORIES LTD. ROMANIA CUTIE X 2 BLIST. AL-PEJD/AL X10 COMPR. P-6L 20 5.55 0.277500 0.124500 0.112050429 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6.46 0.215333 0.124500 0.112050430 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 10.55 0.211000 0.124500 0.112050431 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-6L 100 20.66 0.206600 0.124500 0.112050432 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 10.59 0.529500 0.124500 0.112050433 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 6.89 0.344500 0.124500 0.112050434 C09AA02 ENALAPRILUM EDNYT (R) 2,5 mg COMPR. 2,5mg GEDEON RICHTER LTD. UNGARIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 7.75 0.258333 0.258333 0.232499435 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 7.46 0.373000 0.183700 0.165330436 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 20 mg COMPR. 20mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 9.55 0.477500 0.183700 0.165330437 C09AA02 ENALAPRILUM EDNYT (R) 20 mg COMPR. 20mg GEDEON RICHTER LTD. UNGARIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 16.53 0.551000 0.183700 0.165330438 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 10.48 0.524000 0.183700 0.165330439 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 9.55 0.477500 0.183700 0.165330440 C09AA02 ENALAPRILUM ENALAPRIL FABIOL 20 mg COMPR. 20mg FABIOL SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6.69 0.334500 0.183700 0.165330441 C09AA02 ENALAPRILUM ENALAPRIL AL 20 COMPR. 20mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 100 18.37 0.183700 0.183700 0.165330442 C09AA02 ENALAPRILUM ENALAPRIL AL 20 COMPR. 20mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 50 15.41 0.308200 0.183700 0.165330443 C09AA02 ENALAPRILUM ENALAPRIL AL 20 COMPR. 20mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 10.91 0.363666 0.183700 0.165330444 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 16.07 0.573928 0.183700 0.165330445 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 11.77 0.588500 0.183700 0.165330446 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 10.45 0.522500 0.183700 0.165330447 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 10.46 0.348666 0.183700 0.165330448 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 FOLII X 10 COMPR. P-6L 20 3.44 0.172000 0.093100 0.083790449 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3.44 0.172000 0.093100 0.083790450 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 5 mg COMPR. 5mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3.44 0.172000 0.093100 0.083790451 C09AA02 ENALAPRILUM EDNYT (R) 5 mg COMPR. 5mg GEDEON RICHTER LTD. UNGARIA CUTIE X 3 BLIST.X 10 COMPR. P-6L 30 7.75 0.258333 0.093100 0.083790452 C09AA02 ENALAPRILUM ENALAPRIL AL 5 COMPR. 5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 4.93 0.164333 0.093100 0.083790453 C09AA02 ENALAPRILUM ENALAPRIL AL 5 COMPR. 5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 100 9.31 0.093100 0.093100 0.083790454 C09AA02 ENALAPRILUM ENALAPRIL AL 5 COMPR. 5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 50 7.95 0.159000 0.093100 0.083790455 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 3.59 0.179500 0.093100 0.083790456 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 7.40 0.264285 0.093100 0.083790457 C09AA02 ENALAPRILUM ENALAPRIL LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 5.24 0.262000 0.093100 0.083790458 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 3.68 0.184000 0.093100 0.083790459 C09AA02 ENALAPRILUM INVORIL 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 5.18 0.172666 0.093100 0.083790460 C09AA02 ENALAPRILUM ENALAPRIL ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5.24 0.174666 0.093100 0.083790461 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 3.56 0.178000 0.093100 0.083790462 C09AA02 ENALAPRILUM ENAP (R) SOL. INJ. 1,25mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 14.50 2.900000 2.900000 2.610000463 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER PLC UNGARIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 14.51 0.518214 0.322666 0.290399464 C09AA03 LISINOPRILUM RANOLIP COMPR. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 14.07 0.469000 0.322666 0.290399465 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 10.09 0.504500 0.322666 0.290399466 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 10 mg COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 9.54 0.477000 0.322666 0.290399467 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 10 mg COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 14.81 0.493666 0.322666 0.290399468 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 9.68 0.322666 0.322666 0.290399469 C09AA03 LISINOPRILUM LISIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 15.16 0.505333 0.322666 0.290399470 C09AA03 LISINOPRILUM LISINOPRIL 10 MEDO COMPR. 10mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 13.56 0.452000 0.322666 0.290399471 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 12.08 0.402666 0.322666 0.290399

Pagina 11 din 34

Page 14: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

472 C09AA03 LISINOPRILUM TONOLYSIN 2,5 mg COMPR. 2,5mg GEDEON RICHTER PLC UNGARIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 8.21 0.293214 0.293214 0.263892473 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER PLC UNGARIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 21.51 0.768214 0.471333 0.424199474 C09AA03 LISINOPRILUM RANOLIP COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 21.69 0.723000 0.471333 0.424199475 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 14.70 0.735000 0.471333 0.424199476 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 14.14 0.471333 0.471333 0.424199477 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 26.79 0.893000 0.471333 0.424199478 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 13.56 0.678000 0.471333 0.424199479 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 20 mg COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-6L 10 6.98 0.698000 0.471333 0.424199480 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 20 mg COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 22.05 0.735000 0.471333 0.424199481 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 20 mg COMPR. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 21.94 0.731333 0.471333 0.424199482 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 40 mg COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 36.91 1.230333 1.230333 1.107299483 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 40 mg COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-6L 10 12.94 1.294000 1.230333 1.107299484 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER PLC UNGARIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 8.72 0.311428 0.224000 0.201600485 C09AA03 LISINOPRILUM RANOLIP COMPR. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 7.18 0.239333 0.224000 0.201600486 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 5 mg COMPR. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6.72 0.224000 0.224000 0.201600487 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 9.49 0.316333 0.224000 0.201600488 C09AA03 LISINOPRILUM LISINOPRIL 5 MEDO COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 8.14 0.271333 0.224000 0.201600489 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 6.90 0.230000 0.224000 0.201600490 C09AA05 RAMIPRILUM EMREN 10 mg COMPR. 10 mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 32.02 1.067333 0.357900 0.322110491 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 25.12 0.897142 0.357900 0.322110492 C09AA05 RAMIPRILUM TRITACE 10 COMPR. 10mg SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 33.62 1.200714 0.357900 0.322110493 C09AA05 RAMIPRILUM PIRAMIL 10 mg COMPR. 10mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 23.68 0.845714 0.357900 0.322110494 C09AA05 RAMIPRILUM RAMIPRIL-AC 10 mg COMPR. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 41.98 1.399333 0.357900 0.322110495 C09AA05 RAMIPRILUM AMPRIL 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 39.43 1.314333 0.357900 0.322110496 C09AA05 RAMIPRILUM HARTIL 10 mg COMPR. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 45.33 1.618928 0.357900 0.322110497 C09AA05 RAMIPRILUM ZENRA 10 COMPR. 10mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 35.85 1.280357 0.357900 0.322110498 C09AA05 RAMIPRILUM RAMIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/AL X 10 COMPR. P-6L/S 100 35.79 0.357900 0.357900 0.322110499 C09AA05 RAMIPRILUM RAMIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 9.86 0.493000 0.357900 0.322110500 C09AA05 RAMIPRILUM EMREN 2,5 mg COMPR. 2,5 mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 10.51 0.350333 0.250357 0.225321501 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR. P-6L 28 7.01 0.250357 0.250357 0.225321502 C09AA05 RAMIPRILUM TRITACE (R) 2,5 COMPR. 2,5mg AVENTIS PHARMA DEUTSCHLAND GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 13.53 0.483214 0.250357 0.225321503 C09AA05 RAMIPRILUM PIRAMIL 2,5 mg COMPR. 2,5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 10.06 0.359285 0.250357 0.225321504 C09AA05 RAMIPRILUM RAMIPRIL-AC 2,5 mg COMPR. 2,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 12.20 0.406666 0.250357 0.225321505 C09AA05 RAMIPRILUM AMPRIL 2,5 mg COMPR. 2,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 13.08 0.436000 0.250357 0.225321506 C09AA05 RAMIPRILUM HARTIL 2,5 mg COMPR. 2,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 13.70 0.489285 0.250357 0.225321507 C09AA05 RAMIPRILUM ZENRA 2,5 COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 10.31 0.368214 0.250357 0.225321508 C09AA05 RAMIPRILUM EMREN 5 mg COMPR. 5 mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 19.24 0.641333 0.242800 0.218520509 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 12.48 0.445714 0.242800 0.218520510 C09AA05 RAMIPRILUM TRITACE (R) 5 COMPR. 5mg AVENTIS PHARMA DEUTSCHLAND GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 14.67 0.523928 0.242800 0.218520511 C09AA05 RAMIPRILUM PIRAMIL 5 mg COMPR. 5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 11.79 0.421071 0.242800 0.218520512 C09AA05 RAMIPRILUM RAMIPRIL-AC 5 mg COMPR. 5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 32.92 1.097333 0.242800 0.218520513 C09AA05 RAMIPRILUM AMPRIL 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 21.59 0.719666 0.242800 0.218520514 C09AA05 RAMIPRILUM HARTIL 5 mg COMPR. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 24.19 0.863928 0.242800 0.218520515 C09AA05 RAMIPRILUM ZENRA 5 COMPR. 5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 20.63 0.736785 0.242800 0.218520516 C09AA05 RAMIPRILUM RAMIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. A/AL X 10 COMPR. P-6L/S 100 24.28 0.242800 0.242800 0.218520517 C09AA05 RAMIPRILUM RAMIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. A/AL X 10 COMPR. P-6L 20 6.66 0.333000 0.242800 0.218520518 C09AA05 RAMIPRILUM RAMIRAN 1,25 mg COMPR. FILM. 1,25mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 FOLII AL/PEJD X 10 COMPR. FILM. P-6L 30 6.47 0.215666 0.215666 0.194099

Pagina 12 din 34

Page 15: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

519 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. FILM. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 FOLII AL/PEJD X 10 COMPR. FILM. P-6L 30 32.02 1.067333 1.067333 0.960599520 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. FILM. 2,5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 FOLII AL/PEJD X 10 COMPR. FILM. P-6L 30 10.54 0.351333 0.351333 0.316199521 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. FILM. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 FOLII AL/PEJD X 10 COMPR. FILM. P-6L 30 19.24 0.641333 0.641333 0.577199522 C09AA06 QUINAPRILUM QUINAPRIL SANDOZ 10 mg COMPR. FILM. 10 mg HEXAL AG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 9.68 0.322666 0.322666 0.290399523 C09AA06 QUINAPRILUM AQUIRIL 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. FILM. P-6L 30 17.64 0.588000 0.322666 0.290399524 C09AA06 QUINAPRILUM ACCUPRO 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL/PA X 10 COMPR. FILM. P-6L 30 10.97 0.365666 0.322666 0.290399525 C09AA06 QUINAPRILUM QUINARAN 10 mg COMPR. FILM. 10mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 14.50 0.483333 0.322666 0.290399526 C09AA06 QUINAPRILUM QUINAPRIL SANDOZ 20 mg COMPR. FILM. 20 mg HEXAL AG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 14.14 0.471333 0.471333 0.424199527 C09AA06 QUINAPRILUM ACCUPRO (R) 20 COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 15.72 0.524000 0.471333 0.424199528 C09AA06 QUINAPRILUM QUINARAN 20 mg COMPR. FILM. 20mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 28.51 0.950333 0.471333 0.424199529 C09AA06 QUINAPRILUM QUINAPRIL SANDOZ 40 mg COMPR. FILM. 40 mg HEXAL AG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 54.57 1.819000 1.379666 1.241699530 C09AA06 QUINAPRILUM QUINARAN 40 mg COMPR. FILM. 40mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 41.39 1.379666 1.379666 1.241699531 C09AA06 QUINAPRILUM ACCUPRO (R) 5 COMPR. FILM. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 7.70 0.256666 0.238333 0.214499532 C09AA06 QUINAPRILUM QUINARAN 5 mg COMPR. FILM. 5mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 7.15 0.238333 0.238333 0.214499533 C09AA09 FOSINOPRILUM MONOPRIL 10 mg COMPR. 10mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 19.57 0.698928 0.462333 0.416099534 C09AA09 FOSINOPRILUM FOSYPRIL 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. P-6L 30 13.87 0.462333 0.462333 0.416099535 C09AA09 FOSINOPRILUM FOSYPRIL 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL-PVC-PA/AL X 15 COMPR. P-6L 30 13.87 0.462333 0.462333 0.416099536 C09AA09 FOSINOPRILUM FOSINOPRIL TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 14.53 0.726500 0.462333 0.416099537 C09AA09 FOSINOPRILUM MONOPRIL 20 mg COMPR. 20mg BRISTOL-MYERS SQUIBB UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 26.83 0.958214 0.591666 0.532499538 C09AA09 FOSINOPRILUM FOSINOPRIL TEVA 20 mg COMPR. 20mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 30 17.75 0.591666 0.591666 0.532499539 C09AA09 FOSINOPRILUM FOSYPRIL 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. P-6L 30 24.04 0.801333 0.591666 0.532499540 C09AA09 FOSINOPRILUM FOSYPRIL 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL-PVC-PA/AL X 15 COMPR. P-6L 30 24.04 0.801333 0.591666 0.532499541 C09AA09 FOSINOPRILUM FOSINOPRIL TERAPIA 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 19.46 0.973000 0.591666 0.532499

542 C09BA02

COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP HL COMPR. 10mg+12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 8.34 0.417000 0.417000 0.375300

543 C09BA02

COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP H COMPR. 10mg+25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 9.23 0.461500 0.376333 0.338699

544 C09BA02

COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENALAPRIL HCT SANDOZ 10 mg/25 mg COMPR. 10mg/25mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 11.29 0.376333 0.376333 0.338699

545 C09BA02

COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP (R) HL 20 mg/12,5 mg COMPR. 20 mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 7.47 0.373500 0.373500 0.336150

546 C09BA02

COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENALAPRIL HCT SANDOZ 20 mg/12,5 mg COMPR. 20mg/12,5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 15.72 0.524000 0.373500 0.336150

547 C09BA02

COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) VIMAPRIL HL COMPR. FARA CONCENTRATIE VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. PVC/COC/PVDC-AL X 10 COMPR. P-6L 30 13.44 0.448000 0.417000 0.375300

Pagina 13 din 34

Page 16: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

548 C09BA02

COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) VIMAPRIL H COMPR. FARA CONCENTRATIE VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. PVC/COC/PVDC-AL X 10 COMPR. P-6L 30 16.19 0.539666 0.376333 0.338699

549 C09BA05

COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) HARTIL HCT 2,5 mg/12,5mg COMPR. 2,5mg/12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PCTFE/AL X 14 COMPR. P-6L 28 21.80 0.778571 0.268000 0.241200

550 C09BA05

COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) RAMIPRIL HCT-MEDOCHEMIE COMPR. 2,5mg/12,5mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 12.45 0.415000 0.268000 0.241200

551 C09BA05

COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) TENSIL 2,5mg/12,5mg COMPR. 2,5mg/12,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 8.04 0.268000 0.268000 0.241200

552 C09BA05

COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) EMREN HCT 2,5mg/12,5mg COMPR. 2,5mg/12,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 12.36 0.412000 0.268000 0.241200

553 C09BA05

COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) HARTIL HCT 5 mg/25mg COMPR. 5mg/25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PCTFE/AL X 14 COMPR. P-6L 28 27.66 0.987857 0.570000 0.513000

554 C09BA05

COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) RAMIPRIL HCT-MEDOCHEMIE COMPR. 5mg/25mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 21.33 0.711000 0.570000 0.513000

555 C09BA05

COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) TENSIL 5mg/25mg COMPR. 5mg/25mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 17.10 0.570000 0.570000 0.513000

556 C09BA05

COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) EMREN HCT 5mg/25mg COMPR. 5mg/25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 22.00 0.733333 0.570000 0.513000

557 C09CA01 LOSARTANUM LOZAP 100 COMPR. FILM. 100mg ZENTIVA A.S. SLOVACIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 35.31 1.177000 1.045666 0.941099558 C09CA01 LOSARTANUM TALOSAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 31.37 1.045666 1.045666 0.941099559 C09CA01 LOSARTANUM TALOSAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 31.37 1.045666 1.045666 0.941099560 C09CA01 LOSARTANUM LOZAP 12,5 COMPR. FILM. 12,5mg ZENTIVA A.S. SLOVACIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 4.62 0.154000 0.133666 0.120299561 C09CA01 LOSARTANUM TALOSAN 12,5 mg COMPR. FILM. 12,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 4.01 0.133666 0.133666 0.120299562 C09CA01 LOSARTANUM TALOSAN 12,5 mg COMPR. FILM. 12,5mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 4.01 0.133666 0.133666 0.120299563 C09CA01 LOSARTANUM TALOSAN 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 7.33 0.244333 0.244333 0.219899564 C09CA01 LOSARTANUM TALOSAN 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 7.33 0.244333 0.244333 0.219899565 C09CA01 LOSARTANUM COZAAR COMPR. FILM. 50mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPACE AL/PVC-PE-PVDC X 14 COMPR. FILM. P-6L 28 62.70 2.239285 0.561000 0.504900566 C09CA01 LOSARTANUM LOZAP 50 COMPR. FILM. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 18.43 0.614333 0.561000 0.504900567 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 16.83 0.561000 0.561000 0.504900568 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 16.83 0.561000 0.561000 0.504900569 C09CA01 LOSARTANUM LOSARTAN FARMAL 50 mg COMPR. FILM. 50mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PE- PVDC/AL X 14 COMPR. FILM. P-6L 28 16.79 0.599642 0.561000 0.504900570 C10AA01 SIMVASTATINUM SIMVASTATIN 10 mg COMPR. FILM. 10 mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 13.94 0.497857 0.293214 0.263892571 C10AA01 SIMVASTATINUM SIMVASTATINA BIOGALENICA 10 mg COMPR. FILM. 10 mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 14.13 0.504642 0.293214 0.263892

Pagina 14 din 34

Page 17: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

572 C10AA01 SIMVASTATINUM SIMVOR 10 mg COMPR. FILM. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 5.44 0.388571 0.293214 0.263892573 C10AA01 SIMVASTATINUM SIMVOR 10 mg COMPR. FILM. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. X 7 COMPR. FILM. P-6L 28 10.88 0.388571 0.293214 0.263892574 C10AA01 SIMVASTATINUM SIMVACARD (R) 10 COMPR. FILM. 10mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. AL/PVDC-PE-PVC X 14 COMPR. FILM. P-6L 28 11.28 0.402857 0.293214 0.263892575 C10AA01 SIMVASTATINUM SIMGAL (R) 10 mg COMPR. FILM. 10mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 8.21 0.293214 0.293214 0.263892576 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 10 mg COMPR. FILM. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 9.86 0.328666 0.293214 0.263892577 C10AA01 SIMVASTATINUM ZEPLAN (R) 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 14 8.35 0.596428 0.293214 0.263892578 C10AA01 SIMVASTATINUM ZEPLAN (R) 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM P-6L 28 11.28 0.402857 0.293214 0.263892579 C10AA01 SIMVASTATINUM ZOCOR 10 mg COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 14 6.32 0.451428 0.293214 0.263892580 C10AA01 SIMVASTATINUM ZOCOR 10 mg COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 12.63 0.451071 0.293214 0.263892581 C10AA01 SIMVASTATINUM SINTENAL 10 mg COMPR. FILM. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 15.78 0.526000 0.293214 0.263892582 C10AA01 SIMVASTATINUM SIMVAGAMMA 10 mg COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. FILM. P-6L 30 14.55 0.485000 0.293214 0.263892583 C10AA01 SIMVASTATINUM SIMVAGAMMA 10 mg COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/AL X 10 COMPR. FILM. P-6L 100 44.97 0.449700 0.293214 0.263892584 C10AA01 SIMVASTATINUM VASILIP 10 mg COMPR. FILM. 10mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. DIN PVC-PE/PVDC-PE-AL X 7 COMPR. FILM. P-6L 28 11.28 0.402857 0.293214 0.263892585 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 21.73 0.724333 0.293214 0.263892586 C10AA01 SIMVASTATINUM VABADIN 10 mg COMPR. FILM. 10mg MENARINI INTERNATIONAL OPERATIONS S.A. LUXEMBOURG CUTIE X 4 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. P-6L 28 21.57 0.770357 0.293214 0.263892587 C10AA01 SIMVASTATINUM ZAREDIL 10 mg COMPR. FILM. 10mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 8.21 0.293214 0.293214 0.263892588 C10AA01 SIMVASTATINUM SIMVASTATIN ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC- PE- PVDC /AL X 30 COMPR. FILM. P-6L 30 13.73 0.457666 0.293214 0.263892589 C10AA01 SIMVASTATINUM SIMVASTATIN 20 mg COMPR. FILM. 20 mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 27.86 0.995000 0.554642 0.499178590 C10AA01 SIMVASTATINUM SIMVASTATINA BIOGALENICA 20 mg COMPR. FILM. 20 mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 29.49 1.053214 0.554642 0.499178591 C10AA01 SIMVASTATINUM SIMVOR 20 mg COMPR. FILM. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. X 7 COMPR. FILM. P-6L 28 18.01 0.643214 0.554642 0.499178592 C10AA01 SIMVASTATINUM SIMVOR 20 mg COMPR. FILM. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 9.00 0.642857 0.554642 0.499178593 C10AA01 SIMVASTATINUM SIMVACARD (R) 20 COMPR. FILM. 20mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. AL/PVDC-PE-PVC X 14 COMPR. FILM. P-6L 28 21.14 0.755000 0.554642 0.499178594 C10AA01 SIMVASTATINUM SIMGAL (R) 20 mg COMPR. FILM. 20mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 15.53 0.554642 0.554642 0.499178595 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 20 mg COMPR. FILM. 20mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 19.29 0.643000 0.554642 0.499178596 C10AA01 SIMVASTATINUM ZEPLAN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM P-6L 28 22.50 0.803571 0.554642 0.499178597 C10AA01 SIMVASTATINUM ZEPLAN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 14 16.27 1.162142 0.554642 0.499178598 C10AA01 SIMVASTATINUM ZOCOR 20 mg COMPR. FILM. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 14 11.96 0.854285 0.554642 0.499178599 C10AA01 SIMVASTATINUM ZOCOR 20 mg COMPR. FILM. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 28 23.91 0.853928 0.554642 0.499178600 C10AA01 SIMVASTATINUM SINTENAL 20 mg COMPR. FILM. 20mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 31.54 1.051333 0.554642 0.499178601 C10AA01 SIMVASTATINUM SIMVAGAMMA 20 mg COMPR. FILM. 20mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/AL X 10 COMPR. FILM. P-6L 100 105.53 1.055300 0.554642 0.499178602 C10AA01 SIMVASTATINUM SIMVAGAMMA 20 mg COMPR. FILM. 20mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. FILM. P-6L 30 35.13 1.171000 0.554642 0.499178603 C10AA01 SIMVASTATINUM VASILIP 20 mg COMPR. FILM. 20mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. DIN PVC-PE/PVDC-PE-AL X 7 COMPR. FILM. P-6L 28 22.50 0.803571 0.554642 0.499178604 C10AA01 SIMVASTATINUM SIMCOR 20 mg COMPR. FILM. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 16.64 0.554667 0.554642 0.499178605 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 47.19 1.573000 0.554642 0.499178606 C10AA01 SIMVASTATINUM VABADIN 20 mg COMPR. FILM. 20mg MENARINI INTERNATIONAL OPERATIONS S.A. LUXEMBOURG CUTIE X 4 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. P-6L 28 41.75 1.491071 0.554642 0.499178607 C10AA01 SIMVASTATINUM ZAREDIL 20 mg COMPR. FILM. 20mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 15.55 0.555357 0.554642 0.499178608 C10AA01 SIMVASTATINUM SIMVASTATIN ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC- PE- PVDC /AL X 30 COMPR. FILM. P-6L 30 27.43 0.914333 0.554642 0.499178609 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 30 mg COMPR. FILM. 30mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 27.80 0.926666 0.926666 0.833999610 C10AA01 SIMVASTATINUM SIMVASTATIN 40 mg COMPR. FILM. 40 mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 47.18 1.685000 0.616428 0.554785611 C10AA01 SIMVASTATINUM SIMVASTATINA BIOGALENICA 40 mg COMPR. FILM. 40 mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 43.41 1.550357 0.616428 0.554785612 C10AA01 SIMVASTATINUM SIMVOR 40 mg COMPR. FILM. 40mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 17.26 1.232857 0.616428 0.554785613 C10AA01 SIMVASTATINUM VASILIP (R) 40 mg COMPR. FILM. 40mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-6L 28 43.00 1.535714 0.616428 0.554785614 C10AA01 SIMVASTATINUM SIMVACARD (R) 40 COMPR. FILM. 40mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. AL/PVDC-PE-PVC X 14 COMPR. FILM. P-6L 28 40.98 1.463571 0.616428 0.554785615 C10AA01 SIMVASTATINUM ZOCOR FORTE COMPR. FILM. 40mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 28 41.75 1.491071 0.616428 0.554785616 C10AA01 SIMVASTATINUM ZOCOR FORTE COMPR. FILM. 40mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 14 21.57 1.540714 0.616428 0.554785617 C10AA01 SIMVASTATINUM ZEPLAN (R) 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 43.59 1.556785 0.616428 0.554785618 C10AA01 SIMVASTATINUM ZEPLAN (R) 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 14 17.26 1.232857 0.616428 0.554785

Pagina 15 din 34

Page 18: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

619 C10AA01 SIMVASTATINUM SIMGAL (R) 40 mg COMPR. FILM. 40mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 28.04 1.001428 0.616428 0.554785620 C10AA01 SIMVASTATINUM SINTENAL 40 mg COMPR. FILM. 40mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 49.59 1.653000 0.616428 0.554785621 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 40 mg COMPR. FILM. 40mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 33.64 1.121333 0.616428 0.554785622 C10AA01 SIMVASTATINUM SIMVAGAMMA 40 mg COMPR. FILM. 40mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/AL X 10 COMPR. FILM. P-6L 100 126.01 1.260100 0.616428 0.554785623 C10AA01 SIMVASTATINUM SIMVAGAMMA 40 mg COMPR. FILM. 40mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. FILM. P-6L 30 53.50 1.783333 0.616428 0.554785624 C10AA01 SIMVASTATINUM SIMCOR 40 mg COMPR. FILM. 40mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 10 10.02 1.002000 0.616428 0.554785625 C10AA01 SIMVASTATINUM SIMCOR 40 mg COMPR. FILM. 40mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 30.05 1.001666 0.616428 0.554785626 C10AA01 SIMVASTATINUM VABADIN 40 mg COMPR. FILM. 40mg MENARINI INTERNATIONAL OPERATIONS S.A. LUXEMBOURG CUTIE X 4 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. P-6L 28 63.42 2.265000 0.616428 0.554785627 C10AA01 SIMVASTATINUM ZAREDIL 40 mg COMPR. FILM. 40mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 17.26 0.616428 0.616428 0.554785628 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 40 mg COMPR. FILM. 40mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 48.94 1.631333 0.616428 0.554785629 C10AA01 SIMVASTATINUM SIMVASTATIN ACCORD 40 mg COMPR. FILM. 40mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC- PE- PVDC /AL X 30 COMPR. FILM. P-6L 30 41.60 1.386666 0.616428 0.554785630 C10AA01 SIMVASTATINUM SIMVOR 5 mg COMPR. FILM. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 6.02 0.430000 0.430000 0.387000631 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 80 mg COMPR. FILM. 80mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 77.07 2.569000 2.306333 2.075699632 C10AA01 SIMVASTATINUM SIMVASTATIN ACCORD 80 mg COMPR. FILM. 80mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC- PE- PVDC /AL X 30 COMPR. FILM. P-6L 30 69.19 2.306333 2.306333 2.075699633 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. X 10 COMPR. P-6L 100 63.47 0.634700 0.634700 0.571230634 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. X 10 COMPR. P-6L 10 13.56 1.356000 0.634700 0.571230635 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 19.52 0.650666 0.634700 0.571230636 C10AA03 PRAVASTATINUM PRAVATOR 10 mg COMPR. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 7 COMPR. P-6L 28 16.15 0.576785 0.576785 0.519106637 C10AA03 PRAVASTATINUM PRAVATOR 20 mg COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 7 COMPR. P-6L 28 21.08 0.752857 0.752857 0.677571638 C10AA03 PRAVASTATINUM PRALIP 40 mg COMPR. 40mg SANDOZ SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 35.73 1.191000 1.190714 1.071642639 C10AA03 PRAVASTATINUM PRAVATOR 40 mg COMPR. 40mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PE-AL-PVC/AL X 7 COMPR. P-6L 28 33.34 1.190714 1.190714 1.071642640 C10AB05 FENOFIBRATUM LIPANTHYL (R) 100 CAPS. 100mg LAB. FOURNIER SA FRANTA CUTIE X 4 BLIST. AL/PVC X 12 CAPS. P-6L 48 19.48 0.405833 0.405833 0.365249641 C10AB05 FENOFIBRATUM LIPOFIB 160 mg CAPS. 160mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 47.42 1.580666 1.580666 1.422599642 C10AB05 FENOFIBRATUM LIPOFIB 200 mg CAPS. 200mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 26.13 0.871000 0.808000 0.727200643 C10AB05 FENOFIBRATUM FENOFIBRAT TERAPIA 200 mg CAPS. 200mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 30 24.24 0.808000 0.808000 0.727200644 C10AB05 FENOFIBRATUM LIPANTHYL 200 M CAPS. 200mg LAB. FOURNIER SA FRANTA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-6L 10 12.73 1.273000 0.871000 0.783900645 C10AB05 FENOFIBRATUM LIPANTHYL 200 M CAPS. 200mg LAB. FOURNIER SA FRANTA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. P-6L 30 36.98 1.232666 0.871000 0.783900646 C10AB05 FENOFIBRATUM LIPOFIB 267 mg CAPS. 267mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 30 32.54 1.084666 1.084666 0.976199647 C10AB05 FENOFIBRATUM LIPOFIB 67 mg CAPS. 67mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 30 11.46 0.382000 0.382000 0.343800648 C10AB05 FENOFIBRATUM FENOFIBRAT LPH 200 mg CAPS. PULB. MICRONIZATA 200mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 21.06 1.053000 0.871000 0.783900649 C10AB05 FENOFIBRATUM LIPIVIM CAPS. PULB. MICRONIZATA 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 26.13 0.871000 0.871000 0.783900650 C10AB05 FENOFIBRATUM LIPANTHYL SUPRA 160 mg COMPR. FILM. ELIB. MODIF. 160mg LAB. FOURNIER SA FRANTA CUTIE X 1 BLIST. PVC- PE-PVDC/AL X 10 COMPR. FILM. CU ELIB. MOD. P-6L 10 12.94 1.294000 1.252666 1.127399651 C10AB05 FENOFIBRATUM LIPANTHYL SUPRA 160 mg COMPR. FILM. ELIB. MODIF. 160mg LAB. FOURNIER SA FRANTA CUTIE X 3 BLIST. PVC- PE-PVDC/AL X 10 COMPR. FILM. CU ELIB. MOD. P-6L 30 37.58 1.252666 1.252666 1.127399652 D01AC02 MICONAZOLUM MEDACTER CREMA 2% FARAN LABORATORIES S.A. GRECIA CUTIE X 1 TUB X 30G P-RF 1 8.03 8.030000 6.410000 5.769000653 D01AC02 MICONAZOLUM MICONAZOL NITRAT 2% CREMA 2% SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 6.41 6.410000 6.410000 5.769000654 D01AC02 MICONAZOLUM MICONAL ECOBI CREMA 20mg/g FARMACEUTICI ECOBI S.A.S ITALIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 8.94 8.940000 6.410000 5.769000655 D01AC10 BIFONAZOLUM BIAZOL 10 mg/g CREMA 10mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 15 G CREMA P-RF 1 8.89 8.890000 8.890000 8.001000656 D06BB03 ACICLOVIRUM CLOVIRAL (R) 5% CREMA 5% ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB AL. X 12 G P-RF 1 6.01 6.010000 3.940000 3.546000657 D06BB03 ACICLOVIRUM ZOVIRAX CREMA 5% THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 TUB X 5G CREMA P-RF 1 19.78 19.780000 3.940000 3.546000658 D06BB03 ACICLOVIRUM ACICLOVIR 5% CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 5 G CREMA P-RF 1 4.67 4.670000 3.940000 3.546000659 D06BB03 ACICLOVIRUM ACICLOVIR 5% CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 15 G CREMA P-RF 1 7.13 7.130000 3.940000 3.546000660 D06BB03 ACICLOVIRUM ACICLOVIR MK CREMA 5% FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB AL X 7,5 G P-RF 1 3.94 3.940000 3.940000 3.546000661 D06BB03 ACICLOVIRUM ACICLOVIR MK CREMA 5% FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB AL X 15 G P-RF 1 6.32 6.320000 3.940000 3.546000662 D06BB03 ACICLOVIRUM ACIKLOVIR CREMA CREMA 50mg/g A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB X 5 G CREMA P-RF 1 5.55 5.550000 3.940000 3.546000663 D06BB03 ACICLOVIRUM ACIKLOVIR CREMA CREMA 50mg/g A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB X 10 G CREMA P-RF 1 8.32 8.320000 3.940000 3.546000664 D06BB03 ACICLOVIRUM ACICLOVIR HYPERION CREMA 50mg/g HYPERION S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 6.87 6.870000 3.940000 3.546000665 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 4.41 4.410000 3.940000 3.546000

Pagina 16 din 34

Page 19: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

666 D07AA02 HYDROCORTISONUM HIDROCORTIZON 1% UNGUENT 1% ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 5.81 5.810000 5.810000 5.229000667 D07AA02 HYDROCORTISONUM HIDROCORTIZON FITERMAN 10 mg/g UNGUENT 10mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 20 G UNGUENT P-RF 1 5.32 5.320000 5.320000 4.788000668 D07AA02 HYDROCORTISONUM HIDROCORTIZON FITERMAN 10 mg/g UNGUENT 10mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 35 G UNGUENT P-RF 1 9.32 9.320000 5.320000 4.788000669 D07AC01 BETAMETHASONUM BETADERM CREMA 0,1% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 5.59 5.590000 5.590000 5.031000670 D07AC01 BETAMETHASONUM BELODERM CREMA CREMA 0,5mg/g A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB X 15 G CREMA P-RF 1 8.32 8.320000 8.320000 7.488000671 D07AC01 BETAMETHASONUM BETAMETAZONA ANTIBIOTICE 0,5mg/g CREMA 0,5mg/g ANTIBIOTICE S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 8.55 8.550000 8.550000 7.695000672 D07AC01 BETAMETHASONUM BETADERM UNGUENT 0,1% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 5.59 5.590000 5.590000 5.031000673 D07AC01 BETAMETHASONUM BELODERM UNGUENT UNGUENT 0,5mg/g A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB X 15 G UNGUENT P-RF 1 8.32 8.320000 8.320000 7.488000674 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 5.59 0.931666 0.931666 0.838499675 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 5.36 1.786666 1.786666 1.607999676 G01AF04 MICONAZOLUM MEDACTER CREMA VAG. 2% FARAN LABORATORIES S.A. GRECIA CUTIE X 1 TUB X 78 G P-RF 1 18.18 18.180000 13.070000 11.763000677 G01AF04 MICONAZOLUM MICONAL ECOBI CREMA VAG. 20mg/g FARMACEUTICI ECOBI S.A.S ITALIA CUTIE X 1 TUB DIN AL X 78 G CREMA VAGINALA + CANULA P-RF 1 13.07 13.070000 13.070000 11.763000678 G01AF04 MICONAZOLUM MICONAL ECOBI OVULE 50mg FARMACEUTICI ECOBI S.A.S ITALIA CUTIE X 3 FOLII PREFORMATE PVC/PE X 5 OVULE P-RF 15 8.44 0.562666 0.562666 0.506399679 G01AF04 MICONAZOLUM MICONAL ECOBI SOL. VAGINALA 2mg/ml FARMACEUTICI ECOBI S.A.S ITALIA CUTIE X 5 FLACOANE DIN PEJD X 150 ML SOL. VAG. + 5 CANULE P-RF 5 16.89 3.378000 3.378000 3.040200680 G02AB03 ERGOMETRINUM MALEAT DE ERGOMETRINA 0,2 mg/ml SOL. INJ. 0,2mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ., CU INEL DE RUPERE P-RF 5 3.78 0.756000 0.756000 0.680400681 G03BA03 TESTOSTERONUM* UNDESTOR TESTOCAPS 40 mg CAPS. MOI 40mg N.V. ORGANON OLANDA CUTIE X 6 PLICURI DIN PES-AL-PE X 1 BLIST. AL/PVC X 10 CAPS. MOI P-RF 60 44.45 0.740833 0.740833 0.666749682 G03BA03 TESTOSTERONUM* ANDROGEL 50 mg GEL 50mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 30 PLICURI DIN FOLIE PET/AL/PE X 5 G GEL P-RF 30 209.72 6.990666 6.990666 6.291599683 G03BA03 TESTOSTERONUM* NEBIDO 1000 mg/4 ml SOL. INJ. 1000mg/4ml BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 FIOLA X 4 ML SOL. INJ. S/P-RF 1 459.28 459.280000 459.280000 413.352000684 G03CA03 ESTRADIOLUM* ESTROFEM 1 mg COMPR. FILM. 1mg NOVO NORDISK A/S DANEMARCA CUTIE X 1 DISC TIP CALENDAR X 28 COMPR.FILM. P-6L 1 15.35 15.350000 15.350000 13.815000685 G03CA03 ESTRADIOLUM* VAGIFEM COMPR. VAG. 25mcg NOVO NORDISK A/S DANEMARCA CUTIE X 3 BLIST. AL/PVC X 5 APLICATOARE DIN PE/PP X 1 COMPR. VAG. P-6L 15 43.24 2.882666 2.882666 2.594399686 G03CA03 ESTRADIOLUM* OESTROGEL (R) GEL 0,06% LAB. BESINS INTERNATIONAL FRANTA CUTIE X 1 TUB DIN AL X 80 G P-6L 1 15.59 15.590000 15.590000 14.031000687 G03CA03 ESTRADIOLUM* ESTREVA (R) GEL 0,1% LAB. THERAMEX MONACO CUTIE X 1 FLACON PE, INCHIS CU POMPA DOZATOARE X 50 G P-6L 1 27.61 27.610000 27.610000 24.849000688 G03CA03 ESTRADIOLUM* CLIMARA PLASTURE TRANSDERM. 50mcg/24ore BAYER SCHERING PHARMA AG GERMANIA CUTIE X 4 PLICURI X 1 PLASTURE TRANSDERM. P-6L 4 32.34 8.085000 8.085000 7.276500689 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 1 (vezi G04CAN1) COMPR. 1mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 50 44.64 0.892800 0.318333 0.286499690 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 1 (vezi G04CAN1) COMPR. 1mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 17.69 0.884500 0.318333 0.286499691 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 1 (vezi G04CAN1) COMPR. 1mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 100 84.80 0.848000 0.318333 0.286499692 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 1mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 9.55 0.318333 0.318333 0.286499693 G04CAN1 DOXAZOSINUM DOXAZOSIN 1 MEDOCHEMIE (vezi G04CAN1) COMPR. 1mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 7 COMPR. P-6L 14 10.15 0.725000 0.318333 0.286499694 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 1 (vezi G04CAN1) COMPR. 1mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 50 44.64 0.892800 0.318333 0.286499695 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 1 (vezi G04CAN1) COMPR. 1mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 17.69 0.884500 0.318333 0.286499696 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 1 (vezi G04CAN1) COMPR. 1mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 100 84.80 0.848000 0.318333 0.286499697 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 1mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 9.55 0.318333 0.318333 0.286499698 G04CAN1 DOXAZOSINUM DOXAZOSIN 1 MEDOCHEMIE (vezi G04CAN1) COMPR. 1mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 7 COMPR. P-6L 14 10.15 0.725000 0.318333 0.286499699 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 2 (vezi G04CAN1) COMPR. 2mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 100 95.22 0.952200 0.534000 0.480600700 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 2 (vezi G04CAN1) COMPR. 2mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 50 49.98 0.999600 0.534000 0.480600701 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 2 (vezi G04CAN1) COMPR. 2mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 20.34 1.017000 0.534000 0.480600702 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 2mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 16.02 0.534000 0.534000 0.480600703 G04CAN1 DOXAZOSINUM DOXAZOSIN 2 MEDOCHEMIE (vezi G04CAN1) COMPR. 2mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 7 COMPR. P-6L 14 11.77 0.840714 0.534000 0.480600704 G04CAN1 DOXAZOSINUM ZOXON 2 (vezi G04CAN1) COMPR. 2mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. PVDC/PVC/AL X 10 COMPR. P-6L 30 16.07 0.535666 0.534000 0.480600705 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 2 (vezi G04CAN1) COMPR. 2mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 100 95.22 0.952200 0.411000 0.369900706 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 2 (vezi G04CAN1) COMPR. 2mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 50 49.98 0.999600 0.411000 0.369900707 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 2 (vezi G04CAN1) COMPR. 2mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 20.34 1.017000 0.411000 0.369900708 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 2mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 16.02 0.534000 0.411000 0.369900709 G04CAN1 DOXAZOSINUM DOXAZOSIN 2 MEDOCHEMIE (vezi G04CAN1) COMPR. 2mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 7 COMPR. P-6L 14 11.77 0.840714 0.411000 0.369900710 G04CAN1 DOXAZOSINUM ZOXON 2 (vezi G04CAN1) COMPR. 2mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. PVDC/PVC/AL X 10 COMPR. P-6L 30 16.07 0.535666 0.411000 0.369900711 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 4 (vezi G04CAN1) COMPR. 4mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 100 115.27 1.152700 0.726333 0.653699712 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 4 (vezi G04CAN1) COMPR. 4mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 25.45 1.272500 0.726333 0.653699

Pagina 17 din 34

Page 20: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

713 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 4 (vezi G04CAN1) COMPR. 4mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 50 61.73 1.234600 0.726333 0.653699714 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L 30 28.97 0.965666 0.726333 0.653699715 G04CAN1 DOXAZOSINUM DOXAZOSIN SANDOZ 4 mg (vezi G04CAN1) COMPR. 4mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. P-6L 30 24.98 0.832666 0.726333 0.653699716 G04CAN1 DOXAZOSINUM DOXAZOSIN 4 MEDOCHEMIE (vezi G04CAN1) COMPR. 4mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 7 COMPR. P-6L 14 16.32 1.165714 0.726333 0.653699717 G04CAN1 DOXAZOSINUM ZOXON 4 (vezi G04CAN1) COMPR. 4mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. PVDC/PVC/AL X 10 COMPR. P-6L 30 29.15 0.971666 0.726333 0.653699718 G04CAN1 DOXAZOSINUM ANIPROSIN 4 mg (vezi C02CA04) COMPR. 4mg OZONE LABORATORIES BV OLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 21.79 0.726333 0.726333 0.653699719 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 4 (vezi G04CAN1) COMPR. 4mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 100 115.27 1.152700 0.726333 0.653699720 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 4 (vezi G04CAN1) COMPR. 4mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 25.45 1.272500 0.726333 0.653699721 G04CAN1 DOXAZOSINUM DOXAZOSIN AL 4 (vezi G04CAN1) COMPR. 4mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 50 61.73 1.234600 0.726333 0.653699722 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L 30 28.97 0.965666 0.726333 0.653699723 G04CAN1 DOXAZOSINUM DOXAZOSIN SANDOZ 4 mg (vezi G04CAN1) COMPR. 4mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. P-6L 30 24.98 0.832666 0.726333 0.653699724 G04CAN1 DOXAZOSINUM DOXAZOSIN 4 MEDOCHEMIE (vezi G04CAN1) COMPR. 4mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 7 COMPR. P-6L 14 16.32 1.165714 0.726333 0.653699725 G04CAN1 DOXAZOSINUM ZOXON 4 (vezi G04CAN1) COMPR. 4mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. PVDC/PVC/AL X 10 COMPR. P-6L 30 29.15 0.971666 0.726333 0.653699726 G04CAN1 DOXAZOSINUM ANIPROSIN 4 mg (vezi C02CA04) COMPR. 4mg OZONE LABORATORIES BV OLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 21.79 0.726333 0.726333 0.653699727 G04CAN1 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL-PVDC X 14 COMPR. ELIB. PREL. P-6L 28 43.65 1.558928 1.558928 1.403035728 G04CAN1 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL-PVDC X 14 COMPR. ELIB. PREL. P-6L 28 43.65 1.558928 1.558928 1.403035729 H02AB04 METHYLPREDNISOLONUM* LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8.26 8.260000 8.260000 7.434000730 H02AB04 METHYLPREDNISOLONUM* LEMOD SOLU 40 mg LIOF. PT. SOL. INJ. 40mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 15 FLAC. LIOF. + 15 FIOLE SOLV. X 1 ML S/P-RF 15 63.83 4.255333 4.255333 3.829799731 H02AB04 METHYLPREDNISOLONUM* LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 29.12 29.120000 29.120000 26.208000732 H02AB04 METHYLPREDNISOLONUM* SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIO P-RF 1 19.21 19.210000 19.210000 17.289000733 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 1.68 0.084000 0.077666 0.069899734 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.47 0.082333 0.077666 0.069899735 H02AB07 PREDNISONUM N - PREDNISON COMPR. 5mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 2.33 0.077666 0.077666 0.069899736 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.37 0.079000 0.077666 0.069899737 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 1.68 0.084000 0.077666 0.069899738 H02AB09 HYDROCORTISONUM* HYDROCORTISONE SUCCINAT SODIC LIOF. + SOLV. PT. SOL. INJ. 100mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 3.67 3.670000 3.670000 3.303000739 H02AB09 HYDROCORTISONUM* HIDROCORTIZON HEMISUCCINAT SOL. INJ. I.V. 25mg/5ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE X 1 ML SOL. A + 5 FIOLE X 4 ML SOL. B S/P-RF 5 12.77 2.554000 2.554000 2.298600740 J01AA02 DOXYCYCLINUM DOXICICLINA CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6.56 0.328000 0.240000 0.216000741 J01AA02 DOXYCYCLINUM DOXICICLINA 100 mg CAPS. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 2.40 0.240000 0.240000 0.216000742 J01AA02 DOXYCYCLINUM DOXICICLINA SANDOZ 100 mg CAPS. 100mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3.37 0.337000 0.240000 0.216000743 J01AA02 DOXYCYCLINUM UNIDOX SOLUTAB COMPR. DISP. 100mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 BLIST. DIN AL/PVC X 10 COMPR.DISP. P-RF 10 9.00 0.900000 0.900000 0.810000744 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5.58 0.279000 0.228000 0.205200745 J01CA04 AMOXICILLINUM AMOXICILINA ANTIBIOTICE 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4.61 0.230500 0.228000 0.205200746 J01CA04 AMOXICILLINUM OSPAMOX 250 mg CAPS. 250mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. AL-PVC/PVDC X 6 CAPS. P-RF/S 12 4.18 0.348333 0.228000 0.205200747 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg CAPSULE CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5.78 0.289000 0.228000 0.205200748 J01CA04 AMOXICILLINUM AMOXICILINA 250 mg CAPS. 250mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 4.56 0.228000 0.228000 0.205200749 J01CA04 AMOXICILLINUM EPHAMOX 500 mg CAPS. 500mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 6 CAPS. P-RF 12 6.15 0.512500 0.413000 0.371700750 J01CA04 AMOXICILLINUM AMOXICILINA ANTIBIOTICE 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 4.50 0.450000 0.413000 0.371700751 J01CA04 AMOXICILLINUM E - MOX CAPS. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 8 CAPS. P-RF 8 7.07 0.883750 0.413000 0.371700752 J01CA04 AMOXICILLINUM AMOXICILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 5.55 0.555000 0.413000 0.371700753 J01CA04 AMOXICILLINUM AMOXICILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 8.26 0.413000 0.413000 0.371700754 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS. P-RF 10 5.33 0.533000 0.413000 0.371700755 J01CA04 AMOXICILLINUM MOXILEN CAPS. 500mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. X 8 CAPS. P-RF 16 6.78 0.423750 0.413000 0.371700756 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 500 mg CAPSULE CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 4.61 0.461000 0.413000 0.371700757 J01CA04 AMOXICILLINUM AMOXICILINA FORTE 500 mg CAPS. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 4.56 0.456000 0.413000 0.371700758 J01CA04 AMOXICILLINUM OSPAMOX 1000 mg COMPR. FILM. 1000mg SANDOZ GMBH AUSTRIA CUTIE 2 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 12 10.92 0.910000 0.910000 0.819000759 J01CA04 AMOXICILLINUM OSPAMOX 500 mg COMPR. FILM. 500mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM. P-RF 12 5.33 0.444166 0.444166 0.399749

Pagina 18 din 34

Page 21: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

760 J01CA04 AMOXICILLINUM RANOXIL 1g COMPR. PT. DISP. ORALA 1g TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 7 COMPR. PT. DISP. ORALA P-RF 21 19.74 0.940000 0.940000 0.846000761 J01CA04 AMOXICILLINUM DUOMOX 1000 mg COMPR. PT. DISPERSIE ORALA 1000mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 22.31 1.115500 1.115500 1.003950762 J01CA04 AMOXICILLINUM DUOMOX 250 mg COMPR. PT. DISPERSIE ORALA 250mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 9.49 0.474500 0.474500 0.427050763 J01CA04 AMOXICILLINUM DUOMOX 500 mg COMPR. PT. DISPERSIE ORALA 500mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 13.87 0.693500 0.693500 0.624150764 J01CA04 AMOXICILLINUM DUOMOX 750 mg COMPR. PT. DISPERSIE ORALA 750mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 18.55 0.927500 0.927500 0.834750765 J01CA04 AMOXICILLINUM JULPHAMOX PULB. PT. SUSP. ORALA 125mg/5ml GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 100 ML SUSP. P-RF 1 8.61 8.610000 4.280000 3.852000766 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 125 mg/5 ml PULBERE PENTRU SUSPENSIE ORALA PULB. PT. SUSP. ORALA 125mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA CONTINAND 20 G PULB PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 5.39 5.390000 4.280000 3.852000767 J01CA04 AMOXICILLINUM OSPAMOX (R) 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 5,1 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 4.28 4.280000 4.280000 3.852000768 J01CA04 AMOXICILLINUM JULPHAMOX PULB. PT. SUSP. ORALA 250mg/5ml GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 100 ML SUSP. P-RF 1 11.80 11.800000 4.580000 4.122000769 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg/ 5 ml PULBERE PENTRU SUSPENSIE ORALA PULB. PT. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. X 20 G PULB. PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE PE, CU GRADATII PT. 1,25 P-RF 1 7.80 7.800000 4.580000 4.122000770 J01CA04 AMOXICILLINUM E - MOX PULB. PT. SUSP. ORALA 250mg/5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 60 ML SUSP. P-RF 1 4.58 4.580000 4.580000 4.122000771 J01CA04 AMOXICILLINUM OSPAMOX 250 mg/5 ml PULB. PT. SUSP. ORALA 250mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 6,6 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 4.58 4.580000 4.580000 4.122000772 J01CE02 PHENOXYMETHYLPENICILLINUM PENICILINA V 1 000 000 U.I. COMPR. 1000000ui EUROPHARM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 8.55 0.427500 0.427500 0.384750773 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 1000 COMPR. FILM. 1000000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 3.25 0.270833 0.270833 0.243749774 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 1500 COMPR. FILM. 1500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 5.73 0.477500 0.477500 0.429750775 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 500 COMPR. FILM. 500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 2.47 0.205833 0.205833 0.185249776 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 400 SIROP 400000ui/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLACON X 60ML P-RF 1 8.94 8.940000 8.940000 8.046000777 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN (R) PULB. PT. SUSP. INJ. 1200000ui ANTIBIOTICE SA ROMANIA FLACON PULB. PT. SUSP. INJ. P-RF/S 1 1.96 1.960000 1.960000 1.764000778 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN (R) PULB. PT. SUSP. INJ. 600000ui ANTIBIOTICE SA ROMANIA FLACON PULB. PT. SUSP. INJ. P-RF/S 1 1.31 1.310000 1.310000 1.179000779 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6.33 0.316500 0.266500 0.239850780 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6.33 0.316500 0.266500 0.239850781 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg EUROPHARM SA ROMANIA CUTIE X 1 BLIST.AL/PVC X 12 CAPS. P-RF 12 5.73 0.477500 0.266500 0.239850782 J01CF04 OXACILLINUM OXACILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7.24 0.362000 0.266500 0.239850783 J01CF04 OXACILLINUM OXACILINA CAPS. 250mg FARMACOM SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 5.33 0.266500 0.266500 0.239850784 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5.67 0.283500 0.266500 0.239850785 J01CF04 OXACILLINUM OXACILINA FARMEX 250 mg CAPS. 250mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6.32 0.316000 0.266500 0.239850786 J01CF04 OXACILLINUM OXACILINA 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 5.81 0.581000 0.524000 0.471600787 J01CF04 OXACILLINUM OXACILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 5.81 0.581000 0.524000 0.471600788 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 10.48 0.524000 0.524000 0.471600789 J01CF04 OXACILLINUM OXACILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 6.61 0.661000 0.524000 0.471600790 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 5.81 0.581000 0.524000 0.471600791 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 2.67 2.670000 2.670000 2.403000792 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 4.51 4.510000 4.510000 4.059000793 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 250 mg PULB. PT. SOL. INJ./PERF.I.M./I.V. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF 1 1.63 1.630000 1.630000 1.467000794 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM FORCID SOLUTAB 250/62,5 COMPR. DISP. 250/62,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 5 BLIST. PA-AL-PVC/AL X 4 COMPR. DISP. P-RF 20 22.68 1.134000 1.134000 1.020600795 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM FORCID SOLUTAB 500/125 COMPR. DISP. 500/125mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 5 BLIST. PA-AL-PVC/AL X 4 COMPR. DISP. P-RF 20 23.30 1.165000 1.165000 1.048500796 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM FORCID SOLUTAB 875/125 COMPR. DISP. 875mg+125mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. DISP. P-RF 14 40.74 2.910000 2.910000 2.619000797 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 36.74 2.624285 1.957857 1.762071798 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV 1000 mg COMPR. FILM. 1000mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL-PVC/AL X 7 COMPR. FILM. P-RF 14 38.23 2.730714 1.957857 1.762071799 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV 375 mg COMPR. FILM. 250mg+125mg MEDOCHEMIE LTD. CIPRU CUTIE X 4 BLIST. X 4 COMPR. FILM. P-RF 16 21.26 1.328750 1.328750 1.195875800 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 625 mg COMPR. FILM. 500mg+125mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 2 BLIST. AL/PVDC-PVC X 7 COMPR. FILM., FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOA P-RF 14 15.65 1.117857 1.108571 0.997713801 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV 625 mg COMPR. FILM. 500mg+125mg MEDOCHEMIE LTD. CIPRU CUTIE X 4 BLIST. X 4 COMPR. FILM. P-RF 16 27.94 1.746250 1.108571 0.997713802 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 26.35 1.882142 1.108571 0.997713803 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 625 mg COMPR. FILM. 625mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 FOLII AL-PEJD X 7 COMPR. FILM. P-RF 21 23.28 1.108571 1.108571 0.997713804 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 625 mg COMPR. FILM. 625mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 4 FOLII AL-PEJD X 7 COMPR. FILM. P-RF 28 31.05 1.108928 1.108571 0.997713805 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 1 g COMPR. FILM. 875mg+125mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 2 BLIST. AL/PVDC-PVC X 7 COMPR. FILM., FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOA P-RF 14 27.41 1.957857 1.957857 1.762071806 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN™ SR COMPR. FILM. ELIB. PREL. 1062,5mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 7 BLIST. AL/PVC-AL SAU AL/PP-AL X 4 COMPR. FILM. ELIB. PREL. P-RF 28 63.54 2.269285 2.269285 2.042356

Pagina 19 din 34

Page 22: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

807 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 1000 mg COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE 1000mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 59.64 4.260000 4.260000 3.834000808 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 625 mg COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE 625mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 33.10 2.364285 2.364285 2.127856809 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV 156,25 mg/5 ml PULB. PT. SUSP. ORALA 125mg+31,25/5ml MEDOCHEMIE LTD. CIPRU CUTIE X 1 FLAC. CU PULB. PT. 100ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 13.99 13.990000 10.970000 9.873000810 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 10.97 10.970000 10.970000 9.873000811 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV FORTE 312,5mg/5ml PULB. PT. SUSP. ORALA 250mg+62,5mg/5ml MEDOCHEMIE LTD. CIPRU CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 100 ML SUSP. P-RF 1 20.75 20.750000 20.750000 18.675000812 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS PULB. PT. SUSP. ORALA 400mg+57mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. 70 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 18.71 18.710000 9.350000 8.415000813 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS PULB. PT. SUSP. ORALA 400mg+57mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. 35 ML SUSP. ORALA + 1 SERIGA PT. ADM. ORALA P-RF 1 9.35 9.350000 9.350000 8.415000814 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN (R) ES PULB. PT. SUSP. ORALA 642,90mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA CU PULB. PT. 100 ML SUSP. ORALA + 1 MASURA DOZATOARE P-RF 1 33.28 33.280000 33.280000 29.952000815 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 22.56 22.560000 20.750000 18.675000816 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 312,5 mg/5 ml PULB. PT.SUSP. ORALA 312,5mg/5ml RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID CU PULB. PT. SUSP. ORALA MARCAT PT. 100ML+ MASURA DOZATOARE P-RF 1 21.33 21.330000 20.750000 18.675000817 J01DB01 CEFALEXINUM CEFALEXINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 11.19 0.559500 0.378500 0.340650818 J01DB01 CEFALEXINUM CEFALEXINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 7.57 0.378500 0.378500 0.340650819 J01DB01 CEFALEXINUM OSPEXIN (R) 250 mg CAPS. 250mg SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 CAPS. P-RF 12 6.72 0.560000 0.378500 0.340650820 J01DB01 CEFALEXINUM CEFALEXIN 250 mg CAPS. 250mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 4.56 0.456000 0.378500 0.340650821 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ 250 mg CAPSULE CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 5.61 0.561000 0.378500 0.340650822 J01DB01 CEFALEXINUM SPORIDEX 250 mg CAPS. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 5.55 0.555000 0.378500 0.340650823 J01DB01 CEFALEXINUM CEFALEXINA 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 7.41 0.741000 0.741000 0.666900824 J01DB01 CEFALEXINUM CEFALEXINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 8.44 0.844000 0.741000 0.666900825 J01DB01 CEFALEXINUM CEFALEXIN 500 mg CAPS. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 7.81 0.781000 0.741000 0.666900826 J01DB01 CEFALEXINUM SPORIDEX 500 mg CAPS. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 9.86 0.986000 0.741000 0.666900827 J01DB01 CEFALEXINUM OSPEXIN 1000 mg COMPR. FILM. 1000mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM. P-RF 12 14.84 1.236666 1.236666 1.112999828 J01DB01 CEFALEXINUM OSPEXIN 500 mg COMPR. FILM. 500mg SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR.FILM. P-RF 12 11.16 0.930000 0.930000 0.837000829 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ 500 mg COMPRIMATE FILMATE COMPR. FILM. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 10 9.31 0.931000 0.930000 0.837000830 J01DB01 CEFALEXINUM KEFLEX (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 5.81 5.810000 5.810000 5.229000831 J01DB01 CEFALEXINUM OSPEXIN (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 33 G GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA PP P-RF 1 7.15 7.150000 5.810000 5.229000832 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ 125 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 6.52 6.520000 5.810000 5.229000833 J01DB01 CEFALEXINUM KEFLEX (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 9.83 9.830000 9.040000 8.136000834 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ 250 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 9.06 9.060000 9.040000 8.136000835 J01DB01 CEFALEXINUM OSPEXIN (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 33G GRANULE PT. 60ML SUSP.+ LINGURITA DOZATOARE X 5ML P-RF 1 9.04 9.040000 9.040000 8.136000836 J01DB05 CEFADROXILUM CEXYL 250 mg CAPS. 250mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 17.41 1.741000 1.741000 1.566900837 J01DB05 CEFADROXILUM CEFORAN (R) 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 12.22 1.222000 0.894000 0.804600838 J01DB05 CEFADROXILUM CEXYL 500 mg CAPS. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 12.63 1.263000 0.894000 0.804600839 J01DB05 CEFADROXILUM CEFADROXIL TERAPIA CAPS. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC/PVDC-AL X 10 CAPS. P-RF 10 8.94 0.894000 0.894000 0.804600840 J01DB05 CEFADROXILUM CEXYL 1000 mg COMPR. FILM. 1000mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/PVDC X 10. COMPR. FILM. P-RF 10 24.55 2.455000 2.455000 2.209500841 J01DB05 CEFADROXILUM CEXYL 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. CU GRAN PENTRU 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 11.31 11.310000 11.310000 10.179000842 J01DB05 CEFADROXILUM CEXYL 250 mg/5 ml GRAN. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. CU GRAN. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 21.06 21.060000 21.060000 18.954000843 J01DC02 CEFUROXIMUM CEROXIM 250 mg COMPR. 250mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 13.50 1.350000 1.350000 1.215000844 J01DC02 CEFUROXIMUM CEFUROXIMA ANTIBIOTICE 250 mg COMPR. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR. P-RF 10 22.99 2.299000 1.350000 1.215000845 J01DC02 CEFUROXIMUM CEFUROXIMA ANTIBIOTICE 250 mg COMPR. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 22.99 2.299000 1.350000 1.215000846 J01DC02 CEFUROXIMUM CEROXIM 500 mg COMPR. 500mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 28.35 2.835000 2.835000 2.551500847 J01DC02 CEFUROXIMUM CEFUROXIMA ANTIBIOTICE 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR. P-RF 10 42.45 4.245000 2.835000 2.551500848 J01DC02 CEFUROXIMUM CEFUROXIMA ANTIBIOTICE 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 42.45 4.245000 2.835000 2.551500849 J01DC02 CEFUROXIMUM AXYCEF (R) 125 COMPR. ACOPERITE 125mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. X 10 COMPR. ACOPERITE P-RF 10 16.52 1.652000 1.419000 1.277100850 J01DC02 CEFUROXIMUM AXYCEF (R) 250 COMPR. ACOPERITE 250mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. X 10 COMPR. ACOPERITE P-RF 10 33.02 3.302000 1.559000 1.403100851 J01DC02 CEFUROXIMUM AXYCEF (R) 500 COMPR. ACOPERITE 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. X 10 COMPR. ACOPERITE P-RF 10 61.08 6.108000 2.596000 2.336400852 J01DC02 CEFUROXIMUM ZINNAT (R) 125 mg COMPR. FILM. 125mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 14.19 1.419000 1.419000 1.277100853 J01DC02 CEFUROXIMUM ZINNAT (R) 250 mg COMPR. FILM. 250mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR.FILM P-RF 10 15.59 1.559000 1.559000 1.403100

Pagina 20 din 34

Page 23: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

854 J01DC02 CEFUROXIMUM ZINNAT (R) 500 mg COMPR. FILM. 500mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR.FILM P-RF 10 25.96 2.596000 2.596000 2.336400855 J01DC02 CEFUROXIMUM ZINNAT GRAN. PT. SUSP. ORALA 125mg/5ml GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA CU GRANULE PT 50 ML SUSP. ORALA + PAHAR MENZURA A 20 ML SI LINGURIT P-RF 1 18.23 18.230000 18.230000 16.407000856 J01DC02 CEFUROXIMUM CEROXIM 125mg/5ml GRAN. PT. SUSP. ORALA 125mg/5ml RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON CU GRANULE PT. SUSP. ORALA (PT. 100 ML SUSPENSIE ORALA) + LINGURITA DOZATOARE A 5 M P-RF 1 36.74 36.740000 18.230000 16.407000857 J01DC02 CEFUROXIMUM CEROXIM 250mg/5ml GRAN. PT. SUSP. ORALA 250mg/5ml RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON CU GRANULE PT. SUSP. ORALA (PT. 100 ML SUSPENSIE ORALA) + LINGURITA DOZATOARE A 5 M P-RF 1 55.11 55.110000 55.110000 49.599000858 J01DC02 CEFUROXIMUM AXYCEF (R) 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. PULB. PT. 70 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 35.13 35.130000 35.130000 31.617000859 J01DC04 CEFACLORUM CEFACLOR OZONE 250 mg CAPS. 250mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 15 CAPS. P-RF 15 13.08 0.872000 0.872000 0.784800860 J01DC04 CEFACLORUM CECLODYNE 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 15.10 1.510000 0.872000 0.784800861 J01DC04 CEFACLORUM CEFACLOR ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 14.22 1.422000 0.872000 0.784800862 J01DC04 CEFACLORUM MEDOCLOR 250 CAPS. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. X 8 CAPS. P-RF 16 23.47 1.466875 0.872000 0.784800863 J01DC04 CEFACLORUM CLORACEF (R) 250 CAPS. 250mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. X 8 CAPS. P-RF 16 20.09 1.255625 0.872000 0.784800864 J01DC04 CEFACLORUM CEFACLOR OZONE 500 mg CAPS. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 15 CAPS. P-RF 15 27.73 1.848666 1.674375 1.506937865 J01DC04 CEFACLORUM MEDOCLOR 500 CAPS. 500mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. X 8 CAPS. P-RF 16 43.29 2.705625 1.674375 1.506937866 J01DC04 CEFACLORUM CECLODYNE FORTE 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 27.73 2.773000 1.674375 1.506937867 J01DC04 CEFACLORUM CLORACEF (R) FORTE 500 CAPS. 500mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. X 8 CAPS. P-RF 16 26.79 1.674375 1.674375 1.506937868 J01DC04 CEFACLORUM CECLOZONE MR 375 mg COMPR. ELIB. PREL. 375mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. ELIB. PREL. P-RF 10 32.05 3.205000 3.205000 2.884500869 J01DC04 CEFACLORUM CECLOZONE MR 750 mg COMPR. ELIB. PREL. 750mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. ELIB. PREL. P-RF 10 58.15 5.815000 5.815000 5.233500870 J01DC04 CEFACLORUM CECLODYNE (R) MR 375 mg COMPR. FILM. ELIB. MODIF. 375mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF. P-RF 10 33.31 3.331000 3.331000 2.997900871 J01DC04 CEFACLORUM CECLODYNE (R) MR 500 mg COMPR. FILM. ELIB. MODIF. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF. P-RF 10 44.03 4.403000 4.403000 3.962700872 J01DC04 CEFACLORUM CECLODYNE (R) MR 750 mg COMPR. FILM. ELIB. MODIF. 750mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-RF 10 64.67 6.467000 6.467000 5.820300873 J01DC04 CEFACLORUM CECLOR (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 15.70 15.700000 11.650000 10.485000874 J01DC04 CEFACLORUM CEFACLOR 125 mg/5ml GRAN. PT. SUSP. ORALA 125mg/5ml OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 37,5 G GRAN. PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 15.21 15.210000 11.650000 10.485000875 J01DC04 CEFACLORUM CECLODYNE 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. X 38,1 G GRANULE PT. 60 ML SUSP. ORALA P-RF 1 15.96 15.960000 11.650000 10.485000876 J01DC04 CEFACLORUM VERCEF 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN.PT. 75 ML SUSP.ORALA P-RF 1 11.65 11.650000 11.650000 10.485000877 J01DC04 CEFACLORUM CECLOR (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 31.14 31.140000 27.730000 24.957000878 J01DC04 CEFACLORUM CEFACLOR 250 mg/5ml GRAN. PT. SUSP. ORALA 250mg/5ml OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 37,5 G GRAN. PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 27.92 27.920000 27.730000 24.957000879 J01DC04 CEFACLORUM CECLODYNE 250 mg/ 5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. X 38,1 G GRANULE PT. 60 ML SUSP. ORALA P-RF 1 27.73 27.730000 27.730000 24.957000880 J01DC04 CEFACLORUM CEFAKLOR 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF 1 8.54 8.540000 8.540000 7.686000881 J01DC04 CEFACLORUM CLORACEF (R) 125 PULB. PT. SUSP. ORALA 125mg/5ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP.+ LINGURITA DOZATOARE P-RF 1 11.17 11.170000 8.540000 7.686000882 J01DC04 CEFACLORUM CEFAKLOR 250 mg/5 ml PULB. PT. SUSP. ORALA 250mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF 1 15.52 15.520000 15.520000 13.968000883 J01DC04 CEFACLORUM CLORACEF (R) 250 PULB. PT. SUSP. ORALA 250mg/5ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP. + LINGURITA DOZATOARE P-RF 1 20.09 20.090000 15.520000 13.968000884 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 27.04 2.704000 2.704000 2.433600885 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM BISEPTRIM CAPS. RET. 400mg/80mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 3.56 0.178000 0.104000 0.093600886 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2.08 0.104000 0.104000 0.093600887 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM COMPR. 400mg/80mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3.88 0.194000 0.104000 0.093600888 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM CO - TRIM ELL COMPR. 400mg/80mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3.14 0.157000 0.104000 0.093600889 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM BITRIM 400mg/80mg COMPR. 400mg/80mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3.14 0.157000 0.104000 0.093600890 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SIROP 25mg/5mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 7.70 7.700000 7.700000 6.930000891 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM EPITRIM SUSP. ORALA 200mg/40mg /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 4.47 4.470000 4.470000 4.023000892 J01FA01 ERYTHROMYCINUM ERITROMAGIS 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 6.66 0.333000 0.333000 0.299700893 J01FA01 ERYTHROMYCINUM ERITROMICINA 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9.01 0.450500 0.333000 0.299700894 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR. 200mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 7.94 0.397000 0.333000 0.299700895 J01FA01 ERYTHROMYCINUM ERITROMICINA EUROPHARM 200 mg COMPR. 200mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 9.49 0.474500 0.333000 0.299700896 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200mg/5ml PULB. PT. SUSP. ORALA 200mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. X 30G + PULB. PT. 60 ML SUSP. ORALA + O LIGURITA DOZATOARE P-RF 1 10.75 10.750000 10.750000 9.675000897 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT SPA ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 26.81 1.915000 0.983571 0.885213898 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 250 mg COMPR. FILM. 250mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 30.26 2.161428 0.983571 0.885213899 J01FA09 CLARITHROMYCINUM CLAR 250 COMPR. FILM. 250mg MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 5 BLIST. X 4 COMPR. FILM. P-RF 20 32.30 1.615000 0.983571 0.885213900 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 17.66 1.261428 0.983571 0.885213

Pagina 21 din 34

Page 24: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

901 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 13.77 0.983571 0.983571 0.885213902 J01FA09 CLARITHROMYCINUM CLARITROMICINA 250 mg COMPR. FILM. 250mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 13.77 0.983571 0.983571 0.885213903 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 15.65 1.117857 0.983571 0.885213904 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 500 mg COMPR. FILM. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 54.83 3.916428 2.082500 1.874250905 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 33.22 2.372857 2.082500 1.874250906 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 30.14 2.152857 2.082500 1.874250907 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mg MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF 20 41.65 2.082500 2.082500 1.874250908 J01FA09 CLARITHROMYCINUM CLARITROMICINA 500 mg COMPR. FILM. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 30.14 2.152857 2.082500 1.874250909 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 30.63 2.187857 2.082500 1.874250910 J01FA09 CLARITHROMYCINUM LEKOKLAR XL 500 mg COMPR. FILM. ELIB. MODIF. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FOLIE AL/AL X 5 COMPR. FILM. ELIB. MODIF. P-RF 5 17.26 3.452000 3.451428 3.106285911 J01FA09 CLARITHROMYCINUM LEKOKLAR XL 500 mg COMPR. FILM. ELIB. MODIF. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FOLIE AL/AL X 7 COMPR. FILM. ELIB. MODIF. P-RF 7 24.16 3.451428 3.451428 3.106285912 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 33.04 4.720000 3.451428 3.106285913 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 34.21 6.842000 3.451428 3.106285914 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 26.38 3.768571 3.451428 3.106285915 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA 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 36.76 36.760000 17.800000 16.020000916 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA 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 22.99 22.990000 17.800000 16.020000917 J01FA09 CLARITHROMYCINUM FROMILID (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. P-RF 1 21.86 21.860000 17.800000 16.020000918 J01FA09 CLARITHROMYCINUM LEKOKLAR 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 24.61 24.610000 17.800000 16.020000919 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 29.68 29.680000 17.800000 16.020000920 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 17.80 17.800000 17.800000 16.020000921 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 68,3 G GRANULE PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 57.78 57.780000 29.740000 26.766000922 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 42.11 42.110000 29.740000 26.766000923 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 47.97 47.970000 29.740000 26.766000924 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 29.74 29.740000 29.740000 26.766000925 J01MA01 OFLOXACINUM OFLOXACIN 200 mg COMPR. FILM. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 45.49 4.549000 1.066000 0.959400926 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 18.80 1.880000 1.066000 0.959400927 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 10.66 1.066000 1.066000 0.959400928 J01MA01 OFLOXACINUM ZANOCIN (R) OD 400 COMPR. FILM. ELIB. PREL. 400mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 1 BLIST. X 5 COMPR. FILM. ELIB. PREL. P-RF 5 25.76 5.152000 4.742000 4.267800929 J01MA01 OFLOXACINUM ZANOCIN (R) OD 400 COMPR. FILM. ELIB. PREL. 400mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 5 COMPR. FILM. ELIB. PREL. P-RF 10 47.42 4.742000 4.742000 4.267800930 J01MA02 CIPROFLOXACINUM EUCIPRIN CAPS. 250mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 6 CAPS. P-RF 12 7.53 0.627500 0.627500 0.564750931 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 6.41 0.641000 0.447000 0.402300932 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 6.41 0.641000 0.447000 0.402300933 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 7.33 0.733000 0.447000 0.402300934 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 6.41 0.641000 0.447000 0.402300935 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 15.08 0.754000 0.447000 0.402300936 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 250 mg COMPR. FILM. 250mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 7.40 0.740000 0.447000 0.402300937 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 6.52 0.652000 0.447000 0.402300938 J01MA02 CIPROFLOXACINUM CIPHIN 250 COMPR. FILM. 250mg ZENTIVA A.S. SLOVACIA CUTIE X 1 BLIST. PVDC/PVC/AL X 10 COMPR. FILM. P-RF 10 8.95 0.895000 0.447000 0.402300939 J01MA02 CIPROFLOXACINUM CIPROLET 250 mg COMPR. FILM. 250mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 4.47 0.447000 0.447000 0.402300940 J01MA02 CIPROFLOXACINUM EUCIPRIN 250 mg COMPR. FILM. 250mg EUROPHARM SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 5.73 0.573000 0.447000 0.402300941 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 12.42 1.242000 0.795000 0.715500942 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 12.42 1.242000 0.795000 0.715500943 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 13.07 1.307000 0.795000 0.715500944 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 12.42 1.242000 0.795000 0.715500945 J01MA02 CIPROFLOXACINUM CIPROZONE FORTE 500 mg COMPR. FILM. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 7.95 0.795000 0.795000 0.715500946 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 500 mg COMPR. FILM. 500mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 14.18 1.418000 0.795000 0.715500947 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 8.24 0.824000 0.795000 0.715500

Pagina 22 din 34

Page 25: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

948 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 12.42 1.242000 0.795000 0.715500949 J01MA02 CIPROFLOXACINUM CIPHIN 500 COMPR. FILM. 500mg ZENTIVA A.S. SLOVACIA CUTIE X 1 BLIST. PVDC/PVC/AL X 10 COMPR. FILM. P-RF 10 17.87 1.787000 0.795000 0.715500950 J01MA02 CIPROFLOXACINUM CIPRODAR COMPR. FILM. 500mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 15.62 1.562000 0.795000 0.715500951 J01MA02 CIPROFLOXACINUM EUCIPRIN 500 mg COMPR. FILM. 500mg EUROPHARM SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 8.67 0.867000 0.795000 0.715500952 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 36.14 3.614000 3.614000 3.252600953 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 79.53 11.361428 11.361428 10.225285954 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 25.95 8.650000 8.650000 7.785000955 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 43.81 4.381000 4.381000 3.942900956 J01MA06 NORFLOXACINUM H - NORFLOXACIN 400 mg COMPR. FILM. 400mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 20.69 1.034500 0.517142 0.465427957 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 14.78 0.739000 0.517142 0.465427958 J01MA06 NORFLOXACINUM NORFLOX - 400 COMPR. FILM. 400mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 5.81 0.581000 0.517142 0.465427959 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 16.53 0.826500 0.517142 0.465427960 J01MA06 NORFLOXACINUM EPINOR COMPR. FILM. 400mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 7.24 0.517142 0.517142 0.465427961 J01MA06 NORFLOXACINUM NORFLOXACIN OZONE 400 mg COMPR. FILM. 400mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 5.36 0.536000 0.517142 0.465427962 J01MA06 NORFLOXACINUM NORFLOXACINA TERAPIA 400 mg COMPR. FILM. 400mg TERAPIA SA ROMANIA CUTIE X 1 FOLIE TERMOSUDATA DIN AL-PEJD X 10 COMPR. FILM. P-RF 10 5.49 0.549000 0.517142 0.465427963 J01MB02 ACIDUM NALIDIXICUM NALIXID 500 mg CAPS. 500mg ZENTIVA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 11.40 0.380000 0.380000 0.342000964 J01XD01 METRONIDAZOLUM METRONIDAZOL 250 mg (J01XD01) COMPR. 250mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 1.31 0.065500 0.062000 0.055800965 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 1.86 0.062000 0.062000 0.055800966 J01XD01 METRONIDAZOLUM METRONIDAZOL 250 mg (J01XD01) COMPR. 250mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 1.31 0.065500 0.062000 0.055800967 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 1.86 0.062000 0.062000 0.055800968 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 7.89 0.394500 0.394500 0.355050969 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 7.89 0.394500 0.394500 0.355050970 J01XD01 METRONIDAZOLUM FLAGYL 4 % (J01XD01) SUSP. ORALA 4% LABORATOIRE AVENTIS FRANTA CUTIE X 1 FLACON X 120 ML SUSP. ORALA + LINGURITA DOZATOARE X 5 ML P-RF 1 7.47 7.470000 7.470000 6.723000971 J01XD01 METRONIDAZOLUM FLAGYL 4 % (J01XD01) SUSP. ORALA 4% LABORATOIRE AVENTIS FRANTA CUTIE X 1 FLACON X 120 ML SUSP. ORALA + LINGURITA DOZATOARE X 5 ML P-RF 1 7.47 7.470000 7.470000 6.723000972 J02AB02 KETOCONAZOLUM NIZORAL 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 19.21 1.921000 0.646000 0.581400973 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 6.47 0.647000 0.646000 0.581400974 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 8.61 0.861000 0.646000 0.581400975 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 6.46 0.646000 0.646000 0.581400976 J02AB02 KETOCONAZOLUM KETOSTIN 200 mg COMPR. 200mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 11.85 1.185000 0.646000 0.581400977 J02AB02 KETOCONAZOLUM KEFUNGIN COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 6.46 0.646000 0.646000 0.581400978 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 221.98 7.927857 4.225714 3.803142979 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 24.04 6.010000 4.225714 3.803142980 J02AC01 FLUCONAZOLUM FLUCORIC 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 40.71 5.815714 4.225714 3.803142981 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 77.60 4.850000 4.225714 3.803142982 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 8.86 4.430000 4.225714 3.803142983 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 29.58 4.225714 4.225714 3.803142984 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 21.14 21.140000 6.190000 5.571000985 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 73.82 18.455000 6.190000 5.571000986 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 2 BLIST. AL/PVC X 1 CAPS. P-RF 2 40.62 20.310000 6.190000 5.571000987 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 9.32 9.320000 6.190000 5.571000988 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 23.54 23.540000 6.190000 5.571000989 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 17.72 17.720000 6.190000 5.571000990 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 13.68 13.680000 6.190000 5.571000991 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 9.32 9.320000 6.190000 5.571000992 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 8.64 8.640000 6.190000 5.571000993 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 3 CAPS. P-RF 3 30.05 10.016666 6.190000 5.571000994 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 15.47 15.470000 6.190000 5.571000

Pagina 23 din 34

Page 26: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

995 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 6.19 6.190000 6.190000 5.571000996 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 9.09 9.090000 6.190000 5.571000997 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 8.49 8.490000 6.190000 5.571000998 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7.70 7.700000 6.190000 5.571000999 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 6.19 6.190000 6.190000 5.5710001,000 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDICO UNO 150 mg CAPS. 150mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 8.49 8.490000 6.190000 5.5710001,001 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 36.96 5.280000 5.280000 4.7520001,002 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 57.94 8.277142 2.115714 1.9041421,003 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 21.19 3.027142 2.115714 1.9041421,004 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 53.08 7.582857 2.115714 1.9041421,005 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 27.80 3.971428 2.115714 1.9041421,006 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 39.37 5.624285 2.115714 1.9041421,007 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 21.19 3.027142 2.115714 1.9041421,008 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 17.87 2.233750 2.115714 1.9041421,009 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 23.98 2.398000 2.115714 1.9041421,010 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 15.65 2.235714 2.115714 1.9041421,011 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 18.49 2.641428 2.115714 1.9041421,012 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 18.38 2.625714 2.115714 1.9041421,013 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 17.95 2.564285 2.115714 1.9041421,014 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 15.16 2.165714 2.115714 1.9041421,015 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 14.81 2.115714 2.115714 1.9041421,016 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 53.08 53.080000 53.080000 47.7720001,017 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 19.00 0.950000 0.950000 0.8550001,018 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 20.11 1.005500 0.950000 0.8550001,019 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 18.29 1.829000 1.829000 1.6461001,020 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 12.20 0.610000 0.610000 0.5490001,021 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 16.16 0.808000 0.610000 0.5490001,022 J05AB01 ACICLOVIRUM CLOVIRAL 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 15.42 0.771000 0.610000 0.5490001,023 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 12.94 0.647000 0.610000 0.5490001,024 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 12.20 0.610000 0.610000 0.5490001,025 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 18.06 1.806000 1.806000 1.6254001,026 J05AB01 ACICLOVIRUM ACICLOVIR OZONE 200 mg COMPR. DISP. 200mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. DISP. P-RF 20 6.80 0.340000 0.340000 0.3060001,027 J05AB01 ACICLOVIRUM LOVIR 200 mg COMPR. DISP. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 10 COMPR. DISP. P-RF 10 3.51 0.351000 0.340000 0.3060001,028 J05AB01 ACICLOVIRUM ACIKLOVIR COMPR. FILM. 400mg A & G MED TRADING S.R.L. ROMANIA CUTIE X 7 BLIST. AL/PVC X 5 COMPR. FILM. P-RF 35 53.68 1.533714 1.533714 1.3803421,029 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 5 265.70 53.140000 53.140000 47.8260001,030 L02BG01 AMINOGLUTETHIMIDUM ROGLUTEN (R) 250 mg COMPR. 250mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 40 COMPR. P-RF 40 142.14 3.553500 3.553500 3.1981501,031 M01AB01 INDOMETACINUM INDOMETACIN 25 mg CAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 2.00 0.066666 0.066666 0.0599991,032 M01AB01 INDOMETACINUM INDOMETACIN LAROPHARM 25 mg CAPS. 25mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 CAPS. P-6L 20 1.53 0.076500 0.066666 0.0599991,033 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE AL-PE X 3 SUPOZ. P-6L 6 1.74 0.290000 0.190000 0.1710001,034 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 1.90 0.190000 0.190000 0.1710001,035 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 2.27 0.227000 0.190000 0.1710001,036 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 20 44.79 2.239500 2.239500 2.0155501,037 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg PHARMASWISS CESKA REPUBLIKA S.R.O. CEHIA CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 19.23 0.641000 0.641000 0.5769001,038 M01AB05 DICLOFENACUM TRATUL 50 CAPS. GASTROREZ. 50mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. P-6L 30 15.21 0.507000 0.507000 0.4563001,039 M01AB05 DICLOFENACUM DICLAC (R) 75 ID COMPR. ELIB. MODIF. 75mg HEXAL AG GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR. ELIB. MODIF. P-6L 10 3.68 0.368000 0.368000 0.3312001,040 M01AB05 DICLOFENACUM VOLTAREN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL. P-6L 10 6.16 0.616000 0.159500 0.1435501,041 M01AB05 DICLOFENACUM REFEN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 8.55 0.427500 0.159500 0.143550

Pagina 24 din 34

Page 27: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1,042 M01AB05 DICLOFENACUM DICLOTARD (R) 100 mg COMPR. FILM. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL P-6L 20 3.19 0.159500 0.159500 0.1435501,043 M01AB05 DICLOFENACUM RHEUMAVEK COMPR. FILM. GASTROREZ. 25mg FARAN LABORATORIES S.A. GRECIA CUTIE X 3 BLIST. PVC-AL/PVDC X 10 COMPR. FILM. GASTROREZ. P-6L 30 5.36 0.178666 0.178666 0.1607991,044 M01AB05 DICLOFENACUM VOLTAREN (R) 50 COMPR. FILM. GASTROREZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L 20 6.16 0.308000 0.105500 0.0949501,045 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 2.13 0.106500 0.105500 0.0949501,046 M01AB05 DICLOFENACUM CLAFEN 50 mg COMPR. FILM. GASTROREZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. GASTROREZ. P-6L 20 2.31 0.115500 0.105500 0.0949501,047 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 2.11 0.105500 0.105500 0.0949501,048 M01AB05 DICLOFENACUM DICLOGESIC 50 COMPRIMATE FILMATE GASTROREZISTENTE COMPR. FILM. GASTROREZ. 50mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 3.57 0.178500 0.105500 0.0949501,049 M01AB05 DICLOFENACUM EPIFENAC COMPR. GASTROREZ. 25mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 3 BLIST. X 10 COMPR. GASTROREZ. P-6L 30 4.24 0.141333 0.141333 0.1271991,050 M01AB05 DICLOFENACUM VOLTAREN RAPID (R) DRAJ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L 10 2.19 0.219000 0.219000 0.1971001,051 M01AB05 DICLOFENACUM DICLOFENAC 25 mg DRAJ. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L 30 5.81 0.193666 0.193666 0.1742991,052 M01AB05 DICLOFENACUM DICLOFENAC 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L 20 2.50 0.125000 0.119500 0.1075501,053 M01AB05 DICLOFENACUM N - DICLOFENAC DRAJ. GASTROREZ. 50mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. PE X 20 DRAJ. GASTROREZ. P-6L 20 2.39 0.119500 0.119500 0.1075501,054 M01AB05 DICLOFENACUM VOLTAREN (R) SOL. INJ. 25mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 ML P-RF 5 8.83 1.766000 0.762000 0.6858001,055 M01AB05 DICLOFENACUM RHEUMAVEK SOL. INJ. 25mg/ml FARAN LABORATORIES S.A. GRECIA CUTIE X 5 FIOLE DE STICLA BRUNA PREVAZUTE CU INEL DE RUPERE X 3 ML P-RF 5 5.73 1.146000 0.762000 0.6858001,056 M01AB05 DICLOFENACUM REFEN (R) SOL. INJ. 25mg/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 5 FIOLE X 3 ML P-RF 5 3.81 0.762000 0.762000 0.6858001,057 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF 5 13.37 2.674000 2.674000 2.4066001,058 M01AB05 DICLOFENACUM DICLAC SOL. INJ. 75mg HEXAL AG GERMANIA CUTIE X 5 FIOLE X 3 ML SOL. INJ. P-RF 5 6.16 1.232000 0.762000 0.6858001,059 M01AB05 DICLOFENACUM ALMIRAL SOL. INJ. 75mg/3ml MEDOCHEMIE LTD. CIPRU CUTIE X 10 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE, IN 2 SUPORTURI TERMOFORMATE DIN MATERIAL PLASTI P-RF 10 9.31 0.931000 0.762000 0.6858001,060 M01AB05 DICLOFENACUM DICLOFENAC 75 mg SOL. INJ. 75mg/3ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 ML P-RF 5 9.58 1.916000 0.762000 0.6858001,061 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF 5 9.12 1.824000 0.762000 0.6858001,062 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF 10 12.63 1.263000 0.762000 0.6858001,063 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 30 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF/S 30 30.88 1.029333 0.762000 0.6858001,064 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 2.77 0.461666 0.288000 0.2592001,065 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ. P-6L 5 5.13 1.026000 0.288000 0.2592001,066 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 2.88 0.288000 0.288000 0.2592001,067 M01AB05 DICLOFENACUM DICLOFENAC SODIC 100 mg SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 3.00 0.300000 0.288000 0.2592001,068 M01AB05 DICLOFENACUM EPIFENAC SUPOZ. 100mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FOLIE AL/PEJD. X 5 SUPOZ. P-6L 5 3.33 0.666000 0.288000 0.2592001,069 M01AB05 DICLOFENACUM DICLOGESIC 12,5 SUPOZITOARE SUPOZ. 12,5mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 4.73 0.473000 0.473000 0.4257001,070 M01AB05 DICLOFENACUM TRATUL 120 SUPOZ. 120mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 6 SUPOZ. P-6L 6 9.74 1.623333 1.623333 1.4609991,071 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ. P-6L 10 8.88 0.888000 0.888000 0.7992001,072 M01AB05 DICLOFENACUM TRATUL 60 SUPOZ. 60mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 6 SUPOZ. P-6L 6 9.04 1.506666 1.506666 1.3559991,073 M01AB15 KETOROLACUM TROMETHAMIN KETOROL COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 6.33 0.316500 0.316500 0.2848501,074 M01AB15 KETOROLACUM TROMETHAMIN KETANOV 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-6L 20 6.33 0.316500 0.316500 0.2848501,075 M01AB15 KETOROLACUM TROMETHAMIN KETOROL SOL. INJ. 30mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. X 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. P-RF 10 18.41 1.841000 1.841000 1.6569001,076 M01AB15 KETOROLACUM TROMETHAMIN KETANOV SOL. INJ. 30mg/ml TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 1 ML P-RF 10 23.24 2.324000 1.841000 1.6569001,077 M01AB16 ACECLOFENACUM AFLAMIL COMPR. FILM. 100mg GEDEON RICHTER PLC. UNGARIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR. P-6L 20 21.33 1.066500 1.066500 0.9598501,078 M01AC02 TENOXICAMUM TENOXICAM LPH 20 mg CAPS. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 12.73 0.636500 0.636500 0.5728501,079 M01AC02 TENOXICAMUM TENOXICAM 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 13.25 0.662500 0.662500 0.5962501,080 M01AC02 TENOXICAMUM NEO - ENDUSIX (R) COMPR. FILM. 20mg ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 5.96 0.596000 0.596000 0.5364001,081 M01AC02 TENOXICAMUM TILCOTIL COMPR. FILM. 20mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 10 9.18 0.918000 0.596000 0.5364001,082 M01AC02 TENOXICAMUM NEO - ENDUSIX (R) LIOF. + SOLV. PT. SOL. INJ. 20mg ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 1 FLAC. PULB. + 1 FIOLA SOLV. P-RF 1 5.10 5.100000 5.100000 4.5900001,083 M01AC06 MELOXICAMUM MOVALIS (R) 15 mg COMPR. 15mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 14.48 0.724000 0.466333 0.4196991,084 M01AC06 MELOXICAMUM MOVALIS (R) 15 mg COMPR. 15mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 10 7.24 0.724000 0.466333 0.4196991,085 M01AC06 MELOXICAMUM MELOXICAM LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 25.58 1.279000 0.466333 0.4196991,086 M01AC06 MELOXICAMUM MELOXICAM SANDOZ 15 mg COMPR. 15mg HEXAL AG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 9.37 0.468500 0.466333 0.4196991,087 M01AC06 MELOXICAMUM MELOX 15 mg COMPR. 15mg MEDOCHEMIE LTD CIPRU CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 30 28.54 0.951333 0.466333 0.4196991,088 M01AC06 MELOXICAMUM MELOX 15 mg COMPR. 15mg MEDOCHEMIE LTD CIPRU CUTIE X 1 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 10 9.95 0.995000 0.466333 0.419699

Pagina 25 din 34

Page 28: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1,089 M01AC06 MELOXICAMUM RECOXA 15 COMPR. 15mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 13.25 0.662500 0.466333 0.4196991,090 M01AC06 MELOXICAMUM RECOXA 15 COMPR. 15mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 10 8.21 0.821000 0.466333 0.4196991,091 M01AC06 MELOXICAMUM MELARTRIN 15 mg COMPR. 15mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 30.25 1.512500 0.466333 0.4196991,092 M01AC06 MELOXICAMUM MELOXICAM MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 9.41 0.470500 0.466333 0.4196991,093 M01AC06 MELOXICAMUM CELOMIX COMPR. 15mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 15.16 0.505333 0.466333 0.4196991,094 M01AC06 MELOXICAMUM VALZER 15 mg COMPR. 15mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 10.49 0.524500 0.466333 0.4196991,095 M01AC06 MELOXICAMUM ANTREND 15 mg COMPR. 15mg OZONE LABORATORIES BV OLANDA CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 13.99 0.466333 0.466333 0.4196991,096 M01AC06 MELOXICAMUM MELOXICAM VIM SPECTRUM 15 mg COMPR. 15mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 15.93 0.796500 0.466333 0.4196991,097 M01AC06 MELOXICAMUM MELOX 7,5 mg COMPR. 7,5 mg MEDOCHEMIE LTD CIPRU CUTIE X 1 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 10 9.03 0.903000 0.453000 0.4077001,098 M01AC06 MELOXICAMUM MELOX 7,5 mg COMPR. 7,5 mg MEDOCHEMIE LTD CIPRU CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 30 24.08 0.802666 0.453000 0.4077001,099 M01AC06 MELOXICAMUM MOVALIS (R) 7,5 mg COMPR. 7,5mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 10 6.96 0.696000 0.453000 0.4077001,100 M01AC06 MELOXICAMUM MOVALIS (R) 7,5 mg COMPR. 7,5mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 13.93 0.696500 0.453000 0.4077001,101 M01AC06 MELOXICAMUM MELOXICAM LPH 7,5 mg COMPR. 7,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 18.43 0.921500 0.453000 0.4077001,102 M01AC06 MELOXICAMUM MELOXICAM SANDOZ 7,5 mg COMPR. 7,5mg HEXAL AG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 10.79 0.539500 0.453000 0.4077001,103 M01AC06 MELOXICAMUM MELOXICAM MCC 7,5 mg COMPR. 7,5mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIAT. AL/PVC X 10 COMPR. P-6L 20 9.06 0.453000 0.453000 0.4077001,104 M01AC06 MELOXICAMUM VALZER 7,5mg COMPR. 7,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 9.92 0.496000 0.453000 0.4077001,105 M01AC06 MELOXICAMUM MELOXICAM VIM SPECTRUM 7,5 mg COMPR. 7,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 13.34 0.667000 0.453000 0.4077001,106 M01AC06 MELOXICAMUM MOVALIS 15mg/1,5ml SOL. INJ. 15mg/1,5ml BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1,5 ML SIL. INJ. P-RF 5 14.18 2.836000 2.836000 2.5524001,107 M01AC06 MELOXICAMUM MOVALIS (R) 15 mg SUPOZ. 15mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 1 FOLIE TERMOSUDATA AL/PE X 6 SUPOZ. P-6L 6 12.57 2.095000 1.335000 1.2015001,108 M01AC06 MELOXICAMUM MELOXICAM 15 mg SUPOZ. 15mg MAGISTRA C & C ROMANIA CUTII X 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ. P-6L 6 8.01 1.335000 1.335000 1.2015001,109 M01AC06 MELOXICAMUM MELOXICAM 7,5 mg SUPOZ. 7,5mg MAGISTRA C & C ROMANIA CUTII X 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ. P-6L 6 7.66 1.276666 1.276666 1.1489991,110 M01AE03 KETOPROFENUM KETOPROFEN SR 100 mg CAPS. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. CU ELIB. PREL. P-6L 10 11.20 1.120000 1.120000 1.0080001,111 M01AE03 KETOPROFENUM KETONAL (R) DUO 150 mg CAPS. ELIB. PREL. 150mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC-TE-PVDC X 10 CAPS. ELIB. PREL. P-6L 20 15.47 0.773500 0.773500 0.6961501,112 M01AE03 KETOPROFENUM KETOPROFEN SR 200 mg CAPS. ELIB. PREL. 200mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. CU ELIB. PREL. P-6L 10 14.19 1.419000 1.235500 1.1119501,113 M01AE03 KETOPROFENUM KETONAL UNO CAPS. ELIB. PREL. 200mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC-TE-PVDC X 10 CAPS. ELIB. PREL. P-6L 20 24.71 1.235500 1.235500 1.1119501,114 M01AE03 KETOPROFENUM KETONAL RETARD COMPR. ELIB. PREL. 150mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. X 20 COMPR. CU ELIB. PREL. P-6L 20 14.11 0.705500 0.705500 0.6349501,115 M01AE03 KETOPROFENUM RUBIFEN 100 mg COMPR. FILM. 100 mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 7.41 0.370500 0.370500 0.3334501,116 M01AE03 KETOPROFENUM PROFENID (R) 100 mg COMPR. FILM. 100mg LAB. AVENTIS FRANTA CUTIE X 2 BLIST X 15 COMPR. FILM. P-6L 30 17.13 0.571000 0.370500 0.3334501,117 M01AE03 KETOPROFENUM KETONAL FORTE 100 mg COMPR. FILM. 100mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. X 20 COMPR. FILM. P-6L 20 10.91 0.545500 0.370500 0.3334501,118 M01AE03 KETOPROFENUM KETOPROXIN 100 mg COMPR. FILM. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L 20 14.85 0.742500 0.370500 0.3334501,119 M01AE03 KETOPROFENUM KETOPROXIN 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L 20 11.08 0.554000 0.554000 0.4986001,120 M01AE03 KETOPROFENUM PROFENID (R) LP 200 mg COMPR. FILM. ELIB. PREL. 200mg LAB. AVENTIS FRANTA CUTIE X 1 BLIST X 14 COMPR. FILM. ELIB. PREL. P-6L 14 15.28 1.091428 1.091428 0.9822851,121 M01AE03 KETOPROFENUM PROFENID (R) 100 mg LIOF. + SOLV. PT. SOL. INJ. 100mg LAB. AVENTIS FRANTA CUTIE X 6 FLAC. LIOF. + 6 FIOLE X 5 ML SOLV. P-6L 6 8.14 1.356666 1.356666 1.2209991,122 M01AE03 KETOPROFENUM KETONAL 100 mg/ 2 ml SOL. INJ. 100mg/2ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 10 FIOLE X 2 ML SOL. INJ/CONC PT.SOL. PERF. P-RF 10 10.66 1.066000 1.066000 0.9594001,123 M01AE03 KETOPROFENUM KETOPROFEN 100mg/2ml SOL. INJ./CONC. SOL. PERF. 100mg/2ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML P-RF 5 9.04 1.808000 1.066000 0.9594001,124 M01AE03 KETOPROFENUM KETONAL 100 mg SUPOZ. 100mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 FOLII AL/PE X 6 SUPOZ. P-6L 12 7.70 0.641666 0.613000 0.5517001,125 M01AE03 KETOPROFENUM RUBIFEN (R) 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE METALIZATE AL-PE X 3 SUPOZ. P-6L 6 3.99 0.665000 0.613000 0.5517001,126 M01AE03 KETOPROFENUM KETOMAG SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII LAMINATE PVC/PE X 5 SUPOZ. P-6L 10 6.13 0.613000 0.613000 0.5517001,127 M03BX07 TETRAZEPAMUM MYOLASTAN (R) 50 mg COMPR. FILM. 50mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 8.95 0.447500 0.447500 0.4027501,128 M04AA01 ALLOPURINOLUM* MILURIT 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 5.67 0.113400 0.113400 0.1020601,129 M04AA01 ALLOPURINOLUM* MILURIT 300 mg COMPR. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-6L 30 9.78 0.326000 0.326000 0.2934001,130 M04AC01 COLCHICINUM COLCHICINA COMPR. 1mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 COMPR. P-RF 40 5.42 0.135500 0.135500 0.1219501,131 N02AD01 PENTAZOCINUM FORTRAL 50 mg COMPR. 50mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLAC. X 100 COMPR. P-RF/S 100 71.87 0.718700 0.718700 0.6468301,132 N02AD01 PENTAZOCINUM FORTRAL 50 mg COMPR. 50mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLAC X 20 COMPR. P-RF 20 17.43 0.871500 0.718700 0.6468301,133 N02AD01 PENTAZOCINUM FORTRAL SOL. INJ. 30mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE X 1 ML SOL. INJ. P-RF 10 13.81 1.381000 1.296600 1.1669401,134 N02AD01 PENTAZOCINUM FORTRAL SOL. INJ. 30mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 50 FIOLE X 1 ML SOL. INJ. P-RF/S 50 64.83 1.296600 1.296600 1.1669401,135 N02AX02 TRAMADOLUM TRAMAL (R) CAPS. 50mg GRUNENTHAL GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 11.09 0.554500 0.274500 0.247050

Pagina 26 din 34

Page 29: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1,136 N02AX02 TRAMADOLUM TRALGIT 50 CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7.43 0.371500 0.274500 0.2470501,137 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5.49 0.274500 0.274500 0.2470501,138 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. X 10 CAPS. P-RF 30 12.26 0.408666 0.274500 0.2470501,139 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. X 10 CAPS. P-RF/S 50 21.39 0.427800 0.274500 0.2470501,140 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. X 10 CAPS. P-RF/S 100 41.39 0.413900 0.274500 0.2470501,141 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 3.82 0.382000 0.274500 0.2470501,142 N02AX02 TRAMADOLUM MABRON 50 mg CAPS. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 4.68 0.468000 0.274500 0.2470501,143 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7.21 0.360500 0.274500 0.2470501,144 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 6.07 0.607000 0.274500 0.2470501,145 N02AX02 TRAMADOLUM TRAMADOL LPH 50 mg CAPS. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 12.67 0.633500 0.274500 0.2470501,146 N02AX02 TRAMADOLUM URGENDOL CAPS. 50mg MEDICAROM GROUP SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 4.35 0.435000 0.274500 0.2470501,147 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 8.44 0.422000 0.274500 0.2470501,148 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7.21 0.360500 0.360500 0.3244501,149 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 11.14 0.557000 0.360500 0.3244501,150 N02AX02 TRAMADOLUM TRAMADOL 50 mg COMPR. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 9.35 0.467500 0.360500 0.3244501,151 N02AX02 TRAMADOLUM TRAMADOLOR (R) 100 ID COMPR. ELIB. MODIF. 100mg HEXAL AG GERMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. MODIF. P-RF 10 7.06 0.706000 0.592333 0.5330991,152 N02AX02 TRAMADOLUM TRAMADOL (R) RETARD COMPR. ELIB. PREL. 100mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. X 10 COMPR. ELIB. PREL. P-RF 30 17.77 0.592333 0.592333 0.5330991,153 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 50 45.52 0.910400 0.592333 0.5330991,154 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 10 9.26 0.926000 0.592333 0.5330991,155 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 25.62 0.854000 0.592333 0.5330991,156 N02AX02 TRAMADOLUM NOAX UNO 100 mg COMPR. ELIB. PREL. 100mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 5 COMPR.ELIM.PREL. P-RF 5 6.96 1.392000 0.592333 0.5330991,157 N02AX02 TRAMADOLUM NOAX UNO 100 mg COMPR. ELIB. PREL. 100mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.ELIM.PREL. P-RF 30 37.10 1.236666 0.592333 0.5330991,158 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 31.51 1.050333 1.050333 0.9452991,159 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 10 19.77 1.977000 1.050333 0.9452991,160 N02AX02 TRAMADOLUM TRALGIT SR 200 COMPR. ELIB. PREL. 200mg ZENTIVA AS SLOVACIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 10 25.82 2.582000 1.622333 1.4600991,161 N02AX02 TRAMADOLUM NOAX UNO 200 mg COMPR. ELIB. PREL. 200mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 10 COMPR.ELIB. PREL. P-RF 10 18.86 1.886000 1.622333 1.4600991,162 N02AX02 TRAMADOLUM NOAX UNO 200 mg COMPR. ELIB. PREL. 200mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.ELIB. PREL. P-RF 30 48.67 1.622333 1.622333 1.4600991,163 N02AX02 TRAMADOLUM NOAX UNO 300 mg COMPR. ELIB. PREL. 300mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. X PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P-RF 10 26.22 2.622000 2.393333 2.1539991,164 N02AX02 TRAMADOLUM NOAX UNO 300 mg COMPR. ELIB. PREL. 300mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST. X PVC-PE-ACLAR/AL X 10 COMPR. ELIB. PREL. P-RF 30 71.80 2.393333 2.393333 2.1539991,165 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 9.98 0.332666 0.332666 0.2993991,166 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. FILM. ELIB. PREL. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. AL/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-RF 10 14.39 1.439000 1.439000 1.2951001,167 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 20.68 2.068000 1.954333 1.7588991,168 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 58.63 1.954333 1.954333 1.7588991,169 N02AX02 TRAMADOLUM TRAMAL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. ELIB. PREL. P-RF 10 26.47 2.647000 2.375333 2.1377991,170 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 71.26 2.375333 2.375333 2.1377991,171 N02AX02 TRAMADOLUM TRALGIT PIC. ORALE, SOL. 100mg/ml ZENTIVA A.S. SLOVACIA CUTIE X 1 FLACON DIN STICLA BRUNA X 96 ML PIC. ORALE, SOL. P-RF 1 94.31 94.310000 6.040000 5.4360001,172 N02AX02 TRAMADOLUM TRALGIT PIC. ORALE, SOL. 100mg/ml ZENTIVA A.S. SLOVACIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-RF 1 11.83 11.830000 6.040000 5.4360001,173 N02AX02 TRAMADOLUM TRAMADOL AL PICATURI PIC. ORALE, SOL. FARA CONCENTRATIE ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-RF 1 6.04 6.040000 6.040000 5.4360001,174 N02AX02 TRAMADOLUM TRAMADOL AL PICATURI PIC. ORALE, SOL. FARA CONCENTRATIE ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL. P-RF 1 13.00 13.000000 6.040000 5.4360001,175 N02AX02 TRAMADOLUM TRAMAL (R) PICATURI ORALE-SOL. 100mg/ml GRUNENTHAL GMBH GERMANIA CUTIE X 1 FLACON PICURATOR X 10 ML P-RF 1 7.27 7.270000 6.040000 5.4360001,176 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 100 128.64 1.286400 1.286400 1.1577601,177 N02AX02 TRAMADOLUM TRALGIT 100 SOL. INJ. 100mg/2ml ZENTIVA A.S. SLOVACIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 11.53 2.306000 1.286400 1.1577601,178 N02AX02 TRAMADOLUM TRAMAL (R) 50 SOL. INJ. 50mg/ml GRUNENTHAL GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 7.10 1.420000 1.368000 1.2312001,179 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 10.06 2.012000 1.368000 1.2312001,180 N02AX02 TRAMADOLUM TRALGIT 50 SOL. INJ. 50mg/ml ZENTIVA A.S. SLOVACIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S/P-RF 5 10.79 2.158000 1.368000 1.2312001,181 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 6.84 1.368000 1.368000 1.2312001,182 N02AX02 TRAMADOLUM TRAMAL (R) 100 SOL. INJ. 50mg/ml GRUNENTHAL GMBH GERMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 12.74 2.548000 1.286400 1.157760

Pagina 27 din 34

Page 30: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1,183 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 12.30 2.460000 1.286400 1.1577601,184 N02AX02 TRAMADOLUM TRAMADOL (R) AL 100 Fiole SOL. INJ. 50mg/ml ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 FIOLE X 2 ML S/P-RF 10 18.06 1.806000 1.286400 1.1577601,185 N02AX02 TRAMADOLUM TRAMADOL (R) AL 100 Fiole SOL. INJ. 50mg/ml ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 9.06 1.812000 1.286400 1.1577601,186 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 8.49 1.698000 1.286400 1.1577601,187 N02AX02 TRAMADOLUM TRAMAL (R) SUPOZ. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 FOLIE PP/AL/PE X 5 SUPOZ. P-RF 5 12.13 2.426000 1.048000 0.9432001,188 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 5 SUPOZ. P-RF 5 5.24 1.048000 1.048000 0.9432001,189 N02CC01 SUMATRIPTANUM* SUMATRIPTAN TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. P-RF 6 51.59 8.598333 8.167500 7.3507501,190 N02CC01 SUMATRIPTANUM* SUMATRIPTAN TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR. P-RF 12 98.01 8.167500 8.167500 7.3507501,191 N02CC01 SUMATRIPTANUM* SUMATRIPTAN TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 3 COMPR. P-RF 3 20.03 6.676666 6.321666 5.6894991,192 N02CC01 SUMATRIPTANUM* SUMATRIPTAN TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 3 COMPR. P-RF 6 37.93 6.321666 6.321666 5.6894991,193 N02CC01 SUMATRIPTANUM* IMIGRAN (R) 100 COMPR. FILM. 100mg GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-AL-OPA/AL X 2 COMPR. FILM. P-RF 2 39.81 19.905000 9.095000 8.1855001,194 N02CC01 SUMATRIPTANUM* SUMATRIPTAN COMPR. FILM. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 10 93.69 9.369000 9.095000 8.1855001,195 N02CC01 SUMATRIPTANUM* SUMATRIPTAN COMPR. FILM. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 6 54.57 9.095000 9.095000 8.1855001,196 N02CC01 SUMATRIPTANUM* SUMACTA 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 2 COMPR. FILM. P-RF 2 25.45 12.725000 9.095000 8.1855001,197 N02CC01 SUMATRIPTANUM* SUMACTA 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 2 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 6 71.44 11.906666 9.095000 8.1855001,198 N02CC01 SUMATRIPTANUM* XIBIMER 100 mg COMPR. FILM. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 10 93.69 9.369000 9.095000 8.1855001,199 N02CC01 SUMATRIPTANUM* XIBIMER 100 mg COMPR. FILM. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 6 54.57 9.095000 9.095000 8.1855001,200 N02CC01 SUMATRIPTANUM* IMIGRAN (R) 50 COMPR. FILM. 50mg GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-AL-OPA/AL X 2 COMPR. FILM. P-RF 2 22.63 11.315000 6.486000 5.8374001,201 N02CC01 SUMATRIPTANUM* SUMATRIPTAN COMPR. FILM. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 10 64.86 6.486000 6.486000 5.8374001,202 N02CC01 SUMATRIPTANUM* SUMATRIPTAN COMPR. FILM. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 6 38.92 6.486666 6.486000 5.8374001,203 N02CC01 SUMATRIPTANUM* SUMACTA 50 mg COMPR. FILM. 50mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 2 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 6 52.25 8.708333 6.486000 5.8374001,204 N02CC01 SUMATRIPTANUM* SUMACTA 50 mg COMPR. FILM. 50mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 2 COMPR. FILM. P-RF 2 18.00 9.000000 6.486000 5.8374001,205 N02CC01 SUMATRIPTANUM* XIBIMER 50 mg COMPR. FILM. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 10 64.86 6.486000 6.486000 5.8374001,206 N02CC01 SUMATRIPTANUM* XIBIMER 50 mg COMPR. FILM. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 6 38.92 6.486666 6.486000 5.8374001,207 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA COMPR. 200mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVCX 10 COMPR. P-6L 20 4.25 0.212500 0.135600 0.1220401,208 N03AF01 CARBAMAZEPINUM NEUROTOP COMPR. 200mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. P-6L 50 10.62 0.212400 0.135600 0.1220401,209 N03AF01 CARBAMAZEPINUM TEGRETOL (R) 200 COMPR. 200mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 50 16.33 0.326600 0.135600 0.1220401,210 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA LPH 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 11.46 0.229200 0.135600 0.1220401,211 N03AF01 CARBAMAZEPINUM CARBAVIM COMPR. 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 13.90 0.278000 0.135600 0.1220401,212 N03AF01 CARBAMAZEPINUM CARBEPSIL 200 COMPR. 200mg AC HELCOR SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 15.13 0.302600 0.135600 0.1220401,213 N03AF01 CARBAMAZEPINUM TAVER COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 6.78 0.135600 0.135600 0.1220401,214 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4.81 0.240500 0.135600 0.1220401,215 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN EEL COMPR. 200mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4.93 0.246500 0.135600 0.1220401,216 N03AF01 CARBAMAZEPINUM FINLEPSIN COMPR. 200mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. P-6L 50 10.62 0.212400 0.135600 0.1220401,217 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4.65 0.232500 0.135600 0.1220401,218 N03AF01 CARBAMAZEPINUM CARBEPSIL 400 COMPR. 400mg AC HELCOR SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 24.65 0.493000 0.493000 0.4437001,219 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 300 mg COMPR. ELIB. PREL. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL P-6L 50 19.41 0.388200 0.387000 0.3483001,220 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 600 mg COMPR. ELIB. PREL. 600mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL. P-6L 50 34.36 0.687200 0.686000 0.6174001,221 N03AF01 CARBAMAZEPINUM FINLEPSIN 400 RETARD COMPR. FILM. 400mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 25.45 0.509000 0.509000 0.4581001,222 N03AF01 CARBAMAZEPINUM TEGRETOL CR 200 COMPR. FILM. ELIB. PREL. 200mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L 50 18.00 0.360000 0.233800 0.2104201,223 N03AF01 CARBAMAZEPINUM TEGRETOL CR 400 COMPR. FILM. ELIB. PREL. 400mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L 30 23.79 0.793000 0.793000 0.7137001,224 N03AF01 CARBAMAZEPINUM TIMONIL 150 RETARD COMPR. RET. 150mg DESITIN GERMANIA CUTIE X 5 BLIST. X 10 COMPR. RET. P-6L 50 14.22 0.284400 0.284400 0.2559601,225 N03AF01 CARBAMAZEPINUM TIMONIL 300 RETARD COMPR. RET. 300mg DESITIN GERMANIA CUTIE X 5 BLIST. X 10 COMPR. RET. P-6L 50 19.35 0.387000 0.387000 0.3483001,226 N03AF01 CARBAMAZEPINUM TIMONIL 600 RETARD COMPR. RET. 600mg DESITIN GERMANIA CUTIE X 5 BLIST. X 10 COMPR. RET. P-6L 50 34.30 0.686000 0.686000 0.6174001,227 N03AF01 CARBAMAZEPINUM FINLEPSIN 200 RETARD COMPR.FILM.ELIB.PREL 200mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL-HARTIE/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 11.69 0.233800 0.233800 0.2104201,228 N03AF01 CARBAMAZEPINUM TIMONIL SIROP SUSP. ORALA 100mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE P-6L 1 21.14 21.140000 21.140000 19.0260001,229 N03AX12 GABAPENTINUM GABAGAMMA 100 mg CAPS. 100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 56.90 0.569000 0.536800 0.483120

Pagina 28 din 34

Page 31: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1,230 N03AX12 GABAPENTINUM GABAGAMMA 100 mg CAPS. 100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 29.15 0.583000 0.536800 0.4831201,231 N03AX12 GABAPENTINUM GABALEPT 100 mg CAPS. 100mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 53.68 0.536800 0.536800 0.4831201,232 N03AX12 GABAPENTINUM GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 67.75 1.355000 1.249700 1.1247301,233 N03AX12 GABAPENTINUM GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 32.22 1.611000 1.249700 1.1247301,234 N03AX12 GABAPENTINUM GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 125.41 1.254100 1.249700 1.1247301,235 N03AX12 GABAPENTINUM GABARAN 300 mg CAPS. 300mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 64.06 1.281200 1.249700 1.1247301,236 N03AX12 GABAPENTINUM GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 124.97 1.249700 1.249700 1.1247301,237 N03AX12 GABAPENTINUM GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 88.76 1.775200 1.390200 1.2511801,238 N03AX12 GABAPENTINUM GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 40.38 2.019000 1.390200 1.2511801,239 N03AX12 GABAPENTINUM GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 164.48 1.644800 1.390200 1.2511801,240 N03AX12 GABAPENTINUM GABARAN 400 mg CAPS. 400mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 69.51 1.390200 1.390200 1.2511801,241 N03AX12 GABAPENTINUM GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 158.84 1.588400 1.390200 1.2511801,242 N03AX12 GABAPENTINUM GABARAN 600 mg COMPR. FILM. 600mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 61.23 2.041000 2.041000 1.8369001,243 N03AX12 GABAPENTINUM GABARAN 800 mg COMPR. FILM. 800mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 97.88 3.262666 3.262666 2.9363991,244 N05AD01 HALOPERIDOLUM HALOPERIDOL LAROPHARM 0,5 mg COMPR. 0,5mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3.05 0.152500 0.152500 0.1372501,245 N05AD01 HALOPERIDOLUM HALDOL COMPR. 5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 16.84 0.673600 0.673600 0.6062401,246 N05AD01 HALOPERIDOLUM HALOPERIDOL 2 mg/ml PIC. ORALE-SOL. 2mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 10ML PICATURI ORALE-SOLUTIE P-RF 1 6.26 6.260000 4.410000 3.9690001,247 N05AD01 HALOPERIDOLUM HALOPERIDOL PICATURI ORALE-SOL. 2mg/ml TERAPIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 10 ML P-RF 1 4.41 4.410000 4.410000 3.9690001,248 N05AD01 HALOPERIDOLUM HALOPERIDOL DECANOAT SOL. INJ. 50mg/ml GEDEON RICHTER PLC. UNGARIA CUTIE X 5 FIOLE X 1 ML P-RF 5 41.81 8.362000 8.362000 7.5258001,249 N05AD01 HALOPERIDOLUM HALOPERIDOL RICHTER 5 mg/ml SOL. INJ. 5mg/ml GEDEON RICHTER PLC. UNGARIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 5 11.71 2.342000 2.342000 2.1078001,250 N05BA01 DIAZEPAMUM DIAZEPAM 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0.86 0.043000 0.043000 0.0387001,251 N05BA01 DIAZEPAMUM DIAZEPAM COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.08 0.069333 0.043000 0.0387001,252 N05BA01 DIAZEPAMUM DIAZEPAM LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.99 0.049500 0.043000 0.0387001,253 N05BA01 DIAZEPAMUM DIAZEPAM 10 mg SOL. INJ. 10mg/2ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 4.35 0.870000 0.663100 0.5967901,254 N05BA01 DIAZEPAMUM DIAZEPAM DESITIN (R) SOLUTIE RECTALA 10 mg SOL. RECTALA 10mg/2,5ml DESITIN GERMANIA CUTIE X 5 PUNGI X 1 TUB X 2,5 ML + CANULA S/P-RF 5 25.52 5.104000 5.104000 4.5936001,255 N05BA01 DIAZEPAMUM DIAZEPAM DESITIN (R) SOLUTIE RECTALA 5 mg SOL. RECTALA 5mg/2,5ml DESITIN GERMANIA CUTIE X 5 PUNGI X 1 TUB X 2,5 ML + CANULA S/P-RF 5 20.15 4.030000 4.030000 3.6270001,256 N05BA03 MEDAZEPAMUM* ANSILAN 10 mg CAPS. 10mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 25 CAPS. P-RF 25 3.57 0.142800 0.142800 0.1285201,257 N05BA03 MEDAZEPAMUM* MEDAZEPAM COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2.30 0.115000 0.105400 0.0948601,258 N05BA03 MEDAZEPAMUM* MEDAZEPAM COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-RF 50 5.27 0.105400 0.105400 0.0948601,259 N05BA03 MEDAZEPAMUM* MEDAZEPAM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. X 20 COMPR. P-RF 20 2.20 0.110000 0.105400 0.0948601,260 N05BA03 MEDAZEPAMUM* RUDOTEL COMPR. 10mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 COMPR. P-RF 50 8.09 0.161800 0.105400 0.0948601,261 N05BA03 MEDAZEPAMUM* MEDAZEPAM LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2.36 0.118000 0.105400 0.0948601,262 N05BA06 LORAZEPAMUM* ANXIAR (R) 1 mg COMPR. 1 mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-RF 50 6.29 0.125800 0.125800 0.1132201,263 N05BA08 BROMAZEPAMUM* CALMEPAM (R) COMPR. 1,5mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 BLIST X 10 COMPR. P-RF 10 2.90 0.290000 0.209000 0.1881001,264 N05BA08 BROMAZEPAMUM* BROMAZEPAM LPH 1,5 mg COMPR. 1,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 4.18 0.209000 0.209000 0.1881001,265 N05BA08 BROMAZEPAMUM* CALMEPAM (R) COMPR. 3mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 3.81 0.381000 0.224333 0.2018991,266 N05BA08 BROMAZEPAMUM* LEXOTAN COMPR. 3mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 6.73 0.224333 0.224333 0.2018991,267 N05BA08 BROMAZEPAMUM* LEXOTANIL COMPR. 3mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 4.61 0.461000 0.224333 0.2018991,268 N05BA08 BROMAZEPAMUM* BROMAZEPAM LPH 3 mg COMPR. 3mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 4.84 0.242000 0.224333 0.2018991,269 N05BA08 BROMAZEPAMUM* BROMAZEPAM SLAVIA 3 mg COMPR. 3mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 2.36 0.236000 0.224333 0.2018991,270 N05BA12 ALPRAZOLAMUM* XANAX 0,25 mg COMPR. 0,25mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 5.30 0.176666 0.148500 0.1336501,271 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM LPH (R) 0,25 mg COMPR. 0,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 2.97 0.148500 0.148500 0.1336501,272 N05BA12 ALPRAZOLAMUM* PRAZOLEX (R) 0,25 mg COMPR. 0,25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 8.58 0.286000 0.148500 0.1336501,273 N05BA12 ALPRAZOLAMUM* FRONTIN 0,25 mg COMPR. 0,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 4.62 0.154000 0.148500 0.1336501,274 N05BA12 ALPRAZOLAMUM* XANAX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 8.38 0.279333 0.233666 0.2102991,275 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM LPH (R) 0,5 mg COMPR. 0,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 4.78 0.239000 0.233666 0.2102991,276 N05BA12 ALPRAZOLAMUM* FRONTIN 0,5 mg COMPR. 0,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 7.01 0.233666 0.233666 0.210299

Pagina 29 din 34

Page 32: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1,277 N05BA12 ALPRAZOLAMUM* PRAZOLEX (R) 0,5 mg COMPR. 0,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 10.86 0.362000 0.233666 0.2102991,278 N05BA12 ALPRAZOLAMUM* XANAX 1 mg COMPR. 1mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 11.93 0.397666 0.354500 0.3190501,279 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM LPH (R) 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 7.09 0.354500 0.354500 0.3190501,280 N05BA12 ALPRAZOLAMUM* PRAZOLEX (R) 1 mg COMPR. 1mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 13.44 0.448000 0.354500 0.3190501,281 N05BA12 ALPRAZOLAMUM* FRONTIN 1mg COMPR. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 11.83 0.394333 0.354500 0.3190501,282 N05BA12 ALPRAZOLAMUM* XANAX 2 mg COMPR. 2mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 29.21 0.973666 0.973666 0.8762991,283 N05BA12 ALPRAZOLAMUM* NEUROL (R) SR 0,5 COMPR. ELIB. PREL. 0,5mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. ELIB. PREL. P-RF 30 10.97 0.365666 0.365666 0.3290991,284 N05BA12 ALPRAZOLAMUM* NEUROL (R) SR 0,5 COMPR. ELIB. PREL. 0,5mg ZENTIVA AS CEHIA CUTIE X 1 FLAC. X 30 COMPR. ELIB. PREL. P-RF 30 10.97 0.365666 0.365666 0.3290991,285 N05BA12 ALPRAZOLAMUM* NEUROL (R) SR 1 COMPR. ELIB. PREL. 1mg ZENTIVA AS CEHIA CUTIE X 1 FLAC. X 30 COMPR. ELIB. PREL. P-RF 30 19.48 0.649333 0.355333 0.3197991,286 N05BA12 ALPRAZOLAMUM* NEUROL (R) SR 1 COMPR. ELIB. PREL. 1mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. ELIB. PREL. P-RF 30 10.66 0.355333 0.355333 0.3197991,287 N05BA12 ALPRAZOLAMUM* NEUROL (R) SR 2 COMPR. ELIB. PREL. 2mg ZENTIVA AS CEHIA CUTIE X 1 FLAC. X 30 COMPR. ELIB. PREL. P-RF 30 29.46 0.982000 0.897333 0.8075991,288 N05BA12 ALPRAZOLAMUM* NEUROL (R) SR 2 COMPR. ELIB. PREL. 2mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. ELIB. PREL. P-RF 30 26.92 0.897333 0.897333 0.8075991,289 N05CD02 NITRAZEPAMUM NITRAZEPAM LPH (R) 2,5 mg COMPR. 2,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 1.29 0.064500 0.064500 0.0580501,290 N05CD02 NITRAZEPAMUM NITRAZEPAM LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 1.48 0.074000 0.074000 0.0666001,291 N05CD02 NITRAZEPAMUM NITRAZEPAM 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 1.48 0.074000 0.074000 0.0666001,292 N05CF01 ZOPICLONUM* IMOVANE 7,5 mg COMPR. FILM. 7,5mg SANOFI AVENTIS FRANTA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. FILM. P-RF 20 14.55 0.727500 0.727500 0.6547501,293 N05CF02 ZOLPIDEMUM* HYPNOGEN 10 mg COMPR. FILM. 10mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 15 COMPR. FILM. P-RF 15 9.43 0.628666 0.388000 0.3492001,294 N05CF02 ZOLPIDEMUM* HYPNOGEN 10 mg COMPR. FILM. 10mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-RF 7 4.50 0.642857 0.388000 0.3492001,295 N05CF02 ZOLPIDEMUM* SANVAL (R) 10 mg COMPR. FILM. 10mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 3.88 0.388000 0.388000 0.3492001,296 N05CF02 ZOLPIDEMUM* SANVAL (R) 10 mg COMPR. FILM. 10mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 7.77 0.388500 0.388000 0.3492001,297 N05CF02 ZOLPIDEMUM* ZOLPIDEM 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 6.96 0.696000 0.388000 0.3492001,298 N05CF02 ZOLPIDEMUM* LADINOX COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 6.43 0.643000 0.388000 0.3492001,299 N05CF02 ZOLPIDEMUM* ZOLPIDEM ANTIBIOTICE 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 4.01 0.401000 0.388000 0.3492001,300 N05CF02 ZOLPIDEMUM* BUNAPTE COMPR. FILM. 10mg BMF PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 6.53 0.653000 0.388000 0.3492001,301 N05CF02 ZOLPIDEMUM* BUNAPTE COMPR. FILM. 10mg BMF PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 20 12.05 0.602500 0.388000 0.3492001,302 N05CF02 ZOLPIDEMUM* ZOLPIDEM ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL X 7 COMPR. FILM. P-RF 7 6.16 0.880000 0.388000 0.3492001,303 N06AA04 CLOMIPRAMINUM* ANAFRANIL (R) 10 mg DRAJ. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 6.78 0.226000 0.226000 0.2034001,304 N06AA04 CLOMIPRAMINUM* ANAFRANIL (R) 25 mg DRAJ. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 13.44 0.448000 0.448000 0.4032001,305 N06AA09 AMITRIPTYLINUM* AMITRIPTILIN 25 R. DESITIN CAPS. RET. 25mg DESITIN GERMANIA CUTIE X 5 BLIST. X 10 CAPS.RET. P-RF 50 21.19 0.423800 0.423800 0.3814201,306 N06AA12 DOXEPINUM* DOXEPIN 25 mg DRAJ. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 14.31 0.477000 0.477000 0.4293001,307 N06AB03 FLUOXETINUM* FLUOXIN 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 CAPS. P-RF 14 10.59 0.756428 0.515666 0.4640991,308 N06AB03 FLUOXETINUM* FLUOXIN 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 4 BLIST. PVC/AL X 7 CAPS. P-RF 28 20.71 0.739642 0.515666 0.4640991,309 N06AB03 FLUOXETINUM* FLURAN CAPS. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 15 CAPS. P-RF 30 15.47 0.515666 0.515666 0.4640991,310 N06AB03 FLUOXETINUM* MAGRILAN 20 mg CAPS. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 27.78 0.926000 0.515666 0.4640991,311 N06AB03 FLUOXETINUM* PROZAC 20 mg COMPR. DISP. 20mg ELI LILLY SA SPANIA CUTIE X 2 BLIST. PVC-PE-ACLAR/AL X 14 COMPR. DISP. P-RF 28 34.56 1.234285 1.234285 1.1108561,312 N06AB04 CITALOPRAMUM** CITALORAN 10 mg COMPR. FILM. 10mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 2 BLIST. PVDC-PVC/AL X 14 COMPR. FILM. P-RF 28 6.93 0.247500 0.247500 0.2227501,313 N06AB04 CITALOPRAMUM** LINISAN 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 39.51 1.317000 0.247500 0.2227501,314 N06AB04 CITALOPRAMUM** CITALORAN 20mg COMPR. FILM. 20mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 2 BLIST. PVDC-PVC/AL X 14 COMPR. FILM. P-RF 28 10.08 0.360000 0.360000 0.3240001,315 N06AB04 CITALOPRAMUM** LINISAN 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 74.71 2.490333 0.360000 0.3240001,316 N06AB04 CITALOPRAMUM** CITALORAN 40 mg COMPR. FILM. 40mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 2 BLIST. PVDC-PVC/AL X 14 COMPR. FILM. P-RF 28 31.53 1.126071 1.126071 1.0134631,317 N06AB04 CITALOPRAMUM** LINISAN 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 135.23 4.507666 1.126071 1.0134631,318 N06AB05 PAROXETINUM* ARKETIS COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 51.47 1.715666 1.715666 1.5440991,319 N06AB05 PAROXETINUM* SEROXAT 20 mg COMPR. FILM. 20mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 33.28 1.109333 0.721000 0.6489001,320 N06AB05 PAROXETINUM* PALUXETIL 20 mg COMPR. FILM. 20mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 28.18 0.939333 0.721000 0.6489001,321 N06AB05 PAROXETINUM* REXETIN COMPR. FILM. 20mg GEDEON RICHTER PLC. UNGARIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 43.35 1.445000 0.721000 0.6489001,322 N06AB05 PAROXETINUM* PAXETIN 20 mg COMPR. FILM. 20mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. AL/AL X 10 COMPR. FILM. P-RF 30 28.55 0.951666 0.721000 0.6489001,323 N06AB05 PAROXETINUM* PAROXETIN TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. TRANSPARENTE DIN PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 21.63 0.721000 0.721000 0.648900

Pagina 30 din 34

Page 33: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1,324 N06AB05 PAROXETINUM* PALUXETIL 40 mg COMPR. FILM. 40mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 57.93 1.931000 1.931000 1.7379001,325 N06AB06 SERTRALINUM* ZOLOFT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-RF 28 64.33 2.297500 1.178000 1.0602001,326 N06AB06 SERTRALINUM* SERLIFT 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-RF 28 33.12 1.182857 1.178000 1.0602001,327 N06AB06 SERTRALINUM* ASENTRA (R) COMPR. FILM. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-RF 28 38.35 1.369642 1.178000 1.0602001,328 N06AB06 SERTRALINUM* STIMULOTON (R) 100 mg COMPR. FILM. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 50.00 1.785714 1.178000 1.0602001,329 N06AB06 SERTRALINUM* SERTRALIN SANDOZ 100 mg COMPR. FILM. 100mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 38.02 1.267333 1.178000 1.0602001,330 N06AB06 SERTRALINUM* SERTRALINA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 35.34 1.178000 1.178000 1.0602001,331 N06AB06 SERTRALINUM* SERTRALINA DR. REDDY'S 100 mg COMPR. FILM. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 33.12 1.182857 1.178000 1.0602001,332 N06AB06 SERTRALINUM* SETALOFT 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM. P-RF 28 33.07 1.181071 1.178000 1.0602001,333 N06AB06 SERTRALINUM* SERTRALINA BIOGALENICA 100 mg COMPR. FILM. 100mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-RF 28 41.10 1.467857 1.178000 1.0602001,334 N06AB06 SERTRALINUM* XIMPROVE 100 mg COMPR. FILM. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 33.12 1.182857 1.178000 1.0602001,335 N06AB06 SERTRALINUM* ZOLOFT 50 mg COMPR. FILM. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-RF 28 34.71 1.239642 0.628571 0.5657131,336 N06AB06 SERTRALINUM* SERLIFT 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-RF 28 18.35 0.655357 0.628571 0.5657131,337 N06AB06 SERTRALINUM* ASENTRA (R) COMPR. FILM. 50mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-RF 28 21.48 0.767142 0.628571 0.5657131,338 N06AB06 SERTRALINUM* STIMULOTON (R) 50 mg COMPR. FILM. 50mg EGIS PHARMACEUTICALS P.L.C. MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. FILM. P-RF 30 26.07 0.869000 0.628571 0.5657131,339 N06AB06 SERTRALINUM* SERTRALIN SANDOZ 50 mg COMPR. FILM. 50mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 19.55 0.651666 0.628571 0.5657131,340 N06AB06 SERTRALINUM* SERTRALINA 50 mg COMPR. FILM. 50mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 19.65 0.655000 0.628571 0.5657131,341 N06AB06 SERTRALINUM* SERTRALINA DR. REDDY'S 50 mg COMPR. FILM. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 18.35 0.655357 0.628571 0.5657131,342 N06AB06 SERTRALINUM* SETALOFT 50 mg COMPR. FILM. 50mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM. P-RF 28 17.60 0.628571 0.628571 0.5657131,343 N06AB06 SERTRALINUM* SERTRALINA BIOGALENICA 50 mg COMPR. FILM. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-RF 28 28.98 1.035000 0.628571 0.5657131,344 N06AB06 SERTRALINUM* XIMPROVE 50 mg COMPR. FILM. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 18.35 0.655357 0.628571 0.5657131,345 N06AB06 SERTRALINUM* ZOLOFT (R) CONC. PT. SOL. ORALA 20mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 60 ML CONC. PT. SOL. ORALA+ 1 PIPETA P-RF 1 63.75 63.750000 63.750000 57.3750001,346 N06AB08 FLUVOXAMINUM* FEVARIN (R) 100 COMPR. FILM. 100mg SOLVAY PHARMACEUTICALS BV OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM. P-RF 30 45.87 1.529000 1.026666 0.9239991,347 N06AB08 FLUVOXAMINUM* FLUVOXAMINE TEVA 100 mg COMPR. FILM. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 30.80 1.026666 1.026666 0.9239991,348 N06AB08 FLUVOXAMINUM* FEVARIN (R) 50 COMPR. FILM. 50mg SOLVAY PHARMACEUTICALS BV OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM. P-RF 30 23.67 0.789000 0.529666 0.4766991,349 N06AB08 FLUVOXAMINUM* FLUVOXAMINE TEVA 50 mg COMPR. FILM. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 15.89 0.529666 0.529666 0.4766991,350 N06AX03 MIANSERINUM* MIANSERIN 10 COMPR. FILM. 10mg REMEDICA LTD. CIPRU CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF/S 100 43.84 0.438400 0.438400 0.3945601,351 N06AX03 MIANSERINUM* MIANSERIN 30 COMPR. FILM. 30mg REMEDICA LTD. CIPRU CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 24.47 1.223500 1.223500 1.1011501,352 N06AX03 MIANSERINUM* MIANSERIN 10 mg DRAJ. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 8.12 0.270666 0.270666 0.2435991,353 N06AX03 MIANSERINUM* MIANSERIN 30 mg DRAJ. 30mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ. P-RF 20 20.43 1.021500 1.021500 0.9193501,354 N06AX11 MIRTAZAPINUM* REMERON SOLTAB 30 mg COMPR. DISP. 30mg NV ORGANON OLANDA CUTIE X 5 BLIST. AL/PVC-PA-POLIESTER PERFORAT PT. ELIB. UNEI UNIT. DOZATE X 6 COMPR. DISP. P-RF 30 77.14 2.571333 2.571333 2.3141991,355 N06AX11 MIRTAZAPINUM* MIRZATEN (R) 30 mg COMPR. FILM. 30mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 35.61 1.187000 1.127333 1.0145991,356 N06AX11 MIRTAZAPINUM* ESPRITAL (R) 30 COMPR. FILM. 30mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 54.83 1.827666 1.127333 1.0145991,357 N06AX11 MIRTAZAPINUM* MIRTAZAPINE-TEVA 30 mg COMPR. FILM. 30mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 35.59 1.186333 1.127333 1.0145991,358 N06AX11 MIRTAZAPINUM* PHARMATAZ 30 mg COMPR. FILM. 30mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 33.82 1.127333 1.127333 1.0145991,359 N06AX11 MIRTAZAPINUM* ESPRITAL (R) 45 COMPR. FILM. 45mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 77.11 2.570333 2.570333 2.3132991,360 N06AX11 MIRTAZAPINUM* MIRZATEN Q-TAB 30 mg COMPR. ORODISPERSABILE 30mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 30 COMPR. ORODISPERSABILE P-RF 30 35.61 1.187000 1.187000 1.0683001,361 N06AX16 VENLAFAXINUM** EFECTIN ER 150 mg CAPS. ELIB. PREL. 150mg WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 1 BLIST. ACLAR/PE/PVC/AL X 28 CAPS. ELIB. PREL. P-RF 28 168.45 6.016071 3.298666 2.9687991,362 N06AX16 VENLAFAXINUM** VELAXIN 150 mg CAPS. ELIB. PREL. 150mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 97.95 3.498214 3.298666 2.9687991,363 N06AX16 VENLAFAXINUM** ALVENTA 150mg CAPS. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 104.43 3.481000 3.298666 2.9687991,364 N06AX16 VENLAFAXINUM** FOBILESS 150 mg CAPS. ELIB. PREL. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 98.96 3.298666 3.298666 2.9687991,365 N06AX16 VENLAFAXINUM** NOPEKAR 150 mg CAPS. ELIB. PREL. 150mg OZONE LABORATORIES BV OLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. P-RF 28 97.95 3.498214 3.298666 2.9687991,366 N06AX16 VENLAFAXINUM** ADOXA EP 150 mg CAPS. ELIB. PREL. 150mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 128.42 4.280666 3.298666 2.9687991,367 N06AX16 VENLAFAXINUM** ELIFY EP 150 mg CAPS. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 117.82 3.927333 3.298666 2.9687991,368 N06AX16 VENLAFAXINUM** FOBILESS 37,5 mg CAPS. ELIB. PREL. 37,5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 33.40 1.113333 1.113333 1.0019991,369 N06AX16 VENLAFAXINUM** NOPEKAR 37,5 mg CAPS. ELIB. PREL. 37,5mg OZONE LABORATORIES BV OLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. CU ELIB. PREL. P-RF 28 43.72 1.561428 1.113333 1.0019991,370 N06AX16 VENLAFAXINUM** ADOXA EP 37,5 mg CAPS. ELIB. PREL. 37,5mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 39.13 1.304333 1.113333 1.001999

Pagina 31 din 34

Page 34: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1,371 N06AX16 VENLAFAXINUM** EFECTIN ER 75 mg CAPS. ELIB. PREL. 75mg WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 1 BLIST. ACLAR/PE/PVC/AL X 28 CAPS. ELIB. PREL. P-RF 28 104.68 3.738571 1.816428 1.6347851,372 N06AX16 VENLAFAXINUM** VELAXIN 75 mg CAPS. ELIB. PREL. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL P-RF 28 50.86 1.816428 1.816428 1.6347851,373 N06AX16 VENLAFAXINUM** ALVENTA 75 mg CAPS. ELIB. PREL. 75mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 54.93 1.831000 1.816428 1.6347851,374 N06AX16 VENLAFAXINUM** FOBILESS 75 mg CAPS. ELIB. PREL. 75mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 62.39 2.079666 1.816428 1.6347851,375 N06AX16 VENLAFAXINUM** NOPEKAR 75 mg CAPS. ELIB. PREL. 75mg OZONE LABORATORIES BV OLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. P-RF 28 50.86 1.816428 1.816428 1.6347851,376 N06AX16 VENLAFAXINUM** ADOXA EP 75 mg CAPS. ELIB. PREL. 75mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 67.86 2.262000 1.816428 1.6347851,377 N06AX16 VENLAFAXINUM** ELIFY EP 75 mg CAPS. ELIB. PREL. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 62.03 2.067666 1.816428 1.6347851,378 N06AX16 VENLAFAXINUM** ADOXA 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-RF 30 27.49 0.916333 0.916333 0.8246991,379 N06AX16 VENLAFAXINUM** ADOXA 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-ACLAR/AL X 10 COMPR. P-RF 30 27.49 0.916333 0.916333 0.8246991,380 N06AX16 VENLAFAXINUM** VENLAFAXINA LPH 37,5 mg COMPR. 37,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-RF 60 58.50 0.975000 0.975000 0.8775001,381 N06AX16 VENLAFAXINUM** VELAXIN 37,5 mg COMPR. 37,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 56 77.60 1.385714 0.975000 0.8775001,382 N06AX16 VENLAFAXINUM** ADOXA 37,5 mg COMPR. 37,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-RF 30 30.23 1.007666 0.975000 0.8775001,383 N06AX16 VENLAFAXINUM** ADOXA 37,5 mg COMPR. 37,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 30 30.23 1.007666 0.975000 0.8775001,384 N06AX16 VENLAFAXINUM** ADOXA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-RF 30 36.14 1.204666 1.204666 1.0841991,385 N06AX16 VENLAFAXINUM** ADOXA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 30 36.14 1.204666 1.204666 1.0841991,386 N06AX16 VENLAFAXINUM** VENLAFAXINA LPH 75 mg COMPR. 75mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-RF 60 72.90 1.215000 1.215000 1.0935001,387 N06AX16 VENLAFAXINUM** VELAXIN 75 mg COMPR. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 56 104.20 1.860714 1.215000 1.0935001,388 N06AX16 VENLAFAXINUM** ADOXA 75 mg COMPR. 75mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-RF 30 66.02 2.200666 1.215000 1.0935001,389 N06AX16 VENLAFAXINUM** ADOXA 75 mg COMPR. 75mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 30 66.02 2.200666 1.215000 1.0935001,390 N06AX16 VENLAFAXINUM** ARGOFAN 150 SR COMPR. ELIB. PREL. 150mg ZENTIVA A.S. SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-RF 30 164.11 5.470333 5.470333 4.9232991,391 N06AX16 VENLAFAXINUM** ARGOFAN 75 SR COMPR. ELIB. PREL. 75mg ZENTIVA A.S. SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-RF 30 88.03 2.934333 2.934333 2.6408991,392 N06AX16 VENLAFAXINUM** VENLAFAXINA ACTAVIS 37,5 mg COMPR. FILM. 37,5 mg ACTAVIS S.R.L. ROMANIA CUTIE X 4 BLIST. AL/PVC X 14 COMPR. FILM. P-RF 56 35.79 0.639107 0.639107 0.5751961,393 N06AX16 VENLAFAXINUM** VENLAFAXINA ACTAVIS 75 mg COMPR. FILM. 75mg ACTAVIS S.R.L. ROMANIA CUTIE X 4 BLIST. AL/PVC X 14 COMPR. FILM. P-RF 56 61.97 1.106607 1.106607 0.9959461,394 N07AA01 NEOSTIGMINI BROMIDUM NEOSTIGMINA LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 12.94 0.647000 0.647000 0.5823001,395 N07AA01 NEOSTIGMINI BROMIDUM MIOSTIN 0,5 mg/ml SOL. INJ. 0,5mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 1 ML SOL. INJ. S/P-RF 5 3.57 0.714000 0.714000 0.6426001,396 P01AB02 TINIDAZOLUM FASIGYN (P01AB02) COMPR. FILM. 500mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. X 4 COMPR. FILM. P-RF 4 5.59 1.397500 0.862500 0.7762501,397 P01AB02 TINIDAZOLUM TINIZOL (R) 500 mg (J01XD02) COMPR. FILM. 500mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. X 4 COMPR. FILM. P-RF 4 3.47 0.867500 0.862500 0.7762501,398 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P-RF 4 3.45 0.862500 0.862500 0.7762501,399 P01AB02 TINIDAZOLUM FASIGYN (P01AB02) COMPR. FILM. 500mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. X 4 COMPR. FILM. P-RF 4 5.59 1.397500 0.862500 0.7762501,400 P01AB02 TINIDAZOLUM TINIZOL (R) 500 mg (J01XD02) COMPR. FILM. 500mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. X 4 COMPR. FILM. P-RF 4 3.47 0.867500 0.862500 0.7762501,401 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P-RF 4 3.45 0.862500 0.862500 0.7762501,402 P02CA03 ALBENDAZOLUM DUADOR 200 mg COMPR. FILM. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. X 2 COMPR. FILM. P-RF 2 9.20 4.600000 3.005000 2.7045001,403 P02CA03 ALBENDAZOLUM ZENTEL 200 mg COMPR. FILM. 200mg GLAXOSMITHKLINE EXPORT LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVDC-PVC X 2 COMPR. FILM. P-RF 2 9.23 4.615000 3.005000 2.7045001,404 P02CA03 ALBENDAZOLUM ALBENDAZOL COMPR.FILM 200mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 2 COMPR. FILM. P-RF 2 6.01 3.005000 3.005000 2.7045001,405 P02CA03 ALBENDAZOLUM ZENTEL 0,4 g/10 ml SUSP. ORALA 0,4g/10ml GLAXOSMITHKLINE EXPORT LTD. MAREA BRITANIE CUTIE X 1 FLACON UNIDOZA DIN PVC X 10 ML SUSP. ORALA P-RF 1 5.39 5.390000 5.390000 4.8510001,406 P02CA03 ALBENDAZOLUM ALBENDAZOL BIOFARM 400 mg SUSP. ORALA 400mg BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 ML SUSP. ORALA P-RF 1 7.13 7.130000 5.390000 4.8510001,407 P02CE01 LEVAMISOLUM DECARIS 150 mg COMPR. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 COMPR. P-RF 1 3.20 3.200000 3.200000 2.8800001,408 P02CE01 LEVAMISOLUM DECARIS 50 mg COMPR. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 2 COMPR. P-RF 2 2.84 1.420000 1.420000 1.2780001,409 R03AC02 SALBUTAMOLUM VENTOLIN (R) SOL. INHAL. 5mg/ml GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FALC. DIN STICLA BRUNA X 10 ML SOL. DE INHAL. P-6L 1 8.37 8.370000 8.370000 7.5330001,410 R03AC02 SALBUTAMOLUM VENTOLIN (R) SOL. INHAL. 5mg/ml GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FALC. DIN STICLA BRUNA X 20 ML SOL. DE INHAL. P-6L 1 14.21 14.210000 8.370000 7.5330001,411 R03AC02 SALBUTAMOLUM VENTOLIN 100 INHALER CFC-FREE SUSP. INHAL. PRESURIZATA 100mcg/doza GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE X 200 DOZE + DISPOZITIV DE ADMINISTRA P-RF 1 9.86 9.860000 6.390000 5.7510001,412 R03AC02 SALBUTAMOLUM ECOSAL Easi-Breath SUSP. INHAL. PRESURIZATA 100mcg/doza IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON PRESURIZAT X 200 DOZE PREVAZUT CU VALVA DOZATOARE + DISPOZITIV DE ADM. ACTIONAT PRI P-6L 1 35.43 35.430000 6.390000 5.7510001,413 R03AC02 SALBUTAMOLUM ASTHALIN INHALER SUSP. INHAL. PRESURIZATA 100mcg/doza CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 FLAC. AL + VALVA DOZATOARE + DISP. ADM. X 200 DOZE SUSP. INHAL. PRESURIZATA P-6L 1 6.39 6.390000 6.390000 5.7510001,414 R03BA01 BECLOMETASONUM* ECOBEC EASI - BREATHE 100 mcg CFC FREE AEROSOL SOL. INHAL. 100mcg/doza IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON PRESURIZAT X 200 DOZE + DISPOZITIV DE ADM. TIP SPACER P-RF 1 64.03 64.030000 21.660000 19.4940001,415 R03BA01 BECLOMETASONUM* ECOBEC 100 mcg CFC FREE AEROSOL SOL. INHAL. 100mcg/doza IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON PRESURIZAT X 200 DOZE P-RF 1 21.66 21.660000 21.660000 19.4940001,416 R03BA01 BECLOMETASONUM* ECOBEC EASI - BREATHE 250 mcg CFC FREE AEROSOL SOL. INHAL. 250mcg/doza IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON PRESURIZAT X 200 DOZE + DISPOZITIV DE ADM. DE TIP SPACER P-RF 1 86.37 86.370000 40.650000 36.5850001,417 R03BA01 BECLOMETASONUM* ECOBEC 250 mcg CFC FREE AEROSOL SOL. INHAL. 250mcg/doza IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON PRESURIZAT X 200 DOZE P-RF 1 40.65 40.650000 40.650000 36.585000

Pagina 32 din 34

Page 35: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1,418 R03BA01 BECLOMETASONUM* CLENIL (R) JET 250 mcg SOL. INHALAT PRESURIZATA 250mcg/doza CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 FLACON PRESURIZAT DIN AL X 200 DOZE, PREVAZUT CU VALVA DOZATOARE + DISPOZITIV DE ADM., "SP P-RF 1 95.73 95.730000 40.650000 36.5850001,419 R03BA01 BECLOMETASONUM* RINOCLENIL 100 SPRAY NAZ.,SUSP. 100mcg/doza CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 FLACON DIN PET X 30 ML SPRAY NAZ.,SUSP., PREVAZUT CU POMPA DOZATOARE P-RF 1 45.57 45.570000 45.570000 41.0130001,420 R03BA02 BUDESONIDUM* FRENOLYN 200 PULB. INHAL. 200 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 PUNGA X 1 INHALATOR X 200 DOZE P-RF 1 95.72 95.720000 38.710000 34.8390001,421 R03BA02 BUDESONIDUM* FRENOLYN 200 PULB. INHAL. 200 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 PUNGA X 1 INHALATOR X 100 DOZE P-RF 1 38.71 38.710000 38.710000 34.8390001,422 R03BA02 BUDESONIDUM* PULMICORT TURBUHALER 200 mcg/doza PULB. INHAL. 200mcg/doza ASTRAZENECA AB SUEDIA CUTIE X 1 FLACON MULTIDOZA DIN PEID X 100 DOZE PULB. INHAL. P-RF 1 57.05 57.050000 38.710000 34.8390001,423 R03BA02 BUDESONIDUM* FRENOLYN 400 PULB. INHAL. 400 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 PUNGA X 1 INHALATOR X 200 DOZE P-RF 1 161.84 161.840000 79.060000 71.1540001,424 R03BA02 BUDESONIDUM* FRENOLYN 400 PULB. INHAL. 400 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 PUNGA X 1 INHALATOR X 100 DOZE P-RF 1 79.06 79.060000 79.060000 71.1540001,425 R03BB01 IPRATROPII BROMIDUM* IPRAVENT INHALER 20mcg/doza SUSP. INHAL. PRESURIZATA 20mcg/doza CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 FLACON AL PRESURIZAT X 200 DOZE SUSP.DE INHALAT PRESURIZATA P-6L 1 11.83 11.830000 11.830000 10.6470001,426 R03CC02 SALBUTAMOLUM SALBUTAMOL EIPICO 2mg/5ml SIROP 2mg/5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 125 ML SIROP P-6L 1 2.87 2.870000 2.870000 2.5830001,427 R03CC02 SALBUTAMOLUM VENTOLIN 2mg/5ml SIROP 2mg/5ml GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA INCOLORA X 150 ML SIROP + LINGURITA DOZATOARE DUBLA X 2,5 ML, RESPECTIV P-6L 1 5.29 5.290000 2.870000 2.5830001,428 R03CC02 SALBUTAMOLUM VENTOLIN (R) SOL. INJ. 0,5mg/ml GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 5 FIOLE DIN STICLA X 1 ML P-6L 5 3.33 0.666000 0.666000 0.5994001,429 R03CC02 SALBUTAMOLUM SALBUTAMOL T SOL. ORALA 0,04% TIS FARMACEUTIC SA ROMANIA CUTIE X 1 FLACON X 100 ML P-6L 1 2.51 2.510000 2.510000 2.2590001,430 R03CC02 SALBUTAMOLUM SALBUTAMOL SOL. ORALA 2mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLACON DIN STICLA X 100 ML SOL. ORALA + LINGURITA DOZATOARE P-6L 1 3.76 3.760000 2.510000 2.2590001,431 R03DA04 THEOPHYLLINUM THEO SR 100 CAPS. ELIB. PREL. 100mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 2 BLIST. PVC/PVDC-AL X 10 CAPS. ELIB. PREL. P-RF 20 5.36 0.268000 0.268000 0.2412001,432 R03DA04 THEOPHYLLINUM TEOFILINA SR 100 mg CAPS. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. ELIB. PREL. P-RF 10 2.68 0.268000 0.268000 0.2412001,433 R03DA04 THEOPHYLLINUM TEOTARD (R) 200 CAPS. ELIB. PREL. 200mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-RF 40 8.81 0.220250 0.220000 0.1980001,434 R03DA04 THEOPHYLLINUM THEO SR 200 CAPS. ELIB. PREL. 200mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 BLIST. PVC/PVDC-AL X 10 CAPS. ELIB. PREL. P-RF 10 4.02 0.402000 0.220000 0.1980001,435 R03DA04 THEOPHYLLINUM TEOFILINA SR 200 mg CAPS. ELIB. PREL. 200mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. ELIB. PREL. P-RF 10 2.20 0.220000 0.220000 0.1980001,436 R03DA04 THEOPHYLLINUM THEO SR 300 CAPS. ELIB. PREL. 300mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 BLIST. PVC/PVDC - AL X 10 CAPS. ELIB. PREL. P-RF 10 5.59 0.559000 0.559000 0.5031001,437 R03DA04 THEOPHYLLINUM TEOFILINA SR 300 mg CAPS. ELIB. PREL. 300mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. ELIB. PREL. P-RF 10 5.59 0.559000 0.559000 0.5031001,438 R03DA04 THEOPHYLLINUM TEOTARD (R) 350 CAPS. ELIB. PREL. 350mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-RF 40 13.13 0.328250 0.328250 0.2954251,439 R03DA04 THEOPHYLLINUM TEOFILINA SR 50 mg CAPS. ELIB. PREL. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. ELIB. PREL. P-RF 10 3.39 0.339000 0.339000 0.3051001,440 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 4.61 0.153666 0.139500 0.1255501,441 R05DA04 CODEINUM CODEINA FOSFORICA COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 4.81 0.192400 0.139500 0.1255501,442 R05DA04 CODEINUM FARMACOD COMPR. 15mg FARMACOM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 2.84 0.142000 0.139500 0.1255501,443 R05DA04 CODEINUM CODEINA FOSFAT 15 mg COMPR. 15mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2.79 0.139500 0.139500 0.1255501,444 R05DA04 CODEINUM CODEINA FOSFAT COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2.84 0.142000 0.139500 0.1255501,445 R05DA04 CODEINUM CODEINA FOSFAT LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-RF 20 3.00 0.150000 0.139500 0.1255501,446 R06AB04 CHLORPHENAMINUM CLORFENIRAMIN COMPR. 4mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.20 0.110000 0.110000 0.0990001,447 R06AE07 CETIRIZINUM CELERG COMPR. FILM. 10 mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 20 19.86 0.993000 0.993000 0.8937001,448 R06AE07 CETIRIZINUM ZYRTEC 10 mg/ml PICATURI ORALE-SOL. 10mg/ml U.C.B. GMBH GERMANIA CUTIE X 1 FLAC. STICLA BRUNA X 20 ML PIC. ORAL. SOL + APLICATOR PT. PICURARE P-6L 1 21.57 21.570000 21.570000 19.4130001,449 R06AX17 KETOTIFENUM KETOF 1 mg CAPS. 1mg HEXAL AG GERMANIA CUTIE X 5 BLIST. AL/PP X 10 CAPS. P-6L 50 12.94 0.258800 0.246500 0.2218501,450 R06AX17 KETOTIFENUM KETOF 1 mg CAPS. 1mg HEXAL AG GERMANIA CUTIE X 2 BLIST. AL/PP X 10 CAPS. P-6L 20 4.93 0.246500 0.246500 0.2218501,451 R06AX17 KETOTIFENUM KETOTIFEN LPH (R) 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3.10 0.155000 0.155000 0.1395001,452 R06AX17 KETOTIFENUM H - KETOTIFEN COMPR. 1mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3.42 0.171000 0.155000 0.1395001,453 R06AX17 KETOTIFENUM KETOTIFEN COMPR. 1mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3.24 0.162000 0.155000 0.1395001,454 R06AX17 KETOTIFENUM KETOTIFEN LAROPHARM 1 mg COMPR. 1mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 3.24 0.162000 0.155000 0.1395001,455 R06AX17 KETOTIFENUM KETOF 1 mg/5 ml SIROP 1mg/5ml HEXAL AG GERMANIA CUTIE X 1 FLACON X 100 ML SIROP + MASURA DOZATOARE P-6L 1 10.72 10.720000 10.720000 9.6480001,456 S01AX13 CIPROFLOXACINUM CIPLOX (vezi S01AX13) UNG. OFT. 0,3% CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 TUB DIN AL + VARF APLICATOR SI CAPAC DIN PEID X 5G UNG. OFT. P-RF 1 4.02 4.020000 4.020000 3.6180001,457 S01BC03 DICLOFENACUM DICLOFENAC RPH PIC. OFT.-SOL. 1mg/ml ROMPHARM COMPANY SRL ROMANIA FLACON PICURATOR DIN PEJD X 5 ML PIC. OFT., SOL. P-6L 1 4.73 4.730000 4.730000 4.2570001,458 S01BC03 DICLOFENACUM UNICLOPHEN (R) 0,1% PICATURI OFT.-SOL. 0,1% UNIMED PHARMA LTD. SLOVACIA CUTIE X 1 FLACON DIN PE X 10 ML PIC. OFTALMICE, SOL., PREVAZUT CU PICURATOR P-6L 1 10.54 10.540000 4.730000 4.2570001,459 S01BC03 DICLOFENACUM DICLOGESIC 0,1% PICATURI OFTALMICE, SOLUTIE PICATURI OFT.-SOL. 0,1% DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLACON CU PICURATOR PE X 5 ML P-6L 1 10.05 10.050000 4.730000 4.2570001,460 S01CA05 COMBINATII OPHTAMESONE - N SOL. OFT. FARA CONCENTRATIE DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLACON X 10ML P-RF 1 4.24 4.240000 4.240000 3.816000

1,461 S01CA05

COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM) BETABIOPTAL PICATURI OFT.SUSP. 0,2g+0,5g/100ml FARMILA FARMACEUTICI ITALIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT.,SUSP. + APLICATOR PT. PICURARE P-RF 1 12.63 12.630000 12.630000 11.367000

Pagina 33 din 34

Page 36: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1,462 S01CA05

COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM) BETABIOPTAL UNG. OFT. 0,2g+0,5g/100g FARMILA FARMACEUTICI ITALIA CUTIE X 1 TUB AL X 5 G P-RF 1 14.50 14.500000 14.500000 13.050000

NOTĂ:

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătății Publice și cu aprobarea comisiilor de la nivelul Caselor Județene de Asigurări de Sănătate;

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (1) se efectueaza pentru pacienții cu intoleranță la acidum acetylsalicylicum.

- 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 corespunzătoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătății Publice;

Pagina 34 din 34

Page 37: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

ANEXA2

Nr. crt codifatc den_internationala denumire formaF

concentratie Firma detinatoare tara forma ambalare prescriere

cant/

am

balaj

Pret amanuntul maximal/ambalaj (RON)

Pret amanuntul maximal/UT (RON)

Val suportata de CNAS/UT (RON)Legea nr. 95/2006 art 213 alin.1

Val suportata CNAS/UT (RON) pt. Adulti

1 A02BC02 PANTOPRAZOLUM CONTROLOC 20 mg COMPR. FILM. GASTROREZ. 20mg ALTANA PHARMA AG GERMANIA CUTIE X 2 BLIST. DIN AL/AL X 14 COMPR. FILM. GASTROREZ. P-6L 28 32.73 1.168928 0.760000 0.380000

2 A02BC02 PANTOPRAZOLUM SELTRAZ 20 mg COMPR. FILM. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIACUTIE X 2 BLIST. DIN OPA-AL-PVC/AL X 14 COMPR. FILM. GASTROREZISTENTE P-6L 28 21.28 0.760000 0.760000 0.380000

3 A02BC02 PANTOPRAZOLUM CONTROLOC 40mg COMPR. FILM. GASTROREZ. 40mg ALTANA PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN AL/AL X 14 COMPR.FILM. GASTROREZ. P-6L 14 33.57 2.397857 2.397857 1.198928

4 A02BC02 PANTOPRAZOLUM

CONTROLOC 40mg LIOFILIZAT PENTRU SOLUTIE INJECTABILA LIOF. PT. SOL. INJ. 40mg ALTANA PHARMA AG GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. S/P-RF 1 31.56 31.560000 31.560000 15.780000

5 A02BC05 ESOMEPRAZOLUM NEXIUM 20 mg

COMPR. FILM. GASTROREZ. 20mg ASTRAZENECA AB SUEDIA CUTIE X 1 BLIST. X 7 COMPR. FILM. GASTROREZ. P-6L 7 27.98 3.997142 3.613571 1.806785

6 A02BC05 ESOMEPRAZOLUM NEXIUM 20 mg

COMPR. FILM. GASTROREZ. 20mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. X 7 COMPR. FILM. GASTROREZ. P-6L 14 50.59 3.613571 3.613571 1.806785

7 A02BC05 ESOMEPRAZOLUM NEXIUM 40 mg

COMPR. FILM. GASTROREZ. 40mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. AL/PVC X 7 COMPR. FILM. GASTROREZ. P-6L 14 71.83 5.130714 5.130714 2.565357

8 A02BC05 ESOMEPRAZOLUM NEXIUM 10 mg

GRAN. GASTROREZ. PT. SUSP.ORALA 10mg ASTRAZENECA AB SUEDIA

CUTIE X 28 PLICURI DIN PET/AL/PEJD CONTINAND GRANULE GASTROREZ. PT. SUSP. ORALA P-6L 28 163.62 5.843571 5.843571 2.921785

9 A02BC05 ESOMEPRAZOLUM NEXIUM (R) LIOF. PT. SOL. INJ./PERF. 40mg ASTRAZENECA AB SUEDIA CUTIE X 10 FLACOANE LIOF. PT. SOL. INJ./PERF. S/P-RF 10 279.32 27.932000 27.932000 13.966000

10 A02BX02 SUCRALFATUM GASTROFAIT COMPR. 1g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. P-6L 20 5.81 0.290500 0.290500 0.145250

11 A02BX02 SUCRALFATUM SUCRALAN (R) COMPR. 1g LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 2 BLIST. AL/PVC TRANSPARENTE, ALBASTRUI X 10 COMPR. P-6L 20 5.81 0.290500 0.290500 0.145250

12 A02BX02 SUCRALFATUM VENTER COMPR. 1g KRKA D.D. SLOVENIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 14.98 0.299600 0.290500 0.145250

13 A02BX05 BISMUTHI SUBCITRAS DE - NOL COMPR. FILM. 120mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 5 BLIST. AL/AL X 8 COMPR. FILM. P-6L 40 37.52 0.938000 0.938000 0.469000

SUBLISTA B - MEDICAMENTE CU NIVEL DE COMPENSARE 50% DIN PRETUL DE REFERINTA

LISTA DENUMIRILOR COMUNE INTERNATIONALE (DCI) ALE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU CONTRIBUTIE PERSONALA CONFOR HG NR. 720/2008 VALABILA INCEPAND CU 1 APRILIE 2009

Pagina 1 din 23

Page 38: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

14 A03AB06 OTILONIUM BROMIDUM SPASMOMEN (R) COMPR. FILM. 40mg A. MENARINI IND. FARM. RIUNITE SRL ITALIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 31.51 1.050333 1.050333 0.525166

15 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 34.39 2.865833 2.865833 1.432916

16 A07EA06 BUDESONIDUM** BUDENOFALK CAPS. GASTROREZ. 3mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 CAPS. CU PELETE GASTROREZ. P-RF 100 421.74 4.217400 4.217400 2.108700

17 A07XA04 RACECADOTRILUM HIDRASEC 100 mg CAPS. 100mg LAB. FOURNIER SA FRANTA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 CAPS. P-RF 20 40.92 2.046000 2.046000 1.023000

18 A07XA04 RACECADOTRILUM HIDRASEC 10 mg PULB. PT. SOL. ORALA 10mg LAB. FOURNIER SA FRANTA CUTIE X 16 PLICURI X 1 G P-RF 16 38.53 2.408125 2.408125 1.204062

19 A07XA04 RACECADOTRILUM HIDRASEC 30 mg PULB. PT. SOL. ORALA 30mg LAB. FOURNIER SA FRANTA CUTIE X 30 PLICURI X 3 P-RF 30 38.53 1.284333 1.284333 0.642166

20 A08AA10 SIBUTRAMINUM**** REDUCTIL 10mg CAPS. 10mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 CAPS. P-RF 28 95.16 3.398571 2.190333 1.095166

21 A08AA10 SIBUTRAMINUM**** LINDAXA 10 CAPS. 10mg ZENTIVA A.S. CEHIA CUTIE X 3 BLIST. AL-PVDC/PVC X 10 CAPS. P-RF 30 65.71 2.190333 2.190333 1.095166

22 A08AA10 SIBUTRAMINUM**** MINIMACIN 10 mg CAPS. 10mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-RF 28 63.42 2.265000 2.190333 1.095166

23 A08AA10 SIBUTRAMINUM**** REDUCTIL 15 mg CAPS. 15mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 CAPS. P-RF 28 123.49 4.410357 2.524333 1.262166

24 A08AA10 SIBUTRAMINUM**** LINDAXA 15 CAPS. 15mg ZENTIVA A.S. CEHIA CUTIE X 3 BLIST. AL-PVDC/PVC X 10 CAPS. P-RF 30 75.73 2.524333 2.524333 1.262166

25 A08AA10 SIBUTRAMINUM**** MINIMACIN 15 mg CAPS. 15mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-RF 28 73.07 2.609642 2.524333 1.262166

26 A08AB01 ORLISTATUM**** XENICAL 120mg CAPS. 120mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 21 CAPS. TARI (BLISTER PVC/PE/PVDC) P-RF 21 86.43 4.115714 3.373214 1.686607

27 A08AB01 ORLISTATUM**** XENICAL 120mg CAPS. 120mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 84 CAPS. TARI (BLISTER PVC/PE/PVDC) P-RF 84 283.35 3.373214 3.373214 1.686607

28 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 32.63 0.652600 0.652600 0.326300

29 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 29.48 0.982666 0.982666 0.491333

30 A16AX01ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#

THIOGAMMA (R) 600 oral (vezi A16AX01) COMPR. FILM. 600mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM. P-6L 100 308.81 3.088100 3.088100 1.544050

31 A16AX01ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#

THIOGAMMA (R) 600 oral (vezi A16AX01) COMPR. FILM. 600mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM. P-6L 30 101.17 3.372333 3.088100 1.544050

32 A16AX01ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#

THIOGAMMA (R) 600 oral (vezi A16AX01) COMPR. FILM. 600mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 6 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM. P-6L 60 185.59 3.093166 3.088100 1.544050

33 A16AX01ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#

THIOGAMMA (R) 600 INJEKT (vezi N07XN03) CONC. PT. SOL. PERF. 30mg/ml WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 FIOLE X 20 ML S/P-RF 5 145.73 29.146000 26.535000 13.267500

34 A16AX01ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#

THIOGAMMA (R) 600 INJEKT (vezi N07XN03) CONC. PT. SOL. PERF. 30mg/ml WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 20 FIOLE X 20 ML S/P-RF 20 530.70 26.535000 26.535000 13.267500

35 A16AX01ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#

THIOCTACID 600T (vezi N07XN03) SOL. INJ. 25mg/ml MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 5 FIOLE X 24 ML SOL.INJ. S/P-RF 5 131.15 26.230000 26.230000 13.115000

36 A16AX01ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#

THIOGAMMA (R) TURBO-SET (vezi N07XN03) SOL. PERF. 12mg/ml WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 FLACOANE X 50 ML S/P-RF 10 242.42 24.242000 24.242000 12.121000

37 B01AB04 DALTEPARINUM**# FRAGMIN 10000 UI/ml SOL. INJ. 10000ui/ml PFIZER EUROPE MA EEIG MAREA BRITANIE

CUTIE X 2 SUPORTURI TERMOFORMATATE X 5 FIOLE X 1 ML S/P-RF 10 250.55 25.055000 25.055000 12.527500

38 B01AB04 DALTEPARINUM**# FRAGMIN 2500 UI/0,2 ml SOL. INJ. 2500ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE

CUTIE X 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,2 ML S/P-RF 10 72.85 7.285000 7.285000 3.642500

39 B01AB04 DALTEPARINUM**# FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE

CUTIE X 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,2 ML S/P-RF 10 135.91 13.591000 13.591000 6.795500

40 B01AB04 DALTEPARINUM**# FRAGMIN 7500 UI/0,3 ml SOL. INJ. 7500ui/0,3ml PFIZER EUROPE MA EEIG MAREA BRITANIE

CUTIE X 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,3 ML S/P-RF 10 190.61 19.061000 19.061000 9.530500

41 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. S/P-RF 10 69.71 6.971000 6.971000 3.485500

42 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. S/P-RF 10 135.74 13.574000 13.574000 6.787000

Pagina 2 din 23

Page 39: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

43 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. S/P-RF 10 176.41 17.641000 17.641000 8.820500

44 B01AB05 ENOXAPARINUM**#CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000ui anti-Xa/0,8ml LAB. AVENTIS FRANTA CUTIE X 2 SERINGI PREUMPLUTE X 0,8 ML SOL. INJ. S/P-RF 2 49.01 24.505000 24.505000 12.252500

45 B01AB06 NADROPARINUM**#FRAXODI 11400 UI anti-factor Xa/0,6ml SOL. INJ. 11400 uiAXa/0,6ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. S/P-RF 10 249.56 24.956000 24.956000 12.478000

46 B01AB06 NADROPARINUM**#FRAXODI 15200 UI anti-factor Xa/0,8ml SOL. INJ. 15200 uiAXa/0,8ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 10 SERINGI PREUMPLUTE X 0,8 ML SOL. INJ. S/P-RF 10 343.08 34.308000 34.308000 17.154000

47 B01AB06 NADROPARINUM**#FRAXIPARINE (R) 2850 UI anti-factor Xa/0,3 ml SOL. INJ. 2850 ui AFXa/0,3ml GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 10 SERINGI PREUMPLUTE DIN STICLA, PREVAZUTE CU DISPOZITIV DE PROTECTIE A ACULUI X 0,3 ML S/P-RF 10 72.07 7.207000 7.207000 3.603500

48 B01AB06 NADROPARINUM**#FRAXIPARINE (R) 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4ml GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 10 SERINGI PREUMPLUTE DIN STICLA, PREVAZUTE CU DISPOZITIV DE PROTECTIE A ACULUI X 0,4 ML S/P-RF 10 97.15 9.715000 9.715000 4.857500

49 B01AB06 NADROPARINUM**#FRAXIPARINE (R) 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6ml GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 10 SERINGI PREUMPLUTE DIN STICLA, PREVAZUTE CU DISPOZITIV DE PROTECTIE A ACULUI X 0,6 ML S/P-RF 10 124.37 12.437000 12.437000 6.218500

50 B01AB06 NADROPARINUM**#FRAXIPARINE (R) 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AXa/0,8ml GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 10 SERINGI PREUMPLUTE DIN STICLA, PREVAZUTE CU DISPOZITIV DE PROTECTIE A ACULUI X 0,8 ML S/P-RF 10 178.17 17.817000 17.817000 8.908500

51 B01AB08 REVIPARINUM**# CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 79.30 7.930000 7.930000 3.965000

52 B01AB08 REVIPARINUM**# CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 95.22 19.044000 19.044000 9.522000

53 B01AB10 TINZAPARINUM**# INNOHEP SOL. INJ. 10000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 2 SERINGI PREUMPLUTE X 0.35 ML SOL. INJ. (3500 U-AXA) S/P-RF 2 24.53 12.265000 12.265000 6.132500

54 B01AB10 TINZAPARINUM**# INNOHEP SOL. INJ. 10000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 2 SERINGI PREUMPLUTE X 0.45 ML SOL. INJ. (4500 U-AXA) S/P-RF 2 32.97 16.485000 16.485000 8.242500

55 B01AB10 TINZAPARINUM**# INNOHEP SOL. INJ. 10000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 2 ML SOL. INJ. (10000 U-AXA) S/P-RF 10 507.63 50.763000 50.763000 25.381500

56 B01AB10 TINZAPARINUM**# INNOHEP SOL. INJ. 20000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 2 SERINGI PREUMPLUTE X 0,50 ML SOL. IN. (10000 U-AXA) S/P-RF 2 70.40 35.200000 35.200000 17.600000

57 B01AB10 TINZAPARINUM**# INNOHEP SOL. INJ. 20000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 2 SERINGI PREUMPLUTE X 0,70 ML SOL. IN. (14000 U-AXA) S/P-RF 2 96.86 48.430000 48.430000 24.215000

58 B01AB10 TINZAPARINUM**# INNOHEP SOL. INJ. 20000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 2 SERINGI PREUMPLUTE X 0,90 ML SOL. IN. (18000 U-AXA) S/P-RF 2 123.59 61.795000 61.795000 30.897500

59 B01AB10 TINZAPARINUM**# INNOHEP SOL. INJ. 20000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 2ML SOL. INJ. (20000 U-AXA) S/P-RF 10 1049.60 104.960000 104.960000 52.480000

60 B01AB11 SULODEXIDUM** VESSEL DUE F CAPS. MOI 250ULS ALFA WASSERMANN SPA ITALIA CUTIE X 2 BLIST. PVDC-PVC/AL-PVDC X 25 CAPS. MOI P-RF 50 103.22 2.064400 2.064400 1.032200

61 B01AB11 SULODEXIDUM** VESSEL DUE F SOL. INJ. 600ULS/2ml ALFA WASSERMANN SPA ITALIA CUTIE X 10 FIOLE DIN STICLA GALBENA X 2 ML P-RF 10 73.64 7.364000 7.364000 3.682000

62 B01AC04 CLOPIDOGRELUM** PLAVIX 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA) P-RF 30 737.48 24.582666 24.582666 12.291333

63 B01AC04 CLOPIDOGRELUM** PLAVIX 75mg COMPR. FILM. 75mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 28 179.46 6.409285 6.409285 3.204642

64 B01AC18 TRIFLUSALUM AFLEN (R) CAPS. 300mg GALENICA S.A. GRECIA CUTIE X 5 BLIST. X 10 CAPS. P-RF 50 79.74 1.594800 1.594800 0.797400

65 B01AC30

COMBINATII (ACID ACETYLSALICYLICUM+DIPYRIDAMOLUM)** AGGRENOX CAPS. ELIB. MODIF. 25mg/200mg

BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 1 FLAC. DIN PP X 60 CAPS. CU ELIB.MODIF. P-6L 60 59.73 0.995500 0.995500 0.497750

66 B01AX05 FONDAPARINUX SODIUM**# ARIXTRA 10mg/0,8ml

SOL. INJ. IN SERINGA PREUMPLUTA 10mg/0,8ml GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 10 SERINGI PREUMPLUTE X 0,8 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CU P-RF 10 617.71 61.771000 61.771000 30.885500

67 B01AX05 FONDAPARINUX SODIUM**# ARIXTRA 2,5mg/0,5ml

SOL. INJ. IN SERINGA PREUMPLUTA 2,5mg/0,5ml GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 10 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CU P-RF 10 219.52 21.952000 21.952000 10.976000

Pagina 3 din 23

Page 40: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

68 B01AX05 FONDAPARINUX SODIUM**# ARIXTRA 5mg/0,4ml

SOL. INJ. IN SERINGA PREUMPLUTA 5mg/0,4ml GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 10 SERINGI PREUMPLUTE X 0,4 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CU P-RF 10 435.51 43.551000 43.551000 21.775500

69 B01AX05 FONDAPARINUX SODIUM**# ARIXTRA 7,5mg/0,6ml

SOL. INJ. IN SERINGA PREUMPLUTA 7,5mg/0,6ml GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CU P-RF 10 617.71 61.771000 61.771000 30.885500

70 B03AC02COMPLEX DE HIDROXID DE FER (III) SUCROZA VENOFER (R) SOL. INJ./PERF. 20mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 140.63 28.126000 28.126000 14.063000

71 C01BB02 MEXILETINUM MEXITIL (R) 200 mg CAPS. 200mg

BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-RF 100 55.17 0.551700 0.551700 0.275850

72 C01EB17 IVABRADINUM** CORLENTOR 5mg COMPR. FILM. 5mg LES LAB. SERVIER FRANTA CUTIE X 28 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 28 150.46 5.373571 4.028571 2.014285

73 C01EB17 IVABRADINUM** CORLENTOR 5mg COMPR. FILM. 5mg LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 56 225.60 4.028571 4.028571 2.014285

74 C01EB17 IVABRADINUM** CORLENTOR 7,5mg COMPR. FILM. 7,5mg LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 56 244.46 4.365357 4.365357 2.182678

75 C01EB17 IVABRADINUM** CORLENTOR 7,5mg COMPR. FILM. 7,5mg LES LAB. SERVIER FRANTA CUTIE X 28 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 28 150.46 5.373571 4.365357 2.182678

76 C02AC05 MOXONIDINUM PHYSIOTENS 0,2 COMPR. FILM. 0,2mg SOLVAY PHARMACEUTICALS BV GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 30.51 1.089642 0.682000 0.341000

77 C02AC05 MOXONIDINUM MOXOGAMMA 0,2 mg COMPR. FILM. 0,2mg WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 20.46 0.682000 0.682000 0.341000

78 C02AC05 MOXONIDINUM PHYSIOTENS 0,2 COMPR. FILM. 0,2mg SOLVAY PHARMACEUTICALS BV GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR.FILM. P-6L 28 30.51 1.089642 0.682000 0.341000

79 C02AC05 MOXONIDINUM MOXOGAMMA 0,3 mg COMPR. FILM. 0,3mg WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 24.28 0.809333 0.809333 0.404666

80 C02AC05 MOXONIDINUM PHYSIOTENS 0,4 COMPR. FILM. 0,4mg SOLVAY PHARMACEUTICALS BV GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR.FILM. P-6L 28 43.97 1.570357 1.037333 0.518666

81 C02AC05 MOXONIDINUM MOXOGAMMA 0,4 mg COMPR. FILM. 0,4mg WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 31.12 1.037333 1.037333 0.518666

82 C02AC05 MOXONIDINUM PHYSIOTENS 0,4 COMPR. FILM. 0,4mg SOLVAY PHARMACEUTICALS BV GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR.FILM. P-6L 28 43.97 1.570357 1.037333 0.518666

83 C02AC06 RILMENIDINUM TENAXUM COMPR. 1mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 39.07 1.302333 1.302333 0.651166

84 C02CA01 PRAZOSINUM MINIPRESS (R) 1 mg COMPR. 1mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5.38 0.179333 0.179333 0.089666

85 C02CA01 PRAZOSINUM MINIPRESS (R) 2 mg COMPR. 2mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7.52 0.250666 0.250666 0.125333

86 C03DA04 EPLERENONUM*# INSPRA 25 mg COMPR. FILM. 25mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PERFORATE UNIDOZA PVC/AL X 10 COMPR. FILM. P-RF 30 174.27 5.809000 5.809000 2.904500

87 C03DA04 EPLERENONUM*# INSPRA 25 mg COMPR. FILM. 25mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. PERFORAT UNIDOZA PVC/AL X 10 COMPR. FILM. P-RF 10 64.51 6.451000 5.809000 2.904500

88 C03DA04 EPLERENONUM*# INSPRA 50 mg COMPR. FILM. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PERFORATE UNIDOZA PVC/AL X 10 COMPR. FILM. P-RF 30 174.27 5.809000 5.809000 2.904500

89 C03DA04 EPLERENONUM*# INSPRA 50 mg COMPR. FILM. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. PERFORAT UNIDOZA PVC/AL X 10 COMPR. FILM. P-RF 10 64.51 6.451000 5.809000 2.904500

90 C04AE02 NICERGOLINUM NICERIUM (R) 15 CAPS. ELIB. MODIF. 15mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PP/AL X 10 CAPS. ELIB. MODIF. P-6L 30 26.19 0.873000 0.873000 0.436500

91 C04AE02 NICERGOLINUM NICERIUM (R) 30 UNO CAPS. ELIB. MODIF. 30mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PP/AL X 10 CAPS. ELIB. MODIF. P-6L 30 48.25 1.608333 1.608333 0.804166

92 C04AE02 NICERGOLINUM NICERGOLINA LPH 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 12.68 0.422666 0.422666 0.211333

93 C04AE02 NICERGOLINUM SERMION COMPR. FILM. 30mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL-PVC X 15 COMPR. FILM P-6L 30 45.36 1.512000 1.305666 0.652833

94 C04AE02 NICERGOLINUM NICERGOLINA LPH 30 mg COMPR. FILM. 30mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 39.17 1.305666 1.305666 0.652833

95 C04AE02 NICERGOLINUM NICERGOLINA LPH 5 mg COMPR. FILM. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 9.32 0.310666 0.310666 0.155333

96 C04AE02 NICERGOLINUM NICERIUM (R) 10 DRAJ. 10mg HEXAL AG GERMANIA CUTIE X 1 BLIST. AL/PVC X 25 DRAJ. P-6L 25 13.25 0.530000 0.426000 0.213000

97 C04AE02 NICERGOLINUM SINERGOLIN 10 DRAJ. 10mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ. P-6L 20 8.52 0.426000 0.426000 0.213000

98 C04AE02 NICERGOLINUM SINERGOLIN 30 DRAJ. 30mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-6L 30 39.14 1.304666 1.304666 0.652333

99 C04AE02 NICERGOLINUM SINERGOLIN 30 DRAJ. 30mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ. P-6L 20 26.96 1.348000 1.304666 0.652333

100 C04AX07 VINCAMINUM OXYBRAL SR 30 mg CAPS. ELIB. PREL. 30mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 CAPS. CU ELIB. PREL. P-6L 10 8.71 0.871000 0.871000 0.435500

101 C04AX07 VINCAMINUM VINCAMIL COMPR. 20mg FARMACEUTICI ECOBI S.A.S ITALIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-6L 50 12.94 0.258800 0.258800 0.129400

102 C04AX07 VINCAMINUM VINCAMINA DRAJ. 10mg BIOFARM SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 DRAJ. P-6L 20 5.73 0.286500 0.286500 0.143250

Pagina 4 din 23

Page 41: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

103 C04AXN1 GINKGO BILOBA** BILOBIL 40 mg (C04AXN1) CAPS. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 CAPS. P-6L 20 9.00 0.450000 0.430333 0.215166

104 C04AXN1 GINKGO BILOBA** BILOBIL 40 mg (C04AXN1) CAPS. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. AL/PVC-PVDC X 10 CAPS. P-6L 60 25.82 0.430333 0.430333 0.215166

105 C04AXN1 GINKGO BILOBA** BILOBIL FORTE (vezi C04AXN1) CAPS. 80mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. AL/PVC X 10 CAPS. P-6L 60 42.53 0.708833 0.708833 0.354416

106 C04AXN1 GINKGO BILOBA** GINGIUM 120mg (vezi N06DX02) COMPR. FILM. 120mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PP X 10 COMPR. FILM. P-6L 30 32.73 1.091000 1.091000 0.545500

107 C04AXN1 GINKGO BILOBA** FLAVOTAN 40 mg (C04AXN1) COMPR. FILM. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 14.93 0.497666 0.390333 0.195166

108 C04AXN1 GINKGO BILOBA** TANAKAN (EGB 761) (N06DX02) COMPR. FILM. 40mg IPSEN BIOTECH FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 23.67 0.789000 0.390333 0.195166

109 C04AXN1 GINKGO BILOBA** GINGIUM 40mg (vezi N06DX02 ) COMPR. FILM. 40mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PP X 10 COMPR. FILM. P-6L 30 11.71 0.390333 0.390333 0.195166

110 C04AXN1 GINKGO BILOBA** TEBOKAN (vezi C04AXN1) COMPR. FILM. 40mg DR. WILLMAR SCHWABE GMBH & CO KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 21.94 0.438800 0.390333 0.195166

111 C04AXN1 GINKGO BILOBA** TEBOKAN (vezi C04AXN1) COMPR. FILM. 40mg DR. WILLMAR SCHWABE GMBH & CO KG GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 8.75 0.437500 0.390333 0.195166

112 C04AXN1 GINKGO BILOBA** GINGIUM 80mg (vezi N06DX02) COMPR. FILM. 80mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PP X 10 COMPR. FILM. P-6L 30 22.06 0.735333 0.735333 0.367666

113 C04AXN1 GINKGO BILOBA** TANAKAN (EGB 761) (C04AXN1) PICATURI ORALE-SOL. 40mg/ml BEAUFOUR IPSEN PHARMA FRANTACUTIE X 1 FLACON DE STICLA BRUNA X 30 ML + 1 PIPETA DIN POLIETILENA P-6L 1 23.36 23.360000 23.360000 11.680000

114 C05CA53 DIOSMINUM (COMBINATII)** DETRALEX ( R ) COMPR. FILM. 500mg LES LAB. SERVIER IND. FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 24.78 0.826000 0.826000 0.413000

115 C07AB12 NEBIVOLOLUM EZOCEM 5 mg COMPR 5mg OZONE LABORATORIES BV OLANDA CUTIE X 28 COMPR. IN BLIST. PVC-PE-PVDC/AL P-6L 28 23.99 0.856785 0.856666 0.428333

116 C07AB12 NEBIVOLOLUM NEBILET (R) COMPR. 5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. AL/PVC X 7 COMPR. P-6L 28 51.07 1.823928 0.856666 0.428333

117 C07AB12 NEBIVOLOLUM NEBIVOLOL ACTAVIS 5 mg COMPR. 5mg ACTAVIS S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 25.70 0.856666 0.856666 0.428333

118 C07AB12 NEBIVOLOLUM NEBACOP 5 mg COMPR. 5mg JUST BUSINESS SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. P-6L 28 44.14 1.576428 0.856666 0.428333

119 C07BB07

COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 10 mg COMPR. FILM.

FARA CONCENTRATIE MERCK KGAA GERMANIA CUTIE X 3 BLIST. PP/AL X 10 COMPR. FILM. P-6L 30 27.67 0.922333 0.922333 0.461166

120 C07BB07

COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5 mg COMPR. FILM.

FARA CONCENTRATIE MERCK KGAA GERMANIA CUTIE X 3 BLIST. PP/AL X 10 COMPR. FILM. P-6L 30 24.68 0.822666 0.822666 0.411333

121 C07BB07

COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5 mg COMPR. FILM.

FARA CONCENTRATIE MERCK KGAA GERMANIA CUTIE X 3 BLIST. PP/AL X 10 COMPR. FILM. P-6L 30 27.67 0.922333 0.922333 0.461166

122 C07EBN1

COMBINATII (METOPROLOLUL+FELODIPINUM) LOGIMAX (R) COMPR. ELIB. PREL. 50mg+5mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. PVC X 30 COMPR. ELIB. PREL. P-6L 30 41.83 1.394333 1.394333 0.697166

123 C08CA09 LACIDIPINUM LACIPIL 4 mg COMPR. FILM. 4mg GLAXO OPERATIONS UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-6L 14 12.02 0.858571 0.858571 0.429285

124 C08CA13 LERCANIDIPINUM LERIDIP COMPR. FILM. 10mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.FILM. P-6L 28 60.06 2.145000 2.145000 1.072500

125 C08CA13 LERCANIDIPINUM LERIDIP 20 COMPR. FILM. 20mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 68.78 2.456428 2.456428 1.228214

126 C09AA04 PERINDOPRILUM VIDOTIN 4 mg COMPR. 4mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 31.42 1.047333 1.047333 0.523666

127 C09AA04 PERINDOPRILUM VIDOTIN 8 mg COMPR. 8mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 60.78 2.026000 2.026000 1.013000

128 C09AA04 PERINDOPRILUM PRESTARIUM 10 mg COMPR. FILM. 10 mg LES LAB. SERVIER IND. FRANTA CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L 30 61.78 2.059333 2.059333 1.029666

129 C09AA04 PERINDOPRILUM PRESTARIUM 5 mg COMPR. FILM. 5mg LES LAB. SERVIER IND. FRANTA CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L 30 38.61 1.287000 1.287000 0.643500

130 C09AA07 BENAZEPRILUM CIBACEN (R) 10 mg COMPR. FILM. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 40.99 1.463928 1.463928 0.731964

131 C09AA07 BENAZEPRILUM CIBACEN (R) 20 mg COMPR. FILM. 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 53.80 1.921428 1.921428 0.960714

132 C09AA07 BENAZEPRILUM CIBACEN (R) 5 mg COMPR. FILM. 5mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 20.46 0.730714 0.730714 0.365357

133 C09AA10 TRANDOLAPRILUM GOPTEN (R) 0,5 mg CAPS. 0,5mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 10 CAPS. P-6L 20 9.12 0.456000 0.456000 0.228000

134 C09AA10 TRANDOLAPRILUM GOPTEN (R) 2 mg CAPS. 2mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 26.38 0.942142 0.942142 0.471071

135 C09AA10 TRANDOLAPRILUM GOPTEN (R) 4 mg CAPS. 4mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 43.93 1.568928 1.568928 0.784464

136 C09AA15 ZOFENOPRILUM ZOMEN (R) 30 mg COMPR. FILM. 30mg BERLIN CHEMIE AG GERMANIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-6L 28 41.75 1.491071 1.491071 0.745535

137 C09AA15 ZOFENOPRILUM ZOMEN (R) 7,5 mg COMPR. FILM. 7,5mg BERLIN CHEMIE AG GERMANIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-6L 28 18.49 0.660357 0.660357 0.330178

Pagina 5 din 23

Page 42: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

138 C09BA04

COMBINATII (PERINDOPRILUM+INDAPAMIDUM)

NOLIPREL ARG 2,5mg/0,625mg COMPR. FILM. 2,5mg/0,625mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM. P-6L 30 53.68 1.789333 1.789333 0.894666

139 C09BA04

COMBINATII (PERINDOPRILUM+INDAPAMIDUM)

NOLIPREL ARG FORTE 5mg/1,25mg COMPR. FILM. 5mg/1,25mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM. P-6L 30 57.86 1.928666 1.928666 0.964333

140 C09BA04

COMBINATII (PERINDOPRILUM+INDAPAMIDUM)

PRESTARIUM ARG PLUS 5mg/1,25mg COMPR. FILM. 5mg/1,25mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM. P-6L 30 57.86 1.928666 1.928666 0.964333

141 C09BA06

COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE COMPR. FILM. 10mg/12,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 20.34 0.678000 0.678000 0.339000

142 C09BA06

COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACUZIDE FORTE COMPR. FILM. 20mg/12,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 29.65 0.988333 0.986000 0.493000

143 C09BA06

COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) EDOLFIX H 20mg/12,5mg COMPR. FILM. 20mg/12,5mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 29.58 0.986000 0.986000 0.493000

144 C09BB02

COMBINATII (NITRENDIPINUM+ENALAPRILUM) ENEAS COMPR. 10mg+20mg FERRER INTERNACIONAL SA SPANIA CUTIE X 3 BLIST. PA-PVC-AL/AL X 10 COMPR. P-6L 30 90.63 3.021000 3.021000 1.510500

145 C09BB10

COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA COMPR.FILM.ELIB.MODIF. 180mg/2mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. AL/PVDC-PVC X 14 COMPR. FILM. CU ELIB. PREL. P-6L 28 49.61 1.771785 1.771785 0.885892

146 C09CA03 VALSARTANUM DIOVAN 160 mg COMPR. FILM. 160mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-6L 28 109.48 3.910000 3.910000 1.955000

147 C09CA03 VALSARTANUM DIOVAN 40 mg COMPR. FILM. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-6L 28 68.73 2.454642 2.454642 1.227321

148 C09CA03 VALSARTANUM DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-6L 28 86.27 3.081071 3.081071 1.540535

149 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 74.87 2.673928 2.673928 1.336964

150 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 101.17 3.613214 3.613214 1.806607

151 C09CA06 CANDESARTANUM CILEXETIL ATACAND COMPR. 16mg ASTRAZENECA AB SUEDIA

CUTIE X 1 FLAC. DIN PE, PREV. CU SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. P-6L 28 64.82 2.315000 2.315000 1.157500

152 C09CA06 CANDESARTANUM CILEXETIL ATACAND COMPR. 8mg ASTRAZENECA AB SUEDIA

CUTIE X 1 FLAC. DIN PE, PREV. CU SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. P-6L 28 52.67 1.881071 1.881071 0.940535

153 C09CA07 TELMISARTANUM MICARDIS 40 mg COMPR. 40mg

BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 28 COMPR. ( BLIST. PA/AL/PVC) P-6L 28 56.99 2.035357 2.035357 1.017678

154 C09CA07 TELMISARTANUM PRITOR 40 mg COMPR. 40mg BAYER HEALTHCARE AG GERMANIA CUTIE X 28COMPR.( BLIST. PERFORATE UNIDOZA PA/AL/PVC ) P-6L 28 62.27 2.223928 2.035357 1.017678

155 C09CA07 TELMISARTANUM MICARDIS 80 mg COMPR. 80mg

BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 72.69 2.596071 2.596071 1.298035

156 C09CA07 TELMISARTANUM PRITOR 80 mg COMPR. 80mg BAYER HEALTHCARE AG GERMANIA CUTIE X 28COMPR.( BLIST. PERFORATE UNIDOZA PA/AL/PVC ) P-6L 28 72.69 2.596071 2.596071 1.298035

157 C09DA01

COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) HYZAAR (R) 50 mg/12,5 mg COMPR. FILM. 50mg+12,5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 74.62 2.665000 2.665000 1.332500

Pagina 6 din 23

Page 43: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

158 C09DA04

COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg COMPR. 150mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 78.10 2.789285 2.789285 1.394642

159 C09DA04

COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/12,5mg COMPR. 300mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 105.46 3.766428 3.766428 1.883214

160 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/12,5mg COMPR. 80/12,5mg

BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 72.69 2.596071 2.596071 1.298035

161 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/25mg COMPR. 80/25mg

BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA

CUTIE X 28 COMPR. (BLIST. PA/AL/PVC/AL SAU PA/PA/AL/PVC/AL) P-6L 28 98.45 3.516071 3.516071 1.758035

162 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) PRITOR PLUS 80mg/12,5mg COMPR. 80mg/12,5mg BAYER HEALTHCARE AG GERMANIA CUTIE X 28COMPR.( BLIST. PA/AL/PVC ) P-6L 28 74.71 2.668214 2.596071 1.298035

163 C09DB01

COMBINATII ( VALSARTANUM+AMLODIPINUM) EXFORGE 10mg/160mg COMPR. FILM. 10mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P-6L 56 237.31 4.237678 4.237678 2.118839

164 C09DB01

COMBINATII ( VALSARTANUM+AMLODIPINUM) EXFORGE 5mg/160mg COMPR. FILM. 5mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P-6L 56 237.31 4.237678 4.237678 2.118839

165 C09DB01

COMBINATII ( VALSARTANUM+AMLODIPINUM) EXFORGE 5mg/80mg COMPR. FILM. 5mg/80mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM.(BLIST.PVC/PVDC ) P-6L 56 201.69 3.601607 3.601607 1.800803

166 C10AA04 FLUVASTATINUM LESCOL 20 mg CAPS. 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/AL X 7 CAPS. P-6L 28 15.01 0.536071 0.536071 0.268035

167 C10AA04 FLUVASTATINUM LESCOL 40 mg CAPS. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/AL X 7 CAPS. P-6L 28 27.32 0.975714 0.975714 0.487857

168 C10AA04 FLUVASTATINUM LESCOL XL 80 mg COMPR. ELIB. PREL. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. ELIB. PREL. P-6L 28 43.42 1.550714 1.550714 0.775357

169 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 74.38 2.479333 2.479333 1.239666

170 C10AA05 ATORVASTATINUM SORTIS 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 119.07 3.969000 3.969000 1.984500

171 C10AA05 ATORVASTATINUM SORTIS 40 mg COMPR. FILM. 40mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 51.49 3.677857 3.677857 1.838928

172 C10AA05 ATORVASTATINUM SORTIS 80 mg COMPR. FILM. 80mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 80.68 5.762857 5.762857 2.881428

173 C10AA07 ROSUVASTATINUM CRESTOR 10 mg COMPR. FILM. 10mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 98.62 3.522142 3.522142 1.761071

174 C10AA07 ROSUVASTATINUM CRESTOR 20 mg COMPR. FILM. 20mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 140.25 5.008928 5.008928 2.504464

175 C10AA07 ROSUVASTATINUM CRESTOR 40 mg COMPR. FILM. 40mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 140.25 5.008928 5.008928 2.504464

176 C10AA07 ROSUVASTATINUM CRESTOR 5 mg COMPR. FILM. 5mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/AL X 14 COMPR. FILM. P-6L 28 85.79 3.063928 3.063928 1.531964

177 C10AB02 BEZAFIBRATUM REGADRIN (R) B DRAJ. 200mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 5 BLIST. X 10 DRAJ. P-6L 50 26.79 0.535800 0.535800 0.267900

178 C10AB08 CIPROFIBRATUM LIPANOR (R) 100 mg CAPS. 100mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. X 10 CAPS. P-6L 30 24.10 0.803333 0.803333 0.401666

179 C10AX06 ACID OMEGA-3-ESTERI ETILICI 90** OMACOR (R) CAPS. MOI 1000mg PRONOVA BIOPHARMA NORGE A.S. NORVEGIA FALC. DIN PEID X 28 CAPS. MOI P-RF 28 93.92 3.354285 3.354285 1.677142

180 C10AX09 EZETIMIBUM EZETROL (R) COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PCTFE/PVC/AL X 14 COMPR. P-RF 14 89.61 6.400714 6.069642 3.034821

181 C10AX09 EZETIMIBUM EZETROL (R) COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PCTFE/PVC/AL X 14 COMPR. P-RF 28 169.95 6.069642 6.069642 3.034821

182 C10BX03

COMBINATII (ATORVASTATINUM + AMLODIPINUM) CADUET 10mg/10mg COMPR. FILM. 10mg/10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM. P-6L 30 76.47 2.549000 2.549000 1.274500

183 C10BX03

COMBINATII (ATORVASTATINUM + AMLODIPINUM) CADUET 5mg/10mg COMPR. FILM. 5mg/10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM. P-6L 30 68.18 2.272666 2.272666 1.136333

Pagina 7 din 23

Page 44: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

184 D01AA02 NATAMYCINUM PIMAFUCIN CREMA 20mg/g ASTELLAS EUROPE B.V. OLANDA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 11.71 11.710000 11.710000 5.855000

185 D01BA02 TERBINAFINUM EXIFINE 125 mg COMPR. 125mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 28 48.45 1.730357 1.730357 0.865178

186 D01BA02 TERBINAFINUM EXIFINE 125 mg COMPR. 125mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 14 25.38 1.812857 1.730357 0.865178

187 D01BA02 TERBINAFINUM LAMISIL (R) COMPR. 250mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. X 14 COMPR. P-RF 14 82.53 5.895000 0.997142 0.498571

188 D01BA02 TERBINAFINUM TERBISIL (R) 250 mg COMPR. 250mg GEDEON RICHTER LTD. UNGARIA CUTIE X 2 BLIST. X 14 COMPR. P-RF 28 102.13 3.647500 0.997142 0.498571

189 D01BA02 TERBINAFINUM TERBINARAN COMPR. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-RF 30 220.61 7.353666 0.997142 0.498571

190 D01BA02 TERBINAFINUM TERBINARAN COMPR. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR. P-RF 28 100.88 3.602857 0.997142 0.498571

191 D01BA02 TERBINAFINUM EXIFINE 250 mg COMPR. 250mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 28 31.28 1.117142 0.997142 0.498571

192 D01BA02 TERBINAFINUM EXIFINE 250 mg COMPR. 250mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 14 15.64 1.117142 0.997142 0.498571

193 D01BA02 TERBINAFINUM TERBINAFINE 250 mg COMPR. 250mg ACTAVIS GROUP HF ISLANDA CUTIE X 1 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 14 15.84 1.131428 0.997142 0.498571

194 D01BA02 TERBINAFINUM TERBINAFINE 250 mg COMPR. 250mg ACTAVIS GROUP HF ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 28 27.92 0.997142 0.997142 0.498571

195 D01BA02 TERBINAFINUM TERBINAFINA SLAVIA 250mg COMPR. 250mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 COMPR. P-RF 14 17.10 1.221428 0.997142 0.498571

196 D05AX02 CALCIPOTRIOLUM* DAIVONEX CREMA 50mcg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB DIN AL X 30 G CREMA P-6L 1 40.62 40.620000 40.620000 20.310000

197 D05AX02 CALCIPOTRIOLUM* DAIVONEX SOLUTIE CUTANATA PENTRU SCALP SOL. CUT. 50mcg/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 FLACON DIN PEID X 30 ML SOL. CUTANATA PENTRU SCALP P-6L 1 44.73 44.730000 44.730000 22.365000

198 D05AX02 CALCIPOTRIOLUM* DAIVONEX UNGUENT UNGUENT 50mcg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB DIN AL X 30 G UNGUENT P-6L 1 34.42 34.420000 34.420000 17.210000

199 D05AX52

COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM)* DAIVOBET (R) UNGUENT UNGUENT FARA CONCENTRATIE LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB X 15 G P-RF 1 58.45 58.450000 58.450000 29.225000

200 D06AX01 ACIDUM FUSIDICUM FUCIDIN 20 mg/g CREMA 20mg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 14.25 14.250000 14.250000 7.125000

201 D06AX01 ACIDUM FUSIDICUM FUCIDIN 20 mg/g UNGUENT 20mg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 14.25 14.250000 14.250000 7.125000

202 D06AXN1 COMBINATII BANEOCIN (R) PULB. CUT. FARA CONCENTRATIE SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. DE PUDRAT PE X 10 G P-RF 1 3.99 3.990000 3.990000 1.995000

203 D06AXN1 COMBINATII BANEOCIN (R) UNGUENT FARA CONCENTRATIE SANDOZ GMBH AUSTRIA CUTIE X 1 TUB AL X 20 G P-RF 1 3.99 3.990000 3.990000 1.995000

204 D06BB04 PODOPHYLLOTOXINUM* WARTEC 1,5 mg/g CREMA 1,5 mg/g STIEFEL LABORATORIES IRELAND LTD. MAREA BRITANIE CUTIE X 1 TUB X 5 G CREMA P-RF 1 80.32 80.320000 80.320000 40.160000

205 D06BB04 PODOPHYLLOTOXINUM* CONDYLINE SOL. CUT. 5mg/ml ASTELLAS PHARMA EUROPE BV OLANDA

CUTIE X 1 FLACON DIN STICLA BRUNA X 3,5 ML SOL. CUTANATA + 15 DISPOZITIVE DE APLICARE P-RF 1 71.32 71.320000 71.320000 35.660000

206 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID (R) crema 0,1% CREMA 0,1% ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 TUB DIN AL X 30 G P-RF 1 12.14 12.140000 12.140000 6.070000

207 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID (R) LIPOCREAM 0,1% CREMA 0,1% ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 TUB DIN AL X 30 G P-RF 1 12.57 12.570000 12.140000 6.070000

208 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID CRELO (R) 0,1% EMULSIE CUT. 0.1% ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 FLACON X 30 G P-RF 1 12.02 12.020000 12.020000 6.010000

209 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID (R) SOL. CUT. 0,1% ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 FLACON PICURATOR DIN PP X 30 ML P-RF 1 10.54 10.540000 10.540000 5.270000

210 D07AC13 MOMETASONUM ELOCOM CREMA 1mg/g SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 14.73 14.730000 14.730000 7.365000

211 D07AC13 MOMETASONUM ELOCOM SOL. CUT. 1mg/g SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 FLACON DIN PEID X 20 ML SOL. CUTANATA P-RF 1 17.63 17.630000 17.630000 8.815000

212 D07AC13 MOMETASONUM ELOCOM UNGUENT 1mg/g SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 14.73 14.730000 14.730000 7.365000

213 D07AC14METHYLPREDNISOLONUM ACEPONAT ADVANTAN CREMA 1mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 12.45 12.450000 12.450000 6.225000

214 D07AC14METHYLPREDNISOLONUM ACEPONAT ADVANTAN (R) MILK EMULSIE CUT. 0,1% INTENDIS GMBH GERMANIA CUTIE X 1 TUB X 20 G P-RF 1 18.41 18.410000 18.410000 9.205000

215 D07AC14METHYLPREDNISOLONUM ACEPONAT ADVANTAN UNGUENT 1mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 12.45 12.450000 12.450000 6.225000

216 D07AC17 FLUTICASONUM PROPIONAT CUTIVATE CREMA 0,05% GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 9.68 9.680000 9.680000 4.840000

217 D07AC17 FLUTICASONUM PROPIONAT CUTIVATE UNGUENT 0,005% GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 9.68 9.680000 9.680000 4.840000

218 D07AD01 CLOBETASOLUM* DERMOVATE CREMA 0,05% GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 TUB X 25 G P-RF 1 11.34 11.340000 11.340000 5.670000

219 D07AD01 CLOBETASOLUM* DERMOVATE (R) SOL. CUT. 0,05% GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON CU PICURATOR DIN PP X 25 ML P-RF 1 4.88 4.880000 4.880000 2.440000

220 D07AD01 CLOBETASOLUM* DERMOVATE UNGUENT 0,05% GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 TUB X 25 G P-RF 1 8.35 8.350000 5.420000 2.710000

221 D07AD01 CLOBETASOLUM* DERMIONE UNGUENT 0,05% OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 TUB DIN AL X 20 G P-RF 1 5.42 5.420000 5.420000 2.710000

Pagina 8 din 23

Page 45: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

222 D07AD01 CLOBETASOLUM* CLOBETASOL MK UNGUENT 0,05% FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 7.70 7.700000 5.420000 2.710000

223 D07CA01 COMBINATII PIMAFUCORT CREMA FARA CONCENTRATIE ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 9.92 9.920000 9.920000 4.960000

224 D07CA01 COMBINATII PIMAFUCORT UNGUENT FARA CONCENTRATIE ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 9.92 9.920000 9.920000 4.960000

225 D07CC01

COMBINATII (ACIDUM FUSIDICUM+ BETAMETHASONUM) FUCICORT 20 mg/1mg pe gram CREMA 20mg/1mg pe gram LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 22.37 22.370000 22.370000 11.185000

226 D07XC03

COMBINATII (MOMETASONUM + AC. SALICILICUM) ELOSALIC UNGUENT FARA CONCENTRATIE SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 TUB X 15 G P-RF 1 19.35 19.350000 19.350000 9.675000

227 D07XC03

COMBINATII (MOMETASONUM + AC. SALICILICUM) ELOSALIC UNGUENT FARA CONCENTRATIE SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 TUB X 45 G P-RF 1 55.23 55.230000 19.350000 9.675000

228 D10AD54

COMBINATII (ISOTRETINOINUM + ERITROMICINUM) ISOTREXIN GEL GEL 0,05%/0,2% STIEFEL LABORATORIES IRELAND LTD. MAREA BRITANIE CUTIE X 1 TUB DIN AL X 30 G GEL P-RF 1 34.00 34.000000 34.000000 17.000000

229 D10AX03 ACIDUM AZELAICUM SKINOREN CREMA 200mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 33.08 33.080000 33.080000 16.540000

230 D10AX03 ACIDUM AZELAICUM SKINOREN (R) 15% GEL 15% INTENDIS GMBH GERMANIA CUTIE X 1 TUB AL X 30 G GEL P-RF 1 41.75 41.750000 41.750000 20.875000

231 D10BA01 ISOTRETINOINUM** ROACCUTANE 10 mg CAPS. MOI 10mg ROCHE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. MOI P-RF 30 50.04 1.668000 1.668000 0.834000

232 D10BA01 ISOTRETINOINUM** SOTRET 10 mg CAPS. MOI 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. PE-PVDC-PVC/HARTIE-AL X 10 CAPS. MOI P-RF 30 60.72 2.024000 1.668000 0.834000

233 D10BA01 ISOTRETINOINUM** SOTRET 20 mg CAPS. MOI 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. PE-PVDC-PVC/HARTIE-AL X 10 CAPS. MOI P-RF 30 95.40 3.180000 3.180000 1.590000

234 G01AA02 NATAMYCINUM PIMAFUCIN (R) OVULE 100mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 FOLIE X 3 OVULE P-RF 3 10.42 3.473333 3.473333 1.736666

235 G01AA51 COMBINATII MACMIROR COMPLEX CAPS. MOI VAG. 500mg/200000UI POLICHEM SA LUXEMBURG CUTIE X 1 BLIST. AL/PVDC-PVC X 12 CAPS. MOI. VAG. P-RF 12 35.79 2.982500 2.982500 1.491250

236 G01AA51 COMBINATII POLYGYNAX CAPS. MOI VAG. FARA CONCENTRATIE LAB. INNOTECH INT. FRANTA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. MOI VAG. P-RF 6 16.39 2.731666 2.731666 1.365833

237 G01AA51 COMBINATII MACMIROR COMPLEX CREMA VAG. 10g/400000UI POLICHEM SA LUXEMBURG CUTIE X 1 TUB DIN AL CREMA VAG. X 30 G + APLICATOR P-RF 1 33.30 33.300000 33.300000 16.650000

238 G01AF12 FENTICONAZOLUM LOMEXIN 600 mg CAPS. MOI VAG. 600mg RECORDATI SPA ITALIA CUTIE X 1 BLIST. PVC/PVDC-AL X 1 CAPS. VAG. MOALE P-RF 1 18.86 18.860000 18.860000 9.430000

239 G01AF15 BUTOCONAZOLUM GYNOFORT 2% CREMA VAG. FARA CONCENTRATIE GEDEON RICHTER PLC UNGARIACUTIE X 1 APLICATOR PREUMPLUT UNIDOZA DIN PP CU 5 G CREMA VAG. P-RF 1 37.81 37.810000 37.810000 18.905000

240 G01AF20

COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLODIN COMPR. VAG. 500mg/200mg ARENA GROUP S.A. ROMANIA

CUTIE X 2 BLIST. TRANSPARENT DIN AL/PVC X 5 COMPR. VAG. P-RF 10 14.10 1.410000 1.410000 0.705000

241 G01AF20

COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON (R) CREMA FARA CONCENTRATIE FARMIGEA SPA ITALIA CUTIE X 1 TUB DIN AL X 30 G P-RF 1 9.04 9.040000 9.040000 4.520000

242 G01AF20

COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON CREMA VAG. FARA CONCENTRATIE FARMIGEA SPA ITALIA

CUTIE X 1 TUB DIN AL X 30 G CREMA VAG. + 6 APLICATOARE DIN POLIPROPILENA P-RF 1 12.08 12.080000 12.080000 6.040000

243 G01AF20

COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON OVULE FARA CONCENTRATIE FARMIGEA SPA ITALIA CUTIE X 2 FOLII PVC-PE X 5 OVULE P-RF 10 10.48 1.048000 1.048000 0.524000

244 G01AF20

COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON SOL. VAGINALA FARA CONCENTRATIE FARMIGEA SPA ITALIA

CUTIE X 5 FLACOANE PVC-PE X 10 ML + 5 FLACOANE PEJD X 130 ML + 5 CANULE P-RF 5 20.63 4.126000 4.126000 2.063000

245 G01AF20

COMBINATII (METRONIDAZOLUM+MICONAZOLUM) KLION-D 100 COMPR. VAG. 100mg/100mg GEDEON RICHTER PLC UNGARIA CUTIE X 1 FOLIE AL/PEJD X 10 COMPR. VAG. P-RF 10 10.79 1.079000 1.079000 0.539500

246 G01AX05 NIFURATELUM MACMIROR DRAJ. 200mg POLICHEM SA LUXEMBURG CUTIE X 2 BLIST. AL/PVC X 10 DRAJ. P-RF 20 18.37 0.918500 0.918500 0.459250

247 G02CB03 CABERGOLINUM* DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 40.92 20.460000 14.522500 7.261250

248 G02CB03 CABERGOLINUM* DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 116.18 14.522500 14.522500 7.261250

Pagina 9 din 23

Page 46: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

249 G03AC03 LEVONORGESTRELUM***# MIRENA 20 mcg/24 h DISPOZITIV INTRAUTERIN 52mg BAYER SCHERING PHARMA AG FINLANDA CUTIE X 1 BLIST. X 1 DISP. PT. ADM. INTRAUTERINA + 1 INSERTOR P-RF 1 486.51 486.510000 486.510000 243.255000

250 G03CA04 ESTRIOLUM* OVESTIN CREMA VAG. 0.1% ORGANON NV OLANDA CUTIE X 1 FLACON X 15 G + APLICATOR P-RF 1 13.87 13.870000 13.870000 6.935000

251 G03CA04 ESTRIOLUM* OVESTIN OVULE 0,5mg ORGANON NV OLANDA CUTIE X 3 FOLII X 5 OVULE P-RF 15 19.35 1.290000 1.290000 0.645000

252 G03CA09 PROMESTRIENUM* COLPOTROPHINE (R) CAPS. MOI VAG. 10mg LAB. THERAMEX MONACO CUTIE X 1 BLIST. AL/PVC X 10 CAPS. MOI VAG. P-RF 10 11.34 1.134000 1.134000 0.567000

253 G03CA09 PROMESTRIENUM* COLPOTROPHINE (R) CREMA VAG. 1% LAB. THERAMEX MONACO CUTIE X 1 TUB X 15 G P-RF 1 13.00 13.000000 13.000000 6.500000

254 G03DA04 PROGESTERONUM* UTROGESTAN (R) 100 mg CAPS. MOI 100mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. X 15 CAPS. MOI P-6L 30 28.17 0.939000 0.708666 0.354333

255 G03DA04 PROGESTERONUM* AREFAM 100 mg CAPS. MOI 100mg LADEE PHARMA KFT. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. MOI P-6L 30 21.26 0.708666 0.708666 0.354333

256 G03DA04 PROGESTERONUM* UTROGESTAN (R) 200 mg CAPS. MOI 200mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. AL/PVC X 7 CAPS. MOI P-6L 14 28.17 2.012142 1.371666 0.685833

257 G03DA04 PROGESTERONUM* AREFAM 200 mg CAPS. MOI 200mg LADEE PHARMA KFT. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 CAPS. MOI P-6L 30 41.15 1.371666 1.371666 0.685833

258 G03DA04 PROGESTERONUM* PROGESTOGEL GEL 1% LAB. BESINS INTERNATIONAL FRANTA CUTIE X 1 TUB X 80 G + DISPOZITIV DE MASURA P-6L 1 16.89 16.890000 5.490000 2.745000

259 G03DA04 PROGESTERONUM* MASTOPROFEN 1% GEL 1% ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB DIN AL X 40 G P-6L 1 5.49 5.490000 5.490000 2.745000

260 G03DB01 DYDROGESTERONUM* DUPHASTON (R) COMPR. FILM. 10mg SOLVAY PHARMACEUTICALS BV OLANDA CUTIE X 1 BLIST. X 20 COMPR. FILM. P-6L 20 13.50 0.675000 0.675000 0.337500

261 G03DC03 LYNESTRENOLUM* ORGAMETRIL COMPR. 5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 30 COMPR. P-6L 30 8.57 0.285666 0.285666 0.142833

262 G03DC05 TIBOLONUM** LIVIAL (R) 2,5 mg COMPR. 2,5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 28 COMPR. P-RF 28 69.59 2.485357 2.020714 1.010357

263 G03DC05 TIBOLONUM** LADYBON COMPR. 2,5mg ZENTIVA A.S. CEHIA CUTIE X 1 BLIST. DIN AL-PVDC/PVC X 28 COMPR. P-RF 28 68.03 2.429642 2.020714 1.010357

264 G03DC05 TIBOLONUM** LADYBON COMPR. 2,5mg ZENTIVA A.S. CEHIA CUTIE X 3 BLIST. DIN AL-PVDC/PVC X 28 COMPR. P-RF 84 169.74 2.020714 2.020714 1.010357

265 G03FA01 COMBINATII** ACTIVELLE 1mg/0,5mg COMPR. FILM. 1mg/0,5mg NOVO NORDISK A/S DANEMARCA CUTIE X 1 DISC TIP CALENDAR X 28 COMPR. FILM. P-RF 1 31.68 31.680000 31.680000 15.840000

266 G03FA14 COMBINATII** FEMOSTON (R) conti 1/5 COMPR. FILM. FARA CONCENTRATIE SOLVAY PHARMACEUTICALS BV OLANDA CUTIE X 1 BLIST. X 28 COMPR. FILM. P-RF 1 29.71 29.710000 29.710000 14.855000

267 G03FA15ESTRADIOLUMVALERAT+DIENOGEST** KLIMODIEN DRAJ. FARA CONCENTRATIE BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 BLIST. X 28 DRAJ. P-RF 1 33.17 33.170000 33.170000 16.585000

268 G03FA17 COMBINATII** ANGELIQ COMPR. FILM. FARA CONCENTRATIE BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 BLIST. CALENDARISTIC PVC/AL X 28 COMPR. FILM. P-RF 1 64.22 64.220000 64.220000 32.110000

269 G03FB01 COMBINATII** CYCLO PROGINOVA (R) DRAJ. FARA CONCENTRATIE BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 BLIST. TIP CALENDAR X 21 DRAJEURI P-RF 1 7.58 7.580000 7.580000 3.790000

270 G03FB05 COMBINATII** NOVOFEM COMPR. FILM. FARA CONCENTRATIE NOVO NORDISK A/S DANEMARCA

CUTIE X 1 DISC TIP CALENDAR X 28 COMPR. FILM. (12 COMPR. FILM. ALBE SI 16 COMPR. FILM. ROSII) P-6L 1 30.26 30.260000 30.260000 15.130000

271 G03FB08 COMBINATII** FEMOSTON 2/10 COMPR. FILM. FARA CONCENTRATIE SOLVAY PHARMACEUTICALS BV OLANDA

CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GAL P-RF 1 29.71 29.710000 29.710000 14.855000

272 G03GA05 FOLLITROPINUM ALFA****# GONAL - f 150 UI

PULB. + SOLV. PT. SOL. INJ. 150UI SERONO EUROPE LTD. MAREA BRITANIE

CUTIE X 1 FIOLA DIN STICLA INCOLORA CU PULB. PT. SOL. INJ.+ 1 FIOLA X 1 ML SOLV. P-RF/R 1 174.08 174.080000 174.080000 87.040000

273 G03GA05 FOLLITROPINUM ALFA****# GONAL - f 75 UI

PULB. + SOLV. PT. SOL. INJ. 75UI SERONO EUROPE LTD. MAREA BRITANIE

CUTIE X 5 FIOLE DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 5 FIOLE X 1 ML SOLV. P-RF/R 5 424.10 84.820000 84.820000 42.410000

274 G03GA05 FOLLITROPINUM ALFA****# GONAL - f 75 UI

PULB. + SOLV. PT. SOL. INJ. 75UI SERONO EUROPE LTD. MAREA BRITANIE

CUTIE X 1 FIOLA DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 FIOLA X 1 ML SOLV. P-RF/R 1 91.78 91.780000 84.820000 42.410000

275 G03GA05 FOLLITROPINUM ALFA****#GONAL-f 300 UI/0,5 ml ( 22 mcg/0,5 ml)

SOL. INJ. IN STILOU INJECTOR PREUMPLUT 300UI/0,5ml SERONO EUROPE LTD. MAREA BRITANIE

CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 5 ACE PT. ADM. P-RF/R 1 499.87 499.870000 499.870000 249.935000

276 G03GA05 FOLLITROPINUM ALFA****#GONAL-f 450 UI/0,75 ml (33 mcg/0,75 ml)

SOL. INJ. IN STILOU INJECTOR PREUMPLUT 450UI/0,75ml SERONO EUROPE LTD. MAREA BRITANIE

CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 7 ACE PT. ADM. SUBCUTANATA P-RF/R 1 714.43 714.430000 714.430000 357.215000

Pagina 10 din 23

Page 47: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

277 G03GA05 FOLLITROPINUM ALFA****#GONAL-f 900 UI/1,5ml (66 mcg/1,5 ml)

SOL. INJ. IN STILOU INJECTOR PREUMPLUT 900UI/0,75ml SERONO EUROPE LTD. MAREA BRITANIE

CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1,5 ML SOL. INJ. + 14 ACE PT. ADM. SUBCUTANATA P-RF/R 1 1358.05 1358.050000 1358.050000 679.025000

278 G03GA06 FOLLITROPINUM BETA****# PUREGON 100UI/0,5ml SOL. INJ. 100UI/0,5ml N. V. ORGANON OLANDA CUTIE X 1 FLACON DIN STICLA X 0,5 ML SOL. INJ. P-RF 1 188.62 188.620000 188.620000 94.310000

279 G03GA06 FOLLITROPINUM BETA****# PUREGON 300UI/0,36 ml SOL. INJ. 300UI/0,36ml N. V. ORGANON OLANDA CUTIE X 1 CARTUS + 6 ACE P-RF 1 490.06 490.060000 490.060000 245.030000

280 G03GA06 FOLLITROPINUM BETA****# PUREGON 50UI/0,5ml SOL. INJ. 50UI/0,5ml N. V. ORGANON OLANDA CUTIE X 1 FLACON DIN STICLA INCOLORA X 0,5 ML SOL. INJ. P-RF 1 99.85 99.850000 99.850000 49.925000

281 G03GA06 FOLLITROPINUM BETA****# PUREGON 600UI/0,72 ml SOL. INJ. 600UI/0,72ml N. V. ORGANON OLANDA CUTIE X 1 CARTUS SOL. INJ + 6 ACE P-RF/R 1 909.28 909.280000 909.280000 454.640000

282 G03GA06 FOLLITROPINUM BETA****# PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml N. V. ORGANON OLANDA CUTIE X 1 CARTUS SOL. INJ. + 9 ACE P-RF 1 1329.05 1329.050000 1329.050000 664.525000

283 G03GB02 CLOMIFENUM CLOSTILBEGYT COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. P-RF 10 13.44 1.344000 1.245000 0.622500

284 G03GB02 CLOMIFENUM OVA - MIT COMPR. 50mg REMEDICA LTD. CIPRU CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 12.45 1.245000 1.245000 0.622500

285 G04BD04 OXYBUTYNINUM DRIPTANE ( R ) 5 mg COMPR. 5mg LAB. FOURNIER SA FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. P-6L 60 25.01 0.416833 0.416833 0.208416

286 G04BD07 TOLTERODINUM**# DETRUSITOL SR 4 mg CAPS. ELIB. PREL. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. X 7 CAPS. ELIB. PREL. P-6L 28 116.96 4.177142 4.177142 2.088571

287 G04BD07 TOLTERODINUM**# DETRUSITOL SR 4 mg CAPS. ELIB. PREL. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. X 7 CAPS. ELIB. PREL. P-6L 7 45.51 6.501428 4.177142 2.088571

288 G04BD07 TOLTERODINUM**# UROFLOW 1 COMPR. FILM. 1mg ZENTIVA A.S. CEHIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 25.64 0.915714 0.915714 0.457857

289 G04BD07 TOLTERODINUM**# UROFLOW 2 COMPR. FILM. 2mg ZENTIVA A.S. CEHIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 49.62 1.772142 1.772142 0.886071

290 G04BD08 SOLIFENACINUM SUCCINATE**# VESICARE 10 mg COMPR. FILM. 10mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 213.25 7.108333 7.108333 3.554166

291 G04BD08 SOLIFENACINUM SUCCINATE**# VESICARE 5 mg COMPR. FILM. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 172.16 5.738666 5.738666 2.869333

292 G04BD09 TROSPIUM INKONTAN 15 mg COMPR. FILM. 15mg PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. AUSTRIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 27.20 1.360000 1.102200 0.551100

293 G04BD09 TROSPIUM INKONTAN 15 mg COMPR. FILM. 15mg PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 55.11 1.102200 1.102200 0.551100

294 G04BD09 TROSPIUM INKONTAN 15 mg COMPR. FILM. 15mg PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 35.79 1.193000 1.102200 0.551100

295 G04BD09 TROSPIUM INKONTAN 30 mg COMPR. FILM. 30mg PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 87.23 1.744600 1.744600 0.872300

296 G04BD09 TROSPIUM INKONTAN 30 mg COMPR. FILM. 30mg PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 59.64 1.988000 1.744600 0.872300

297 G04BD09 TROSPIUM INKONTAN 30 mg COMPR. FILM. 30mg PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. AUSTRIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 44.08 2.204000 1.744600 0.872300

298 G04CA01 ALFUZOSINUM XATRAL SR 10 mg COMPR. ELIB. PREL. 10mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 3 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-6L 30 55.28 1.842666 1.842666 0.921333

299 G04CA01 ALFUZOSINUM ALFURAN MR 10 mg COMPR. ELIB. PREL. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. ELIB. PREL. P-6L 30 99.13 3.304333 1.842666 0.921333

300 G04CA01 ALFUZOSINUM XATRAL LP 5 mg COMPR. FILM. ELIB. PREL. 5mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. FILM. ELIB. PREL. P-6L 28 32.74 1.169285 1.169285 0.584642

301 G04CA02 TAMSULOSINUM TAMSOL 0,4 mg CAPS. ELIB. MODIF. 0,4mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-6L 30 34.12 1.137333 0.429333 0.214666

302 G04CA02 TAMSULOSINUM FOKUSIN CAPS. ELIB. MODIF. 0,4mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. MODIF. P-6L 30 37.99 1.266333 0.429333 0.214666

303 G04CA02 TAMSULOSINUM TAMSULOSIN ACTAVIS CAPS. ELIB. MODIF. 0,4mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. ELIB. MODIF. P-6L 30 12.88 0.429333 0.429333 0.214666

304 G04CA02 TAMSULOSINUM CONTIFLO MR CAPS. ELIB. PREL. 0,4mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 25.27 0.842333 0.429333 0.214666

305 G04CA02 TAMSULOSINUM TANYZ CAPS. ELIB. PREL. 0,4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 28.66 0.955333 0.429333 0.214666

306 G04CA02 TAMSULOSINUM OMNIC TOCAS (R) 0,4 COMPR. FILM. ELIB. PREL. 0,4mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 FOLII AL/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 62.15 2.071666 2.071666 1.035833

307 G04CB01 FINASTERIDUM* FINASTERID SANDOZ 5 mg COMPR. FILM. 5 mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC ALB OPAC/AL X 10 COMPR. FILM. P-6L 30 33.10 1.103333 1.101000 0.550500

308 G04CB01 FINASTERIDUM* PROSCAR 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PVC/PE/PVD-AL X 14 COMPR.FILM. P-6L 14 31.23 2.230714 1.101000 0.550500

309 G04CB01 FINASTERIDUM* PROSCAR 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC/PE/PVD-AL X 14 COMPR.FILM. P-6L 28 60.44 2.158571 1.101000 0.550500

310 G04CB01 FINASTERIDUM* MOSTRAFIN COMPR. FILM. 5mg PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 33.03 1.179642 1.101000 0.550500

311 G04CB01 FINASTERIDUM* TAREDOX 5 mg COMPR. FILM. 5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. FILM. P-6L 28 31.93 1.140357 1.101000 0.550500

312 G04CB01 FINASTERIDUM* FINASTERIDA BIOGALENICA 5 mg COMPR. FILM. 5mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 34.16 1.220000 1.101000 0.550500

313 G04CB01 FINASTERIDUM* FINASTERIDE TEVA 5mg COMPR. FILM. 5mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 33.03 1.101000 1.101000 0.550500

314 G04CB02 DUTASTERIDUM* AVODART 0,5 mg CAPS. MOI 0,5mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 3 BLIST.PVC-PVDC/AL X 10 CAPS. MOI P-6L 30 89.78 2.992666 2.992666 1.496333

315 H01AA02 TETRACOSACTIDUM SYNACHTEN DEPOT SUSP. INJ. 1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FIOLA DIN STICLA X 1 ML SUSP. INJ. S/P-RF 1 5.41 5.410000 5.410000 2.705000

316 H01AC01 SOMATROPINUM***# ZOMACTON LIOF. + SOLV. PT. SOL. INJ. 4mg (12ui) FERING GMBH GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1 FIOLA X 3,5 ML SOLV. P-RF 1 442.32 442.320000 442.320000 221.160000

Pagina 11 din 23

Page 48: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

317 H01AC01 SOMATROPINUM***# GENOTROPIN (R) 16 ui (5,3 mg) PULB. + SOLV. PT. SOL. INJ. 5,3mg/ml (16ui) PFIZER EUROPE MA EEIG MAREA BRITANIE

CUTIE X 1 CARTUS BICAMERAL MULTIDOZA CU PULB. SI SOLV. PT. SOL. INJ. P-RF 1 526.04 526.040000 526.040000 263.020000

318 H01AC01 SOMATROPINUM***# NORDITROPIN SIMPLEX x 10mg/1,5ml SOL. INJ. 10mg/1,5ml NOVO NORDISK A/S DANEMARCA CUTIE X 1 CARTUS DIN STICLA X 1,5 ML SOL. INJ. P-RF 1 1244.44 1244.440000 1244.440000 622.220000

319 H01AC01 SOMATROPINUM***# NUTROPINAq 10 mg/2 ml SOL. INJ. 10mg/2ml IPSEN LIMITED MAREA BRITANIE CUTIE X 1 CARTUS X 2 ML. SOL. INJ. P-RF/R 1 935.05 935.050000 935.050000 467.525000

320 H01AC01 SOMATROPINUM***# OMNITROPE 3,3mg/ml SOL. INJ. 3,3mg/ml SANDOZ GMBH AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ. P-RF/R 1 458.90 458.900000 458.900000 229.450000

321 H01AC01 SOMATROPINUM***# NORDITROPIN SIMPLEXx 5 mg/1,5 ml SOL. INJ. 5mg/1,5ml NOVO NORDISK A/S DANEMARCA CUTIE X 1 CARTUS DIN STICLA X 1,5 ML SOL. INJ. P-RF 1 596.68 596.680000 458.900000 229.450000

322 H01AC01 SOMATROPINUM***# OMNITROPE 6,7mg/ml SOL. INJ. 6,7mg/ml SANDOZ GMBH AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ. P-RF/R 1 723.32 723.320000 723.320000 361.660000

323 H01CC01 GANIRELIXUM***# ORGALUTRAN 0.25mg/0,5ml SOL. INJ. 0,25mg/0,5ml N. V. ORGANON OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT P-RF/R 1 166.09 166.090000 166.090000 83.045000

324 H01CC02 CETRORELIXUM***# CETROTIDE 0,25 mg PULB+SOLV. PT. SOL. INJ. 0,25mg SERONO EUROPE LTD. MAREA BRITANIE

CUTIE CU UN SUPORT CONTINAND: 7 FLAC.PULB. + 7 SERINGI PRE-UMPLUTE X 1 ML SOLV. + 7 ACE PT. INJECTII P-RF 7 797.89 113.984285 113.984285 56.992142

325 H01CC02 CETRORELIXUM***# CETROTIDE 3 mg PULB+SOLV.PT.SOL.INJ. 3mg SERONO EUROPE LTD. MAREA BRITANIE

CUTIE CU UN SUPORT CONTINAND: 1 FLAC.PULB. + 1 SERINGA PRE-UMPLUTA X 3 ML SOLV. + 1 AC PT. INJECTII P-RF 1 797.89 797.890000 797.890000 398.945000

326 H02AA02 FLUDROCORTISONUM ASTONIN H COMPR. 0,1mg MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. P-RF 50 44.85 0.897000 0.897000 0.448500

327 H02AB01 BETAMETHASONUM DIPROPHOS (R) SUSP. INJ. I.M. 7mg/ml SCHERING PLOUGH EUROPE BELGIA CUTIE X 5 FIOLE X 1 ML P-RF 5 33.51 6.702000 6.702000 3.351000

328 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 250 LIOF. + SOLV. PT. SOL. INJ. 250mg MERCK KGAA GERMANIA

CUTIE X 3 FLAC. DIN STICLA INCOLORA X 250 MG FIOF. PT. SOL. INJ. + 3 FIOLE X 5 ML SOLV. P-RF 3 89.78 29.926666 29.926666 14.963333

329 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 50 LIOF. + SOLV. PT. SOL. INJ. 50mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. X 50 MG LIOF. PT. SOL. INJ. + 3 FIOLE X 1 ML SOLVENT P-RF 3 33.52 11.173333 11.173333 5.586666

330 H03BB01 CARBIMAZOLUM CARBIMAZOLE 5 COMPR. FILM. 5mg REMEDICA LTD. CIPRU CUTIE X 10 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 100 15.84 0.158400 0.158400 0.079200

331 H03BB02 THIAMAZOLUM THYROZOL (R) 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 5 BLIST. X 10 COMPR. FILM. P-6L 50 19.72 0.394400 0.394400 0.197200

332 H03BB02 THIAMAZOLUM THYROZOL (R) 20 mg COMPR. FILM. 20mg MERCK KGAA GERMANIA CUTIE X 5 BLIST. X 10 COMPR. FILM. P-6L 50 23.98 0.479600 0.479600 0.239800

333 H03BB02 THIAMAZOLUM THYROZOL (R) 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L/S 100 28.97 0.289700 0.289700 0.144850

334 H05BA01 CALCITONINUM (SOMON) TONOCALCIN 100 UI SOL. INJ. 100UI ALFA WASSERMANN SPA ITALIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. P-RF 5 63.77 12.754000 6.078000 3.039000

335 H05BA01 CALCITONINUM (SOMON) NYLEX (R) SOL. INJ. 100UI/ml PROEL E.P. CORONIS SA GRECIA CUTIE X 5 FIOLE X 1ML P-RF 5 30.39 6.078000 6.078000 3.039000

336 H05BA01 CALCITONINUM (SOMON) MIACALCIC (R) SOL. INJ. 50ui/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML P-RF 5 33.44 6.688000 6.688000 3.344000

337 H05BA01 CALCITONINUM (SOMON) NYLEX 100 UI/doza SPRAY NAZ.,SOL. 100UI/doza

PHARMACEUTICAL IND. PROEL EPAM. G.CORONIS SA GRECIA

CUTIE X 1 FLACON PREVAZUT CU POMPA DOZATOARE X 2 ML SPRAY NAZAL, SOL. P-RF 1 45.40 45.400000 45.400000 22.700000

338 H05BA01 CALCITONINUM (SOMON) NYLEX (R) SPRAY NAZAL - SOL. 200UI/doza PROEL E.P. CORONIS SA GRECIA

CUTIE X 1 FLACON DIN STICLA PREVAZUT CU POMPA DOZATOARE CU APLICATOR NAZAL X 2 ML P-RF 1 68.14 68.140000 68.140000 34.070000

339 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS (R) 1,5 g PULB. PT. SOL. INJ. 1g+500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. X 1,5 G P-RF 1 23.71 23.710000 13.775800 6.887900

340 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS (R) 1,5 g PULB. PT. SOL. INJ. 1g+500mg ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. PULB. PT. SOL. INJ. X 1,5 G P-RF/S 50 688.79 13.775800 13.775800 6.887900

341 J01CR04 SULTAMICILLINUM UNASYN COMPR. FILM. 375mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC/PVDC X 6 COMPR. P-RF 12 32.19 2.682500 2.682500 1.341250

342 J01CR04 SULTAMICILLINUM UNASYN PULB. PT. SUSP. ORALA 250mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID CU PULBERE PT. 60 ML SUSP. ORALA P-RF 1 22.91 22.910000 22.910000 11.455000

343 J01DD14 CEFTIBUTENUM CEDAX CAPS. 400mg SCHERING PLOUGH EUROPE BELGIA CUTIE X 5 BLIST. X 1 CAPS. P-RF 5 66.19 13.238000 13.238000 6.619000

344 J01DD14 CEFTIBUTENUM CEDAX PULB. PT. SUSP. ORALA 36mg/ml SCHERING PLOUGH EUROPE BELGIA

CUTIE X 1 FLAC. PULB. PT. 30 ML SUSP. ORALA + 1 LINGURITA GRADATA PT. 45 MG, 90 MG, 135 MG + 1 CAPAC P-RF 1 41.04 41.040000 41.040000 20.520000

345 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 9.24 0.577500 0.577500 0.288750

346 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 26.18 2.618000 2.618000 1.309000

Pagina 12 din 23

Page 49: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

347 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 8 CAPS. P-RF 8 35.61 4.451250 4.263333 2.131666

348 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. P-RF 6 25.58 4.263333 4.263333 2.131666

349 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 23.81 3.968333 3.968333 1.984166

350 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 45.84 7.640000 6.958333 3.479166

351 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 41.75 6.958333 6.958333 3.479166

352 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 41.75 6.958333 6.958333 3.479166

353 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 35.85 11.950000 8.026666 4.013333

354 J01FA10 AZITHROMYCINUM AZITROX (R) 500 COMPR. FILM. 500mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 41.42 13.806666 8.026666 4.013333

355 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 45.84 15.280000 8.026666 4.013333

356 J01FA10 AZITHROMYCINUM ZITROCIN 500 mg COMPR. FILM. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC/AL X 3 COMPR. FILM. P-RF 3 24.08 8.026666 8.026666 4.013333

357 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 34.89 11.630000 8.026666 4.013333

358 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 34.89 11.630000 8.026666 4.013333

359 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 41.89 13.963333 13.963333 6.981666

360 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 41.89 13.963333 13.963333 6.981666

361 J01FA10 AZITHROMYCINUM ZMAX 2 g

GRAN. ELIB. PREL. PT. SUSP. ORALA 2g PFIZER EUROPE MA EEIG MAREA BRITANIE

CUTIE X 1 FLACON DIN PEID CU GRAN. CU ELIB. PREL. P-RF 1 59.64 59.640000 59.640000 29.820000

362 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5ml ZENTIVA S.A. ROMANIA

CUTIE X 1 FLAC. DIN PE CU PULB. PT. 15 ML SUSP. ORALA RECONSTITUITA + FLAC. CU SOLV. X 7,5 ML SOLV. P-RF 1 17.50 17.500000 17.500000 8.750000

363 J01FA10 AZITHROMYCINUMAZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA

CUTIE X 1 FLAC. DIN PEID CONTINAD PULBERE PT. 20 ML SUSP. ORALA + SERINGA DOZATOARE DIN PE/PP P-RF 1 21.08 21.080000 21.080000 10.540000

364 J01FA10 AZITHROMYCINUMAZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA

CCUTIE X 1 FLAC. DIN PEID CONTINAD PULBERE PT. 20 ML SUSP. ORALA + SERINGA DOZATOARE DIN PE/PP P-RF 1 33.34 33.340000 17.500000 8.750000

365 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml 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 23.64 23.640000 17.500000 8.750000

366 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml 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 45.63 45.630000 17.500000 8.750000

367 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml 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 56.66 56.660000 17.500000 8.750000

368 J01FF01 CLINDAMYCINUM DALACIN C 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 8 CAPS. P-RF 16 11.40 0.712500 0.712500 0.356250

369 J01FF01 CLINDAMYCINUM DALACIN C 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 8 CAPS. P-RF 16 21.90 1.368750 1.368750 0.684375

370 J01FF01 CLINDAMYCINUM CLINDAMYCIN - MIP 600 mg COMPR. FILM. 600mg MIP PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC/AL X 8 COMPR. FILM. P-RF 16 48.98 3.061250 3.000333 1.500166

371 J01FF01 CLINDAMYCINUM CLINDAMYCIN - MIP 600 mg COMPR. FILM. 600mg MIP PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 6 COMPR. FILM. P-RF 30 90.01 3.000333 3.000333 1.500166

Pagina 13 din 23

Page 50: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

372 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 73.64 10.520000 10.520000 5.260000

373 J01MA12 LEVOFLOXACINUM TAVANIC 500 mg COMPR. FILM. 500mg SANOFI - AVENTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF 7 48.91 6.987142 6.987142 3.493571

374 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 7 107.63 15.375714 6.987142 3.493571

375 J01MA14 MOXIFLOXACINUM AVELOX (R) 400 mg COMPR. FILM. 400mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. ALB OPAC PP/AL X 5 COMPR. FILM. P-RF 5 78.31 15.662000 15.662000 7.831000

376 J02AC02 ITRACONAZOLUM* ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 72.22 4.814666 3.290666 1.645333

377 J02AC02 ITRACONAZOLUM* ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 49.36 3.290666 3.290666 1.645333

378 J02AC02 ITRACONAZOLUM* ITRACONAZOL 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 116.70 7.780000 3.290666 1.645333

379 J02AC02 ITRACONAZOLUM* ITRACONAZOL 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 116.66 7.777333 3.290666 1.645333

380 J02AC02 ITRACONAZOLUM* OMICRAL 100 mg CAPS. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 86.10 5.740000 3.290666 1.645333

381 J02AC02 ITRACONAZOLUM* SPORILIN 100 mg CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 112.79 7.519333 3.290666 1.645333

382 J05AB11 VALACYCLOVIRUM* VALDACIR 500 mg COMPR. FILM 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 68.32 6.832000 6.832000 3.416000

383 J05AB11 VALACYCLOVIRUM* VALTREX 500 mg COMPR. FILM. 500mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 94.50 9.450000 6.832000 3.416000

384 J05AB15 BRIVUDINUM*# BRIVAL 125mg COMPR. 125mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 BLIST. PVC/AL X 7 COMPR. P-RF 7 312.29 44.612857 44.612857 22.306428

385 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 24.53 0.490600 0.490600 0.245300

386 L02AE02 LEUPRORELINUM***# LUCRIN DEPOT 11,25mg

LIOF.+ SOLV. PT. SUSP. INJ. ELIB. PREL. 11,25mg ABBOTT LABORATORIES LTD. SPANIA

CUTIE X 1 KIT X 1 FLAC. CU LIOFILIZAT (MICROSFERE) + 1 FIOLA X 2 ML SOLV. + 1 SERINGA + 2 ACE SI TA S/P-RF 1 938.54 938.540000 938.540000 469.270000

387 L02AE02 LEUPRORELINUM***# LUCRIN DEPOT 3,75mg

LIOF.+ SOLV. PT. SUSP. INJ. ELIB. PREL. 3,75mg ABBOTT LABORATORIES LTD. SPANIA

CUTIE X 1 KIT X 1 FLAC. CU LIOFILIZAT (MICROSFERE) + 1 FIOLA X 2 ML SOLV. + 1 SERINGA SI TAMPON IMB S/P-RF 1 407.81 407.810000 407.810000 203.905000

388 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 1 414.20 414.200000 414.200000 207.100000

389 L02AE04 TRIPTORELINUM***# DIPHERELINE 0,1 mgLIOF. + SOLV. PT. SOL. INJ. 0,1mg BEAUFOUR IPSEN PHARMA FRANTA

CUTIE X 7 FLAC. CU LIOF. PT. SOL. INJ. + 7 FIOLE X 1 ML SOLV. S/P-RF 7 126.39 18.055714 18.055714 9.027857

390 L02AE04 TRIPTORELINUM***# DIPHERELINE (R) 11,25 mg

LIOF.+ SOLV. PT. SUSP. INJ. I.M. ELIB. PREL. 11,25mg BEAUFOUR IPSEN PHARMA FRANTA

CUTIE X 1 FLAC. LIOF. + 1 FIOLA X 2 ML SOLV. + O SERINGA X 3 ML + 2 ACE PTR. INJECTIE S/P-RF 1 1116.81 1116.810000 1116.810000 558.405000

391 L02AE04 TRIPTORELINUM***# DIPHERELINE (R) 3,75 mg

LIOF.+ SOLV. PT. SUSP. INJ. I.M. ELIB. PREL. 3,75mg BEAUFOUR IPSEN PHARMA FRANTA

CUTIE X 1 FLAC. LIOF. + 1 FIOLA X 2 ML SOLV. + O SERINGA X 3 ML + 2 ACE PTR. INJECTIE S/P-RF 1 418.02 418.020000 418.020000 209.010000

392 L04AX01 AZATHIOPRINUM* IMURAN (R) COMPR. FILM. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 75.98 0.759800 0.759800 0.379900

393 M01AC01 PIROXICAMUM PIROXSAL 20 mg COMPR. 20mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST.PVC/ AL X 10 COMPR. P-6L 20 2.48 0.124000 0.111500 0.055750

394 M01AC01 PIROXICAMUM FLAMEXIN COMPR. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 3 BLIST. PVC-PDVC/AL-LAC PVDC X 10 COMPR. P-6L 30 27.24 0.908000 0.111500 0.055750

395 M01AC01 PIROXICAMUM FLAMEXIN COMPR. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 BLIST. PVC-PDVC/AL-LAC PVDC X 10 COMPR. P-6L 10 16.52 1.652000 0.111500 0.055750

396 M01AC01 PIROXICAMUM PIROXICAM LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3.47 0.173500 0.111500 0.055750

397 M01AC01 PIROXICAMUM PIROXICAM 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 4.18 0.209000 0.111500 0.055750

398 M01AC01 PIROXICAMUM N - PIROXICAM MEDUMAN 20 mg COMPR. 20mg MEDUMAN S.A. ROMANIA CUTIE X 1 FLAC. DIN PEJD X 20 COMPR. P-6L 20 2.23 0.111500 0.111500 0.055750

399 M01AC01 PIROXICAMUM PIROXICAM 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.33 0.116500 0.111500 0.055750

400 M01AC01 PIROXICAMUM FLAMEXIN COMPR. EFF. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 BLIST. AL-PE/AL X 10 COMPR. EFF. P-6L 10 19.54 1.954000 1.515000 0.757500

Pagina 14 din 23

Page 51: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

401 M01AC01 PIROXICAMUM FLAMEXIN COMPR. EFF. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 2 BLIST. AL-PE/AL X 10 COMPR. EFF. P-6L 20 36.96 1.848000 1.515000 0.757500

402 M01AC01 PIROXICAMUM FLAMEXIN COMPR. EFF. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 3 BLIST. AL-PE/AL X 10 COMPR. EFF. P-6L 30 45.45 1.515000 1.515000 0.757500

403 M01AC01 PIROXICAMUM FLAMEXIN (R) PULB. PT. SOL. ORALA 20mg/plic CHIESI FARMACEUTICI SPA ITALIA

CUTIE X 20 PLICURI DUBLU COMPARTIMENTAT X 3 G PULB. PT. SOL. ORALA P-6L 20 25.70 1.285000 1.285000 0.642500

404 M01AC01 PIROXICAMUM FELDENE (R) 20 mg/ml SOL. INJ. 20mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 6 FIOLE DIN STICLA BRUNA X 1 ML P-RF 6 8.97 1.495000 1.495000 0.747500

405 M01AC01 PIROXICAMUM HOTEMIN SOL. INJ. 20mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 BLIST. C-PET/PE X 5 FIOLE X 1 ML SOL. INJ. P-RF 5 11.05 2.210000 1.495000 0.747500

406 M01AC01 PIROXICAMUM PIROXICAM 20 mg SUPOZ. 20mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE X 5 SUPOZ. P-6L 10 2.39 0.239000 0.239000 0.119500

407 M01AC01 PIROXICAMUM PIROXICAM 40 mg SUPOZ. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE AL-PE X 3 SUPOZ. P-6L 6 2.31 0.385000 0.385000 0.192500

408 M01AC05 LORNOXICAMUM XEFO (R) 4 mg COMPR. FILM. 4mg NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 17.32 0.577333 0.577333 0.288666

409 M01AC05 LORNOXICAMUM XEFO (R) 4 mg COMPR. FILM. 4mg NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 11.69 0.584500 0.577333 0.288666

410 M01AC05 LORNOXICAMUM XEFO (R) 4 mg COMPR. FILM. 4mg NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 5.82 0.582000 0.577333 0.288666

411 M01AC05 LORNOXICAMUM XEFO (R) 8 mg COMPR. FILM. 8mg NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 10.97 1.097000 0.887666 0.443833

412 M01AC05 LORNOXICAMUM XEFO (R) 8 mg COMPR. FILM. 8mg NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 22.20 1.110000 0.887666 0.443833

413 M01AC05 LORNOXICAMUM XEFO (R) 8 mg COMPR. FILM. 8mg NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 26.63 0.887666 0.887666 0.443833

414 M01AC05 LORNOXICAMUM XEFO 8 mg/ 2 ml PULB. + SOLV. PT. SOL. INJ. 8mg/2ml NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 10 FLAC. CU PULB. PT. SOL. INJ. + 10 FLAC. X 2 ML SOLV P-RF 10 131.27 13.127000 13.127000 6.563500

415 M01AE17 DEXKETOPROFENUM TADOR 25 mg COMPR. FILM. 25mg BERLIN CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 10 13.19 1.319000 1.319000 0.659500

416 M01AE17 DEXKETOPROFENUM TADOR INJECT SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml MENARINI INTERNATIONAL OPERATIONS S.A. LUXEMBOURG CUTIE X 5 FIOLE X 2 ML SOL. INJ./CONC. PT.SOL.PERF. P-RF 5 28.66 5.732000 5.732000 2.866000

417 M01AH01 CELECOXIBUM CELEBREX 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 61.73 2.057666 2.057666 1.028833

418 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 32.05 3.205000 2.945000 1.472500

419 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 88.35 2.945000 2.945000 1.472500

420 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 7 32.94 4.705714 4.470000 2.235000

421 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg MERCK SHARP & DOHME ROMANIA CUTIE X2 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 28 125.16 4.470000 4.470000 2.235000

422 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 63.70 4.550000 4.470000 2.235000

423 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 63.70 4.550000 4.470000 2.235000

424 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 7 27.01 3.858571 3.546428 1.773214

425 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 52.28 3.734285 3.546428 1.773214

426 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 28 99.30 3.546428 3.546428 1.773214

427 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 52.28 3.734285 3.546428 1.773214

428 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 55.53 3.966428 3.767500 1.883750

429 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 7 28.69 4.098571 3.767500 1.883750

430 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 55.53 3.966428 3.767500 1.883750

431 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 28 105.49 3.767500 3.767500 1.883750

432 M01AX05 GLUCOSAMINUM DONA (R) PULB. PT. SOL. ORALA 150mg/plic ROTTAPHARM SPA ITALIA CUTIE X 20 PLICURI UNIDOZA CU PULB. P-6L 20 40.56 2.028000 2.028000 1.014000

433 M01AX17 NIMESULIDUM LEMESIL COMPR. 100mg ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9.14 0.457000 0.336000 0.168000

434 M01AX17 NIMESULIDUM AULIN (R) 100 mg COMPR. 100mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 7.03 0.703000 0.336000 0.168000

435 M01AX17 NIMESULIDUM NIMESULID 100 mg COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 4.56 0.456000 0.336000 0.168000

436 M01AX17 NIMESULIDUM NIMESULID SLAVIA COMPR. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 6.78 0.678000 0.336000 0.168000

437 M01AX17 NIMESULIDUM COXTRAL COMPR. 100mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. P-RF 10 4.51 0.451000 0.336000 0.168000

438 M01AX17 NIMESULIDUM COXTRAL COMPR. 100mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 COMPR. P-RF 30 12.03 0.401000 0.336000 0.168000

439 M01AX17 NIMESULIDUM NIMESULID LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 6.81 0.681000 0.336000 0.168000

440 M01AX17 NIMESULIDUM APONIL COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7.70 0.385000 0.336000 0.168000

441 M01AX17 NIMESULIDUM APONIL COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 4.25 0.425000 0.336000 0.168000

442 M01AX17 NIMESULIDUM NIMESULID ARENA 100 mg COMPR. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 4.48 0.448000 0.336000 0.168000

Pagina 15 din 23

Page 52: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

443 M01AX17 NIMESULIDUM NISE 100 mg COMPR. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 3.36 0.336000 0.336000 0.168000

444 M01AX17 NIMESULIDUM NIMESULID FARMEX 100 mg COMPR. 100mg FARMEX COMPANY SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. P-RF 10 6.76 0.676000 0.336000 0.168000

445 M01AX17 NIMESULIDUM AULIN (R) GRAN. PT. SUSP. ORALA 100mg/plic CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA

CUTIE X 15 PLICURI HARTIE/AL/HDPE/FOLIE SURLYN X 2 G GRAN. SUSP. ORALA P-RF 15 10.55 0.703333 0.703333 0.351666

446 M01AX17 NIMESULIDUM NIMESIL GRAN. PT. SUSP. ORALA 100mg/plic LAB. GUIDOTTI SPA ITALIA CUTIE X 9 PLICURI X 2 G GRAN. PT. SUSP. ORALA P-RF 9 7.20 0.800000 0.703333 0.351666

447 M03BX01 BACLOFENUM LIORESAL (R) COMPR. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 19.11 0.382200 0.382200 0.191100

448 M03BX01 BACLOFENUM LIORESAL (R) COMPR. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 31.43 0.628600 0.628600 0.314300

449 M05BA04 ACIDUM ALENDRONICUM* FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. AL/AL IN PORTOFEL X 2 COMPR. P-6L 2 34.86 17.430000 17.430000 8.715000

450 M05BA06 ACIDUM IBANDRONICUM* BONVIVA 150mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 COMPR. FILM.( BLIST. AL/AL) P-6L 1 125.77 125.770000 124.446666 62.223333

451 M05BA06 ACIDUM IBANDRONICUM* BONVIVA 150mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 3 COMPR. FILM.( BLIST. AL/AL) P-6L 3 373.34 124.446666 124.446666 62.223333

452 M05BA06 ACIDUM IBANDRONICUM* BONVIVA 3mg/3ml SOL. INJ. IN SERINGA PREUMPLUTA 1mg/1ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA DIN STICLA X 3 ML SOL. INJ. + 1 AC P-6L 1 402.98 402.980000 402.980000 201.490000

453 M05BA07 ACIDUM RISEDRONICUM* RISENDROS 35 mg COMPR. FILM. 35mg ZENTIVA A.S. CEHIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 4 COMPR. FILM. P-6L 4 108.36 27.090000 19.780000 9.890000

454 M05BA07 ACIDUM RISEDRONICUM* RISEDRONAT TEVA 35 mg COMPR. FILM. 35mg TEVA PHARMACEUTICAL S.R.L. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L 4 84.97 21.242500 19.780000 9.890000

455 M05BA07 ACIDUM RISEDRONICUM* JUVERITAL 35 mg COMPR. FILM. 35mg OZONE LABORATORIES BV OLANDA CUTIE X BLISTER PVC-PE-PVDC/AL X 4 COMPRIMATE FILMATE P-6L 4 79.12 19.780000 19.780000 9.890000

456 M05BA07 ACIDUM RISEDRONICUM* ACTONEL (R) SAPTAMANAL COMPR. FILM. 35mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. X 4 COMPR. FILM. P-6L 4 121.73 30.432500 19.780000 9.890000

457 M05BB03

COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)* FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UI MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.) P-6L 4 84.37 21.092500 21.092500 10.546250

458 M05BB03

COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)* FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UI MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 2 COMPR. (1 PLIANT CU BLIST. AL/AL X 2 COMPR.) P-6L 2 44.42 22.210000 21.092500 10.546250

459 M05BB03

COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)* FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UI MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 2 COMPR. (1 PLIANT CU BLIST. AL/AL X 2 COMPR.) P-6L 2 44.42 22.210000 21.092500 10.546250

460 M05BB03

COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)* FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UI MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.) P-6L 4 84.37 21.092500 21.092500 10.546250

461 M05BX03 STRONTIUM RANELATUM* OSSEOR 2 g GRAN. PT. SUSP. ORALA 2g LES LAB. SERVIER FRANTA CUTIE X 14 PLICURI HARTI-PE-AL/PE GRAN. PT. SUSP. ORALA P-RF 14 98.34 7.024285 5.855000 2.927500

462 M05BX03 STRONTIUM RANELATUM* OSSEOR 2 g GRAN. PT. SUSP. ORALA 2g LES LAB. SERVIER FRANTA CUTIE X 28 PLICURI HARTI-PE-AL/PE GRAN. PT. SUSP. ORALA P-RF 28 163.94 5.855000 5.855000 2.927500

463 N02AA05 OXYCODONUM*# OXYCONTIN (R) 10 mg COMPR. FILM. ELIB. MODIF. 10 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. X 56 COMPR. FILM. ELIB. MODIF. P-TS 56 109.69 1.958750 1.958750 0.979375

464 N02AA05 OXYCODONUM*# OXYCONTIN (R) 20 mg COMPR. FILM. ELIB. MODIF. 20 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. X 56 COMPR. FILM. ELIB. MODIF. P-TS 56 201.54 3.598928 3.598928 1.799464

465 N02AA05 OXYCODONUM*# OXYCONTIN (R) 40 mg COMPR. FILM. ELIB. MODIF. 40 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. X 56 COMPR. FILM. ELIB. MODIF. P-TS 56 373.69 6.673035 6.673035 3.336517

466 N02AA05 OXYCODONUM*# OXYCONTIN (R) 80 mg COMPR. FILM. ELIB. MODIF. 80mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. X 56 COMPR. FILM. ELIB. MODIF. P-TS 56 617.28 11.022857 11.022857 5.511428

467 N02AA08 DIHYDROCODEINUM* DHC CONTINUS 120 mg COMPR. ELIB. PREL. 120mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. P-RF 56 125.00 2.232142 2.232142 1.116071

468 N02AA08 DIHYDROCODEINUM* DHC CONTINUS 60 mg COMPR. ELIB. PREL. 60mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. P-RF 56 27.55 0.491964 0.491964 0.245982

469 N02AA08 DIHYDROCODEINUM* DHC CONTINUS 90 mg COMPR. ELIB. PREL. 90mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. P-RF 56 95.49 1.705178 1.705178 0.852589

470 N02AX52

COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 3 BLIST. PP OPAC/AL X 10 COMPR. FILM. P-RF 30 33.73 1.124333 1.085200 0.542600

471 N02AX52

COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC OPAC/AL X 10 COMPR. FILM. P-RF 10 11.40 1.140000 1.085200 0.542600

472 N02AX52

COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 2 BLIST. PVC OPAC/AL X 10 COMPR. FILM. P-RF 20 22.51 1.125500 1.085200 0.542600

Pagina 16 din 23

Page 53: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

473 N02AX52

COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 3 BLIST. PVC OPAC/AL X 10 COMPR. FILM. P-RF 30 33.73 1.124333 1.085200 0.542600

474 N02AX52

COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PP OPAC/AL X 10 COMPR. FILM. P-RF 10 11.40 1.140000 1.085200 0.542600

475 N02AX52

COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 5 BLIST. PVC OPAC/AL X 10 COMPR. FILM. P-RF 50 54.26 1.085200 1.085200 0.542600

476 N02AX52

COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 5 BLIST. PP OPAC/AL X 10 COMPR. FILM. P-RF 50 54.26 1.085200 1.085200 0.542600

477 N02AX52

COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 2 BLIST. PP OPAC/AL X 10 COMPR. FILM. P-RF 20 22.51 1.125500 1.085200 0.542600

478 N03AE01 CLONAZEPAMUM RIVOTRIL COMPR. 0,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 COMPR. P-RF 50 6.47 0.129400 0.129400 0.064700

479 N03AE01 CLONAZEPAMUM RIVOTRIL (R) COMPR. 2mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 6.16 0.205333 0.205333 0.102666

480 N03AX16 PREGABALINUM**# LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 71.51 5.107857 4.843928 2.421964

481 N03AX16 PREGABALINUM**# LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 271.26 4.843928 4.843928 2.421964

482 N03AX16 PREGABALINUM**# LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 401.20 7.164285 7.164285 3.582142

483 N03AX16 PREGABALINUM**# LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 107.30 7.664285 7.164285 3.582142

484 N03AX16 PREGABALINUM**# LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 50.44 3.602857 3.244821 1.622410

485 N03AX16 PREGABALINUM**# LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 181.71 3.244821 3.244821 1.622410

486 N04AA02 BIPERIDENUM AKINETON COMPR. 2mg DESMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 9.92 0.198400 0.198400 0.099200

487 N04BC05 PRAMIPEXOLUM* OPRYMEA 0,088mg COMPR. 0,088mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 18.55 0.618333 0.618333 0.309166

488 N04BC05 PRAMIPEXOLUM* MIRAPEXIN 0,18 mg COMPR. 0,18mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 46.73 1.557666 1.193000 0.596500

489 N04BC05 PRAMIPEXOLUM* OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 35.79 1.193000 1.193000 0.596500

490 N04BC05 PRAMIPEXOLUM* MIRAPEXIN 0,7 mg COMPR. 0,7mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 157.60 5.253333 3.965000 1.982500

491 N04BC05 PRAMIPEXOLUM* OPRYMEA 0,7mg COMPR. 0,7mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 118.95 3.965000 3.965000 1.982500

492 N04BC08 PIRIBEDILUM* PRONORAN 50 mg DRAJ. ELIB. PREL. 50mg LES LAB. SERVIER IND. FRANTA CUTIE X 2 BLIST. AL/PVC X 15 DRAJ. CU ELIB. PREL. P-RF 30 26.93 0.897666 0.897666 0.448833

493 N05AL03 TIAPRIDUM TIAPRIDAL (R) 100 mg COMPR. 100mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 8.67 0.433500 0.433500 0.216750

494 N05AL03 TIAPRIDUM TIAPRIDAL 100 mg/2 ml SOL. INJ. 100mg/2ml SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 SUPORTURI PVC X 6 FIOLE X 2 ML P-RF 12 8.94 0.745000 0.745000 0.372500

495 N05BE01 BUSPIRONUM SPITOMIN 10 mg COMPR. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-RF 60 16.66 0.277666 0.277666 0.138833

496 N05BE01 BUSPIRONUM SPITOMIN 5 mg COMPR. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-RF 60 10.17 0.169500 0.169500 0.084750

497 N06AA21 MAPROTILINUM* LUDIOMIL (R) 10 mg COMPR. FILM. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 50 14.25 0.285000 0.285000 0.142500

498 N06AA21 MAPROTILINUM* LUDIOMIL (R) 25 mg COMPR. FILM. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 9.80 0.326666 0.326666 0.163333

499 N06AB10 ESCITALOPRAMUM** CIPRALEX 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. ALBE PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 84.85 3.030357 3.030357 1.515178

500 N06AB10 ESCITALOPRAMUM** CIPRALEX 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 1 BLIST. ALB PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 14 58.17 4.155000 3.030357 1.515178

501 N06AB10 ESCITALOPRAMUM** CIPRALEX 5 mg COMPR. FILM. 5mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. ALBE PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 46.64 1.665714 1.665714 0.832857

502 N06AX05 TRAZODONUM** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 20 23.42 1.171000 1.171000 0.585500

503 N06AX14 TIANEPTINUM** COAXIL (R) DRAJ. 12,5mg LES LAB. SERVIER IND. FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ. P-RF 30 32.73 1.091000 1.091000 0.545500

504 N06AX17 MILNACIPRANUM** IXEL CAPS. 25mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE X 4 BLIST. AL/PVC X 14 CAPS. P-RF 56 67.17 1.199464 1.199464 0.599732

505 N06AX17 MILNACIPRANUM** IXEL CAPS. 50mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE X 4 BLIST. AL/PVC X 14 CAPS. P-RF 56 110.10 1.966071 1.966071 0.983035

506 N06AX12 BUPROPIONUM**# WELLBUTRIN SR 150 mg COMPR. FILM. ELIB. PREL. 150mg GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-RF 60 125.33 2.088833 2.088833 1.044416

507 N06AX21 DULOXETINUM** CYMBALTA 30mg CAPS. GASTROREZ. 30mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 98.96 3.534285 3.534285 1.767142

508 N06AX21 DULOXETINUM** CYMBALTA 60mg CAPS. GASTROREZ. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 167.97 5.998928 5.998928 2.999464

Pagina 17 din 23

Page 54: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

509 N06BX16 PRAMIRACETAMUM**# PRAMISTAR COMPR. FILM. 600mg F.I.R.M.A. S.P.A. (MENARINI GROUP) ITALIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR.FILM. P-6L 20 67.54 3.377000 3.377000 1.688500

510 N06BX18 VINPOCETINUM VIMPOCETIN 5 mg CAPS. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. X 10 CAPS. P-6L 50 13.94 0.278800 0.278800 0.139400

511 N06BX18 VINPOCETINUM CAVINTON (R) FORTE COMPR. 10mg GEDEON RICHTER LTD. UNGARIA CUTIE X 2 BLIST. X 15 COMPR. P-6L 30 13.57 0.452333 0.452333 0.226166

512 N06BX18 VINPOCETINUM CAVINTON (R) COMPR. 5mg GEDEON RICHTER PLC. UNGARIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-6L 50 14.87 0.297400 0.297400 0.148700

513 N07CA01 BETAHISTINUM BETASERC (R) 24 mg COMPR. 24mg SOLVAY PHARMACEUTICALS BV OLANDA CUTIE X 1 BLIST X 20 COMPR. P-6L 20 26.50 1.325000 1.325000 0.662500

514 N07CA01 BETAHISTINUM URUTAL 8 mg COMPR. 80mg A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 FLACON X 100 COMPR. P-6L 100 37.87 0.378700 0.257666 0.128833

515 N07CA01 BETAHISTINUM BETASERC (R) 8 mg COMPR. 8mg SOLVAY PHARMACEUTICALS BV OLANDA CUTIE X 4 BLIST. X 25 COMPR. P-6L 100 31.11 0.311100 0.257666 0.128833

516 N07CA01 BETAHISTINUM BETASERC (R) 8 mg COMPR. 8mg SOLVAY PHARMACEUTICALS BV OLANDA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 13.87 0.462333 0.257666 0.128833

517 N07CA01 BETAHISTINUM MICROSER COMPR. 8mg PRODOTTI FORMENTI ITALIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 25.02 0.500400 0.257666 0.128833

518 N07CA01 BETAHISTINUM VESTIBO 8 mg COMPR. 8mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 7.73 0.257666 0.257666 0.128833

519 N07CA01 BETAHISTINUM VESTIBO 8 mg COMPR. 8mg ACTAVIS GROUP HF. ISLANDA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 100 25.79 0.257900 0.257666 0.128833

520 N07CA52

COMBINATII (CINARIZINUM +DIMENHIDRINATUM) ARLEVERT COMPR. FARA CONCENTRATIE HENNIG ARZNEIMITTEL GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 25 COMPR. P-RF 50 30.26 0.605200 0.511041 0.255520

521 N07CA52

COMBINATII (CINARIZINUM +DIMENHIDRINATUM) ARLEVERT COMPR. FARA CONCENTRATIE HENNIG ARZNEIMITTEL GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 24 COMPR. P-RF 48 24.53 0.511041 0.511041 0.255520

522 N07XXN3

HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA** CEREBROLYSIN (R) SOL. INJ./PERF. 215,2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 10 ML P-RF 5 123.37 24.674000 24.674000 12.337000

523 N07XXN3

HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA** CEREBROLYSIN (R) SOL. INJ./PERF. 215,2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 1 ML P-RF 10 36.86 3.686000 3.686000 1.843000

524 N07XXN3

HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA** CEREBROLYSIN (R) SOL. INJ./PERF. 215,2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 5 ML P-RF 5 82.25 16.450000 16.450000 8.225000

525 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL (R) COMPR. FILM. 200mg SANOFI-SYNTHELABO LTD. MAREA BRITANIE CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L 60 31.40 0.523333 0.523333 0.261666

526 R01AD05 BUDESONIDUM* TAFEN NASAL SPRAY NAZ.,SUSP. 50mcg/doza LEK PHARMACEUTICALS D.D. SLOVENIA

CUTIE X 1 FLACON DIN STICLA BRUNA X 200 DOZE, PREVAZUT CU POMPA DOZATOARE P-RF 1 15.96 15.960000 15.960000 7.980000

527 R01AD05 BUDESONIDUM* RHINOCORT (R) AQUA SPRAY NAZAL SUSP. 32mcg/doza ASTRAZENECA AB SUEDIA CUTIE X 1 FLACON X 120 DOZE PREVAZUT CU POMPA DOZATOARE P-RF 1 23.87 23.870000 23.870000 11.935000

528 R01AD08 FLUTICASONUM PROPIONAT* FLIXONASE (R) SPRAY NAZAL SUSP. 50mcg/doza GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON X 120 DOZE, PREVAZUT CU POMPA DOZATOARE P-RF 1 37.65 37.650000 37.650000 18.825000

529 R01AD09 MOMETASONUM* NASONEX SPRAY NAZAL SUSP. 50mcg/doza SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 FLACON PP X 140 DOZE P-RF 1 55.50 55.500000 55.500000 27.750000

530 R03AC04 FENOTEROLUM BEROTEC N - 100 mcg

SOL. DE INHALAT PRESURIZATA 100mcg/doza

BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA

CUTIE X 1 FLACON PRESURIZAT X 200 DOZE SOL. DE INHALAT PRESURIZATA P-6L 1 15.64 15.640000 15.640000 7.820000

531 R03AK03

COMBINATII (FENOTEROLUM + IPRATROPIUM)* BERODUAL (R) N AEROSOL SOL. INHAL. 0,020mg+0,050mg

BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA

CUTIE X 1 FLACON PRESURIZAT DIN OTEL X 200 DOZE SOLUTIE DE INHALAT PRESURIZATA P-6L 1 37.81 37.810000 37.810000 18.905000

532 R03AK06 SALMETEROLUM+FLUTICASONUM* SERETIDE DISKUS 50/100 PULB. INHAL. 50mg/100mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE

CUTIE X 1DISPOZITIV DE INHALAT X 60 DOZE PULB. DE INHAL. P-6L 1 110.26 110.260000 110.260000 55.130000

Pagina 18 din 23

Page 55: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

533 R03AK06 SALMETEROLUM+FLUTICASONUM* SERETIDE DISKUS 50/250 PULB. INHAL. 50mg/250mg GLAXOWELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 DISPOZITIV DE INHALAT X 60 DOZE PULB. DE INHAL. P-6L 1 147.74 147.740000 147.740000 73.870000

534 R03AK06 SALMETEROLUM+FLUTICASONUM* SERETIDE DISKUS 50/500 PULB. INHAL. 50mg/500mg GLAXOWELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 DISPOZITIV DE INHALAT X 60 DOZE PULB. DE INHAL. P-6L 1 210.21 210.210000 210.210000 105.105000

535 R03AK06 SALMETEROLUM+FLUTICASONUM*

SERETIDE 25 mcg/125 mcg INHALER CFC FREE

SUSP. INHAL. PRESURIZATA 25mcg/125mcg GLAXOWELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA P-6L 1 154.27 154.270000 154.270000 77.135000

536 R03AK06 SALMETEROLUM+FLUTICASONUM*

SERETIDE 25 mcg/250 mcg INHALER CFC FREE

SUSP. INHAL. PRESURIZATA 25mcg/250mcg GLAXOWELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA P-6L 1 219.37 219.370000 219.370000 109.685000

537 R03AK06 SALMETEROLUM+FLUTICASONUM*

SERETIDE 25 mcg/50 mcg INHALER CFC FREE

SUSP. INHAL. PRESURIZATA 25mcg/50mcg GLAXOWELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA P-6L 1 115.10 115.100000 115.100000 57.550000

538 R03AK07

COMBINATII (BUDESONIDUM + FORMOTEROLUM)*

SYMBICORT (R) TURBUHALER (R) 160/4,5 mcg PULB. INHAL. 160/4,5mcg ASTRAZENECA AB SUEDIA

CUTIE X 1 RECIPIENT MULTIDOZA X 120 DOZE, PREVAZUT CU DISPOZITIV DE ADM. + DISPOZITIV INDICATOR AL N P-6L 1 213.89 213.890000 112.780000 56.390000

539 R03AK07

COMBINATII (BUDESONIDUM + FORMOTEROLUM)*

SYMBICORT (R) TURBUHALER (R) 160/4,5 mcg PULB. INHAL. 160/4,5mcg ASTRAZENECA AB SUEDIA

CUTIE X 1 RECIPIENT MULTIDOZA X 60 DOZE, PREVAZUT CU DISPOZITIV DE ADM. + DISPOZITIV INDICATOR AL NU P-6L 1 112.78 112.780000 112.780000 56.390000

540 R03AK07

COMBINATII (BUDESONIDUM + FORMOTEROLUM)*

SYMBICORT (R) TURBUHALER (R) 320/9 mcg PULB. INHAL. 320/9mcg ASTRAZENECA AB SUEDIA

CUTIE X 1 RECIPIENT MULTIDOZA X 60 DOZE, PREVAZUT CU UN DISPOZITIV DE ADM. + DISPOZITIV INDICATOR AL P-6L 1 213.89 213.890000 213.890000 106.945000

541 R03AK07

COMBINATII (BUDESONIDUM + FORMOTEROLUM)*

SYMBICORT (R) TURBUHALER (R) 80/4,5 mcg PULB. INHAL. 80/4,5mcg ASTRAZENECA AB SUEDIA

CUTIE X 1 RECIPIENT MULTIDOZA X 60 DOZE, PREVAZUT CU DISPOZITIV DE ADM. + DISPOZITIV INDICATOR AL NU P-6L 1 89.30 89.300000 89.300000 44.650000

542 R03AK07

COMBINATII (BUDESONIDUM + FORMOTEROLUM)*

SYMBICORT (R) TURBUHALER (R) 80/4,5 mcg PULB. INHAL. 80/4,5mcg ASTRAZENECA AB SUEDIA

CUTIE X 1 RECIPIENT MULTIDOZA X 120 DOZE, PREVAZUT CU DISPOZITIV DE ADM. + DISPOZITIV INDICATOR AL N P-6L 1 169.36 169.360000 89.300000 44.650000

543 R03BA05 FLUTICASONUM PROPIONAT* FLIXOTIDE DISKUS 100 mcg PULB. INHAL. 100mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE P-RF 1 38.17 38.170000 38.170000 19.085000

544 R03BA05 FLUTICASONUM PROPIONAT* FLIXOTIDE DISKUS 250 mcg PULB. INHAL. 250mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE P-RF 1 79.30 79.300000 79.300000 39.650000

545 R03BA05 FLUTICASONUM PROPIONAT* FLIXOTIDE DISKUS 500 mcg PULB. INHAL. 500mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE P-RF 1 131.21 131.210000 131.210000 65.605000

546 R03BA05 FLUTICASONUM PROPIONAT* FLIXOTIDE 125 INHALER CFC - Free SUSP. INHAL. PRESURIZATA 125mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 FLACON PRESURIZAT DIN AL X 60 DOZE SUSP. DE INHALAT PRESURIZATA P-RF 1 41.87 41.870000 41.870000 20.935000

547 R03BA05 FLUTICASONUM PROPIONAT* FLIXOTIDE (R) 50 INHALER CFC - Free SUSP. INHAL. PRESURIZATA 50mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 FLACON PRESURIZAT X 120 DOZE X 50 MCG, PREVAZUT CU VALVA DOZATOARE P-RF 1 34.18 34.180000 34.180000 17.090000

548 R03BA05 FLUTICASONUM PROPIONAT* FLIXOTIDE NEBULES 0,5 mg/2 ml

SUSP. INHAL. PRIN NEBULIZATOR 0,5mg/2ml GLAXO WELLCOME UK LIMITED MAREA BRITANIE

CUTIE X 5 BLIST. PA-AL-PVC/HARTIE-PTF-AL X 2 FIOLE PEJD X 2,5ML CONTINAND 2ML SUSP. INHAL. PRIN NEB P-RF 10 29.46 2.946000 2.946000 1.473000

Pagina 19 din 23

Page 56: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

549 R03BA05 FLUTICASONUM PROPIONAT* FLIXOTIDE NEBULES 2 mg/2 ml

SUSP. INHAL. PRIN NEBULIZATOR 2mg/2ml GLAXO WELLCOME UK LIMITED MAREA BRITANIE

CUTIE X 5 BLIST. PA-AL-PVC/HARTIE-PTF-AL X 2 FIOLE PEJD X 2,5ML CONTINAND 2ML SUSP. INHAL. PRIN NEB P-RF 10 85.12 8.512000 8.512000 4.256000

550 R03BA07 MOMETASONUM* ASMANEX TWISTHALER 200 mcg PULB. INHAL. 200mcg/doza SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 DISPOZITIV DE ADM. X 60 DOZE P-6L 1 133.84 133.840000 80.780000 40.390000

551 R03BA07 MOMETASONUM* ASMANEX TWISTHALER 200 mcg PULB. INHAL. 200mcg/doza SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE P-6L 1 80.78 80.780000 80.780000 40.390000

552 R03BA07 MOMETASONUM* ASMANEX TWISTHALER 400 mcg PULB. INHAL. 400mcg/doza SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 DISPOZITIV DE ADM. X 60 DOZE P-6L 1 234.21 234.210000 234.210000 117.105000

553 R03BA08 CICLESONIDUM* ALVESCO 160 INHALER

SOL. DE INHALAT PRESURIZATA 160mcg/doza ALTANA PHARMA AG GERMANIA

CUTIE X 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA P-RF 1 121.36 121.360000 121.360000 60.680000

554 R03BA08 CICLESONIDUM* ALVESCO 160 INHALER

SOL. DE INHALAT PRESURIZATA 160mcg/doza ALTANA PHARMA AG GERMANIA

CUTIE X 1 FLAC. DIN AL CU VALVA DOZATOARE X 120 DOZE SOL. DE INHALAT PRESURIZATA P-RF 1 234.84 234.840000 121.360000 60.680000

555 R03BA08 CICLESONIDUM* ALVESCO 80 INHALER

SOL. DE INHALAT PRESURIZATA 80mcg/doza ALTANA PHARMA AG GERMANIA

CUTIE X 1 FLAC. DIN AL CU VALVA DOZATOARE X 120 DOZE SOL. DE INHALAT PRESURIZATA P-RF 1 212.71 212.710000 105.470000 52.735000

556 R03BA08 CICLESONIDUM* ALVESCO 80 INHALER

SOL. DE INHALAT PRESURIZATA 80mcg/doza ALTANA PHARMA AG GERMANIA

CUTIE X 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA P-RF 1 105.47 105.470000 105.470000 52.735000

557 R03BB04 TIOTROPIUM* SPIRIVA 18 mcg CAPS. CU PULB.INHAL. 18mcg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA

CUTIE X 3 BLIST.AL/PVC-AL X 10 CAPS. CU PULB. DE INHALAT + DISPOZITIV HANDIHALER P-RF 30 154.31 5.143666 5.143666 2.571833

558 R03DA05 AMINOPHYLLINUM MIOFILIN 100 mg CAPS. 100mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 2.40 0.120000 0.120000 0.060000

559 R03DA05 AMINOPHYLLINUM AMINOFILINA EEL COMPR. 100mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-RF 50 2.50 0.050000 0.036250 0.018125

560 R03DA05 AMINOPHYLLINUM AMINOFILINA 100 mg COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-RF 40 1.45 0.036250 0.036250 0.018125

561 R03DA05 AMINOPHYLLINUM AMINOFILINA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 4.11 0.205500 0.205500 0.102750

562 R03DA05 AMINOPHYLLINUM MIOFILIN SOL. INJ. 24mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE PREVAZUTE CU INEL DE RUPERE X 10 ML SOL.INJ. S/P-RF 5 7.03 1.406000 1.406000 0.703000

563 R03DC03 MONTELUKASTUM* SINGULAIR (R) COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC X 14 COMPR. FILM. P-RF 14 72.11 5.150714 4.886071 2.443035

564 R03DC03 MONTELUKASTUM* SINGULAIR (R) COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC X 14 COMPR. FILM. P-RF 28 136.81 4.886071 4.886071 2.443035

565 R03DC03 MONTELUKASTUM* SINGULAIR COMPR. MAST. 4mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P-RF 28 147.89 5.281785 5.281785 2.640892

566 R03DC03 MONTELUKASTUM* SINGULAIR COMPR. MAST. 4mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 7 COMPR. MAST. P-RF 14 77.97 5.569285 5.281785 2.640892

567 R03DC03 MONTELUKASTUM* SINGULAIR (R) COMPR. MAST. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P-RF 14 71.94 5.138571 4.873214 2.436607

568 R03DC03 MONTELUKASTUM* SINGULAIR (R) COMPR. MAST. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P-RF 28 136.45 4.873214 4.873214 2.436607

569 R03DC03 MONTELUKASTUM* SINGULAIR (R) GRANULE 4mg/plic MERCK SHARP & DOHME ROMANIA CUTIE X 28 PLICURI CU GRANULE P-RF 28 149.22 5.329285 5.329285 2.664642

570 R03DX03 FENSPIRIDUM EURESPAL 80 mg COMPR. FILM. 80mg LES LAB. SERVIER IND. FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 26.38 0.879333 0.879333 0.439666

571 R03DX03 FENSPIRIDUM EURESPAL 2 mg/ml SIROP 2mg/ml LES LAB. SERVIER IND. FRANTA CUTIE X 1 FLACON PVC DE CULOARE BRUNA X 150 ML P-6L 1 18.80 18.800000 18.800000 9.400000

572 R05CB15 ERDOSTEINUM ERDOMED 300 mg CAPS. 300mg CSC PHARMACEUTICALS HANDELS GMBH CEHIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 10 14.85 1.485000 1.485000 0.742500

573 R05CB15 ERDOSTEINUM ERDOMED (R) 175 PULB. PT. SUSP. ORALA 175mg/5ml CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 FLAC. PULB. PT. 100 ML SUSP. ORALA P-6L 1 23.42 23.420000 23.420000 11.710000

574 R05DA09 DEXTROMETHORPHANUM TUSSIN COMPR. 10mg EUROPHARM SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-RF 20 3.50 0.175000 0.175000 0.087500

575 R05DA09 DEXTROMETHORPHANUM TUSSIN FORTE COMPR. 20mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6.36 0.318000 0.318000 0.159000

Pagina 20 din 23

Page 57: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

576 R05DA09 DEXTROMETHORPHANUM HUMEX SIROP 0,1% LAB. URGO SA FRANTA

CUTIE X 1 FLACON X 125 ML SIROP + O MASURA DOZATOARE PENTRU MASURAREA VOLUMELOR 2,5ML; 5ML; 7,5ML; 1 P-RF 1 7.95 7.950000 7.950000 3.975000

577 R05DA09 DEXTROMETHORPHANUM HUMEX 0,133 g/100 ml SIROP 0,13% LAB. URGO SA FRANTACUTIE X 1 FLACON X 200 ML + O MASURA DOZATOARE DIN POLIPROPILENA P-RF 1 10.17 10.170000 10.170000 5.085000

578 R05DA09 DEXTROMETHORPHANUM ROFEDEX SIROP 15mg/5ml BIOFARM SA ROMANIA CUTIE X 1 FLACON DIN STILCA BRUNA X 100 ML + MASURA DOZATOARE P-RF 1 4.95 4.950000 4.950000 2.475000

579 R05DA09 DEXTROMETHORPHANUM ROBITUSSIN JUNIOR SOL. ORALA 3,75mg/5ml WYETH WHITEHALL EXPORT GMBH AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SOL. ORALA P-RF 1 8.07 8.070000 8.070000 4.035000

580 R05DA09 DEXTROMETHORPHANUM ROBITUSSIN ANTITUSSICUM SOL. ORALA 7,5mg/5ml WYETH WHITEHALL EXPORT GMBH AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SOL. ORALA P-RF 1 8.07 8.070000 8.070000 4.035000

581 R06AE09 LEVOCETIRIZINUM XYZAL (R) COMPR. FILM. 5mg U.C.B. GMBH GERMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 15.89 1.589000 1.589000 0.794500

582 R06AE09 LEVOCETIRIZINUM XYZAL PIC. ORALE, SOL. 5mg/ml U.C.B. GMBH GERMANIA

CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL., PREVAZUT CU PICURATOR P-6L 1 34.01 34.010000 34.010000 17.005000

583 R06AX26 FEXOFENADINUM TELFAST (R) 120 mg COMPR. FILM. 120mg AVENTIS PHARMA DEUTSCHLAND GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 COMPR.FILM. P-6L 10 12.50 1.250000 1.122000 0.561000

584 R06AX26 FEXOFENADINUM EWOFEX 120 mg COMPR. FILM. 120mg EWOPHARMA INTERNATIONAL S.R.O. SLOVACIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 10 11.22 1.122000 1.122000 0.561000

585 R06AX26 FEXOFENADINUM TELFAST (R) 180 mg COMPR. FILM. 180mg AVENTIS PHARMA DEUTSCHLAND GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 10 18.20 1.820000 1.683000 0.841500

586 R06AX26 FEXOFENADINUM EWOFEX 180 mg COMPR. FILM. 180mg EWOPHARMA INTERNATIONAL S.R.O. SLOVACIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 10 16.83 1.683000 1.683000 0.841500

587 R06AX26 FEXOFENADINUM TELFAST (R) 30 mg COMPR. FILM. 30mg AVENTIS PHARMA DEUTSCHLAND GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 15 COMPR. FILM. P-6L 15 5.39 0.359333 0.359333 0.179666

588 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg SP EUROPE BELGIA CUTIE X 30COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 30 51.21 1.707000 1.707000 0.853500

589 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg SP EUROPE BELGIA CUTIE X 10 COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 10 20.43 2.043000 1.707000 0.853500

590 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg SP EUROPE BELGIA CUTIE X 7 COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 7 16.39 2.341428 1.707000 0.853500

591 R06AX27 DESLORATADINUM AERIUS 0,5mg/ml SIROP 0,5mg/ml SP EUROPE BELGIA CUTIE X 1 FLACON X 60 ML + LIGURITA DOZATOARE DE 2,5 ML SI 5 ML P-RF 1 9.48 9.480000 9.480000 4.740000

592 S01AA11 GENTAMICINUM GENTAMICIN SULPHATE PIC. OFT., SOL 0,3% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 10ML P-RF 1 4.42 4.420000 4.420000 2.210000

593 S01AA12 TOBRAMYCINUM TOBISOL PIC. OFT., SOL. 0,3% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 5 ML PIC. OFT., SOL. P-RF 1 3.84 3.840000 3.840000 1.920000

594 S01AA12 TOBRAMYCINUM TOBREX PIC. OFT.,SOL. 3mg/ml ALCON COUVREUR NV BELGIA

CUTIE X 1 FLACON DIN PEJD CU PICURATOR X 5 ML PIC. OFTALMICE, SOL. P-RF 1 10.62 10.620000 3.840000 1.920000

595 S01AA12 TOBRAMYCINUM TOBREX (R) UNG. OFT. 0,3% ALCON COUVREUR NV BELGIA CUTIE X 1 TUB DIN AL X 3,5 G UNGUENT OFTALMIC P-RF 1 8.10 8.100000 8.100000 4.050000

596 S01AA23 NETILMICINUM NETTACIN (R) PIC. OFT., SOL 0,3% S.I.F.I. SPA ITALIA CUTIE X 1 FLACON X 5ML P-RF 1 9.49 9.490000 1.812000 0.906000

597 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 27.18 1.812000 1.812000 0.906000

598 S01AA23 NETILMICINUM NETTAVISC 3mg/g UNG. OFT. 3mg/g S.I.F.I. SPA ITALIACUTIE X 1 TUB DIN AL X 5 G UNGUENT OFTALMIC, PREV. CU APLICATOR P-RF 1 30.51 30.510000 30.510000 15.255000

599 S01AX11 OFLOXACINUM FLOXAL (R) PICATURI OFT.-SOL. 0,3% DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE X 1 FLACON DIN PEJD X 5 ML PICATURI OFT., SOL. P-RF 1 13.57 13.570000 13.570000 6.785000

600 S01AX11 OFLOXACINUM FLOXAL (R) UNG. OFT. 0,3% DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE X 1 TUB DIN AL PREVAZUT CU APLICATOR X 3 G P-RF 1 14.42 14.420000 14.420000 7.210000

601 S01BA01 DEXAMETHASONUM DEXAMETAZONA RPH 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 7.07 7.070000 7.070000 3.535000

602 S01BA01 DEXAMETHASONUM DEXAMETAZONA RPH 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 12.93 12.930000 7.070000 3.535000

603 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 8.01 8.010000 7.070000 3.535000

604 S01BA06 BETAMETHASONUM OPHTAMESONE SOL. OFT. 0,1% DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLACON X 10ML P-RF 1 4.24 4.240000 4.240000 2.120000

605 S01CA01

COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX PIC. OFT.,SOL. FARA CONCENTRATIE S.I.F.I. SPA ITALIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT.SOL. P-RF 1 29.46 29.460000 29.460000 14.730000

606 S01CA01

COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX PIC. OFT.SOL. UNIDOZA FARA CONCENTRATIE S.I.F.I. SPA ITALIA CUTIE X 20 FLAC. UNIDOZA DIN PEJD X 0,3 ML PIC.OFT. SOL. P-RF 20 48.18 2.409000 2.409000 1.204500

Pagina 21 din 23

Page 58: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

607 S01CA01

COMBINATII (CLORAMPHENICOLUM+DEXAMETHASONUM) SPERSADEX COMP PICATURI OFT.-SOL. 5mg/ml+1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON X 5 ML SOL. OFT. + PICURATOR P-RF 1 11.76 11.760000 11.760000 5.880000

608 S01CA01

COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX ( R ) PICATURI OFT.-SUSP. 1mg+3mg ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON PICURATOR PEJD X 5 ML P-RF 1 14.44 14.440000 14.440000 7.220000

609 S01CA01

COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX (R) UNG. OFT. 1mg+3mg ALCON COUVREUR NV BELGIA CUTIE X 1 TUB AL, PREVAZUT CU APLICATOR PEID X 3,5 G P-RF 1 12.26 12.260000 12.260000 6.130000

610 S01GX09 OLOPATADINUM OPATANOL 1mg/ml PIC. OFT., SOL. 1mg/ml ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON X 5 ML P-RF 1 28.64 28.640000 28.640000 14.320000

611 S01XA02 RETINOLUM OCULOTECT GEL OFT. 10mg/g NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 TUB X 10 G GEL. OFT. P-6L 1 15.41 15.410000 15.410000 7.705000

A06AD15 MACROGOLUM*2

A08AX01 RIMONABANTUM****

C09BA09

COMBINATII (FOSINOPRILUM + HYDROCHLOROTHIAZIDUM)

C09DA03

COMBINATII (VALSARTANUM + HYDROCHLOROTHIAZIDUM)

C10BA02

COMBINATII (EZETIMIBUM + SIMVASTATINUM)

D05BB02 ACITRETINUM**D06BA01 SULFADIAZINUMD06BB10 IMIQUIMODUM*G03AC02 LYNESTRENOLUM*G03GA07 LUTROPINA ALFA****#G03XC01 RALOXIFENUMJ01DC10 CEFPROZILUM

NOTĂ:

- 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 corespunzătoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătății Publice;

- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătății Publice și cu aprobarea comisiilor de la nivelul Caselor Județene de Asigurări de Sănătate;

Pagina 22 din 23

Page 59: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (****) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MSP si cu aprobarea comisiilor de la nivelul Casei Nationale de Asigurari de Sanatate;

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (2) se prescrie numai in etapa pregătitoare pentru colonoscopie;

- Pentru medicamentele corespunzătoare DCI-urilor notate cu (#) regulile de prescriere sunt stabilite prin Contractul Cadru.

Pagina 23 din 23

Page 60: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

NR.CRT COD ATC DENUMIRE COMUNA INTERNATIONALA DENUMIRE COMERCIALA FORMA FARMACEUTICA CONCENTRATIE FIRMA DETINATOARE TARA DETINATOARE FORMA AMBALAJ PRESCCANT FL

PRET AMANUNTUL MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART 213 alin.(1) lit. a)

si f)

VAL.SUPORTATAT CNAS/ UT

(RON) PT. ADULTI

1 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.94 0.098000 0.098000 0.0980002 B01AA07 ACENOCUMAROLUM SINTROM (R) COMPR. 4mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 6.35 0.317500 0.317500 0.3175003 C01AA05 DIGOXINUM DIGOXIN 0,25 mg COMPR. 0,25mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 1.80 0.072000 0.072000 0.0720004 C01AA05 DIGOXINUM DIGOXIN 0,5 mg/2 ml SOL. INJ. 0,5mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. S/P-RF 5 4.25 0.850000 0.850000 0.8500005 C01AA05 DIGOXINUM LANOXIN SOLUTIE ORALA SOL. ORALA 0,05mg/ml THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA BRUNA X 60 ML SOL. ORALA + PIPETA X 1 ML P-RF 1 10.42 10.420000 10.420000 10.4200006 C03AA03 HYDROCHLOROTHIAZIDUM NEFRIX 25 mg COMPR. 25mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L 25 0.99 0.039600 0.039600 0.0396007 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 1.53 0.076500 0.075500 0.0755008 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.13 0.106500 0.075500 0.0755009 C03CA01 FUROSEMIDUM FUROSEMID EEL COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 1.83 0.091500 0.075500 0.075500

10 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 1.53 0.076500 0.075500 0.07550011 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.88 0.144000 0.075500 0.07550012 C03CA01 FUROSEMIDUM FUROSEMID ARENA 40 mg COMPR. 40mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 1.51 0.075500 0.075500 0.07550013 C03CA01 FUROSEMIDUM FUROSEMID 20 mg/2 ml SOL. INJ. 10mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 3.14 0.628000 0.628000 0.62800014 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER PLC UNGARIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 26.75 0.891666 0.891666 0.89166615 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER PLC UNGARIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 15.69 0.523000 0.523000 0.52300016 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA EEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4.05 0.202500 0.202500 0.20250017 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA OZONE 25 mg COMPR. 25mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 10.14 0.202800 0.202500 0.20250018 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 12.68 0.253600 0.202500 0.20250019 C03DA01 SPIRONOLACTONUM ALSPIRON 25 mg COMPR. FILM. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 4.05 0.202500 0.202500 0.20250020 C03DA01 SPIRONOLACTONUM ALSPIRON 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 12.91 0.645500 0.645500 0.64550021 C07AB02 METOPROLOLUM BLOXAN COMPR. 100mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC/PVDC TRANSPARENT/AL X 10 COMPR. P-6L 30 13.19 0.439666 0.185500 0.18550022 C07AB02 METOPROLOLUM BETAPROL 100 mg COMPR. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10.28 0.342666 0.185500 0.18550023 C07AB02 METOPROLOLUM EGILOK 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 6.16 0.308000 0.185500 0.18550024 C07AB02 METOPROLOLUM METOPROLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10.11 0.337000 0.185500 0.185500

ANEXA 3SECŢIUNEA C1 - CU PROCENT DE COMPENSARE 100% DIN PREŢUL DE REFERINŢĂ -

CUPRINDE DCI-urile UTILIZATE ÎN TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOLI PENTRU CARE DECONTAREA SE FACE PE BAZA PROTOCOALELOR TERAPEUTICE CU MONITORIZAREA PRESCRIERII ŞI CONSUMULUI PRIN COMISIILE PARITARE; MEDICAMENTELE DIN ACEASTĂ SUBLISTĂ SE ELIBEREAZĂ PRIN FARMACII CU CIRCUIT DESCHIS PE

BAZĂ DE PRESCRIPŢIE MEDICALĂ CU REŢINERE ÎN FARMACIE ( P-RF) CONFORM HG NR. 720/2008

VALABILĂ ÎNCEPÂND CU 1 APRILIE 2009

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

Pagina 1 din 38

Page 61: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

25 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 8.57 0.285666 0.185500 0.18550026 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 100 18.55 0.185500 0.185500 0.18550027 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 50 12.20 0.244000 0.185500 0.18550028 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 7.60 0.380000 0.185500 0.18550029 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 8.24 0.274666 0.185500 0.18550030 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 12.68 0.422666 0.185500 0.18550031 C07AB02 METOPROLOLUM METOPROLOL MEDICO UNO 100 mg COMPR. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10.11 0.337000 0.185500 0.18550032 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 100 mg COMPR. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6.92 0.346000 0.185500 0.18550033 C07AB02 METOPROLOLUM EGILOK 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 1.79 0.089500 0.089333 0.08933334 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 2.74 0.137000 0.089333 0.08933335 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2.68 0.089333 0.089333 0.08933336 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2.68 0.089333 0.089333 0.08933337 C07AB02 METOPROLOLUM METOPROLOL MEDICO UNO 25 mg COMPR. 25mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.11 0.137000 0.089333 0.08933338 C07AB02 METOPROLOLUM BETAPROL 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 8.26 0.275333 0.078900 0.07890039 C07AB02 METOPROLOLUM EGILOK 50 mg COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 3.30 0.165000 0.078900 0.07890040 C07AB02 METOPROLOLUM METOPROLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7.94 0.264666 0.078900 0.07890041 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 5.98 0.199333 0.078900 0.07890042 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. DIN PVC-PVDC/ALX 10 COMPR P-6L 100 7.89 0.078900 0.078900 0.07890043 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 50 6.66 0.133200 0.078900 0.07890044 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.95 0.165000 0.078900 0.07890045 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3.30 0.165000 0.078900 0.07890046 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.95 0.165000 0.078900 0.07890047 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 9.48 0.316000 0.078900 0.07890048 C07AB02 METOPROLOLUM METOPROLOL MEDICO UNO 50 mg COMPR. 50mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6.26 0.208666 0.078900 0.07890049 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 50 mg COMPR. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6.22 0.311000 0.078900 0.07890050 C07AB02 METOPROLOLUM METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L 20 12.36 0.618000 0.618000 0.61800051 C07AB02 METOPROLOLUM VASOCARDIN (R) SR 200 COMPR. ELIB. PREL. 200mg ZENTIVA AS SLOVACIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 100 56.22 0.562200 0.562200 0.56220052 C07AB02 METOPROLOLUM VASOCARDIN (R) SR 200 COMPR. ELIB. PREL. 200mg ZENTIVA AS SLOVACIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 60 34.61 0.576833 0.562200 0.56220053 C07AB02 METOPROLOLUM VASOCARDIN (R) SR 200 COMPR. ELIB. PREL. 200mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 30 20.63 0.687666 0.562200 0.56220054 C07AB02 METOPROLOLUM BETALOC (R) ZOC 100 mg COMPR. FILM. ELIB. PREL. 100mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 24.13 0.804333 0.522333 0.52233355 C07AB02 METOPROLOLUM EMZOK 100 mg COMPR. FILM. ELIB. PREL. 100mg IVAX PHARMCEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. AL/PP X 10 COMPR. FILM. ELIB. PREL. P-6L 30 15.67 0.522333 0.522333 0.52233356 C07AB02 METOPROLOLUM BETALOC (R) ZOC 50 mg COMPR. FILM. ELIB. PREL. 50mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 14.73 0.491000 0.319333 0.31933357 C07AB02 METOPROLOLUM EMZOK 50 mg COMPR. FILM. ELIB. PREL. 50mg IVAX PHARMCEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. AL/PP X 10 COMPR. FILM. ELIB. PREL. P-6L 30 9.58 0.319333 0.319333 0.31933358 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mg COMPR.FILM.ELIB.MOD. 190mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 21.33 0.711000 0.711000 0.71100059 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 7.64 0.254666 0.254666 0.25466660 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 12.76 0.425333 0.425333 0.42533361 C07AB02 METOPROLOLUM BETALOC SOL. INJ. 1mg/ml ASTRAZENECA AB SUEDIA CUTIE X 5 FIOLE X 5 ML SOL.INJ. I.V./PERF. S 5 19.29 3.858000 3.858000 3.85800062 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 13.87 0.462333 0.462333 0.46233363 C07AB12 NEBIVOLOLUM** EZOCEM 5 mg COMPR 5mg OZONE LABORATORIES BV OLANDA CUTIE X 28 COMPR. IN BLIST. PVC-PE-PVDC/AL P-6L 28 23.99 0.856785 0.856666 0.85666664 C07AB12 NEBIVOLOLUM** NEBILET (R) COMPR. 5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. AL/PVC X 7 COMPR. P-6L 28 51.07 1.823928 0.856666 0.85666665 C07AB12 NEBIVOLOLUM** NEBIVOLOL ACTAVIS 5 mg COMPR. 5mg ACTAVIS S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 25.70 0.856666 0.856666 0.85666666 C07AB12 NEBIVOLOLUM** NEBACOP 5 mg COMPR. 5mg JUST BUSINESS SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. P-6L 28 44.14 1.576428 0.856666 0.85666667 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8.20 0.273333 0.271333 0.27133368 C07AG02 CARVEDILOLUM DILATREND (R) 12,5 mg COMPR. 12,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 28.10 1.003571 0.271333 0.27133369 C07AG02 CARVEDILOLUM CORYOL 12,5 mg COMPR. 12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 11.71 0.418214 0.271333 0.271333

Pagina 2 din 38

Page 62: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

70 C07AG02 CARVEDILOLUM TALLITON (R) 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 12.48 0.416000 0.271333 0.27133371 C07AG02 CARVEDILOLUM ATRAM 12,5 COMPR. 12,5mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. P-6L 30 14.99 0.499666 0.271333 0.27133372 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,5 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 13.13 0.656500 0.271333 0.27133373 C07AG02 CARVEDILOLUM CARVEDILOL LPH 12,5 mg COMPR. 12,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 22.00 0.733333 0.271333 0.27133374 C07AG02 CARVEDILOLUM CARVEDILOL TEVA 12,5 mg COMPR. 12,5mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8.14 0.271333 0.271333 0.27133375 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 12,5mg COMPR. 12,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 19.06 0.953000 0.271333 0.27133376 C07AG02 CARVEDILOLUM DILATREND (R) 25 mg COMPR. 25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 32.45 1.158928 0.283666 0.28366677 C07AG02 CARVEDILOLUM CORYOL 25 mg COMPR. 25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. P-6L 28 20.69 0.738928 0.283666 0.28366678 C07AG02 CARVEDILOLUM TALLITON (R) 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 25.25 0.841666 0.283666 0.28366679 C07AG02 CARVEDILOLUM ATRAM 25 COMPR. 25mg ZENTIVA AS CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 24.10 0.803333 0.283666 0.28366680 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 22.36 1.118000 0.283666 0.28366681 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 25mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8.63 0.287666 0.283666 0.28366682 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 32.71 1.090333 0.283666 0.28366683 C07AG02 CARVEDILOLUM CARVEDILOL TEVA 25 mg COMPR. 25mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8.51 0.283666 0.283666 0.28366684 C07AG02 CARVEDILOLUM DILATREND (R) 6,25 mg COMPR. 6,25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 15.44 0.551428 0.189000 0.18900085 C07AG02 CARVEDILOLUM CORYOL (R) COMPR. 6,25mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 6.04 0.215714 0.189000 0.18900086 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 8.69 0.289666 0.189000 0.18900087 C07AG02 CARVEDILOLUM ATRAM 6,25 COMPR. 6,25mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. P-6L 30 6.04 0.201333 0.189000 0.18900088 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 6,25mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 7.52 0.250666 0.189000 0.18900089 C07AG02 CARVEDILOLUM CARVEDILOL LPH 6,25 mg COMPR. 6,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 8.44 0.281333 0.189000 0.18900090 C07AG02 CARVEDILOLUM CARVEDILOL TEVA 6,25 mg COMPR. 6,25mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 5.67 0.189000 0.189000 0.18900091 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 6,25 mg COMPR. 6,25mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 8.61 0.430500 0.189000 0.18900092 C07AG02 CARVEDILOLUM CARVEDIGAMMA 12,5 mg COMPR. FILM. 12,5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 13.07 0.435666 0.435666 0.43566693 C07AG02 CARVEDILOLUM CARVEDIGAMMA 25 mg COMPR. FILM. 25mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 22.80 0.760000 0.760000 0.76000094 C07AG02 CARVEDILOLUM CARVEDIGAMMA 6,25 mg COMPR. FILM. 6,25mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 8.51 0.283666 0.283666 0.28366695 C09AA01 CAPTOPRILUM CAPTOPRIL 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 30 2.77 0.092333 0.092333 0.09233396 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 12,5 mg COMPR. 12,5mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2.77 0.092333 0.092333 0.09233397 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 30 3.20 0.106666 0.106500 0.10650098 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3.20 0.106666 0.106500 0.10650099 C09AA01 CAPTOPRILUM CAPTOPRIL 25 EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.84 0.142000 0.106500 0.106500

100 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.13 0.106500 0.106500 0.106500101 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3.20 0.106666 0.106500 0.106500102 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.13 0.137666 0.106500 0.106500103 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3.24 0.108000 0.106500 0.106500104 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.13 0.106500 0.106500 0.106500105 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 50 mg COMPR. 50 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.51 0.125500 0.122666 0.122666106 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 20 4.18 0.209000 0.122666 0.122666107 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.25 0.141666 0.122666 0.122666108 C09AA01 CAPTOPRILUM CAPTOPRIL 50 EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3.62 0.181000 0.122666 0.122666109 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.51 0.125500 0.122666 0.122666110 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.24 0.141333 0.122666 0.122666111 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3.68 0.122666 0.122666 0.122666112 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 FOLII X 10 COMPR. P-6L 20 4.59 0.229500 0.124500 0.124500113 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 4.59 0.229500 0.124500 0.124500114 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 10 mg COMPR. 10mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3.71 0.185500 0.124500 0.124500

Pagina 3 din 38

Page 63: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

115 C09AA02 ENALAPRILUM EDNYT (R) 10 mg COMPR. 10mg GEDEON RICHTER LTD. UNGARIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 9.57 0.319000 0.124500 0.124500116 C09AA02 ENALAPRILUM ENALAP COMPR. 10mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 4.13 0.206500 0.124500 0.124500117 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 7.24 0.362000 0.124500 0.124500118 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 4.13 0.206500 0.124500 0.124500119 C09AA02 ENALAPRILUM ENALAPRIL FABIOL 10 mg COMPR. 10mg FABIOL SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6.29 0.314500 0.124500 0.124500120 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 6.19 0.309500 0.124500 0.124500121 C09AA02 ENALAPRILUM ENALAPRIL AL 10 COMPR. 10mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 7.95 0.265000 0.124500 0.124500122 C09AA02 ENALAPRILUM ENALAPRIL AL 10 COMPR. 10mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 50 9.80 0.196000 0.124500 0.124500123 C09AA02 ENALAPRILUM ENALAPRIL AL 10 COMPR. 10mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 100 12.45 0.124500 0.124500 0.124500124 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 9.88 0.352857 0.124500 0.124500125 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 7.73 0.386500 0.124500 0.124500126 C09AA02 ENALAPRILUM ENAM 10 mg COMPR. 10mg REPREZENTANTA DR. REDDY'S LABORATORIES LTD. ROMANIA CUTIE X 2 BLIST. AL-PEJD/AL X10 COMPR. P-6L 20 5.55 0.277500 0.124500 0.124500127 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 6.84 0.342000 0.124500 0.124500128 C09AA02 ENALAPRILUM MUNEVER 10 mg COMPR. 10mg REPREZENTANTA DR. REDDY'S LABORATORIES LTD. ROMANIA CUTIE X 2 BLIST. AL-PEJD/AL X10 COMPR. P-6L 20 5.55 0.277500 0.124500 0.124500129 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6.46 0.215333 0.124500 0.124500130 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 10.55 0.211000 0.124500 0.124500131 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-6L 100 20.66 0.206600 0.124500 0.124500132 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 10.59 0.529500 0.124500 0.124500133 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 6.89 0.344500 0.124500 0.124500134 C09AA02 ENALAPRILUM EDNYT (R) 2,5 mg COMPR. 2,5mg GEDEON RICHTER LTD. UNGARIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 7.75 0.258333 0.258333 0.258333135 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 7.46 0.373000 0.183700 0.183700136 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 20 mg COMPR. 20mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 9.55 0.477500 0.183700 0.183700137 C09AA02 ENALAPRILUM EDNYT (R) 20 mg COMPR. 20mg GEDEON RICHTER LTD. UNGARIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 16.53 0.551000 0.183700 0.183700138 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 10.48 0.524000 0.183700 0.183700139 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 9.55 0.477500 0.183700 0.183700140 C09AA02 ENALAPRILUM ENALAPRIL FABIOL 20 mg COMPR. 20mg FABIOL SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6.69 0.334500 0.183700 0.183700141 C09AA02 ENALAPRILUM ENALAPRIL AL 20 COMPR. 20mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 100 18.37 0.183700 0.183700 0.183700142 C09AA02 ENALAPRILUM ENALAPRIL AL 20 COMPR. 20mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 50 15.41 0.308200 0.183700 0.183700143 C09AA02 ENALAPRILUM ENALAPRIL AL 20 COMPR. 20mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 10.91 0.363666 0.183700 0.183700144 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 16.07 0.573928 0.183700 0.183700145 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 11.77 0.588500 0.183700 0.183700146 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 10.45 0.522500 0.183700 0.183700147 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 10.46 0.348666 0.183700 0.183700148 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 FOLII X 10 COMPR. P-6L 20 3.44 0.172000 0.093100 0.093100149 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3.44 0.172000 0.093100 0.093100150 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 5 mg COMPR. 5mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3.44 0.172000 0.093100 0.093100151 C09AA02 ENALAPRILUM EDNYT (R) 5 mg COMPR. 5mg GEDEON RICHTER LTD. UNGARIA CUTIE X 3 BLIST.X 10 COMPR. P-6L 30 7.75 0.258333 0.093100 0.093100152 C09AA02 ENALAPRILUM ENALAPRIL AL 5 COMPR. 5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 4.93 0.164333 0.093100 0.093100153 C09AA02 ENALAPRILUM ENALAPRIL AL 5 COMPR. 5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 100 9.31 0.093100 0.093100 0.093100154 C09AA02 ENALAPRILUM ENALAPRIL AL 5 COMPR. 5mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 50 7.95 0.159000 0.093100 0.093100155 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 3.59 0.179500 0.093100 0.093100156 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 7.40 0.264285 0.093100 0.093100157 C09AA02 ENALAPRILUM ENALAPRIL LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 5.24 0.262000 0.093100 0.093100158 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 3.68 0.184000 0.093100 0.093100159 C09AA02 ENALAPRILUM INVORIL 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 5.18 0.172666 0.093100 0.093100

Pagina 4 din 38

Page 64: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

160 C09AA02 ENALAPRILUM ENALAPRIL ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5.24 0.174666 0.093100 0.093100161 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 3.56 0.178000 0.093100 0.093100162 C09AA02 ENALAPRILUM ENAP (R) SOL. INJ. 1,25mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 14.50 2.900000 2.900000 2.900000163 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER PLC UNGARIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 14.51 0.518214 0.322666 0.322666164 C09AA03 LISINOPRILUM RANOLIP COMPR. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 14.07 0.469000 0.322666 0.322666165 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 10.09 0.504500 0.322666 0.322666166 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 10 mg COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 9.54 0.477000 0.322666 0.322666167 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 10 mg COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 14.81 0.493666 0.322666 0.322666168 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 9.68 0.322666 0.322666 0.322666169 C09AA03 LISINOPRILUM LISIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 15.16 0.505333 0.322666 0.322666170 C09AA03 LISINOPRILUM LISINOPRIL 10 MEDO COMPR. 10mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 13.56 0.452000 0.322666 0.322666171 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 12.08 0.402666 0.322666 0.322666172 C09AA03 LISINOPRILUM TONOLYSIN 2,5 mg COMPR. 2,5mg GEDEON RICHTER PLC UNGARIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 8.21 0.293214 0.293214 0.293214173 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER PLC UNGARIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 21.51 0.768214 0.471333 0.471333174 C09AA03 LISINOPRILUM RANOLIP COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 21.69 0.723000 0.471333 0.471333175 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 14.70 0.735000 0.471333 0.471333176 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 14.14 0.471333 0.471333 0.471333177 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 26.79 0.893000 0.471333 0.471333178 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 13.56 0.678000 0.471333 0.471333179 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 20 mg COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-6L 10 6.98 0.698000 0.471333 0.471333180 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 20 mg COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 22.05 0.735000 0.471333 0.471333181 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 20 mg COMPR. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 21.94 0.731333 0.471333 0.471333182 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 40 mg COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 36.91 1.230333 1.230333 1.230333183 C09AA03 LISINOPRILUM LISINOPRIL ANTIBIOTICE 40 mg COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-6L 10 12.94 1.294000 1.230333 1.230333184 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER PLC UNGARIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 8.72 0.311428 0.224000 0.224000185 C09AA03 LISINOPRILUM RANOLIP COMPR. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 7.18 0.239333 0.224000 0.224000186 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 5 mg COMPR. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6.72 0.224000 0.224000 0.224000187 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 9.49 0.316333 0.224000 0.224000188 C09AA03 LISINOPRILUM LISINOPRIL 5 MEDO COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 8.14 0.271333 0.224000 0.224000189 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 6.90 0.230000 0.224000 0.224000190 C09AA05 RAMIPRILUM EMREN 10 mg COMPR. 10 mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 32.02 1.067333 0.357900 0.357900191 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 25.12 0.897142 0.357900 0.357900192 C09AA05 RAMIPRILUM TRITACE 10 COMPR. 10mg SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 33.62 1.200714 0.357900 0.357900193 C09AA05 RAMIPRILUM PIRAMIL 10 mg COMPR. 10mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 23.68 0.845714 0.357900 0.357900194 C09AA05 RAMIPRILUM RAMIPRIL-AC 10 mg COMPR. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 41.98 1.399333 0.357900 0.357900195 C09AA05 RAMIPRILUM AMPRIL 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 39.43 1.314333 0.357900 0.357900196 C09AA05 RAMIPRILUM HARTIL 10 mg COMPR. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 45.33 1.618928 0.357900 0.357900197 C09AA05 RAMIPRILUM ZENRA 10 COMPR. 10mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 35.85 1.280357 0.357900 0.357900198 C09AA05 RAMIPRILUM RAMIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/AL X 10 COMPR. P-6L/S 100 35.79 0.357900 0.357900 0.357900199 C09AA05 RAMIPRILUM RAMIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 9.86 0.493000 0.357900 0.357900200 C09AA05 RAMIPRILUM EMREN 2,5 mg COMPR. 2,5 mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 10.51 0.350333 0.250357 0.250357201 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR. P-6L 28 7.01 0.250357 0.250357 0.250357202 C09AA05 RAMIPRILUM TRITACE (R) 2,5 COMPR. 2,5mg AVENTIS PHARMA DEUTSCHLAND GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 13.53 0.483214 0.250357 0.250357203 C09AA05 RAMIPRILUM PIRAMIL 2,5 mg COMPR. 2,5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 10.06 0.359285 0.250357 0.250357204 C09AA05 RAMIPRILUM RAMIPRIL-AC 2,5 mg COMPR. 2,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 12.20 0.406666 0.250357 0.250357

Pagina 5 din 38

Page 65: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

205 C09AA05 RAMIPRILUM AMPRIL 2,5 mg COMPR. 2,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 13.08 0.436000 0.250357 0.250357206 C09AA05 RAMIPRILUM HARTIL 2,5 mg COMPR. 2,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 13.70 0.489285 0.250357 0.250357207 C09AA05 RAMIPRILUM ZENRA 2,5 COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 10.31 0.368214 0.250357 0.250357208 C09AA05 RAMIPRILUM EMREN 5 mg COMPR. 5 mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 19.24 0.641333 0.242800 0.242800209 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 12.48 0.445714 0.242800 0.242800210 C09AA05 RAMIPRILUM TRITACE (R) 5 COMPR. 5mg AVENTIS PHARMA DEUTSCHLAND GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 14.67 0.523928 0.242800 0.242800211 C09AA05 RAMIPRILUM PIRAMIL 5 mg COMPR. 5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 11.79 0.421071 0.242800 0.242800212 C09AA05 RAMIPRILUM RAMIPRIL-AC 5 mg COMPR. 5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 32.92 1.097333 0.242800 0.242800213 C09AA05 RAMIPRILUM AMPRIL 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 21.59 0.719666 0.242800 0.242800214 C09AA05 RAMIPRILUM HARTIL 5 mg COMPR. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 24.19 0.863928 0.242800 0.242800215 C09AA05 RAMIPRILUM ZENRA 5 COMPR. 5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 20.63 0.736785 0.242800 0.242800216 C09AA05 RAMIPRILUM RAMIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. A/AL X 10 COMPR. P-6L/S 100 24.28 0.242800 0.242800 0.242800217 C09AA05 RAMIPRILUM RAMIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. A/AL X 10 COMPR. P-6L 20 6.66 0.333000 0.242800 0.242800218 C09AA05 RAMIPRILUM RAMIRAN 1,25 mg COMPR. FILM. 1,25mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 FOLII AL/PEJD X 10 COMPR. FILM. P-6L 30 6.47 0.215666 0.215666 0.215666219 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. FILM. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 FOLII AL/PEJD X 10 COMPR. FILM. P-6L 30 32.02 1.067333 1.067333 1.067333220 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. FILM. 2,5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 FOLII AL/PEJD X 10 COMPR. FILM. P-6L 30 10.54 0.351333 0.351333 0.351333221 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. FILM. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 FOLII AL/PEJD X 10 COMPR. FILM. P-6L 30 19.24 0.641333 0.641333 0.641333222 C09CA03 VALSARTANUM** DIOVAN 160 mg COMPR. FILM. 160mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-6L 28 109.48 3.910000 3.910000 3.910000223 C09CA03 VALSARTANUM** DIOVAN 40 mg COMPR. FILM. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-6L 28 68.73 2.454642 2.454642 2.454642224 C09CA03 VALSARTANUM** DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-6L 28 86.27 3.081071 3.081071 3.081071225 C09CA06 CANDESARTANUM CILEXETIL** ATACAND COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE, PREV. CU SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. P-6L 28 64.82 2.315000 2.315000 2.315000226 C09CA06 CANDESARTANUM CILEXETIL** ATACAND COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE, PREV. CU SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. P-6L 28 52.67 1.881071 1.881071 1.881071

1 B01AA07 ACENOCUMAROLUM* TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.94 0.098000 0.098000 0.0980002 B01AA07 ACENOCUMAROLUM* SINTROM (R) COMPR. 4mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 6.35 0.317500 0.317500 0.317500

Tratamentul se initiază de către medicul în specialitatea cardiologie si chirurgie cardiaca si a vaselor mari

1 B01AC04 CLOPIDOGRELUM*** PLAVIX 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA) P-RF 30 737.48 24.582666 24.582666 24.5826662 B01AC04 CLOPIDOGRELUM*** PLAVIX 75mg COMPR. FILM. 75mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 28 179.46 6.409285 6.409285 6.409285

(cel mult 9 luni)Tratamentul se initiază de către medicul în specialitatea cardiologie

1 B03XA01 EPOETINUM ALFA** EPREX (R) 10000 UI SOL. INJ. 10000ui/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 1 ML S/P-RF 6 2219.85 369.975000 369.975000 369.9750002 B03XA01 EPOETINUM ALFA** EPREX (R) 1000 UI SOL. INJ. 1000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 248.03 41.338333 34.180000 34.1800003 B03XA01 EPOETINUM ALFA** EPOPHAR 2000 U.I. SOL. INJ. 2000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 311.55 31.155000 31.155000 31.1550004 B03XA01 EPOETINUM ALFA** EPREX (R) 2000 UI SOL. INJ. 2000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 506.75 84.458333 84.458333 84.4583335 B03XA01 EPOETINUM ALFA** EPREX (R) 3000 UI SOL. INJ. 3000ui/0,3ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,3 ML S/P-RF 6 717.00 119.500000 119.500000 119.500000

2. BOLNAVI CU PROTEZE VALVULARE SI VASCULARE - G2

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

4. HEPATITELE CRONICE DE ETIOLOGIE VIRALA B, C şi D - G4

Pagina 6 din 38

Page 66: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

6 B03XA01 EPOETINUM ALFA** EPREX (R) 40 000 UI SOL. INJ. 40 000UI JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 1 ML S/P-RF 1 1405.01 1405.010000 1405.010000 1405.0100007 B03XA01 EPOETINUM ALFA** EPOPHAR 4000 U.I. SOL. INJ. 4000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 576.62 57.662000 57.662000 57.6620008 B03XA01 EPOETINUM ALFA** EPREX (R) 4000 UI SOL. INJ. 4000ui/0,4ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,4 ML S/P-RF 6 930.20 155.033333 123.031666 123.0316669 B03XA01 EPOETINUM ALFA** BINOCRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1627.37 271.228333 271.228333 271.228333

10 B03XA01 EPOETINUM ALFA** ABSEAMED 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1730.88 288.480000 271.228333 271.22833311 B03XA01 EPOETINUM ALFA** BINOCRIT 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 205.08 34.180000 34.180000 34.18000012 B03XA01 EPOETINUM ALFA** ABSEAMED 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,5ML SOL. INJ S/P-RF/R 6 224.10 37.350000 34.180000 34.18000013 B03XA01 EPOETINUM ALFA** BINOCRIT 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 404.17 67.361666 67.361666 67.36166614 B03XA01 EPOETINUM ALFA** ABSEAMED 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 435.08 72.513333 67.361666 67.36166615 B03XA01 EPOETINUM ALFA** BINOCRIT 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 571.20 95.200000 95.200000 95.20000016 B03XA01 EPOETINUM ALFA** ABSEAMED 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,3ML SOL. INJ. S/P-RF/R 6 617.68 102.946666 95.200000 95.20000017 B03XA01 EPOETINUM ALFA** BINOCRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 738.19 123.031666 123.031666 123.03166618 B03XA01 EPOETINUM ALFA** ABSEAMED 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 794.92 132.486666 123.031666 123.03166619 B03XA01 EPOETINUM ALFA** BINOCRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 905.14 150.856666 150.856666 150.85666620 B03XA01 EPOETINUM ALFA** ABSEAMED 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 982.53 163.755000 150.856666 150.85666621 B03XA01 EPOETINUM ALFA** ABSEAMED 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML SOL. INJ. S/P-RF/R 6 1164.90 194.150000 194.150000 194.15000022 B03XA01 EPOETINUM ALFA** ABSEAMED 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,8ML SOL. INJ. S/P-RF/R 6 1529.62 254.936666 254.936666 254.93666623 B03XA01 EPOETINUM BETA** NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 2207.69 367.948333 367.948333 367.94833324 B03XA01 EPOETINUM BETA** NEORECORMON 1000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 262.83 43.805000 43.805000 43.80500025 B03XA01 EPOETINUM BETA** NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 498.48 83.080000 83.080000 83.08000026 B03XA01 EPOETINUM BETA** NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 1107.18 1107.180000 1107.180000 1107.18000027 B03XA01 EPOETINUM BETA** NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 925.50 154.250000 154.250000 154.25000028 B03XA01 EPOETINUM BETA** NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 1138.88 189.813333 189.813333 189.81333329 B03XA01 EPOETINUM BETA** NEORECORMON 500UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 500UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. + 6 ACE S/P-RF/R 6 135.15 22.525000 22.525000 22.52500030 J05AB04 RIBAVIRINUM**** REBETOL 200 mg CAPS. 200mg SP EUROPE BELGIA CUTIE X 140CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 575.63 4.111642 4.111642 4.11164231 J05AB04 RIBAVIRINUM**** COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168 625.75 3.724702 3.724702 3.72470232 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 28 261.71 9.346785 9.346785 9.34678533 J05AF05 LAMIVUDINUM**** EPIVIR 150mg COMPR. FILM. 150mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILM. P-RF/R 60 376.23 6.270500 6.270500 6.27050034 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 1 106.45 106.450000 106.450000 106.45000035 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 1 123.49 123.490000 123.490000 123.49000036 J05AF08 ADEFOVIRUM DIPIVOXILUM**** HEPSERA COMPR. 10mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF/R 30 1815.58 60.519333 60.519333 60.51933337 J05AF10 ENTECAVIRUM**** BARACLUDE 0,5mg COMPR. FILM. 0,5mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA) P-RF/R 30 1646.23 54.874333 54.874333 54.87433338 J05AF10 ENTECAVIRUM**** BARACLUDE 1mg COMPR. FILM. 1mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM.(BLIST. AL/AL UNIDOZA) P-RF/R 30 1824.44 60.814666 60.814666 60.81466639 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 306.12 306.120000 306.120000 306.12000040 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 486.97 486.970000 486.970000 486.97000041 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 1 245.48 245.480000 245.480000 245.48000042 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 1 404.39 404.390000 404.390000 404.39000043 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 1 403.07 403.070000 403.070000 403.07000044 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 82.11 82.110000 82.110000 82.11000045 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 1 465.15 465.150000 465.150000 465.15000046 L03AB05 INTERFERONUM ALFA 2B**** INTRON A 30 milioane U.I. SOL. INJ. PEN MULTIDOZA 30 milioane U.I. SP EUROPE BELGIA CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 729.73 729.730000 729.730000 729.73000047 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 100 mcg PULB. + SOLV. PT. SOL. INJ. 100mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 774.27 774.270000 774.270000 774.27000048 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 120 mcg PULB. + SOLV. PT. SOL. INJ. 120mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 914.98 914.980000 914.980000 914.98000049 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 150 mcg PULB. + SOLV. PT. SOL. INJ. 150mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 1125.13 1125.130000 1125.130000 1125.13000050 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 50 mcg PULB. + SOLV. PT. SOL. INJ. 50mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 422.84 422.840000 422.840000 422.840000

Pagina 7 din 38

Page 67: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

51 L03AB11 PEGINTERFERON ALFA-2A**** PEGASYS 135 mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 135mcg/0,5ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC P-RF/R 1 733.57 733.570000 733.570000 733.57000052 L03AB11 PEGINTERFERON ALFA-2A**** PEGASYS 180 mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 180mcg/0,5ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC P-RF/R 1 919.96 919.960000 919.960000 919.96000053 N04BB01 AMANTADINUM** VIREGYT (R)- K CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 16.02 0.320400 0.320400 0.320400

1 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 30.63 0.612600 0.612600 0.6126002 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 27.83 1.391500 1.391500 1.3915003 H02AB04 METHYLPREDNISOLONUM MEDROL 4 mg COMPR. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA X 30 COMPR. P-RF 30 6.13 0.204333 0.204333 0.2043334 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8.26 8.260000 8.260000 8.2600005 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 40 mg LIOF. PT. SOL. INJ. 40mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 15 FLAC. LIOF. + 15 FIOLE SOLV. X 1 ML S/P-RF 15 63.83 4.255333 4.255333 4.2553336 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 29.12 29.120000 29.120000 29.1200007 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIO P-RF 1 19.21 19.210000 19.210000 19.2100008 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 250 LIOF. + SOLV. PT. SOL. INJ. 250mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. DIN STICLA INCOLORA X 250 MG FIOF. PT. SOL. INJ. + 3 FIOLE X 5 ML SOLV. P-RF 3 89.78 29.926666 29.926666 29.9266669 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 50 LIOF. + SOLV. PT. SOL. INJ. 50mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. X 50 MG LIOF. PT. SOL. INJ. + 3 FIOLE X 1 ML SOLVENT P-RF 3 33.52 11.173333 11.173333 11.173333

10 L04AX01 AZATHIOPRINUM* IMURAN (R) COMPR. FILM. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 75.98 0.759800 0.759800 0.759800

Tratamentul se initiază de către medicul în specialitatea gastroenterologie

1 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P-6L/S 100 116.69 1.166900 1.166900 1.1669002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 68.32 1.366400 1.166900 1.1669003 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 64.58 1.291600 1.166900 1.166900

Tratamentul se initiază de către medicul în specialitatea gastroenterologie

7. CIROZA HEPATICA - G7

1 A06AD11 LACTULOSUM* DUPHALAC (R) LICHID ORAL 66,7% SOLVAY PHARMACEUTICALS BV OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P-RF 1 10.29 10.290000 10.290000 10.2900002 A06AD11 LACTULOSUM* LACTULOSE AL SIROP SIROP 66,7% ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 FLACON DIN TFPE BRUNA X 200 ML SIROP + MASURA GRADATA X 20 ML P-RF 1 11.77 11.770000 10.290000 10.2900003 A06AD11 LACTULOSUM* LAEVOLAC 670mg/ml SOL. ORALA 670mg/ml FRESENIUS KABI AUSTRIA GMBH AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SOL. ORALA + DISPOZITIV DE CURGERE + MASURA CU GRADATII D P-RF 1 7.15 7.150000 7.150000 7.1500004 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 34.39 2.865833 2.865833 2.8658335 B03XA01 EPOETINUM ALFA** EPREX (R) 10000 UI SOL. INJ. 10000ui/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 1 ML S/P-RF 6 2219.85 369.975000 369.975000 369.9750006 B03XA01 EPOETINUM ALFA** EPREX (R) 1000 UI SOL. INJ. 1000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 248.03 41.338333 34.180000 34.1800007 B03XA01 EPOETINUM ALFA** EPOPHAR 2000 U.I. SOL. INJ. 2000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 311.55 31.155000 31.155000 31.1550008 B03XA01 EPOETINUM ALFA** EPREX (R) 2000 UI SOL. INJ. 2000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 506.75 84.458333 84.458333 84.4583339 B03XA01 EPOETINUM ALFA** EPREX (R) 3000 UI SOL. INJ. 3000ui/0,3ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,3 ML S/P-RF 6 717.00 119.500000 119.500000 119.500000

10 B03XA01 EPOETINUM ALFA** EPREX (R) 40 000 UI SOL. INJ. 40 000UI JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 1 ML S/P-RF 1 1405.01 1405.010000 1405.010000 1405.01000011 B03XA01 EPOETINUM ALFA** EPOPHAR 4000 U.I. SOL. INJ. 4000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 576.62 57.662000 57.662000 57.66200012 B03XA01 EPOETINUM ALFA** EPREX (R) 4000 UI SOL. INJ. 4000ui/0,4ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,4 ML S/P-RF 6 930.20 155.033333 123.031666 123.03166613 B03XA01 EPOETINUM ALFA** BINOCRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1627.37 271.228333 271.228333 271.228333

Tratamentul se initiază de către medicul în specialitatea gastroenterologie / boli infectioase si nefrologie (doar pentru pacientii cu afectare renala consecutiva infectiei cu virusuri hepatitice)

5. HEPATITA AUTOIMUNA - G5

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

Pagina 8 din 38

Page 68: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

14 B03XA01 EPOETINUM ALFA** ABSEAMED 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1730.88 288.480000 271.228333 271.22833315 B03XA01 EPOETINUM ALFA** BINOCRIT 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 205.08 34.180000 34.180000 34.18000016 B03XA01 EPOETINUM ALFA** ABSEAMED 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,5ML SOL. INJ S/P-RF/R 6 224.10 37.350000 34.180000 34.18000017 B03XA01 EPOETINUM ALFA** BINOCRIT 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 404.17 67.361666 67.361666 67.36166618 B03XA01 EPOETINUM ALFA** ABSEAMED 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 435.08 72.513333 67.361666 67.36166619 B03XA01 EPOETINUM ALFA** BINOCRIT 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 571.20 95.200000 95.200000 95.20000020 B03XA01 EPOETINUM ALFA** ABSEAMED 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,3ML SOL. INJ. S/P-RF/R 6 617.68 102.946666 95.200000 95.20000021 B03XA01 EPOETINUM ALFA** BINOCRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 738.19 123.031666 123.031666 123.03166622 B03XA01 EPOETINUM ALFA** ABSEAMED 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 794.92 132.486666 123.031666 123.03166623 B03XA01 EPOETINUM ALFA** BINOCRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 905.14 150.856666 150.856666 150.85666624 B03XA01 EPOETINUM ALFA** ABSEAMED 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 982.53 163.755000 150.856666 150.85666625 B03XA01 EPOETINUM ALFA** ABSEAMED 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML SOL. INJ. S/P-RF/R 6 1164.90 194.150000 194.150000 194.15000026 B03XA01 EPOETINUM ALFA** ABSEAMED 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,8ML SOL. INJ. S/P-RF/R 6 1529.62 254.936666 254.936666 254.93666627 B03XA01 EPOETINUM BETA** NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 2207.69 367.948333 367.948333 367.94833328 B03XA01 EPOETINUM BETA** NEORECORMON 1000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 262.83 43.805000 43.805000 43.80500029 B03XA01 EPOETINUM BETA** NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 498.48 83.080000 83.080000 83.08000030 B03XA01 EPOETINUM BETA** NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 1107.18 1107.180000 1107.180000 1107.18000031 B03XA01 EPOETINUM BETA** NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 925.50 154.250000 154.250000 154.25000032 B03XA01 EPOETINUM BETA** NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 1138.88 189.813333 189.813333 189.81333333 B03XA01 EPOETINUM BETA** NEORECORMON 500UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 500UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. + 6 ACE S/P-RF/R 6 135.15 22.525000 22.525000 22.52500034 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 1.53 0.076500 0.075500 0.07550035 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.13 0.106500 0.075500 0.07550036 C03CA01 FUROSEMIDUM FUROSEMID EEL COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 1.83 0.091500 0.075500 0.07550037 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 1.53 0.076500 0.075500 0.07550038 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.88 0.144000 0.075500 0.07550039 C03CA01 FUROSEMIDUM FUROSEMID ARENA 40 mg COMPR. 40mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 1.51 0.075500 0.075500 0.07550040 C03CA01 FUROSEMIDUM FUROSEMID 20 mg/2 ml SOL. INJ. 10mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 3.14 0.628000 0.628000 0.62800041 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER PLC UNGARIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 26.75 0.891666 0.891666 0.89166642 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER PLC UNGARIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 15.69 0.523000 0.523000 0.52300043 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA EEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4.05 0.202500 0.202500 0.20250044 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA OZONE 25 mg COMPR. 25mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 10.14 0.202800 0.202500 0.20250045 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 12.68 0.253600 0.202500 0.20250046 C03DA01 SPIRONOLACTONUM ALSPIRON 25 mg COMPR. FILM. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 4.05 0.202500 0.202500 0.20250047 C03DA01 SPIRONOLACTONUM ALSPIRON 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 12.91 0.645500 0.645500 0.64550048 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 250 LIOF. + SOLV. PT. SOL. INJ. 250mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. DIN STICLA INCOLORA X 250 MG FIOF. PT. SOL. INJ. + 3 FIOLE X 5 ML SOLV. P-RF 3 89.78 29.926666 29.926666 29.92666649 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 50 LIOF. + SOLV. PT. SOL. INJ. 50mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. X 50 MG LIOF. PT. SOL. INJ. + 3 FIOLE X 1 ML SOLVENT P-RF 3 33.52 11.173333 11.173333 11.17333350 J05AB04 RIBAVIRINUM**** REBETOL 200 mg CAPS. 200mg SP EUROPE BELGIA CUTIE X 140CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 2302.53 16.446642 16.446642 16.44664251 J05AB04 RIBAVIRINUM**** COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168 625.75 3.724702 3.724702 3.72470252 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 28 261.71 9.346785 9.346785 9.34678553 J05AF05 LAMIVUDINUM**** EPIVIR 150mg COMPR. FILM. 150mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILM. P-RF/R 60 376.23 6.270500 6.270500 6.27050054 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 1 106.45 106.450000 106.450000 106.45000055 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 1 123.49 123.490000 123.490000 123.49000056 J05AF08 ADEFOVIRUM DIPIVOXILUM**** HEPSERA COMPR. 10mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF/R 30 1815.58 60.519333 60.519333 60.51933357 J05AF10 ENTECAVIRUM**** BARACLUDE 0,5mg COMPR. FILM. 0,5mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA) P-RF/R 30 1646.23 54.874333 54.874333 54.87433358 J05AF10 ENTECAVIRUM**** BARACLUDE 1mg COMPR. FILM. 1mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM.(BLIST. AL/AL UNIDOZA) P-RF/R 30 1824.44 60.814666 60.814666 60.814666

Pagina 9 din 38

Page 69: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

59 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 306.12 306.120000 306.120000 306.12000060 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 486.97 486.970000 486.970000 486.97000061 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 1 245.48 245.480000 245.480000 245.48000062 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 1 404.39 404.390000 404.390000 404.39000063 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 1 403.07 403.070000 403.070000 403.07000064 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 82.11 82.110000 82.110000 82.11000065 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 1 465.15 465.150000 465.150000 465.15000066 L03AB05 INTERFERONUM ALFA 2B**** INTRON A 30 milioane U.I. SOL. INJ. PEN MULTIDOZA 30 milioane U.I. SP EUROPE BELGIA CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 729.73 729.730000 729.730000 729.73000067 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 100 mcg PULB. + SOLV. PT. SOL. INJ. 100mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 774.27 774.270000 774.270000 774.27000068 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 120 mcg PULB. + SOLV. PT. SOL. INJ. 120mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 914.98 914.980000 914.980000 914.98000069 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 150 mcg PULB. + SOLV. PT. SOL. INJ. 150mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 1125.13 1125.130000 1125.130000 1125.13000070 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 50 mcg PULB. + SOLV. PT. SOL. INJ. 50mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 422.84 422.840000 422.840000 422.84000071 L03AB11 PEGINTERFERON ALFA-2A**** PEGASYS 135 mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 135mcg/0,5ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC P-RF/R 1 733.57 733.570000 733.570000 733.57000072 L03AB11 PEGINTERFERON ALFA-2A**** PEGASYS 180 mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 180mcg/0,5ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC P-RF/R 1 919.96 919.960000 919.960000 919.96000073 N04BB01 AMANTADINUM** VIREGYT (R)- K CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 16.02 0.320400 0.320400 0.320400

Tratamentul se inițiază de către medicul in specialitatea gastroenterologie sau boli infectioase

1 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 17.87 1.787000 1.787000 1.7870002 A04AA01 ONDANSETRONUM** ZOFRAN 4 mg COMPR. FILM. 4mg GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/AL X 5 COMPR. FILM. P-RF 10 64.45 6.445000 1.787000 1.7870003 A04AA01 ONDANSETRONUM** SETRONON 4 mg COMPR. FILM. 4mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 17.87 1.787000 1.787000 1.7870004 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 31.28 3.128000 3.128000 3.1280005 A04AA01 ONDANSETRONUM** SETRONON 8 mg COMPR. FILM. 8mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR.FILM. P-RF 10 31.28 3.128000 3.128000 3.1280006 A04AA01 ONDANSETRONUM** ONDARAN MD 4mg COMPR. ORODISPERSABILE 4mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 1 FOLIE DIN POLIAMIDA/AL/PVC X 10 COMPR. ORODISPERSABILE P-RF 10 18.00 1.800000 1.800000 1.8000007 A04AA01 ONDANSETRONUM** ONDARAN MD 4mg COMPR. ORODISPERSABILE 4mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 1 FOLIE DIN AL/PE X 10 COMPR. ORODISPERSABILE P-RF 10 18.00 1.800000 1.800000 1.8000008 A04AA01 ONDANSETRONUM** ONDARAN MD 8 mg COMPR. ORODISPERSABILE 8mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FOLE PA/AL/PVC X 10 COMPR. ORODISPERSABILE P-RF 10 31.51 3.151000 3.151000 3.1510009 A04AA01 ONDANSETRONUM** OSETRON 4 mg 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 22.33 4.466000 4.426000 4.426000

10 A04AA01 ONDANSETRONUM** OSETRON 8 mg 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 41.10 8.220000 8.216000 8.21600011 A04AA01 ONDANSETRONUM** ZOFRAN 4mg/2ml SOL. INJ. 4mg/2ml GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 128.36 25.672000 4.426000 4.42600012 A04AA01 ONDANSETRONUM** ZOFRAN 8mg/4ml SOL. INJ. 8mg/4ml GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 5 FIOLE DIN STICLA INCOLORA X 4 ML SOL. INJ. S/P-RF 5 165.32 33.064000 8.216000 8.21600013 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 22.34 4.468000 4.426000 4.42600014 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 41.08 8.216000 8.216000 8.21600015 A04AA01 ONDANSETRONUM** SETRONON 4 mg/2 ml SOL. INJ./PERF. 4mg/2ml PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 2 ML SOL INJ/PERF. S/P-RF 5 22.13 4.426000 4.426000 4.42600016 A04AA01 ONDANSETRONUM** SETRONON 8 mg/4 ml SOL. INJ./PERF. 8mg/4 ml PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 4 ML SOL.INJ./PERF. S/P-RF 5 41.10 8.220000 8.216000 8.21600017 A04AA02 GRANISETRONUM** KYTRIL (R) 1 mg COMPR. FILM. 1mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 270.04 27.004000 27.004000 27.00400018 A04AA02 GRANISETRONUM** GRANISETRON TEVA 1mg/1ml CONC. PT. SOL. PERF./INJ. 1mg/1ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA X 1 ML CONC. PT. SOL. PERF./INJ. S 5 67.17 13.434000 13.434000 13.43400019 A04AA02 GRANISETRONUM** GRANISETRON TEVA 3mg/3ml CONC. PT. SOL. PERF./INJ. 3mg/3ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA X 3 ML CONC. PT. SOL. PERF./INJ. S 5 187.67 37.534000 37.534000 37.53400020 A04AA02 GRANISETRONUM** KYTRIL SOL. INJ. 3mg/3ml ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FIOLA X 3 ML SOL. INJ. S/P-RF 1 64.12 64.120000 64.120000 64.12000021 A04AA05 PALONOSETRONUM** ALOXI SOL. INJ. 250 mcg/5ml HELSINN BIREX PHARMACEUTICALS LTD. IRLANDA CUTIE X 1 FLAC. DIN STICLA X 5 ML SOL. INJ. P-RF 1 360.75 360.750000 360.750000 360.750000

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

Pagina 10 din 38

Page 70: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

22 B03XA01 EPOETINUM ALFA*** EPREX (R) 10000 UI SOL. INJ. 10000ui/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 1 ML S/P-RF 6 2219.85 369.975000 369.975000 369.97500023 B03XA01 EPOETINUM ALFA*** EPREX (R) 1000 UI SOL. INJ. 1000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 248.03 41.338333 34.180000 34.18000024 B03XA01 EPOETINUM ALFA*** EPOPHAR 2000 U.I. SOL. INJ. 2000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 311.55 31.155000 31.155000 31.15500025 B03XA01 EPOETINUM ALFA*** EPREX (R) 2000 UI SOL. INJ. 2000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 506.75 84.458333 84.458333 84.45833326 B03XA01 EPOETINUM ALFA*** EPREX (R) 3000 UI SOL. INJ. 3000ui/0,3ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,3 ML S/P-RF 6 717.00 119.500000 119.500000 119.50000027 B03XA01 EPOETINUM ALFA*** EPREX (R) 40 000 UI SOL. INJ. 40 000UI JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 1 ML S/P-RF 1 1405.01 1405.010000 1405.010000 1405.01000028 B03XA01 EPOETINUM ALFA*** EPOPHAR 4000 U.I. SOL. INJ. 4000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 576.62 57.662000 57.662000 57.66200029 B03XA01 EPOETINUM ALFA*** EPREX (R) 4000 UI SOL. INJ. 4000ui/0,4ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,4 ML S/P-RF 6 930.20 155.033333 123.031666 123.03166630 B03XA01 EPOETINUM ALFA*** BINOCRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1627.37 271.228333 271.228333 271.22833331 B03XA01 EPOETINUM ALFA*** ABSEAMED 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1730.88 288.480000 271.228333 271.22833332 B03XA01 EPOETINUM ALFA*** BINOCRIT 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 205.08 34.180000 34.180000 34.18000033 B03XA01 EPOETINUM ALFA*** ABSEAMED 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,5ML SOL. INJ S/P-RF/R 6 224.10 37.350000 34.180000 34.18000034 B03XA01 EPOETINUM ALFA*** BINOCRIT 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 404.17 67.361666 67.361666 67.36166635 B03XA01 EPOETINUM ALFA*** ABSEAMED 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 435.08 72.513333 67.361666 67.36166636 B03XA01 EPOETINUM ALFA*** BINOCRIT 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 571.20 95.200000 95.200000 95.20000037 B03XA01 EPOETINUM ALFA*** ABSEAMED 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,3ML SOL. INJ. S/P-RF/R 6 617.68 102.946666 95.200000 95.20000038 B03XA01 EPOETINUM ALFA*** BINOCRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 738.19 123.031666 123.031666 123.03166639 B03XA01 EPOETINUM ALFA*** ABSEAMED 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 794.92 132.486666 123.031666 123.03166640 B03XA01 EPOETINUM ALFA*** BINOCRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 905.14 150.856666 150.856666 150.85666641 B03XA01 EPOETINUM ALFA*** ABSEAMED 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 982.53 163.755000 150.856666 150.85666642 B03XA01 EPOETINUM ALFA*** ABSEAMED 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML SOL. INJ. S/P-RF/R 6 1164.90 194.150000 194.150000 194.15000043 B03XA01 EPOETINUM ALFA*** ABSEAMED 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,8ML SOL. INJ. S/P-RF/R 6 1529.62 254.936666 254.936666 254.93666644 B03XA01 EPOETINUM BETA*** NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 2207.69 367.948333 367.948333 367.94833345 B03XA01 EPOETINUM BETA*** NEORECORMON 1000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 262.83 43.805000 43.805000 43.80500046 B03XA01 EPOETINUM BETA*** NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 498.48 83.080000 83.080000 83.08000047 B03XA01 EPOETINUM BETA*** NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 1107.18 1107.180000 1107.180000 1107.18000048 B03XA01 EPOETINUM BETA*** NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 925.50 154.250000 154.250000 154.25000049 B03XA01 EPOETINUM BETA*** NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 1138.88 189.813333 189.813333 189.81333350 B03XA01 EPOETINUM BETA*** NEORECORMON 500UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 500UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. + 6 ACE S/P-RF/R 6 135.15 22.525000 22.525000 22.52500051 B03XA02 DARBEPOETINUM ALFA*** ARANESP 100mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 100mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 2983.68 745.920000 745.920000 745.92000052 B03XA02 DARBEPOETINUM ALFA*** ARANESP 10mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 10mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 369.99 92.497500 92.497500 92.49750053 B03XA02 DARBEPOETINUM ALFA*** ARANESP 150mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 150mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 4425.31 1106.327500 1106.327500 1106.32750054 B03XA02 DARBEPOETINUM ALFA*** ARANESP 15mcg/0,375ml SOL. INJ. IN SERINGA PREUMPLUTA 15mcg/0,375ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,375 ML P-RF/R 4 518.36 129.590000 129.590000 129.59000055 B03XA02 DARBEPOETINUM ALFA*** ARANESP 20mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 20mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 664.07 166.017500 166.017500 166.01750056 B03XA02 DARBEPOETINUM ALFA*** ARANESP 300mcg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML P-RF/R 1 2078.14 2078.140000 2078.140000 2078.14000057 B03XA02 DARBEPOETINUM ALFA*** ARANESP 30mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 30mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 952.18 238.045000 238.045000 238.04500058 B03XA02 DARBEPOETINUM ALFA*** ARANESP 40mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 40mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 1242.77 310.692500 310.692500 310.69250059 B03XA02 DARBEPOETINUM ALFA*** ARANESP 500mcg/ml SOL. INJ. IN SERINGA PREUMPLUTA 500mcg/ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 1 ML P-RF/R 1 3416.34 3416.340000 3416.340000 3416.34000060 B03XA02 DARBEPOETINUM ALFA*** ARANESP 50mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 50mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 1531.80 382.950000 382.950000 382.95000061 B03XA02 DARBEPOETINUM ALFA*** ARANESP 60mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 60mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 1823.26 455.815000 455.815000 455.81500062 B03XA02 DARBEPOETINUM ALFA*** ARANESP 80mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 80mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 2404.28 601.070000 601.070000 601.07000063 G03HA01 CYPROTERONUM** ANDROCUR COMPR. 50mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 FLAC. X 50 COMPR. P-RF 50 152.43 3.048600 3.048600 3.04860064 H02AB02 DEXAMETHASONUM DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ. 8mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 100 120.26 1.202600 0.865500 0.86550065 H02AB02 DEXAMETHASONUM DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ. 8mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 5 6.55 1.310000 0.865500 0.86550066 H02AB02 DEXAMETHASONUM DEXAMED SOL. INJ. 8mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF/S 100 86.55 0.865500 0.865500 0.865500

Pagina 11 din 38

Page 71: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

67 H02AB02 DEXAMETHASONUM DEXAMED SOL. INJ. 8mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 10 9.74 0.974000 0.865500 0.86550068 J02AC02 ITRACONAZOLUM ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 72.22 4.814666 3.290666 3.29066669 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 49.36 3.290666 3.290666 3.29066670 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 116.70 7.780000 3.290666 3.29066671 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 116.66 7.777333 3.290666 3.29066672 J02AC02 ITRACONAZOLUM OMICRAL 100 mg CAPS. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 86.10 5.740000 3.290666 3.29066673 J02AC02 ITRACONAZOLUM SPORILIN 100 mg CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 112.79 7.519333 3.290666 3.29066674 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3682.94 131.533571 131.533571 131.53357175 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 973.64 34.772857 34.772857 34.77285776 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 508.98 508.980000 508.980000 508.98000077 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 P-RF 1 2295.40 2295.400000 2295.400000 2295.40000078 J02AC04 POSACONAZOLUM** NOXAFIL SP 40mg/ml SUSP. ORALA 40mg/ml SP EUROPE BELGIA CUTIE X 1 FLAC. X 105ML SUSP. ORALA P-RF/R 1 2804.00 2804.000000 2804.000000 2804.00000079 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 1270.77 1270.770000 1270.770000 1270.77000080 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 1636.91 1636.910000 1636.910000 1636.91000081 L01XX35 ANAGRELIDUM*** THROMBOREDUCTIN CAPS. 0,5mg ORPHA-DEVEL HANDELS UND VERTRIEBS GMBH AUSTRIA CUTIE X 1 FLAC. DIN PE X 42 CAPS. P-RF 42 826.79 19.685476 16.242400 16.24240082 L01XX35 ANAGRELIDUM*** THROMBOREDUCTIN CAPS. 0,5mg ORPHA-DEVEL HANDELS UND VERTRIEBS GMBH AUSTRIA CUTIE X 1 FLAC. DIN PE X 100 CAPS. P-RF/S 100 1624.24 16.242400 16.242400 16.24240083 L04AD02 CICLOSPORINUM* EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 446.87 8.937400 8.937400 8.93740084 L04AD02 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 131.29 2.625800 1.767600 1.76760085 L04AD02 CICLOSPORINUM* EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 88.38 1.767600 1.767600 1.76760086 L04AD02 CICLOSPORINUM* CICLORAL 25 mg CAPS. MOI 25mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 131.44 2.628800 1.767600 1.76760087 L04AD02 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 274.32 5.486400 3.566200 3.56620088 L04AD02 CICLOSPORINUM* EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 178.31 3.566200 3.566200 3.56620089 L04AD02 CICLOSPORINUM* CICLORAL 50 mg CAPS. MOI 50mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 286.57 5.731400 3.566200 3.56620090 L04AD02 CICLOSPORINUM* EQUORAL (R) SOL. ORALA 100mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON DIN STICLA BRUNA X 50 ML, UN DISPOZITIV DE MASURAT + UN CAPAC CU FILET S/P-RF 1 406.57 406.570000 406.570000 406.57000091 N02AA01 MORPHYNUM SEVREDOL 10 mg COMPR. FILM. 10mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 4 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-TS 56 44.09 0.787321 0.787321 0.78732192 N02AA01 MORPHYNUM SEVREDOL 20 mg COMPR. FILM. 20mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 4 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-TS 56 63.23 1.129107 1.129107 1.12910793 N02AA01 MORPHYNUM MST CONTINUS 100 mg COMPR. FILM. ELIB. MODIF. 100mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 30 COMPR. FILM. CU ELIB. MOD. P-TS 60 232.99 3.883166 2.662000 2.66200094 N02AA01 MORPHYNUM MST CONTINUS 10 mg COMPR. FILM. ELIB. MODIF. 10mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 30 COMPR. FILM. CU ELIB. MOD. P-TS 60 43.30 0.721666 0.721666 0.72166695 N02AA01 MORPHYNUM MST CONTINUS 200 mg COMPR. FILM. ELIB. MODIF. 200mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 4 BLIST. PVC-PVDC/AL X 15 COMPR. FILM. CU ELIB. MOD. P-TS 60 401.08 6.684666 6.684666 6.68466696 N02AA01 MORPHYNUM MST CONTINUS 30 mg COMPR. FILM. ELIB. MODIF. 30mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 30 COMPR. FILM. CU ELIB. MOD. P-TS 60 71.80 1.196666 0.846000 0.84600097 N02AA01 MORPHYNUM MST CONTINUS 60 mg COMPR. FILM. ELIB. MODIF. 60mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 30 COMPR. FILM. CU ELIB. MOD. P-TS 60 145.21 2.420166 1.746666 1.74666698 N02AA01 MORPHYNUM VENDAL (R) RETARD 100 mg COMPR. FILM. ELIB. PREL. 100mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 79.86 2.662000 2.662000 2.66200099 N02AA01 MORPHYNUM VENDAL (R) RETARD 10 mg COMPR. FILM. ELIB. PREL. 10mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 23.76 0.792000 0.721666 0.721666

100 N02AA01 MORPHYNUM VENDAL (R) RETARD 30 mg COMPR. FILM. ELIB. PREL. 30mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 25.39 0.846333 0.846000 0.846000101 N02AA01 MORPHYNUM VENDAL (R) RETARD 30 mg COMPR. FILM. ELIB. PREL. 30mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 10 8.46 0.846000 0.846000 0.846000102 N02AA01 MORPHYNUM VENDAL (R) RETARD 60 mg COMPR. FILM. ELIB. PREL. 60mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 52.40 1.746666 1.746666 1.746666103 N02AA01 MORPHYNUM VENDAL (R) RETARD 60 mg COMPR. FILM. ELIB. PREL. 60mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 10 18.04 1.804000 1.746666 1.746666104 N02AA01 MORPHYNUM MSI 10 mg MUNDIPHARMA SOL. INJ. 10 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. P-TS 10 24.22 2.422000 2.422000 2.422000105 N02AA01 MORPHYNUM MSI 20 mg MUNDIPHARMA SOL. INJ. 20mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. P-TS 10 45.93 4.593000 4.593000 4.593000106 N02AA01 MORPHYNUM MORFINA 20 mg/ml SOL. INJ. 20mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE X 1 ML P-TS 5 7.78 1.556000 1.556000 1.556000107 N02AA05 OXYCODONUM OXYCONTIN (R) 10 mg COMPR. FILM. ELIB. MODIF. 10 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. X 56 COMPR. FILM. ELIB. MODIF. P-TS 56 109.69 1.958750 1.958750 1.958750108 N02AA05 OXYCODONUM OXYCONTIN (R) 20 mg COMPR. FILM. ELIB. MODIF. 20 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. X 56 COMPR. FILM. ELIB. MODIF. P-TS 56 201.54 3.598928 3.598928 3.598928109 N02AA05 OXYCODONUM OXYCONTIN (R) 40 mg COMPR. FILM. ELIB. MODIF. 40 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. X 56 COMPR. FILM. ELIB. MODIF. P-TS 56 373.69 6.673035 6.673035 6.673035110 N02AA05 OXYCODONUM OXYCONTIN (R) 80 mg COMPR. FILM. ELIB. MODIF. 80mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. X 56 COMPR. FILM. ELIB. MODIF. P-TS 56 617.28 11.022857 11.022857 11.022857111 N02AA08 DIHYDROCODEINUM DHC CONTINUS 120 mg COMPR. ELIB. PREL. 120mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. P-RF 56 125.00 2.232142 2.232142 2.232142

Pagina 12 din 38

Page 72: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

112 N02AA08 DIHYDROCODEINUM DHC CONTINUS 60 mg COMPR. ELIB. PREL. 60mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. P-RF 56 27.55 0.491964 0.491964 0.491964113 N02AA08 DIHYDROCODEINUM DHC CONTINUS 90 mg COMPR. ELIB. PREL. 90mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. P-RF 56 95.49 1.705178 1.705178 1.705178114 N02AB02 PETHIDINUM MIALGIN (R) 100 mg/2 ml SOL. INJ. 50mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA X 2 ML P-TS 5 7.32 1.464000 1.464000 1.464000115 N02AB03 FENTANYLUM** FENTANYL SANDOZ MATRIX 75mcg/h PLASTURE TRANSDERM. 17,34mg/31,50cmp SANDOZ S.R.L. ROMANIA CUTIE X 5 PLICURI MULTISTRAT X 1 PLASTURE TRANSDERMIC P-TS 5 145.14 29.028000 29.028000 29.028000116 N02AB03 FENTANYLUM** FENTANYL SANDOZ MATRIX 100mcg/h PLASTURE TRANSDERM. 23,12mg/42.00cmp SANDOZ S.R.L. ROMANIA CUTIE X 5 PLICURI MULTISTRAT X 1 PLASTURE TRANSDERMIC P-TS 5 179.57 35.914000 35.914000 35.914000117 N02AB03 FENTANYLUM** FENTANYL SANDOZ 100 mcg/h PLASTURE TRANSDERMIC 100mcg/h SANDOZ S.R.L. ROMANIA CUTIE X 5 PLICURI DIN HARTIE/PE/AL/AL X 1 PLASTURE TRANSDERMIC CU REZERVOR P-TS 5 179.57 35.914000 35.914000 35.914000118 N02AB03 FENTANYLUM** DOLFORIN 100 mcg/ORA PLASTURE TRANSDERMIC 100mcg/ora GEDEON RICHTER PLC UNGARIA CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC P-TS 5 290.81 58.162000 58.162000 58.162000119 N02AB03 FENTANYLUM** FENTANYL ACTAVIS 100micrograme/h PLASTURE TRANSDERMIC 100micrograme/h ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC P-TS 5 307.09 61.418000 61.418000 61.418000120 N02AB03 FENTANYLUM** FENTANYL SANDOZ MATRIX 50mcg/h PLASTURE TRANSDERMIC 11,56mg/21,00cmp SANDOZ S.R.L. ROMANIA CUTIE X 5 PLICURI MULTISTRAT X 1 PLASTURE TRANSDERMIC P-TS 5 113.40 22.680000 22.680000 22.680000121 N02AB03 FENTANYLUM** FENTANYL SANDOZ 25 mcg/h PLASTURE TRANSDERMIC 25mcg/h SANDOZ S.R.L. ROMANIA CUTIE X 5 PLICURI DIN HARTIE/PE/AL/AL X 1 PLASTURE TRANSDERMIC CU REZERVOR P-TS 5 68.61 13.722000 13.722000 13.722000122 N02AB03 FENTANYLUM** DOLFORIN 25 mcg/ORA PLASTURE TRANSDERMIC 25mcg/ora GEDEON RICHTER PLC UNGARIA CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC P-TS 5 97.36 19.472000 19.472000 19.472000123 N02AB03 FENTANYLUM** FENTANYL ACTAVIS 25micrograme/h PLASTURE TRANSDERMIC 25micrograme/h ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC P-TS 5 95.67 19.134000 19.134000 19.134000124 N02AB03 FENTANYLUM** FENTANYL SANDOZ MATRIX 25mcg/h PLASTURE TRANSDERMIC 5,78mg/10,5cmp SANDOZ S.R.L. ROMANIA CUTIE X 5 PLICURI MULTISTRAT X 1 PLASTURE TRANSDERMIC P-TS 5 68.61 13.722000 13.722000 13.722000125 N02AB03 FENTANYLUM** FENTANYL SANDOZ 50 mcg/h PLASTURE TRANSDERMIC 50mcg/h SANDOZ S.R.L. ROMANIA CUTIE X 5 PLICURI DIN HARTIE/PE/AL/AL X 1 PLASTURE TRANSDERMIC CU REZERVOR P-TS 5 113.40 22.680000 22.680000 22.680000126 N02AB03 FENTANYLUM** DOLFORIN 50 mcg/ORA PLASTURE TRANSDERMIC 50mcg/ora GEDEON RICHTER PLC UNGARIA CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC P-TS 5 179.09 35.818000 35.818000 35.818000127 N02AB03 FENTANYLUM** FENTANYL ACTAVIS 50micrograme/h PLASTURE TRANSDERMIC 50micrograme/h ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC P-TS 5 172.43 34.486000 34.486000 34.486000128 N02AB03 FENTANYLUM** FENTANYL SANDOZ 75 mcg/h PLASTURE TRANSDERMIC 75mcg/h SANDOZ S.R.L. AUSTRIA CUTIE X 5 PLICURI DIN HARTIE/PE/AL/AL X 1 PLASTURE TRANSDERMIC CU REZERVOR P-TS 5 145.14 29.028000 29.028000 29.028000129 N02AB03 FENTANYLUM** DOLFORIN 75 mcg/ORA PLASTURE TRANSDERMIC 75mcg/ora GEDEON RICHTER PLC UNGARIA CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC P-TS 5 255.23 51.046000 51.046000 51.046000130 N02AX02 TRAMADOLUM TRAMAL (R) CAPS. 50mg GRUNENTHAL GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 11.09 0.554500 0.274500 0.274500131 N02AX02 TRAMADOLUM TRALGIT 50 CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7.43 0.371500 0.274500 0.274500132 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5.49 0.274500 0.274500 0.274500133 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. X 10 CAPS. P-RF 30 12.26 0.408666 0.274500 0.274500134 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. X 10 CAPS. P-RF/S 50 21.39 0.427800 0.274500 0.274500135 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. X 10 CAPS. P-RF/S 100 41.39 0.413900 0.274500 0.274500136 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 3.82 0.382000 0.274500 0.274500137 N02AX02 TRAMADOLUM MABRON 50 mg CAPS. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 4.68 0.468000 0.274500 0.274500138 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7.21 0.360500 0.274500 0.274500139 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 6.07 0.607000 0.274500 0.274500140 N02AX02 TRAMADOLUM TRAMADOL LPH 50 mg CAPS. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 12.67 0.633500 0.274500 0.274500141 N02AX02 TRAMADOLUM URGENDOL CAPS. 50mg MEDICAROM GROUP SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 4.35 0.435000 0.274500 0.274500142 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 8.44 0.422000 0.274500 0.274500143 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7.21 0.360500 0.360500 0.360500144 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 11.14 0.557000 0.360500 0.360500145 N02AX02 TRAMADOLUM TRAMADOL 50 mg COMPR. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 9.35 0.467500 0.360500 0.360500146 N02AX02 TRAMADOLUM TRAMADOLOR (R) 100 ID COMPR. ELIB. MODIF. 100mg HEXAL AG GERMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. MODIF. P-RF 10 7.06 0.706000 0.592333 0.592333147 N02AX02 TRAMADOLUM TRAMADOL (R) RETARD COMPR. ELIB. PREL. 100mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. X 10 COMPR. ELIB. PREL. P-RF 30 17.77 0.592333 0.592333 0.592333148 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 50 45.52 0.910400 0.592333 0.592333149 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 10 9.26 0.926000 0.592333 0.592333150 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 25.62 0.854000 0.592333 0.592333151 N02AX02 TRAMADOLUM NOAX UNO 100 mg COMPR. ELIB. PREL. 100mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 5 COMPR.ELIM.PREL. P-RF 5 6.96 1.392000 0.592333 0.592333152 N02AX02 TRAMADOLUM NOAX UNO 100 mg COMPR. ELIB. PREL. 100mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.ELIM.PREL. P-RF 30 37.10 1.236666 0.592333 0.592333153 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 31.51 1.050333 1.050333 1.050333154 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 10 19.77 1.977000 1.050333 1.050333155 N02AX02 TRAMADOLUM TRALGIT SR 200 COMPR. ELIB. PREL. 200mg ZENTIVA AS SLOVACIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 10 25.82 2.582000 1.622333 1.622333156 N02AX02 TRAMADOLUM NOAX UNO 200 mg COMPR. ELIB. PREL. 200mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 10 COMPR.ELIB. PREL. P-RF 10 18.86 1.886000 1.622333 1.622333

Pagina 13 din 38

Page 73: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

157 N02AX02 TRAMADOLUM NOAX UNO 200 mg COMPR. ELIB. PREL. 200mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.ELIB. PREL. P-RF 30 48.67 1.622333 1.622333 1.622333158 N02AX02 TRAMADOLUM NOAX UNO 300 mg COMPR. ELIB. PREL. 300mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. X PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P-RF 10 26.22 2.622000 2.393333 2.393333159 N02AX02 TRAMADOLUM NOAX UNO 300 mg COMPR. ELIB. PREL. 300mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST. X PVC-PE-ACLAR/AL X 10 COMPR. ELIB. PREL. P-RF 30 71.80 2.393333 2.393333 2.393333160 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 9.98 0.332666 0.332666 0.332666161 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. FILM. ELIB. PREL. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. AL/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-RF 10 14.39 1.439000 1.439000 1.439000162 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 20.68 2.068000 1.954333 1.954333163 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 58.63 1.954333 1.954333 1.954333164 N02AX02 TRAMADOLUM TRAMAL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. ELIB. PREL. P-RF 10 26.47 2.647000 2.375333 2.375333165 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 71.26 2.375333 2.375333 2.375333166 N02AX02 TRAMADOLUM TRALGIT PIC. ORALE, SOL. 100mg/ml ZENTIVA A.S. SLOVACIA CUTIE X 1 FLACON DIN STICLA BRUNA X 96 ML PIC. ORALE, SOL. P-RF 1 94.31 94.310000 6.040000 6.040000167 N02AX02 TRAMADOLUM TRALGIT PIC. ORALE, SOL. 100mg/ml ZENTIVA A.S. SLOVACIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-RF 1 11.83 11.830000 6.040000 6.040000168 N02AX02 TRAMADOLUM TRAMADOL AL PICATURI PIC. ORALE, SOL. FARA CONCENTRATIE ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-RF 1 6.04 6.040000 6.040000 6.040000169 N02AX02 TRAMADOLUM TRAMADOL AL PICATURI PIC. ORALE, SOL. FARA CONCENTRATIE ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL. P-RF 1 13.00 13.000000 6.040000 6.040000170 N02AX02 TRAMADOLUM TRAMAL (R) PICATURI ORALE-SOL. 100mg/ml GRUNENTHAL GMBH GERMANIA CUTIE X 1 FLACON PICURATOR X 10 ML P-RF 1 7.27 7.270000 6.040000 6.040000171 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 100 128.64 1.286400 1.286400 1.286400172 N02AX02 TRAMADOLUM TRALGIT 100 SOL. INJ. 100mg/2ml ZENTIVA A.S. SLOVACIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 11.53 2.306000 1.286400 1.286400173 N02AX02 TRAMADOLUM TRAMAL (R) 50 SOL. INJ. 50mg/ml GRUNENTHAL GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 7.10 1.420000 1.368000 1.368000174 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 10.06 2.012000 1.368000 1.368000175 N02AX02 TRAMADOLUM TRALGIT 50 SOL. INJ. 50mg/ml ZENTIVA A.S. SLOVACIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S/P-RF 5 10.79 2.158000 1.368000 1.368000176 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 6.84 1.368000 1.368000 1.368000177 N02AX02 TRAMADOLUM TRAMAL (R) 100 SOL. INJ. 50mg/ml GRUNENTHAL GMBH GERMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 12.74 2.548000 1.286400 1.286400178 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 12.30 2.460000 1.286400 1.286400179 N02AX02 TRAMADOLUM TRAMADOL (R) AL 100 Fiole SOL. INJ. 50mg/ml ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 FIOLE X 2 ML S/P-RF 10 18.06 1.806000 1.286400 1.286400180 N02AX02 TRAMADOLUM TRAMADOL (R) AL 100 Fiole SOL. INJ. 50mg/ml ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 9.06 1.812000 1.286400 1.286400181 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 8.49 1.698000 1.286400 1.286400182 N02AX02 TRAMADOLUM TRAMAL (R) SUPOZ. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 FOLIE PP/AL/PE X 5 SUPOZ. P-RF 5 12.13 2.426000 1.048000 1.048000183 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 5 SUPOZ. P-RF 5 5.24 1.048000 1.048000 1.048000184 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 12.30 0.246000 0.246000 0.246000185 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 4.61 0.153666 0.139500 0.139500186 R05DA04 CODEINUM CODEINA FOSFORICA COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 4.81 0.192400 0.139500 0.139500187 R05DA04 CODEINUM FARMACOD COMPR. 15mg FARMACOM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 2.84 0.142000 0.139500 0.139500188 R05DA04 CODEINUM CODEINA FOSFAT 15 mg COMPR. 15mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2.79 0.139500 0.139500 0.139500189 R05DA04 CODEINUM CODEINA FOSFAT COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2.84 0.142000 0.139500 0.139500190 R05DA04 CODEINUM CODEINA FOSFAT LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-RF 20 3.00 0.150000 0.139500 0.139500191 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 10 129.13 12.913000 12.913000 12.913000192 V03AC03 DEFERASIROXUM*** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL) P-RF/R 28 743.82 26.565000 24.877976 24.877976193 V03AC03 DEFERASIROXUM*** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 84 COMPR. DISP. (BLIST. PVC/PE/PVDC/AL) P-RF/R 84 2089.75 24.877976 24.877976 24.877976194 V03AC03 DEFERASIROXUM*** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 84 COMPR. DISP. ( PVC/PE/PVDC/AL) P-RF/R 84 4465.73 53.163452 53.163452 53.163452195 V03AC03 DEFERASIROXUM*** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) P-RF/R 28 1535.81 54.850357 53.163452 53.163452196 V03AC03 DEFERASIROXUM*** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 84 COMPR. DISP. ( PVC/PE/PVDC/AL) P-RF/R 84 8146.44 96.981428 96.981428 96.981428197 V03AC03 DEFERASIROXUM*** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) P-RF/R 28 2762.71 98.668214 96.981428 96.981428Tratamentul se initiaza de catre medicul in specialitatea oncologie sau hematologie

9. EPILEPSIE - G11

Pagina 14 din 38

Page 74: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1 N03AA02 PHENOBARBITALUM FENOBARBITAL 100 mg COMPR. 100 mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 2.60 0.104000 0.104000 0.1040002 N03AA02 PHENOBARBITALUM FENOBARBITAL 100 mg COMPR. 100mg SC ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 10 COMPR. P-RF 10 1.08 0.108000 0.104000 0.1040003 N03AA02 PHENOBARBITALUM FENOBARBITAL 200 mg/ 2 ml SOL. INJ. 10% ZENTIVA S.A ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF 5 4.87 0.974000 0.974000 0.9740004 N03AB02 PHENYTOINUM FENITOIN 100 mg COMPR. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 1.14 0.057000 0.057000 0.0570005 N03AB02 PHENYTOINUM PHENHYDAN (R)SOLUTIE INJECTABILA SOL. INJ. 50mg/ml DESITIN GERMANIA CUTIE X 5 FIOLE X 5ML P-RF 5 48.79 9.758000 9.758000 9.7580006 N03AE01 CLONAZEPAMUM RIVOTRIL COMPR. 0,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 COMPR. P-RF 50 6.47 0.129400 0.129400 0.1294007 N03AE01 CLONAZEPAMUM RIVOTRIL (R) COMPR. 2mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 6.16 0.205333 0.205333 0.2053338 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA COMPR. 200mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVCX 10 COMPR. P-6L 20 4.25 0.212500 0.135600 0.1356009 N03AF01 CARBAMAZEPINUM NEUROTOP COMPR. 200mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. P-6L 50 10.62 0.212400 0.135600 0.135600

10 N03AF01 CARBAMAZEPINUM TEGRETOL (R) 200 COMPR. 200mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 50 16.33 0.326600 0.135600 0.13560011 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA LPH 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 11.46 0.229200 0.135600 0.13560012 N03AF01 CARBAMAZEPINUM CARBAVIM COMPR. 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 13.90 0.278000 0.135600 0.13560013 N03AF01 CARBAMAZEPINUM CARBEPSIL 200 COMPR. 200mg AC HELCOR SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 15.13 0.302600 0.135600 0.13560014 N03AF01 CARBAMAZEPINUM TAVER COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 6.78 0.135600 0.135600 0.13560015 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4.81 0.240500 0.135600 0.13560016 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN EEL COMPR. 200mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4.93 0.246500 0.135600 0.13560017 N03AF01 CARBAMAZEPINUM FINLEPSIN COMPR. 200mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. P-6L 50 10.62 0.212400 0.135600 0.13560018 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4.65 0.232500 0.135600 0.13560019 N03AF01 CARBAMAZEPINUM CARBEPSIL 400 COMPR. 400mg AC HELCOR SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 24.65 0.493000 0.493000 0.49300020 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 300 mg COMPR. ELIB. PREL. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL P-6L 50 19.41 0.388200 0.387000 0.38700021 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 600 mg COMPR. ELIB. PREL. 600mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL. P-6L 50 34.36 0.687200 0.686000 0.68600022 N03AF01 CARBAMAZEPINUM FINLEPSIN 400 RETARD COMPR. FILM. 400mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 25.45 0.509000 0.509000 0.50900023 N03AF01 CARBAMAZEPINUM TEGRETOL CR 200 COMPR. FILM. ELIB. PREL. 200mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L 50 18.00 0.360000 0.233800 0.23380024 N03AF01 CARBAMAZEPINUM TEGRETOL CR 400 COMPR. FILM. ELIB. PREL. 400mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L 30 23.79 0.793000 0.793000 0.79300025 N03AF01 CARBAMAZEPINUM TIMONIL 150 RETARD COMPR. RET. 150mg DESITIN GERMANIA CUTIE X 5 BLIST. X 10 COMPR. RET. P-6L 50 14.22 0.284400 0.284400 0.28440026 N03AF01 CARBAMAZEPINUM TIMONIL 300 RETARD COMPR. RET. 300mg DESITIN GERMANIA CUTIE X 5 BLIST. X 10 COMPR. RET. P-6L 50 19.35 0.387000 0.387000 0.38700027 N03AF01 CARBAMAZEPINUM TIMONIL 600 RETARD COMPR. RET. 600mg DESITIN GERMANIA CUTIE X 5 BLIST. X 10 COMPR. RET. P-6L 50 34.30 0.686000 0.686000 0.68600028 N03AF01 CARBAMAZEPINUM FINLEPSIN 200 RETARD COMPR.FILM.ELIB.PREL 200mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL-HARTIE/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 11.69 0.233800 0.233800 0.23380029 N03AF01 CARBAMAZEPINUM TIMONIL SIROP SUSP. ORALA 100mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE P-6L 1 21.14 21.140000 21.140000 21.14000030 N03AF02 OXCARBAZEPINUM TRILEPTAL (R) 300 mg COMPR. FILM. 300mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 50 60.78 1.215600 1.215600 1.21560031 N03AF02 OXCARBAZEPINUM TRILEPTAL (R) 600 mg COMPR. FILM. 600mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 50 111.08 2.221600 2.221600 2.22160032 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 150 mg CAPS. ELIB. PREL. 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 20.60 0.412000 0.412000 0.41200033 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 300 mg CAPS. ELIB. PREL. 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PREL. P-6L 50 34.50 0.690000 0.690000 0.69000034 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX (R) 150 mg CAPS. MOI GASTROREZ. 150mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ. P-6L 100 19.03 0.190300 0.190300 0.19030035 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX (R) 300 mg CAPS. MOI GASTROREZ. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ. P-6L 100 31.25 0.312500 0.312500 0.31250036 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX (R) 500 mg CAPS. MOI GASTROREZ. 500mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 10 BLIST. AL/PVDC-PVCX 10 CAPS. MOI GASTROREZ. P-6L 100 48.00 0.480000 0.480000 0.48000037 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX RETARD 300 mg COMPR. FILM. ELIB. MODIF. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 COMPR. FILM. ELIB. MODIF. P-6L 50 21.34 0.426800 0.337300 0.33730038 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX RETARD 300 mg COMPR. FILM. ELIB. MODIF. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PEID X 50 COMPR. FILM. ELIB. MODIF. CU CAPAC SNAP-ON P-6L 50 21.34 0.426800 0.337300 0.33730039 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX RETARD 300 mg COMPR. FILM. ELIB. MODIF. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PEID X 50 COMPR. FILM. ELIB. MODIF. CU CAPAC SCREW CAP P-6L 50 21.34 0.426800 0.337300 0.33730040 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX RETARD 500 mg COMPR. FILM. ELIB. MODIF. 500mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 COMPR. FILM. ELIB. MODIF. P-6L 50 32.56 0.651200 0.502666 0.50266641 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX RETARD 500 mg COMPR. FILM. ELIB. MODIF. 500mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PEID X 50 COMPR. FILM. ELIB. MODIF. CU CAPAC SNAP-ON P-6L 50 32.56 0.651200 0.502666 0.50266642 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX RETARD 500 mg COMPR. FILM. ELIB. MODIF. 500mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PEID X 50 COMPR. FILM. ELIB. MODIF. CU CAPAC SCREW CAP P-6L 50 32.56 0.651200 0.502666 0.50266643 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 300 mg COMPR. FILM. ELIB. PREL. DIVIZ. 300mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 FLAC. DIN PP X 50 COMPR. FILM. ELIB. PREL., DIVIZIBILE P-6L 100 33.73 0.337300 0.337300 0.33730044 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE (R) CHRONO 500 mg COMPR. FILM. ELIB. PREL. DIVIZ. 500mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. DIVIZIBILE P-6L 30 15.08 0.502666 0.502666 0.502666

Pagina 15 din 38

Page 75: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

45 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 150 COMPR. FILM. GASTROREZ. 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 COMPR.FILM. GASTROREZ. P-6L 100 27.37 0.273700 0.273700 0.27370046 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. FILM. GASTROREZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. DIN PP X 40 COMPR. FILM. GASTROREZ. P-6L 40 10.08 0.252000 0.252000 0.25200047 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 300 COMPR. FILM. GASTROREZ. 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 100 COMPR. FILM. GASTROREZ. P-6L 100 35.28 0.352800 0.352800 0.35280048 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 600 COMPR. FILM. GASTROREZ. 600mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. FILM. GASTROREZ. P-6L 50 37.56 0.751200 0.751200 0.75120049 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE (R) 400 mg/4 ml LIOFILIZAT SI SOLVENT PENTRU SOLUTIE INJECTABILA i.v. LIOF. + SOLV. PT. SOL. 400mg/4ml SANOFI-AVENTIS FRANCE FRANTA CUTIE X 4 FLAC. CU LIOF. PT. SOL. INJ. + 4 FIOLE SOLV. X 4ML S/P-RF 4 123.57 30.892500 30.892500 30.89250050 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 1000 mg MINICOMPR. ELIB. PREL. 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 89.13 1.782600 1.782600 1.78260051 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 500 mg MINICOMPR. ELIB. PREL. 500mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 55.84 1.116800 1.116800 1.11680052 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL SIROP SIROP 300mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLACON X 250 ML + LINGURITA DOZATOARE PP A 5 ML P-6L 1 34.04 34.040000 34.040000 34.04000053 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 50mg/ml SIROP 50mg/ml GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML SIROP + 1 SERINGA PT. ADMIN. ORALA (0,5-10,0 ML) P-6L 1 8.17 8.170000 8.170000 8.17000054 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA P-6L 1 21.71 21.710000 21.710000 21.71000055 N03AX09 LAMOTRIGINUM** LAMOTIRAN 100 mg COMPR. 100mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR. P-6L 28 32.22 1.150714 0.903333 0.90333356 N03AX09 LAMOTRIGINUM** LAMOTIRAN 100 mg COMPR. 100mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-6L 30 33.40 1.113333 0.903333 0.90333357 N03AX09 LAMOTRIGINUM** LAMOTRIX 100 mg COMPR. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 54.75 1.825000 0.903333 0.90333358 N03AX09 LAMOTRIGINUM** LAMOLEP 100 mg COMPR. 100mg GEDEON RICHTER PLC UNGARIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 54.28 1.809333 0.903333 0.90333359 N03AX09 LAMOTRIGINUM** EPIMIL 100 mg COMPR. 100mg IVAX PHARMCEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. PVC-PVDC/PVC-AL X 10 COMPR. P-6L 30 27.10 0.903333 0.903333 0.90333360 N03AX09 LAMOTRIGINUM** PLEXXO (R) 100 mg COMPR. 100mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 36.80 1.226666 0.903333 0.90333361 N03AX09 LAMOTRIGINUM** XEBARIN 100 mg COMPR. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 29.98 1.070714 0.903333 0.90333362 N03AX09 LAMOTRIGINUM** LAMOTRIGINE FARMAL 100 mg COMPR. 100mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 37.87 1.262333 0.903333 0.90333363 N03AX09 LAMOTRIGINUM** LAMICTAL 100 mg COMPR. 100mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 40.35 1.345000 0.903333 0.90333364 N03AX09 LAMOTRIGINUM** LAMOTIRAN 200 mg COMPR. 200mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-6L 30 107.64 3.588000 1.946071 1.94607165 N03AX09 LAMOTRIGINUM** LAMOTIRAN 200 mg COMPR. 200mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR. P-6L 28 86.44 3.087142 1.946071 1.94607166 N03AX09 LAMOTRIGINUM** LAMOTRIX 200 mg COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 93.45 3.115000 1.946071 1.94607167 N03AX09 LAMOTRIGINUM** XEBARIN 200 mg COMPR. 200mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 54.49 1.946071 1.946071 1.94607168 N03AX09 LAMOTRIGINUM** LAMICTAL 25 mg COMPR. 25mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10.46 0.348666 0.080357 0.08035769 N03AX09 LAMOTRIGINUM** LAMOTIRAN 25 mg COMPR. 25mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR. P-6L 28 13.57 0.484642 0.080357 0.08035770 N03AX09 LAMOTRIGINUM** LAMOTIRAN 25 mg COMPR. 25mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-6L 30 14.55 0.485000 0.080357 0.08035771 N03AX09 LAMOTRIGINUM** LAMOTRIX 25 mg COMPR. 25mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 19.72 0.657333 0.080357 0.08035772 N03AX09 LAMOTRIGINUM** LAMOLEP 25 mg COMPR. 25mg GEDEON RICHTER PLC UNGARIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 17.86 0.595333 0.080357 0.08035773 N03AX09 LAMOTRIGINUM** EPIMIL 25mg COMPR. 25mg IVAX PHARMCEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. PVC--PVDC/PVC-AL X 10 COMPR. P-6L 30 6.80 0.226666 0.080357 0.08035774 N03AX09 LAMOTRIGINUM** PLEXXO (R) 25 mg COMPR. 25mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 16.21 0.540333 0.080357 0.08035775 N03AX09 LAMOTRIGINUM** XEBARIN 25 mg COMPR. 25mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 2.25 0.080357 0.080357 0.08035776 N03AX09 LAMOTRIGINUM** LAMOTRIGINE FARMAL 25 mg COMPR. 25mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 14.79 0.493000 0.080357 0.08035777 N03AX09 LAMOTRIGINUM** PLEXXO (R) 50 mg COMPR. 50mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 26.19 0.873000 0.451000 0.45100078 N03AX09 LAMOTRIGINUM** LAMOTIRAN 50 mg COMPR. 50mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR. P-6L 28 21.86 0.780714 0.451000 0.45100079 N03AX09 LAMOTRIGINUM** LAMOTIRAN 50 mg COMPR. 50mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-6L 30 23.42 0.780666 0.451000 0.45100080 N03AX09 LAMOTRIGINUM** LAMOTRIX 50 mg COMPR. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 33.40 1.113333 0.451000 0.45100081 N03AX09 LAMOTRIGINUM** LAMOLEP 50 mg COMPR. 50mg GEDEON RICHTER PLC UNGARIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 32.80 1.093333 0.451000 0.45100082 N03AX09 LAMOTRIGINUM** EPIMIL 50 mg COMPR. 50mg IVAX PHARMCEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. PVC-PVDC/PVC-AL X 10 COMPR. P-6L 30 13.53 0.451000 0.451000 0.45100083 N03AX09 LAMOTRIGINUM** XEBARIN 50 mg COMPR. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 15.41 0.550357 0.451000 0.45100084 N03AX09 LAMOTRIGINUM** LAMOTRIGINE FARMAL 50 mg COMPR. 50mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 24.81 0.827000 0.451000 0.45100085 N03AX09 LAMOTRIGINUM** LAMICTAL 50 mg COMPR. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 20.82 0.694000 0.451000 0.45100086 N03AX09 LAMOTRIGINUM** LAMOTRIGIN STADA 100 mg COMPR. DISP. 100mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. DISP. P-6L 30 28.03 0.934333 0.934333 0.93433387 N03AX09 LAMOTRIGINUM** LAMOTRIN 100 mg COMPR. DISP. 100mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 36.09 1.203000 0.934333 0.93433388 N03AX09 LAMOTRIGINUM** LAMOTRIGIN STADA 25 mg COMPR. DISP. 25mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. DISP. P-6L 30 0.71 0.023666 0.023666 0.02366689 N03AX09 LAMOTRIGINUM** LAMOTRIN 25 mg COMPR. DISP. 25mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 3.57 0.119000 0.023666 0.023666

Pagina 16 din 38

Page 76: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

90 N03AX09 LAMOTRIGINUM** LAMOTRIGIN STADA 50 mg COMPR. DISP. 50mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. DISP. P-6L 30 14.05 0.468333 0.468333 0.46833391 N03AX09 LAMOTRIGINUM** LAMOTRIN 50 mg COMPR. DISP. 50mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 24.84 0.828000 0.468333 0.46833392 N03AX09 LAMOTRIGINUM** LAMICTAL 25 mg COMPR. DISP./MAST. 25mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISP./MAST. P-6L 30 17.09 0.569666 0.023666 0.02366693 N03AX11 TOPIRAMATUM** TOPAMAX 100 mg COMPR. FILM. 100mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. P-6L 28 121.67 4.345357 2.678333 2.67833394 N03AX11 TOPIRAMATUM** TOPRAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L 60 229.36 3.822666 2.678333 2.67833395 N03AX11 TOPIRAMATUM** TOPIRAMAT TEVA 100 mg COMPR. FILM. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 84.74 2.824666 2.678333 2.67833396 N03AX11 TOPIRAMATUM** TOPIRAMAT ACTAVIS 100 mg COMPR. FILM. 100mg ACTAVIS S.R.L. ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 60 240.76 4.012666 2.678333 2.67833397 N03AX11 TOPIRAMATUM** ZIDOXER 100 mg COMPR. FILM. 100mg OZONE LABORATORIES BV OLANDA CUTIE X BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 79.09 2.824642 2.678333 2.67833398 N03AX11 TOPIRAMATUM** ZIDOXER 100 mg COMPR. FILM. 100mg OZONE LABORATORIES BV OLANDA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 160.70 2.678333 2.678333 2.67833399 N03AX11 TOPIRAMATUM** TOPILEX 100 mg COMPR. FILM. 100mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE CU BLIST. PVC-PE - PVDC/AL X 30 COMPR. FILM. P-6L 30 84.74 2.824666 2.678333 2.678333

100 N03AX11 TOPIRAMATUM** TOPAMAX 200 mg COMPR. FILM. 200mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. P-6L 28 214.47 7.659642 4.978571 4.978571101 N03AX11 TOPIRAMATUM** TOPRAN 200 mg COMPR. FILM. 200mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L 60 433.73 7.228833 4.978571 4.978571102 N03AX11 TOPIRAMATUM** TOPIRAMAT TEVA 200 mg COMPR. FILM. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 149.37 4.979000 4.978571 4.978571103 N03AX11 TOPIRAMATUM** ZIDOXER 200 mg COMPR. FILM. 200mg OZONE LABORATORIES BV OLANDA CUTIE X BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 139.40 4.978571 4.978571 4.978571104 N03AX11 TOPIRAMATUM** ZIDOXER 200 mg COMPR. FILM. 200mg OZONE LABORATORIES BV OLANDA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 298.72 4.978666 4.978571 4.978571105 N03AX11 TOPIRAMATUM** TOPAMAX 25 mg COMPR. FILM. 25mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. P-6L 28 38.14 1.362142 0.885500 0.885500106 N03AX11 TOPIRAMATUM** TOPRAN 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L 60 63.54 1.059000 0.885500 0.885500107 N03AX11 TOPIRAMATUM** TOPIRAMAT TEVA 25 mg COMPR. FILM. 25mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 27.44 0.914666 0.885500 0.885500108 N03AX11 TOPIRAMATUM** TOPIRAMAT ACTAVIS 25 mg COMPR. FILM. 25mg ACTAVIS S.R.L. ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 60 84.97 1.416166 0.885500 0.885500109 N03AX11 TOPIRAMATUM** ZIDOXER 25 mg COMPR. FILM. 25mg OZONE LABORATORIES BV OLANDA CUTIE X BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 25.62 0.915000 0.885500 0.885500110 N03AX11 TOPIRAMATUM** ZIDOXER 25 mg COMPR. FILM. 25mg OZONE LABORATORIES BV OLANDA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 53.13 0.885500 0.885500 0.885500111 N03AX11 TOPIRAMATUM** TOPILEX 25 mg COMPR. FILM. 25mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE CU BLIST. PVC-PE - PVDC/AL X 30 COMPR. FILM. P-6L 30 27.44 0.914666 0.885500 0.885500112 N03AX11 TOPIRAMATUM** TOPAMAX 50 mg COMPR. FILM. 50mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. P-6L 28 69.97 2.498928 1.595666 1.595666113 N03AX11 TOPIRAMATUM** TOPRAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L 60 120.87 2.014500 1.595666 1.595666114 N03AX11 TOPIRAMATUM** TOPIRAMAT TEVA 50 mg COMPR. FILM. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 50.40 1.680000 1.595666 1.595666115 N03AX11 TOPIRAMATUM** TOPIRAMAT ACTAVIS 50 mg COMPR. FILM. 50mg ACTAVIS S.R.L. ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 60 113.29 1.888166 1.595666 1.595666116 N03AX11 TOPIRAMATUM** ZIDOXER 50 mg COMPR. FILM. 50mg OZONE LABORATORIES BV OLANDA CUTIE X BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 47.04 1.680000 1.595666 1.595666117 N03AX11 TOPIRAMATUM** ZIDOXER 50 mg COMPR. FILM. 50mg OZONE LABORATORIES BV OLANDA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 95.74 1.595666 1.595666 1.595666118 N03AX11 TOPIRAMATUM** TOPILEX 50 mg COMPR. FILM. 50mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE CU BLIST. PVC-PE - PVDC/AL X 30 COMPR. FILM. P-6L 30 50.40 1.680000 1.595666 1.595666119 N03AX12 GABAPENTINUM*** GABAGAMMA 100 mg CAPS. 100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 56.90 0.569000 0.536800 0.536800120 N03AX12 GABAPENTINUM*** GABAGAMMA 100 mg CAPS. 100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 29.15 0.583000 0.536800 0.536800121 N03AX12 GABAPENTINUM*** GABALEPT 100 mg CAPS. 100mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 53.68 0.536800 0.536800 0.536800122 N03AX12 GABAPENTINUM*** GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 67.75 1.355000 1.249700 1.249700123 N03AX12 GABAPENTINUM*** GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 32.22 1.611000 1.249700 1.249700124 N03AX12 GABAPENTINUM*** GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 125.41 1.254100 1.249700 1.249700125 N03AX12 GABAPENTINUM*** GABARAN 300 mg CAPS. 300mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 64.06 1.281200 1.249700 1.249700126 N03AX12 GABAPENTINUM*** GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 124.97 1.249700 1.249700 1.249700127 N03AX12 GABAPENTINUM*** GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 88.76 1.775200 1.390200 1.390200128 N03AX12 GABAPENTINUM*** GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 40.38 2.019000 1.390200 1.390200129 N03AX12 GABAPENTINUM*** GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 164.48 1.644800 1.390200 1.390200130 N03AX12 GABAPENTINUM*** GABARAN 400 mg CAPS. 400mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 69.51 1.390200 1.390200 1.390200131 N03AX12 GABAPENTINUM*** GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 158.84 1.588400 1.390200 1.390200132 N03AX12 GABAPENTINUM*** GABARAN 600 mg COMPR. FILM. 600mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 61.23 2.041000 2.041000 2.041000133 N03AX12 GABAPENTINUM*** GABARAN 800 mg COMPR. FILM. 800mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 97.88 3.262666 3.262666 3.262666134 N03AX14 LEVETIRACETAMUM** KEPPRA 1000 mg COMPR. FILM. 1000mg UCB PHARMA SA BELGIA CUTIE X 30 COMPR. FILM.1 (BLIST. AL/PVC) P-RF 30 324.12 10.804000 10.804000 10.804000

Pagina 17 din 38

Page 77: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

135 N03AX14 LEVETIRACETAMUM** KEPPRA 250 mg COMPR. FILM. 250mg UCB PHARMA SA BELGIA CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF 30 85.55 2.851666 2.851666 2.851666136 N03AX14 LEVETIRACETAMUM** KEPPRA 500 mg COMPR. FILM. 500mg UCB PHARMA LTD BELGIA CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF 30 161.05 5.368333 5.368333 5.368333137 N03AX14 LEVETIRACETAMUM** KEPPRA 100 mg/ml SOL. ORALA 100mg/ml UCB PHARMA SA BELGIA CUTIE X 1 FLACON X 300 ML SOL. ORALA + SERINGA PT. ADMIN. ORALA P-RF 1 318.56 318.560000 318.560000 318.560000138 N03AX16 PREGABALINUM*** LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 71.51 5.107857 4.843928 4.843928139 N03AX16 PREGABALINUM*** LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 271.26 4.843928 4.843928 4.843928140 N03AX16 PREGABALINUM*** LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 401.20 7.164285 7.164285 7.164285141 N03AX16 PREGABALINUM*** LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 107.30 7.664285 7.164285 7.164285142 N03AX16 PREGABALINUM*** LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 50.44 3.602857 3.244821 3.244821143 N03AX16 PREGABALINUM*** LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 181.71 3.244821 3.244821 3.244821

Tratamentul se initiaza de catre medicul in specialitatea neurologie

10. BOALA PARKINSON - G12

1 N04AA01 TRIHEXYPHENIDYLUM ROMPARKIN (R) 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 13.85 0.277000 0.277000 0.2770002 N04AA02 BIPERIDENUM AKINETON COMPR. 2mg DESMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 9.92 0.198400 0.198400 0.198400

3 N04BA02

COMBINATII (LEVODOPUM+BENSERAZIDUM)** MADOPAR HBS CAPS. ELIB. MODIF. 100mg+25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 CAPS. CU ELIB. MODIF. P-6L 100 55.28 0.552800 0.552800 0.552800

4 N04BA02

COMBINATII (LEVODOPUM+BENSERAZIDUM)** MADOPAR (R) 250 COMPR. 200mg+50mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. X 30 COMPR. P-6L 30 45.40 1.513333 0.758000 0.758000

5 N04BA02

COMBINATII (LEVODOPUM+BENSERAZIDUM)** MADOPAR 250 COMPR. 200mg+50mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 22.74 0.758000 0.758000 0.758000

6 N04BA02

COMBINATII (LEVODOPUM+CARBIDOPUM)** ZIMOX COMPR. 250mg+25mg FARAN LABORATORIES S.A. GRECIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 18.04 0.601333 0.400700 0.400700

7 N04BA02

COMBINATII (LEVODOPUM+CARBIDOPUM)** CREDANIL 25/250 COMPR. 250mg+25mg REMEDICA LTD. CIPRU CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 18.12 0.906000 0.400700 0.400700

8 N04BA02

COMBINATII (LEVODOPUM+CARBIDOPUM)** CARBIDOPA / LEVODOPA TEVA 25/250 COMPR. 250mg+25mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10 BLIST. X 10 COMPR. P-6L 100 40.07 0.400700 0.400700 0.400700

9 N04BA02

COMBINATII (LEVODOPUM+CARBIDOPUM)** NAKOM COMPR. 250mg+25mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-6L 100 58.26 0.582600 0.400700 0.400700

10 N04BA02

COMBINATII (LEVODOPUM+CARBIDOPUM)** ISICOM 250 mg/25 mg COMPR. 250mg/25mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 10 BLIST. PP/AL X 10 COMPR. P-6L 100 71.26 0.712600 0.400700 0.400700

11 N04BA02

COMBINATII (LEVODOPUM+CARBIDOPUM)** DUODOPA GEL INT. FARA CONCENTRATIE SOLVAY PHARMACEUTICALS BV GERMANIA CUTIE X 7 CASETE BRUNE TRANSPARENTE X 100 GEL INT. IN PUNGA PVC S/P-RF 7 3220.07 460.010000 460.010000 460.010000

12 N04BA03

COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 393.05 3.930500 3.930500 3.930500

Pagina 18 din 38

Page 78: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

13 N04BA03

COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 393.05 3.930500 3.930500 3.930500

14 N04BA03

COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 515.96 5.159600 5.159600 5.159600

15 N04BA03

COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 393.05 3.930500 3.930500 3.930500

16 N04BB01 AMANTADINUM** VIREGYT (R)- K CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 16.02 0.320400 0.320400 0.32040017 N04BC01 BROMOCRIPTINUM BROCRIPTIN (N04BC01) DRAJ. 2,5mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 DRAJ. P-RF 40 19.86 0.496500 0.496500 0.49650018 N04BC04 ROPINIROLUM** REQUIP 0,25 mg COMPR. FILM. 0,25mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 4 FOLII = 1 X 21 COMPR.FILM. + 1 X 42 COMPR.FILM. + 1 X 63 COMPR.FILM. + 1 X 84 COMPR.FILM. P-6L 210 102.50 0.488095 0.488095 0.48809519 N04BC04 ROPINIROLUM** ALETA 0,25mg COMPR. FILM. 0,25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 30 15.28 0.509333 0.488095 0.48809520 N04BC04 ROPINIROLUM** ALETA 0,25mg COMPR. FILM. 0,25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. FILM. P-RF 30 15.28 0.509333 0.488095 0.48809521 N04BC04 ROPINIROLUM** ALETA 0,5mg COMPR. FILM. 0,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 30 24.28 0.809333 0.809333 0.80933322 N04BC04 ROPINIROLUM** ALETA 0,5mg COMPR. FILM. 0,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. FILM. P-RF 30 24.28 0.809333 0.809333 0.80933323 N04BC04 ROPINIROLUM** REQUIP 1 mg COMPR. FILM. 1mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 21 COMPR.FILM. P-6L 21 33.18 1.580000 1.443333 1.44333324 N04BC04 ROPINIROLUM** ALETA 1mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 30 43.30 1.443333 1.443333 1.44333325 N04BC04 ROPINIROLUM** ALETA 1mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X 3 BLIST.PVC-ACLAR/AL X 10 COMPR. FILM. P-RF 30 43.30 1.443333 1.443333 1.44333326 N04BC04 ROPINIROLUM** REQUIP 2 mg COMPR. FILM. 2mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 21 COMPR.FILM. P-6L 21 52.90 2.519047 2.237000 2.23700027 N04BC04 ROPINIROLUM** ALETA 2mg COMPR. FILM. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 30 67.11 2.237000 2.237000 2.23700028 N04BC04 ROPINIROLUM** ALETA 2mg COMPR. FILM. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. FILM. P-RF 30 67.11 2.237000 2.237000 2.23700029 N04BC04 ROPINIROLUM** REQUIP 5 mg COMPR. FILM. 5mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 21 COMPR.FILM. P-6L 21 114.48 5.451428 4.384333 4.38433330 N04BC04 ROPINIROLUM** ALETA 5mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 30 131.53 4.384333 4.384333 4.38433331 N04BC04 ROPINIROLUM** ALETA 5mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. FILM. P-RF 30 131.53 4.384333 4.384333 4.38433332 N04BC04 ROPINIROLUM** REQUIP-MODUTAB 2 mg COMPR. FILM. ELIB. PREL. 2mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. ELIB. PREL. P-RF 28 57.62 2.057857 2.057857 2.05785733 N04BC04 ROPINIROLUM** REQUIP-MODUTAB 4 mg COMPR. FILM. ELIB. PREL. 4mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. ELIB. PREL, P-RF 28 109.35 3.905357 3.905357 3.90535734 N04BC04 ROPINIROLUM** REQUIP-MODUTAB 8 mg COMPR. FILM. ELIB. PREL. 8mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. ELIB. PREL. P-RF 28 207.47 7.409642 7.409642 7.40964235 N04BC05 PRAMIPEXOLUM** OPRYMEA 0,088mg COMPR. 0,088mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 18.55 0.618333 0.618333 0.61833336 N04BC05 PRAMIPEXOLUM** MIRAPEXIN 0,18 mg COMPR. 0,18mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 46.73 1.557666 1.193000 1.19300037 N04BC05 PRAMIPEXOLUM** OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 35.79 1.193000 1.193000 1.19300038 N04BC05 PRAMIPEXOLUM** MIRAPEXIN 0,7 mg COMPR. 0,7mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 157.60 5.253333 3.965000 3.96500039 N04BC05 PRAMIPEXOLUM** OPRYMEA 0,7mg COMPR. 0,7mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 118.95 3.965000 3.965000 3.96500040 N04BC09 ROTIGOTINUM*** NEUPRO 2mg/24h PLASTURE TRANSDERMIC 2mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 346.36 12.370000 12.370000 12.37000041 N04BC09 ROTIGOTINUM*** NEUPRO 2mg/24h PLASTURE TRANSDERMIC 2mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 7 PLASTURI TRANSDERMICI P-RF 7 92.16 13.165714 12.370000 12.37000042 N04BC09 ROTIGOTINUM*** NEUPRO 4mg/24h PLASTURE TRANSDERMIC 4mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 7 PLASTURI TRANSDERMICI P-RF 7 95.45 13.635714 12.926071 12.92607143 N04BC09 ROTIGOTINUM*** NEUPRO 4mg/24h PLASTURE TRANSDERMIC 4mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 361.93 12.926071 12.926071 12.92607144 N04BC09 ROTIGOTINUM*** NEUPRO 6mg/24h PLASTURE TRANSDERMIC 6mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 452.74 16.169285 16.169285 16.16928545 N04BC09 ROTIGOTINUM*** NEUPRO 6mg/24h PLASTURE TRANSDERMIC 6mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 7 PLASTURI TRANSDERMICI P-RF 7 124.05 17.721428 16.169285 16.16928546 N04BC09 ROTIGOTINUM*** NEUPRO 8mg/24h PLASTURE TRANSDERMIC 8mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 540.86 19.316428 19.316428 19.31642847 N04BC09 ROTIGOTINUM*** NEUPRO 8mg/24h PLASTURE TRANSDERMIC 8mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 7 PLASTURI TRANSDERMICI P-RF 7 144.76 20.680000 19.316428 19.31642848 N04BD01 SELEGILINUM SELEGOS COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 BLIST. DIN AL/PVC X 10 COMPR. P-6L 50 34.09 0.681800 0.660700 0.66070049 N04BD01 SELEGILINUM SELEGOS COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. DIN AL/PVC X 10 COMPR. P-6L 100 66.07 0.660700 0.660700 0.66070050 N04BD01 SELEGILINUM JUMEX 5 mg COMPR. 5mg CHINOIN PRIVATE CO. LTD. UNGARIA CUTIE X 5 BLIST. AL/AL X 10 COMPR. P-6L 50 39.19 0.783800 0.660700 0.66070051 N04BD02 RASAGILINUM*** AZILECT 1mg COMPR. 1mg TEVA PHARMA GMBH GERMANIA CUTIE X 30 COMPR.(BLIST. AL/AL) P-RF 30 495.95 16.531666 16.531666 16.53166652 N04BX02 ENTACAPONUM*** COMTAN 200mg COMPR. FILM. 200mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA CU SISTEM DE INCHIDERE SECURIZAT X 100 COMPR. FILM. P-RF 100 370.08 3.700800 3.700800 3.700800

Pagina 19 din 38

Page 79: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

53 N04BX02 ENTACAPONUM*** COMTAN 200mg COMPR. FILM. 200mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA CU SISTEM DE INCHIDERE SECURIZAT X 30 COMPR. FILM. P-RF 30 117.61 3.920333 3.700800 3.70080054 N05AH02 CLOZAPINUM** LEPONEX (R) 100 mg COMPR. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 100.26 2.005200 2.005200 2.00520055 N05AH02 CLOZAPINUM** LEPONEX (R) 25 mg COMPR. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 31.59 0.631800 0.631800 0.631800

Tratamentul se initiaza de catre medicul in specialitatea neurologie

1 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 1.68 0.084000 0.077666 0.0776662 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.47 0.082333 0.077666 0.0776663 H02AB07 PREDNISONUM N - PREDNISON COMPR. 5mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 2.33 0.077666 0.077666 0.0776664 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.37 0.079000 0.077666 0.0776665 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 1.68 0.084000 0.077666 0.0776666 L01BA01 METHOTREXATUM4

METOTREXATE BELLON 2,5 mg COMPR. 2,5mg FARMEXINM S.R.L. ROMANIA CUTIE X 20 COMPR. X 20 21.45 1.072500 1.072500 1.0725007 L01BA01 METHOTREXATUM4

METOTREXATE BELLON 2,5 mg COMPR. 2,5mg FARMEXINM S.R.L. ROMANIA CUTIE X 20 COMPR. X 20 21.45 1.072500 1.072500 1.0725008 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 84.17 84.170000 84.170000 84.1700009 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 1 378.95 378.950000 378.950000 378.950000

10 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 500 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 5 ML S 5 226.36 45.272000 45.272000 45.27200011 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5 mg SOL. INJ. 5mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE X 1 ML S 10 22.37 2.237000 2.237000 2.23700012 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 50 mg SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 12.51 12.510000 12.510000 12.51000013 L04AX01 AZATHIOPRINUM IMURAN (R) COMPR. FILM. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 75.98 0.759800 0.759800 0.75980014 N07AA01 NEOSTIGMINI BROMIDUM NEOSTIGMINA LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 12.94 0.647000 0.647000 0.64700015 N07AA01 NEOSTIGMINI BROMIDUM MIOSTIN 0,5 mg/ml SOL. INJ. 0,5mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 1 ML SOL. INJ. S/P-RF 5 3.57 0.714000 0.714000 0.71400016 N07AA02 PYRIDOSTIGMINI BROMIDUM MESTINON 60 mg DRAJ. 60mg ICN POLFA RZESZOW S.A. POLONIA CUTIE X 1 FLAC. X 20 DRAJ. S/P-RF 20 9.37 0.468500 0.468500 0.468500

Tratamentul se initiaza de catre medicul in specialitatea neurologie

12. SCLEROZA MULTIPLA - G14

1 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 30.63 0.612600 0.612600 0.6126002 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 27.83 1.391500 1.391500 1.3915003 H02AB04 METHYLPREDNISOLONUM MEDROL 4 mg COMPR. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA X 30 COMPR. P-RF 30 6.13 0.204333 0.204333 0.2043334 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8.26 8.260000 8.260000 8.2600005 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 40 mg LIOF. PT. SOL. INJ. 40mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 15 FLAC. LIOF. + 15 FIOLE SOLV. X 1 ML S/P-RF 15 63.83 4.255333 4.255333 4.2553336 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 29.12 29.120000 29.120000 29.1200007 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIO P-RF 1 19.21 19.210000 19.210000 19.2100008 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 1.68 0.084000 0.077666 0.0776669 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.47 0.082333 0.077666 0.077666

10 H02AB07 PREDNISONUM N - PREDNISON COMPR. 5mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 2.33 0.077666 0.077666 0.07766611 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.37 0.079000 0.077666 0.07766612 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 1.68 0.084000 0.077666 0.07766613 L01BA01 METHOTREXATUM4

METOTREXATE BELLON 2,5 mg COMPR. 2,5mg FARMEXINM S.R.L. ROMANIA CUTIE X 20 COMPR. X 20 21.45 1.072500 1.072500 1.07250014 L01BA01 METHOTREXATUM4

METOTREXATE BELLON 2,5 mg COMPR. 2,5mg FARMEXINM S.R.L. ROMANIA CUTIE X 20 COMPR. X 20 21.45 1.072500 1.072500 1.07250015 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 84.17 84.170000 84.170000 84.170000

11. MIASTENIA GRAVIS - G13

Pagina 20 din 38

Page 80: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

16 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 1 378.95 378.950000 378.950000 378.95000017 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 500 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 5 ML S 5 226.36 45.272000 45.272000 45.27200018 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5 mg SOL. INJ. 5mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE X 1 ML S 10 22.37 2.237000 2.237000 2.23700019 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 50 mg SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 12.51 12.510000 12.510000 12.51000020 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 1 608.66 608.660000 608.660000 608.66000021 L04AX01 AZATHIOPRINUM IMURAN (R) COMPR. FILM. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 75.98 0.759800 0.759800 0.759800

Tratamentul se initiaza de catre medicul in specialitatea neurologie

1 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 150 mg CAPS. ELIB. PREL. 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 20.60 0.412000 0.412000 0.4120002 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 300 mg CAPS. ELIB. PREL. 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PREL. P-6L 50 34.50 0.690000 0.690000 0.6900003 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX (R) 150 mg CAPS. MOI GASTROREZ. 150mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ. P-6L 100 19.03 0.190300 0.190300 0.1903004 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX (R) 300 mg CAPS. MOI GASTROREZ. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ. P-6L 100 31.25 0.312500 0.312500 0.3125005 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX (R) 500 mg CAPS. MOI GASTROREZ. 500mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 10 BLIST. AL/PVDC-PVCX 10 CAPS. MOI GASTROREZ. P-6L 100 48.00 0.480000 0.480000 0.4800006 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX RETARD 300 mg COMPR. FILM. ELIB. MODIF. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 COMPR. FILM. ELIB. MODIF. P-6L 50 21.34 0.426800 0.337300 0.3373007 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX RETARD 300 mg COMPR. FILM. ELIB. MODIF. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PEID X 50 COMPR. FILM. ELIB. MODIF. CU CAPAC SNAP-ON P-6L 50 21.34 0.426800 0.337300 0.3373008 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX RETARD 300 mg COMPR. FILM. ELIB. MODIF. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PEID X 50 COMPR. FILM. ELIB. MODIF. CU CAPAC SCREW CAP P-6L 50 21.34 0.426800 0.337300 0.3373009 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX RETARD 500 mg COMPR. FILM. ELIB. MODIF. 500mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 COMPR. FILM. ELIB. MODIF. P-6L 50 32.56 0.651200 0.502666 0.502666

10 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX RETARD 500 mg COMPR. FILM. ELIB. MODIF. 500mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PEID X 50 COMPR. FILM. ELIB. MODIF. CU CAPAC SNAP-ON P-6L 50 32.56 0.651200 0.502666 0.50266611 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX RETARD 500 mg COMPR. FILM. ELIB. MODIF. 500mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLAC. DIN PEID X 50 COMPR. FILM. ELIB. MODIF. CU CAPAC SCREW CAP P-6L 50 32.56 0.651200 0.502666 0.50266612 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 300 mg COMPR. FILM. ELIB. PREL. DIVIZ. 300mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 FLAC. DIN PP X 50 COMPR. FILM. ELIB. PREL., DIVIZIBILE P-6L 100 33.73 0.337300 0.337300 0.33730013 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE (R) CHRONO 500 mg COMPR. FILM. ELIB. PREL. DIVIZ. 500mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. DIVIZIBILE P-6L 30 15.08 0.502666 0.502666 0.50266614 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 150 COMPR. FILM. GASTROREZ. 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 COMPR.FILM. GASTROREZ. P-6L 100 27.37 0.273700 0.273700 0.27370015 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. FILM. GASTROREZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. DIN PP X 40 COMPR. FILM. GASTROREZ. P-6L 40 10.08 0.252000 0.252000 0.25200016 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 300 COMPR. FILM. GASTROREZ. 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 100 COMPR. FILM. GASTROREZ. P-6L 100 35.28 0.352800 0.352800 0.35280017 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 600 COMPR. FILM. GASTROREZ. 600mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. FILM. GASTROREZ. P-6L 50 37.56 0.751200 0.751200 0.75120018 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE (R) 400 mg/4 ml LIOFILIZAT SI SOLVENT PENTRU SOLUTIE INJECTABILA i.v. LIOF. + SOLV. PT. SOL. 400mg/4ml SANOFI-AVENTIS FRANCE FRANTA CUTIE X 4 FLAC. CU LIOF. PT. SOL. INJ. + 4 FIOLE SOLV. X 4ML S/P-RF 4 123.57 30.892500 30.892500 30.89250019 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 1000 mg MINICOMPR. ELIB. PREL. 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 89.13 1.782600 1.782600 1.78260020 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 500 mg MINICOMPR. ELIB. PREL. 500mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 55.84 1.116800 1.116800 1.11680021 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL SIROP SIROP 300mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLACON X 250 ML + LINGURITA DOZATOARE PP A 5 ML P-6L 1 34.04 34.040000 34.040000 34.04000022 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 50mg/ml SIROP 50mg/ml GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML SIROP + 1 SERINGA PT. ADMIN. ORALA (0,5-10,0 ML) P-6L 1 8.17 8.170000 8.170000 8.17000023 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA P-6L 1 21.71 21.710000 21.710000 21.71000024 N03AX09 LAMOTRIGINUM** LAMOTIRAN 100 mg COMPR. 100mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR. P-6L 28 32.22 1.150714 0.903333 0.90333325 N03AX09 LAMOTRIGINUM** LAMOTIRAN 100 mg COMPR. 100mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-6L 30 33.40 1.113333 0.903333 0.90333326 N03AX09 LAMOTRIGINUM** LAMOTRIX 100 mg COMPR. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 54.75 1.825000 0.903333 0.90333327 N03AX09 LAMOTRIGINUM** LAMOLEP 100 mg COMPR. 100mg GEDEON RICHTER PLC UNGARIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 54.28 1.809333 0.903333 0.90333328 N03AX09 LAMOTRIGINUM** EPIMIL 100 mg COMPR. 100mg IVAX PHARMCEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. PVC-PVDC/PVC-AL X 10 COMPR. P-6L 30 27.10 0.903333 0.903333 0.90333329 N03AX09 LAMOTRIGINUM** PLEXXO (R) 100 mg COMPR. 100mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 36.80 1.226666 0.903333 0.90333330 N03AX09 LAMOTRIGINUM** XEBARIN 100 mg COMPR. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 29.98 1.070714 0.903333 0.90333331 N03AX09 LAMOTRIGINUM** LAMOTRIGINE FARMAL 100 mg COMPR. 100mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 37.87 1.262333 0.903333 0.903333

Medicamentele specifice se prescriu numai pentru pacientii inclusi in Programul National de boli neurologice (Subprogramul de tratament al screlozei multiple)

13. BOLI PSIHICE (SCHIZOFRENIE, TULBURARI SCHIZOTIPALE SI DELIRANTE, TULBURARI AFECTIVE MAJORE, TULBURARI PSIHOTICE ACUTE SI BOLI PSIHICE COPII, AUTISM) - G15

Pagina 21 din 38

Page 81: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

32 N03AX09 LAMOTRIGINUM** LAMICTAL 100 mg COMPR. 100mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 40.35 1.345000 0.903333 0.90333333 N03AX09 LAMOTRIGINUM** LAMOTIRAN 200 mg COMPR. 200mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-6L 30 107.64 3.588000 1.946071 1.94607134 N03AX09 LAMOTRIGINUM** LAMOTIRAN 200 mg COMPR. 200mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR. P-6L 28 86.44 3.087142 1.946071 1.94607135 N03AX09 LAMOTRIGINUM** LAMOTRIX 200 mg COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 93.45 3.115000 1.946071 1.94607136 N03AX09 LAMOTRIGINUM** XEBARIN 200 mg COMPR. 200mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 54.49 1.946071 1.946071 1.94607137 N03AX09 LAMOTRIGINUM** LAMICTAL 25 mg COMPR. 25mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10.46 0.348666 0.080357 0.08035738 N03AX09 LAMOTRIGINUM** LAMOTIRAN 25 mg COMPR. 25mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR. P-6L 28 13.57 0.484642 0.080357 0.08035739 N03AX09 LAMOTRIGINUM** LAMOTIRAN 25 mg COMPR. 25mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-6L 30 14.55 0.485000 0.080357 0.08035740 N03AX09 LAMOTRIGINUM** LAMOTRIX 25 mg COMPR. 25mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 19.72 0.657333 0.080357 0.08035741 N03AX09 LAMOTRIGINUM** LAMOLEP 25 mg COMPR. 25mg GEDEON RICHTER PLC UNGARIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 17.86 0.595333 0.080357 0.08035742 N03AX09 LAMOTRIGINUM** EPIMIL 25mg COMPR. 25mg IVAX PHARMCEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. PVC--PVDC/PVC-AL X 10 COMPR. P-6L 30 6.80 0.226666 0.080357 0.08035743 N03AX09 LAMOTRIGINUM** PLEXXO (R) 25 mg COMPR. 25mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 16.21 0.540333 0.080357 0.08035744 N03AX09 LAMOTRIGINUM** XEBARIN 25 mg COMPR. 25mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 2.25 0.080357 0.080357 0.08035745 N03AX09 LAMOTRIGINUM** LAMOTRIGINE FARMAL 25 mg COMPR. 25mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 14.79 0.493000 0.080357 0.08035746 N03AX09 LAMOTRIGINUM** PLEXXO (R) 50 mg COMPR. 50mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 26.19 0.873000 0.451000 0.45100047 N03AX09 LAMOTRIGINUM** LAMOTIRAN 50 mg COMPR. 50mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR. P-6L 28 21.86 0.780714 0.451000 0.45100048 N03AX09 LAMOTRIGINUM** LAMOTIRAN 50 mg COMPR. 50mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-6L 30 23.42 0.780666 0.451000 0.45100049 N03AX09 LAMOTRIGINUM** LAMOTRIX 50 mg COMPR. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 33.40 1.113333 0.451000 0.45100050 N03AX09 LAMOTRIGINUM** LAMOLEP 50 mg COMPR. 50mg GEDEON RICHTER PLC UNGARIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 32.80 1.093333 0.451000 0.45100051 N03AX09 LAMOTRIGINUM** EPIMIL 50 mg COMPR. 50mg IVAX PHARMCEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. PVC-PVDC/PVC-AL X 10 COMPR. P-6L 30 13.53 0.451000 0.451000 0.45100052 N03AX09 LAMOTRIGINUM** XEBARIN 50 mg COMPR. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 15.41 0.550357 0.451000 0.45100053 N03AX09 LAMOTRIGINUM** LAMOTRIGINE FARMAL 50 mg COMPR. 50mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 24.81 0.827000 0.451000 0.45100054 N03AX09 LAMOTRIGINUM** LAMICTAL 50 mg COMPR. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 20.82 0.694000 0.451000 0.45100055 N03AX09 LAMOTRIGINUM** LAMOTRIGIN STADA 100 mg COMPR. DISP. 100mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. DISP. P-6L 30 28.03 0.934333 0.934333 0.93433356 N03AX09 LAMOTRIGINUM** LAMOTRIN 100 mg COMPR. DISP. 100mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 36.09 1.203000 0.934333 0.93433357 N03AX09 LAMOTRIGINUM** LAMOTRIGIN STADA 25 mg COMPR. DISP. 25mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. DISP. P-6L 30 0.71 0.023666 0.023666 0.02366658 N03AX09 LAMOTRIGINUM** LAMOTRIN 25 mg COMPR. DISP. 25mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 3.57 0.119000 0.023666 0.02366659 N03AX09 LAMOTRIGINUM** LAMOTRIGIN STADA 50 mg COMPR. DISP. 50mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. DISP. P-6L 30 14.05 0.468333 0.468333 0.46833360 N03AX09 LAMOTRIGINUM** LAMOTRIN 50 mg COMPR. DISP. 50mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 24.84 0.828000 0.468333 0.46833361 N03AX09 LAMOTRIGINUM** LAMICTAL 25 mg COMPR. DISP./MAST. 25mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISP./MAST. P-6L 30 17.09 0.569666 0.023666 0.02366662 N04AA01 TRIHEXYPHENIDYLUM ROMPARKIN (R) 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 13.85 0.277000 0.277000 0.27700063 N05AD01 HALOPERIDOLUM HALOPERIDOL LAROPHARM 0,5 mg COMPR. 0,5mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3.05 0.152500 0.152500 0.15250064 N05AD01 HALOPERIDOLUM HALDOL COMPR. 5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 16.84 0.673600 0.673600 0.67360065 N05AD01 HALOPERIDOLUM HALOPERIDOL 2 mg/ml PIC. ORALE-SOL. 2mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 10ML PICATURI ORALE-SOLUTIE P-RF 1 6.26 6.260000 4.410000 4.41000066 N05AD01 HALOPERIDOLUM HALOPERIDOL PICATURI ORALE-SOL. 2mg/ml TERAPIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 10 ML P-RF 1 4.41 4.410000 4.410000 4.41000067 N05AD01 HALOPERIDOLUM HALOPERIDOL DECANOAT SOL. INJ. 50mg/ml GEDEON RICHTER PLC. UNGARIA CUTIE X 5 FIOLE X 1 ML P-RF 5 41.81 8.362000 8.362000 8.36200068 N05AD01 HALOPERIDOLUM HALOPERIDOL RICHTER 5 mg/ml SOL. INJ. 5mg/ml GEDEON RICHTER PLC. UNGARIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 5 11.71 2.342000 2.342000 2.34200069 N05AE03 SERTINDOL** SERDOLECT 12 mg COMPR. FILM. 12mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 352.18 12.577857 12.577857 12.57785770 N05AE03 SERTINDOL** SERDOLECT 16 mg COMPR. FILM. 16mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 459.50 16.410714 16.410714 16.41071471 N05AE03 SERTINDOL** SERDOLECT 20 mg COMPR. FILM. 20mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 506.82 18.100714 18.100714 18.10071472 N05AE03 SERTINDOL** SERDOLECT 4 mg COMPR. FILM. 4mg H. LUNDBECK A/S DANEMARCA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 124.34 4.144666 4.144666 4.14466673 N05AE04 ZIPRASIDONUM** ZELDOX (R) 40 mg CAPS. 40mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. X 14 CAPS. P-RF 56 395.57 7.063750 7.063750 7.06375074 N05AE04 ZIPRASIDONUM** ZELDOX (R) 60 mg CAPS. 60mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. X 14 CAPS. P-RF 56 513.40 9.167857 9.167857 9.16785775 N05AE04 ZIPRASIDONUM** ZELDOX (R) 80 mg CAPS. 80mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. X 14 CAPS. P-RF 56 551.82 9.853928 9.853928 9.85392876 N05AE04 ZIPRASIDONUM** ZELDOX (R) 20 mg/ml LIOF. PT. SOL. INJ. + SOLV. 20mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. LIOF. + 1 FIOLA X 1,2 ML SOLV. S/P-RF 1 62.36 62.360000 62.360000 62.360000

Pagina 22 din 38

Page 82: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

77 N05AF01 FLUPENTIXOLUM** FLUANXOL DEPOT SOL. INJ. 20mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 10 68.63 6.863000 6.863000 6.86300078 N05AF05 ZUCLOPENTHIXOLUM** CLOPIXOL (R) 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA FLAC. X 50 COMPR. FILM. P-RF 50 21.71 0.434200 0.434200 0.43420079 N05AF05 ZUCLOPENTHIXOLUM** CLOPIXOL (R) 25 mg COMPR. FILM. 25mg H. LUNDBECK A/S DANEMARCA FLAC. X 50 COMPR. FILM. P-RF 50 32.57 0.651400 0.651400 0.65140080 N05AF05 ZUCLOPENTHIXOLUM** CLOPIXOL 20 mg/ml PIC. ORALE-SOL. 20mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 1 FLAC. + CAPAC SECURIZAT PT. COPII X 20 ML P-RF 1 30.69 30.690000 30.690000 30.69000081 N05AF05 ZUCLOPENTHIXOLUM** CLOPIXOL (R) DEPOT SOL. INJ. 200mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 10 FIOLE X 1 ML P-RF 10 148.17 14.817000 14.817000 14.81700082 N05AF05 ZUCLOPENTHIXOLUM** CLOPIXOL ACUPHASE (R) SOL. INJ. 50mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 5 FIOLE X 1 ML P-RF 5 43.65 8.730000 8.730000 8.73000083 N05AH02 CLOZAPINUM** LEPONEX (R) 100 mg COMPR. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 100.26 2.005200 2.005200 2.00520084 N05AH02 CLOZAPINUM** LEPONEX (R) 25 mg COMPR. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 31.59 0.631800 0.631800 0.63180085 N05AH03 OLANZAPINUM** ZYPREXA 10 mg COMPR. FILM. 10mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 COMPR. FILM. ( BLIST.AL ABUTISATE LA RECE) P-RF 28 442.21 15.793214 15.793214 15.79321486 N05AH03 OLANZAPINUM** ZYPREXA 5 mg COMPR. FILM. 5mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 COMPR. FILM. ( BLIST.AL ABUTISATE LA RECE) P-RF 28 228.72 8.168571 8.168571 8.16857187 N05AH03 OLANZAPINUM** ZYPREXA VELOTAB 10 mg COMPR. ORODISPERSABILE 10mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28COMPR. ORODISPERSABILE (BLIST. AL/AL ) P-RF 28 442.10 15.789285 15.789285 15.78928588 N05AH03 OLANZAPINUM** ZYPREXA VELOTAB 15 mg COMPR. ORODISPERSABILE 15mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28COMPR. ORODISPERSABILE (BLIST. AL/AL ) P-RF 28 734.74 26.240714 26.240714 26.24071489 N05AH03 OLANZAPINUM** ZYPREXA VELOTAB 20 mg COMPR. ORODISPERSABILE 20mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28COMPR. ORODISPERSABILE (BLIST. AL/AL ) P-RF 28 956.03 34.143928 34.143928 34.14392890 N05AH03 OLANZAPINUM** ZYPREXA VELOTAB 5 mg COMPR. ORODISPERSABILE 5mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28COMPR. ORODISPERSABILE (BLIST. AL/AL ) P-RF 28 228.67 8.166785 8.166785 8.16678591 N05AH03 OLANZAPINUM** ZYPADHERA 210mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 210mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 210MG PULB. + 1 FLAC. X 3ML SOLVENT P-RF/R 1 843.40 843.400000 843.400000 843.40000092 N05AH03 OLANZAPINUM** ZYPADHERA 300mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 300mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 300MG PULB. + 1 FLAC. X 3ML SOLVENT P-RF/R 1 1299.93 1299.930000 1299.930000 1299.93000093 N05AH03 OLANZAPINUM** ZYPADHERA 405mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 405mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 405MG PULB. + 1 FLAC. X 3ML SOLVENT P-RF/R 1 1615.95 1615.950000 1615.950000 1615.95000094 N05AH03 OLANZAPINUM** ZYPREXA 10 mg PULB. PT. SOL. INJ. 10mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC. X 10 MG PULB.PT.SOL.INJ. P-RF 1 18.74 18.740000 18.740000 18.74000095 N05AH04 QUETIAPINUM** SEROQUEL 100mg COMPR. FILM. 100mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. AL/ PVC X 10 COMPR. FILM. P-RF 60 241.96 4.032666 4.032666 4.03266696 N05AH04 QUETIAPINUM** SEROQUEL 200 mg COMPR. FILM. 200mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 60 385.33 6.422166 6.422166 6.42216697 N05AH04 QUETIAPINUM** SEROQUEL (R) 300 mg COMPR. FILM. 300mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-RF 60 522.28 8.704666 8.704666 8.70466698 N05AH04 QUETIAPINUM** SEROQUEL XR 200 mg COMPR. FILM. ELIB. PREL. 200mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. OPACE AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL. P-RF 60 470.16 7.836000 7.836000 7.83600099 N05AH04 QUETIAPINUM** SEROQUEL XR 300 mg COMPR. FILM. ELIB. PREL. 300mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. OPACE AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL. P-RF 60 545.26 9.087666 9.087666 9.087666

100 N05AL01 SULPIRIDUM EGLONYL (R) 50 mg CAPS. 50mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 2 BLIST. X 15 CAPS. P-RF 30 10.12 0.337333 0.337333 0.337333101 N05AL01 SULPIRIDUM EGLONYL (R) 200 mg COMPR. 200mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 1 BLIST. X 12 COMPR. P-RF 12 9.88 0.823333 0.823333 0.823333102 N05AL01 SULPIRIDUM EGLONYL 100 mg/2 ml SOL. INJ. 50mg/ml SANOFI-AVENTIS FRANCE FRANTA CUTIE X 6 FIOLE X 2 ML P-RF 6 4.73 0.788333 0.788333 0.788333103 N05AL05 AMISULPRIDUM** SOLIAN 200 mg COMPR. DIVIZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ. P-RF 30 124.14 4.138000 4.138000 4.138000104 N05AL05 AMISULPRIDUM** SOLIAN 400 mg COMPR. FILM. 400mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 124.92 4.164000 4.164000 4.164000105 N05AX08 RISPERIDONUM** RISSET 1 mg COMPR. FILM. 1 mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 2 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 20 7.33 0.366500 0.366500 0.366500106 N05AX08 RISPERIDONUM** RISSET 1 mg COMPR. FILM. 1 mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 6 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 60 23.24 0.387333 0.366500 0.366500107 N05AX08 RISPERIDONUM** RISPOLEPT (R) 1 mg COMPR. FILM. 1mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 2 BLIST. PVC-LDPE-PVDC/AL X 10 COMPR. FILM. P-RF 20 33.77 1.688500 0.366500 0.366500108 N05AX08 RISPERIDONUM** RISPEN 1 COMPR. FILM. 1mg ZENTIVA AS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 22.19 0.443800 0.366500 0.366500109 N05AX08 RISPERIDONUM** RISPEN 1 COMPR. FILM. 1mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 8.88 0.444000 0.366500 0.366500110 N05AX08 RISPERIDONUM** RILEPTID 1 mg COMPR. FILM. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 48.22 0.803666 0.366500 0.366500111 N05AX08 RISPERIDONUM** RISPERIDONE TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 7.83 0.391500 0.366500 0.366500112 N05AX08 RISPERIDONUM** RISPERIDONE TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 23.11 0.385166 0.366500 0.366500113 N05AX08 RISPERIDONUM** RISPERIDONA 1 mg COMPR. FILM. 1mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 8.24 0.412000 0.366500 0.366500114 N05AX08 RISPERIDONUM** RISPERIDONA ACCORD 1 mg COMPR. FILM. 1mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. P-RF 60 22.10 0.368333 0.366500 0.366500115 N05AX08 RISPERIDONUM** XENOMA 1 mg COMPR. FILM. 1mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 20 7.60 0.380000 0.366500 0.366500116 N05AX08 RISPERIDONUM** XENOMA 1 mg COMPR. FILM. 1mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 22.79 0.379833 0.366500 0.366500117 N05AX08 RISPERIDONUM** RISPERIDONA FARMAL 1 mg COMPR. FILM. 1mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 50 22.50 0.450000 0.366500 0.366500118 N05AX08 RISPERIDONUM** RISPEN 2 COMPR. FILM. 2 mg ZENTIVA AS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 42.94 0.858800 0.700833 0.700833119 N05AX08 RISPERIDONUM** RISPEN 2 COMPR. FILM. 2 mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 17.75 0.887500 0.700833 0.700833120 N05AX08 RISPERIDONUM** RISSET 2 mg COMPR. FILM. 2 mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 6 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 60 44.38 0.739666 0.700833 0.700833121 N05AX08 RISPERIDONUM** RISSET 2 mg COMPR. FILM. 2 mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 2 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 20 15.28 0.764000 0.700833 0.700833

Pagina 23 din 38

Page 83: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

122 N05AX08 RISPERIDONUM** RISPOLEPT (R) 2 mg COMPR. FILM. 2mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 2 BLIST. PVC-LDPE-PVDC/AL X 10 COMPR. FILM. P-RF 20 65.30 3.265000 0.700833 0.700833123 N05AX08 RISPERIDONUM** RILEPTID 2 mg COMPR. FILM. 2mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 95.15 1.585833 0.700833 0.700833124 N05AX08 RISPERIDONUM** RISPERIDONE TEVA 2 mg COMPR. FILM. 2mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 15.10 0.755000 0.700833 0.700833125 N05AX08 RISPERIDONUM** RISPERIDONE TEVA 2 mg COMPR. FILM. 2mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 43.84 0.730666 0.700833 0.700833126 N05AX08 RISPERIDONUM** RISON 2 mg COMPR. FILM. 2mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 20.96 1.048000 0.700833 0.700833127 N05AX08 RISPERIDONUM** RISPERIDONA 2 mg COMPR. FILM. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 16.43 0.821500 0.700833 0.700833128 N05AX08 RISPERIDONUM** RISPERIDONA ACCORD 2 mg COMPR. FILM. 2mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 42.05 0.700833 0.700833 0.700833129 N05AX08 RISPERIDONUM** XENOMA 2 mg COMPR. FILM. 2mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 43.24 0.720666 0.700833 0.700833130 N05AX08 RISPERIDONUM** ESSENS 2 mg COMPR. FILM. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVDC-PVC/AL X 10 COMPR. FILM. P-RF 30 22.93 0.764333 0.700833 0.700833131 N05AX08 RISPERIDONUM** RISPERIDONA FARMAL 2 mg COMPR. FILM. 2mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 50 41.75 0.835000 0.700833 0.700833132 N05AX08 RISPERIDONUM** RISPOLEPT (R) 3 mg COMPR. FILM. 3mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 2 BLIST. PVC-LDPE-PVDC/AL X 10 COMPR. FILM. P-RF 20 93.07 4.653500 1.091166 1.091166133 N05AX08 RISPERIDONUM** RISPEN 3 COMPR. FILM. 3mg ZENTIVA AS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 64.42 1.288400 1.091166 1.091166134 N05AX08 RISPERIDONUM** RISPEN 3 COMPR. FILM. 3mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 26.63 1.331500 1.091166 1.091166135 N05AX08 RISPERIDONUM** RISSET 3 mg COMPR. FILM. 3mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 6 BLIST. PVC/PVDC-AL X 10 COMP. FILM. P-RF 60 71.39 1.189833 1.091166 1.091166136 N05AX08 RISPERIDONUM** RISSET 3 mg COMPR. FILM. 3mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 2 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 20 25.90 1.295000 1.091166 1.091166137 N05AX08 RISPERIDONUM** RILEPTID 3 mg COMPR. FILM. 3mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 136.40 2.273333 1.091166 1.091166138 N05AX08 RISPERIDONUM** TORENDO 3 mg COMPR. FILM. 3mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 33.61 1.120333 1.091166 1.091166139 N05AX08 RISPERIDONUM** RISPERIDONE TEVA 3 mg COMPR. FILM. 3mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 25.52 1.276000 1.091166 1.091166140 N05AX08 RISPERIDONUM** RISPERIDONE TEVA 3 mg COMPR. FILM. 3mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 70.86 1.181000 1.091166 1.091166141 N05AX08 RISPERIDONUM** RISON 3 mg COMPR. FILM. 3mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 32.03 1.601500 1.091166 1.091166142 N05AX08 RISPERIDONUM** RISPERIDONA 3 mg COMPR. FILM. 3mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 27.80 1.390000 1.091166 1.091166143 N05AX08 RISPERIDONUM** RISPERIDONA ACCORD 3 mg COMPR. FILM. 3mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 65.47 1.091166 1.091166 1.091166144 N05AX08 RISPERIDONUM** XENOMA 3 mg COMPR. FILM. 3mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 71.48 1.191333 1.091166 1.091166145 N05AX08 RISPERIDONUM** ESSENS 3 mg COMPR. FILM. 3mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVDC-PVC/AL X 10 COMPR. FILM. P-RF 30 37.58 1.252666 1.091166 1.091166146 N05AX08 RISPERIDONUM** RISPERIDONA FARMAL 3 mg COMPR. FILM. 3mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 50 63.42 1.268400 1.091166 1.091166147 N05AX08 RISPERIDONUM** RISPEN 4 COMPR. FILM. 4 mg ZENTIVA AS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 81.57 1.631400 1.490666 1.490666148 N05AX08 RISPERIDONUM** RISPEN 4 COMPR. FILM. 4 mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 34.36 1.718000 1.490666 1.490666149 N05AX08 RISPERIDONUM** RISPOLEPT (R) 4 mg COMPR. FILM. 4mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 2 BLIST. PVC-LDPE-PVDC/AL X 10 COMPR. FILM. P-RF 20 123.29 6.164500 1.490666 1.490666150 N05AX08 RISPERIDONUM** RISSET 4 mg COMPR. FILM. 4mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 2 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 20 33.40 1.670000 1.490666 1.490666151 N05AX08 RISPERIDONUM** RISSET 4 mg COMPR. FILM. 4mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 6 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 60 95.16 1.586000 1.490666 1.490666152 N05AX08 RISPERIDONUM** RILEPTID 4 mg COMPR. FILM. 4mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 182.47 3.041166 1.490666 1.490666153 N05AX08 RISPERIDONUM** TORENDO 4 mg COMPR. FILM. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 44.72 1.490666 1.490666 1.490666154 N05AX08 RISPERIDONUM** RISPERIDONE TEVA 4 mg COMPR. FILM. 4mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 94.65 1.577500 1.490666 1.490666155 N05AX08 RISPERIDONUM** RISPERIDONE TEVA 4 mg COMPR. FILM. 4mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 33.22 1.661000 1.490666 1.490666156 N05AX08 RISPERIDONUM** RISON 4 mg COMPR. FILM. 4mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 42.94 2.147000 1.490666 1.490666157 N05AX08 RISPERIDONUM** RISPERIDONA 4 mg COMPR. FILM. 4mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 34.36 1.718000 1.490666 1.490666158 N05AX08 RISPERIDONUM** ESSENS 4 mg COMPR. FILM. 4mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 47.06 1.568666 1.490666 1.490666159 N05AX08 RISPERIDONUM** XENOMA 4 mg COMPR. FILM. 4mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 93.63 1.560500 1.490666 1.490666160 N05AX08 RISPERIDONUM** RISPERIDONA FARMAL 4 mg COMPR. FILM. 4mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 50 87.80 1.756000 1.490666 1.490666161 N05AX08 RISPERIDONUM** ESSENS 6 mg COMPR. FILM. 6mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 63.83 2.127666 2.127666 2.127666162 N05AX08 RISPERIDONUM** RISPOLEPT QUICKLET COMPR. ORODISPERSABILE 1mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 14 BLIST. PVC-AL-PA/AL X 4 COMPR. ORODISPERSABILE P-RF 56 135.44 2.418571 0.616333 0.616333163 N05AX08 RISPERIDONUM** TORENDO Q-TAB 1 mg COMPR. ORODISPERSABILE 1mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 18.49 0.616333 0.616333 0.616333164 N05AX08 RISPERIDONUM** ESSENS OD 1 mg COMPR. ORODISPERSABILE 1mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 19.60 0.653333 0.616333 0.616333165 N05AX08 RISPERIDONUM** RISPOLEPT QUICKLET COMPR. ORODISPERSABILE 2mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 14 BLIST. PVC-AL-PA/AL X 4 COMPR. ORODISPERSABILE P-RF 56 265.96 4.749285 1.289333 1.289333166 N05AX08 RISPERIDONUM** TORENDO Q-TAB 2 mg COMPR. ORODISPERSABILE 2mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 38.68 1.289333 1.289333 1.289333

Pagina 24 din 38

Page 84: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

167 N05AX08 RISPERIDONUM** ESSENS OD 2 mg COMPR. ORODISPERSABILE 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 41.75 1.391666 1.289333 1.289333168 N05AX08 RISPERIDONUM** ESSENS OD 3 mg COMPR. ORODISPERSABILE 3mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 66.02 2.200666 2.200666 2.200666169 N05AX08 RISPERIDONUM** RISPOLEPT CONSTA (R) 25 mg PULB. + SOLV. PT. SOL. INJ. 25mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. PULB. PT. SUSP. INJ. + 1 SERINGA PREUMPLUTA X 2 ML SOLV. + 1 CUTIE X 2 ACE HYPOINT S S/P-RF 1 402.67 402.670000 402.670000 402.670000170 N05AX08 RISPERIDONUM** RISPOLEPT CONSTA (R) 37,5 mg PULB. + SOLV. PT. SOL. INJ. 37,5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. PULB. PT. SUSP. INJ. + 1 SERINGA PREUMPLUTA X 2 ML SOLV. + 1 CUTIE X 2 ACE HYPOINT S S/P-RF 1 565.30 565.300000 565.300000 565.300000171 N05AX08 RISPERIDONUM** RISPOLEPT CONSTA (R) 50 mg PULB. + SOLV. PT. SOL. INJ. 50mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. PULB. PT. SUSP. INJ. + 1 SERINGA PREUMPLUTA X 2 ML SOLV. + 1 CUTIE X 2 ACE HYPOINT S S/P-RF 1 679.46 679.460000 679.460000 679.460000172 N05AX08 RISPERIDONUM** RISPOLEPT SOL. ORALA 1mg/ml JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SOL. ORALA + 1 PIPETA P-RF 1 147.07 147.070000 48.970000 48.970000173 N05AX08 RISPERIDONUM** RISPOLEPT SOL. ORALA 1mg/ml JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLACON DIN STICLA BRUNA X 30 ML SOL. ORALA + 1 PIPETA P-RF 1 48.97 48.970000 48.970000 48.970000174 N05AX12 ARIPIPRAZOLUM** ABILIFY 10mg COMPR. 10mg OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 28 (X1) COMPR. P-RF 28 458.05 16.358928 16.358928 16.358928175 N05AX12 ARIPIPRAZOLUM** ABILIFY 15mg COMPR. 15mg OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 28 (X1) COMPR. P-RF 28 458.05 16.358928 16.358928 16.358928176 N05AX12 ARIPIPRAZOLUM** ABILIFY 7,5mg/ml SOL. INJ. 7,5mg/ml OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE X 1FLAC. X 1,3ML SOL.INJ P-RF 1 19.72 19.720000 19.720000 19.720000177 N06AB04 CITALOPRAMUM** CITALORAN 10 mg COMPR. FILM. 10mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 2 BLIST. PVDC-PVC/AL X 14 COMPR. FILM. P-RF 28 6.93 0.247500 0.247500 0.247500178 N06AB04 CITALOPRAMUM** LINISAN 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 39.51 1.317000 0.247500 0.247500179 N06AB04 CITALOPRAMUM** CITALORAN 20mg COMPR. FILM. 20mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 2 BLIST. PVDC-PVC/AL X 14 COMPR. FILM. P-RF 28 10.08 0.360000 0.360000 0.360000180 N06AB04 CITALOPRAMUM** LINISAN 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 74.71 2.490333 0.360000 0.360000181 N06AB04 CITALOPRAMUM** CITALORAN 40 mg COMPR. FILM. 40mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 2 BLIST. PVDC-PVC/AL X 14 COMPR. FILM. P-RF 28 31.53 1.126071 1.126071 1.126071182 N06AB04 CITALOPRAMUM** LINISAN 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 135.23 4.507666 1.126071 1.126071183 N06AB10 ESCITALOPRAMUM** CIPRALEX 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. ALBE PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 84.85 3.030357 3.030357 3.030357184 N06AB10 ESCITALOPRAMUM** CIPRALEX 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 1 BLIST. ALB PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 14 58.17 4.155000 3.030357 3.030357185 N06AB10 ESCITALOPRAMUM** CIPRALEX 5 mg COMPR. FILM. 5mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. ALBE PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 46.64 1.665714 1.665714 1.665714186 N06AX05 TRAZODONUM** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 20 23.42 1.171000 1.171000 1.171000187 N06AX14 TIANEPTINUM** COAXIL (R) DRAJ. 12,5mg LES LAB. SERVIER IND. FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ. P-RF 30 32.73 1.091000 1.091000 1.091000188 N06AX16 VENLAFAXINUM** EFECTIN ER 150 mg CAPS. ELIB. PREL. 150mg WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 1 BLIST. ACLAR/PE/PVC/AL X 28 CAPS. ELIB. PREL. P-RF 28 168.45 6.016071 3.298666 3.298666189 N06AX16 VENLAFAXINUM** VELAXIN 150 mg CAPS. ELIB. PREL. 150mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 97.95 3.498214 3.298666 3.298666190 N06AX16 VENLAFAXINUM** ALVENTA 150mg CAPS. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 104.43 3.481000 3.298666 3.298666191 N06AX16 VENLAFAXINUM** FOBILESS 150 mg CAPS. ELIB. PREL. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 98.96 3.298666 3.298666 3.298666192 N06AX16 VENLAFAXINUM** NOPEKAR 150 mg CAPS. ELIB. PREL. 150mg OZONE LABORATORIES BV OLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. P-RF 28 97.95 3.498214 3.298666 3.298666193 N06AX16 VENLAFAXINUM** ADOXA EP 150 mg CAPS. ELIB. PREL. 150mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 128.42 4.280666 3.298666 3.298666194 N06AX16 VENLAFAXINUM** ELIFY EP 150 mg CAPS. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 117.82 3.927333 3.298666 3.298666195 N06AX16 VENLAFAXINUM** FOBILESS 37,5 mg CAPS. ELIB. PREL. 37,5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 33.40 1.113333 1.113333 1.113333196 N06AX16 VENLAFAXINUM** NOPEKAR 37,5 mg CAPS. ELIB. PREL. 37,5mg OZONE LABORATORIES BV OLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. CU ELIB. PREL. P-RF 28 43.72 1.561428 1.113333 1.113333197 N06AX16 VENLAFAXINUM** ADOXA EP 37,5 mg CAPS. ELIB. PREL. 37,5mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 39.13 1.304333 1.113333 1.113333198 N06AX16 VENLAFAXINUM** EFECTIN ER 75 mg CAPS. ELIB. PREL. 75mg WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 1 BLIST. ACLAR/PE/PVC/AL X 28 CAPS. ELIB. PREL. P-RF 28 104.68 3.738571 1.816428 1.816428199 N06AX16 VENLAFAXINUM** VELAXIN 75 mg CAPS. ELIB. PREL. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL P-RF 28 50.86 1.816428 1.816428 1.816428200 N06AX16 VENLAFAXINUM** ALVENTA 75 mg CAPS. ELIB. PREL. 75mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 54.93 1.831000 1.816428 1.816428201 N06AX16 VENLAFAXINUM** FOBILESS 75 mg CAPS. ELIB. PREL. 75mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 62.39 2.079666 1.816428 1.816428202 N06AX16 VENLAFAXINUM** NOPEKAR 75 mg CAPS. ELIB. PREL. 75mg OZONE LABORATORIES BV OLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. P-RF 28 50.86 1.816428 1.816428 1.816428203 N06AX16 VENLAFAXINUM** ADOXA EP 75 mg CAPS. ELIB. PREL. 75mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 67.86 2.262000 1.816428 1.816428204 N06AX16 VENLAFAXINUM** ELIFY EP 75 mg CAPS. ELIB. PREL. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 62.03 2.067666 1.816428 1.816428205 N06AX16 VENLAFAXINUM** ADOXA 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-RF 30 27.49 0.916333 0.916333 0.916333206 N06AX16 VENLAFAXINUM** ADOXA 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-ACLAR/AL X 10 COMPR. P-RF 30 27.49 0.916333 0.916333 0.916333207 N06AX16 VENLAFAXINUM** VENLAFAXINA LPH 37,5 mg COMPR. 37,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-RF 60 58.50 0.975000 0.975000 0.975000208 N06AX16 VENLAFAXINUM** VELAXIN 37,5 mg COMPR. 37,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 56 77.60 1.385714 0.975000 0.975000209 N06AX16 VENLAFAXINUM** ADOXA 37,5 mg COMPR. 37,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-RF 30 30.23 1.007666 0.975000 0.975000210 N06AX16 VENLAFAXINUM** ADOXA 37,5 mg COMPR. 37,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 30 30.23 1.007666 0.975000 0.975000211 N06AX16 VENLAFAXINUM** ADOXA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-RF 30 36.14 1.204666 1.204666 1.204666

Pagina 25 din 38

Page 85: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

212 N06AX16 VENLAFAXINUM** ADOXA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 30 36.14 1.204666 1.204666 1.204666213 N06AX16 VENLAFAXINUM** VENLAFAXINA LPH 75 mg COMPR. 75mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-RF 60 72.90 1.215000 1.215000 1.215000214 N06AX16 VENLAFAXINUM** VELAXIN 75 mg COMPR. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 56 104.20 1.860714 1.215000 1.215000215 N06AX16 VENLAFAXINUM** ADOXA 75 mg COMPR. 75mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-RF 30 66.02 2.200666 1.215000 1.215000216 N06AX16 VENLAFAXINUM** ADOXA 75 mg COMPR. 75mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 30 66.02 2.200666 1.215000 1.215000217 N06AX16 VENLAFAXINUM** ARGOFAN 150 SR COMPR. ELIB. PREL. 150mg ZENTIVA A.S. SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-RF 30 164.11 5.470333 5.470333 5.470333218 N06AX16 VENLAFAXINUM** ARGOFAN 75 SR COMPR. ELIB. PREL. 75mg ZENTIVA A.S. SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-RF 30 88.03 2.934333 2.934333 2.934333219 N06AX16 VENLAFAXINUM** VENLAFAXINA ACTAVIS 37,5 mg COMPR. FILM. 37,5 mg ACTAVIS S.R.L. ROMANIA CUTIE X 4 BLIST. AL/PVC X 14 COMPR. FILM. P-RF 56 35.79 0.639107 0.639107 0.639107220 N06AX16 VENLAFAXINUM** VENLAFAXINA ACTAVIS 75 mg COMPR. FILM. 75mg ACTAVIS S.R.L. ROMANIA CUTIE X 4 BLIST. AL/PVC X 14 COMPR. FILM. P-RF 56 61.97 1.106607 1.106607 1.106607221 N06AX17 MILNACIPRANUM** IXEL CAPS. 25mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE X 4 BLIST. AL/PVC X 14 CAPS. P-RF 56 67.17 1.199464 1.199464 1.199464222 N06AX17 MILNACIPRANUM** IXEL CAPS. 50mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE X 4 BLIST. AL/PVC X 14 CAPS. P-RF 56 110.10 1.966071 1.966071 1.966071223 N06AX21 DULOXETINUM** CYMBALTA 30mg CAPS. GASTROREZ. 30mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 98.96 3.534285 3.534285 3.534285224 N06AX21 DULOXETINUM** CYMBALTA 60mg CAPS. GASTROREZ. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 167.97 5.998928 5.998928 5.998928

Tratamentul se initiaza de catre medicul in specialitatea psihiatrie

1 N06DA02 DONEPEZILUM*** ARICEPT (R) 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC/AL X 14 COMPR. FILM. P-RF 28 336.90 12.032142 9.631000 9.6310002 N06DA02 DONEPEZILUM*** DAVIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 288.93 9.631000 9.631000 9.6310003 N06DA02 DONEPEZILUM*** DAVIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 288.93 9.631000 9.631000 9.6310004 N06DA02 DONEPEZILUM*** ARICEPT (R) 5 mg COMPR. FILM. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-RF 28 286.84 10.244285 7.901666 7.9016665 N06DA02 DONEPEZILUM*** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 237.05 7.901666 7.901666 7.9016666 N06DA02 DONEPEZILUM*** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 237.05 7.901666 7.901666 7.9016667 N06DA02 DONEPEZILUM*** ARICEPT EVESS COMPR. ORODISPERSABILE 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC-PVDC-PE-PVDC-PVC X 14 COMPR. ORODISPERSABILE P-RF 28 358.63 12.808214 12.808214 12.8082148 N06DA02 DONEPEZILUM*** ARICEPT EVESS COMPR. ORODISPERSABILE 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC-PVDC-PE-PVDC-PVC X 14 COMPR. ORODISPERSABILE P-RF 28 286.84 10.244285 10.244285 10.2442859 N06DA03 RIVASTIGMINUM*** EXELON 1,5mg CAPS. 1,5mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 327.39 5.846250 5.846250 5.846250

10 N06DA03 RIVASTIGMINUM*** EXELON 3mg CAPS. 3mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 311.98 5.571071 5.571071 5.57107111 N06DA03 RIVASTIGMINUM*** EXELON 4,6mg/24h PLASTURE TRANSDERMIC 4,6mg/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC P-RF/R 30 369.07 12.302333 12.302333 12.30233312 N06DA03 RIVASTIGMINUM*** EXELON 9,5mg/24h PLASTURE TRANSDERMIC 9,5mg/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC P-RF/R 30 369.07 12.302333 12.302333 12.30233313 N06DA04 GALANTAMINUM*** REMINYL 16 mg CAPS. ELIB. PREL. 16mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 4 BLIST. PVC-PE-PVDC X 7 CAPS. CU ELIB. PREL. P-RF 28 353.59 12.628214 12.628214 12.62821414 N06DA04 GALANTAMINUM*** REMINYL 24 mg CAPS. ELIB. PREL. 24mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 4 BLIST. PVC-PE-PVDC X 7 CAPS. CU ELIB. PREL. P-RF 28 396.27 14.152500 14.152500 14.15250015 N06DA04 GALANTAMINUM*** REMINYL 8 mg CAPS. ELIB. PREL. 8mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 4 BLIST. PVC-PE-PVDC X 7 CAPS. CU ELIB. PREL. P-RF 28 188.81 6.743214 6.743214 6.74321416 N06DA04 GALANTAMINUM*** REMINYL (R) 12 mg COMPR. FILM. 12mg JANSSEN-PHARMACEUTICA NV BELGIA CUTIE X 4 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-RF 56 375.05 6.697321 6.697321 6.69732117 N06DA04 GALANTAMINUM*** REMINYL (R) 4 mg COMPR. FILM. 4mg JANSSEN-PHARMACEUTICA NV BELGIA CUTIE X 1 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-RF 14 64.40 4.600000 4.600000 4.60000018 N06DA04 GALANTAMINUM*** REMINYL (R) 8 mg COMPR. FILM. 8mg JANSSEN-PHARMACEUTICA NV BELGIA CUTIE X 4 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-RF 56 333.89 5.962321 5.962321 5.96232119 N06DA04 GALANTAMINUM*** REMINYL (R) 8 mg COMPR. FILM. 8mg JANSSEN-PHARMACEUTICA NV BELGIA CUTIE X 1 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-RF 14 88.03 6.287857 5.962321 5.96232120 N06DA04 GALANTAMINUM*** REMINYL (R) 4 mg/ml SOL. ORALA 4mg/ml JANSSEN-PHARMACEUTICA NV BELGIA CUTIE X 1 FLACON X 100 ML + 1 PIPETA DOZATOARE P-RF 1 238.71 238.710000 238.710000 238.71000021 N06DX01 MEMANTINUM*** EBIXA 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 56 COMPR. FILM. (BLIST. AL/PP) P-RF/R 56 396.08 7.072857 7.072857 7.07285722 N06DX01 MEMANTINUM*** EBIXA 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 28 COMPR. FILM. (BLIST. AL/PP) P-RF/R 28 201.78 7.206428 7.072857 7.07285723 N06DX01 MEMANTINUM*** EBIXA (R) 10 mg/g PIC. ORALE, SOL. 10mg/g H. LUNDBECK A/S DANEMARCA CUTIE X 1 FLACON, DIN STICLA BRUNA, PICURATOR X 50 G SOLUTIE P-RF/R 1 357.42 357.420000 160.970000 160.97000024 N06DX01 MEMANTINUM*** EBIXA (R) 10 mg/g PIC. ORALE, SOL. 10mg/g H. LUNDBECK A/S DANEMARCA CUTIE X 1 FLACON, DIN STICLA BRUNA, PICURATOR X 100 G SOLUTIE P-RF/R 1 681.25 681.250000 160.970000 160.97000025 N06DX01 MEMANTINUM*** EBIXA (R) 10 mg/g PIC. ORALE, SOL. 10mg/g H. LUNDBECK A/S DANEMARCA CUTIE X 1 FLACON, DIN STICLA BRUNA, PICURATOR X 20 G SOLUTIE P-RF/R 1 160.97 160.970000 160.970000 160.970000

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

Pagina 26 din 38

Page 86: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

Tratamentul se initiaza de catre medicul in specialitatea psihiatrie, neurologie sau geriatrie

1 H02AB04 METHYLPREDNISOLONUM5 MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 30.63 0.612600 0.612600 0.6126002 H02AB04 METHYLPREDNISOLONUM5 MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 27.83 1.391500 1.391500 1.3915003 H02AB04 METHYLPREDNISOLONUM5 MEDROL 4 mg COMPR. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA X 30 COMPR. P-RF 30 6.13 0.204333 0.204333 0.2043334 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 24.53 0.490600 0.490600 0.4906005 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 14.92 14.920000 14.920000 14.9200006 L04AX01 AZATHIOPRINUM* IMURAN (R) COMPR. FILM. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 75.98 0.759800 0.759800 0.7598007 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL (R) COMPR. FILM. 200mg SANOFI-SYNTHELABO LTD. MAREA BRITANIE CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L 60 31.40 0.523333 0.523333 0.523333

Tratamentul se initiaza si monitorizeaza de catre medicul in specialitatea reumatologie, nefrologie si boli infectioase.

1 A07EC01 SULFASALAZINUM SULFASALAZIN EN COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 26.50 0.530000 0.293400 0.2934002 A07EC01 SULFASALAZINUM SALAZOPYRIN EN COMPR. FILM. GASTROREZ. 500mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. GASTROREZ. P-6L 100 29.34 0.293400 0.293400 0.2934003 H02AB01 BETAMETHASONUM DIPROPHOS (R) SUSP. INJ. I.M. 7mg/ml SCHERING PLOUGH EUROPE BELGIA CUTIE X 5 FIOLE X 1 ML P-RF 5 33.51 6.702000 6.702000 6.7020004 H02AB04 METHYLPREDNISOLONUM5 MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 30.63 0.612600 0.612600 0.6126005 H02AB04 METHYLPREDNISOLONUM5 MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 27.83 1.391500 1.391500 1.3915006 H02AB04 METHYLPREDNISOLONUM5 MEDROL 4 mg COMPR. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA X 30 COMPR. P-RF 30 6.13 0.204333 0.204333 0.2043337 L01BA01 METHOTREXATUM4

METOTREXATE BELLON 2,5 mg COMPR. 2,5mg FARMEXINM S.R.L. ROMANIA CUTIE X 20 COMPR. X 20 21.45 1.072500 1.072500 1.0725008 L01BA01 METHOTREXATUM4

METOTREXATE BELLON 2,5 mg COMPR. 2,5mg FARMEXINM S.R.L. ROMANIA CUTIE X 20 COMPR. X 20 21.45 1.072500 1.072500 1.0725009 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 84.17 84.170000 84.170000 84.170000

10 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 1 378.95 378.950000 378.950000 378.95000011 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 500 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 5 ML S 5 226.36 45.272000 45.272000 45.27200012 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5 mg SOL. INJ. 5mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE X 1 ML S 10 22.37 2.237000 2.237000 2.23700013 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 50 mg SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 12.51 12.510000 12.510000 12.51000014 L04AA13 LEFLUNOMIDUM** ARAVA 10mg COMPR. FILM. 10mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. P-RF/R 30 262.94 8.764666 8.764666 8.76466615 L04AA13 LEFLUNOMIDUM** ARAVA 20mg COMPR. FILM. 20mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. P-RF/R 30 274.79 9.159666 9.159666 9.15966616 L04AD02 CICLOSPORINUM* EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 446.87 8.937400 8.937400 8.93740017 L04AD02 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 131.29 2.625800 1.767600 1.76760018 L04AD02 CICLOSPORINUM* EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 88.38 1.767600 1.767600 1.76760019 L04AD02 CICLOSPORINUM* CICLORAL 25 mg CAPS. MOI 25mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 131.44 2.628800 1.767600 1.76760020 L04AD02 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 274.32 5.486400 3.566200 3.56620021 L04AD02 CICLOSPORINUM* EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 178.31 3.566200 3.566200 3.56620022 L04AD02 CICLOSPORINUM* CICLORAL 50 mg CAPS. MOI 50mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 286.57 5.731400 3.566200 3.56620023 L04AD02 CICLOSPORINUM* EQUORAL (R) SOL. ORALA 100mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON DIN STICLA BRUNA X 50 ML, UN DISPOZITIV DE MASURAT + UN CAPAC CU FILET S/P-RF 1 406.57 406.570000 406.570000 406.57000024 L04AX01 AZATHIOPRINUM* IMURAN (R) COMPR. FILM. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 75.98 0.759800 0.759800 0.75980025 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 20 44.79 2.239500 2.239500 2.23950026 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg PHARMASWISS CESKA REPUBLIKA S.R.O. CEHIA CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 19.23 0.641000 0.641000 0.64100027 M01AB05 DICLOFENACUM TRATUL 50 CAPS. GASTROREZ. 50mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. P-6L 30 15.21 0.507000 0.507000 0.50700028 M01AB05 DICLOFENACUM DICLAC (R) 75 ID COMPR. ELIB. MODIF. 75mg HEXAL AG GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR. ELIB. MODIF. P-6L 10 3.68 0.368000 0.368000 0.368000

15. COLAGENOZE MAJORE (LUPUS ERITEMATOS SISTEMIC, SCLERODERMIE, POLI/DERMATOMICOZA, VASCULITE SISTEMICE) - G 17

16. POLIARTRITA REUMATOIDA , ARTROPATIA PSORIAZICA SI ARTRITA JUVENILA - G 18

Pagina 27 din 38

Page 87: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

29 M01AB05 DICLOFENACUM VOLTAREN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL. P-6L 10 6.16 0.616000 0.159500 0.15950030 M01AB05 DICLOFENACUM REFEN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 8.55 0.427500 0.159500 0.15950031 M01AB05 DICLOFENACUM DICLOTARD (R) 100 mg COMPR. FILM. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL P-6L 20 3.19 0.159500 0.159500 0.15950032 M01AB05 DICLOFENACUM RHEUMAVEK COMPR. FILM. GASTROREZ. 25mg FARAN LABORATORIES S.A. GRECIA CUTIE X 3 BLIST. PVC-AL/PVDC X 10 COMPR. FILM. GASTROREZ. P-6L 30 5.36 0.178666 0.178666 0.17866633 M01AB05 DICLOFENACUM VOLTAREN (R) 50 COMPR. FILM. GASTROREZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L 20 6.16 0.308000 0.105500 0.10550034 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 2.13 0.106500 0.105500 0.10550035 M01AB05 DICLOFENACUM CLAFEN 50 mg COMPR. FILM. GASTROREZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. GASTROREZ. P-6L 20 2.31 0.115500 0.105500 0.10550036 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 2.11 0.105500 0.105500 0.10550037 M01AB05 DICLOFENACUM DICLOGESIC 50 COMPRIMATE FILMATE GASTROREZISTENTE COMPR. FILM. GASTROREZ. 50mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 3.57 0.178500 0.105500 0.10550038 M01AB05 DICLOFENACUM EPIFENAC COMPR. GASTROREZ. 25mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 3 BLIST. X 10 COMPR. GASTROREZ. P-6L 30 4.24 0.141333 0.141333 0.14133339 M01AB05 DICLOFENACUM VOLTAREN RAPID (R) DRAJ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L 10 2.19 0.219000 0.219000 0.21900040 M01AB05 DICLOFENACUM DICLOFENAC 25 mg DRAJ. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L 30 5.81 0.193666 0.193666 0.19366641 M01AB05 DICLOFENACUM DICLOFENAC 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L 20 2.50 0.125000 0.119500 0.11950042 M01AB05 DICLOFENACUM N - DICLOFENAC DRAJ. GASTROREZ. 50mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. PE X 20 DRAJ. GASTROREZ. P-6L 20 2.39 0.119500 0.119500 0.11950043 M01AB05 DICLOFENACUM VOLTAREN (R) SOL. INJ. 25mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 ML P-RF 5 8.83 1.766000 0.762000 0.76200044 M01AB05 DICLOFENACUM RHEUMAVEK SOL. INJ. 25mg/ml FARAN LABORATORIES S.A. GRECIA CUTIE X 5 FIOLE DE STICLA BRUNA PREVAZUTE CU INEL DE RUPERE X 3 ML P-RF 5 5.73 1.146000 0.762000 0.76200045 M01AB05 DICLOFENACUM REFEN (R) SOL. INJ. 25mg/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 5 FIOLE X 3 ML P-RF 5 3.81 0.762000 0.762000 0.76200046 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF 5 13.37 2.674000 2.674000 2.67400047 M01AB05 DICLOFENACUM DICLAC SOL. INJ. 75mg HEXAL AG GERMANIA CUTIE X 5 FIOLE X 3 ML SOL. INJ. P-RF 5 6.16 1.232000 0.762000 0.76200048 M01AB05 DICLOFENACUM ALMIRAL SOL. INJ. 75mg/3ml MEDOCHEMIE LTD. CIPRU CUTIE X 10 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE, IN 2 SUPORTURI TERMOFORMATE DIN MATERIAL PLASTI P-RF 10 9.31 0.931000 0.762000 0.76200049 M01AB05 DICLOFENACUM DICLOFENAC 75 mg SOL. INJ. 75mg/3ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 ML P-RF 5 9.58 1.916000 0.762000 0.76200050 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF 5 9.12 1.824000 0.762000 0.76200051 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF 10 12.63 1.263000 0.762000 0.76200052 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 30 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF/S 30 30.88 1.029333 0.762000 0.76200053 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 2.77 0.461666 0.288000 0.28800054 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ. P-6L 5 5.13 1.026000 0.288000 0.28800055 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 2.88 0.288000 0.288000 0.28800056 M01AB05 DICLOFENACUM DICLOFENAC SODIC 100 mg SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 3.00 0.300000 0.288000 0.28800057 M01AB05 DICLOFENACUM EPIFENAC SUPOZ. 100mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FOLIE AL/PEJD. X 5 SUPOZ. P-6L 5 3.33 0.666000 0.288000 0.28800058 M01AB05 DICLOFENACUM DICLOGESIC 12,5 SUPOZITOARE SUPOZ. 12,5mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 4.73 0.473000 0.473000 0.47300059 M01AB05 DICLOFENACUM TRATUL 120 SUPOZ. 120mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 6 SUPOZ. P-6L 6 9.74 1.623333 1.623333 1.62333360 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ. P-6L 10 8.88 0.888000 0.888000 0.88800061 M01AB05 DICLOFENACUM TRATUL 60 SUPOZ. 60mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 6 SUPOZ. P-6L 6 9.04 1.506666 1.506666 1.50666662 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL (R) COMPR. FILM. 200mg SANOFI-SYNTHELABO LTD. MAREA BRITANIE CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L 60 31.40 0.523333 0.523333 0.523333

1 A07EC01 SULFASALAZINUM SULFASALAZIN EN COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 26.50 0.530000 0.293400 0.2934002 A07EC01 SULFASALAZINUM SALAZOPYRIN EN COMPR. FILM. GASTROREZ. 500mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. GASTROREZ. P-6L 100 29.34 0.293400 0.293400 0.2934003 H02AB01 BETAMETHASONUM DIPROPHOS (R) SUSP. INJ. I.M. 7mg/ml SCHERING PLOUGH EUROPE BELGIA CUTIE X 5 FIOLE X 1 ML P-RF 5 33.51 6.702000 6.702000 6.7020004 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 20 44.79 2.239500 2.239500 2.239500

Tratamentul se initiaza si monitorizeaza de catre medicul in specialitatea reumatologie, nefrologie, medicina interna sau recuperare medicina fizica balneofizioterapie (unitati sanitare nominalizate de catre Ministerul Sanatatii Publice pt specialitatea recuperare, medicina fizica balneofizioterapie )

17. SPONDILITA ANKILOZANTA - G 19

Pagina 28 din 38

Page 88: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

5 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg PHARMASWISS CESKA REPUBLIKA S.R.O. CEHIA CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 19.23 0.641000 0.641000 0.6410006 M01AB05 DICLOFENACUM TRATUL 50 CAPS. GASTROREZ. 50mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. P-6L 30 15.21 0.507000 0.507000 0.5070007 M01AB05 DICLOFENACUM DICLAC (R) 75 ID COMPR. ELIB. MODIF. 75mg HEXAL AG GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR. ELIB. MODIF. P-6L 10 3.68 0.368000 0.368000 0.3680008 M01AB05 DICLOFENACUM VOLTAREN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL. P-6L 10 6.16 0.616000 0.159500 0.1595009 M01AB05 DICLOFENACUM REFEN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 8.55 0.427500 0.159500 0.159500

10 M01AB05 DICLOFENACUM DICLOTARD (R) 100 mg COMPR. FILM. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL P-6L 20 3.19 0.159500 0.159500 0.15950011 M01AB05 DICLOFENACUM RHEUMAVEK COMPR. FILM. GASTROREZ. 25mg FARAN LABORATORIES S.A. GRECIA CUTIE X 3 BLIST. PVC-AL/PVDC X 10 COMPR. FILM. GASTROREZ. P-6L 30 5.36 0.178666 0.178666 0.17866612 M01AB05 DICLOFENACUM VOLTAREN (R) 50 COMPR. FILM. GASTROREZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L 20 6.16 0.308000 0.105500 0.10550013 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 2.13 0.106500 0.105500 0.10550014 M01AB05 DICLOFENACUM CLAFEN 50 mg COMPR. FILM. GASTROREZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. GASTROREZ. P-6L 20 2.31 0.115500 0.105500 0.10550015 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 2.11 0.105500 0.105500 0.10550016 M01AB05 DICLOFENACUM DICLOGESIC 50 COMPRIMATE FILMATE GASTROREZISTENTE COMPR. FILM. GASTROREZ. 50mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 3.57 0.178500 0.105500 0.10550017 M01AB05 DICLOFENACUM EPIFENAC COMPR. GASTROREZ. 25mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 3 BLIST. X 10 COMPR. GASTROREZ. P-6L 30 4.24 0.141333 0.141333 0.14133318 M01AB05 DICLOFENACUM VOLTAREN RAPID (R) DRAJ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L 10 2.19 0.219000 0.219000 0.21900019 M01AB05 DICLOFENACUM DICLOFENAC 25 mg DRAJ. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L 30 5.81 0.193666 0.193666 0.19366620 M01AB05 DICLOFENACUM DICLOFENAC 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L 20 2.50 0.125000 0.119500 0.11950021 M01AB05 DICLOFENACUM N - DICLOFENAC DRAJ. GASTROREZ. 50mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. PE X 20 DRAJ. GASTROREZ. P-6L 20 2.39 0.119500 0.119500 0.11950022 M01AB05 DICLOFENACUM VOLTAREN (R) SOL. INJ. 25mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 ML P-RF 5 8.83 1.766000 0.762000 0.76200023 M01AB05 DICLOFENACUM RHEUMAVEK SOL. INJ. 25mg/ml FARAN LABORATORIES S.A. GRECIA CUTIE X 5 FIOLE DE STICLA BRUNA PREVAZUTE CU INEL DE RUPERE X 3 ML P-RF 5 5.73 1.146000 0.762000 0.76200024 M01AB05 DICLOFENACUM REFEN (R) SOL. INJ. 25mg/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 5 FIOLE X 3 ML P-RF 5 3.81 0.762000 0.762000 0.76200025 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF 5 13.37 2.674000 2.674000 2.67400026 M01AB05 DICLOFENACUM DICLAC SOL. INJ. 75mg HEXAL AG GERMANIA CUTIE X 5 FIOLE X 3 ML SOL. INJ. P-RF 5 6.16 1.232000 0.762000 0.76200027 M01AB05 DICLOFENACUM ALMIRAL SOL. INJ. 75mg/3ml MEDOCHEMIE LTD. CIPRU CUTIE X 10 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE, IN 2 SUPORTURI TERMOFORMATE DIN MATERIAL PLASTI P-RF 10 9.31 0.931000 0.762000 0.76200028 M01AB05 DICLOFENACUM DICLOFENAC 75 mg SOL. INJ. 75mg/3ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 ML P-RF 5 9.58 1.916000 0.762000 0.76200029 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF 5 9.12 1.824000 0.762000 0.76200030 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF 10 12.63 1.263000 0.762000 0.76200031 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 30 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF/S 30 30.88 1.029333 0.762000 0.76200032 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 2.77 0.461666 0.288000 0.28800033 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ. P-6L 5 5.13 1.026000 0.288000 0.28800034 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 2.88 0.288000 0.288000 0.28800035 M01AB05 DICLOFENACUM DICLOFENAC SODIC 100 mg SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 3.00 0.300000 0.288000 0.28800036 M01AB05 DICLOFENACUM EPIFENAC SUPOZ. 100mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FOLIE AL/PEJD. X 5 SUPOZ. P-6L 5 3.33 0.666000 0.288000 0.28800037 M01AB05 DICLOFENACUM DICLOGESIC 12,5 SUPOZITOARE SUPOZ. 12,5mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 4.73 0.473000 0.473000 0.47300038 M01AB05 DICLOFENACUM TRATUL 120 SUPOZ. 120mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 6 SUPOZ. P-6L 6 9.74 1.623333 1.623333 1.62333339 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ. P-6L 10 8.88 0.888000 0.888000 0.88800040 M01AB05 DICLOFENACUM TRATUL 60 SUPOZ. 60mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 6 SUPOZ. P-6L 6 9.04 1.506666 1.506666 1.506666

1 G02CB03 CABERGOLINUM** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 40.92 20.460000 14.522500 14.522500

Tratamentul se initiaza si monitorizeaza de catre medicul in specialitatea reumatologie sau recuperare medicina fizica balneofizioterapie (unitati sanitare nominalizate de catre Ministerul Sanatatii Publice pt specialitatea recuperare, medicina fizica balneofizioterapie )

18. BOLI ENDOCRINE (GUSA ENDEMICA, INSUFICIENTA SUPRARELNALA CRONICA, DIABETUL INSIPID, MIXEDEMUL ADULTULUI, TUMORI HIPOFIZARE CU EXPANSIUNE SUPRASELARA SI TUMORI NEUROENDOCRINE) - G 22

Pagina 29 din 38

Page 89: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

2 G02CB03 CABERGOLINUM** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 116.18 14.522500 14.522500 14.5225003 H01AX01 PEGVISOMANTUM**** SOMAVERT 10 mg LIOF. + SOLV. PT. SOL. INJ. 10mg PFIZER LIMITED MAREA BRITANIE CUTIE X 30 FLAC. CU PULB., INSOTITE DE 30 FLAC. X 8 ML SOLV. PT. RECONSTITUIRE P-RF/R 30 8082.27 269.409000 269.409000 269.4090004 H01AX01 PEGVISOMANTUM**** SOMAVERT 20 mg LIOF. + SOLV. PT. SOL. INJ. 20mg PFIZER LIMITED MAREA BRITANIE CUTIE X 30 FLAC. CU LIOF., INSOTITE DE 30 FLAC. A 8 ML SOLV. PT. RECONSTITUIRE P-RF/R 30 16093.69 536.456333 536.456333 536.4563335 H01BA02 DESMOPRESSINUM MINIRIN 0,2 mg COMPR. 0,2mg FERRING AB SUEDIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF 30 183.38 6.112666 6.112666 6.1126666 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 3600.22 3600.220000 3600.220000 3600.2200007 H01CB02 OCTREOTIDUM**** SANDOSTATIN LAR 10 mg PULB.+SOLV.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 2258.35 2258.350000 2258.350000 2258.3500008 H01CB02 OCTREOTIDUM**** SANDOSTATIN LAR 30 mg PULB.+SOLV.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 4970.44 4970.440000 4970.440000 4970.4400009 H01CB02 OCTREOTIDUM**** SANDOSTATIN (R) SOL. INJ. 0,1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 143.31 28.662000 28.662000 28.662000

10 H01CB03 LANREOTIDUM**** SOMATULINE (R) PR 30 mg LIOF. PT. SOL. INJ. + SOLV. 30mg BEAUFOUR IPSEN PHARMA FRANTA CUTIE X 1 FLACON LIOF. + 1 FIOLA X 2 ML SOLV. + 1 SERINGA X 3 ML + 2 ACE S 1 1481.48 1481.480000 1481.480000 1481.48000011 H01CB03 LANREOTIDUM**** SOMATULINE AUTOGEL 60 mg SOL. INJ. CU ELIB. PREL. 60mg BEAUFOUR IPSEN PHARMA FRANTA CUTIE X 1 SERINGA PREUMPLUTA X 0,3 ML SOL. INJ. CU ELIB. PREL., IN PUNGA AL/NYLON/PE + AC S/P-RF 1 2830.73 2830.730000 2830.730000 2830.73000012 H02AA02 FLUDROCORTISONUM ASTONIN H COMPR. 0,1mg MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. P-RF 50 44.85 0.897000 0.897000 0.89700013 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 250 LIOF. + SOLV. PT. SOL. INJ. 250mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. DIN STICLA INCOLORA X 250 MG FIOF. PT. SOL. INJ. + 3 FIOLE X 5 ML SOLV. P-RF 3 89.78 29.926666 29.926666 29.92666614 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 50 LIOF. + SOLV. PT. SOL. INJ. 50mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. X 50 MG LIOF. PT. SOL. INJ. + 3 FIOLE X 1 ML SOLVENT P-RF 3 33.52 11.173333 11.173333 11.17333315 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 1.68 0.084000 0.077666 0.07766616 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.47 0.082333 0.077666 0.07766617 H02AB07 PREDNISONUM N - PREDNISON COMPR. 5mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 2.33 0.077666 0.077666 0.07766618 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.37 0.079000 0.077666 0.07766619 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 1.68 0.084000 0.077666 0.07766620 H02AB09 HYDROCORTISONUM HYDROCORTISONE 100 mg LIOF. + SOLV. PT. SOL. INJ. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA X 2 ML SOLV. S 1 3.67 3.670000 3.670000 3.67000021 H02AB09 HYDROCORTISONUM HYDROCORTISONE SUCCINAT SODIC LIOF. + SOLV. PT. SOL. INJ. 100mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 3.67 3.670000 3.670000 3.67000022 H02AB09 HYDROCORTISONUM HYDROCORTISONE 500 mg LIOF. PT. SOL. INJ. + SOLV. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA X 4 ML SOLV. S 1 11.19 11.190000 11.190000 11.19000023 H02AB09 HYDROCORTISONUM HIDROCORTIZON HEMISUCCINAT SOL. INJ. I.V. 25mg/5ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE X 1 ML SOL. A + 5 FIOLE X 4 ML SOL. B S/P-RF 5 12.77 2.554000 2.554000 2.55400024 H03AA01 LEVOTHYROXINUM THYRO - 4 0,1 mg COMPR. 0,1mg FARAN LABORATORIES S.A. GRECIA CUTIE X 1 FLAC. DIN PEID X 100 COMPR. P-6L 100 7.15 0.071500 0.071500 0.07150025 H03AA01 LEVOTHYROXINUM THYRO - 4 0,2 mg COMPR. 0,2mg FARAN LABORATORIES S.A. GRECIA CUTIE X 1 FLAC. PEID X 100 COMPR. P-6L 100 8.94 0.089400 0.089400 0.08940026 H03AA01 LEVOTHYROXINUM EUTHYROX (R) 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 10.97 0.109700 0.109700 0.10970027 H03AA01 LEVOTHYROXINUM L-THYROXIN 100 BERLIN - CHEMIE COMPR. 100mcg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-6L 100 11.71 0.117100 0.109700 0.10970028 H03AA01 LEVOTHYROXINUM EUTHYROX (R) 200 COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-6L 100 22.68 0.226800 0.226800 0.22680029 H03AA01 LEVOTHYROXINUM EUTHYROX (R) 25 COMPR. 25mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 8.94 0.089400 0.089400 0.08940030 H03AA01 LEVOTHYROXINUM EUTHYROX (R) 50 COMPR. 50mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 7.77 0.077700 0.077700 0.07770031 H03AA01 LEVOTHYROXINUM L-THYROXIN 50 COMPR. 50mcg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-6L/S 100 7.89 0.078900 0.077700 0.07770032 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-RF 100 11.59 0.115900 0.115900 0.11590033 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-RF 100 11.59 0.115900 0.115900 0.11590034 H03CA01 KALII IODIDUM JODID 200 COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-RF 100 18.06 0.180600 0.180600 0.18060035 H03CA01 KALII IODIDUM JODID 200 COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-RF 100 18.06 0.180600 0.180600 0.18060036 N04BC01 BROMOCRIPTINUM BROCRIPTIN (G02CB01) DRAJ. 2,5mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 DRAJ. P-RF 40 19.86 0.496500 0.496500 0.496500

Tratamentul se initiaza de catre medicul in specialitatea endocrinologie sau oncologie

1 M01CC01 PENICILLAMINUM4 CUPRENIL COMPR. FILM. 250mg CN UNIFARM ROMANIA CUTIE X 1FLAC. X 100 COMPR. FILM. X 100 106.78 1.067800 1.067800 1.067800

Tratamentul se initiaza de catre medicul in specialitatea endocrinologie sau neurologie

19. BOALA WILSON - G23

Pagina 30 din 38

Page 90: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1 A11CC07 PARICALCITOLUM** ZEMPLAR 1mcg CAPS. MOI 1mcg ABBOTT LABORATORIES LTD. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. MOI P-RF 28 443.76 15.848571 15.848571 15.8485712 A11CC07 PARICALCITOLUM** ZEMPLAR 2mcg CAPS. MOI 2mcg ABBOTT LABORATORIES LTD. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. P-RF 28 878.67 31.381071 31.381071 31.3810713 A11CC07 PARICALCITOLUM** ZEMPLAR SOL. INJ. 5 mcg/ml ABBOTT LABORATORIES LTD. SPANIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S 5 450.17 90.034000 90.034000 90.0340004 A11CC07 PARICALCITOLUM** ZEMPLAR SOL. INJ. 5 mcg/ml ABBOTT LABORATORIES LTD. SPANIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. S 5 851.29 170.258000 170.258000 170.2580005 B03AC02 COMPLEX DE HIDROXID DE FER (III) SUCROZA** VENOFER (R) SOL. INJ./PERF. 20mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 140.63 28.126000 28.126000 28.1260006 B03XA01 EPOETINUM ALFA** EPREX (R) 10000 UI SOL. INJ. 10000ui/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 1 ML S/P-RF 6 2219.85 369.975000 369.975000 369.9750007 B03XA01 EPOETINUM ALFA** EPREX (R) 1000 UI SOL. INJ. 1000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 248.03 41.338333 34.180000 34.1800008 B03XA01 EPOETINUM ALFA** EPOPHAR 2000 U.I. SOL. INJ. 2000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 311.55 31.155000 31.155000 31.1550009 B03XA01 EPOETINUM ALFA** EPREX (R) 2000 UI SOL. INJ. 2000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 506.75 84.458333 84.458333 84.458333

10 B03XA01 EPOETINUM ALFA** EPREX (R) 3000 UI SOL. INJ. 3000ui/0,3ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,3 ML S/P-RF 6 717.00 119.500000 119.500000 119.50000011 B03XA01 EPOETINUM ALFA** EPREX (R) 40 000 UI SOL. INJ. 40 000UI JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 1 ML S/P-RF 1 1405.01 1405.010000 1405.010000 1405.01000012 B03XA01 EPOETINUM ALFA** EPOPHAR 4000 U.I. SOL. INJ. 4000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 576.62 57.662000 57.662000 57.66200013 B03XA01 EPOETINUM ALFA** EPREX (R) 4000 UI SOL. INJ. 4000ui/0,4ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,4 ML S/P-RF 6 930.20 155.033333 123.031666 123.03166614 B03XA01 EPOETINUM ALFA** BINOCRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1627.37 271.228333 271.228333 271.22833315 B03XA01 EPOETINUM ALFA** ABSEAMED 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1730.88 288.480000 271.228333 271.22833316 B03XA01 EPOETINUM ALFA** BINOCRIT 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 205.08 34.180000 34.180000 34.18000017 B03XA01 EPOETINUM ALFA** ABSEAMED 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,5ML SOL. INJ S/P-RF/R 6 224.10 37.350000 34.180000 34.18000018 B03XA01 EPOETINUM ALFA** BINOCRIT 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 404.17 67.361666 67.361666 67.36166619 B03XA01 EPOETINUM ALFA** ABSEAMED 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 435.08 72.513333 67.361666 67.36166620 B03XA01 EPOETINUM ALFA** BINOCRIT 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 571.20 95.200000 95.200000 95.20000021 B03XA01 EPOETINUM ALFA** ABSEAMED 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,3ML SOL. INJ. S/P-RF/R 6 617.68 102.946666 95.200000 95.20000022 B03XA01 EPOETINUM ALFA** BINOCRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 738.19 123.031666 123.031666 123.03166623 B03XA01 EPOETINUM ALFA** ABSEAMED 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 794.92 132.486666 123.031666 123.03166624 B03XA01 EPOETINUM ALFA** BINOCRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 905.14 150.856666 150.856666 150.85666625 B03XA01 EPOETINUM ALFA** ABSEAMED 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 982.53 163.755000 150.856666 150.85666626 B03XA01 EPOETINUM ALFA** ABSEAMED 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML SOL. INJ. S/P-RF/R 6 1164.90 194.150000 194.150000 194.15000027 B03XA01 EPOETINUM ALFA** ABSEAMED 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,8ML SOL. INJ. S/P-RF/R 6 1529.62 254.936666 254.936666 254.93666628 B03XA01 EPOETINUM BETA** NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 2207.69 367.948333 367.948333 367.94833329 B03XA01 EPOETINUM BETA** NEORECORMON 1000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 262.83 43.805000 43.805000 43.80500030 B03XA01 EPOETINUM BETA** NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 498.48 83.080000 83.080000 83.08000031 B03XA01 EPOETINUM BETA** NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 1107.18 1107.180000 1107.180000 1107.18000032 B03XA01 EPOETINUM BETA** NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 925.50 154.250000 154.250000 154.25000033 B03XA01 EPOETINUM BETA** NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 1138.88 189.813333 189.813333 189.81333334 B03XA01 EPOETINUM BETA** NEORECORMON 500UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 500UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. + 6 ACE S/P-RF/R 6 135.15 22.525000 22.525000 22.52500035 B03XA02 DARBEPOETINUM ALFA** ARANESP 100mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 100mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 2983.68 745.920000 745.920000 745.92000036 B03XA02 DARBEPOETINUM ALFA** ARANESP 10mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 10mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 369.99 92.497500 92.497500 92.49750037 B03XA02 DARBEPOETINUM ALFA** ARANESP 150mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 150mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 4425.31 1106.327500 1106.327500 1106.32750038 B03XA02 DARBEPOETINUM ALFA** ARANESP 15mcg/0,375ml SOL. INJ. IN SERINGA PREUMPLUTA 15mcg/0,375ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,375 ML P-RF/R 4 518.36 129.590000 129.590000 129.59000039 B03XA02 DARBEPOETINUM ALFA** ARANESP 20mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 20mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 664.07 166.017500 166.017500 166.01750040 B03XA02 DARBEPOETINUM ALFA** ARANESP 300mcg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML P-RF/R 1 2078.14 2078.140000 2078.140000 2078.14000041 B03XA02 DARBEPOETINUM ALFA** ARANESP 30mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 30mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 952.18 238.045000 238.045000 238.04500042 B03XA02 DARBEPOETINUM ALFA** ARANESP 40mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 40mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 1242.77 310.692500 310.692500 310.69250043 B03XA02 DARBEPOETINUM ALFA** ARANESP 500mcg/ml SOL. INJ. IN SERINGA PREUMPLUTA 500mcg/ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 1 ML P-RF/R 1 3416.34 3416.340000 3416.340000 3416.340000

20. BOALA CRONICA DE RINICHI - faza predializa - G 25

Pagina 31 din 38

Page 91: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

44 B03XA02 DARBEPOETINUM ALFA** ARANESP 50mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 50mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 1531.80 382.950000 382.950000 382.95000045 B03XA02 DARBEPOETINUM ALFA** ARANESP 60mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 60mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 1823.26 455.815000 455.815000 455.81500046 B03XA02 DARBEPOETINUM ALFA** ARANESP 80mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 80mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 2404.28 601.070000 601.070000 601.07000047 C09CA04 IRBESARTANUM** APROVEL 150mg COMPR. FILM. 150mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 74.87 2.673928 2.673928 2.67392848 C09CA04 IRBESARTANUM** APROVEL 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 101.17 3.613214 3.613214 3.61321449 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 1.68 0.084000 0.077666 0.07766650 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.47 0.082333 0.077666 0.07766651 H02AB07 PREDNISONUM N - PREDNISON COMPR. 5mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 2.33 0.077666 0.077666 0.07766652 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.37 0.079000 0.077666 0.07766653 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 1.68 0.084000 0.077666 0.07766654 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 24.53 0.490600 0.490600 0.49060055 L04AX01 AZATHIOPRINUM* IMURAN (R) COMPR. FILM. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 75.98 0.759800 0.759800 0.75980056 L04AD02 CICLOSPORINUM* EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 446.87 8.937400 8.937400 8.93740057 L04AD02 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 131.29 2.625800 1.767600 1.76760058 L04AD02 CICLOSPORINUM* EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 88.38 1.767600 1.767600 1.76760059 L04AD02 CICLOSPORINUM* CICLORAL 25 mg CAPS. MOI 25mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 131.44 2.628800 1.767600 1.76760060 L04AD02 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 274.32 5.486400 3.566200 3.56620061 L04AD02 CICLOSPORINUM* EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 178.31 3.566200 3.566200 3.56620062 L04AD02 CICLOSPORINUM* CICLORAL 50 mg CAPS. MOI 50mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 286.57 5.731400 3.566200 3.56620063 L04AD02 CICLOSPORINUM* EQUORAL (R) SOL. ORALA 100mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON DIN STICLA BRUNA X 50 ML, UN DISPOZITIV DE MASURAT + UN CAPAC CU FILET S/P-RF 1 406.57 406.570000 406.570000 406.57000064 V06DDN1 COMBINATII (AMINOACIZI)** KETOSTERIL COMPR. FILM. FARA CONCENTRATIE FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE X 5 BLIST. DIN PVC/AL X 20 COMPR. FILM. P-RF 100 219.70 2.197000 2.197000 2.197000

1 S01EC03 DORZOLAMIDUM TRUSOPT SOL. OFT. 20mg/ml MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON TIP OCULOMETER PLUS X 5 ML SOL. OFT. P-6L 1 38.28 38.280000 38.280000 38.2800002 S01EC04 BRINZOLAMIDUM AZOPT 10mg/ml PICATURI OFT.-SUSP. 10mg/ml ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON PEJD X 5 ML P-6L 1 47.84 47.840000 47.840000 47.8400003 S01ED01 TIMOLOLUM NYOLOL GEL GEL OFT. 1mg/g NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN PEID X 5 G GEL OFTALMIC , PREVAZUT CU PICURATOR P-6L 1 14.44 14.440000 14.440000 14.4400004 S01ED01 TIMOLOLUM TIMOLOL RPH 0,25% PIC. OFT., SOL. 2,5mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PICURATOR DIN PEID X 5 ML PIC. OFTALMICE, SOL. P-6L 1 3.79 3.790000 2.940000 2.9400005 S01ED01 TIMOLOLUM TIMABAK 2,5 mg/ml PIC. OFT.,SOL. 2,5mg/ml LABORATOIRES THEA FRANTA CUTIE X 1 FLAC. DIN PEJD X 5 ML PIC. OFTALMICE, SOL. P-6L 1 24.65 24.650000 2.940000 2.9400006 S01ED01 TIMOLOLUM TIMABAK 5 mg/ml PIC. OFT.,SOL. 5mg/ml LABORATORIES THEA FRANTA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT. SOL. P-6L 1 25.89 25.890000 4.670000 4.6700007 S01ED01 TIMOLOLUM TIMOLOL RPH 0,5% PIC. OFT.,SOL. 5mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PICURATOR DIN PEID X 5 ML PIC. OFTALMICE, SOL. P-6L 1 4.67 4.670000 4.670000 4.6700008 S01ED01 TIMOLOLUM TIMOPTIC PIC. OFT.-SOL. 2,5mg/ml MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON TIP OCUMETER PLUS X 5 ML PIC. OFTALMICE, SOL. P-6L 1 8.86 8.860000 2.940000 2.9400009 S01ED01 TIMOLOLUM TIMOPTIC PIC. OFT.-SOL. 5mg/ml MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON TIP OCUMETER PLUS X 5 ML PIC. OFTALMICE SOL. P-6L 1 9.49 9.490000 4.670000 4.670000

10 S01ED01 TIMOLOLUM TIMOLOL 0,25% PICATURI OFT.-SOL. 0,25% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON PEID, PREVAZUT CU PICURATOR X 5 ML P-6L 1 2.94 2.940000 2.940000 2.94000011 S01ED01 TIMOLOLUM TIMOLOL 0,5% PICATURI OFT.-SOL. 0,5% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON CU PICURATOR X 5 ML P-6L 1 5.07 5.070000 4.670000 4.67000012 S01ED01 TIMOLOLUM UNITIMOLOL (R) PICATURI OFT.-SOL. 0,5% UNIMED PHARMA LTD. SLOVACIA CUTIE X 1 FLACON PICURATOR PEJD X 10 ML PIC. OFT. SOL. P-6L 1 9.86 9.860000 4.670000 4.67000013 S01ED01 TIMOLOLUM TIMO-GAL (R) PICATURI OFT.-SOL. 0,5% TERAPIA SA ROMANIA CUTIE X 1 FLACON X 10 ML P-6L 1 4.71 4.710000 4.670000 4.67000014 S01ED02 BETAXOLOLUM BETAXOLOL PIC. OFT., SOL. 5mg/ml TERAPIA SA ROMANIA CUTIE X 1 FLACON DIN PEJD X 10 ML PIC. OFTALMICE, SOL. P-6L 1 5.53 5.530000 5.530000 5.53000015 S01ED02 BETAXOLOLUM BETOPTIC PIC.OFTALMICE,SOL. 5mg/ml ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON DIN PEJD PREV. CU PICURATOR X 5 ML PIC.OFTALMICE, SOL. P-6L 1 14.38 14.380000 5.530000 5.53000016 S01ED02 BETAXOLOLUM BETOPTIC - S PICATURI OFT.-SUSP. 0,25% ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON DIN PEJD X 5ML PIC. OFT.SUSP. P-6L 1 14.38 14.380000 14.380000 14.38000017 S01ED05 CARTEOLOLUM FORTINOL EP 2% PIC. OFTALMICE CU ELIB. PREL. 20mg/ml DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC. OFTALMICE CU ELIB. PREL. P-6L 1 12.76 12.760000 12.760000 12.760000

Tratamentul se initiaza de catre medicul in specialitatea nefrologie. Medicamentele specifice se prescriu numai pentru pacientii inclusi in Programul National de supleere a functiei renale la bolnavii cu insuficienta renala cronica.

21. GLAUCOM - G 26

Pagina 32 din 38

Page 92: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

18 S01ED05 CARTEOLOLUM CARTEOL 2% PICATURI OFT.-SOL. 2% S.I.F.I. SPA ITALIA CUTIE X 30 FLACOANE UNIDOZA DIN PEJD X 0,3 ML P-6L/S 1 31.68 31.680000 31.680000 31.68000019 S01ED05 CARTEOLOLUM CARTEOL 2% PICATURI OFT.-SOL. 20mg/ml S.I.F.I. SPA ITALIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFTALMICE, SOL. P-6L 1 14.98 14.980000 14.980000 14.98000020 S01ED51 COMBINATII (BIMATOPROSTUM + TIMOLOLUM) GANFORT PIC. OFT.,SOL. 300mcg/ml+5mg/ml ALLERGAN PHARMACEUTICALS IRELAND IRLANDA CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC.OFT.SOL. P-RF 1 76.85 76.850000 76.850000 76.85000021 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM) COSOPT PIC. OFT.-SOL. FARA CONCENTRATIE MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DE TIP OCUMETER PLUS X 5ML PIC. OFT., SOL. P-6L 1 65.48 65.480000 65.480000 65.48000022 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM) XALCOM (R) SOL. OFT. FARA CONCENTRATIE PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 2,5 ML P-6L 1 77.79 77.790000 77.790000 77.79000023 S01ED51 COMBINATII (TAVOPROSTUM+TIMOLOLUM) DUOTRAV 40mcg/ml + 5mg/ml PIC. OFT.-SOL. 40mcg/ml + 5mg/ml ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PP X 2,5 ML PIC. OFTALMICE,SOLUTIE P-RF 1 83.10 83.100000 83.100000 83.10000024 S01EE01 LATANOPROSTUM XALATAN (R) PICATURI OFT.-SOL. 0,005% PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON PICURATOR PE X 2,5 ML P-6L 1 71.93 71.930000 71.930000 71.93000025 S01EE03 BIMATOPROSTUM LUMIGAN 0,3mg/ml PIC. OFT.,SOL. 0,3mg/ml ALLERGAN PHARMACEUTICALS IRELAND IRLANDA CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC. OFT. SOL. P-RF 1 69.36 69.360000 69.360000 69.36000026 S01EE04 TRAVOPROSTUM TRAVATAN 40mcg/ml PICATURI OFT.SOL. 40mcg/ml ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON X 2,5 ML P-6L 1 67.63 67.630000 67.630000 67.630000

Tratamentul se initiaza de catre medicul in specialitatea oftalmologie

1 H02AB02 DEXAMETHASONUM DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ. 8mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 100 120.26 1.202600 0.865500 0.8655002 H02AB02 DEXAMETHASONUM DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ. 8mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 5 6.55 1.310000 0.865500 0.8655003 H02AB02 DEXAMETHASONUM DEXAMED SOL. INJ. 8mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF/S 100 86.55 0.865500 0.865500 0.8655004 H02AB02 DEXAMETHASONUM DEXAMED SOL. INJ. 8mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 10 9.74 0.974000 0.865500 0.8655005 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 30.63 0.612600 0.612600 0.6126006 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 27.83 1.391500 1.391500 1.3915007 H02AB04 METHYLPREDNISOLONUM MEDROL 4 mg COMPR. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA X 30 COMPR. P-RF 30 6.13 0.204333 0.204333 0.2043338 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8.26 8.260000 8.260000 8.2600009 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 40 mg LIOF. PT. SOL. INJ. 40mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 15 FLAC. LIOF. + 15 FIOLE SOLV. X 1 ML S/P-RF 15 63.83 4.255333 4.255333 4.255333

10 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 29.12 29.120000 29.120000 29.12000011 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIO P-RF 1 19.21 19.210000 19.210000 19.21000012 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 1.68 0.084000 0.077666 0.07766613 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.47 0.082333 0.077666 0.07766614 H02AB07 PREDNISONUM N - PREDNISON COMPR. 5mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 2.33 0.077666 0.077666 0.07766615 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2.37 0.079000 0.077666 0.07766616 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 1.68 0.084000 0.077666 0.07766617 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 24.53 0.490600 0.490600 0.49060018 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 14.92 14.920000 14.920000 14.92000019 L01BA01 METHOTREXATUM4

METOTREXATE BELLON 2,5 mg COMPR. 2,5mg FARMEXINM S.R.L. ROMANIA CUTIE X 20 COMPR. X 20 21.45 1.072500 1.072500 1.07250020 L01BA01 METHOTREXATUM4

METOTREXATE BELLON 2,5 mg COMPR. 2,5mg FARMEXINM S.R.L. ROMANIA CUTIE X 20 COMPR. X 20 21.45 1.072500 1.072500 1.07250021 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 84.17 84.170000 84.170000 84.17000022 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 1 378.95 378.950000 378.950000 378.95000023 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 500 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 5 ML S 5 226.36 45.272000 45.272000 45.27200024 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5 mg SOL. INJ. 5mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE X 1 ML S 10 22.37 2.237000 2.237000 2.23700025 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 50 mg SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 12.51 12.510000 12.510000 12.51000026 L04AD02 CICLOSPORINUM* EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 446.87 8.937400 8.937400 8.93740027 L04AD02 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 131.29 2.625800 1.767600 1.76760028 L04AD02 CICLOSPORINUM* EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 88.38 1.767600 1.767600 1.76760029 L04AD02 CICLOSPORINUM* CICLORAL 25 mg CAPS. MOI 25mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 131.44 2.628800 1.767600 1.76760030 L04AD02 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 274.32 5.486400 3.566200 3.566200

22. PEMFIGUS - G 27

Pagina 33 din 38

Page 93: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

31 L04AD02 CICLOSPORINUM* EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 178.31 3.566200 3.566200 3.56620032 L04AD02 CICLOSPORINUM* CICLORAL 50 mg CAPS. MOI 50mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 286.57 5.731400 3.566200 3.56620033 L04AD02 CICLOSPORINUM* EQUORAL (R) SOL. ORALA 100mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON DIN STICLA BRUNA X 50 ML, UN DISPOZITIV DE MASURAT + UN CAPAC CU FILET S/P-RF 1 406.57 406.570000 406.570000 406.57000034 L04AX01 AZATHIOPRINUM* IMURAN (R) COMPR. FILM. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 75.98 0.759800 0.759800 0.759800

J04BA02 DAPSONUM4

Tratamentul se initiaza de catre medicul in specialitatea dermatologie

1 A16AB02 IMIGLUCERASUM**** CEREZYME 200U PULB. PT.CONC. PT.SOL. PERF. 200U GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. S 1 2662.94 2662.940000 2662.940000 2662.9400002 A16AB02 IMIGLUCERASUM**** CEREZYME 400U PULB. PT.CONC. PT.SOL. PERF. 400U GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. S 1 5254.89 5254.890000 5254.890000 5254.8900003 A16AX06 MIGLUSTATUM**** ZAVESCA CAPS. 100mg ACTELION REGISTRATION LTD. MAREA BRITANIE CUTIE X 4 BLIST AL/ACLAR X 21 CAPS. P-RF/R 84 26057.03 310.202738 310.202738 310.202738

1 J01AA02 DOXYCYCLINUM DOXICICLINA CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6.56 0.328000 0.240000 0.2400002 J01AA02 DOXYCYCLINUM DOXICICLINA 100 mg CAPS. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 2.40 0.240000 0.240000 0.2400003 J01AA02 DOXYCYCLINUM DOXICICLINA SANDOZ 100 mg CAPS. 100mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3.37 0.337000 0.240000 0.2400004 J01AA02 DOXYCYCLINUM UNIDOX SOLUTAB COMPR. DISP. 100mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 BLIST. DIN AL/PVC X 10 COMPR.DISP. P-RF 10 9.00 0.900000 0.900000 0.9000005 J01AA07 TETRACYCLINUM TETRACICLINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 2.67 0.133500 0.110000 0.1100006 J01AA07 TETRACYCLINUM TETRACICLINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 2.57 0.128500 0.110000 0.1100007 J01AA07 TETRACYCLINUM TETRACICLINA 250 mg CAPS. 250mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 2.84 0.142000 0.110000 0.1100008 J01AA07 TETRACYCLINUM TETRACICLINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 2.20 0.110000 0.110000 0.1100009 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA PULB. PT. SOL. INJ. 1 000 000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF 1 2.40 2.400000 1.940000 1.940000

10 J01CE01 BENZYLPENICILLINUM PENICILINA G POTASICA PULB. PT. SOL. INJ. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF 1 1.94 1.940000 1.940000 1.94000011 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA PULB. PT. SOL. INJ. 400 000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF 1 1.45 1.450000 1.310000 1.31000012 J01CE01 BENZYLPENICILLINUM PENICILINA G POTASICA PULB. PT. SOL. INJ. 400000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF 1 1.31 1.310000 1.310000 1.31000013 J01CE02 PHENOXYMETHYLPENICILLINUM PENICILINA V 1 000 000 U.I. COMPR. 1000000ui EUROPHARM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 8.55 0.427500 0.427500 0.42750014 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 1000 COMPR. FILM. 1000000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 3.25 0.270833 0.270833 0.27083315 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 1500 COMPR. FILM. 1500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 5.73 0.477500 0.477500 0.47750016 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 500 COMPR. FILM. 500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 2.47 0.205833 0.205833 0.20583317 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 400 SIROP 400000ui/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLACON X 60ML P-RF 1 8.94 8.940000 8.940000 8.94000018 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN (R) PULB. PT. SUSP. INJ. 1200000ui ANTIBIOTICE SA ROMANIA FLACON PULB. PT. SUSP. INJ. P-RF/S 1 1.96 1.960000 1.960000 1.96000019 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN (R) PULB. PT. SUSP. INJ. 600000ui ANTIBIOTICE SA ROMANIA FLACON PULB. PT. SUSP. INJ. P-RF/S 1 1.31 1.310000 1.310000 1.31000020 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 27.04 2.704000 2.704000 2.70400021 J01FA01 ERYTHROMYCINUM ERITROMAGIS 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 6.66 0.333000 0.333000 0.33300022 J01FA01 ERYTHROMYCINUM ERITROMICINA 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9.01 0.450500 0.333000 0.33300023 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR. 200mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 7.94 0.397000 0.333000 0.33300024 J01FA01 ERYTHROMYCINUM ERITROMICINA EUROPHARM 200 mg COMPR. 200mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 9.49 0.474500 0.333000 0.33300025 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200mg/5ml PULB. PT. SUSP. ORALA 200mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. X 30G + PULB. PT. 60 ML SUSP. ORALA + O LIGURITA DOZATOARE P-RF 1 10.75 10.750000 10.750000 10.75000026 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 8 CAPS. P-RF 8 35.61 4.451250 4.263333 4.263333

23. BOALA GAUCHER - G 29

După precizarea diagnosticului de catre laboratoarele de specialitate, va putea fi prescris de către medicul de specialitatea gastroenterologie, hematologie, neurologie si pediatrie.

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

Pagina 34 din 38

Page 94: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

27 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. P-RF 6 25.58 4.263333 4.263333 4.26333328 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 23.81 3.968333 3.968333 3.96833329 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 45.84 7.640000 6.958333 6.95833330 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 41.75 6.958333 6.958333 6.95833331 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 41.75 6.958333 6.958333 6.95833332 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 35.85 11.950000 8.026666 8.02666633 J01FA10 AZITHROMYCINUM AZITROX (R) 500 COMPR. FILM. 500mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 41.42 13.806666 8.026666 8.02666634 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 45.84 15.280000 8.026666 8.02666635 J01FA10 AZITHROMYCINUM ZITROCIN 500 mg COMPR. FILM. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC/AL X 3 COMPR. FILM. P-RF 3 24.08 8.026666 8.026666 8.02666636 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 34.89 11.630000 8.026666 8.02666637 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 34.89 11.630000 8.026666 8.02666638 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 41.89 13.963333 13.963333 13.96333339 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 41.89 13.963333 13.963333 13.96333340 J01FA10 AZITHROMYCINUM ZMAX 2 g GRAN. ELIB. PREL. PT. SUSP. ORALA 2g PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON DIN PEID CU GRAN. CU ELIB. PREL. P-RF 1 59.64 59.640000 59.640000 59.64000041 J01FA10 AZITHROMYCINUM SUMAMED (R) LIOF. PT. SOL. PERF. 500mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 5 FLAC. LIOF. PT. SOL. PERF. S/P-RF 5 151.88 30.376000 30.376000 30.37600042 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLAC. DIN PE CU PULB. PT. 15 ML SUSP. ORALA RECONSTITUITA + FLAC. CU SOLV. X 7,5 ML SOLV. P-RF 1 17.50 17.500000 17.500000 17.50000043 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CONTINAD PULBERE PT. 20 ML SUSP. ORALA + SERINGA DOZATOARE DIN PE/PP P-RF 1 21.08 21.080000 21.080000 21.08000044 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA CCUTIE X 1 FLAC. DIN PEID CONTINAD PULBERE PT. 20 ML SUSP. ORALA + SERINGA DOZATOARE DIN PE/PP P-RF 1 33.34 33.340000 17.500000 17.50000045 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml 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 23.64 23.640000 17.500000 17.50000046 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml 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 45.63 45.630000 17.500000 17.50000047 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml 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 56.66 56.660000 17.500000 17.50000048 J01MA02 CIPROFLOXACINUM EUCIPRIN CAPS. 250mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 6 CAPS. P-RF 12 7.53 0.627500 0.627500 0.62750049 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 6.41 0.641000 0.447000 0.44700050 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 6.41 0.641000 0.447000 0.44700051 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 7.33 0.733000 0.447000 0.44700052 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 6.41 0.641000 0.447000 0.44700053 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 15.08 0.754000 0.447000 0.44700054 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 250 mg COMPR. FILM. 250mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 7.40 0.740000 0.447000 0.44700055 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 6.52 0.652000 0.447000 0.44700056 J01MA02 CIPROFLOXACINUM CIPHIN 250 COMPR. FILM. 250mg ZENTIVA A.S. SLOVACIA CUTIE X 1 BLIST. PVDC/PVC/AL X 10 COMPR. FILM. P-RF 10 8.95 0.895000 0.447000 0.44700057 J01MA02 CIPROFLOXACINUM CIPROLET 250 mg COMPR. FILM. 250mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 4.47 0.447000 0.447000 0.44700058 J01MA02 CIPROFLOXACINUM EUCIPRIN 250 mg COMPR. FILM. 250mg EUROPHARM SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 5.73 0.573000 0.447000 0.44700059 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 12.42 1.242000 0.795000 0.79500060 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 12.42 1.242000 0.795000 0.79500061 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 13.07 1.307000 0.795000 0.79500062 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 12.42 1.242000 0.795000 0.79500063 J01MA02 CIPROFLOXACINUM CIPROZONE FORTE 500 mg COMPR. FILM. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 7.95 0.795000 0.795000 0.79500064 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 500 mg COMPR. FILM. 500mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 14.18 1.418000 0.795000 0.79500065 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 8.24 0.824000 0.795000 0.79500066 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 12.42 1.242000 0.795000 0.79500067 J01MA02 CIPROFLOXACINUM CIPHIN 500 COMPR. FILM. 500mg ZENTIVA A.S. SLOVACIA CUTIE X 1 BLIST. PVDC/PVC/AL X 10 COMPR. FILM. P-RF 10 17.87 1.787000 0.795000 0.79500068 J01MA02 CIPROFLOXACINUM CIPRODAR COMPR. FILM. 500mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 15.62 1.562000 0.795000 0.79500069 J01MA02 CIPROFLOXACINUM EUCIPRIN 500 mg COMPR. FILM. 500mg EUROPHARM SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 8.67 0.867000 0.795000 0.79500070 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 36.14 3.614000 3.614000 3.61400071 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 79.53 11.361428 11.361428 11.361428

Pagina 35 din 38

Page 95: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

72 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 25.95 8.650000 8.650000 8.65000073 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10ml KRKA D.D. SLOVENIA CUTIE X 50 FIOLE X 10 ML S 50 130.55 2.611000 2.611000 2.61100074 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 10 ML S/P-RF 5 15.76 3.152000 2.611000 2.61100075 J01MA02 CIPROFLOXACINUM CIPRINOL SOL. PERF. 100mg/50ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 50 ML SOL. PERF. S/P-RF 1 4.50 4.500000 4.500000 4.50000076 J01MA02 CIPROFLOXACINUM CIPRINOL SOL. PERF. 200mg/100ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML SOL. PERF. S/P-RF 1 9.00 9.000000 9.000000 9.00000077 J01MA02 CIPROFLOXACINUM UFEXIL 2 mg/ ml SOL. PERF. 2mg/ml DEMO SA GRECIA CUTIE X 10 PUNGI PP X 100 ML SOL. PERF. S 10 152.66 15.266000 9.000000 9.00000078 J01MA02 CIPROFLOXACINUM CIPROBAY (R) 400 SOL. PERF. 2mg/ml BAYER HEALTHCARE AG GERMANIA CUTIE X 5 FLACOANE X 200 ML S/P-RF 5 665.12 133.024000 133.024000 133.02400079 J01MA02 CIPROFLOXACINUM CIPRINOL (R) SOL. PERF. 400mg/200ml KRKA D.D. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 200 ML S/P-RF 1 18.12 18.120000 18.120000 18.120000

1 L04AB02 INFLIXIMABUM**** REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg CENTOCOR B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU LIOF. PT. CONC. PT. SOL. PERF. S 3 7047.00 2349.000000 2349.000000 2349.0000002 L04AB02 INFLIXIMABUM**** REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg CENTOCOR B.V. OLANDA CUTIE X 2 FLAC. DIN STICLA CU LIOF. PT. CONC. PT. SOL. PERF. S 2 4823.35 2411.675000 2349.000000 2349.0000003 L04AB04 ADALIMUMABUM **** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 2 SERINGI PREUMPLUTE X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4463.59 2231.795000 2231.795000 2231.795000

1 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 2313.85 1156.925000 1156.925000 1156.9250002 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 5678.51 5678.510000 5678.510000 5678.5100003 L04AB01 ETANERCEPTUM**** ENBREL 50 mg PULB+SOLV.PT.SOL.INJ 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. PULB. PT. SOL. INJ. + 4 SERINGI PREUMPLUTE CU SOLVENT + 4 ADAPTOARE PT. FLAC. + 8 TA P-RF/R 4 4291.33 1072.832500 1072.832500 1072.8325004 L04AB01 ETANERCEPTUM**** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 TAMPOANE CU ALCOOL P-RF/R 4 2140.66 535.165000 533.947500 533.9475005 L04AB01 ETANERCEPTUM**** ENBREL DE UZ PEDIATRIC PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 SERINGI DIN PLASTIC GOALE + 20 ACE + 24 TAMPOANE P-RF/R 4 2135.79 533.947500 533.947500 533.9475006 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. IN SERINGA PREUMPLUTA 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 2135.79 533.947500 533.947500 533.9475007 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 4200.73 1050.182500 1050.182500 1050.1825008 L04AB02 INFLIXIMABUM**** REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg CENTOCOR B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU LIOF. PT. CONC. PT. SOL. PERF. S 3 7047.00 2349.000000 2349.000000 2349.0000009 L04AB02 INFLIXIMABUM**** REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg CENTOCOR B.V. OLANDA CUTIE X 2 FLAC. DIN STICLA CU LIOF. PT. CONC. PT. SOL. PERF. S 2 4823.35 2411.675000 2349.000000 2349.0000008 L04AB04 ADALIMUMABUM **** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 2 SERINGI PREUMPLUTE X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4463.59 2231.795000 2231.795000 2231.795000

1 L04AB01 ETANERCEPTUM**** ENBREL 50 mg PULB+SOLV.PT.SOL.INJ 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. PULB. PT. SOL. INJ. + 4 SERINGI PREUMPLUTE CU SOLVENT + 4 ADAPTOARE PT. FLAC. + 8 TA P-RF/R 4 4291.33 1072.832500 1072.832500 1072.8325002 L04AB01 ETANERCEPTUM**** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 TAMPOANE CU ALCOOL P-RF/R 4 2140.66 535.165000 533.947500 533.9475003 L04AB01 ETANERCEPTUM**** ENBREL DE UZ PEDIATRIC PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 SERINGI DIN PLASTIC GOALE + 20 ACE + 24 TAMPOANE P-RF/R 4 2135.79 533.947500 533.947500 533.9475004 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. IN SERINGA PREUMPLUTA 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 2135.79 533.947500 533.947500 533.9475005 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 4200.73 1050.182500 1050.182500 1050.1825006 L04AB02 INFLIXIMABUM**** REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg CENTOCOR B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU LIOF. PT. CONC. PT. SOL. PERF. S 3 7047.00 2349.000000 2349.000000 2349.0000007 L04AB02 INFLIXIMABUM**** REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg CENTOCOR B.V. OLANDA CUTIE X 2 FLAC. DIN STICLA CU LIOF. PT. CONC. PT. SOL. PERF. S 2 4823.35 2411.675000 2349.000000 2349.000000

Tratamentul se initiaza de catre medicul in specialitatea dermatologie si obstetrica-ginecologie (pentru gonoree si infectia cu Chlamidia)

IMUNOSUPRESOARE SELECTIVE - G3125. BOALA CRONICA INFLAMATORIE INTESTINALA - G31a

Tratamentul se prescrie și monitorizează de către medicul în specialitatea gastro-enterologie și medicină internă (unități sanitare nominalizate de către Ministerul Sănătății Publice)

26. POLIARTITRITA REUMATOIDA - G31b

Tratamentul se prescrie si monitorizeaza de catre medicul in specialitatea reumatologie, medicina interna, nefrologie (pentru pacienţii cu afectare renală), medicina interna sau recuperare medicina fizica şi balneofizioieterapie (unitati sanitare nominalizate de catre Ministerul Sanatatii Publice)

27. ARTROPATIA PSORIAZICA - G31c

Pagina 36 din 38

Page 96: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

8 L04AB04 ADALIMUMABUM **** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 2 SERINGI PREUMPLUTE X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4463.59 2231.795000 2231.795000 2231.795000

1 L04AB01 ETANERCEPTUM**** ENBREL 50 mg PULB+SOLV.PT.SOL.INJ 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. PULB. PT. SOL. INJ. + 4 SERINGI PREUMPLUTE CU SOLVENT + 4 ADAPTOARE PT. FLAC. + 8 TA P-RF/R 4 4291.33 1072.832500 1072.832500 1072.8325002 L04AB01 ETANERCEPTUM**** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 TAMPOANE CU ALCOOL P-RF/R 4 2140.66 535.165000 533.947500 533.9475003 L04AB01 ETANERCEPTUM**** ENBREL DE UZ PEDIATRIC PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 SERINGI DIN PLASTIC GOALE + 20 ACE + 24 TAMPOANE P-RF/R 4 2135.79 533.947500 533.947500 533.9475004 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. IN SERINGA PREUMPLUTA 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 2135.79 533.947500 533.947500 533.9475005 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 4200.73 1050.182500 1050.182500 1050.1825006 L04AB02 INFLIXIMABUM**** REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg CENTOCOR B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU LIOF. PT. CONC. PT. SOL. PERF. S 3 7047.00 2349.000000 2349.000000 2349.0000007 L04AB02 INFLIXIMABUM**** REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg CENTOCOR B.V. OLANDA CUTIE X 2 FLAC. DIN STICLA CU LIOF. PT. CONC. PT. SOL. PERF. S 2 4823.35 2411.675000 2349.000000 2349.0000008 L04AB04 ADALIMUMABUM **** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 2 SERINGI PREUMPLUTE X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4463.59 2231.795000 2231.795000 2231.795000

1 L04AB01 ETANERCEPTUM**** ENBREL 50 mg PULB+SOLV.PT.SOL.INJ 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. PULB. PT. SOL. INJ. + 4 SERINGI PREUMPLUTE CU SOLVENT + 4 ADAPTOARE PT. FLAC. + 8 TA P-RF/R 4 4291.33 1072.832500 1072.832500 1072.8325002 L04AB01 ETANERCEPTUM**** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 TAMPOANE CU ALCOOL P-RF/R 4 2140.66 535.165000 533.947500 533.9475003 L04AB01 ETANERCEPTUM**** ENBREL DE UZ PEDIATRIC PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 SERINGI DIN PLASTIC GOALE + 20 ACE + 24 TAMPOANE P-RF/R 4 2135.79 533.947500 533.947500 533.9475004 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. IN SERINGA PREUMPLUTA 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 2135.79 533.947500 533.947500 533.9475005 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 4200.73 1050.182500 1050.182500 1050.182500

1 L04AB01 ETANERCEPTUM**** ENBREL 50 mg PULB+SOLV.PT.SOL.INJ 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. PULB. PT. SOL. INJ. + 4 SERINGI PREUMPLUTE CU SOLVENT + 4 ADAPTOARE PT. FLAC. + 8 TA P-RF/R 4 4291.33 1072.832500 1072.832500 1072.8325002 L04AB01 ETANERCEPTUM**** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 TAMPOANE CU ALCOOL P-RF/R 4 2140.66 535.165000 533.947500 533.9475003 L04AB01 ETANERCEPTUM**** ENBREL DE UZ PEDIATRIC PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 SERINGI DIN PLASTIC GOALE + 20 ACE + 24 TAMPOANE P-RF/R 4 2135.79 533.947500 533.947500 533.9475004 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. IN SERINGA PREUMPLUTA 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 2135.79 533.947500 533.947500 533.9475005 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 4200.73 1050.182500 1050.182500 1050.1825006 L04AB02 INFLIXIMABUM**** REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg CENTOCOR B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU LIOF. PT. CONC. PT. SOL. PERF. S 3 7047.00 2349.000000 2349.000000 2349.0000007 L04AB02 INFLIXIMABUM**** REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg CENTOCOR B.V. OLANDA CUTIE X 2 FLAC. DIN STICLA CU LIOF. PT. CONC. PT. SOL. PERF. S 2 4823.35 2411.675000 2349.000000 2349.0000008 L04AB04 ADALIMUMABUM **** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 2 SERINGI PREUMPLUTE X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4463.59 2231.795000 2231.795000 2231.795000

L04AA21 EFALIZUMABUM ****

NOTA:

Tratamentul se prescrie si monitorizeaza de catre medicul in specialitatea reumatologie si recuperare medicina fizica şi balneofizioieterapie (unitati sanitare nominalizate de catre Ministerul Sanatatii Publice)

30. PSORIAZIS CRONIC SEVER - G 31f

Tratamentul se prescrie si monitorizeaza de catre medicul in specialitatea dermatologie (unitati sanitare nominalizate de catre

28. SPONDILITA ANKILOZANTA - G 31d

Tratamentul se prescrie si monitorizeaza de catre medicul in specialitatea reumatologie, medicina interna sau recuperare medicina fizica şi balneofizioieterapie (unitati sanitare nominalizate de catre Ministerul Sanatatii Publice)

29. ARTRITA JUVENILA - G 31e

Tratamentul se prescrie si monitorizeaza de catre medicul in specialitatea reumatologie si recuperare medicina fizica şi balneofizioieterapie (unitati sanitare nominalizate de catre Ministerul Sanatatii Publice)

Pagina 37 din 38

Page 97: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

- Pentru medicamentele corespunzatoare acestei sectiuni initierea tratamentului se face de catre medicul de specialitate altul decat medicul de familie, exceptie facand medicamentele din G1-INSUFICIENTA CARDIACA CRONICA (CLASA III SAU IV NYHA) pozitiile 2, 3, 4, 5, 6, 7, 9 pentru care initierea tratamentului poate fi efectuata si de medicul de familie;

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

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (5) se utilizeaza numai pentru cazurile fara raspuns terapeutic la prednisonum.

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

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MSP;

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MSP si cu aprobarea comisiilor de la nivelul Caselor Judetene de Asigurari de Sanatate;

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (****) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MSP si cu aprobarea comisiilor de la nivelul Casei Nationale de Asigurari de Sanatate;

Medicamentul corespunzator DCI-ului notat cu (3) se livreaza impreuna cu solvent;

Pagina 38 din 38

Page 98: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

ANEXA 4

P1: PROGRAMUL NATIONAL DE BOLI TRANSMISIBILE

A) SUBPROGRAMUL DE TRATAMENT SI MONITORIZARE A PERSOANELOR CU INFECTIE HIV/SIDA si TRATAMENTUL POSTEXPUNERE

Nr.crt

Grupa terapeutica

Denumire generica Denumire comerciala

Forma farmaceutica

Concentratie / U.T. Firma Tara Ambalaj al U.T.

PRESCRIERE

Cantitate

Preţ cu ridicata/amb Preţ maxim/amb Preţ maxim/UT

1 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 28.49 31.520000 2.6266662 D01AC02 MICONAZOLUM MEDACTER CREMA 2% FARAN LABORATORIES S.A. GRECIA CUTIE X 1 TUB X 30G P-RF 1 5.85 6.470000 6.4700003 D01AC02 MICONAZOLUM MICONAZOL NITRAT 2% CREMA 2% SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 4.47 4.940000 4.9400004 D01AC02 MICONAZOLUM MICONAL ECOBI CREMA 20mg/g FARMACEUTICI ECOBI S.A.S ITALIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 6.50 7.190000 7.1900005 D06BB03 ACICLOVIRUM CLOVIRAL (R) 5% CREMA 5% ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB AL. X 12 G P-RF 1 4.19 4.640000 4.6400006 D06BB03 ACICLOVIRUM ZOVIRAX CREMA 5% THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 TUB X 5G CREMA P-RF 1 14.63 19.780000 19.780000

7 D06BB03 ACICLOVIRUM ACICLOVIR 5% CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 5 G CREMA P-RF 1 3.25 3.600000 3.6000008 D06BB03 ACICLOVIRUM ACICLOVIR 5% CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 15 G CREMA P-RF 1 4.97 5.500000 5.5000009 D06BB03 ACICLOVIRUM ACICLOVIR MK CREMA 5% FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB AL X 7,5 G P-RF 1 3.02 3.340000 3.340000

10 D06BB03 ACICLOVIRUM ACICLOVIR MK CREMA 5% FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB AL X 15 G P-RF 1 4.82 5.330000 5.33000011 D06BB03 ACICLOVIRUM ACIKLOVIR CREMA CREMA 50mg/g A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB X 5 G CREMA P-RF 1 4.03 4.460000 4.46000012 D06BB03 ACICLOVIRUM ACIKLOVIR CREMA CREMA 50mg/g A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB X 10 G CREMA P-RF 1 6.05 6.690000 6.69000013 D06BB03 ACICLOVIRUM ACICLOVIR HYPERION CREMA 50mg/g HYPERION S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 4.79 5.300000 5.30000014 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 3.07 3.400000 3.40000015 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 4.06 4.490000 0.74833316 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 3.90 4.310000 1.43666617 G01AF04 MICONAZOLUM MEDACTER CREMA VAG. 2% FARAN LABORATORIES S.A. GRECIA CUTIE X 1 TUB X 78 G P-RF 1 13.22 14.630000 14.630000

18 G01AF04 MICONAZOLUM MICONAL ECOBI CREMA VAG. 20mg/g FARMACEUTICI ECOBI S.A.S ITALIA CUTIE X 1 TUB DIN AL X 78 G CREMA VAGINALA + CANULA P-RF 1 9.50 10.510000 10.510000

19 G01AF04 MICONAZOLUM MICONAL ECOBI OVULE 50mg FARMACEUTICI ECOBI S.A.S ITALIA CUTIE X 3 FOLII PREFORMATE PVC/PE X 5 OVULE P-RF 15 6.14 6.790000 0.45266620 G01AF04 MICONAZOLUM MICONAL ECOBI SOL. VAGINALA 2mg/ml FARMACEUTICI ECOBI S.A.S ITALIA CUTIE X 5 FLACOANE DIN PEJD X 150 ML SOL. VAG. + 5 CANULE P-RF 5 12.27 13.580000 2.71600021 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4.88 5.400000 0.27000022 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 177.18 196.020000 0.19602023 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4.42 4.890000 0.24450024 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 211.14 233.590000 0.23359025 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg EUROPHARM SA ROMANIA CUTIE X 1 BLIST.AL/PVC X 12 CAPS. P-RF 12 4.00 4.430000 0.369166

VALABILĂ ÎNCEPÂND CU 1 APRILIE 2009

SECŢIUNEA C2 - CU PROCENT DE COMPENSARE 100% din pret de decontare - cuprinde denumirile comune internaţionale corespunzătoare medicamentelor de care beneficiaza asiguratii inclusi in programele nationale de sănătate cu scop curativ

in tratamentul ambulatoriu si spitalicesc CONFORM HG NR. 367/2009

Pagina 1 din 52

Page 99: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

26 J01CF04 OXACILLINUM OXACILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5.04 5.580000 0.27900027 J01CF04 OXACILLINUM OXACILINA CAPS. 250mg FARMACOM SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 3.72 4.120000 0.20600028 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4.19 4.640000 0.23200029 J01CF04 OXACILLINUM OXACILINA FARMEX 250 mg CAPS. 250mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4.41 4.880000 0.24400030 J01CF04 OXACILLINUM OXACILINA 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. X 10 CAPS. P-RF/S 1000 244.90 270.950000 0.27095031 J01CF04 OXACILLINUM OXACILINA 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 4.06 4.490000 0.44900032 J01CF04 OXACILLINUM OXACILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 5.12 5.670000 0.56700033 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 50 BLIST. AL/PVC X 10 CAPS. P-RF/S 500 179.03 198.070000 0.39614034 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7.30 8.080000 0.40400035 J01CF04 OXACILLINUM OXACILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 4.61 5.100000 0.51000036 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 4.30 5.810000 0.581000

37 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 1.86 2.060000 2.060000

38 J01CF04 OXACILLINUMOXACILINA 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 3.15 4.120000 4.120000

39 J01CF04 OXACILLINUM

OXACILINA ANTIBIOTICE 250 mg

PULB. PT. SOL. INJ./PERF.I.M./I.V. 250mg ANTIBIOTICE SA ROMANIA

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF 1 1.14 1.260000 1.260000

40 J01CR01AMPICILLINUM + SULBACTAM AMPIPLUS (R) 1,5 g

PULB. PT. SOL. INJ. 1g+500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. X 1,5 G P-RF 1 16.54 18.300000 18.300000

41 J01CR01AMPICILLINUM + SULBACTAM AMPIPLUS (R) 1,5 g

PULB. PT. SOL. INJ. 1g+500mg ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. PULB. PT. SOL. INJ. X 1,5 G P-RF/S 50 609.42 674.230000 13.484600

42 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM FORCID SOLUTAB 250/62,5 COMPR. DISP. 250/62,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 5 BLIST. PA-AL-PVC/AL X 4 COMPR. DISP. P-RF 20 16.53 18.290000 0.914500

43 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM FORCID SOLUTAB 500/125 COMPR. DISP. 500/125mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 5 BLIST. PA-AL-PVC/AL X 4 COMPR. DISP. P-RF 20 17.24 23.300000 1.165000

44 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM FORCID SOLUTAB 875/125 COMPR. DISP. 875mg+125mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. DISP. P-RF 14 35.84 39.650000 2.832142

45 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 28.09 36.740000 2.624285

46 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV 1000 mg COMPR. FILM. 1000mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL-PVC/AL X 7 COMPR. FILM. P-RF 14 34.23 37.870000 2.705000

47 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV 375 mg COMPR. FILM. 250mg+125mg MEDOCHEMIE LTD. CIPRU CUTIE X 4 BLIST. X 4 COMPR. FILM. P-RF 16 15.46 17.100000 1.068750

48 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 625 mg COMPR. FILM. 500mg+125mg BEECHAM GROUP PLC MAREA BRITANIE

CUTIE X 2 BLIST. AL/PVDC-PVC X 7 COMPR. FILM., FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOA P-RF 14 11.58 15.650000 1.117857

49 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV 625 mg COMPR. FILM. 500mg+125mg MEDOCHEMIE LTD. CIPRU CUTIE X 4 BLIST. X 4 COMPR. FILM. P-RF 16 22.71 25.130000 1.570625

50 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 19.50 26.350000 1.882142

Pagina 2 din 52

Page 100: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

51 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 625 mg COMPR. FILM. 625mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 4 FOLII AL-PEJD X 7 COMPR. FILM. P-RF 28 22.97 31.050000 1.108928

52 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 1 g COMPR. FILM. 875mg+125mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 2 BLIST. AL/PVDC-PVC X 7 COMPR. FILM., FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOA P-RF 14 20.28 27.410000 1.957857

53 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN™ SR COMPR. FILM. ELIB. PREL. 1062,5mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 7 BLIST. AL/PVC-AL SAU AL/PP-AL X 4 COMPR. FILM. ELIB. PREL. P-RF 28 49.37 54.620000 1.950714

54 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 625 mg COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE 625mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 24.87 27.510000 1.965000

55 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 1,2 g PULB. PT. SOL. INJ./PERF. 1,2g ANTIBIOTICE SA ROMANIA CUTIE X 100 FLACOANE CU PULB. PT. SOL. INJ. / PERF. P-RF/S 100 314.60 381.060000 3.810600

56 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 1,2 g PULB. PT. SOL. INJ./PERF. 1,2g ANTIBIOTICE SA ROMANIA CUTIE X 50 FLACOANE CU PULB. PT. SOL. INJ. / PERF. P-RF/S 50 157.30 192.030000 3.840600

57 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 1,2 g PULB. PT. SOL. INJ./PERF. 1,2g ANTIBIOTICE SA ROMANIA CUTIE X 1 FLACON CU PULB. PT. SOL. INJ. / PERF. P-RF 1 3.26 4.410000 4.410000

58 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN INTRAVENOS 1,2g PULB. PT. SOL. INJ./PERF. 1000mg+200mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S/P-RF 10 49.37 54.620000 5.462000

59 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 600 mg PULB. PT. SOL. INJ./PERF. 600mg ANTIBIOTICE SA ROMANIA CUTIE X 1 FLACON CU PULB. PT. SOL INJ. / PERF. P-RF 1 4.42 4.890000 4.890000

60 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 600 mg PULB. PT. SOL. INJ./PERF. 600mg ANTIBIOTICE SA ROMANIA CUTIE X 100 FLACOANE CU PULB. PT. SOL INJ. / PERF. P-RF/S 100 417.70 462.120000 4.621200

61 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 600 mg PULB. PT. SOL. INJ./PERF. 600mg ANTIBIOTICE SA ROMANIA CUTIE X 50 FLACOANE CU PULB. PT. SOL INJ. / PERF. P-RF/S 50 211.14 233.590000 4.671800

62 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN INTRAVENOS 2,2g PULB. PT. SOL. PERF. 2000mg+200mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. S/P-RF 1 13.64 18.440000 18.440000

63 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV 156,25 mg/5 ml PULB. PT. SUSP. ORALA 125mg+31,25/5ml MEDOCHEMIE LTD. CIPRU CUTIE X 1 FLAC. CU PULB. PT. 100ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 12.50 13.830000 13.830000

64 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 8.12 10.970000 10.970000

65 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV FORTE 312,5mg/5ml PULB. PT. SUSP. ORALA 250mg+62,5mg/5ml MEDOCHEMIE LTD. CIPRU

CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 100 ML SUSP. P-RF 1 15.14 16.750000 16.750000

66 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS PULB. PT. SUSP. ORALA 400mg+57mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE

CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. 70 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 13.84 18.710000 18.710000

67 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS PULB. PT. SUSP. ORALA 400mg+57mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE

CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. 35 ML SUSP. ORALA + 1 SERIGA PT. ADM. ORALA P-RF 1 6.92 9.350000 9.350000

Pagina 3 din 52

Page 101: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

68 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN (R) ES PULB. PT. SUSP. ORALA 642,90mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE

CUTIE X 1 FLACON DIN STICLA CU PULB. PT. 100 ML SUSP. ORALA + 1 MASURA DOZATOARE P-RF 1 24.19 26.760000 26.760000

69 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 16.40 18.140000 18.140000

70 J01CR02

AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 312,5 mg/5 ml PULB. PT.SUSP. ORALA 312,5mg/5ml RANBAXY UK LIMITED MAREA BRITANIE

CUTIE X 1 FLAC. DIN PEID CU PULB. PT. SUSP. ORALA MARCAT PT. 100ML+ MASURA DOZATOARE P-RF 1 15.50 17.150000 17.150000

71 J01CR05PIPERACILLINUM + TAZOBACTAMUM TAZOCIN 4,5 LIOF. PT. SOL. INJ. FARA CONCENTRATIE WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 12 FLAC. CU LIOF. PT. SOL. INJ. S/P-RF 12 652.44 749.310000 62.442500

72 J01CR05PIPERACILLINUM + TAZOBACTAMUM TAZOCIN 2,25 LIOF. PT. SOL. INJ. FARA CONCENTRATIE WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 12 FLAC. CU LIOF. PT. SOL. INJ. S/P-RF 12 378.48 450.690000 37.557500

73 J01DD04 CEFTRIAXONUM CEFORT 1 g PULB. PT. SOL. INJ./PERF. 1g ANTIBIOTICE SA ROMANIA CUTIE X 10 FLAC. CU PULB. PT. SOL. INJ./PERF. S/P-RF 10 122.81 135.870000 13.587000

74 J01DD04 CEFTRIAXONUM CEFORT 250 mg PULB. PT. SOL. INJ./PERF. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. CU PULB. PT. SOL. INJ.PERF. S/P-RF 50 302.13 334.260000 6.68520075 J01DD04 CEFTRIAXONUM CEFORT 250 mg PULB. PT. SOL. INJ./PERF. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. CU PULB. PT. SOL. INJ.PERF. S 100 566.52 626.770000 6.26770076 J01DD04 CEFTRIAXONUM CEFORT 250 mg PULB. PT. SOL. INJ./PERF. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ.PERF. S/P-RF 1 6.05 6.690000 6.69000077 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 10 314.25 380.680000 38.068000

78 J01DD04 CEFTRIAXONUM CEFORT 2 g PULB. PT. SOL. INJ./PERF. 2g ANTIBIOTICE SA ROMANIA CUTIE X 10 FLAC. CU PULB. PT. SOL. INJ./PERF. S/P-RF 10 285.36 315.710000 31.571000

79 J01DD04 CEFTRIAXONUM CEFORT 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. CU PULB. PT. SOL. INJ./PERF. S/P-RF 50 566.52 626.770000 12.535400

80 J01DD04 CEFTRIAXONUM CEFORT 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. CU PULB. PT. SOL. INJ./PERF. S 100 1,062.01 1195.740000 11.957400

81 J01DD04 CEFTRIAXONUM CEFORT 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ./PERF. S/P-RF 1 12.27 13.570000 13.570000

82 J01DD04 CEFTRIAXONUM ROCEPHIN (R) PULB. PT. SOL. PERF. 2g ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. X 2 G S/P-RF 1 41.31 54.040000 54.040000

83 J01DD04 CEFTRIAXONUM NOVOSEF 1 g i.m. PULB.+SOLV. PT. SOL. INJ. 1g ZENTIVA S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 15 ML CONTINAND PULB. PT. SOL. INJ.+ 1 FIOLA DIN STICLA INCOLO P-RF 1 5.56 6.150000 6.15000084 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 18.87 20.880000 2.08800085 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 1,654.87 1841.960000 1.84196086 J01DD12 CEFOPERAZONUM MEDOCEF 1 g PULB. PT. SOL. INJ. 1g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 148.15 163.910000 16.391000

87 J01DD12 CEFOPERAZONUM MEDOCEF 2 g PULB. PT. SOL. INJ. 2g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 246.89 273.150000 27.315000

88 J01DD12 CEFOPERAZONUM LYZONE 2 g PULB. PT. SOL. INJ. 2g MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. S/P-RF 1 18.51 20.480000 20.480000

89 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 3.64 4.920000 4.92000090 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 10.72 11.860000 11.860000

91 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 6.50 7.190000 7.19000092 J01DE02 CEFPIROMUM CEFROM (R) 1 g PULB. PT. SOL. INJ./PERF. 1g LAB. AVENTIS FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. INJ./PERF. S/P-RF 1 56.27 62.250000 62.250000

93 J01DE02 CEFPIROMUM CEFROM (R) 2 g PULB. PT. SOL. INJ./PERF. 2g LAB. AVENTIS FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. INJ./PERF. S/P-RF 1 97.89 108.300000 108.300000

94 J01DH02 MEROPENEMUM MERONEM IV 1 g PULB. PT. SOL. INJ. I.V./PERF. 1g ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 10 FLAC. PULB. PT. SOL. INJ. (CAP. 20 ML) S 10 969.60 1095.010000 109.501000

95 J01DH02 MEROPENEMUM MERONEM IV 500 mg PULB. PT. SOL. INJ. I.V./PERF. 500mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 10 FLAC. PULB. PT. SOL. INJ. (CAP. 20 ML) S 10 508.50 592.420000 59.242000

96 J01DH51IMIPENEMUM + CILASTATINUM TIENAM I.V. PULB. PT. SOL. PERF. 500mg/500mg MERCK SHARP & DOHME ROMANIA TAVA DIN PLASTIC X 10 FLAC. DIN STICLA INCOLORA CU PULB.PT. SOL. PERF. S/P-RF 10 420.10 496.060000 49.606000

97 J01DH51IMIPENEMUM + CILASTATINUM TIENAM I.V. PULB. PT. SOL. PERF. 500mg/500mg MERCK SHARP & DOHME ROMANIA TAVA DIN PLASTIC X 25 FLAC. DIN STICLA INCOLORA CU PULB.PT. SOL. PERF. S/P-RF 25 1,005.25 1133.870000 45.354800

98 J01EE01

SULFAMETHOXAZOLUM + TRIMETHOPRIMUM BISEPTRIM CAPS. RET. 400mg/80mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 2.48 2.740000 0.137000

99 J01EE01

SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 1.44 1.590000 0.079500

100 J01EE01

SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM COMPR. 400mg/80mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2.82 3.120000 0.156000

Pagina 4 din 52

Page 102: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

101 J01EE01

SULFAMETHOXAZOLUM + TRIMETHOPRIMUM CO - TRIM ELL COMPR. 400mg/80mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2.20 2.430000 0.121500

102 J01EE01

SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SIROP 25mg/5mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA

CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 5.60 6.200000 6.200000

103 J01EE01

SULFAMETHOXAZOLUM + TRIMETHOPRIMUM EPITRIM SUSP. ORALA 200mg/40mg /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 3.24 3.590000 3.590000

104 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 6.84 9.240000 0.577500105 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 19.08 21.110000 2.111000106 J01FA06 ROXITHROMYCINUM ROXAMED (R) 150 COMPR. FILM. 150mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 10.39 11.500000 1.150000107 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT SPA ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 19.49 21.560000 1.540000108 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 250 mg COMPR. FILM. 250mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 21.14 23.390000 1.670714109 J01FA09 CLARITHROMYCINUM CLAR 250 COMPR. FILM. 250mg MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 5 BLIST. X 4 COMPR. FILM. P-RF 20 25.99 28.750000 1.437500110 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 13.07 17.660000 1.261428111 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 10.19 13.770000 0.983571112 J01FA09 CLARITHROMYCINUM CLARITROMICINA 250 mg COMPR. FILM. 250mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 10.19 13.770000 0.983571113 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 11.58 15.650000 1.117857114 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 500 mg COMPR. FILM. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 39.54 43.740000 3.124285115 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 25.40 33.220000 2.372857116 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 22.30 30.140000 2.152857117 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mg MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF 20 33.52 37.080000 1.854000118 J01FA09 CLARITHROMYCINUM CLARITROMICINA 500 mg COMPR. FILM. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 22.30 30.140000 2.152857119 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 22.66 30.630000 2.187857120 J01FA09 CLARITHROMYCINUM LEKOKLAR XL 500 mg COMPR. FILM. ELIB. MODIF. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FOLIE AL/AL X 5 COMPR. FILM. ELIB. MODIF. P-RF 5 12.77 17.260000 3.452000121 J01FA09 CLARITHROMYCINUM LEKOKLAR XL 500 mg COMPR. FILM. ELIB. MODIF. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FOLIE AL/AL X 7 COMPR. FILM. ELIB. MODIF. P-RF 7 17.88 24.160000 3.451428122 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 24.82 27.460000 3.922857123 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 25.99 28.750000 5.750000124 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 19.17 21.210000 3.030000125 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA 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 27.60 30.540000 30.540000

126 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA 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 16.89 18.690000 18.690000

127 J01FA09 CLARITHROMYCINUM FROMILID (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. P-RF 1 16.89 18.690000 18.690000

128 J01FA09 CLARITHROMYCINUM LEKOKLAR 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 17.16 18.990000 18.990000

129 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 23.74 26.270000 26.270000

130 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 14.56 16.110000 16.110000

131 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 68,3 G GRANULE PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 41.66 46.090000 46.090000

132 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 30.35 33.580000 33.580000

133 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 38.08 42.130000 42.130000

134 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 22.00 29.740000 29.740000

135 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 37.94 41.970000 41.970000

136 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 8 CAPS. P-RF 8 27.22 35.610000 4.451250137 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. P-RF 6 18.93 25.580000 4.263333138 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 17.62 23.810000 3.968333139 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 33.05 36.560000 6.093333140 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 31.36 34.700000 5.783333141 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 31.36 34.700000 5.783333142 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 27.41 35.850000 11.950000

Pagina 5 din 52

Page 103: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

143 J01FA10 AZITHROMYCINUM AZITROX (R) 500 COMPR. FILM. 500mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 34.99 38.710000 12.903333

144 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 33.05 36.560000 12.186666

145 J01FA10 AZITHROMYCINUM ZITROCIN 500 mg COMPR. FILM. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC/AL X 3 COMPR. FILM. P-RF 3 17.82 24.080000 8.026666146 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 26.21 29.000000 9.666666147 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 26.21 29.000000 9.666666148 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 31.45 34.790000 11.596666

149 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 31.45 34.790000 11.596666

150 J01FA10 AZITHROMYCINUM ZMAX 2 g GRAN. ELIB. PREL. PT. SUSP. ORALA 2g PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON DIN PEID CU GRAN. CU ELIB. PREL. P-RF 1 44.80 49.560000 49.560000

151 J01FA10 AZITHROMYCINUM SUMAMED (R) LIOF. PT. SOL. PERF. 500mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 5 FLAC. LIOF. PT. SOL. PERF. S/P-RF 5 126.67 140.140000 28.028000

152 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLAC. DIN PE CU PULB. PT. 15 ML SUSP. ORALA RECONSTITUITA + FLAC. CU SOLV. X 7,5 ML SOLV. P-RF 1 12.73 14.080000 14.080000

153 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CONTINAD PULBERE PT. 20 ML SUSP. ORALA + SERINGA DOZATOARE DIN PE/PP P-RF 1 15.32 16.950000 16.950000

154 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA CCUTIE X 1 FLAC. DIN PEID CONTINAD PULBERE PT. 20 ML SUSP. ORALA + SERINGA DOZATOARE DIN PE/PP P-RF 1 24.23 26.810000 26.810000

155 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml 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 17.49 23.640000 23.640000

156 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml 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 37.32 41.290000 41.290000

157 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml 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 46.59 51.550000 51.550000

158 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 4.87 5.390000 0.539000159 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 29.26 32.370000 0.647400160 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 6.54 7.240000 0.724000161 J01GB03 GENTAMICINUM PAN - GENTAMICINE SOL.INJ. 80mg/2ml LAB. PANPHARMA FRANTA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF 10 4.62 5.110000 0.511000162 J01GB06 AMIKACINUM AMIKOZIT (R) 100 mg/2 ml SOL. INJ. 100mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA X 2 ML P-RF 1 2.42 2.680000 2.680000163 J01GB06 AMIKACINUM AMIKOZIT (R) 500 mg/2 ml SOL. INJ. 500mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA X 2 ML P-RF 1 4.75 5.250000 5.250000164 J01GB07 NETILMICINUM NETROMYCINE (R) SOL. INJ. 150mg/1,5ml SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 FLACON X 1,5 ML S/P-RF 1 13.64 15.090000 15.090000

165 J01GB07 NETILMICINUM NETROMYCINE (R) SOL. INJ. 200mg/2ml SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 FLACON X 2 ML S/P-RF 1 16.57 18.330000 18.330000

166 J01GB07 NETILMICINUM NETROMYCINE (R) SOL. INJ. 50mg/2ml SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 FLACON X 2 ML S/P-RF 1 5.28 7.130000 7.130000167 J01MA01 OFLOXACINUM OFLOXACIN 200 mg COMPR. FILM. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 32.81 36.300000 3.630000168 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 14.02 15.510000 1.551000169 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 7.89 10.660000 1.066000170 J01MA01 OFLOXACINUM ZANOCIN (R) OD 400 COMPR. FILM. ELIB. PREL. 400mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 1 BLIST. X 5 COMPR. FILM. ELIB. PREL. P-RF 5 18.73 20.720000 4.144000171 J01MA01 OFLOXACINUM ZANOCIN (R) OD 400 COMPR. FILM. ELIB. PREL. 400mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 5 COMPR. FILM. ELIB. PREL. P-RF 10 35.61 39.400000 3.940000172 J01MA02 CIPROFLOXACINUM EUCIPRIN CAPS. 250mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 6 CAPS. P-RF 12 5.25 5.810000 0.484166173 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 4.74 6.410000 0.641000174 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 4.74 6.410000 0.641000175 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 5.12 5.670000 0.567000176 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 5.22 5.770000 0.577000177 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 10.52 11.640000 0.582000178 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 250 mg COMPR. FILM. 250mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 5.38 5.950000 0.595000179 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 4.82 6.520000 0.652000180 J01MA02 CIPROFLOXACINUM CIPHIN 250 COMPR. FILM. 250mg ZENTIVA A.S. SLOVACIA CUTIE X 1 BLIST. PVDC/PVC/AL X 10 COMPR. FILM. P-RF 10 7.86 8.700000 0.870000181 J01MA02 CIPROFLOXACINUM ALVEBAR 250 mg COMPR. FILM. 250mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 3.24 3.590000 0.359000182 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 9.19 12.420000 1.242000183 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 9.19 12.420000 1.242000184 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 9.13 10.100000 1.010000185 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 10.04 11.110000 1.111000186 J01MA02 CIPROFLOXACINUM CIPROZONE FORTE 500 mg COMPR. FILM. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 5.88 7.950000 0.795000187 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 500 mg COMPR. FILM. 500mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 10.30 11.400000 1.140000188 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 6.10 8.240000 0.824000

Pagina 6 din 52

Page 104: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

189 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 9.19 12.420000 1.242000190 J01MA02 CIPROFLOXACINUM CIPHIN 500 COMPR. FILM. 500mg ZENTIVA A.S. SLOVACIA CUTIE X 1 BLIST. PVDC/PVC/AL X 10 COMPR. FILM. P-RF 10 12.99 14.370000 1.437000191 J01MA02 CIPROFLOXACINUM CIPRODAR COMPR. FILM. 500mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 11.37 12.580000 1.258000192 J01MA02 CIPROFLOXACINUM ALVEBAR 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 4.42 4.890000 0.489000193 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 27.15 30.040000 3.004000194 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 62.90 69.590000 9.941428195 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 18.86 20.870000 6.956666196 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10ml KRKA D.D. SLOVENIA CUTIE X 50 FIOLE X 10 ML S 50 106.94 118.310000 2.366200197 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 10 ML S/P-RF 5 11.87 13.130000 2.626000198 J01MA02 CIPROFLOXACINUM CIPRINOL SOL. PERF. 100mg/50ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 50 ML SOL. PERF. S/P-RF 1 3.27 3.620000 3.620000199 J01MA02 CIPROFLOXACINUM CIPRINOL SOL. PERF. 200mg/100ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML SOL. PERF. S/P-RF 1 6.54 7.240000 7.240000200 J01MA02 CIPROFLOXACINUM CIPROBAY (R) 400 SOL. PERF. 2mg/ml BAYER HEALTHCARE AG GERMANIA CUTIE X 5 FLACOANE X 200 ML S/P-RF 5 575.20 665.120000 133.024000

201 J01MA02 CIPROFLOXACINUM UFEXIL 2 mg/ ml SOL. PERF. 2mg/ml DEMO SA GRECIA CUTIE X 10 PUNGI PP X 100 ML SOL. PERF. S 10 127.32 140.860000 14.086000

202 J01MA02 CIPROFLOXACINUM CIPRINOL (R) SOL. PERF. 400mg/200ml KRKA D.D. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 200 ML S/P-RF 1 13.17 14.570000 14.570000

203 J01MA03 PEFLOXACINUM ABAKTAL COMPR. FILM. 400mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 20.03 22.160000 2.216000204 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 31.58 34.940000 3.494000205 J01MA03 PEFLOXACINUM ABAKTAL 400mg/5ml CONC. PT. SOL. PERF. 400mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S/P-RF 10 28.55 37.340000 3.734000206 J01MA06 NORFLOXACINUM NORFLOXACINA - 400 CAPS. 400mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 10 CAPS. P-RF 10 6.75 7.470000 0.747000207 J01MA06 NORFLOXACINUM NORFLOXACIN 400 mg COMPR. FILM. 400mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 8.56 11.570000 0.826428208 J01MA06 NORFLOXACINUM H - NORFLOXACIN 400 mg COMPR. FILM. 400mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 14.45 15.990000 0.799500209 J01MA06 NORFLOXACINUM NORFLOXACIN 400 mg COMPR. FILM. 400mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 6.09 6.740000 0.674000210 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 10.30 11.400000 0.570000211 J01MA06 NORFLOXACINUM NORFLOX - 400 COMPR. FILM. 400mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 4.22 4.670000 0.467000212 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 12.02 13.300000 0.665000213 J01MA06 NORFLOXACINUM EPINOR COMPR. FILM. 400mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 5.36 7.240000 0.517142214 J01MA06 NORFLOXACINUM NORFLOXACIN OZONE 400 mg COMPR. FILM. 400mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 3.90 4.310000 0.431000215 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 58.24 64.430000 9.204285216 J01MA12 LEVOFLOXACINUM TAVANIC 500 mg COMPR. FILM. 500mg SANOFI - AVENTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF 7 37.39 48.910000 6.987142217 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 85.12 94.170000 13.452857

218 J01MA12 LEVOFLOXACINUM TAVANIC I.V. 500 mg SOL. PERF. 5mg/ml SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML SOL. PERF. P-RF/S 1 107.25 118.660000 118.660000

219 J01MA14 MOXIFLOXACINUM AVELOX (R) 400 mg COMPR. FILM. 400mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. ALB OPAC PP/AL X 5 COMPR. FILM. P-RF 5 65.23 72.170000 14.434000

220 J01MA14 MOXIFLOXACINUM AVELOX (R) 400 mg/250 ml SOL. PERF. 400mg/250ml BAYER HEALTHCARE AG GERMANIA CUTIE X 5 FLACOANE DIN STICLA X 250 ML S 5 583.75 674.440000 134.888000

221 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 44.80 49.560000 49.560000

222 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 22.40 24.780000 24.780000

223 J01XA01 VANCOMYCINUM EDICIN LIOF. PT. SOL. PERF./INJ. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 500 MG LIOF. PT. SOL. PERF./INJ. S/P-RF 1 36.25 40.100000 40.100000

224 J01XA01 VANCOMYCINUM EDICIN PULB.LIOF.PT.SOL.PERF./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 53.42 67.540000 67.540000

225 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 1 110.96 135.460000 135.460000

226 J01XB01 COLISTINUM COLISTINA ANTIBIOTICE 1000000 UI PULB. PT. SOL. INJ./PERF. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S 100 1,510.15 1684.220000 16.842200

227 J01XB01 COLISTINUM COLISTINA ANTIBIOTICE 1000000 UI PULB. PT. SOL. INJ./PERF. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S 50 770.08 877.540000 17.550800

228 J01XD01 METRONIDAZOLUM METRONIDAZOL 250 mg (J01XD01) COMPR. 250mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.91 1.010000 0.050500229 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 1.31 1.450000 0.048333230 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 5.84 7.890000 0.394500231 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 71.45 79.050000 6.587500232 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 5.97 6.610000 6.610000233 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 70.07 77.520000 6.460000234 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 5.83 6.450000 6.450000

Pagina 7 din 52

Page 105: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

235 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 34.49 38.160000 3.816000236 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 34.49 38.160000 3.816000237 J01XD01 METRONIDAZOLUM FLAGYL 4 % (J01XD01) SUSP. ORALA 4% LABORATOIRE AVENTIS FRANTA CUTIE X 1 FLACON X 120 ML SUSP. ORALA + LINGURITA DOZATOARE X 5 ML P-RF 1 5.53 7.470000 7.470000238 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1,507.24 1681.040000 168.104000

239 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml 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 1 827.52 940.150000 940.150000

240 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1,507.24 1681.040000 168.104000

241 J02AB02 KETOCONAZOLUM NIZORAL 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 13.40 14.830000 1.483000242 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 4.90 5.420000 0.542000243 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 6.01 6.650000 0.665000244 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 5.74 6.350000 0.635000245 J02AB02 KETOCONAZOLUM KETOSTIN 200 mg COMPR. 200mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 8.28 9.160000 0.916000246 J02AB02 KETOCONAZOLUM KEFUNGIN COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 4.78 6.460000 0.646000247 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 185.14 204.830000 7.315357248 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 16.77 18.550000 4.637500249 J02AC01 FLUCONAZOLUM FLUCORIC 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 31.12 40.710000 5.815714250 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 61.37 67.900000 4.243750251 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 6.45 7.140000 3.570000252 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 21.50 23.790000 3.398571253 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 17.54 19.400000 19.400000

254 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 58.38 73.820000 18.455000

255 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 2 BLIST. AL/PVC X 1 CAPS. P-RF 2 36.43 40.300000 20.150000

256 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 6.51 7.200000 7.200000257 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 19.61 21.700000 21.700000

258 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 13.88 15.360000 15.360000

259 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10.12 13.680000 13.680000

260 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 6.90 9.320000 9.320000261 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 6.03 6.670000 6.670000262 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 3 CAPS. P-RF 3 22.23 30.050000 10.016666

263 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 11.24 12.440000 12.440000

264 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 4.70 5.200000 5.200000265 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6.35 7.020000 7.020000266 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5.92 6.550000 6.550000267 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5.60 6.200000 6.200000268 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 4.32 4.780000 4.780000269 J02AC01 FLUCONAZOLUM FLUCONAZOL LAROPHARM 150 mg CAPS. 150mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 6.03 6.670000 6.670000270 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDICO UNO 150 mg CAPS. 150mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 5.92 6.550000 6.550000271 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 27.78 30.730000 4.390000272 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 38.26 42.330000 6.047142273 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 14.79 16.360000 2.337142274 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 40.58 53.080000 7.582857275 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 20.57 27.800000 3.971428276 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 29.57 32.710000 4.672857277 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 15.92 17.610000 2.515714278 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 12.99 14.370000 1.796250279 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 16.72 18.500000 1.850000280 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 11.38 12.590000 1.798571

Pagina 8 din 52

Page 106: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

281 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.90 14.270000 2.038571282 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.82 14.180000 2.025714283 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.53 13.860000 1.980000284 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 11.02 12.190000 1.741428285 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 10.33 11.430000 1.632857286 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 40.58 53.080000 53.080000

287 J02AC01 FLUCONAZOLUM DIFLUCAN (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S/P-RF 1 127.32 140.860000 140.860000

288 J02AC01 FLUCONAZOLUM DIFLUCAN (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S/P-RF 1 28.58 31.620000 31.620000

289 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 32.90 43.030000 43.030000

290 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 50 ML SOL. PERF. S 1 28.18 31.180000 31.180000

291 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 100 ML SOL. PERF. S 1 39.34 43.520000 43.520000

292 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 200 ML SOL. PERF. S 1 131.40 145.370000 145.370000

293 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 2mg/ml SOL. PERF. 2mg/ml LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 35.97 39.790000 39.790000

294 J02AC02 ITRACONAZOLUM ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 57.12 72.220000 4.814666295 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 37.74 49.360000 3.290666296 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 88.60 98.020000 6.534666297 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 88.56 97.980000 6.532000298 J02AC02 ITRACONAZOLUM OMICRAL 100 mg CAPS. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 68.10 75.340000 5.022666299 J02AC02 ITRACONAZOLUM SPORILIN 100 mg CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 85.61 94.720000 6.314666300 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3,343.84 3682.940000 131.533571

301 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 858.25 973.640000 34.772857

302 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 431.95 508.980000 508.980000

303 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 P-RF 1 2,070.87 2295.400000 2295.400000

304 J02AC04 POSACONAZOLUM** NOXAFIL SP 40mg/ml SUSP. ORALA 40mg/ml SP EUROPE BELGIA CUTIE X 1 FLAC. X 105ML SUSP. ORALA P-RF/R 1 2,537.47 2804.000000 2804.000000

305 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 1,130.84 1270.770000 1270.770000

306 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 1,466.75 1636.910000 1636.910000

307 J04AB04 RIFABUTINUM MYCOBUTIN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 15 CAPS. S/P-RF 30 292.32 323.410000 10.780333

308 J04AC01 ISONIAZIDUM ISONIAZIDA 100 mg COMPR. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. X 10 COMPR. S 1500 45.08 49.870000 0.033246309 J04AC01 ISONIAZIDUM ISONIAZIDA 100 mg COMPR. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. S/P-RF 20 0.54 0.600000 0.030000310 J04AC01 ISONIAZIDUM IZONIAZIDA ANTIBIOTICE 300 mg COMPR. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. PVC/AL X 10 COMPR. S/P-RF 1500 198.47 219.580000 0.146386311 J04AC01 ISONIAZIDUM IZONIAZIDA 500 mg SOL. INJ. 500mg/10ml TERAPIA SA ROMANIA CUTIE X 100 FIOLE DIN STICLA BRUNA X 10 ML S 100 59.26 65.560000 0.655600312 J04AK01 PYRAZINAMIDUM PIRAZINAMIDA ANTIBIOTICE 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. S 1500 326.73 361.480000 0.240986313 J04AK01 PYRAZINAMIDUM PIRAZINAMIDA ANTIBIOTICE 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. S/P-RF 20 4.34 4.800000 0.240000314 J04AK02 ETHAMBUTOLUM ETAMBUTOL 250 mg COMPR. FILM. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1500 185.65 205.390000 0.136926315 J04AK02 ETHAMBUTOLUM ETAMBUTOL 400 mg COMPR. FILM. 400mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1500 294.86 326.220000 0.217480316 J04AM02 COMBINATII (RIFAMPICINUM+IZONIAZIDUM) SINERDOL ISO CAPS. 300mg+150mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. S 1000 309.96 342.930000 0.342930317 J04AM02 COMBINATII (RIFAMPICINUM+IZONIAZIDUM) SINERDOL ISO CAPS. 300mg+150mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF/S 10 2.78 3.080000 0.308000318 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 13.25 14.660000 0.733000319 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14.03 15.520000 0.776000320 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 680.47 752.840000 0.752840321 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 12.75 14.110000 1.411000322 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 8.51 9.410000 0.470500323 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 11.27 12.470000 0.623500324 J05AB01 ACICLOVIRUM CLOVIRAL 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 10.77 11.910000 0.595500325 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 9.41 10.410000 0.520500326 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 13.12 14.520000 1.452000

Pagina 9 din 52

Page 107: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

327 J05AB01 ACICLOVIRUM ACICLOVIR OZONE 200 mg COMPR. DISP. 200mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. DISP. P-RF 20 4.94 5.460000 0.273000328 J05AB01 ACICLOVIRUM LOVIR 200 mg COMPR. DISP. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 10 COMPR. DISP. P-RF 10 2.56 2.830000 0.283000329 J05AB01 ACICLOVIRUM ACIKLOVIR COMPR. FILM. 400mg A & G MED TRADING S.R.L. ROMANIA CUTIE X 7 BLIST. AL/PVC X 5 COMPR. FILM. P-RF 35 40.32 44.610000 1.274571330 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 5 217.64 265.700000 53.140000

331 J05AB04 RIBAVIRINUM REBETOL 200 mg CAPS. 200mg SP EUROPE BELGIA CUTIE X 140CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 2,077.41 2302.530000 16.446642

332 J05AB04 RIBAVIRINUM COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168 2,261.34 2503.010000 14.898869

333 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 87.13 110.170000 110.170000

334 J05AB11 VALACYCLOVIRUM VALTREX 500 mg COMPR. FILM. 500mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 75.18 83.170000 8.317000335 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4,568.11 5017.400000 83.623333

336 J05AB15 BRIVUDINUM BRIVAL 125mg COMPR. 125mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 BLIST. PVC/AL X 7 COMPR. P-RF 7 277.76 307.300000 43.900000

337 J05AE01 SAQUINAVIRUM INVIRASE 200mg CAPS. 200mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 270 CAPS. P-RF/R 270 960.19 1084.760000 4.017629338 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 120 953.85 1077.850000 8.982083339 J05AE02 INDINAVIRUM CRIXIVAN 200mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PEID X 360 CAPS. P-RF/R 360 160.19 177.230000 0.492305340 J05AE02 INDINAVIRUM CRIXIVAN 400mg CAPS. 400mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC DIN PEID. X 180 CAPS. P-RF/R 180 160.19 177.230000 0.984611341 J05AE03 RITONAVIRUM** NORVIR 100 mg CAPS. MOI 100mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 4 FLAC. PEID X 84 CAPS. MOI P-RF/R 336 1,041.08 1172.930000 3.490863342 J05AE04 NELFINAVIRUM VIRACEPT 250 mg COMPR. FILM. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 270 COMPR. FILM. P-RF/R 270 960.19 1084.760000 4.017629343 J05AE06 LOPINAVIRUM+RITONAVIRUM** KALETRA 200mg/50mg COMPR. FILM. 200mg/50mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 120 COMPR. FILM. P-RF/R 120 1,470.92 1641.450000 13.678750

344 J05AE06 LOPINAVIRUM+RITONAVIRUM** KALETRA 80mg/ml+20mg/ml SOL. ORALA 80mg/ml+20mg/ml ABBOTT LABORATORIES LTD. MAREA BRITANIE

CUTIE X 5 FLAC. MULTIDOZA DIN TPE X 60 ML + 5 SERINGI GRADATE A 5 ML P-RF/R 5 1,398.88 1562.930000 312.586000

345 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 1,146.98 1288.360000 21.472666

346 J05AE08 ATAZANAVIRUM REYATAZ 150 mg CAPS. 150mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 60 CAPS. (BLIST. AL/AL 6X1) P-RF/R 60 1,485.28 1657.110000 27.618500

347 J05AE09 TIPRANAVIRUM** APTIVUS 250mg CAPS. MOI 250mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 1 FLAC. DIN PEID X 120 CAPS. MOI P-RF/R 120 2,790.00 3079.250000 25.660416

348 J05AE10 DARUNAVIRUM** PREZISTA 300mg COMPR. FILM. 300mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. DIN PEID X 120 COMPR. FILM. P-RF/R 120 2,601.24 2873.510000 23.945916

349 J05AF01 ZIDOVUDINUM RETROVIR (R) CAPS. 100mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. AL/PVC X 10 CAPS. S/P-RF 100 61.60 68.150000 0.681500350 J05AF02 DIDANOSINUM VIDEX EC 125 mg CAPS. GASTROREZ. 125mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. S/P-RF 30 206.08 228.000000 7.600000351 J05AF02 DIDANOSINUM VIDEX EC 200 mg CAPS. GASTROREZ. 200mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. S/P-RF 30 329.73 364.800000 12.160000

352 J05AF02 DIDANOSINUM VIDEX EC 250 mg CAPS. GASTROREZ. 250mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. S/P-RF 30 412.17 456.010000 15.200333

353 J05AF02 DIDANOSINUM VIDEX EC 400 mg CAPS. GASTROREZ. 400mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. S/P-RF 30 618.81 712.650000 23.755000

354 J05AF04 STAVUDINUM ZERIT 15 mg CAPS. 15mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 4 BLIST. ACLA/AL X 14 CAPS. P-RF/R 56 443.29 490.430000 8.757678355 J05AF04 STAVUDINUM ZERIT 20 mg CAPS. 20mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 4 BLIST. ACLAR/AL X 14 CAPS. P-RF/R 56 459.82 508.720000 9.084285356 J05AF04 STAVUDINUM ZERIT 30 mg CAPS. 30mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 4 BLIST. ACLAR/AL X 14 CAPS. P-RF/R 56 481.06 532.220000 9.503928357 J05AF04 STAVUDINUM ZERIT 40 mg CAPS. 40mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 4 BLIST. ACLAR/AL X 14 CAPS. P-RF/R 56 497.10 549.970000 9.820892358 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 28 218.27 241.480000 8.624285359 J05AF05 LAMIVUDINUM EPIVIR 150mg COMPR. FILM. 150mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILM. P-RF/R 60 315.79 349.380000 5.823000

360 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 84.18 93.130000 93.130000

361 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 97.66 108.050000 108.050000

362 J05AF06 ABACAVIRUM ZIAGEN 300 mg COMPR. FILM. 300mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 60 COMPR. FILM. P-RF/R 60 595.85 687.630000 11.460500

363 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 1 182.52 201.930000 201.930000

Pagina 10 din 52

Page 108: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

364 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 1,031.89 1162.910000 38.763666

365 J05AF09 EMTRICITABINUM EMTRIVA 200mg CAPS. 200mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 CAPS. P-RF/R 30 618.00 711.770000 23.725666

366 J05AG01 NEVIRAPINUM VIRAMUNE 200mg COMPR. 200mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 6 BLIST. X 10 COMPR. P-RF/R 60 588.81 679.950000 11.332500

367 J05AG01 NEVIRAPINUM VIRAMUNE 50mg/ml SUSP. ORALA 50mg/5ml BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA

CUTIE X 1 FLACON PEID X 240 ML + O SERINGA X 5 ML + UN DISPOZITIV DE ADAPTARE A SERINGII LA FLACON P-RF/R 1 178.64 197.640000 197.640000

368 J05AG03 EFAVIRENZUM STOCRIN 50 mg COMPR. FILM. 50mg MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 1 FLAC. PEID X 30COMPR. FILM. PREVAZUT CU UN SIST. DE INCHIDERE SECURIZAT PT. COPII P-RF/R 30 11.11 12.290000 0.409666

369 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 63.33 70.070000 2.335666

370 J05AG03 EFAVIRENZUM STOCRIN 600 mg COMPR. FILM. 600mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 BLIST. AL PERFORAT X 30 COMPR. FILM. P-RF/R 30 63.33 70.070000 2.335666

371 J05AR01ZIDOVUDINUM+LAMIVUDINUM** COMBIVIR 150mg/300mg COMPR. FILM. 150mg/300mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 6 BLIST. X 10 COMPR. FILM. P-RF/R 60 635.25 730.570000 12.176166

372 J05AR02ABACAVIRUM+LAMIVUDINUM** KIVEXA 600mg/300mg COMPR. FILM. 600mg/300mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 30 COMPR. FILM.( BLIST.ALB-OPAC PVC-PVDC/AL ) P-RF/R 30 1,249.51 1400.120000 46.670666

373 J05AR04

ABACAVIRUM+LAMIVUDINUM+ZIDOVUDINUM** TRIZIVIR 300mg/150mg/300mg COMPR. FILM. 300mg/150mg/300mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 1,161.70 1304.410000 21.740166

374 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 T P-RF/R 60 5,720.87 6273.910000 104.565166

375 J06BB16 PALIVIZUMABUM** SYNAGIS 100 mg PULB. + SOLV. PT. SOL. INJ. 100mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + FIOLA X 1 ML SOLV. P-RF 1 3,287.40 3621.420000 3621.420000

376 J06BB16 PALIVIZUMABUM** SYNAGIS 50 mg PULB. + SOLV. PT. SOL. INJ. 50mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + FIOLA X 1 ML SOLV. P-RF 1 1,991.52 2208.910000 2208.910000

377 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 250.75 306.120000 306.120000

378 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 411.76 486.970000 486.970000

379 S01AA23 NETILMICINUM NETTACIN (R) PIC. OFT., SOL 0,3% S.I.F.I. SPA ITALIA CUTIE X 1 FLACON X 5ML P-RF 1 6.90 7.630000 7.630000380 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 19.76 21.860000 1.457333381 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 22.17 24.530000 24.530000

382 S01AX17 LOMEFLOXACINUM OKACIN PICATURI OFT.-SOL. 3mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON PICURATOR PEJD X 5 ML P-RF 1 10.76 11.900000 11.900000

383 S01BA01 DEXAMETHASONUM DEXAMETAZONA RPH 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 5.15 5.700000 5.700000384 S01BA01 DEXAMETHASONUM DEXAMETAZONA RPH 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 9.01 9.970000 9.970000385 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 5.93 8.010000 8.010000386 S03AAN2 NORFLOXACINUM NORFLOX PICATURI OFT./AURIC.-SOL. 0,3% CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 FLACON PEJD X 5 ML P-RF 1 3.24 3.590000 3.590000

387 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA

CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 50 ML S 1 640.39 708.500000 708.500000

388 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA

CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 100 ML S 1 1,182.26 1308.000000 1308.000000

389 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S 1 689.65 763.000000 763.000000

390 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 2,555.21 2826.960000 2826.960000

Pagina 11 din 52

Page 109: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

391 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 1,285.40 1422.100000 1422.100000

392 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 50 ML SOL. PERF. S 1 738.92 817.500000 817.500000

393 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 1,448.27 1602.300000 1602.300000

394 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 200 ML SOL. PERF. S 1 2,807.88 3106.500000 3106.500000

1 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 1.21 1.340000 0.0670002 A11HA02 PYRIDOXINUM SICOVIT B6 250 mg COMPR. 250mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 1.21 1.340000 0.067000

3 A11HA02 PYRIDOXINUM SICOVIT B6 250 mg/5 ml SOL. INJ. 250mg/5ml ZENTIVA SA ROMANIACUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF 5 3.50 3.870000 0.774000

4 A11HA02 PYRIDOXINUM SICOVIT B6 50 mg/2ml SOL. INJ. 50mg/2ml ZENTIVA SA ROMANIACUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 2.20 2.430000 0.486000

5 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 1.18 1.300000 0.0650006 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 39.35 43.540000 0.0435407 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1.72 1.900000 0.0633338 H02AB07 PREDNISONUM N - PREDNISON COMPR. 5mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 1.62 1.790000 0.0596669 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1.65 1.830000 0.061000

10 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 1.18 1.300000 0.06500011 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT SPA ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 19.49 21.560000 1.54000012 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 250 mg COMPR. FILM. 250mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 21.14 23.390000 1.67071413 J01FA09 CLARITHROMYCINUM CLAR 250 COMPR. FILM. 250mg MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 5 BLIST. X 4 COMPR. FILM. P-RF 20 25.99 28.750000 1.43750014 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 13.07 17.660000 1.26142815 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 10.19 13.770000 0.98357116 J01FA09 CLARITHROMYCINUM CLARITROMICINA 250 mg COMPR. FILM. 250mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 10.19 13.770000 0.98357117 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 11.58 15.650000 1.11785718 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 500 mg COMPR. FILM. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 39.54 43.740000 3.12428519 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 25.40 33.220000 2.37285720 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 22.30 30.140000 2.15285721 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mg MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF 20 33.52 37.080000 1.85400022 J01FA09 CLARITHROMYCINUM CLARITROMICINA 500 mg COMPR. FILM. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 22.30 30.140000 2.15285723 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 22.66 30.630000 2.18785724 J01FA09 CLARITHROMYCINUM LEKOKLAR XL 500 mg COMPR. FILM. ELIB. MODIF. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FOLIE AL/AL X 5 COMPR. FILM. ELIB. MODIF. P-RF 5 12.77 17.260000 3.45200025 J01FA09 CLARITHROMYCINUM LEKOKLAR XL 500 mg COMPR. FILM. ELIB. MODIF. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FOLIE AL/AL X 7 COMPR. FILM. ELIB. MODIF. P-RF 7 17.88 24.160000 3.45142826 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 24.82 27.460000 3.92285727 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 25.99 28.750000 5.75000028 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 19.17 21.210000 3.03000029 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA 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 27.60 30.540000 30.540000

B) SUBPROGRAMUL DE TRATAMENT AL BOLNAVILOR CU TUBERCULOZAP1: PROGRAMUL NATIONAL DE BOLI TRANSMISIBILE

Pagina 12 din 52

Page 110: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

30 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA 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 16.89 18.690000 18.690000

31 J01FA09 CLARITHROMYCINUM FROMILID (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. P-RF 1 16.89 18.690000 18.690000

32 J01FA09 CLARITHROMYCINUM LEKOKLAR 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 17.16 18.990000 18.990000

33 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 23.74 26.270000 26.270000

34 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 14.56 16.110000 16.110000

35 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 68,3 G GRANULE PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 41.66 46.090000 46.090000

36 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 30.35 33.580000 33.580000

37 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 38.08 42.130000 42.130000

38 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 22.00 29.740000 29.740000

39 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 37.94 41.970000 41.970000

40 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 100 254.99 282.110000 2.82110041 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 50 128.21 141.850000 2.83700042 J01GA01 STREPTOMYCINUM STREVITAL 1 g PULB. PT. SOL. INJ. 1g ANTIBIOTICE SA ROMANIA CUTIE X 10 FLAC. DIN STICLA CONTINAND PULB. PT. SOL. INJ. S 10 25.81 28.550000 2.85500043 J01GB06 AMIKACINUM AMIKOZIT (R) 100 mg/2 ml SOL. INJ. 100mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA X 2 ML P-RF 1 2.42 2.680000 2.68000044 J01GB06 AMIKACINUM AMIKOZIT (R) 500 mg/2 ml SOL. INJ. 500mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA X 2 ML P-RF 1 4.75 5.250000 5.25000045 J01MA01 OFLOXACINUM OFLOXACIN 200 mg COMPR. FILM. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 32.81 36.300000 3.63000046 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 14.02 15.510000 1.55100047 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 7.89 10.660000 1.06600048 J01MA01 OFLOXACINUM ZANOCIN (R) OD 400 COMPR. FILM. ELIB. PREL. 400mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 1 BLIST. X 5 COMPR. FILM. ELIB. PREL. P-RF 5 18.73 20.720000 4.14400049 J01MA01 OFLOXACINUM ZANOCIN (R) OD 400 COMPR. FILM. ELIB. PREL. 400mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 5 COMPR. FILM. ELIB. PREL. P-RF 10 35.61 39.400000 3.94000050 J01MA02 CIPROFLOXACINUM EUCIPRIN CAPS. 250mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 6 CAPS. P-RF 12 5.25 5.810000 0.48416651 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 4.74 6.410000 0.64100052 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 4.74 6.410000 0.64100053 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 5.12 5.670000 0.56700054 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 5.22 5.770000 0.57700055 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 10.52 11.640000 0.58200056 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 250 mg COMPR. FILM. 250mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 5.38 5.950000 0.59500057 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 4.82 6.520000 0.65200058 J01MA02 CIPROFLOXACINUM CIPHIN 250 COMPR. FILM. 250mg ZENTIVA A.S. SLOVACIA CUTIE X 1 BLIST. PVDC/PVC/AL X 10 COMPR. FILM. P-RF 10 7.86 8.700000 0.87000059 J01MA02 CIPROFLOXACINUM ALVEBAR 250 mg COMPR. FILM. 250mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 3.24 3.590000 0.35900060 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 9.19 12.420000 1.24200061 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 9.19 12.420000 1.24200062 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 9.13 10.100000 1.01000063 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 10.04 11.110000 1.11100064 J01MA02 CIPROFLOXACINUM CIPROZONE FORTE 500 mg COMPR. FILM. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 5.88 7.950000 0.79500065 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 500 mg COMPR. FILM. 500mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 10.30 11.400000 1.14000066 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 6.10 8.240000 0.82400067 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 9.19 12.420000 1.24200068 J01MA02 CIPROFLOXACINUM CIPHIN 500 COMPR. FILM. 500mg ZENTIVA A.S. SLOVACIA CUTIE X 1 BLIST. PVDC/PVC/AL X 10 COMPR. FILM. P-RF 10 12.99 14.370000 1.43700069 J01MA02 CIPROFLOXACINUM CIPRODAR COMPR. FILM. 500mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 11.37 12.580000 1.25800070 J01MA02 CIPROFLOXACINUM ALVEBAR 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 4.42 4.890000 0.48900071 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 27.15 30.040000 3.00400072 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 62.90 69.590000 9.94142873 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 18.86 20.870000 6.95666674 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10ml KRKA D.D. SLOVENIA CUTIE X 50 FIOLE X 10 ML S 50 106.94 118.310000 2.36620075 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 10 ML S/P-RF 5 11.87 13.130000 2.626000

Pagina 13 din 52

Page 111: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

76 J01MA02 CIPROFLOXACINUM CIPRINOL SOL. PERF. 100mg/50ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 50 ML SOL. PERF. S/P-RF 1 3.27 3.620000 3.62000077 J01MA02 CIPROFLOXACINUM CIPRINOL SOL. PERF. 200mg/100ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML SOL. PERF. S/P-RF 1 6.54 7.240000 7.24000078 J01MA02 CIPROFLOXACINUM CIPROBAY (R) 400 SOL. PERF. 2mg/ml BAYER HEALTHCARE AG GERMANIA CUTIE X 5 FLACOANE X 200 ML S/P-RF 5 575.20 665.120000 133.024000

79 J01MA02 CIPROFLOXACINUM UFEXIL 2 mg/ ml SOL. PERF. 2mg/ml DEMO SA GRECIA CUTIE X 10 PUNGI PP X 100 ML SOL. PERF. S 10 127.32 140.860000 14.086000

80 J01MA02 CIPROFLOXACINUM CIPRINOL (R) SOL. PERF. 400mg/200ml KRKA D.D. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 200 ML S/P-RF 1 13.17 14.570000 14.570000

81 J01MA14 MOXIFLOXACINUM AVELOX (R) 400 mg COMPR. FILM. 400mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. ALB OPAC PP/AL X 5 COMPR. FILM. P-RF 5 65.23 72.170000 14.434000

82 J01MA14 MOXIFLOXACINUM AVELOX (R) 400 mg/250 ml SOL. PERF. 400mg/250ml BAYER HEALTHCARE AG GERMANIA CUTIE X 5 FLACOANE DIN STICLA X 250 ML S 5 583.75 674.440000 134.888000

83 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 100 319.01 352.940000 3.52940084 J04AB01 CICLOSERINUM CICLOSERINA ANTIBIOTICE 250 mg CAPS. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 5 FOLII TERMOSUDATE DIN AL/AL X 10 CAPS. P-RF 50 161.12 178.260000 3.56520085 J04AB02 RIFAMPICINUM SINERDOL 150 mg CAPS. 150mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. S 1000 120.04 132.810000 0.13281086 J04AB02 RIFAMPICINUM SINERDOL 150 mg CAPS. 150mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. S/P-RF 20 2.82 3.120000 0.15600087 J04AB02 RIFAMPICINUM SINERDOL 300 mg CAPS. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR. S 1000 275.53 304.830000 0.30483088 J04AB02 RIFAMPICINUM SINERDOL 300 mg CAPS. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. S/P-RF 10 2.96 3.280000 0.32800089 J04AB04 RIFABUTINUM MYCOBUTIN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 15 CAPS. S/P-RF 30 292.32 323.410000 10.780333

90 J04AC01 ISONIAZIDUM ISONIAZIDA 100 mg COMPR. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. X 10 COMPR. S 1500 45.08 49.870000 0.03324691 J04AC01 ISONIAZIDUM ISONIAZIDA 100 mg COMPR. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. S/P-RF 20 0.54 0.600000 0.03000092 J04AC01 ISONIAZIDUM IZONIAZIDA ANTIBIOTICE 300 mg COMPR. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. PVC/AL X 10 COMPR. S/P-RF 1500 198.47 219.580000 0.14638693 J04AC01 ISONIAZIDUM IZONIAZIDA 500 mg SOL. INJ. 500mg/10ml TERAPIA SA ROMANIA CUTIE X 100 FIOLE DIN STICLA BRUNA X 10 ML S 100 59.26 65.560000 0.65560094 J04AD01 PROTIONAMIDUM PROTIONAMIDA 250 mg COMPR. FILM. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN POLISTIREN X 50 COMPR. FILM. S/P-RF 50 27.13 30.010000 0.60020095 J04AK01 PYRAZINAMIDUM PIRAZINAMIDA ANTIBIOTICE 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. S 1500 326.73 361.480000 0.24098696 J04AK01 PYRAZINAMIDUM PIRAZINAMIDA ANTIBIOTICE 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. S/P-RF 20 4.34 4.800000 0.24000097 J04AK02 ETHAMBUTOLUM ETAMBUTOL 250 mg COMPR. FILM. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1500 185.65 205.390000 0.13692698 J04AK02 ETHAMBUTOLUM ETAMBUTOL 400 mg COMPR. FILM. 400mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1500 294.86 326.220000 0.217480

99 J04AM02

COMBINATII (RIFAMPICINUM+IZONIAZIDUM) SINERDOL ISO CAPS. 300mg+150mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. S 1000 309.96 342.930000 0.342930

100 J04AM02

COMBINATII (RIFAMPICINUM+IZONIAZIDUM) SINERDOL ISO CAPS. 300mg+150mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF/S 10 2.78 3.080000 0.308000

1 G03HA01 CYPROTERONUM ANDROCUR COMPR. 50mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 FLAC. X 50 COMPR. P-RF 50 121.32 134.220000 2.6844002 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 18.15 24.530000 0.4906003 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 10.40 11.510000 11.510000

4 L01AA02 CHLORAMBUCILUM LEUKERAN COMPR. FILM. 2mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 25 COMPR. FILM. P-RF 25 4.93 6.660000 0.2664005 L01AA03 MELPHALANUM ALKERAN 2 mg COMPR. FILM. 2mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 25 COMPR. FILM. P-RF 25 6.36 7.040000 0.2816006 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 87.00 110.000000 110.000000

7 L01AB01 BUSULFANUM MYLERAN COMPR. FILM. 2mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 25 COMPR. FILM. P-RF 25 10.90 14.730000 0.5892008 L01AX03 TEMOZOLOMIDUM** TEMODAL 100 mg CAPS. 100mg SP EUROPE BELGIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS. P-RF/R 5 1,509.03 1682.990000 336.598000

9 L01AX03 TEMOZOLOMIDUM** TEMODAL 20 mg CAPS. 20mg SP EUROPE BELGIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS. P-RF/R 5 337.80 373.720000 74.744000

10 L01AX03 TEMOZOLOMIDUM** TEMODAL 250 mg CAPS. 250mg SP EUROPE BELGIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS. P-RF/R 5 3,655.09 4022.200000 804.440000

11 L01AX03 TEMOZOLOMIDUM** TEMODAL 5 mg CAPS. 5mg SP EUROPE BELGIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS. P-RF/R 5 86.08 95.230000 19.046000

12 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 500 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 5 ML S 5 188.83 208.910000 41.782000

13 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 74.77 82.720000 82.720000

14 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 1 312.66 378.950000 378.950000

P3: PROGRAMUL NATIONAL DE ONCOLOGIE

Pagina 14 din 52

Page 112: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

15 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5 mg SOL. INJ. 5mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE X 1 ML S 10 16.26 17.990000 1.79900016 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 50 mg SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 9.09 10.060000 10.060000

17 L01BA04 PEMETREXEDUM**** ALIMTA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. S 1 1,182.02 1326.550000 1326.550000

18 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 4,738.98 5203.650000 5203.650000

19 L01BB02 MERCAPTOPURINUM PURI - NETHOL COMPR. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 25 COMPR. P-RF 25 33.38 43.660000 1.74640020 L01BB03 TIOGUANINUM LANVIS COMPR. 40mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 25 COMPR. P-RF 25 71.59 79.200000 3.16800021 L01BB04 CLADRIBINUM LITAK 2 mg/ml SOL. INJ. 2mg/ml LIPOMED GMBH GERMANIA CUTIE X 1 FLACON X 5 ML S 1 1,350.00 1509.650000 1509.650000

22 L01BB05 FLUDARABINUM**** FLUDARA ORAL 10 mg COMPR. FILM. 10mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 FLAC. DIN PE X 4 BLIST. AL/AL X 5 COMPR. FILM. P-RF/S 20 1,579.47 1759.770000 87.988500

23 L01BB05 FLUDARABINUM FLUDARA LIOF. PT. SOL. INJ./PERF. 50mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 5 FLAC. CU LIOF. PT. SOL. INJ./PERF. S 5 2,270.00 2512.450000 502.490000

24 L01BC01 CYTARABINUM CYTOSAR™ 100 mg PULB. + SOLV. PT. SOL. INJ. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. + 1 FIOLA DIN STICLA INCOLORA X 5 ML SOLV. S 1 9.74 10.780000 10.780000

25 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 91.62 101.360000 10.136000

26 L01BC01 CYTARABINUM ALEXAN 20mg/ml SOL. INJ. 20mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 2 ML SOL. INJ. S 1 4.26 4.710000 4.71000027 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 71.68 79.300000 79.300000

28 L01BC01 CYTARABINUM ALEXAN 50mg/ml SOL. INJ. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 10 ML. SOL. INJ. S 1 41.70 46.140000 46.140000

29 L01BC01 CYTARABINUM DEPOCYTE 50mg SUSP. INJ. 50mg PACIRA LIMITED MAREA BRITANIE CUTIE X 1 FLAC. X 50MG SUSP.INJ. (MONODOZA 5ML) S 1 6,546.99 7174.380000 7174.380000

30 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 5 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 3.28 4.440000 4.44000031 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 15.64 17.300000 17.300000

32 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 84.63 93.630000 93.630000

33 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 7.62 8.430000 8.43000034 L01BC05 GEMCITABINUM** GEMCITABINA SINDAN 1 g PULB. PT. SOL. PERF. 1g ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF. S 1 922.35 1043.510000 1043.510000

35 L01BC05 GEMCITABINUM** GEMCITABINA SINDAN 200 mg PULB. PT. SOL. PERF. 200mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF. S 1 217.44 240.570000 240.570000

36 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 60 224.72 248.620000 4.14366637 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 1,389.76 1552.990000 12.941583

38 L01BC53 COMBINATII (TAGAFUR+URACIL) UFT CAPS. 100mg+224mg MERCK KGAA GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 12 CAPS. P-RF 120 1,852.20 2057.050000 17.142083

39 L01BC53 COMBINATII (TAGAFUR+URACIL) UFT CAPS. 100mg+224mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 12 CAPS. P-RF 36 576.64 666.690000 18.519166

40 L01CA02 VINCRISTINUM SINDOVIN 1 mg LIOF. PT. SOL. INJ./PERF. I.V. 1mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. INJ./PERF. I.V. S 1 18.29 20.240000 20.240000

41 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 1 183.17 223.620000 223.620000

42 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 1 274.74 335.400000 335.400000

43 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 1 351.76 421.570000 421.570000

44 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 91.84 101.610000 101.610000

45 L01CA04 VINORELBINUM VINORELBIN TEVA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 332.35 400.410000 400.410000

46 L01CA04 VINORELBINUM VINORELBIN TEVA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 1 ML CONC. PT. SOL. PERF. S 1 67.72 85.630000 85.630000

47 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 1 422.81 467.780000 467.780000

48 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 94.31 104.340000 104.340000

49 L01CA04 VINORELBINUM NAVELBINE (R) SOL. INJ. 10mg/ml LAB. PIERRE FABRE FRANTA CUTIE X 10 FIOLE X 1 ML S 10 960.44 1085.030000 108.503000

50 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 100mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 1 BLIST. PVC/A0-PVC-PVDC X 10 CAPS. P-RF 10 297.68 329.340000 32.934000

51 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 50mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 2 BLIST. PVC/AL-PVC-PVDC X 10 CAPS. P-RF 20 295.01 326.390000 16.319500

52 L01CB01 ETOPOSIDUM ETOPOSID "EBEWE" 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 37.46 41.440000 41.440000

53 L01CB01 ETOPOSIDUM SINTOPOZID 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 29.07 32.160000 32.160000

54 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 29.48 32.610000 32.610000

55 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 50.04 55.360000 55.360000

56 L01CD01 PACLITAXELUM** ONXOL 6mg/ml CONC. PT. SOL. PERF. 6mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON X 16,7 ML CONC. PT. SOL. PERF. S 1 337.00 405.480000 405.480000

57 L01CD01 PACLITAXELUM** ONXOL 6mg/ml CONC. PT. SOL. PERF. 6mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON X 25 ML CONC. PT. SOL. PERF. S 1 527.00 612.580000 612.580000

58 L01CD01 PACLITAXELUM** ONXOL 6mg/ml CONC. PT. SOL. PERF. 6mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON X 50 ML CONC. PT. SOL. PERF. S 1 1,035.30 1166.630000 1166.630000

59 L01CD01 PACLITAXELUM** ONXOL 6mg/ml CONC. PT. SOL. PERF. 6mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON X 5 ML CONC. PT. SOL. PERF. S 1 109.87 134.130000 134.130000

Pagina 15 din 52

Page 113: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

60 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 1 783.13 891.760000 891.760000

61 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 1,536.26 1712.680000 1712.680000

62 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 1 511.97 596.200000 596.200000

63 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 1 175.39 194.040000 194.040000

64 L01CD01 PACLITAXELUM** PACLITAXEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml PHARMEXPRESS S.R.L. ROMANIA CUTIE X 1 FLAC. X 50 ML S 1 951.04 1074.780000 1074.780000

65 L01CD01 PACLITAXELUM** PACLITAXEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml PHARMEXPRESS S.R.L. ROMANIA CUTIE X 10 FLAC. X 5 ML S 10 921.89 1043.010000 104.301000

66 L01CD01 PACLITAXELUM** PACLITAXEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml PHARMEXPRESS S.R.L. ROMANIA CUTIE X 4 FLAC. X 16,7 ML S 4 1,190.11 1335.370000 333.842500

67 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 1 330.05 365.150000 365.150000

68 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 1,035.33 1166.660000 1166.660000

69 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 1 105.48 116.700000 116.700000

70 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 1 534.38 591.210000 591.210000

71 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 1 855.74 970.910000 970.910000

72 L01CD02 DOCETAXELUM** TAXOTERE 20 mg CONC. + SOLV. PT. SOL. PERF. 20mg AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON X 0,5 ML CONC. SOL. PERF. + 1 FLACON X 1,5 ML SOLV. S 1 513.76 598.150000 598.150000

73 L01CD02 DOCETAXELUM** TAXOTERE 80 mg CONC. + SOLV. PT. SOL. PERF. 80mg AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON X 2 ML CONC. SOL. PERF. + 1 FLACON X 6 ML SOLV. S 1 1,965.08 2180.090000 2180.090000

74 L01DB01 DOXORUBICINUM CAELYX 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml SP EUROPE BELGIA CUTIE X 1 FLACON DIN STICLA X 10 ML S 1 1,359.02 1519.480000 1519.480000

75 L01DB01 DOXORUBICINUM CAELYX 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml SP EUROPE BELGIA CUTIE X 1 FLACON DIN STICLA X 25 ML S 1 3,352.53 3692.410000 3692.410000

76 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 1 103.44 114.440000 114.440000

77 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 26.03 28.800000 28.800000

78 L01DB01 DOXORUBICINUM ADRIBLASTINA RD 10 mg LIOF. PT. SOL. INJ. 10mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. S 1 25.27 27.960000 27.960000

79 L01DB01 DOXORUBICINUM ADRIBLASTINA RD 50 mg LIOF. PT. SOL. INJ. 50mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. S 1 104.72 115.860000 115.860000

80 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 24.06 26.620000 26.620000

81 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 CONTINAND 50 MG CLORHIDRAT DE DOXORUBICI S 1 95.22 105.350000 105.350000

82 L01DB01 DOXORUBICINUM DOXORUBICIN TEVA 2 mg/ml SOL. INJ. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML SOL. INJ. S 1 62.40 69.040000 69.040000

83 L01DB01 DOXORUBICINUM DOXORUBICIN TEVA 2 mg/ml SOL. INJ. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 25 ML SOL. INJ. S 1 83.78 92.690000 92.690000

84 L01DB03 EPIRUBICINUM EPIRUBICIN "EBEWE" 2 mg/ml CONC. PT. SOL. INJ. 2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 46.14 51.050000 51.050000

85 L01DB03 EPIRUBICINUM EPIRUBICIN "EBEWE" 2 mg/ml CONC. PT. SOL. INJ. 2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 452.48 500.600000 500.600000

86 L01DB03 EPIRUBICINUM EPIRUBICIN "EBEWE" 2 mg/ml CONC. PT. SOL. INJ. 2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 25 ML S 1 228.48 252.780000 252.780000

87 L01DB03 EPIRUBICINUM EPISINDAN 10 mg LIOF. PT. SOL. INJ. 10mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. CU LIOF. PT. SOL. INJ. S 1 42.85 47.410000 47.410000

88 L01DB03 EPIRUBICINUM FARMORUBICIN RD 10 mg LIOF. PT. SOL. INJ. 10mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 10 MG LIOF. PT. SOL. INJ. S 1 53.82 59.540000 59.540000

89 L01DB03 EPIRUBICINUM EPISINDAN 50 mg LIOF. PT. SOL. INJ. 50mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. CU LIOF. PT. SOL. INJ. S 1 215.10 237.980000 237.980000

90 L01DB03 EPIRUBICINUM FARMORUBICIN (R) RD 50 mg LIOF. PT. SOL. INJ. 50mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 50 MG LIOF. PT. SOL. INJ. S 1 240.26 265.810000 265.810000

91 L01DB06 IDARUBICINUM ZAVEDOS CAPS. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 190.92 233.070000 233.070000

92 L01DB06 IDARUBICINUM ZAVEDOS 5 mg LIOF. PT. SOL. INJ. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. S 1 134.59 164.310000 164.310000

93 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 1 523.40 608.660000 608.660000

94 L01DC01 BLEOMYCINUM SULFAS BLEOCIN LIOF. PT. SOL. INJ. 15mg EURO NIPPON KAYAKU GMBH GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. S 1 56.85 62.900000 62.900000

95 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 10 mg/20 ml CONC. PT. SOL. PERF. 10mg/20ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 20 ML CONC. PT. SOL. PERF. S 1 8.47 9.370000 9.37000096 L01XA01 CISPLATINUM CISPLATIN TEVA 10 mg/20 ml CONC. PT. SOL. PERF. 10mg/20ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 20 ML S 1 8.20 9.070000 9.07000097 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 21.61 23.910000 23.910000

98 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 6.86 7.590000 7.59000099 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 25 mg/50 ml CONC. PT. SOL. PERF. 25mg/50ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML COND. PT. SOL. PERF. S 1 20.34 22.500000 22.500000

100 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 50 mg/100 ml CONC. PT. SOL. PERF. 50mg/100ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 100 ML CONC. PT. SOL. PERF. S 1 29.12 32.220000 32.220000

101 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 45 ML CONC. PT. SOL. PERF. S 1 170.24 188.350000 188.350000

102 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 5 ML CONC. PT. SOL. PERF. S 1 20.16 22.300000 22.300000

103 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 15 ML CONC. PT. SOL. PERF. S 1 57.08 63.150000 63.150000

104 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 43.77 48.420000 48.420000

105 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 1 126.97 140.470000 140.470000

Pagina 16 din 52

Page 114: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

106 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 15.98 17.680000 17.680000

107 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 44.28 48.990000 48.990000

108 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 1 122.08 135.060000 135.060000

109 L01XA03 OXALIPLATINUM ELOXATIN 5mg/ml CONC. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 100 MG/20 ML CONC. PT. SOL. PERF. S 1 1,440.32 1608.100000 1608.100000

110 L01XA03 OXALIPLATINUM ELOXATIN 5mg/ml CONC. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 50 MG/10 ML CONC. PT. SOL. PERF. S 1 735.32 839.650000 839.650000

111 L01XA03 OXALIPLATINUM ELOXATIN 5 mg/ml LIOF. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. X 100 MG OXALIPLATINA S 1 1,440.32 1608.100000 1608.100000

112 L01XA03 OXALIPLATINUM ELOXATIN 5 mg/ml LIOF. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. X 50 MG OXALIPLATINA S 1 735.32 839.650000 839.650000

113 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 1,230.00 1378.850000 1378.850000

114 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 1 630.00 724.850000 724.850000

115 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 S 1 1,512.68 1686.970000 1686.970000

116 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 S 1 820.20 932.170000 932.170000

117 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 S 1 431.20 508.160000 508.160000

118 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 2,087.80 2313.850000 1156.925000

119 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 5,174.64 5678.510000 5678.510000

120 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. S 1 2,463.56 2723.430000 2723.430000

121 L01XC04 ALEMTUZUMABUM**** MABCAMPATH 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml GENZYME EUROPE BV OLANDA CUTIE X 3 FIOLE X 3 ML CONCENTRAT INTR-O FIOLA DE 5ML S 3 4,624.59 5078.960000 1692.986666

122 L01XC04 ALEMTUZUMABUM**** MABCAMPATH 30 mg/ml CONC. PT. SOL. PERF. 30mg/ml GENZYME EUROPE BV OLANDA CUTIE X 3 FLACOANE X 1 ML CONCENTRAT INTR-UN FLACON DE 2ML S 3 4,624.96 5079.360000 1693.120000

123 L01XC06 CETUXIMABUM**** ERBITUX 5mg/ml SOL. PERF. 5mg/ml MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN STICLA X 20 ML SOL. PERF. S 1 819.85 931.790000 931.790000

124 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 4,928.20 5409.890000 5409.890000

125 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 1,253.04 1403.960000 1403.960000

126 L01XE01 IMATINIBUM**** GLIVEC 100 mg CAPS. 100mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 120 CAPS. P-RF/R 120 8,483.35 9285.010000 77.375083

127 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 5,921.75 6492.870000 216.429000

128 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 7,880.79 8628.220000 287.607333

129 L01XE03 ERLOTINIBUM**** TARCEVA 25 mg COMPR. FILM. 25mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF/R 30 1,796.52 1996.360000 66.545333

130 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 4,736.50 5200.940000 173.364666

131 L01XE04 SUNITINIBUM**** SUTENT 25mg CAPS. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 CAPS. P-RF/R 30 9,443.00 10331.030000 344.367666

132 L01XE04 SUNITINIBUM**** SUTENT 50 mg CAPS. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 CAPS. P-RF/R 30 18,855.99 20591.210000 686.373666

133 L01XE05 SORAFENIBUM**** NEXAVAR 200 mg COMPR. FILM. 200mg BAYER HEALTHCARE AG GERMANIA CUTIE X 4 BLIST. AL/PP X 28 COMPR.FILM. P-RF/R 112 13,699.49 14970.610000 133.666160

134 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 7,229.82 7918.660000 131.977666

135 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 14,429.67 15766.510000 262.775166

136 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 14,429.67 15766.510000 262.775166

137 L01XX02 ASPARAGINAZUM ASPARAGINASE 10000 MEDAC LIOF. PT. SOL. INJ./PERF. 10000ui MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 5 FLAC. DIN STICLA X 10 000 UI LIOF. PT. SOL. INJ./PERF. S 5 1,102.00 1239.330000 247.866000

138 L01XX02 ASPARAGINAZUM ASPARAGINASE 5000 MEDAC LIOF. PT. SOL. INJ./PERF. 5000ui MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 5 FLAC. DIN STICLA X 5000 UI LIOF. PT. SOL. INJ./PERF. S 5 710.00 812.050000 162.410000

139 L01XX05 HYDROXYCARBAMIDUM HYDREA CAPS. 500mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 CAPS. P-RF 100 61.72 68.280000 0.682800140 L01XX11 ESTRAMUSTINUM ESTRACYT CAPS. 140mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 100 CAPS. P-RF 100 325.87 393.350000 3.933500141 L01XX17 TOPOTECAMUM HYCAMTIN 1 mg CAPS. 1mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X BLIST. PVC/PCTFE/AL X 10 CAPS. P-RF 10 1,488.08 1660.160000 166.016000

142 L01XX17 TOPOTECAMUM HYCAMTIN 4 mg PULB.CONC.SOL.PERF. 4mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. S 1 924.32 1045.660000 1045.660000

143 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 1 413.33 488.680000 488.680000

144 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 1 153.35 169.660000 169.660000

145 L01XX19 IRINOTECANUM CAMPTO CONC. PT. SOL. PERF. 20mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 ML CONC. PT. SOL. PERF. S 1 602.30 694.660000 694.660000

146 L01XX19 IRINOTECANUM CAMPTO CONC. PT. SOL. PERF. 20mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN PP X 15 ML CONC. PT. SOL. PERF. S 1 2,001.20 2219.460000 2219.460000

147 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 S 1 4,309.02 4734.990000 4734.990000

Pagina 17 din 52

Page 115: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

148 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 91.78 116.050000 3.868333

149 L02AE02 LEUPRORELINUM** ELIGARD 22,5 mg LIOF. SI SOLV. PT. SOL. INJ. 22,5mg ASTELLAS PHARMA EUROPE BV OLANDA

CUTIE X 1 SET X 2 SERINGI DIN PP PREUMPLUTE (O SERINGA A SI O SERINGA B), IN PUNGI LAMINATE S 1 959.84 1084.380000 1084.380000

150 L02AE02 LEUPRORELINUM** ELIGARD 7,5 mg LIOF. SI SOLV. PT. SOL. INJ. 7,5mg ASTELLAS PHARMA EUROPE BV OLANDA

CUTIE X 1 SET X 2 SERINGI DIN PP PREUMPLUTE (O SERINGA A SI O SERINGA B), IN PUNGI LAMINATE S 1 348.52 418.040000 418.040000

151 L02AE02 LEUPRORELINUM** LUCRIN DEPOT 11,25mg LIOF.+ SOLV. PT. SUSP. INJ. ELIB. PREL. 11,25mg ABBOTT LABORATORIES LTD. SPANIA

CUTIE X 1 KIT X 1 FLAC. CU LIOFILIZAT (MICROSFERE) + 1 FIOLA X 2 ML SOLV. + 1 SERINGA + 2 ACE SI TA S/P-RF 1 826.04 938.540000 938.540000

152 L02AE02 LEUPRORELINUM** LUCRIN DEPOT 3,75mg LIOF.+ SOLV. PT. SUSP. INJ. ELIB. PREL. 3,75mg ABBOTT LABORATORIES LTD. SPANIA

CUTIE X 1 KIT X 1 FLAC. CU LIOFILIZAT (MICROSFERE) + 1 FIOLA X 2 ML SOLV. + 1 SERINGA SI TAMPON IMB S/P-RF 1 346.24 383.060000 383.060000

153 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 1 979.06 1105.330000 1105.330000

154 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 1 345.00 414.200000 414.200000

155 L02AE04 TRIPTORELINUM** DIPHERELINE 0,1 mg LIOF. + SOLV. PT. SOL. INJ. 0,1mg BEAUFOUR IPSEN PHARMA FRANTACUTIE X 7 FLAC. CU LIOF. PT. SOL. INJ. + 7 FIOLE X 1 ML SOLV. S/P-RF 7 103.53 126.390000 18.055714

156 L02AE04 TRIPTORELINUM** DIPHERELINE (R) 11,25 mg LIOF.+ SOLV. PT. SUSP. INJ. I.M. ELIB. PREL. 11,25mg BEAUFOUR IPSEN PHARMA FRANTA

CUTIE X 1 FLAC. LIOF. + 1 FIOLA X 2 ML SOLV. + O SERINGA X 3 ML + 2 ACE PTR. INJECTIE S/P-RF 1 989.60 1116.810000 1116.810000

157 L02AE04 TRIPTORELINUM** DIPHERELINE (R) 3,75 mg LIOF.+ SOLV. PT. SUSP. INJ. I.M. ELIB. PREL. 3,75mg BEAUFOUR IPSEN PHARMA FRANTA

CUTIE X 1 FLAC. LIOF. + 1 FIOLA X 2 ML SOLV. + O SERINGA X 3 ML + 2 ACE PTR. INJECTIE S/P-RF 1 348.50 418.020000 418.020000

158 L02BA01 TAMOXIFENUM TAMOXIFEN 10 TEVA COMPR. 10mg PHARMACHEMIE BV OLANDA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. P-RF/S 100 15.86 17.550000 0.175500159 L02BA01 TAMOXIFENUM TAMONEPRIN (R) 10 mg COMPR. 10mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 60 COMPR. P-RF 60 18.92 20.930000 0.348833160 L02BA01 TAMOXIFENUM TAMOXIFEN SANDOZ 10 COMPR. FILM. 10mg HEXAL AG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-RF/S 100 36.69 40.590000 0.405900161 L02BA03 FULVESTRANTUM** FASLODEX 250mg/5ml SOL. INJ. 250mg/5ml ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 5 ML + 1 AC P-RF 1 1,459.01 1628.470000 1628.470000

162 L02BB01 FLUTAMIDUM FLUTAN COMPR. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-RF 100 210.69 233.100000 2.331000163 L02BB01 FLUTAMIDUM FLUTASIN 250 mg COMPR. 250mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA BRUNA X 30 COMPR. P-RF 30 27.28 30.180000 1.006000164 L02BB03 BICALUTAMIDUM CASODEX 150 mg COMPR. FILM. 150mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 556.45 644.680000 23.024285

165 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 28 270.51 330.240000 11.794285

166 L02BB03 BICALUTAMIDUM CALUMID COMPR. FILM. 50mg GEDEON RICHTER PLC. UNGARIA CUTIE X 2 BLIST. AL/PVDC-PVC X 15 COMPR. FILM. P-6L 30 416.64 460.950000 15.365000

167 L02BG01 AMINOGLUTETHIMIDUM ROGLUTEN (R) 250 mg COMPR. 250mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 40 COMPR. P-RF 40 113.79 125.890000 3.147250168 L02BG03 ANASTROZOLUM ARIMIDEX COMPR. FILM. 1mg ACTAVIS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. FILM. P-6L 28 424.78 469.960000 16.784285

169 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 30 446.50 524.840000 17.494666

170 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 30 308.56 341.380000 11.379333

171 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 250.75 306.120000 306.120000

172 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 411.76 486.970000 486.970000

173 L03AA13 PEGFILGRASTIMUM*** NEULASTA 6mg SOL. INJ. 6mg AMGEN EUROPE B.V. OLANDA CUTIE X BLISTER X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. P-RF/R 1 3,640.88 4006.710000 4006.710000

174 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 1 341.37 377.670000 377.670000

175 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 66.50 73.570000 73.570000

176 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 1 420.26 464.960000 464.960000

177 L03AB05 INTERFERONUM ALFA 2B*** INTRON A 30 milioane U.I. SOL. INJ. PEN MULTIDOZA 30 milioane U.I. SP EUROPE BELGIA

CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 634.48 729.730000 729.730000

178 M05BA02 ACIDUM CLODRONICUM** SINDRONAT (R) 400 mg CAPS. 400mg ACTAVIS S.R.L. ROMANIA CUTIE X 12 BLIST. X 10 CAPS. P-6L 120 267.15 295.560000 2.463000

Pagina 18 din 52

Page 116: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

179 M05BA02 ACIDUM CLODRONICUM** BONEFOS (R) 400 mg CAPS. 400mg BAYER SCHERING PHARMA AG FINLANDA CUTIE X 1 FLAC. PEID X 100 CAPS. P-6L 100 483.01 564.630000 5.646300180 M05BA02 ACIDUM CLODRONICUM** BONEFOS (R) 800 mg COMPR. FILM. 800mg BAYER SCHERING PHARMA AG FINLANDA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 60 599.71 691.840000 11.530666

181 M05BA02 ACIDUM CLODRONICUM** BONEFOS (R) 60 mg/ml CONC. PT. SOL. PERF. 60mg/ml BAYER SCHERING PHARMA AG FINLANDA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 144.68 176.620000 35.324000

182 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 2 ML S/P-RF 1 177.63 196.520000 196.520000

183 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 1 ML S/P-RF 1 103.98 115.040000 115.040000

184 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 6 ML S/P-RF 1 525.73 581.640000 581.640000

185 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 4 ML S/P-RF 1 348.99 386.110000 386.110000

186 M05BA03 ACIDUM PAMIDRONICUM** PAMIRED 30 LIOF. PT. SOL. PERF. I.V. 30mg DR. REDDY'S LABORATORIES ROMANIACUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 MG LIOF. PT. SOL. PERF. I.V. S/P-RF 1 146.16 161.700000 161.700000

187 M05BA03 ACIDUM PAMIDRONICUM** PAMIRED 60 LIOF. PT. SOL. PERF. I.V. 60mg DR. REDDY'S LABORATORIES ROMANIACUTIE X 1 FLAC. DIN STICLA INCOLORA X 60 MG LIOF. PT. SOL. PERF. I.V. S/P-RF 1 227.36 251.540000 251.540000

188 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 4 561.31 649.980000 162.495000

189 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 50mg COMPR. FILM. 50mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X BLIST. AL/PVC X 28 COMPR. FILM. S 28 907.07 1026.860000 36.673571

190 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 1 848.18 962.670000 962.670000

191 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. S 1 1,033.24 1164.380000 1164.380000

192 M05BA08 ACIDUM ZOLEDRONICUM** ACLASTA 5mg/100ml SOL. PERF. 5mg/100ml NOVARTIS EUROPHARM LTD. MAREA BRITANIE

CUTIE X 1 FLAC. X 100 ML + 1 CAPAC AL/PP CU COMPONENTA FLIP. S 1 1,316.11 1472.710000 1472.710000

193 V03AF01 MESNUM UROMITEXAN (R) 400 mg SOL. INJ. 400mg/4ml BAXTER ONCOLOGY GMBH GERMANIA

CUTIE X 3 SUPORTURI TERMOFORMATE DIN PLASTIC X 5 FIOLE DE STICLA INCOLORA X 4 ML S 15 42.13 55.110000 3.674000

194 V03AF03 CALCII FOLINAS CALCIUM FOLINAT "EBEWE" 15 mg CAPS. 15mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X1 FLAC. X 20 CAPS. P-6L 20 27.34 35.760000 1.788000195 V03AF03 CALCII FOLINAS LEUCOVORIN-TEVA 100 mg/10 ml SOL. INJ. 10mg/ml TEVA PHARM. IND. LTD. OLANDA CUTIE X 1 FLACON X 10 ML S/P-RF 1 32.35 35.790000 35.790000

196 V03AF03 CALCII FOLINAS FOLCASIN (R) 100 mg/10 ml SOL. INJ. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON X 10 ML S/P-RF 1 32.59 36.060000 36.060000

197 V03AF03 CALCII FOLINAS FOLCASIN (R) 30 mg/10 ml SOL. INJ. 3mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON X 10 ML S/P-RF 1 11.98 13.250000 13.250000

198 V03AF03 CALCII FOLINAS CALCIUMFOLINAT "EBEWE" 10 mg/ml SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 10 ML S/P-RF 5 133.49 162.960000 32.592000

199 V03AF03 CALCII FOLINAS CALCIUMFOLINAT "EBEWE" 10 mg/ml SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 3 ML S/P-RF 5 47.15 61.670000 12.334000

200 V03AF05 AMIFOSTINUM** ETHYOL LIOF. PT. SOL. PERF. 375mg SCHERING PLOUGH EUROPE BELGIACUTIE X 5 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. PERF. S 5 1,882.25 2089.800000 417.960000

201 V03AF05 AMIFOSTINUM** ETHYOL (R) LIOF. PT. SOL. PERF. 500mg SCHERING PLOUGH EUROPE BELGIACUTIE X 3 FLAC. DIN STICLA INCOLORA CONTINAND 500 MG LIOF. PT. SOL. PERF. S 3 1,770.03 1967.490000 655.830000

1 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 MCG PULBERE + 1 SERINGA PRE-UMPLUTA + 1 ML SOLV. + 4 FIOLE PREVAZUT P-RF/R 4 2,898.76 3197.800000 799.450000

2 L03AB07 INTERFERONUM BETA 1A**** REBIF 22 micrograme SOL. INJ. 22mcg/0,5ml SERONO EUROPE LTD. MAREA BRITANIE CUTIE X 12 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ. P-RF/R 12 2,189.37 2424.570000 202.047500

3 L03AB07 INTERFERONUM BETA 1A**** REBIF 22 micrograme SOL. INJ. 22mcg/0,5ml SERONO EUROPE LTD. MAREA BRITANIE CUTIE X 3 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ. P-RF/R 3 575.21 665.130000 221.710000

4 L03AB07 INTERFERONUM BETA 1A**** REBIF 22 micrograme SOL. INJ. 22mcg/0,5ml SERONO EUROPE LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. P-RF/R 1 204.63 226.390000 226.390000

5 L03AB07 INTERFERONUM BETA 1A**** REBIF 44 micrograme SOL. INJ. 44mcg SERONO EUROPE LTD. MAREA BRITANIE CUTIE X 12 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. P-RF/R 12 2,923.19 3234.080000 269.506666

6 L03AB07 INTERFERONUM BETA 1A**** REBIF 44 micrograme SOL. INJ. 44mcg SERONO EUROPE LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. P-RF/R 1 250.09 276.690000 276.690000

P4: PROGRAMUL NATIONAL DE BOLI NEUROLOGICE Subprogramul de tratament al sclerozei multiple

Pagina 19 din 52

Page 117: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

7 L03AB07 INTERFERONUM BETA 1A**** REBIF 44 micrograme SOL. INJ. 44mcg SERONO EUROPE LTD. MAREA BRITANIE CUTIE X 3 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ. P-RF/R 3 691.21 791.570000 263.856666

8 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 2,896.75 3195.610000 114.128928

9 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 6,529.47 7155.280000 7155.280000

10 L04AX01 AZATHIOPRINUM* IMURAN (R) COMPR. FILM. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 53.75 59.470000 0.594700

1 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 42.16 46.640000 46.640000

2 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 85.42 94.510000 18.902000

3 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 99.36 109.930000 21.986000

4 A10AB01 INSULINE UMANE ACTRAPID PENFILL 100 UI/ml SOL. INJ. IN CARTUS 100UI/ml NOVO NORDISK A/S DANEMARCA CUTIE X 5 CARTUSE X 3 ML SOL. INJ. P-RF 5 74.41 94.090000 18.818000

5 A10AB01 INSULINE UMANE ACTRAPID 100 UI/ml SOL. INJ. IN FLACON 100UI/ml NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLACON X 10 ML P-RF 1 43.02 47.590000 47.590000

6 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 5 140.49 155.430000 31.086000

7 A10AB01 INSULINE UMANE ACTRAPID NOVOLET 100 UI/ml SOL. INJ. IN STILOU INJECTOR PREUMPLUT 100UI/ml NOVO NORDISK A/S DANEMARCA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE X 3 ML P-RF 5 77.25 97.680000 19.536000

8 A10AB01 INSULINE UMANE INSUMAN RAPID 100 UI/ml OPTISET SOL. INJ. IN STILOU INJECTOR PREUMPLUT 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 90.11 113.940000 22.788000

9 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 5 133.13 147.290000 29.458000

10 A10AB05 INSULINUM ASPART** NOVORAPID PENFILL 100 U/ml SOL. INJ. IN CARTUS 100Uml NOVO NORDISK A/S DANEMARCA CUTIE X 5 CARTUSE X 3 ML SOL. INJ. P-RF 5 102.94 125.670000 25.134000

11 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 5 129.92 143.740000 28.748000

12 A10AB06 INSULINUM GLULIZINA** APIDRA 100U/ml SOL. INJ. IN FLACON 100U/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLACON X 10 ML SOL. INJ. P-RF 1 74.44 94.120000 94.120000

13 A10AB06 INSULINUM GLULIZINA** APIDRA 100U/ml SOL. INJ. IN STILOU INJECTOR PREUMPLUT 100U/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE (OPTISET®) X 3 ML SOL. INJ. P-RF 5 130.64 159.490000 31.898000

14 A10AB06 INSULINUM GLULIZINA** APIDRA 100U/ml SOL. INJ. IN STILOU INJECTOR PREUMPLUT 100U/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE (SOLOSTAR) X 3 ML SOL. INJ. P-RF 5 120.24 133.030000 26.606000

15 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 42.16 46.640000 46.640000

16 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 85.42 94.510000 18.902000

17 A10AC01 INSULINE UMANE INSULATARD NOVOLET 100 UI/ml SUSP. INJ. IN STILOU INJECTOR PREUMPLUT 100UI/ml NOVO NORDISK A/S DANEMARCA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE X 3 ML P-RF 5 78.14 98.800000 19.760000

18 A10AC01 INSULINE UMANE INSUMAN BASAL 100UI/ml OPTISET SUSP. INJ. IN STILOU INJECTOR PREUMPLUT 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 5 115.32 127.580000 25.516000

19 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 99.36 109.930000 21.986000

20 A10AC01 INSULINE UMANE INSULATARD PENFILL 100 UI/ml SUSP. INJ. IN CARTUS 100UI/ml NOVO NORDISK A/S DANEMARCA CUTIE X 5 CARTUSE X 3 ML P-RF 5 74.41 94.090000 18.818000

21 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 5 129.14 157.650000 31.530000

22 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 42.16 46.640000 46.640000

23 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 85.42 94.510000 18.902000

24 A10AD01 INSULINE UMANE INSUMAN COMB 25 100UI/ml OPTISET SUSP. INJ. IN STILOU INJECTOR PREUMPLUT 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 90.11 113.940000 22.788000

25 A10AD01 INSULINE UMANE INSUMAN COMB 50 100UI/ml OPTISET SUSP. INJ. IN STILOU INJECTOR PREUMPLUT 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 5 128.35 142.000000 28.400000

26 A10AD01 INSULINE UMANE MIXTARD 30 NOVOLET 100 UI/ml SUSP. INJ. IN STILOU INJECTOR PREUMPLUT 100UI/ml NOVO NORDISK A/S DANEMARCA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE X 3 ML SUSP. INJ. P-RF 5 78.14 98.800000 19.760000

27 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 99.36 109.930000 21.986000

28 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 92.96 117.540000 23.508000

29 A10AD01 INSULINE UMANE MIXTARD 30 PENFILL 100 UI/ml SUSP. INJ. IN CARTUS 100UI/ml NOVO NORDISK A/S DANEMARCA CUTIE X 5 CARTUSE X 3 ML SUSP. INJ. P-RF 5 74.41 94.090000 18.818000

30 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 5 129.14 157.650000 31.530000

31 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 5 128.80 142.500000 28.500000

32 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 5 137.88 152.540000 30.508000

33 A10AD05 INSULINUM ASPART** NOVOMIX 30 FLEXPEN SUSP. INJ. IN STILOU INJECTOR PREUMPLUT 100UIml NOVO NORDISK A/S DANEMARCA CUTIE X 5 STILOURI PREUMPLUTE X 3 ML SUSP. INJ. P-RF 5 137.54 167.910000 33.582000

34 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 5 215.27 238.160000 47.632000

35 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 1 148.91 164.750000 164.750000

36 A10AE04 INSULINUM GLARGINE** LANTUS OptiSet SOL. INJ. IN STILOU INJECTOR PREUMPLUT 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE X 3 ML P-RF 5 215.04 237.910000 47.582000

37 A10AE04 INSULINUM GLARGINE** LANTUS SoloStar SOL. INJ. IN STILOU INJECTOR PREUMPLUT 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE X 3 ML P-RF 5 215.04 237.910000 47.582000

38 A10AE05 INSULINUM DETEMIR** LEVEMIR FLEXPEN 100 U/ml SOL. INJ. IN STILOU INJECTOR PREUMPLUT 100U/ml NOVO NORDISK A/S DANEMARCA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE X 3 ML P-RF 5 224.80 248.710000 49.742000

P5: PROGRAMUL NATIONAL DE DIABET ZAHARAT Tratamentul medicamentos al bolnavilor cu diabet zaharat

Pagina 20 din 52

Page 118: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

39 A10BA02 METFORMINUM METFORMIN 1000 mg COMPR. 1000mg ARENA GROUP S.A. ROMANIA FLACON DIN PE X 200 COMPR. P-RF/S 200 64.27 71.100000 0.35550040 A10BA02 METFORMINUM METFORMIN 1000 mg COMPR. 1000mg ARENA GROUP S.A. ROMANIA CUTIE X 10 BLIST. AL/PVC X 5 COMPR. P-RF 50 16.51 18.270000 0.36540041 A10BA02 METFORMINUM METFORMIN 500 mg COMPR. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. DIN PE X 60 COMPR. P-RF 60 3.17 3.510000 0.05850042 A10BA02 METFORMINUM DIAFORMIN (R) 850 mg COMPR. 850mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 6 COMPR. P-RF 30 6.80 7.520000 0.25066643 A10BA02 METFORMINUM METFORMIN 850 mg COMPR. 850mg ARENA GROUP SA ROMANIA CUTIE X 200 BLIST. AL/PVC X 5 COMPR. P-RF/S 1000 231.00 282.000000 0.28200044 A10BA02 METFORMINUM METFORMIN 850 mg COMPR. 850mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 COMPR. P-RF 15 4.38 4.850000 0.32333345 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 12.60 17.030000 0.28383346 A10BA02 METFORMINUM METFOGAMMA 1000mg COMPR. FILM. 1000mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 8 BLIST. AL/PVC X 15 COMPR. FILM P-RF/S 120 26.29 29.090000 0.24241647 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. P-RF 20 2.82 3.120000 0.15600048 A10BA02 METFORMINUM METFOGAMMA (R) 500 COMPR. FILM. 500mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 12 BLIST. AL/PVDC-PVC X 10 COMPR. FILM. P-RF/S 120 16.13 17.840000 0.14866649 A10BA02 METFORMINUM METFORMIN LPH (R) 500 mg COMPR. FILM. 500mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 4.90 5.420000 0.18066650 A10BA02 METFORMINUM DIPIMET 500 mg COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 4.16 4.600000 0.15333351 A10BA02 METFORMINUM METFORMIN-TEVA 500 mg COMPR. FILM. 500mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 3.76 4.160000 0.06933352 A10BA02 METFORMINUM METFORMIN AL 500 COMPR. FILM. 500mg ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 4 BLIST. AL/PVC X 15 COMPR. FILM. P-RF 60 3.74 5.050000 0.08416653 A10BA02 METFORMINUM SIOFOR (R) 850 COMPR. FILM. 850mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. X 15 COMPR. FILM. P-RF 60 14.20 15.710000 0.26183354 A10BA02 METFORMINUM GLUCOPHAGE 850 mg COMPR. FILM. 850mg MERCK SANTE FRANTA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. FILM. P-RF/S 100 17.56 23.730000 0.23730055 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. P-RF 20 4.24 4.690000 0.23450056 A10BA02 METFORMINUM MEDIFOR 850 COMPR. FILM. 850mg STD CHEMICALS LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 56 9.09 10.060000 0.17964257 A10BA02 METFORMINUM METFORMIN LPH (R) 850 mg COMPR. FILM. 850mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 8.89 9.830000 0.32766658 A10BA02 METFORMINUM METFOGAMMA 850 COMPR. FILM. 850mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 12 BLIST. AL/PVC X 10 COMPR. FILM. P-RF/S 120 21.50 23.790000 0.19825059 A10BA02 METFORMINUM METFORMIN AL 850 COMPR. FILM. 850mg ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 4 BLIST. AL/PVC X 15 COMPR. FILM. P-RF 60 5.29 7.150000 0.11916660 A10BA02 METFORMINUM METFORMIN-TEVA 850 mg COMPR. FILM. 850mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 5.38 5.950000 0.09916661 A10BA02 METFORMINUM FORMIRAN 1000 mg COMPR. PT. SOL. ORALA 1000mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. PVC-ACLAR/AL X 6 COMPR. PT. SOL. ORALA P-RF 30 6.36 7.040000 0.23466662 A10BA02 METFORMINUM FORMIRAN 1000 mg COMPR. PT. SOL. ORALA 1000mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. PA-AL-PVC/AL X 6 COMPR. PT. SOL. ORALA P-RF 30 6.36 7.040000 0.23466663 A10BA02 METFORMINUM FORMIRAN 500 mg COMPR. PT. SOL. ORALA 500mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. PA-AL-PVC/AL X 6 COMPR. PT. SOL ORALA P-RF 30 2.64 2.920000 0.09733364 A10BA02 METFORMINUM FORMIRAN 500 mg COMPR. PT. SOL. ORALA 500mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. PVC-ACLAR/AL X 6 COMPR. PT. SOL. ORALA P-RF 30 2.64 2.920000 0.09733365 A10BA02 METFORMINUM FORMIRAN 850 mg COMPR. PT. SOL. ORALA 850mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. PVC-ACLAR/AL X 6 COMPR. PT. SOL. ORALA P-RF 30 4.53 5.010000 0.16700066 A10BA02 METFORMINUM FORMIRAN 850 mg COMPR. PT. SOL. ORALA 850mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. PA-AL-PVC/AL X 6 COMPR. PT. SOL. ORALA P-RF 30 4.53 5.010000 0.16700067 A10BA03 BUFORMINUM SILUBIN RETARD DRAJ. RET. 100mg DITA IMPORT EXPORT SRL ROMANIA CUTIE X 4 BLLIST. X 15 DRAJ.RET. P-RF 60 12.52 13.850000 0.23083368 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ANTIBIOTICE 1,75 mg COMPR. 1,75 mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1.33 1.800000 0.06000069 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 8.02 8.870000 0.07391670 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID LPH 1,75 mg COMPR. 1,75mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-RF 60 4.96 5.490000 0.09150071 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 7.62 8.430000 0.08430072 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 49.21 54.440000 0.05444073 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 5.94 8.030000 0.06691674 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 9.42 10.420000 0.10420075 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID LPH 3,5 mg COMPR. 3,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-RF 60 7.40 8.190000 0.13650076 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 3.68 4.070000 0.13566677 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 68.88 76.210000 0.07621078 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ANTIBIOTICE 3,5 mg COMPR. 3,5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.95 1.290000 0.04300079 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. DIN PE X 100 COMPR. P-RF/S 100 2.44 2.700000 0.02700080 A10BB03 TOLBUTAMIDUM TOLBUTAMID COMPR. 500mg SINTOFARM SA ROMANIA CUTIE X 1 FLAC. X 50 COMPR. P-RF 50 3.07 3.400000 0.06800081 A10BB07 GLIPIZIDUM GLIPIZID LPH 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 12.74 14.100000 0.47000082 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 36.15 39.990000 1.33300083 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 19.04 21.060000 0.70200084 A10BB08 GLIQUIDONUM GLURENORM COMPR. 30mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-RF 60 15.46 17.100000 0.285000

Pagina 21 din 52

Page 119: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

85 A10BB09 GLICLAZIDUM DIABREZIDE COMPR. 80mg L. MOLTENI ITALIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 20 COMPR. P-RF 40 9.09 10.060000 0.25150086 A10BB09 GLICLAZIDUM ESQUEL (R) 80 mg COMPR. 80mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 15 COMPR. P-RF 30 6.84 9.240000 0.30800087 A10BB09 GLICLAZIDUM GLICLAZID LPH COMPR. 80mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-RF 60 13.78 15.240000 0.25400088 A10BB09 GLICLAZIDUM DIAPREL MR COMPR. ELIB. MODIF. 30mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. X 30 COMPR. ELIB. MODIF. P-RF 60 17.53 23.700000 0.39500089 A10BB09 GLICLAZIDUM GLICLAZID MR LPH 30 mg COMPR. ELIB. PREL. 30mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 60 20.96 23.190000 0.38650090 A10BB09 GLICLAZIDUM GLICLAZIDA EP ANTIBIOTICE 30 mg COMPR. ELIB. PREL. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-RF 30 9.83 10.880000 0.36266691 A10BB09 GLICLAZIDUM GLITOPP MR 30 mg COMPR. ELIB. PREL. 30mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P-RF 10 3.09 3.420000 0.34200092 A10BB12 GLIMEPIRIDUM TINERIL 4 mg COMPR 4mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 20.66 22.860000 0.76200093 A10BB12 GLIMEPIRIDUM AMYX 1 COMPR. 1 mg ZENTIVA A.S. SLOVACIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-RF 30 8.06 8.920000 0.29733394 A10BB12 GLIMEPIRIDUM MEGLIMID 1 mg COMPR. 1mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 6.72 7.430000 0.24766695 A10BB12 GLIMEPIRIDUM GLIMEPIRID LPH 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 11.32 12.520000 0.41733396 A10BB12 GLIMEPIRIDUM GLIMERAN 1 mg COMPR. 1mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 COMPR. P-RF 30 4.75 5.250000 0.17500097 A10BB12 GLIMEPIRIDUM GLIMERAN 1 mg COMPR. 1mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 4.75 5.250000 0.17500098 A10BB12 GLIMEPIRIDUM OLTAR 1 mg COMPR. 1mg BERLIN CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-RF 30 4.43 5.990000 0.19966699 A10BB12 GLIMEPIRIDUM TINERIL 1 mg COMPR. 1mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 4.41 4.880000 0.162666

100 A10BB12 GLIMEPIRIDUM AMARYL 1mg COMPR. 1mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 4.62 5.110000 0.170333101 A10BB12 GLIMEPIRIDUM MEGLIMID 2 mg COMPR. 2mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 13.35 14.770000 0.492333102 A10BB12 GLIMEPIRIDUM AMYX 2 COMPR. 2mg ZENTIVA A.S. SLOVACIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-RF 30 10.84 11.990000 0.399666103 A10BB12 GLIMEPIRIDUM GLIMEPIRID LPH 2 mg COMPR. 2mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 17.38 19.230000 0.641000104 A10BB12 GLIMEPIRIDUM GLIMERAN 2 mg COMPR. 2mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 9.94 11.000000 0.366666105 A10BB12 GLIMEPIRIDUM GLIMERAN 2 mg COMPR. 2mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 COMPR. P-RF 30 9.94 11.000000 0.366666106 A10BB12 GLIMEPIRIDUM GLIMEPIRIDE 2 mg COMPR. 2mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 9.37 12.670000 0.422333107 A10BB12 GLIMEPIRIDUM TINERIL 2 mg COMPR. 2mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 10.04 11.110000 0.370333108 A10BB12 GLIMEPIRIDUM AMARYL 2 mg COMPR. 2mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 7.74 10.460000 0.348666109 A10BB12 GLIMEPIRIDUM MEGLIMID 3 mg COMPR. 3mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 18.46 20.420000 0.680666110 A10BB12 GLIMEPIRIDUM AMYX 3 COMPR. 3mg ZENTIVA A.S. SLOVACIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-RF 30 12.90 14.270000 0.475666111 A10BB12 GLIMEPIRIDUM GLIMEPIRID LPH 3 mg COMPR. 3mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 19.78 21.880000 0.729333112 A10BB12 GLIMEPIRIDUM GLIMERAN 3 mg COMPR. 3mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 COMPR. P-RF 30 14.20 15.710000 0.523666113 A10BB12 GLIMEPIRIDUM GLIMERAN 3 mg COMPR. 3mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 14.20 15.710000 0.523666114 A10BB12 GLIMEPIRIDUM OLTAR 3 mg COMPR. 3mg BERLIN CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-RF 30 15.23 16.850000 0.561666115 A10BB12 GLIMEPIRIDUM GLIMEPIRIDE 3 mg COMPR. 3mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 15.83 21.390000 0.713000116 A10BB12 GLIMEPIRIDUM TINERIL 3 mg COMPR. 3mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 14.46 16.000000 0.533333117 A10BB12 GLIMEPIRIDUM AMARYL 3 mg COMPR. 3mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 14.20 15.710000 0.523666118 A10BB12 GLIMEPIRIDUM AMYX 4 COMPR. 4mg ZENTIVA A.S. SLOVACIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-RF 30 20.16 22.300000 0.743333119 A10BB12 GLIMEPIRIDUM GLIMERAN 4 mg COMPR. 4mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 COMPR. P-RF 30 20.25 22.400000 0.746666120 A10BB12 GLIMEPIRIDUM GLIMERAN 4 mg COMPR. 4mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST AL/PVC X 10 COMPR. P-RF 30 20.25 22.400000 0.746666121 A10BB12 GLIMEPIRIDUM AMARYL 4 mg COMPR. 4mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 15.09 16.700000 0.556666122 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 500 163.48 180.870000 0.361740123 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 7.01 7.750000 0.387500124 A10BD02 COMBINATII(GLIBENCLAMIDUM+METFORMINUM) GLIBOMET (R) COMPR. FILM. 2,5mg/400mg LAB. GUIDOTTI SPA ITALIA CUTIE X 3 BLIST. X 20 COMPR. FILM. P-RF 60 17.02 18.830000 0.313833125 A10BD02 COMBINATII(GLIBENCLAMIDUM+METFORMINUM) GLIFORMIN COMPR. FILM. 400mg + 2,5mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 60 18.48 20.450000 0.340833126 A10BD02 COMBINATII(GLIBENCLAMIDUM+METFORMINUM) GLUCOVANCE (R) 500 mg/2,5 mg COMPR. FILM. 500mg/2,5mg MERCK SANTE FRANTA CUTIE X 4 BLIST. X 15 COMPR. FILM. P-RF 60 20.70 22.900000 0.381666127 A10BD02 COMBINATII(GLIBENCLAMIDUM+METFORMINUM) GLUCOVANCE (R) 500 mg/5 mg COMPR. FILM. 500mg/5mg MERCK SANTE FRANTA CUTIE X 4 BLIST. X 15 COMPR. FILM. P-RF 60 22.58 24.980000 0.416333128 A10BD03 COMBINATII (ROSIGLITAZONUM+METFORMINUM)*** AVANDAMET 2mg/1000mg COMPR. FILM. 2mg/1000mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 56 COMPR. FILM.( BLIST. PVC OPAC/PVDC/AL) P-RF 56 94.57 104.630000 1.868392129 A10BD03 COMBINATII (ROSIGLITAZONUM+METFORMINUM)*** AVANDAMET 2mg/500mg COMPR. FILM. 2mg/500mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 56 COMPR. FILM. ( BLIST. PVC OPAC/PVDC/AL) P-RF 56 85.26 94.330000 1.684464130 A10BD03 COMBINATII (ROSIGLITAZONUM+METFORMINUM)*** AVANDAMET 4mg/1000mg COMPR. FILM. 4mg/1000mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 56 COMPR. FILM.( BLIST. PVC OPAC/PVDC/AL) P-RF 56 154.74 171.200000 3.057142

Pagina 22 din 52

Page 120: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

131 A10BD04 COMBINATII (ROSIGLITAZONUM + GLIMEPIRIDUM)*** AVAGLIM 4mg/4mg COMPR. FILM. 4mg/4mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 28 COMPR. FILM. ( BLIST. PVC/PVDC/AL) P-RF 28 87.98 97.340000 3.476428132 A10BD04 COMBINATII (ROSIGLITAZONUM + GLIMEPIRIDUM)*** AVAGLIM 8mg/4mg COMPR. FILM. 8mg/4mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 28 COMPR. FILM. ( BLIST. PVC/PVDC/AL) P-RF 28 161.77 178.980000 6.392142133 A10BD05 COMBINATII ( PIOGLITAZONUM + METFORMINUM)*** COMPETACT COMPR. FILM. 15mg/850mg TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD MAREA BRITANIE CUTIE X 56 COMPR. FILM. ( BLIST. AL/AL ) P-RF 56 161.85 179.060000 3.197500134 A10BF01 ACARBOSUM GLUCOBAY (R) 100 COMPR. 100mg BAYER HEALTHCARE AG GERMANIA CUTIE X 8 BLIST. AL/PP X 15 COMPR. P-RF 120 72.08 79.750000 0.664583135 A10BF01 ACARBOSUM GLUCOBAY (R) 50 COMPR. 50mg BAYER HEALTHCARE AG GERMANIA CUTIE X 8 BLIST. AL/PP X 15 COMPR. P-RF 120 53.45 59.130000 0.492750136 A10BG02 ROSIGLITAZONUM*** AVANDIA 4mg COMPR. FILM. 4mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 28 COMPR.FILM. (BLIST.OPAC AL/PVC) P-RF 28 74.72 82.670000 2.952500137 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 99.13 109.670000 3.916785138 A10BG03 PIOGLITAZONUM*** ACTOS 30mg COMPR. 30mg TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD MAREA BRITANIE CUTIE X 28 COMPR.(BLIST. AL/AL) P-RF 28 151.88 168.030000 6.001071139 A10BG03 PIOGLITAZONUM*** ACTOS 45mg COMPR. 45mg TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD MAREA BRITANIE CUTIE X 28 COMPR.(BLIST. AL/AL) P-RF 28 197.35 218.340000 7.797857140 A10BH01 SITAGLIPTINUM*** JANUVIA 100mg COMPR. FILM. 100mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC/PE/PVDC/AL) P-RF 28 150.92 184.240000 6.580000141 A10BX02 REPAGLINIDUM NOVONORM 0,5 mg COMPR. 0,5mg NOVO NORDISK A/S DANEMARCA CUTIE X 90 COMPR. (BLIST. AL/AL) P-RF 90 54.32 60.100000 0.667777142 A10BX02 REPAGLINIDUM NOVONORM 1 mg COMPR. 1mg NOVO NORDISK A/S DANEMARCA CUTIE X 90 COMPR. (BLIST. AL/AL) P-RF 90 54.96 60.810000 0.675666143 A10BX02 REPAGLINIDUM NOVONORM 2 mg COMPR. 2mg NOVO NORDISK A/S DANEMARCA CUTIE X 90 COMPR. (BLIST. AL/AL) P-RF 90 55.88 61.820000 0.686888144 A10BX04 EXENATIDUM*** BYETTA 10mcg/doza SOL. INJ. IN STILOU INJECTOR PREUMPLUT 10mcg/doza ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT (60 DOZE) P-RF 1 394.55 436.510000 436.510000

145 A10BX04 EXENATIDUM*** BYETTA 5mcg/doza SOL. INJ. IN STILOU INJECTOR PREUMPLUT 5mcg/doza ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT (60 DOZE) P-RF 1 316.80 383.460000 383.460000

146 A11DA03 BENFOTIAMINUM BENFOGAMMA DRAJ. 50mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-6L 50 19.62 21.710000 0.434200147 A11DA03 BENFOTIAMINUM BENFOGAMMA DRAJ. 50mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 20 DRAJ. P-6L 100 36.78 40.690000 0.406900148 A11DBN1 COMBINATII** MILGAMMA (R) N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 20 12.86 14.230000 0.711500149 A11DBN1 COMBINATII** MILGAMMA (R) N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 100 62.63 69.290000 0.692900150 A11DBN1 COMBINATII** MILGAMMA (R) N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 50 33.06 36.580000 0.731600151 A11DBN1 COMBINATII** MILGAMMA (R) N SOL. INJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 25 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF 25 63.39 70.130000 2.805200152 A11DBN1 COMBINATII** MILGAMMA (R) N SOL. INJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF 5 11.15 12.340000 2.468000153 B03BA51 COMBINATII** MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. PVC/PVDC X 10 DRAJ. P-6L 100 62.63 69.290000 0.692900154 B03BA51 COMBINATII** MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC/PVDC X 10 DRAJ. P-6L 20 13.85 15.320000 0.766000155 B03BA51 COMBINATII** MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L 50 33.06 36.580000 0.731600156 H04AA01 GLUCAGONUM GLUCAGEN HYPOKIT 1 mg PULB. + SOLV. PT. SOL. INJ. 1mg NOVO NORDISK A/S DANEMARCA CTUIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV. P-6L 1 66.74 73.840000 73.840000

1 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 10 105.77 129.130000 12.913000

2 V03AC03 DEFERASIROXUM**** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL) P-RF/R 28 647.40 743.820000 26.565000

3 V03AC03 DEFERASIROXUM**** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 84 COMPR. DISP. (BLIST. PVC/PE/PVDC/AL) P-RF/R 84 1,882.20 2089.750000 24.877976

4 V03AC03 DEFERASIROXUM**** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 84 COMPR. DISP. ( PVC/PE/PVDC/AL) P-RF/R 84 4,061.99 4465.730000 53.163452

5 V03AC03 DEFERASIROXUM**** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) P-RF/R 28 1,374.00 1535.810000 54.850357

6 V03AC03 DEFERASIROXUM**** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 84 COMPR. DISP. ( PVC/PE/PVDC/AL) P-RF/R 84 7,438.79 8146.440000 96.981428

7 V03AC03 DEFERASIROXUM**** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) P-RF/R 28 2,499.59 2762.710000 98.668214

8 B02BD02 FACTOR VIII DE COAGULARE** IMMUNATE 1000 UI LIOF. + SOLV. PT. SOL. INJ./PERF. 1000UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. LIOF. + 1 FLAC. X 10 ML SOLV. + 1 TRUSA MEDICALA PT. RECONSTITUIRE SI ADMINISTRARE S 1 1,477.83 1635.000000 1635.000000

9 B02BD02 FACTOR VIII DE COAGULARE** IMMUNATE 250 UI LIOF. + SOLV. PT. SOL. INJ./PERF. 250UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. LIOF. + 1 FLAC. X 5 ML SOLV. + 1 TRUSA MEDICALA PT. RECONSTITUIRE SI ADMINISTRARE S 1 369.46 408.750000 408.750000

10 B02BD02 FACTOR VIII DE COAGULARE** IMMUNATE 500 UI LIOF. + SOLV. PT. SOL. INJ./PERF. 500UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. LIOF. + 1 FLAC. X 5 ML SOLV. + 1 TRUSA MEDICALA PT. RECONSTITUIRE SI ADMINISTRARE S 1 738.92 817.500000 817.500000

11 B02BD02 MOROCTOCOG ALFA** REFACTO 250UI PULB. + SOL. PT. SOL. INJ. 250 UI WYETH EUROPA LTD MAREA BRITANIE CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STER P-RF/R 1 751.12 831.000000 831.000000

12 B02BD02 MOROCTOCOG ALFA** REFACTO 500UI PULB. + SOL. PT. SOL. INJ. 500 UI WYETH EUROPA LTD MAREA BRITANIE CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STER P-RF/R 1 1,503.14 1663.000000 1663.000000

13 B02BD02 OCTOCOG ALFA** RECOMBINATE 1000 UI/10 ml LIOF. + SOLV. PT. SOL. INJ./PERF. 1000UI/10ml BAXTER SA BELGIA CUTIE X 1 FLAC. CU LIF. + 1 FLAC. CU SOLV. PT. SOL. INJ./PERF. P-RF/R 1 2,364.53 2616.000000 2616.000000

14 B02BD02 OCTOCOG ALFA** RECOMBINATE 250 UI/10 ml LIOF. + SOLV. PT. SOL. INJ./PERF. 250UI/10ml BAXTER SA BELGIA CUTIE X 1 FLAC. CU LIOF. +1 FLAC.CU SOLV. PT. SOL. INJ./PERF. P-RF/R 1 591.13 654.000000 654.000000

15 B02BD02 OCTOCOG ALFA** RECOMBINATE 500 UI/10 ml LIOF. + SOLV. PT. SOL. INJ./PERF. 500 UI/10ml BAXTER SA BELGIA CUTIE X 1 FLAC. CU LIOF. + 1 FLAC. CU SOLV. PT. SOL. INJ./PERF. P-RF/R 1 1,182.26 1308.000000 1308.000000

16 B02BD02 OCTOCOG ALFA** ADVATE 1000UI PULB+SOLV.PT.SOL.INJ 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 3,557.69 3936.060000 3936.060000

P6: PROGRAMUL NATIONAL DE HEMOFILIE, TALASEMIE SI ALTE BOLI RARE P6.1: HEMOFILIE SI TALASEMIE

Pagina 23 din 52

Page 121: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

17 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 1000UI PULB+SOLV.PT.SOL.INJ 1000UI BAYER HEALTHCARE AG GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 2,5ML SOL. + AMBALAJ SUPL. CE CONTIN P-RF/R 1 2,653.77 2936.000000 2936.000000

18 B02BD02 OCTOCOG ALFA** ADVATE 1500UI PULB+SOLV.PT.SOL.INJ 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 5,930.21 6560.900000 6560.900000

19 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 250UI PULB+SOLV.PT.SOL.INJ 250UI BAYER HEALTHCARE AG GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 2,5ML SOL. + AMBALAJ SUPL. CE CONTIN P-RF/R 1 663.44 734.000000 734.000000

20 B02BD02 OCTOCOG ALFA** ADVATE 500UI PULB+SOLV.PT.SOL.INJ 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 1,860.95 2058.860000 2058.860000

21 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 500UI PULB+SOLV.PT.SOL.INJ 500UI BAYER HEALTHCARE AG GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 2,5ML SOL. + AMBALAJ SUPL. CE CONTIN P-RF/R 1 1,326.88 1468.000000 1468.000000

22 B02BD02 OCTOCOG ALFA** ADVATE 2000UI PULB+SOLV.PT.SOL.INJ. 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 9,852.20 10900.000000 10900.000000

23 B02BD02 OCTOCOG ALFA** ADVATE 250UI PULB+SOLV.PT.SOL.INJ. 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 1 916.56 1014.040000 1014.040000

24 B02BD02 OCTOCOG ALFA** ADVATE 3000UI PULB+SOLV.PT.SOL.INJ. 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 14,778.31 16350.000000 16350.000000

25 B02BD03 COMPLEX DE ANTIINHIBITORI AI COAGULARII** FEIBA NF 500 U FEIBA LIOF. + SOLV. PT. SOL. INJ./PERF. 500 U/20ml BAXTER AG AUSTRIA CUTIE X 1 FLAC. LIOF. + 1 FLAC. SOLV. + 1 TRUSA MEDICALA PT. RECONSTITUIRE SI ADM. S 1 1,838.28 2033.780000 2033.780000

26 B02BD04FACTOR IX DE COAGULARE** OCTANINE F 250 LIOF. + SOLV. PT. SOL. PERF. 250 UI OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA A 30 ML CU LIOF. + 1 FLAC. X 5 ML SOLV. + 1 SERIN S 1 394.09 436.000000 436.000000

27 B02BD04FACTOR IX DE COAGULARE** OCTANINE F 500 LIOF. + SOLV. PT. SOL. PERF. 500 UI OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA A 30 ML CU LIOF. + 1 FLAC. X 5 ML SOLV. + 1 SERIN S 1 788.18 872.000000 872.000000

28 B02BD04FACTOR IX DE COAGULARE** IMMUNINE 600 UI PULB.+SOLV. PT. SOL. INJ./PERF. 600UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. PULB. PT. SOL. INJ./ PERF. + 1 FLAC. X 5 ML SOLV. + 1 SET DE RECONSTITUIRE SI ADMIN S 1 866.99 959.200000 959.200000

29 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 1,2 mg (60 KUI) PULB. + SOLV. PT. SOL. INJ. 60 KIU NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLAC. PULB. (NOVOSEVEN) PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE X 1 FLAC. STERIL P-RF/R 1 3,150.73 3485.820000 3485.820000

1 D06AA04 TETRACYCLINUM TETRACICLINA CLORHIDRAT UNGUENT 3% ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 12 G P-RF 1 2.02 2.230000 2.2300002 D06AX01 ACIDUM FUSIDICUM FUCIDIN 20 mg/g CREMA 20mg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 11.20 12.390000 12.390000

3 D06AX01 ACIDUM FUSIDICUM FUCIDIN 20 mg/g UNGUENT 20mg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 11.20 12.390000 12.390000

4 D07CC01 COMBINATII DIPROGENTA (R) CREMA FARA CONCENTRATIE SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 TUB X 15 G P-RF 1 9.42 10.420000 10.420000

5 D07CC01 COMBINATII TRIDERM (R) CREMA FARA CONCENTRATIE SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 TUB AL X 15 G P-RF 1 10.39 11.500000 11.500000

6 D07CC01 COMBINATII BELOGENT CREMA FARA CONCENTRATIE A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB. DIN AL X 30 G CREMA P-RF 1 8.56 9.470000 9.4700007 D07CC01 COMBINATII BELOGENT CREMA FARA CONCENTRATIE A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB. DIN AL X 15 G CREMA P-RF 1 7.48 8.280000 8.2800008 D07CC01 COMBINATII DIPROGENTA (R) UNGUENT FARA CONCENTRATIE SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 TUB X 15 G P-RF 1 9.42 10.420000 10.420000

9 D07CC01 COMBINATII TRIDERM UNGUENT FARA CONCENTRATIE SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 10.39 11.500000 11.500000

10 D07CC01 COMBINATII BELOGENT UNGUENT FARA CONCENTRATIE A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT P-RF 1 8.56 9.470000 9.47000011 D07CC01 COMBINATII BELOGENT UNGUENT FARA CONCENTRATIE A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 7.48 8.280000 8.28000012 J01AA07 TETRACYCLINUM TETRACICLINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 1.86 2.060000 0.10300013 J01AA07 TETRACYCLINUM TETRACICLINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. X 10 CAPS. P-RF/S 1000 90.80 100.460000 0.10046014 J01AA07 TETRACYCLINUM TETRACICLINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 1.79 1.980000 0.09900015 J01AA07 TETRACYCLINUM TETRACICLINA 250 mg CAPS. 250mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 1.98 2.190000 0.10950016 J01AA07 TETRACYCLINUM TETRACICLINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 1.54 1.700000 0.08500017 N03AB02 PHENYTOINUM FENITOIN 100 mg COMPR. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.80 0.890000 0.04450018 N03AB02 PHENYTOINUM PHENHYDAN (R)SOLUTIE INJECTABILA SOL. INJ. 50mg/ml DESITIN GERMANIA CUTIE X 5 FIOLE X 5ML P-RF 5 36.64 40.540000 8.108000

1 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 8,949.99 9793.650000 174.886607

2 G04BE03 SILDENAFILUM** REVATIO 20 mg COMPR. FILM. 20mg PFIZER LIMITED MAREA BRITANIE CUTIE X 6 BLIST. AL/PVC X 15 COMPR. FILM. P-RF/R 90 1,761.01 1957.650000 21.751666

P6: PROGRAMUL NATIONAL DE HEMOFILIE, TALASEMIE SI ALTE BOLI RARE

P6: PROGRAMUL NATIONAL DE HEMOFILIE, TALASEMIE SI ALTE BOLI RAREP6.2: EPIDERMOLIZA BULOASA

P6.3: HIPERTENSIUNE PULMONARA

Pagina 24 din 52

Page 122: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT SPA ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 19.49 21.560000 1.5400002 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 250 mg COMPR. FILM. 250mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 21.14 23.390000 1.6707143 J01FA09 CLARITHROMYCINUM CLAR 250 COMPR. FILM. 250mg MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 5 BLIST. X 4 COMPR. FILM. P-RF 20 25.99 28.750000 1.4375004 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 13.07 17.660000 1.2614285 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 10.19 13.770000 0.9835716 J01FA09 CLARITHROMYCINUM CLARITROMICINA 250 mg COMPR. FILM. 250mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 10.19 13.770000 0.9835717 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 11.58 15.650000 1.1178578 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 500 mg COMPR. FILM. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 39.54 43.740000 3.1242859 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 25.40 33.220000 2.372857

10 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 22.30 30.140000 2.15285711 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mg MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF 20 33.52 37.080000 1.85400012 J01FA09 CLARITHROMYCINUM CLARITROMICINA 500 mg COMPR. FILM. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 22.30 30.140000 2.15285713 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 22.66 30.630000 2.18785714 J01FA09 CLARITHROMYCINUM LEKOKLAR XL 500 mg COMPR. FILM. ELIB. MODIF. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FOLIE AL/AL X 5 COMPR. FILM. ELIB. MODIF. P-RF 5 12.77 17.260000 3.45200015 J01FA09 CLARITHROMYCINUM LEKOKLAR XL 500 mg COMPR. FILM. ELIB. MODIF. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FOLIE AL/AL X 7 COMPR. FILM. ELIB. MODIF. P-RF 7 17.88 24.160000 3.45142816 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 24.82 27.460000 3.92285717 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 25.99 28.750000 5.75000018 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 19.17 21.210000 3.03000019 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA 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 27.60 30.540000 30.540000

20 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA 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 16.89 18.690000 18.690000

21 J01FA09 CLARITHROMYCINUM FROMILID (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. P-RF 1 16.89 18.690000 18.690000

22 J01FA09 CLARITHROMYCINUM LEKOKLAR 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 17.16 18.990000 18.990000

23 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 23.74 26.270000 26.270000

24 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 14.56 16.110000 16.110000

25 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 68,3 G GRANULE PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 41.66 46.090000 46.090000

26 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 30.35 33.580000 33.580000

27 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 38.08 42.130000 42.130000

28 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 22.00 29.740000 29.740000

29 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 37.94 41.970000 41.970000

30 J01GB01 TOBRAMYCINUM** TOBI (R) SOL. INHAL. 300mg/5ml 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 28 7,618.79 8342.640000 297.951428

31 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 6 519.76 604.690000 100.781666

1 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 50 ML S 1 640.39 708.500000 708.500000

2 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 100 ML S 1 1,182.26 1308.000000 1308.000000

3 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S 1 689.65 763.000000 763.000000

P6.5: BOLI NEUROLOGICE DEGENERATIVE/INFLAMATORII

P6: PROGRAMUL NATIONAL DE HEMOFILIE, TALASEMIE SI ALTE BOLI RAREP6.4: MUCOVISCIDOZA

P6: PROGRAMUL NATIONAL DE HEMOFILIE, TALASEMIE SI ALTE BOLI RARE

Pagina 25 din 52

Page 123: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

4 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 2,555.21 2826.960000 2826.960000

5 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 1,285.40 1422.100000 1422.100000

6 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 50 ML SOL. PERF. S 1 738.92 817.500000 817.500000

7 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 1,448.27 1602.300000 1602.300000

8 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 200 ML SOL. PERF. S 1 2,807.88 3106.500000 3106.500000

9 N07XX02 RILUZOLUM** RILUTEK 50 mg COMPR. FILM. 50mg AVENTIS PHARMA SA FRANTA CUTIE X 4 BLIST. X 14 COMPR. P-RF/R 56 832.60 945.680000 16.887142

1 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 2 ML S/P-RF 1 177.63 196.520000 196.520000

2 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 1 ML S/P-RF 1 103.98 115.040000 115.040000

3 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 6 ML S/P-RF 1 525.73 581.640000 581.640000

4 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 4 ML S/P-RF 1 348.99 386.110000 386.110000

5 M05BA03 ACIDUM PAMIDRONICUM PAMIRED 30 LIOF. PT. SOL. PERF. I.V. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 MG LIOF. PT. SOL. PERF. I.V. S/P-RF 1 146.16 161.700000 161.700000

6 M05BA03 ACIDUM PAMIDRONICUM PAMIRED 60 LIOF. PT. SOL. PERF. I.V. 60mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 60 MG LIOF. PT. SOL. PERF. I.V. S/P-RF 1 227.36 251.540000 251.540000

7 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 4 561.31 649.980000 162.495000

1 H01AC01 SOMATROPINUM** ZOMACTON LIOF. + SOLV. PT. SOL. INJ. 4mg (12ui) FERING GMBH GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1 FIOLA X 3,5 ML SOLV. P-RF 1 370.80 442.320000 442.320000

2 H01AC01 SOMATROPINUM** GENOTROPIN (R) 16 ui (5,3 mg) PULB. + SOLV. PT. SOL. INJ. 5,3mg/ml (16ui) PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 CARTUS BICAMERAL MULTIDOZA CU PULB. SI SOLV. PT. SOL. INJ. P-RF 1 460.50 509.480000 509.480000

3 H01AC01 SOMATROPINUM** NORDITROPIN SIMPLEX x 10mg/1,5ml SOL. INJ. 10mg/1,5ml NOVO NORDISK A/S DANEMARCA CUTIE X 1 CARTUS DIN STICLA X 1,5 ML SOL. INJ. P-RF 1 1,106.69 1244.440000 1244.440000

4 H01AC01 SOMATROPINUM** NUTROPINAq 10 mg/2 ml SOL. INJ. 10mg/2ml IPSEN LIMITED MAREA BRITANIE CUTIE X 1 CARTUS X 2 ML. SOL. INJ. P-RF/R 1 822.84 935.050000 935.050000

5 H01AC01 SOMATROPINUM** OMNITROPE 3,3mg/ml SOL. INJ. 3,3mg/ml SANDOZ GMBH AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ. P-RF/R 1 398.72 441.120000 441.120000

6 H01AC01 SOMATROPINUM** NORDITROPIN SIMPLEXx 5 mg/1,5 ml SOL. INJ. 5mg/1,5ml NOVO NORDISK A/S DANEMARCA CUTIE X 1 CARTUS DIN STICLA X 1,5 ML SOL. INJ. P-RF 1 512.41 596.680000 596.680000

1 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. S 1 12,957.01 14161.310000 14161.310000

1 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. S 1 2,128.32 2358.020000 2358.020000

P6: PROGRAMUL NATIONAL DE HEMOFILIE, TALASEMIE SI ALTE BOLI RARE P6.9: BOALA POMPE

P6: PROGRAMUL NATIONAL DE HEMOFILIE, TALASEMIE SI ALTE BOLI RARE P6.7: SINDROM PRADER WILLI

P6: PROGRAMUL NATIONAL DE HEMOFILIE, TALASEMIE SI ALTE BOLI RARE P6.8: BOALA FABRY

P6: PROGRAMUL NATIONAL DE HEMOFILIE, TALASEMIE SI ALTE BOLI RARE P6.6: OSTEOGENEZA IMPERFECTA

Pagina 26 din 52

Page 124: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1 A11CC02 DIHYDROTACHYSTEROLUM A.T. 10 (R) PICATURI ORALE-SOL. 1mg/ml MERCK KGAA GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA PREVAZUT CU PICURATOR X 15 ML P-6L 1 17.74 19.630000 19.630000

2 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 27.68 30.620000 0.6124003 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 22.77 25.190000 0.8396664 A11CC04 CALCITRIOLUM ROCALTROL CAPS. MOI 0,25mcg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 CAPS. MOI P-RF 100 57.17 72.280000 0.7228005 G03CA03 ESTRADIOLUM ESTROFEM 1 mg COMPR. FILM. 1mg NOVO NORDISK A/S DANEMARCA CUTIE X 1 DISC TIP CALENDAR X 28 COMPR.FILM. P-6L 1 11.78 13.030000 13.030000

6 G03CA03 ESTRADIOLUM VAGIFEM COMPR. VAG. 25mcg NOVO NORDISK A/S DANEMARCA CUTIE X 3 BLIST. AL/PVC X 5 APLICATOARE DIN PE/PP X 1 COMPR. VAG. P-6L 15 33.19 36.720000 2.4480007 G03CA03 ESTRADIOLUM OESTROGEL (R) GEL 0,06% LAB. BESINS INTERNATIONAL FRANTA CUTIE X 1 TUB DIN AL X 80 G P-6L 1 11.61 12.840000 12.840000

8 G03CA03 ESTRADIOLUM ESTREVA (R) GEL 0,1% LAB. THERAMEX MONACO CUTIE X 1 FLACON PE, INCHIS CU POMPA DOZATOARE X 50 G P-6L 1 20.07 22.200000 22.200000

9 G03CA03 ESTRADIOLUM CLIMARA PLASTURE TRANSDERM. 50mcg/24ore BAYER SCHERING PHARMA AG GERMANIA CUTIE X 4 PLICURI X 1 PLASTURE TRANSDERM. P-6L 4 23.84 26.370000 6.59250010 G03DC05 TIBOLONUM LIVIAL (R) 2,5 mg COMPR. 2,5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 28 COMPR. P-RF 28 55.04 69.590000 2.48535711 G03DC05 TIBOLONUM LADYBON COMPR. 2,5mg ZENTIVA A.S. CEHIA CUTIE X 1 BLIST. DIN AL-PVDC/PVC X 28 COMPR. P-RF 28 52.87 58.490000 2.08892812 G03DC05 TIBOLONUM LADYBON COMPR. 2,5mg ZENTIVA A.S. CEHIA CUTIE X 3 BLIST. DIN AL-PVDC/PVC X 28 COMPR. P-RF 84 141.56 156.620000 1.86452313 G03FA15 ESTRADIOLUMVALERAT+DIENOGEST KLIMODIEN DRAJ. FARA CONCENTRATIE BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 BLIST. X 28 DRAJ. P-RF 1 27.91 30.880000 30.880000

14 H01AB01 TIREOTROPINUM ALFA THYROGEN 0,9 mg PULB. PT. SOL. INJ. 0,9mg GENZYME EUROPE BV OLANDA CUTIE X 2 FLACOANE S 2 2,879.74 3177.070000 1588.535000

15 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 22.66 30.630000 0.61260016 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 20.59 27.830000 1.39150017 H02AB04 METHYLPREDNISOLONUM MEDROL 4 mg COMPR. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA X 30 COMPR. P-RF 30 4.54 6.130000 0.20433318 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 6.11 8.260000 8.26000019 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 40 mg LIOF. PT. SOL. INJ. 40mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 15 FLAC. LIOF. + 15 FIOLE SOLV. X 1 ML S/P-RF 15 48.80 63.830000 4.25533320 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 21.54 29.120000 29.120000

21 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIO P-RF 1 14.21 19.210000 19.210000

22 H03AA01 LEVOTHYROXINUM EUTHYROX (R) 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 7.97 8.820000 0.08820023 H03AA01 LEVOTHYROXINUM L-THYROXIN 100 BERLIN - CHEMIE COMPR. 100mcg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-6L 100 8.51 9.420000 0.09420024 H03AA01 LEVOTHYROXINUM EUTHYROX (R) 200 COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-6L 100 16.49 18.240000 0.18240025 H03AA01 LEVOTHYROXINUM EUTHYROX (R) 25 COMPR. 25mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 6.45 7.140000 0.07140026 H03AA01 LEVOTHYROXINUM EUTHYROX (R) 50 COMPR. 50mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 5.65 6.250000 0.06250027 H03AA01 LEVOTHYROXINUM L-THYROXIN 50 COMPR. 50mcg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-6L/S 100 5.73 6.340000 0.06340028 H03AAN1 LEVOTIROXINUM+KALII IODIDUM JODTHYROX (R) 100/130,8 COMPR. FARA CONCENTRATIE MERCK KGAA GERMANIA CUTIE X 2 BLIST. PP/AL X 25 COMPR. P-6L 50 10.08 11.150000 0.22300029 H03BB01 CARBIMAZOLUM CARBIMAZOLE 5 COMPR. FILM. 5mg REMEDICA LTD. CIPRU CUTIE X 10 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 100 11.52 12.740000 0.12740030 H03BB02 THIAMAZOLUM THYROZOL (R) 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 5 BLIST. X 10 COMPR. FILM. P-6L 50 14.79 16.360000 0.32720031 H03BB02 THIAMAZOLUM THYROZOL (R) 20 mg COMPR. FILM. 20mg MERCK KGAA GERMANIA CUTIE X 5 BLIST. X 10 COMPR. FILM. P-6L 50 17.43 19.280000 0.38560032 H03BB02 THIAMAZOLUM THYROZOL (R) 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L/S 100 21.06 23.300000 0.23300033 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-RF 100 8.82 9.760000 0.09760034 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-RF 100 8.82 9.760000 0.09760035 H03CA01 KALII IODIDUM JODID 200 COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-RF 100 14.52 16.060000 0.16060036 H03CA01 KALII IODIDUM JODID 200 COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-RF 100 14.52 16.060000 0.16060037 H05AA02 TERIPARATIDUM** FORSTEO 20mcg/80mcg SOL. INJ. 20mcg/80mcg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 3 ML (28 DOZE X 20 MCG/80MCL) P-RF 1 1,385.52 1548.370000 1548.370000

38 H05BA01 CALCITONINUM (SOMON) TONOCALCIN 100 UI SOL. INJ. 100UI ALFA WASSERMANN SPA ITALIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. P-RF 5 50.43 63.770000 12.754000

39 H05BA01 CALCITONINUM (SOMON) NYLEX (R) SOL. INJ. 100UI/ml PROEL E.P. CORONIS SA GRECIA CUTIE X 5 FIOLE X 1ML P-RF 5 22.09 24.440000 4.88800040 H05BA01 CALCITONINUM (SOMON) MIACALCIC (R) SOL. INJ. 50ui/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML P-RF 5 24.74 33.440000 6.68800041 H05BA01 CALCITONINUM (SOMON) NYLEX 100 UI/doza SPRAY NAZ.,SOL. 100UI/doza PHARMACEUTICAL IND. PROEL EPAM. G.CORONIS SA GRECIA CUTIE X 1 FLACON PREVAZUT CU POMPA DOZATOARE X 2 ML SPRAY NAZAL, SOL. P-RF 1 34.10 37.730000 37.730000

42 H05BA01 CALCITONINUM (SOMON) NYLEX (R) SPRAY NAZAL - SOL. 200UI/doza PROEL E.P. CORONIS SA GRECIA CUTIE X 1 FLACON DIN STICLA PREVAZUT CU POMPA DOZATOARE CU APLICATOR NAZAL X 2 ML P-RF 1 52.94 58.570000 58.570000

P7: PROGRAM NATIONAL DE BOLI ENDOCRINE

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

Pagina 27 din 52

Page 125: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

43 M05BA04 ACIDUM ALENDRONICUM** TEVA NAT COMPR. 70 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-AL-OPA/AL X 4 COMPR. P-6L 4 34.65 45.320000 11.330000

44 M05BA04 ACIDUM ALENDRONICUM** FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. AL/AL IN PORTOFEL X 2 COMPR. P-6L 2 26.65 34.860000 17.430000

45 M05BA06 ACIDUM IBANDRONICUM** BONVIVA 150mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 COMPR. FILM.( BLIST. AL/AL) P-6L 1 99.47 125.770000 125.770000

46 M05BA06 ACIDUM IBANDRONICUM** BONVIVA 150mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 3 COMPR. FILM.( BLIST. AL/AL) P-6L 3 307.51 373.340000 124.446666

47 M05BA06 ACIDUM IBANDRONICUM** BONVIVA 3mg/3ml SOL. INJ. IN SERINGA PREUMPLUTA 1mg/1ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA DIN STICLA X 3 ML SOL. INJ. + 1 AC P-6L 1 334.71 402.980000 402.980000

48 M05BA07 ACIDUM RISEDRONICUM** RISENDROS 35 mg COMPR. FILM. 35mg ZENTIVA A.S. CEHIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 4 COMPR. FILM. P-6L 4 88.57 97.990000 24.497500

49 M05BA07 ACIDUM RISEDRONICUM** ACTONEL (R) SAPTAMANAL COMPR. FILM. 35mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. X 4 COMPR. FILM. P-6L 4 106.00 117.270000 29.317500

50 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. S 1 1,033.24 1164.380000 1164.380000

51 M05BA08 ACIDUM ZOLEDRONICUM** ACLASTA 5mg/100ml SOL. PERF. 5mg/100ml NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 100 ML + 1 CAPAC AL/PP CU COMPONENTA FLIP. S 1 1,316.11 1472.710000 1472.710000

52 M05BB03

COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)** FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UI MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.) P-6L 4 68.72 76.030000 19.007500

53 M05BB03

COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)** FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UI MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 2 COMPR. (1 PLIANT CU BLIST. AL/AL X 2 COMPR.) P-6L 2 34.37 38.020000 19.010000

54 M05BB03

COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)** FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UI MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 2 COMPR. (1 PLIANT CU BLIST. AL/AL X 2 COMPR.) P-6L 2 34.37 38.020000 19.010000

55 M05BB03

COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)** FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UI MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.) P-6L 4 68.72 76.030000 19.007500

56 M05BX03 STRONTIUM RANELATUM OSSEOR 2 g GRAN. PT. SUSP. ORALA 2g LES LAB. SERVIER FRANTA CUTIE X 14 PLICURI HARTI-PE-AL/PE GRAN. PT. SUSP. ORALA P-RF 14 78.40 86.740000 6.19571457 M05BX03 STRONTIUM RANELATUM OSSEOR 2 g GRAN. PT. SUSP. ORALA 2g LES LAB. SERVIER FRANTA CUTIE X 28 PLICURI HARTI-PE-AL/PE GRAN. PT. SUSP. ORALA P-RF 28 134.29 163.940000 5.855000

1 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 12.99 14.370000 1.4370002 A04AA01 ONDANSETRONUM** ZOFRAN 4 mg COMPR. FILM. 4mg GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/AL X 5 COMPR. FILM. P-RF 10 49.27 64.450000 6.4450003 A04AA01 ONDANSETRONUM** SETRONON 4 mg COMPR. FILM. 4mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 13.40 14.820000 1.4820004 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 22.73 25.150000 2.5150005 A04AA01 ONDANSETRONUM** SETRONON 8 mg COMPR. FILM. 8mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR.FILM. P-RF 10 23.25 25.720000 2.5720006 A04AA01 ONDANSETRONUM** ONDARAN MD 4mg COMPR. ORODISPERSABILE 4mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 1 FOLIE DIN POLIAMIDA/AL/PVC X 10 COMPR. ORODISPERSABILE P-RF 10 13.08 14.470000 1.4470007 A04AA01 ONDANSETRONUM** ONDARAN MD 4mg COMPR. ORODISPERSABILE 4mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 1 FOLIE DIN AL/PE X 10 COMPR. ORODISPERSABILE P-RF 10 13.08 14.470000 1.4470008 A04AA01 ONDANSETRONUM** ONDARAN MD 8 mg COMPR. ORODISPERSABILE 8mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FOLE PA/AL/PVC X 10 COMPR. ORODISPERSABILE P-RF 10 22.90 25.330000 2.5330009 A04AA01 ONDANSETRONUM** OSETRON 4 mg 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 16.24 17.970000 3.594000

10 A04AA01 ONDANSETRONUM** OSETRON 8 mg 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 30.86 34.140000 6.82800011 A04AA01 ONDANSETRONUM** ZOFRAN 4mg/2ml SOL. INJ. 4mg/2ml GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 97.31 107.660000 21.532000

12 A04AA01 ONDANSETRONUM** ZOFRAN 8mg/4ml SOL. INJ. 8mg/4ml GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 5 FIOLE DIN STICLA INCOLORA X 4 ML SOL. INJ. S/P-RF 5 137.88 152.540000 30.508000

13 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 30.86 34.140000 6.82800014 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 16.24 17.970000 3.59400015 A04AA01 ONDANSETRONUM** SETRONON 4 mg/2 ml SOL. INJ./PERF. 4mg/2ml PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 2 ML SOL INJ/PERF. S/P-RF 5 16.08 17.790000 3.55800016 A04AA01 ONDANSETRONUM** SETRONON 8 mg/4 ml SOL. INJ./PERF. 8mg/4 ml PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 4 ML SOL.INJ./PERF. S/P-RF 5 31.32 34.650000 6.93000017 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P-6L/S 100 92.38 102.200000 1.02200018 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 55.28 61.160000 1.22320019 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 50.17 55.510000 1.11020020 B01AB08 REVIPARINUM CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 68.14 75.390000 7.539000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.1: TRANSPLANT MEDULAR

Pagina 28 din 52

Page 126: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

21 B01AB08 REVIPARINUM CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 77.24 85.450000 17.090000

22 B03XA01 EPOETINUM ALFA EPREX (R) 10000 UI SOL. INJ. 10000ui/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 1 ML S/P-RF 6 2,001.56 2219.850000 369.975000

23 B03XA01 EPOETINUM ALFA EPREX (R) 1000 UI SOL. INJ. 1000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 203.17 248.030000 41.338333

24 B03XA01 EPOETINUM ALFA EPOPHAR 2000 U.I. SOL. INJ. 2000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 259.84 287.470000 28.747000

25 B03XA01 EPOETINUM ALFA EPREX (R) 2000 UI SOL. INJ. 2000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 429.91 506.750000 84.458333

26 B03XA01 EPOETINUM ALFA EPREX (R) 3000 UI SOL. INJ. 3000ui/0,3ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,3 ML S/P-RF 6 622.80 717.000000 119.500000

27 B03XA01 EPOETINUM ALFA EPREX (R) 40 000 UI SOL. INJ. 40 000UI JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 1 ML S/P-RF 1 1,254.00 1405.010000 1405.010000

28 B03XA01 EPOETINUM ALFA EPOPHAR 4000 U.I. SOL. INJ. 4000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 519.68 574.950000 57.495000

29 B03XA01 EPOETINUM ALFA EPREX (R) 4000 UI SOL. INJ. 4000ui/0,4ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,4 ML S/P-RF 6 818.39 930.200000 155.033333

30 B03XA01 EPOETINUM ALFA BINOCRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1,458.00 1627.370000 271.228333

31 B03XA01 EPOETINUM ALFA ABSEAMED 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1,552.96 1730.880000 288.480000

32 B03XA01 EPOETINUM ALFA BINOCRIT 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 167.99 205.080000 34.180000

33 B03XA01 EPOETINUM ALFA ABSEAMED 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,5ML SOL. INJ S/P-RF/R 6 187.93 207.920000 34.653333

34 B03XA01 EPOETINUM ALFA BINOCRIT 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 335.80 404.170000 67.361666

35 B03XA01 EPOETINUM ALFA ABSEAMED 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 377.00 417.090000 69.515000

36 B03XA01 EPOETINUM ALFA BINOCRIT 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 489.04 571.200000 95.200000

37 B03XA01 EPOETINUM ALFA ABSEAMED 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,3ML SOL. INJ. S/P-RF/R 6 531.68 617.680000 102.946666

38 B03XA01 EPOETINUM ALFA BINOCRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 642.24 738.190000 123.031666

39 B03XA01 EPOETINUM ALFA ABSEAMED 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 694.28 794.920000 132.486666

40 B03XA01 EPOETINUM ALFA BINOCRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 795.40 905.140000 150.856666

41 B03XA01 EPOETINUM ALFA ABSEAMED 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 866.40 982.530000 163.755000

42 B03XA01 EPOETINUM ALFA ABSEAMED 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML SOL. INJ. S/P-RF/R 6 1,033.71 1164.900000 194.150000

43 B03XA01 EPOETINUM ALFA ABSEAMED 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,8ML SOL. INJ. S/P-RF/R 6 1,368.32 1529.620000 254.936666

44 B03XA01 EPOETINUM BETA NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 1,990.40 2207.690000 367.948333

45 B03XA01 EPOETINUM BETA NEORECORMON 1000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 215.29 262.830000 43.805000

46 B03XA01 EPOETINUM BETA NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 447.61 495.210000 82.535000

47 B03XA01 EPOETINUM BETA NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 980.76 1107.180000 1107.180000

48 B03XA01 EPOETINUM BETA NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 814.08 925.500000 154.250000

49 B03XA01 EPOETINUM BETA NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 1,009.84 1138.880000 189.813333

50 B03XA01 EPOETINUM BETA NEORECORMON 500UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 500UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. + 6 ACE S/P-RF/R 6 110.71 135.150000 22.525000

51 J01CR03

TICARCILLINUM + ACIDUM CLAVULANICUM TIMENTIN 3,2 g PULB. PT. SOL. INJ./PERF. 3,2g BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S/P-RF 10 199.64 243.720000 24.372000

52 J01CR05PIPERACILLINUM + TAZOBACTAMUM TAZOCIN 4,5 LIOF. PT. SOL. INJ. FARA CONCENTRATIE WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 12 FLAC. CU LIOF. PT. SOL. INJ. S/P-RF 12 652.44 749.310000 62.442500

53 J01CR05PIPERACILLINUM + TAZOBACTAMUM TAZOCIN 2,25 LIOF. PT. SOL. INJ. FARA CONCENTRATIE WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 12 FLAC. CU LIOF. PT. SOL. INJ. S/P-RF 12 378.48 450.690000 37.557500

54 J01DH02 MEROPENEMUM MERONEM IV 1 g PULB. PT. SOL. INJ. I.V./PERF. 1g ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 10 FLAC. PULB. PT. SOL. INJ. (CAP. 20 ML) S 10 969.60 1095.010000 109.501000

55 J01DH02 MEROPENEMUM MERONEM IV 500 mg PULB. PT. SOL. INJ. I.V./PERF. 500mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 10 FLAC. PULB. PT. SOL. INJ. (CAP. 20 ML) S 10 508.50 592.420000 59.242000

56 J01DH51 IMIPENEMUM + CILASTATINUM TIENAM I.V. PULB. PT. SOL. PERF. 500mg/500mg MERCK SHARP & DOHME ROMANIA TAVA DIN PLASTIC X 10 FLAC. DIN STICLA INCOLORA CU PULB.PT. SOL. PERF. S/P-RF 10 420.10 496.060000 49.606000

57 J01DH51 IMIPENEMUM + CILASTATINUM TIENAM I.V. PULB. PT. SOL. PERF. 500mg/500mg MERCK SHARP & DOHME ROMANIA TAVA DIN PLASTIC X 25 FLAC. DIN STICLA INCOLORA CU PULB.PT. SOL. PERF. S/P-RF 25 1,005.25 1133.870000 45.354800

58 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 44.80 49.560000 49.560000

59 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 22.40 24.780000 24.780000

60 J01XA01 VANCOMYCINUM EDICIN LIOF. PT. SOL. PERF./INJ. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 500 MG LIOF. PT. SOL. PERF./INJ. S/P-RF 1 36.25 40.100000 40.100000

61 J01XA01 VANCOMYCINUM EDICIN PULB.LIOF.PT.SOL.PERF./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 53.42 67.540000 67.540000

62 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 1 110.96 135.460000 135.460000

63 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1,507.24 1681.040000 168.104000

Pagina 29 din 52

Page 127: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

64 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml 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 1 827.52 940.150000 940.150000

65 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1,507.24 1681.040000 168.104000

66 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 185.14 204.830000 7.31535767 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 16.77 18.550000 4.63750068 J02AC01 FLUCONAZOLUM FLUCORIC 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 31.12 40.710000 5.81571469 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 61.37 67.900000 4.24375070 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 6.45 7.140000 3.57000071 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 21.50 23.790000 3.39857172 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 17.54 19.400000 19.400000

73 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 58.38 73.820000 18.455000

74 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 2 BLIST. AL/PVC X 1 CAPS. P-RF 2 36.43 40.300000 20.150000

75 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 6.51 7.200000 7.20000076 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 19.61 21.700000 21.700000

77 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 13.88 15.360000 15.360000

78 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10.12 13.680000 13.680000

79 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 6.90 9.320000 9.32000080 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 6.03 6.670000 6.67000081 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 3 CAPS. P-RF 3 22.23 30.050000 10.016666

82 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 11.24 12.440000 12.440000

83 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 4.70 5.200000 5.20000084 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6.35 7.020000 7.02000085 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5.92 6.550000 6.55000086 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5.60 6.200000 6.20000087 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 4.32 4.780000 4.78000088 J02AC01 FLUCONAZOLUM FLUCONAZOL LAROPHARM 150 mg CAPS. 150mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 6.03 6.670000 6.67000089 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDICO UNO 150 mg CAPS. 150mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 5.92 6.550000 6.55000090 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 27.78 30.730000 4.39000091 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 38.26 42.330000 6.04714292 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 14.79 16.360000 2.33714293 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 40.58 53.080000 7.58285794 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 20.57 27.800000 3.97142895 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 29.57 32.710000 4.67285796 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 15.92 17.610000 2.51571497 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 12.99 14.370000 1.79625098 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 16.72 18.500000 1.85000099 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 11.38 12.590000 1.798571

100 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.90 14.270000 2.038571101 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.82 14.180000 2.025714102 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.53 13.860000 1.980000103 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 11.02 12.190000 1.741428104 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 10.33 11.430000 1.632857105 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 40.58 53.080000 53.080000

106 J02AC01 FLUCONAZOLUM DIFLUCAN (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S/P-RF 1 127.32 140.860000 140.860000

107 J02AC01 FLUCONAZOLUM DIFLUCAN (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S/P-RF 1 28.58 31.620000 31.620000

108 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 32.90 43.030000 43.030000

109 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 50 ML SOL. PERF. S 1 28.18 31.180000 31.180000

Pagina 30 din 52

Page 128: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

110 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 100 ML SOL. PERF. S 1 39.34 43.520000 43.520000

111 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 200 ML SOL. PERF. S 1 131.40 145.370000 145.370000

112 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 2mg/ml SOL. PERF. 2mg/ml LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 35.97 39.790000 39.790000

113 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3,343.84 3682.940000 131.533571

114 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 858.25 973.640000 34.772857

115 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 431.95 508.980000 508.980000

116 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 P-RF 1 2,070.87 2295.400000 2295.400000

117 J02AC04 POSACONAZOLUM** NOXAFIL SP 40mg/ml SUSP. ORALA 40mg/ml SP EUROPE BELGIA CUTIE X 1 FLAC. X 105ML SUSP. ORALA P-RF/R 1 2,537.47 2804.000000 2804.000000

118 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 1,130.84 1270.770000 1270.770000

119 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 1,466.75 1636.910000 1636.910000

120 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 13.25 14.660000 0.733000121 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14.03 15.520000 0.776000122 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 680.47 752.840000 0.752840123 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 12.75 14.110000 1.411000124 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 8.51 9.410000 0.470500125 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 11.27 12.470000 0.623500126 J05AB01 ACICLOVIRUM CLOVIRAL 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 10.77 11.910000 0.595500127 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 9.41 10.410000 0.520500128 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 13.12 14.520000 1.452000129 J05AB01 ACICLOVIRUM ACICLOVIR OZONE 200 mg COMPR. DISP. 200mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. DISP. P-RF 20 4.94 5.460000 0.273000130 J05AB01 ACICLOVIRUM LOVIR 200 mg COMPR. DISP. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 10 COMPR. DISP. P-RF 10 2.56 2.830000 0.283000131 J05AB01 ACICLOVIRUM ACIKLOVIR COMPR. FILM. 400mg A & G MED TRADING S.R.L. ROMANIA CUTIE X 7 BLIST. AL/PVC X 5 COMPR. FILM. P-RF 35 40.32 44.610000 1.274571132 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 5 217.64 265.700000 53.140000

133 J05AB11 VALACYCLOVIRUM VALTREX 500 mg COMPR. FILM. 500mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 75.18 83.170000 8.317000134 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4,568.11 5017.400000 83.623333

135 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 18.15 24.530000 0.490600136 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 10.40 11.510000 11.510000

137 L01AA03 MELPHALANUM ALKERAN 2 mg COMPR. FILM. 2mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 25 COMPR. FILM. P-RF 25 6.36 7.040000 0.281600138 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 87.00 110.000000 110.000000

139 L01AB01 BUSULFANUM MYLERAN COMPR. FILM. 2mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 25 COMPR. FILM. P-RF 25 10.90 14.730000 0.589200140 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 500 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 5 ML S 5 188.83 208.910000 41.782000

141 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 74.77 82.720000 82.720000

142 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 1 312.66 378.950000 378.950000

143 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5 mg SOL. INJ. 5mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE X 1 ML S 10 16.26 17.990000 1.799000144 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 50 mg SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 9.09 10.060000 10.060000

145 L01BB05 FLUDARABINUM FLUDARA ORAL 10 mg COMPR. FILM. 10mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 FLAC. DIN PE X 4 BLIST. AL/AL X 5 COMPR. FILM. P-RF/S 20 1,579.47 1759.770000 87.988500

146 L01BB05 FLUDARABINUM FLUDARA LIOF. PT. SOL. INJ./PERF. 50mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 5 FLAC. CU LIOF. PT. SOL. INJ./PERF. S 5 2,270.00 2512.450000 502.490000

147 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 100mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 1 BLIST. PVC/A0-PVC-PVDC X 10 CAPS. P-RF 10 297.68 329.340000 32.934000

148 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 50mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 2 BLIST. PVC/AL-PVC-PVDC X 10 CAPS. P-RF 20 295.01 326.390000 16.319500

149 L01CB01 ETOPOSIDUM ETOPOSID "EBEWE" 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 37.46 41.440000 41.440000

150 L01CB01 ETOPOSIDUM SINTOPOZID 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 29.07 32.160000 32.160000

151 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 29.48 32.610000 32.610000

152 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 50.04 55.360000 55.360000

153 L01DB06 IDARUBICINUM ZAVEDOS CAPS. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 190.92 233.070000 233.070000

154 L01DB06 IDARUBICINUM ZAVEDOS 5 mg LIOF. PT. SOL. INJ. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. S 1 134.59 164.310000 164.310000

155 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 1 523.40 608.660000 608.660000

Pagina 31 din 52

Page 129: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

156 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 10 mg/20 ml CONC. PT. SOL. PERF. 10mg/20ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 20 ML CONC. PT. SOL. PERF. S 1 8.47 9.370000 9.370000157 L01XA01 CISPLATINUM CISPLATIN TEVA 10 mg/20 ml CONC. PT. SOL. PERF. 10mg/20ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 20 ML S 1 8.20 9.070000 9.070000158 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 21.61 23.910000 23.910000

159 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 6.86 7.590000 7.590000160 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 25 mg/50 ml CONC. PT. SOL. PERF. 25mg/50ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML COND. PT. SOL. PERF. S 1 20.34 22.500000 22.500000

161 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 50 mg/100 ml CONC. PT. SOL. PERF. 50mg/100ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 100 ML CONC. PT. SOL. PERF. S 1 29.12 32.220000 32.220000

162 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 45 ML CONC. PT. SOL. PERF. S 1 170.24 188.350000 188.350000

163 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 5 ML CONC. PT. SOL. PERF. S 1 20.16 22.300000 22.300000

164 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 15 ML CONC. PT. SOL. PERF. S 1 57.08 63.150000 63.150000

165 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 43.77 48.420000 48.420000

166 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 1 126.97 140.470000 140.470000

167 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 15.98 17.680000 17.680000

168 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 44.28 48.990000 48.990000

169 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 1 122.08 135.060000 135.060000

170 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 2,087.80 2313.850000 1156.925000

171 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 5,174.64 5678.510000 5678.510000

172 L01XC04 ALEMTUZUMABUM** MABCAMPATH 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml GENZYME EUROPE BV OLANDA CUTIE X 3 FIOLE X 3 ML CONCENTRAT INTR-O FIOLA DE 5ML S 3 4,624.59 5078.960000 1692.986666

173 L01XC04 ALEMTUZUMABUM** MABCAMPATH 30 mg/ml CONC. PT. SOL. PERF. 30mg/ml GENZYME EUROPE BV OLANDA CUTIE X 3 FLACOANE X 1 ML CONCENTRAT INTR-UN FLACON DE 2ML S 3 4,624.96 5079.360000 1693.120000

174 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 250.75 306.120000 306.120000

175 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 411.76 486.970000 486.970000

176 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 427.05 503.630000 5.036300177 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 427.05 503.630000 10.072600

178 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 525.44 610.880000 5.090666179 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 980.15 1106.520000 9.221000180 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 COMPR. P-RF/R 100 283.85 346.530000 3.465300181 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg CAPS. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. P-RF/R 50 283.85 346.530000 6.930600182 L04AA08 DACLIZUMABUM** ZENAPAX (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLACON X 5 ML S 1 1,166.85 1310.020000 1310.020000

183 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR) P-RF/R 30 461.26 540.920000 18.030666

184 L04AB01 ETANERCEPTUM** ENBREL 50 mg PULB+SOLV.PT.SOL.INJ 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. PULB. PT. SOL. INJ. + 4 SERINGI PREUMPLUTE CU SOLVENT + 4 ADAPTOARE PT. FLAC. + 8 TA P-RF/R 4 3,901.99 4291.330000 1072.832500

185 L04AB01 ETANERCEPTUM** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 TAMPOANE CU ALCOOL P-RF/R 4 1,928.91 2140.660000 535.165000

186 L04AB01 ETANERCEPTUM** ENBREL DE UZ PEDIATRIC PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 SERINGI DIN PLASTIC GOALE + 20 ACE + 24 TAMPOANE P-RF/R 4 1,924.44 2135.790000 533.947500

187 L04AB01 ETANERCEPTUM** ENBREL 25mg SOL. INJ. IN SERINGA PREUMPLUTA 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 1,924.44 2135.790000 533.947500

188 L04AB01 ETANERCEPTUM** ENBREL 50mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 3,818.88 4200.730000 1050.182500

189 L04AD02 CICLOSPORINUM EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 374.97 446.870000 8.937400190 L04AD02 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 107.54 131.290000 2.625800191 L04AD02 CICLOSPORINUM EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 69.90 88.380000 1.767600192 L04AD02 CICLOSPORINUM CICLORAL 25 mg CAPS. MOI 25mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 107.65 119.100000 2.382000193 L04AD02 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 224.70 274.320000 5.486400194 L04AD02 CICLOSPORINUM EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 146.06 178.310000 3.566200195 L04AD02 CICLOSPORINUM CICLORAL 50 mg CAPS. MOI 50mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 239.01 264.430000 5.288600196 L04AD02 CICLOSPORINUM EQUORAL (R) SOL. ORALA 100mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON DIN STICLA BRUNA X 50 ML, UN DISPOZITIV DE MASURAT + UN CAPAC CU FILET S/P-RF 1 338.00 406.570000 406.570000

197 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 50 192.85 235.430000 4.708600198 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 50 343.36 412.410000 8.248200199 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 1,612.32 1795.580000 35.911600

200 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 192.41 234.900000 4.698000201 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 379.80 452.130000 9.042600

Pagina 32 din 52

Page 130: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

202 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 1,753.56 1949.530000 38.990600

203 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 1,452.71 1621.610000 162.161000

204 N02AX02 TRAMADOLUM TRAMAL (R) CAPS. 50mg GRUNENTHAL GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 8.22 9.090000 0.454500205 N02AX02 TRAMADOLUM TRALGIT 50 CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5.82 6.440000 0.322000206 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4.06 5.490000 0.274500207 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. X 10 CAPS. P-RF 30 9.07 12.260000 0.408666208 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. X 10 CAPS. P-RF/S 50 15.83 21.390000 0.427800209 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. X 10 CAPS. P-RF/S 100 31.64 41.390000 0.413900210 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 2.83 3.820000 0.382000211 N02AX02 TRAMADOLUM MABRON 50 mg CAPS. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3.41 3.770000 0.377000212 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5.33 7.210000 0.360500213 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 4.24 4.690000 0.469000214 N02AX02 TRAMADOLUM TRAMADOL LPH 50 mg CAPS. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 8.83 9.770000 0.488500215 N02AX02 TRAMADOLUM URGENDOL CAPS. 50mg MEDICAROM GROUP SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 3.57 3.950000 0.395000216 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5.88 6.510000 0.325500217 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6.45 7.140000 0.357000218 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7.77 8.600000 0.430000219 N02AX02 TRAMADOLUM TRAMADOL 50 mg COMPR. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6.92 7.660000 0.383000220 N02AX02 TRAMADOLUM TRAMADOLOR (R) 100 ID COMPR. ELIB. MODIF. 100mg HEXAL AG GERMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. MODIF. P-RF 10 5.22 7.060000 0.706000221 N02AX02 TRAMADOLUM TRAMADOL (R) RETARD COMPR. ELIB. PREL. 100mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. X 10 COMPR. ELIB. PREL. P-RF 30 13.15 17.770000 0.592333222 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 50 34.18 37.820000 0.756400223 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 10 6.94 7.680000 0.768000224 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 20.52 22.700000 0.756666225 N02AX02 TRAMADOLUM NOAX UNO 100 mg COMPR. ELIB. PREL. 100mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 5 COMPR.ELIM.PREL. P-RF 5 5.60 6.200000 1.240000226 N02AX02 TRAMADOLUM NOAX UNO 100 mg COMPR. ELIB. PREL. 100mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.ELIM.PREL. P-RF 30 28.23 31.230000 1.041000227 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 23.31 31.510000 1.050333228 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 10 14.88 16.460000 1.646000229 N02AX02 TRAMADOLUM TRALGIT SR 200 COMPR. ELIB. PREL. 200mg ZENTIVA AS SLOVACIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 10 18.77 20.770000 2.077000230 N02AX02 TRAMADOLUM NOAX UNO 200 mg COMPR. ELIB. PREL. 200mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 10 COMPR.ELIB. PREL. P-RF 10 13.95 18.860000 1.886000231 N02AX02 TRAMADOLUM NOAX UNO 200 mg COMPR. ELIB. PREL. 200mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.ELIB. PREL. P-RF 30 37.21 48.670000 1.622333232 N02AX02 TRAMADOLUM NOAX UNO 300 mg COMPR. ELIB. PREL. 300mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. X PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P-RF 10 19.40 26.220000 2.622000233 N02AX02 TRAMADOLUM NOAX UNO 300 mg COMPR. ELIB. PREL. 300mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST. X PVC-PE-ACLAR/AL X 10 COMPR. ELIB. PREL. P-RF 30 56.79 71.800000 2.393333234 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 7.38 9.980000 0.332666235 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. FILM. ELIB. PREL. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. AL/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-RF 10 10.39 11.500000 1.150000236 N02AX02 TRAMADOLUM TRAMUNDIN RETARD 100 mg COMPR. FILM. ELIB. PREL. 100mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.ELIM. PREL. P-RF 30 25.53 28.250000 0.941666237 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 14.84 16.420000 1.642000238 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 46.32 51.250000 1.708333239 N02AX02 TRAMADOLUM TRAMAL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. ELIB. PREL. P-RF 10 19.29 21.340000 2.134000240 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 57.21 63.290000 2.109666241 N02AX02 TRAMADOLUM TRALGIT PIC. ORALE, SOL. 100mg/ml ZENTIVA A.S. SLOVACIA CUTIE X 1 FLACON DIN STICLA BRUNA X 96 ML PIC. ORALE, SOL. P-RF 1 74.59 82.520000 82.520000

242 N02AX02 TRAMADOLUM TRALGIT PIC. ORALE, SOL. 100mg/ml ZENTIVA A.S. SLOVACIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-RF 1 8.60 9.520000 9.520000243 N02AX02 TRAMADOLUM TRAMADOL AL PICATURI PIC. ORALE, SOL. FARA CONCENTRATIE ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-RF 1 4.47 6.040000 6.040000244 N02AX02 TRAMADOLUM TRAMADOL AL PICATURI PIC. ORALE, SOL. FARA CONCENTRATIE ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL. P-RF 1 9.62 13.000000 13.000000

245 N02AX02 TRAMADOLUM TRAMAL (R) PICATURI ORALE-SOL. 100mg/ml GRUNENTHAL GMBH GERMANIA CUTIE X 1 FLACON PICURATOR X 10 ML P-RF 1 5.38 7.270000 7.270000246 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 100 105.37 116.580000 1.165800247 N02AX02 TRAMADOLUM TRALGIT 100 SOL. INJ. 100mg/2ml ZENTIVA A.S. SLOVACIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 8.38 9.270000 1.854000

Pagina 33 din 52

Page 131: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

248 N02AX02 TRAMADOLUM TRAMAL (R) 50 SOL. INJ. 50mg/ml GRUNENTHAL GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 6.17 6.830000 1.366000249 N02AX02 TRAMADOLUM TRAMAL (R) 100 SOL. INJ. 50mg/ml GRUNENTHAL GMBH GERMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 8.42 9.310000 1.862000250 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 8.93 9.880000 1.976000251 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 7.31 8.090000 1.618000252 N02AX02 TRAMADOLUM TRAMADOL (R) AL 100 Fiole SOL. INJ. 50mg/ml ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 FIOLE X 2 ML S/P-RF 10 13.36 18.060000 1.806000253 N02AX02 TRAMADOLUM TRAMADOL (R) AL 100 Fiole SOL. INJ. 50mg/ml ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 6.70 9.060000 1.812000254 N02AX02 TRAMADOLUM TRALGIT 50 SOL. INJ. 50mg/ml ZENTIVA A.S. SLOVACIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S/P-RF 5 7.84 8.670000 1.734000255 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 5.36 5.930000 1.186000256 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 7.31 8.090000 1.618000257 N02AX02 TRAMADOLUM TRAMAL (R) SUPOZ. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 FOLIE PP/AL/PE X 5 SUPOZ. P-RF 5 6.46 7.150000 1.430000258 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 5 SUPOZ. P-RF 5 3.88 5.240000 1.048000259 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 6 519.76 604.690000 100.781666

260 V03AC03 DEFERASIROXUM** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL) P-RF/R 28 647.40 743.820000 26.565000

261 V03AC03 DEFERASIROXUM** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 84 COMPR. DISP. (BLIST. PVC/PE/PVDC/AL) P-RF/R 84 1,882.20 2089.750000 24.877976

262 V03AC03 DEFERASIROXUM** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 84 COMPR. DISP. ( PVC/PE/PVDC/AL) P-RF/R 84 4,061.99 4465.730000 53.163452

263 V03AC03 DEFERASIROXUM** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) P-RF/R 28 1,374.00 1535.810000 54.850357

264 V03AC03 DEFERASIROXUM** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 84 COMPR. DISP. ( PVC/PE/PVDC/AL) P-RF/R 84 7,438.79 8146.440000 96.981428

265 V03AC03 DEFERASIROXUM** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) P-RF/R 28 2,499.59 2762.710000 98.668214

266 V03AF01 MESNUM UROMITEXAN (R) 400 mg SOL. INJ. 400mg/4ml BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 3 SUPORTURI TERMOFORMATE DIN PLASTIC X 5 FIOLE DE STICLA INCOLORA X 4 ML S 15 42.13 55.110000 3.674000

267 B02BD08EPTACOG ALFA ACTIVATUM** NOVOSEVEN 1,2 mg (60 KUI) PULB. + SOLV. PT. SOL. INJ. 60 KIU NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLAC. PULB. (NOVOSEVEN) PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE X 1 FLAC. STERIL P-RF/R 1 3,150.73 3485.820000 3485.820000

268 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 50 ML S 1 640.39 708.500000 708.500000

269 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 100 ML S 1 1,182.26 1308.000000 1308.000000

270 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S 1 689.65 763.000000 763.000000

271 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 2,555.21 2826.960000 2826.960000

272 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 1,285.40 1422.100000 1422.100000

273 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 50 ML SOL. PERF. S 1 738.92 817.500000 817.500000

274 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 1,448.27 1602.300000 1602.300000

275 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 200 ML SOL. PERF. S 1 2,807.88 3106.500000 3106.500000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.2: TRANSPLANT DE CORD

Pagina 34 din 52

Page 132: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1 B01AB08 REVIPARINUM CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 68.14 75.390000 7.5390002 B01AB08 REVIPARINUM CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 77.24 85.450000 17.090000

3 C01CA24 EPINEPHRINUM ADRENALINA 1 mg SOL. INJ. 1mg/ml TERAPIA SA ROMANIA CUTIE X 100 FIOLE X 1 ML S 100 56.94 63.000000 0.6300004 J01CR05 PIPERACILLINUM + TAZOBACTAMUM TAZOCIN 4,5 LIOF. PT. SOL. INJ. FARA CONCENTRATIE WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 12 FLAC. CU LIOF. PT. SOL. INJ. S/P-RF 12 652.44 749.310000 62.442500

5 J01CR05 PIPERACILLINUM + TAZOBACTAMUM TAZOCIN 2,25 LIOF. PT. SOL. INJ. FARA CONCENTRATIE WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 12 FLAC. CU LIOF. PT. SOL. INJ. S/P-RF 12 378.48 450.690000 37.557500

6 J01DD12 CEFOPERAZONUM MEDOCEF 1 g PULB. PT. SOL. INJ. 1g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 148.15 163.910000 16.391000

7 J01DD12 CEFOPERAZONUM MEDOCEF 2 g PULB. PT. SOL. INJ. 2g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 246.89 273.150000 27.315000

8 J01DD12 CEFOPERAZONUM LYZONE 2 g PULB. PT. SOL. INJ. 2g MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. S/P-RF 1 18.51 20.480000 20.480000

9 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 3.64 4.920000 4.92000010 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 10.72 11.860000 11.860000

11 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 6.50 7.190000 7.19000012 J01DH51 IMIPENEMUM + CILASTATINUM TIENAM I.V. PULB. PT. SOL. PERF. 500mg/500mg MERCK SHARP & DOHME ROMANIA TAVA DIN PLASTIC X 10 FLAC. DIN STICLA INCOLORA CU PULB.PT. SOL. PERF. S/P-RF 10 420.10 496.060000 49.606000

13 J01DH51 IMIPENEMUM + CILASTATINUM TIENAM I.V. PULB. PT. SOL. PERF. 500mg/500mg MERCK SHARP & DOHME ROMANIA TAVA DIN PLASTIC X 25 FLAC. DIN STICLA INCOLORA CU PULB.PT. SOL. PERF. S/P-RF 25 1,005.25 1133.870000 45.354800

14 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1,507.24 1681.040000 168.104000

15 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml 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 1 827.52 940.150000 940.150000

16 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1,507.24 1681.040000 168.104000

17 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 185.14 204.830000 7.31535718 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 16.77 18.550000 4.63750019 J02AC01 FLUCONAZOLUM FLUCORIC 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 31.12 40.710000 5.81571420 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 61.37 67.900000 4.24375021 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 6.45 7.140000 3.57000022 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 21.50 23.790000 3.39857123 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 17.54 19.400000 19.400000

24 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 58.38 73.820000 18.455000

25 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 2 BLIST. AL/PVC X 1 CAPS. P-RF 2 36.43 40.300000 20.150000

26 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 6.51 7.200000 7.20000027 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 19.61 21.700000 21.700000

28 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 13.88 15.360000 15.360000

29 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10.12 13.680000 13.680000

30 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 6.90 9.320000 9.32000031 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 6.03 6.670000 6.67000032 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 3 CAPS. P-RF 3 22.23 30.050000 10.016666

33 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 11.24 12.440000 12.440000

34 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 4.70 5.200000 5.20000035 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6.35 7.020000 7.02000036 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5.92 6.550000 6.55000037 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5.60 6.200000 6.20000038 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 4.32 4.780000 4.78000039 J02AC01 FLUCONAZOLUM FLUCONAZOL LAROPHARM 150 mg CAPS. 150mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 6.03 6.670000 6.67000040 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDICO UNO 150 mg CAPS. 150mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 5.92 6.550000 6.55000041 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 27.78 30.730000 4.39000042 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 38.26 42.330000 6.04714243 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 14.79 16.360000 2.33714244 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 40.58 53.080000 7.58285745 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 20.57 27.800000 3.97142846 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 29.57 32.710000 4.672857

Pagina 35 din 52

Page 133: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

47 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 15.92 17.610000 2.51571448 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 12.99 14.370000 1.79625049 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 16.72 18.500000 1.85000050 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 11.38 12.590000 1.79857151 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.90 14.270000 2.03857152 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.82 14.180000 2.02571453 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.53 13.860000 1.98000054 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 11.02 12.190000 1.74142855 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 10.33 11.430000 1.63285756 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 40.58 53.080000 53.080000

57 J02AC01 FLUCONAZOLUM DIFLUCAN (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S/P-RF 1 127.32 140.860000 140.860000

58 J02AC01 FLUCONAZOLUM DIFLUCAN (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S/P-RF 1 28.58 31.620000 31.620000

59 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 32.90 43.030000 43.030000

60 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 50 ML SOL. PERF. S 1 28.18 31.180000 31.180000

61 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 100 ML SOL. PERF. S 1 39.34 43.520000 43.520000

62 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 200 ML SOL. PERF. S 1 131.40 145.370000 145.370000

63 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 2mg/ml SOL. PERF. 2mg/ml LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 35.97 39.790000 39.790000

64 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3,343.84 3682.940000 131.533571

65 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 858.25 973.640000 34.772857

66 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 431.95 508.980000 508.980000

67 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 P-RF 1 2,070.87 2295.400000 2295.400000

68 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4,568.11 5017.400000 83.623333

69 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 427.05 503.630000 5.03630070 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 427.05 503.630000 10.072600

71 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 525.44 610.880000 5.09066672 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 980.15 1106.520000 9.22100073 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 COMPR. P-RF/R 100 283.85 346.530000 3.46530074 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg CAPS. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. P-RF/R 50 283.85 346.530000 6.93060075 L04AD02 CICLOSPORINUM EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 374.97 446.870000 8.93740076 L04AD02 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 107.54 131.290000 2.62580077 L04AD02 CICLOSPORINUM EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 69.90 88.380000 1.76760078 L04AD02 CICLOSPORINUM CICLORAL 25 mg CAPS. MOI 25mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 107.65 119.100000 2.38200079 L04AD02 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 224.70 274.320000 5.48640080 L04AD02 CICLOSPORINUM EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 146.06 178.310000 3.56620081 L04AD02 CICLOSPORINUM CICLORAL 50 mg CAPS. MOI 50mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 239.01 264.430000 5.28860082 L04AD02 CICLOSPORINUM EQUORAL (R) SOL. ORALA 100mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON DIN STICLA BRUNA X 50 ML, UN DISPOZITIV DE MASURAT + UN CAPAC CU FILET S/P-RF 1 338.00 406.570000 406.570000

83 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 50 192.85 235.430000 4.70860084 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 50 343.36 412.410000 8.24820085 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 1,612.32 1795.580000 35.911600

86 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 192.41 234.900000 4.69800087 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 379.80 452.130000 9.04260088 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 1,753.56 1949.530000 38.990600

89 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 1,452.71 1621.610000 162.161000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA Pagina 36 din 52

Page 134: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

1 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P-6L/S 100 92.38 102.200000 1.0220002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 55.28 61.160000 1.2232003 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 50.17 55.510000 1.1102004 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. S/P-RF 10 55.13 69.710000 6.9710005 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. S/P-RF 10 113.79 125.890000 12.589000

6 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. S/P-RF 10 144.50 176.410000 17.641000

7 B01AB05 ENOXAPARINUM CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000ui anti-Xa/0,8ml LAB. AVENTIS FRANTA CUTIE X 2 SERINGI PREUMPLUTE X 0,8 ML SOL. INJ. S/P-RF 2 41.62 46.050000 23.025000

8 B01AB08 REVIPARINUM CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 68.14 75.390000 7.5390009 B01AB08 REVIPARINUM CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 77.24 85.450000 17.090000

10 B01AD02 ALTEPLASUM** ACTILYSE LIOF. + SOLV. PT. SOL. INJ. 50mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1 FLACON SOLV. + CANULA DE TRANSFER S 1 1,401.73 1566.040000 1566.040000

11 C03EB01

COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUREX 50 CAPS. 50mg/20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 10.27 11.360000 0.568000

12 H01BA02 DESMOPRESSINUM MINIRIN 0,2 mg COMPR. 0,2mg FERRING AB SUEDIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF 30 156.80 173.480000 5.782666

13 J01CR05PIPERACILLINUM + TAZOBACTAMUM TAZOCIN 4,5 LIOF. PT. SOL. INJ. FARA CONCENTRATIE WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 12 FLAC. CU LIOF. PT. SOL. INJ. S/P-RF 12 652.44 749.310000 62.442500

14 J01CR05PIPERACILLINUM + TAZOBACTAMUM TAZOCIN 2,25 LIOF. PT. SOL. INJ. FARA CONCENTRATIE WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 12 FLAC. CU LIOF. PT. SOL. INJ. S/P-RF 12 378.48 450.690000 37.557500

15 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1,507.24 1681.040000 168.104000

16 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml 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 1 827.52 940.150000 940.150000

17 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1,507.24 1681.040000 168.104000

18 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3,343.84 3682.940000 131.533571

19 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 858.25 973.640000 34.772857

20 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 431.95 508.980000 508.980000

21 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 P-RF 1 2,070.87 2295.400000 2295.400000

22 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 1,130.84 1270.770000 1270.770000

23 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 1,466.75 1636.910000 1636.910000

24 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4,568.11 5017.400000 83.623333

25 L03AA02 FILGRASTIMUM (G-CSF) NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 250.75 306.120000 306.120000

26 L03AA02 FILGRASTIMUM (G-CSF) NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 411.76 486.970000 486.970000

27 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 427.05 503.630000 5.03630028 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 427.05 503.630000 10.072600

29 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 525.44 610.880000 5.09066630 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 980.15 1106.520000 9.22100031 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 COMPR. P-RF/R 100 283.85 346.530000 3.46530032 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg CAPS. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. P-RF/R 50 283.85 346.530000 6.93060033 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR) P-RF/R 30 461.26 540.920000 18.030666

34 L04AD02 CICLOSPORINUM EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 374.97 446.870000 8.93740035 L04AD02 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 107.54 131.290000 2.62580036 L04AD02 CICLOSPORINUM EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 69.90 88.380000 1.76760037 L04AD02 CICLOSPORINUM CICLORAL 25 mg CAPS. MOI 25mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 107.65 119.100000 2.38200038 L04AD02 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 224.70 274.320000 5.48640039 L04AD02 CICLOSPORINUM EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 146.06 178.310000 3.56620040 L04AD02 CICLOSPORINUM CICLORAL 50 mg CAPS. MOI 50mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 239.01 264.430000 5.28860041 L04AD02 CICLOSPORINUM EQUORAL (R) SOL. ORALA 100mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON DIN STICLA BRUNA X 50 ML, UN DISPOZITIV DE MASURAT + UN CAPAC CU FILET S/P-RF 1 338.00 406.570000 406.570000

P9.3: TRANSPLANT HEPATIC

Pagina 37 din 52

Page 135: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

42 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 50 192.85 235.430000 4.70860043 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 50 343.36 412.410000 8.24820044 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 1,612.32 1795.580000 35.911600

45 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 192.41 234.900000 4.69800046 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 379.80 452.130000 9.04260047 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 1,753.56 1949.530000 38.990600

48 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 1,452.71 1621.610000 162.161000

49 B02BD08EPTACOG ALFA ACTIVATUM** NOVOSEVEN 1,2 mg (60 KUI) PULB. + SOLV. PT. SOL. INJ. 60 KIU NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLAC. PULB. (NOVOSEVEN) PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE X 1 FLAC. STERIL P-RF/R 1 3,150.73 3485.820000 3485.820000

1 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P-6L/S 100 92.38 102.200000 1.0220002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 55.28 61.160000 1.2232003 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 50.17 55.510000 1.1102004 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 27.68 30.620000 0.6124005 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 22.77 25.190000 0.8396666 B01AB04 DALTEPARINUM FRAGMIN 10000 UI/ml SOL. INJ. 10000ui/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 SUPORTURI TERMOFORMATATE X 5 FIOLE X 1 ML S/P-RF 10 180.62 199.830000 19.983000

7 B01AB04 DALTEPARINUM FRAGMIN 2500 UI/0,2 ml SOL. INJ. 2500ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,2 ML S/P-RF 10 62.13 68.740000 6.8740008 B01AB04 DALTEPARINUM FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,2 ML S/P-RF 10 122.03 135.010000 13.501000

9 B01AB04 DALTEPARINUM FRAGMIN 7500 UI/0,3 ml SOL. INJ. 7500ui/0,3ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,3 ML S/P-RF 10 159.15 176.080000 17.608000

10 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. S/P-RF 10 55.13 69.710000 6.97100011 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. S/P-RF 10 113.79 125.890000 12.589000

12 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. S/P-RF 10 144.50 176.410000 17.641000

13 B01AB05 ENOXAPARINUM CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000ui anti-Xa/0,8ml LAB. AVENTIS FRANTA CUTIE X 2 SERINGI PREUMPLUTE X 0,8 ML SOL. INJ. S/P-RF 2 41.62 46.050000 23.025000

14 B01AB08 REVIPARINUM CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 68.14 75.390000 7.53900015 B01AB08 REVIPARINUM CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 77.24 85.450000 17.090000

16 B03XA01 EPOETINUM ALFA EPREX (R) 10000 UI SOL. INJ. 10000ui/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 1 ML S/P-RF 6 2,001.56 2219.850000 369.975000

17 B03XA01 EPOETINUM ALFA EPREX (R) 1000 UI SOL. INJ. 1000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 203.17 248.030000 41.338333

18 B03XA01 EPOETINUM ALFA EPOPHAR 2000 U.I. SOL. INJ. 2000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 259.84 287.470000 28.747000

19 B03XA01 EPOETINUM ALFA EPREX (R) 2000 UI SOL. INJ. 2000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 429.91 506.750000 84.458333

20 B03XA01 EPOETINUM ALFA EPREX (R) 3000 UI SOL. INJ. 3000ui/0,3ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,3 ML S/P-RF 6 622.80 717.000000 119.500000

21 B03XA01 EPOETINUM ALFA EPREX (R) 40 000 UI SOL. INJ. 40 000UI JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 1 ML S/P-RF 1 1,254.00 1405.010000 1405.010000

22 B03XA01 EPOETINUM ALFA EPOPHAR 4000 U.I. SOL. INJ. 4000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 519.68 574.950000 57.495000

23 B03XA01 EPOETINUM ALFA EPREX (R) 4000 UI SOL. INJ. 4000ui/0,4ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,4 ML S/P-RF 6 818.39 930.200000 155.033333

24 B03XA01 EPOETINUM ALFA BINOCRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1,458.00 1627.370000 271.228333

25 B03XA01 EPOETINUM ALFA ABSEAMED 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1,552.96 1730.880000 288.480000

26 B03XA01 EPOETINUM ALFA BINOCRIT 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 167.99 205.080000 34.180000

27 B03XA01 EPOETINUM ALFA ABSEAMED 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,5ML SOL. INJ S/P-RF/R 6 187.93 207.920000 34.653333

28 B03XA01 EPOETINUM ALFA BINOCRIT 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 335.80 404.170000 67.361666

29 B03XA01 EPOETINUM ALFA ABSEAMED 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 377.00 417.090000 69.515000

30 B03XA01 EPOETINUM ALFA BINOCRIT 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 489.04 571.200000 95.200000

31 B03XA01 EPOETINUM ALFA ABSEAMED 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,3ML SOL. INJ. S/P-RF/R 6 531.68 617.680000 102.946666

32 B03XA01 EPOETINUM ALFA BINOCRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 642.24 738.190000 123.031666

33 B03XA01 EPOETINUM ALFA ABSEAMED 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 694.28 794.920000 132.486666

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.4: TRANSPLANT RENAL combinat RINICHI si PANCREAS

Pagina 38 din 52

Page 136: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

34 B03XA01 EPOETINUM ALFA BINOCRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 795.40 905.140000 150.856666

35 B03XA01 EPOETINUM ALFA ABSEAMED 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 866.40 982.530000 163.755000

36 B03XA01 EPOETINUM ALFA ABSEAMED 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML SOL. INJ. S/P-RF/R 6 1,033.71 1164.900000 194.150000

37 B03XA01 EPOETINUM ALFA ABSEAMED 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,8ML SOL. INJ. S/P-RF/R 6 1,368.32 1529.620000 254.936666

38 B03XA01 EPOETINUM BETA NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 1,990.40 2207.690000 367.948333

39 B03XA01 EPOETINUM BETA NEORECORMON 1000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 215.29 262.830000 43.805000

40 B03XA01 EPOETINUM BETA NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 447.61 495.210000 82.535000

41 B03XA01 EPOETINUM BETA NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 980.76 1107.180000 1107.180000

42 B03XA01 EPOETINUM BETA NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 814.08 925.500000 154.250000

43 B03XA01 EPOETINUM BETA NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 1,009.84 1138.880000 189.813333

44 B03XA01 EPOETINUM BETA NEORECORMON 500UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 500UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. + 6 ACE S/P-RF/R 6 110.71 135.150000 22.525000

45 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 3,267.95 3600.220000 3600.220000

46 H01CB02 OCTREOTIDUM** SANDOSTATIN LAR 10 mg PULB.+SOLV.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 2,036.88 2258.350000 2258.350000

47 H01CB02 OCTREOTIDUM** SANDOSTATIN LAR 30 mg PULB.+SOLV.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 4,525.03 4970.440000 4970.440000

48 H01CB02 OCTREOTIDUM** SANDOSTATIN (R) SOL. INJ. 0,1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 117.39 143.310000 28.662000

49 J01CR05PIPERACILLINUM + TAZOBACTAMUM TAZOCIN 4,5 LIOF. PT. SOL. INJ. FARA CONCENTRATIE WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 12 FLAC. CU LIOF. PT. SOL. INJ. S/P-RF 12 652.44 749.310000 62.442500

50 J01CR05PIPERACILLINUM + TAZOBACTAMUM TAZOCIN 2,25 LIOF. PT. SOL. INJ. FARA CONCENTRATIE WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 12 FLAC. CU LIOF. PT. SOL. INJ. S/P-RF 12 378.48 450.690000 37.557500

51 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 1 110.96 135.460000 135.460000

52 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1,507.24 1681.040000 168.104000

53 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml 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 1 827.52 940.150000 940.150000

54 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1,507.24 1681.040000 168.104000

55 J02AB02 KETOCONAZOLUM NIZORAL 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 13.40 14.830000 1.48300056 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 4.90 5.420000 0.54200057 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 6.01 6.650000 0.66500058 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 5.74 6.350000 0.63500059 J02AB02 KETOCONAZOLUM KETOSTIN 200 mg COMPR. 200mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 8.28 9.160000 0.91600060 J02AB02 KETOCONAZOLUM KEFUNGIN COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 4.78 6.460000 0.64600061 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 185.14 204.830000 7.31535762 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 16.77 18.550000 4.63750063 J02AC01 FLUCONAZOLUM FLUCORIC 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 31.12 40.710000 5.81571464 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 61.37 67.900000 4.24375065 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 6.45 7.140000 3.57000066 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 21.50 23.790000 3.39857167 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 17.54 19.400000 19.400000

68 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 58.38 73.820000 18.455000

69 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 2 BLIST. AL/PVC X 1 CAPS. P-RF 2 36.43 40.300000 20.150000

70 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 6.51 7.200000 7.20000071 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 19.61 21.700000 21.700000

72 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 13.88 15.360000 15.360000

73 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10.12 13.680000 13.680000

74 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 6.90 9.320000 9.32000075 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 6.03 6.670000 6.67000076 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 3 CAPS. P-RF 3 22.23 30.050000 10.016666

77 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 11.24 12.440000 12.440000

78 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 4.70 5.200000 5.200000

Pagina 39 din 52

Page 137: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

79 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6.35 7.020000 7.02000080 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5.92 6.550000 6.55000081 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5.60 6.200000 6.20000082 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 4.32 4.780000 4.78000083 J02AC01 FLUCONAZOLUM FLUCONAZOL LAROPHARM 150 mg CAPS. 150mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 6.03 6.670000 6.67000084 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDICO UNO 150 mg CAPS. 150mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 5.92 6.550000 6.55000085 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 27.78 30.730000 4.39000086 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 38.26 42.330000 6.04714287 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 14.79 16.360000 2.33714288 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 40.58 53.080000 7.58285789 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 20.57 27.800000 3.97142890 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 29.57 32.710000 4.67285791 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 15.92 17.610000 2.51571492 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 12.99 14.370000 1.79625093 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 16.72 18.500000 1.85000094 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 11.38 12.590000 1.79857195 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.90 14.270000 2.03857196 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.82 14.180000 2.02571497 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.53 13.860000 1.98000098 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 11.02 12.190000 1.74142899 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 10.33 11.430000 1.632857

100 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 40.58 53.080000 53.080000

101 J02AC01 FLUCONAZOLUM DIFLUCAN (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S/P-RF 1 127.32 140.860000 140.860000

102 J02AC01 FLUCONAZOLUM DIFLUCAN (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S/P-RF 1 28.58 31.620000 31.620000

103 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 32.90 43.030000 43.030000

104 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 50 ML SOL. PERF. S 1 28.18 31.180000 31.180000

105 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 100 ML SOL. PERF. S 1 39.34 43.520000 43.520000

106 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 200 ML SOL. PERF. S 1 131.40 145.370000 145.370000

107 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 2mg/ml SOL. PERF. 2mg/ml LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 35.97 39.790000 39.790000

108 J02AC02 ITRACONAZOLUM ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 57.12 72.220000 4.814666109 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 37.74 49.360000 3.290666110 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 88.60 98.020000 6.534666111 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 88.56 97.980000 6.532000112 J02AC02 ITRACONAZOLUM OMICRAL 100 mg CAPS. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 68.10 75.340000 5.022666113 J02AC02 ITRACONAZOLUM SPORILIN 100 mg CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 85.61 94.720000 6.314666114 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3,343.84 3682.940000 131.533571

115 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 858.25 973.640000 34.772857

116 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 431.95 508.980000 508.980000

117 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 P-RF 1 2,070.87 2295.400000 2295.400000

118 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 1,130.84 1270.770000 1270.770000

119 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 1,466.75 1636.910000 1636.910000

120 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 13.25 14.660000 0.733000121 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14.03 15.520000 0.776000122 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 680.47 752.840000 0.752840123 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 12.75 14.110000 1.411000124 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 8.51 9.410000 0.470500

Pagina 40 din 52

Page 138: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

125 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 11.27 12.470000 0.623500126 J05AB01 ACICLOVIRUM CLOVIRAL 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 10.77 11.910000 0.595500127 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 9.41 10.410000 0.520500128 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 13.12 14.520000 1.452000129 J05AB01 ACICLOVIRUM ACICLOVIR OZONE 200 mg COMPR. DISP. 200mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. DISP. P-RF 20 4.94 5.460000 0.273000130 J05AB01 ACICLOVIRUM LOVIR 200 mg COMPR. DISP. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 10 COMPR. DISP. P-RF 10 2.56 2.830000 0.283000131 J05AB01 ACICLOVIRUM ACIKLOVIR COMPR. FILM. 400mg A & G MED TRADING S.R.L. ROMANIA CUTIE X 7 BLIST. AL/PVC X 5 COMPR. FILM. P-RF 35 40.32 44.610000 1.274571132 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 5 217.64 265.700000 53.140000

133 J05AB11 VALACYCLOVIRUM VALTREX 500 mg COMPR. FILM. 500mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 75.18 83.170000 8.317000134 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4,568.11 5017.400000 83.623333

135 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 18.15 24.530000 0.490600136 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 10.40 11.510000 11.510000

137 L03AA02 FILGRASTIMUM (G-CSF) NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 250.75 306.120000 306.120000

138 L03AA02 FILGRASTIMUM (G-CSF) NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 411.76 486.970000 486.970000

139 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 427.05 503.630000 5.036300140 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 427.05 503.630000 10.072600

141 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 525.44 610.880000 5.090666142 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 980.15 1106.520000 9.221000143 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 COMPR. P-RF/R 100 283.85 346.530000 3.465300144 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg CAPS. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. P-RF/R 50 283.85 346.530000 6.930600145 L04AA08 DACLIZUMABUM** ZENAPAX (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLACON X 5 ML S 1 1,166.85 1310.020000 1310.020000

146 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR) P-RF/R 30 461.26 540.920000 18.030666

147 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 4,008.84 4407.790000 4407.790000

148 L04AD02 CICLOSPORINUM EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 374.97 446.870000 8.937400149 L04AD02 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 107.54 131.290000 2.625800150 L04AD02 CICLOSPORINUM EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 69.90 88.380000 1.767600151 L04AD02 CICLOSPORINUM CICLORAL 25 mg CAPS. MOI 25mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 107.65 119.100000 2.382000152 L04AD02 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 224.70 274.320000 5.486400153 L04AD02 CICLOSPORINUM EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 146.06 178.310000 3.566200154 L04AD02 CICLOSPORINUM CICLORAL 50 mg CAPS. MOI 50mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 239.01 264.430000 5.288600155 L04AD02 CICLOSPORINUM EQUORAL (R) SOL. ORALA 100mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON DIN STICLA BRUNA X 50 ML, UN DISPOZITIV DE MASURAT + UN CAPAC CU FILET S/P-RF 1 338.00 406.570000 406.570000

156 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 50 192.85 235.430000 4.708600157 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 50 343.36 412.410000 8.248200158 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 1,612.32 1795.580000 35.911600

159 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 192.41 234.900000 4.698000160 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 379.80 452.130000 9.042600161 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 1,753.56 1949.530000 38.990600

162 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 1,452.71 1621.610000 162.161000

163 L04AX01 AZATHIOPRINUM IMURAN (R) COMPR. FILM. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 53.75 59.470000 0.594700164 M05BA04 ACIDUM ALENDRONICUM TEVA NAT COMPR. 70 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-AL-OPA/AL X 4 COMPR. P-6L 4 34.65 45.320000 11.330000

165 M05BA04 ACIDUM ALENDRONICUM FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. AL/AL IN PORTOFEL X 2 COMPR. P-6L 2 26.65 34.860000 17.430000

166 N02AB02 PETHIDINUM MIALGIN (R) 100 mg/2 ml SOL. INJ. 50mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA X 2 ML P-TS 5 5.11 5.650000 1.130000

167 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 50 ML S 1 640.39 708.500000 708.500000

Pagina 41 din 52

Page 139: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

168 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 100 ML S 1 1,182.26 1308.000000 1308.000000

169 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S 1 689.65 763.000000 763.000000

170 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 2,555.21 2826.960000 2826.960000

171 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 1,285.40 1422.100000 1422.100000

172 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 50 ML SOL. PERF. S 1 738.92 817.500000 817.500000

173 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 1,448.27 1602.300000 1602.300000

174 J06BA02

IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 200 ML SOL. PERF. S 1 2,807.88 3106.500000 3106.500000

1 B01AB08 REVIPARINUM CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 68.14 75.390000 7.5390002 B01AB08 REVIPARINUM CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 77.24 85.450000 17.090000

3 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1,507.24 1681.040000 168.104000

4 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml 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 1 827.52 940.150000 940.150000

5 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1,507.24 1681.040000 168.104000

6 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3,343.84 3682.940000 131.533571

7 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 858.25 973.640000 34.772857

8 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 431.95 508.980000 508.980000

9 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 P-RF 1 2,070.87 2295.400000 2295.400000

10 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4,568.11 5017.400000 83.623333

1 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. S/P-RF 10 55.13 69.710000 6.9710002 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. S/P-RF 10 113.79 125.890000 12.589000

3 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. S/P-RF 10 144.50 176.410000 17.641000

4 B01AB05 ENOXAPARINUM CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000ui anti-Xa/0,8ml LAB. AVENTIS FRANTA CUTIE X 2 SERINGI PREUMPLUTE X 0,8 ML SOL. INJ. S/P-RF 2 41.62 46.050000 23.025000

5 B01AB08 REVIPARINUM CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 68.14 75.390000 7.5390006 B01AB08 REVIPARINUM CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 77.24 85.450000 17.090000

7 J01CR05PIPERACILLINUM + TAZOBACTAMUM TAZOCIN 4,5 LIOF. PT. SOL. INJ. FARA CONCENTRATIE WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 12 FLAC. CU LIOF. PT. SOL. INJ. S/P-RF 12 652.44 749.310000 62.442500

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.5: TRANSPLANT CELULE PANCREATICE

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.6: TRANSPLANT PULMONAR

Pagina 42 din 52

Page 140: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

8 J01CR05PIPERACILLINUM + TAZOBACTAMUM TAZOCIN 2,25 LIOF. PT. SOL. INJ. FARA CONCENTRATIE WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 12 FLAC. CU LIOF. PT. SOL. INJ. S/P-RF 12 378.48 450.690000 37.557500

9 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1,507.24 1681.040000 168.104000

10 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml 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 1 827.52 940.150000 940.150000

11 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1,507.24 1681.040000 168.104000

12 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 185.14 204.830000 7.31535713 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 16.77 18.550000 4.63750014 J02AC01 FLUCONAZOLUM FLUCORIC 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 31.12 40.710000 5.81571415 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 61.37 67.900000 4.24375016 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 6.45 7.140000 3.57000017 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 21.50 23.790000 3.39857118 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 17.54 19.400000 19.400000

19 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 58.38 73.820000 18.455000

20 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 2 BLIST. AL/PVC X 1 CAPS. P-RF 2 36.43 40.300000 20.150000

21 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 6.51 7.200000 7.20000022 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 19.61 21.700000 21.700000

23 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 13.88 15.360000 15.360000

24 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10.12 13.680000 13.680000

25 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 6.90 9.320000 9.32000026 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 6.03 6.670000 6.67000027 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 3 CAPS. P-RF 3 22.23 30.050000 10.016666

28 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 11.24 12.440000 12.440000

29 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 4.70 5.200000 5.20000030 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6.35 7.020000 7.02000031 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5.92 6.550000 6.55000032 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5.60 6.200000 6.20000033 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 4.32 4.780000 4.78000034 J02AC01 FLUCONAZOLUM FLUCONAZOL LAROPHARM 150 mg CAPS. 150mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 6.03 6.670000 6.67000035 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDICO UNO 150 mg CAPS. 150mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 5.92 6.550000 6.55000036 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 27.78 30.730000 4.39000037 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 38.26 42.330000 6.04714238 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 14.79 16.360000 2.33714239 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 40.58 53.080000 7.58285740 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 20.57 27.800000 3.97142841 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 29.57 32.710000 4.67285742 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 15.92 17.610000 2.51571443 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 12.99 14.370000 1.79625044 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 16.72 18.500000 1.85000045 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 11.38 12.590000 1.79857146 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.90 14.270000 2.03857147 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.82 14.180000 2.02571448 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.53 13.860000 1.98000049 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 11.02 12.190000 1.74142850 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 10.33 11.430000 1.63285751 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 40.58 53.080000 53.080000

52 J02AC01 FLUCONAZOLUM DIFLUCAN (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S/P-RF 1 127.32 140.860000 140.860000

53 J02AC01 FLUCONAZOLUM DIFLUCAN (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S/P-RF 1 28.58 31.620000 31.620000

Pagina 43 din 52

Page 141: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

54 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 32.90 43.030000 43.030000

55 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 50 ML SOL. PERF. S 1 28.18 31.180000 31.180000

56 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 100 ML SOL. PERF. S 1 39.34 43.520000 43.520000

57 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 200 ML SOL. PERF. S 1 131.40 145.370000 145.370000

58 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 2mg/ml SOL. PERF. 2mg/ml LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 35.97 39.790000 39.790000

59 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3,343.84 3682.940000 131.533571

60 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 858.25 973.640000 34.772857

61 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 431.95 508.980000 508.980000

62 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 P-RF 1 2,070.87 2295.400000 2295.400000

63 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 13.25 14.660000 0.73300064 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14.03 15.520000 0.77600065 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 680.47 752.840000 0.75284066 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 12.75 14.110000 1.41100067 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 8.51 9.410000 0.47050068 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 11.27 12.470000 0.62350069 J05AB01 ACICLOVIRUM CLOVIRAL 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 10.77 11.910000 0.59550070 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 9.41 10.410000 0.52050071 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 13.12 14.520000 1.45200072 J05AB01 ACICLOVIRUM ACICLOVIR OZONE 200 mg COMPR. DISP. 200mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. DISP. P-RF 20 4.94 5.460000 0.27300073 J05AB01 ACICLOVIRUM LOVIR 200 mg COMPR. DISP. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 10 COMPR. DISP. P-RF 10 2.56 2.830000 0.28300074 J05AB01 ACICLOVIRUM ACIKLOVIR COMPR. FILM. 400mg A & G MED TRADING S.R.L. ROMANIA CUTIE X 7 BLIST. AL/PVC X 5 COMPR. FILM. P-RF 35 40.32 44.610000 1.27457175 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 5 217.64 265.700000 53.140000

76 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4,568.11 5017.400000 83.623333

77 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 427.05 503.630000 5.03630078 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 427.05 503.630000 10.072600

79 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 525.44 610.880000 5.09066680 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 980.15 1106.520000 9.22100081 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 COMPR. P-RF/R 100 283.85 346.530000 3.46530082 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg CAPS. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. P-RF/R 50 283.85 346.530000 6.93060083 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 4,008.84 4407.790000 4407.790000

84 L04AD02 CICLOSPORINUM EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 374.97 446.870000 8.93740085 L04AD02 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 107.54 131.290000 2.62580086 L04AD02 CICLOSPORINUM EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 69.90 88.380000 1.76760087 L04AD02 CICLOSPORINUM CICLORAL 25 mg CAPS. MOI 25mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 107.65 119.100000 2.38200088 L04AD02 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 224.70 274.320000 5.48640089 L04AD02 CICLOSPORINUM EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 146.06 178.310000 3.56620090 L04AD02 CICLOSPORINUM CICLORAL 50 mg CAPS. MOI 50mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 239.01 264.430000 5.28860091 L04AD02 CICLOSPORINUM EQUORAL (R) SOL. ORALA 100mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON DIN STICLA BRUNA X 50 ML, UN DISPOZITIV DE MASURAT + UN CAPAC CU FILET S/P-RF 1 338.00 406.570000 406.570000

92 L04AX01 AZATHIOPRINUM IMURAN (R) COMPR. FILM. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 53.75 59.470000 0.59470093 N02AX02 TRAMADOLUM TRAMAL (R) CAPS. 50mg GRUNENTHAL GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 8.22 9.090000 0.45450094 N02AX02 TRAMADOLUM TRALGIT 50 CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5.82 6.440000 0.32200095 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4.06 5.490000 0.27450096 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. X 10 CAPS. P-RF 30 9.07 12.260000 0.40866697 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. X 10 CAPS. P-RF/S 50 15.83 21.390000 0.42780098 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. X 10 CAPS. P-RF/S 100 31.64 41.390000 0.41390099 N02AX02 TRAMADOLUM TRAMADOL AL 50 CAPS. 50mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 2.83 3.820000 0.382000

Pagina 44 din 52

Page 142: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

100 N02AX02 TRAMADOLUM MABRON 50 mg CAPS. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3.41 3.770000 0.377000101 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5.33 7.210000 0.360500102 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 4.24 4.690000 0.469000103 N02AX02 TRAMADOLUM TRAMADOL LPH 50 mg CAPS. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 8.83 9.770000 0.488500104 N02AX02 TRAMADOLUM URGENDOL CAPS. 50mg MEDICAROM GROUP SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 3.57 3.950000 0.395000105 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5.88 6.510000 0.325500106 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6.45 7.140000 0.357000107 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7.77 8.600000 0.430000108 N02AX02 TRAMADOLUM TRAMADOL 50 mg COMPR. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6.92 7.660000 0.383000109 N02AX02 TRAMADOLUM TRAMADOLOR (R) 100 ID COMPR. ELIB. MODIF. 100mg HEXAL AG GERMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. MODIF. P-RF 10 5.22 7.060000 0.706000110 N02AX02 TRAMADOLUM TRAMADOL (R) RETARD COMPR. ELIB. PREL. 100mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. X 10 COMPR. ELIB. PREL. P-RF 30 13.15 17.770000 0.592333111 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 50 34.18 37.820000 0.756400112 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 10 6.94 7.680000 0.768000113 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 20.52 22.700000 0.756666114 N02AX02 TRAMADOLUM NOAX UNO 100 mg COMPR. ELIB. PREL. 100mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 5 COMPR.ELIM.PREL. P-RF 5 5.60 6.200000 1.240000115 N02AX02 TRAMADOLUM NOAX UNO 100 mg COMPR. ELIB. PREL. 100mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.ELIM.PREL. P-RF 30 28.23 31.230000 1.041000116 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 23.31 31.510000 1.050333117 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 10 14.88 16.460000 1.646000118 N02AX02 TRAMADOLUM TRALGIT SR 200 COMPR. ELIB. PREL. 200mg ZENTIVA AS SLOVACIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 10 18.77 20.770000 2.077000119 N02AX02 TRAMADOLUM NOAX UNO 200 mg COMPR. ELIB. PREL. 200mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 10 COMPR.ELIB. PREL. P-RF 10 13.95 18.860000 1.886000120 N02AX02 TRAMADOLUM NOAX UNO 200 mg COMPR. ELIB. PREL. 200mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.ELIB. PREL. P-RF 30 37.21 48.670000 1.622333121 N02AX02 TRAMADOLUM NOAX UNO 300 mg COMPR. ELIB. PREL. 300mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. X PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P-RF 10 19.40 26.220000 2.622000122 N02AX02 TRAMADOLUM NOAX UNO 300 mg COMPR. ELIB. PREL. 300mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST. X PVC-PE-ACLAR/AL X 10 COMPR. ELIB. PREL. P-RF 30 56.79 71.800000 2.393333123 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 7.38 9.980000 0.332666124 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. FILM. ELIB. PREL. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. AL/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-RF 10 10.39 11.500000 1.150000125 N02AX02 TRAMADOLUM TRAMUNDIN RETARD 100 mg COMPR. FILM. ELIB. PREL. 100mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.ELIM. PREL. P-RF 30 25.53 28.250000 0.941666126 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 14.84 16.420000 1.642000127 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 46.32 51.250000 1.708333128 N02AX02 TRAMADOLUM TRAMAL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. ELIB. PREL. P-RF 10 19.29 21.340000 2.134000129 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 57.21 63.290000 2.109666130 N02AX02 TRAMADOLUM TRALGIT PIC. ORALE, SOL. 100mg/ml ZENTIVA A.S. SLOVACIA CUTIE X 1 FLACON DIN STICLA BRUNA X 96 ML PIC. ORALE, SOL. P-RF 1 74.59 82.520000 82.520000

131 N02AX02 TRAMADOLUM TRALGIT PIC. ORALE, SOL. 100mg/ml ZENTIVA A.S. SLOVACIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-RF 1 8.60 9.520000 9.520000132 N02AX02 TRAMADOLUM TRAMADOL AL PICATURI PIC. ORALE, SOL. FARA CONCENTRATIE ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-RF 1 4.47 6.040000 6.040000133 N02AX02 TRAMADOLUM TRAMADOL AL PICATURI PIC. ORALE, SOL. FARA CONCENTRATIE ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL. P-RF 1 9.62 13.000000 13.000000

134 N02AX02 TRAMADOLUM TRAMAL (R) PICATURI ORALE-SOL. 100mg/ml GRUNENTHAL GMBH GERMANIA CUTIE X 1 FLACON PICURATOR X 10 ML P-RF 1 5.38 7.270000 7.270000135 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 100 105.37 116.580000 1.165800136 N02AX02 TRAMADOLUM TRALGIT 100 SOL. INJ. 100mg/2ml ZENTIVA A.S. SLOVACIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 8.38 9.270000 1.854000137 N02AX02 TRAMADOLUM TRAMAL (R) 50 SOL. INJ. 50mg/ml GRUNENTHAL GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 6.17 6.830000 1.366000138 N02AX02 TRAMADOLUM TRAMAL (R) 100 SOL. INJ. 50mg/ml GRUNENTHAL GMBH GERMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 8.42 9.310000 1.862000139 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 8.93 9.880000 1.976000140 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 7.31 8.090000 1.618000141 N02AX02 TRAMADOLUM TRAMADOL (R) AL 100 Fiole SOL. INJ. 50mg/ml ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 FIOLE X 2 ML S/P-RF 10 13.36 18.060000 1.806000142 N02AX02 TRAMADOLUM TRAMADOL (R) AL 100 Fiole SOL. INJ. 50mg/ml ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 6.70 9.060000 1.812000143 N02AX02 TRAMADOLUM TRALGIT 50 SOL. INJ. 50mg/ml ZENTIVA A.S. SLOVACIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S/P-RF 5 7.84 8.670000 1.734000144 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 5.36 5.930000 1.186000145 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 7.31 8.090000 1.618000

Pagina 45 din 52

Page 143: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

146 N02AX02 TRAMADOLUM TRAMAL (R) SUPOZ. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 FOLIE PP/AL/PE X 5 SUPOZ. P-RF 5 6.46 7.150000 1.430000147 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 5 SUPOZ. P-RF 5 3.88 5.240000 1.048000

1 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P-6L/S 100 92.38 102.200000 1.0220002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 55.28 61.160000 1.2232003 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 50.17 55.510000 1.1102004 B03XA01 EPOETINUM ALFA** EPREX (R) 10000 UI SOL. INJ. 10000ui/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 1 ML S/P-RF 6 2,001.56 2219.850000 369.975000

5 B03XA01 EPOETINUM ALFA** EPREX (R) 1000 UI SOL. INJ. 1000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 203.17 248.030000 41.338333

6 B03XA01 EPOETINUM ALFA** EPOPHAR 2000 U.I. SOL. INJ. 2000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 259.84 287.470000 28.747000

7 B03XA01 EPOETINUM ALFA** EPREX (R) 2000 UI SOL. INJ. 2000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 429.91 506.750000 84.458333

8 B03XA01 EPOETINUM ALFA** EPREX (R) 3000 UI SOL. INJ. 3000ui/0,3ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,3 ML S/P-RF 6 622.80 717.000000 119.500000

9 B03XA01 EPOETINUM ALFA** EPREX (R) 40 000 UI SOL. INJ. 40 000UI JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 1 ML S/P-RF 1 1,254.00 1405.010000 1405.010000

10 B03XA01 EPOETINUM ALFA** EPOPHAR 4000 U.I. SOL. INJ. 4000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 519.68 574.950000 57.495000

11 B03XA01 EPOETINUM ALFA** EPREX (R) 4000 UI SOL. INJ. 4000ui/0,4ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,4 ML S/P-RF 6 818.39 930.200000 155.033333

12 B03XA01 EPOETINUM ALFA** BINOCRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1,458.00 1627.370000 271.228333

13 B03XA01 EPOETINUM ALFA** ABSEAMED 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1,552.96 1730.880000 288.480000

14 B03XA01 EPOETINUM ALFA** BINOCRIT 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 167.99 205.080000 34.180000

15 B03XA01 EPOETINUM ALFA** ABSEAMED 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,5ML SOL. INJ S/P-RF/R 6 187.93 207.920000 34.653333

16 B03XA01 EPOETINUM ALFA** BINOCRIT 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 335.80 404.170000 67.361666

17 B03XA01 EPOETINUM ALFA** ABSEAMED 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 377.00 417.090000 69.515000

18 B03XA01 EPOETINUM ALFA** BINOCRIT 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 489.04 571.200000 95.200000

19 B03XA01 EPOETINUM ALFA** ABSEAMED 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,3ML SOL. INJ. S/P-RF/R 6 531.68 617.680000 102.946666

20 B03XA01 EPOETINUM ALFA** BINOCRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 642.24 738.190000 123.031666

21 B03XA01 EPOETINUM ALFA** ABSEAMED 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 694.28 794.920000 132.486666

22 B03XA01 EPOETINUM ALFA** BINOCRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 795.40 905.140000 150.856666

23 B03XA01 EPOETINUM ALFA** ABSEAMED 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 866.40 982.530000 163.755000

24 B03XA01 EPOETINUM ALFA** ABSEAMED 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML SOL. INJ. S/P-RF/R 6 1,033.71 1164.900000 194.150000

25 B03XA01 EPOETINUM ALFA** ABSEAMED 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,8ML SOL. INJ. S/P-RF/R 6 1,368.32 1529.620000 254.936666

26 B03XA01 EPOETINUM BETA** NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 1,990.40 2207.690000 367.948333

27 B03XA01 EPOETINUM BETA** NEORECORMON 1000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 215.29 262.830000 43.805000

28 B03XA01 EPOETINUM BETA** NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 447.61 495.210000 82.535000

29 B03XA01 EPOETINUM BETA** NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 980.76 1107.180000 1107.180000

30 B03XA01 EPOETINUM BETA** NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 814.08 925.500000 154.250000

31 B03XA01 EPOETINUM BETA** NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 1,009.84 1138.880000 189.813333

32 B03XA01 EPOETINUM BETA** NEORECORMON 500UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 500UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. + 6 ACE S/P-RF/R 6 110.71 135.150000 22.525000

33 B03XA02 DARBEPOETINUM ALFA** ARANESP 100mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 100mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 2,702.32 2983.680000 745.920000

34 B03XA02 DARBEPOETINUM ALFA** ARANESP 10mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 10mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 304.44 369.990000 92.497500

35 B03XA02 DARBEPOETINUM ALFA** ARANESP 150mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 150mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 4,024.91 4425.310000 1106.327500

36 B03XA02 DARBEPOETINUM ALFA** ARANESP 15mcg/0,375ml SOL. INJ. IN SERINGA PREUMPLUTA 15mcg/0,375ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,375 ML P-RF/R 4 440.56 518.360000 129.590000

37 B03XA02 DARBEPOETINUM ALFA** ARANESP 20mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 20mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 574.24 664.070000 166.017500

38 B03XA02 DARBEPOETINUM ALFA** ARANESP 300mcg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML P-RF/R 1 1,871.55 2078.140000 2078.140000

39 B03XA02 DARBEPOETINUM ALFA** ARANESP 30mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 30mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 838.56 952.180000 238.045000

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

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

Pagina 46 din 52

Page 144: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

40 B03XA02 DARBEPOETINUM ALFA** ARANESP 40mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 40mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 1,105.15 1242.770000 310.692500

41 B03XA02 DARBEPOETINUM ALFA** ARANESP 500mcg/ml SOL. INJ. IN SERINGA PREUMPLUTA 500mcg/ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 1 ML P-RF/R 1 3,099.25 3416.340000 3416.340000

42 B03XA02 DARBEPOETINUM ALFA** ARANESP 50mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 50mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 1,370.32 1531.800000 382.950000

43 B03XA02 DARBEPOETINUM ALFA** ARANESP 60mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 60mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 1,637.71 1823.260000 455.815000

44 B03XA02 DARBEPOETINUM ALFA** ARANESP 80mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 80mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 2,170.76 2404.280000 601.070000

45 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 22.66 30.630000 0.61260046 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 20.59 27.830000 1.39150047 H02AB04 METHYLPREDNISOLONUM MEDROL 4 mg COMPR. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA X 30 COMPR. P-RF 30 4.54 6.130000 0.20433348 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 6.11 8.260000 8.26000049 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 40 mg LIOF. PT. SOL. INJ. 40mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 15 FLAC. LIOF. + 15 FIOLE SOLV. X 1 ML S/P-RF 15 48.80 63.830000 4.25533350 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 21.54 29.120000 29.120000

51 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIO P-RF 1 14.21 19.210000 19.210000

52 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 1.18 1.300000 0.06500053 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 39.35 43.540000 0.04354054 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1.72 1.900000 0.06333355 H02AB07 PREDNISONUM N - PREDNISON COMPR. 5mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 1.62 1.790000 0.05966656 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1.65 1.830000 0.06100057 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 1.18 1.300000 0.065000

58 J01EE01

SULFAMETHOXAZOLUM + TRIMETHOPRIMUM BISEPTRIM CAPS. RET. 400mg/80mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 2.48 2.740000 0.137000

59 J01EE01

SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 1.44 1.590000 0.079500

60 J01EE01

SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM COMPR. 400mg/80mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2.82 3.120000 0.156000

61 J01EE01

SULFAMETHOXAZOLUM + TRIMETHOPRIMUM CO - TRIM ELL COMPR. 400mg/80mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2.20 2.430000 0.121500

62 J01EE01

SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SIROP 25mg/5mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 5.60 6.200000 6.200000

63 J01EE01

SULFAMETHOXAZOLUM + TRIMETHOPRIMUM EPITRIM SUSP. ORALA 200mg/40mg /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 3.24 3.590000 3.590000

64 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 185.14 204.830000 7.31535765 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 16.77 18.550000 4.63750066 J02AC01 FLUCONAZOLUM FLUCORIC 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 31.12 40.710000 5.81571467 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 61.37 67.900000 4.24375068 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 6.45 7.140000 3.57000069 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 21.50 23.790000 3.39857170 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 17.54 19.400000 19.400000

71 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 58.38 73.820000 18.455000

72 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 2 BLIST. AL/PVC X 1 CAPS. P-RF 2 36.43 40.300000 20.150000

73 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 6.51 7.200000 7.20000074 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 19.61 21.700000 21.700000

75 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 13.88 15.360000 15.360000

76 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10.12 13.680000 13.680000

Pagina 47 din 52

Page 145: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

77 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 6.90 9.320000 9.32000078 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 6.03 6.670000 6.67000079 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 3 CAPS. P-RF 3 22.23 30.050000 10.016666

80 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA AS CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 11.24 12.440000 12.440000

81 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 4.70 5.200000 5.20000082 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6.35 7.020000 7.02000083 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5.92 6.550000 6.55000084 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 5.60 6.200000 6.20000085 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 4.32 4.780000 4.78000086 J02AC01 FLUCONAZOLUM FLUCONAZOL LAROPHARM 150 mg CAPS. 150mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 6.03 6.670000 6.67000087 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDICO UNO 150 mg CAPS. 150mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 5.92 6.550000 6.55000088 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 27.78 30.730000 4.39000089 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 38.26 42.330000 6.04714290 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 14.79 16.360000 2.33714291 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 40.58 53.080000 7.58285792 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 20.57 27.800000 3.97142893 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 29.57 32.710000 4.67285794 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 15.92 17.610000 2.51571495 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 12.99 14.370000 1.79625096 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 16.72 18.500000 1.85000097 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 11.38 12.590000 1.79857198 J02AC01 FLUCONAZOLUM FLUCONAZOL TERAPIA 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.90 14.270000 2.03857199 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.82 14.180000 2.025714

100 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 12.53 13.860000 1.980000101 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 11.02 12.190000 1.741428102 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 10.33 11.430000 1.632857103 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 40.58 53.080000 53.080000

104 J02AC01 FLUCONAZOLUM DIFLUCAN (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S/P-RF 1 127.32 140.860000 140.860000

105 J02AC01 FLUCONAZOLUM DIFLUCAN (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S/P-RF 1 28.58 31.620000 31.620000

106 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 32.90 43.030000 43.030000

107 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 50 ML SOL. PERF. S 1 28.18 31.180000 31.180000

108 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 100 ML SOL. PERF. S 1 39.34 43.520000 43.520000

109 J02AC01 FLUCONAZOLUM MYCOMAX (R) INF SOL. PERF. 2mg/ml ZENTIVA AS CEHIA CUTIE X 1 FLACON DIN STICLA X 200 ML SOL. PERF. S 1 131.40 145.370000 145.370000

110 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 2mg/ml SOL. PERF. 2mg/ml LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 35.97 39.790000 39.790000

111 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3,343.84 3682.940000 131.533571

112 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 858.25 973.640000 34.772857

113 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 431.95 508.980000 508.980000

114 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 P-RF 1 2,070.87 2295.400000 2295.400000

115 J02AC04 POSACONAZOLUM** NOXAFIL SP 40mg/ml SUSP. ORALA 40mg/ml SP EUROPE BELGIA CUTIE X 1 FLAC. X 105ML SUSP. ORALA P-RF/R 1 2,537.47 2804.000000 2804.000000

116 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 13.25 14.660000 0.733000117 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14.03 15.520000 0.776000118 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 680.47 752.840000 0.752840119 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 12.75 14.110000 1.411000120 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 8.51 9.410000 0.470500121 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 11.27 12.470000 0.623500122 J05AB01 ACICLOVIRUM CLOVIRAL 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 10.77 11.910000 0.595500

Pagina 48 din 52

Page 146: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

123 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 9.41 10.410000 0.520500124 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 13.12 14.520000 1.452000125 J05AB01 ACICLOVIRUM ACICLOVIR OZONE 200 mg COMPR. DISP. 200mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. DISP. P-RF 20 4.94 5.460000 0.273000126 J05AB01 ACICLOVIRUM LOVIR 200 mg COMPR. DISP. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. DIN PVC-PVDC/AL X 10 COMPR. DISP. P-RF 10 2.56 2.830000 0.283000127 J05AB01 ACICLOVIRUM ACIKLOVIR COMPR. FILM. 400mg A & G MED TRADING S.R.L. ROMANIA CUTIE X 7 BLIST. AL/PVC X 5 COMPR. FILM. P-RF 35 40.32 44.610000 1.274571128 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 5 217.64 265.700000 53.140000

129 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4,568.11 5017.400000 83.623333

130 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 28 218.27 241.480000 8.624285131 J05AF05 LAMIVUDINUM EPIVIR 150mg COMPR. FILM. 150mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILM. P-RF/R 60 315.79 349.380000 5.823000132 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 84.18 93.130000 93.130000

133 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 97.66 108.050000 108.050000

134 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 427.05 503.630000 5.036300135 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 427.05 503.630000 10.072600

136 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 525.44 610.880000 5.090666137 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 980.15 1106.520000 9.221000138 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 COMPR. P-RF/R 100 283.85 346.530000 3.465300139 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg CAPS. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. P-RF/R 50 283.85 346.530000 6.930600140 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR) P-RF/R 30 461.26 540.920000 18.030666

141 L04AD02 CICLOSPORINUM EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 374.97 446.870000 8.937400142 L04AD02 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 107.54 131.290000 2.625800143 L04AD02 CICLOSPORINUM EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 69.90 88.380000 1.767600144 L04AD02 CICLOSPORINUM CICLORAL 25 mg CAPS. MOI 25mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 107.65 119.100000 2.382000145 L04AD02 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 224.70 274.320000 5.486400146 L04AD02 CICLOSPORINUM EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 146.06 178.310000 3.566200147 L04AD02 CICLOSPORINUM CICLORAL 50 mg CAPS. MOI 50mg HEXAL AG GERMANIA CUTIE X 10 BLIST. AL/AL X 5 CAPS. MOI S/P-RF 50 239.01 264.430000 5.288600148 L04AD02 CICLOSPORINUM EQUORAL (R) SOL. ORALA 100mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON DIN STICLA BRUNA X 50 ML, UN DISPOZITIV DE MASURAT + UN CAPAC CU FILET S/P-RF 1 338.00 406.570000 406.570000

149 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 50 192.85 235.430000 4.708600150 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 50 343.36 412.410000 8.248200151 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 1,612.32 1795.580000 35.911600

152 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 192.41 234.900000 4.698000153 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 379.80 452.130000 9.042600154 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA GMBH GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 1,753.56 1949.530000 38.990600

155 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 1,452.71 1621.610000 162.161000

156 L04AX01 AZATHIOPRINUM* IMURAN (R) COMPR. FILM. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 53.75 59.470000 0.594700

1 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 27.68 30.620000 0.6124002 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 22.77 25.190000 0.8396663 A11CC04 CALCITRIOLUM** ROCALTROL CAPS. MOI 0,25mcg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 CAPS. MOI P-RF 100 57.17 72.280000 0.7228004 A11CC07 PARICALCITOLUM** ZEMPLAR SOL. INJ. 5 mcg/ml ABBOTT LABORATORIES LTD. SPANIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S 5 398.72 441.120000 88.224000

5 A11CC07 PARICALCITOLUM** ZEMPLAR SOL. INJ. 5 mcg/ml ABBOTT LABORATORIES LTD. SPANIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. S 5 746.00 851.290000 170.258000

6 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 48.38 53.530000 5.3530007 B01AB01 HEPARINUM** HEPARIN SOL. INJ. 5000ui/ml POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE X 5 FIOLE X 1ML S 5 5.91 6.540000 1.3080008 B01AB01 HEPARINUM** HEPARIN SOL. INJ. 5000ui/ml POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE X 10 FIOLE X 5ML S 10 30.96 34.250000 3.4250009 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. S/P-RF 10 55.13 69.710000 6.971000

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

Pagina 49 din 52

Page 147: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

10 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. S/P-RF 10 113.79 125.890000 12.589000

11 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. S/P-RF 10 144.50 176.410000 17.641000

12 B01AB05 ENOXAPARINUM** CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000ui anti-Xa/0,8ml LAB. AVENTIS FRANTA CUTIE X 2 SERINGI PREUMPLUTE X 0,8 ML SOL. INJ. S/P-RF 2 41.62 46.050000 23.025000

13 B01AB06 NADROPARINUM** FRAXODI 11400 UI anti-factor Xa/0,6ml SOL. INJ. 11400 uiAXa/0,6ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. S/P-RF 10 208.13 230.270000 23.027000

14 B01AB06 NADROPARINUM** FRAXODI 15200 UI anti-factor Xa/0,8ml SOL. INJ. 15200 uiAXa/0,8ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 10 SERINGI PREUMPLUTE X 0,8 ML SOL. INJ. S/P-RF 10 286.14 316.570000 31.657000

15 B01AB06 NADROPARINUM** FRAXIPARINE (R) 2850 UI anti-factor Xa/0,3 ml SOL. INJ. 2850 ui AFXa/0,3ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 10 SERINGI PREUMPLUTE DIN STICLA, PREVAZUTE CU DISPOZITIV DE PROTECTIE A ACULUI X 0,3 ML S/P-RF 10 56.00 61.960000 6.19600016 B01AB06 NADROPARINUM** FRAXIPARINE (R) 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 10 SERINGI PREUMPLUTE DIN STICLA, PREVAZUTE CU DISPOZITIV DE PROTECTIE A ACULUI X 0,4 ML S/P-RF 10 83.60 92.490000 9.24900017 B01AB06 NADROPARINUM** FRAXIPARINE (R) 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 10 SERINGI PREUMPLUTE DIN STICLA, PREVAZUTE CU DISPOZITIV DE PROTECTIE A ACULUI X 0,6 ML S/P-RF 10 101.88 112.710000 11.271000

18 B01AB06 NADROPARINUM** FRAXIPARINE (R) 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AXa/0,8ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 10 SERINGI PREUMPLUTE DIN STICLA, PREVAZUTE CU DISPOZITIV DE PROTECTIE A ACULUI X 0,8 ML S/P-RF 10 148.61 164.410000 16.441000

19 B01AB08 REVIPARINUM** CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 68.14 75.390000 7.53900020 B01AB08 REVIPARINUM** CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 77.24 85.450000 17.090000

21 B01AB10 TINZAPARINUM** INNOHEP SOL. INJ. 10000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 2 SERINGI PREUMPLUTE X 0.45 ML SOL. INJ. (4500 U-AXA) S/P-RF 2 24.78 27.410000 13.705000

22 B01AB10 TINZAPARINUM** INNOHEP SOL. INJ. 10000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 2 SERINGI PREUMPLUTE X 0.35 ML SOL. INJ. (3500 U-AXA) S/P-RF 2 17.83 19.730000 9.86500023 B01AB10 TINZAPARINUM** INNOHEP SOL. INJ. 10000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 2 ML SOL. INJ. (10000 U-AXA) S/P-RF 10 455.66 504.120000 50.412000

24 B01AB10 TINZAPARINUM** INNOHEP SOL. INJ. 20000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 2ML SOL. INJ. (20000 U-AXA) S/P-RF 10 927.93 1049.600000 104.960000

25 B01AB10 TINZAPARINUM** INNOHEP SOL. INJ. 20000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 2 SERINGI PREUMPLUTE X 0,70 ML SOL. IN. (14000 U-AXA) S/P-RF 2 78.80 87.180000 43.590000

26 B01AB10 TINZAPARINUM** INNOHEP SOL. INJ. 20000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 2 SERINGI PREUMPLUTE X 0,90 ML SOL. IN. (18000 U-AXA) S/P-RF 2 101.51 112.310000 56.155000

27 B01AB10 TINZAPARINUM** INNOHEP SOL. INJ. 20000u ANTIF. Xa/ml LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 2 SERINGI PREUMPLUTE X 0,50 ML SOL. IN. (10000 U-AXA) S/P-RF 2 56.13 62.100000 31.050000

28 B03AC02

COMPLEX DE HIDROXID DE FER (III) SUCROZA VENOFER (R) SOL. INJ./PERF. 20mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 117.29 129.760000 25.952000

29 B03XA01 EPOETINUM ALFA** EPREX (R) 10000 UI SOL. INJ. 10000ui/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 1 ML S/P-RF 6 2,001.56 2219.850000 369.975000

30 B03XA01 EPOETINUM ALFA** EPREX (R) 1000 UI SOL. INJ. 1000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 203.17 248.030000 41.338333

31 B03XA01 EPOETINUM ALFA** EPOPHAR 2000 U.I. SOL. INJ. 2000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 259.84 287.470000 28.747000

32 B03XA01 EPOETINUM ALFA** EPREX (R) 2000 UI SOL. INJ. 2000ui/0,5ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,5 ML S/P-RF 6 429.91 506.750000 84.458333

33 B03XA01 EPOETINUM ALFA** EPREX (R) 3000 UI SOL. INJ. 3000ui/0,3ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,3 ML S/P-RF 6 622.80 717.000000 119.500000

34 B03XA01 EPOETINUM ALFA** EPREX (R) 40 000 UI SOL. INJ. 40 000UI JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 1 ML S/P-RF 1 1,254.00 1405.010000 1405.010000

35 B03XA01 EPOETINUM ALFA** EPOPHAR 4000 U.I. SOL. INJ. 4000UI GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 10 FLAC. X 1 ML SOL. INJ. S/P-RF 10 519.68 574.950000 57.495000

36 B03XA01 EPOETINUM ALFA** EPREX (R) 4000 UI SOL. INJ. 4000ui/0,4ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 2 BLIST. X 3 SERINGI PREUMPLUTE X 0,4 ML S/P-RF 6 818.39 930.200000 155.033333

37 B03XA01 EPOETINUM ALFA** BINOCRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1,458.00 1627.370000 271.228333

38 B03XA01 EPOETINUM ALFA** ABSEAMED 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1,552.96 1730.880000 288.480000

39 B03XA01 EPOETINUM ALFA** BINOCRIT 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 167.99 205.080000 34.180000

40 B03XA01 EPOETINUM ALFA** ABSEAMED 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,5ML SOL. INJ S/P-RF/R 6 187.93 207.920000 34.653333

41 B03XA01 EPOETINUM ALFA** BINOCRIT 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 335.80 404.170000 67.361666

42 B03XA01 EPOETINUM ALFA** ABSEAMED 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 377.00 417.090000 69.515000

43 B03XA01 EPOETINUM ALFA** BINOCRIT 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 489.04 571.200000 95.200000

44 B03XA01 EPOETINUM ALFA** ABSEAMED 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTEX 0,3ML SOL. INJ. S/P-RF/R 6 531.68 617.680000 102.946666

45 B03XA01 EPOETINUM ALFA** BINOCRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 642.24 738.190000 123.031666

46 B03XA01 EPOETINUM ALFA** ABSEAMED 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 694.28 794.920000 132.486666

47 B03XA01 EPOETINUM ALFA** BINOCRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 795.40 905.140000 150.856666

48 B03XA01 EPOETINUM ALFA** ABSEAMED 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 866.40 982.530000 163.755000

49 B03XA01 EPOETINUM ALFA** ABSEAMED 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML SOL. INJ. S/P-RF/R 6 1,033.71 1164.900000 194.150000

50 B03XA01 EPOETINUM ALFA** ABSEAMED 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,8ML SOL. INJ. S/P-RF/R 6 1,368.32 1529.620000 254.936666

51 B03XA01 EPOETINUM BETA** NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 1,990.40 2207.690000 367.948333

52 B03XA01 EPOETINUM BETA** NEORECORMON 1000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 215.29 262.830000 43.805000

53 B03XA01 EPOETINUM BETA** NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 447.61 495.210000 82.535000

54 B03XA01 EPOETINUM BETA** NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 980.76 1107.180000 1107.180000

Pagina 50 din 52

Page 148: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

55 B03XA01 EPOETINUM BETA** NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 814.08 925.500000 154.250000

56 B03XA01 EPOETINUM BETA** NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 1,009.84 1138.880000 189.813333

57 B03XA01 EPOETINUM BETA** NEORECORMON 500UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 500UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. + 6 ACE S/P-RF/R 6 110.71 135.150000 22.525000

58 B03XA02 DARBEPOETINUM ALFA** ARANESP 100mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 100mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 2,702.32 2983.680000 745.920000

59 B03XA02 DARBEPOETINUM ALFA** ARANESP 10mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 10mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 304.44 369.990000 92.497500

60 B03XA02 DARBEPOETINUM ALFA** ARANESP 150mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 150mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 4,024.91 4425.310000 1106.327500

61 B03XA02 DARBEPOETINUM ALFA** ARANESP 15mcg/0,375ml SOL. INJ. IN SERINGA PREUMPLUTA 15mcg/0,375ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,375 ML P-RF/R 4 440.56 518.360000 129.590000

62 B03XA02 DARBEPOETINUM ALFA** ARANESP 20mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 20mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 574.24 664.070000 166.017500

63 B03XA02 DARBEPOETINUM ALFA** ARANESP 300mcg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML P-RF/R 1 1,871.55 2078.140000 2078.140000

64 B03XA02 DARBEPOETINUM ALFA** ARANESP 30mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 30mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 838.56 952.180000 238.045000

65 B03XA02 DARBEPOETINUM ALFA** ARANESP 40mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 40mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 1,105.15 1242.770000 310.692500

66 B03XA02 DARBEPOETINUM ALFA** ARANESP 500mcg/ml SOL. INJ. IN SERINGA PREUMPLUTA 500mcg/ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 1 ML P-RF/R 1 3,099.25 3416.340000 3416.340000

67 B03XA02 DARBEPOETINUM ALFA** ARANESP 50mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 50mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 1,370.32 1531.800000 382.950000

68 B03XA02 DARBEPOETINUM ALFA** ARANESP 60mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 60mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 1,637.71 1823.260000 455.815000

69 B03XA02 DARBEPOETINUM ALFA** ARANESP 80mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 80mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 2,170.76 2404.280000 601.070000

70 H05BX01 CINACALCETUM**** MIMPARA 30 mg COMPR. FILM. 30mg AMGEN EUROPE B.V. OLANDA CUTIE X 2 BLIST. ACLAR-PVC-PVAC/AL X 14 COMPR. FILM. P-RF 28 709.92 811.960000 28.998571

71 H05BX01 CINACALCETUM**** MIMPARA 60 mg COMPR. FILM. 60mg AMGEN EUROPE B.V. OLANDA CUTIE X 2 BLIST. ACLAR-PVC-PVAC/AL X 14 COMPR. FILM. P-RF 28 1,300.59 1455.790000 51.992500

72 H05BX01 CINACALCETUM**** MIMPARA 90 mg COMPR. FILM. 90mg AMGEN EUROPE B.V. OLANDA CUTIE X 2 BLIST. ACLAR-PVC-PVAC/AL X 14 COMPR. FILM. P-RF 28 1,849.56 2054.170000 73.363214

73 V03AE02 SEVELAMER** RENAGEL 800mg COMPR. FILM. 800mg GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC.PEID. X 180 COMPR. FILM. P-RF 180 658.12 755.500000 4.197222

1 N07BB04 NALTREXONUM REVIA COMPR. FILM. 50mg TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 4 BLIST. PVC-PE-ACLAR/AL X 7 COMPR. FILM. P-RF 28 254.24 281.280000 10.045714

2 N07BB04 NALTREXONUM REVIA COMPR. FILM. 50mg TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PE-ACLAR/AL X 7 COMPR. FILM. P-RF 14 160.02 177.040000 12.645714

3 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 8.58 9.490000 0.189800

4 N07BC51

COMBINATII ( BUPRENORPHINUM + NALAXONE) SUBOXONE 2mg/0,5mg COMPR. SUBLING. 2mg/0,5mg SP EUROPE BELGIA CUTIE X 7 COMPR. SUBLING. ( BLIST.NYLON/AL/PVC) P-TS; S 7 24.68 27.310000 3.901428

5 N07BC51

COMBINATII ( BUPRENORPHINUM + NALAXONE) SUBOXONE 8mg/2mg COMPR. SUBLING. 8mg/2mg SP EUROPE BELGIA CUTIE X 7 COMPR. SUBLING. ( BLIST.NYLON/AL/PVC) P-TS; S 7 79.92 101.050000 14.435714

NOTA:

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MSP si cu aprobarea comisiilor de la nivelul Caselor Judetene de Asigurari de Sanatate;

- 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 MSP;

P11 PROGRAM NATIONAL DE SANATATE MINTALA SUBPROGRAMUL TRATAMENTUL TOXICODEPENDENTELOR

Pagina 51 din 52

Page 149: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

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

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (****) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MSP si cu aprobarea comisiilor de la nivelul Casei Nationale de Asigurari 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 Publice;

Pagina 52 din 52

Page 150: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

ANEXA 5

Nr. crt cod_atc dci den_com forma_farm conc firma_det tara_det ambalaj pres cant_fl

PRET AMANUNT

UL MAXIMAL

(RON)

PRET AMANUNTU

L MAXIMAL/U

T (RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR.

95/2006 ART 213

alin.(1) lit. a) si f)

VAL.SUPORTATAT

CNAS/ UT (RON) PT.

ADULTI

1 A03AD02 DROTAVERINUM NO - SPA 40 mg/2 ml SOL. INJ. 40mg/2ml CHINOIN PRIVATE CO. LTD. UNGARIA CUTIE X 25 FIOLE X 2ML SOL. INJ. P-RF 25 23.00 0.920000 0.920000 0.9200002 A03BA01 ATROPINUM SULFAT DE ATROPINA ZENTIVA 1 mg/ml SOL. INJ. 1mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 1 ML SOL. INJ. S 5 2.82 0.564000 0.564000 0.5640003 A03BB01 BUTYLSCOPOLAMMONII BROMIDUM SCOBUTIL 10 mg/ml SOL. INJ. 10mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 1 ML SOL. INJ. P-RF 5 3.14 0.628000 0.628000 0.6280004 A03DA02 COMBINATII PIAFEN COMPR. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 2.30 0.115000 0.115000 0.1150005 A03DA02 COMBINATII ALGIFEN COMPRIMATE COMPR. FARA CONCENTRATIE ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3.14 0.157000 0.115000 0.1150006 A03DA02 COMBINATII ALGIFEN SOLUTIE INJECTABILA SOL. INJ. FARA CONCENTRATIE ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF 5 6.10 1.220000 1.220000 1.2200007 A03DA02 COMBINATII PIAFEN SUPOZ. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII X 3 SUPOZ. P-RF 6 2.10 0.350000 0.350000 0.3500008 A05BAN3 COMBINATII ASPATOFORT (R) SOL. INJ. FARA CONCENTRATIE TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 10 ML P-RF 10 9.92 0.992000 0.992000 0.9920009 A06AD65 COMBINATII FORTRANS (R) PULB. PT. SOL. ORALA FARA CONCENTRATIE BEAUFOUR IPSEN INT. FRANTA CUTIE X 4 PLICURI DIN HARTIE/AL/PE A CATE 74 G PULB. PT. SOL. ORALA P-RF 4 36.38 9.095000 7.186666 7.186666

10 A06AD65 COMBINATII ENDOFALK PULB. PT. SOL. ORALA FARA CONCENTRATIE DR. FALK PHARMA GMBH GERMANIA CUTIE X 6 PLICURI DE HARTIE/AL/PEJD X 55,318 G PULB. PT. SOL. ORALA P-RF 6 43.12 7.186666 7.186666 7.18666611 A07AX03 NIFUROXAZIDUM ERCEFURYL (R) 200 mg CAPS. 200mg SANOFI-SYNTHELABO OTC FRANTA CUTIE X 2 BLIST. X 14 CAPS. P-RF 28 10.71 0.382500 0.382500 0.38250012 A11CA01 RETINOLUM VITAMINA A FORTE CAPS. MOI 50000ui BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 CAPS. MOI P-6L 30 5.18 0.172666 0.172666 0.17266613 A11CA01 RETINOLUM VITAMINA A BIOFARM 20mg/ml PIC. ORALE, SOL. 20mg/ml BIOFARM SA ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-6L 1 2.33 2.330000 2.330000 2.33000014 A11CC02 DIHYDROTACHYSTEROLUM A.T. 10 (R) PICATURI ORALE-SOL. 1mg/ml MERCK KGAA GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA PREVAZUT CU PICURATOR X 15 ML P-6L 1 24.41 24.410000 24.410000 24.410000

15 A11CC04 CALCITRIOLUM ROCALTROL CAPS. MOI 0,25mcg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 CAPS. MOI P-RF 100 72.28 0.722800 0.722800 0.72280016 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 1000 COMPR. 1000UI MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 7.77 0.259000 0.259000 0.25900017 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 500 COMPR. 500UI MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 6.29 0.209666 0.209666 0.20966618 A11CC05 COLECALCIFEROLUM VITAMINA D3 BIOFARM 18000UI/ml PIC. ORALE, SOL. 0,45mg/ml BIOFARM S.A. ROMANIA CUTIE X 1 FLACON X 10 ML PIC. ORALE, SOL. P-6L 1 4.75 4.750000 4.750000 4.75000019 A11CC05 COLECALCIFEROLUM VIGANTOL OIL PIC. ORALE, SOL. 0,5mg/ml MERCK KGAA GERMANIA CUTIE X 1 FLACON DIN STICLA X 10 ML PIC. ORALE SOLUTIE, PREVAZUT CU PICURATOR P-6L 1 5.98 5.980000 5.980000 5.98000020 A11CC20 COMBINATII FLUOR VIGANTOLETTEN 1000 COMPR. FARA CONCENTRATIE MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 7.52 0.250666 0.250666 0.25066621 A11CC20 COMBINATII FLUOR VIGANTOLETTEN 500 COMPR. FARA CONCENTRATIE MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 6.04 0.201333 0.201333 0.20133322 A11DA01 THIAMINUM SICOVIT (R) B1 100 mg/2 ml SOL. INJ. 100mg/2ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 3.14 0.628000 0.628000 0.628000

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

VENITURI, PRECUM ŞI GRAVIDE ŞI LĂUZE CONFORM HG NR. 720/2008

VALABILĂ ÎNCEPÂND CU 1 APRILIE 2009

Pagina 1 din 8

Page 151: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

23 A11DA03 BENFOTIAMINUM BENFOGAMMA DRAJ. 50mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-6L 50 26.98 0.539600 0.489700 0.48970024 A11DA03 BENFOTIAMINUM BENFOGAMMA DRAJ. 50mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 20 DRAJ. P-6L 100 48.97 0.489700 0.489700 0.48970025 A11DBN1 COMBINATII MILGAMMA (R) N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 20 19.04 0.952000 0.791900 0.79190026 A11DBN1 COMBINATII MILGAMMA (R) N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 100 79.19 0.791900 0.791900 0.79190027 A11DBN1 COMBINATII MILGAMMA (R) N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 50 44.02 0.880400 0.791900 0.79190028 A11DBN1 COMBINATII MILGAMMA (R) N SOL. INJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 25 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF 25 78.45 3.138000 3.138000 3.13800029 A11DBN1 COMBINATII MILGAMMA (R) N SOL. INJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF 5 17.38 3.476000 3.138000 3.13800030 A11DBN2 COMBINATII NEUROMULTIVIT (R) COMPR. FILM. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 1 BLIST. X 20 COMPR. FILM. P-6L 20 10.48 0.524000 0.417500 0.41750031 A11DBN2 COMBINATII NEUROMULTIVIT (R) COMPR. FILM. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. X 20 COMPR. FILM. P-6L 100 41.75 0.417500 0.417500 0.41750032 A11GA01 ACIDUM ASCORBICUM VITAMINA C ARENA 750 mg SOL. INJ. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 5 ML SOL. INJ. P-RF 5 23.76 4.752000 4.752000 4.75200033 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 1.74 0.087000 0.087000 0.08700034 A11HA02 PYRIDOXINUM SICOVIT B6 250 mg COMPR. 250mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 1.74 0.087000 0.087000 0.08700035 A11HA02 PYRIDOXINUM SICOVIT B6 250 mg/5 ml SOL. INJ. 250mg/5ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF 5 5.02 1.004000 1.004000 1.00400036 A11HA02 PYRIDOXINUM SICOVIT B6 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 3.14 0.628000 0.628000 0.62800037 A11HA03 TOCOFEROLUM VITAMIN E 200 CAPS. MOI 200mg ZENTIVA AS SLOVACIA CUTIE X 1 FLAC. STICLA X 30 CAPS. MOI P-6L 30 8.21 0.273666 0.273666 0.27366638 A11HA03 TOCOFEROLUM VITAMIN E 400 CAPS. MOI 400mg ZENTIVA AS SLOVACIA CUTIE X 1 FLAC. STICLA X 30 CAPS. MOI P-6L 30 15.19 0.506333 0.365833 0.36583339 A11HA03 TOCOFEROLUM VITAMINA E 400 mg CAPS. MOI 400mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 12 CAPS. MOI P-6L 24 8.78 0.365833 0.365833 0.36583340 A12AA03 CALCII GLUCONAS GLUCONAT DE CALCIU 10% SOL. INJ. 10% B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FIOLE DIN PEJD X 10 ML SOL. INJ. P-RF 20 15.84 0.792000 0.792000 0.79200041 A12AA03 CALCII GLUCONAS GLUCONAT DE CALCIU SOL. INJ. FARA CONCENTRATIE ZENTIVA SA ROMANIA CUTIE X 5 FIOLE X 10 ML SOL. INJ. P-RF 5 7.78 1.556000 0.792000 0.79200042 A14AA03 METANDIENONUM NAPOSIM 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3.99 0.199500 0.199500 0.19950043 A16AA01 LEVOCARNITINUM MIOCOR SOL. ORALA 10% ECOBI PHARMACEUTICI ITALIA CUTIE X 10 FLACOANE X 10ML P-6L 10 17.20 1.720000 1.720000 1.72000044 A16AA01 LEVOCARNITINUM CARNIL (R) SOL. ORALA 100mg/ml ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 10 FLACOANE DIN STICLA BRUNA, ACOPERITE CU UN CAPAC DIN AL. X 10 ML P-6L 10 28.06 2.806000 1.720000 1.72000045 A16AXN1 DIVERSE ACTOVEGIN (R) DRAJ. 200mg NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 DRAJ. P-6L 50 136.22 2.724400 2.724400 2.72440046 A16AXN1 DIVERSE ACTOVEGIN (R) SOL. INJ. 200mg/5ml NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 5 FIOLE PUNCT DE RUPERE X 5 ML P-RF 5 102.07 20.414000 20.414000 20.414000

47 B02BX01 ETAMSYLATUM ETAMSILAT 250mg/2ml SOL. INJ. 250mg/2ml ZENTIVA S.A ROMANIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. P-RF 5 3.25 0.650000 0.650000 0.65000048 B02BX02 CARBAZOCHROMI SALICYLAS ADRENOSTAZIN SOL. INJ. 0,3mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 5 ML P-RF 5 4.56 0.912000 0.912000 0.91200049 B03AA03 FERROSI GLUCONAS ASCOFER COMPR. FARA CONCENTRATIE ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 20 COMPR. P-6L 20 3.76 0.188000 0.188000 0.18800050 B03ABN1 FERROCHOLINATUM FER-SOL SOL. ORALA IN PICATURI 24mg Fe/ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 15 ML + DISPOZITIV PT. PICURARE P-6L 1 3.13 3.130000 3.130000 3.13000051 B03AD02 COMBINATII FERRETAB (R) CAPS. ELIB. PREL. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. AL/PVC X 20 CAPS. ELIB. PREL. P-6L 100 25.89 0.258900 0.258900 0.25890052 B03AD02 COMBINATII FERRETAB (R) CAPS. ELIB. PREL. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 30 10.05 0.335000 0.258900 0.25890053 B03AD03 COMBINATII FERRO SANOL GYN CAPS. FARA CONCENTRATIE SCHWARZ PHARMA AG GERMANIA CUTIE X 5 BLIST. AL/PE X 10 CAPS. P-6L 50 34.95 0.699000 0.699000 0.69900054 B03AD03 COMBINATII TARDYFERON FOL (R) DRAJ. ELIB. PREL. FARA CONCENTRATIE LAB. PIERRE FABRE FRANTA CUTIE X 3 BLIST. AL/PVDC-PE-PVC X 10 DRAJ. ELIB. PREL. P-6L 30 14.11 0.470333 0.470333 0.47033355 B03AD04 COMBINATII MALTOFER FOL COMPR. MAST. FARA CONCENTRATIE VIFOR FRANCE S.A. FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MAST. P-6L 30 16.78 0.559333 0.559333 0.55933356 B03AE01 COMBINATII FERRO - FOLGAMMA (R) CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. X 10 CAPS. MOI P-RF 100 40.56 0.405600 0.405600 0.40560057 B03AE01 COMBINATII FERRO - FOLGAMMA (R) CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. X 10 CAPS. MOI P-RF 50 22.80 0.456000 0.405600 0.40560058 B03AE01 COMBINATII FERRO - FOLGAMMA (R) CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. X 10 CAPS. MOI P-RF 20 9.86 0.493000 0.405600 0.40560059 B03AE10 COMBINATII TOT'HEMA SOL. ORALA FARA CONCENTRATIE LAB. INNOTHERA FRANTA CUTIE X 20 FIOLE X 10 ML P-6L 20 16.64 0.832000 0.832000 0.83200060 B03BA01 CYANOCOBALAMINUM SICOVIT B12 50mcg/ml SOL. INJ. 50mcg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 1 ML SOL. INJ. P-RF 5 3.14 0.628000 0.628000 0.62800061 B03BA51 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. PVC/PVDC X 10 DRAJ. P-6L 100 79.19 0.791900 0.791900 0.79190062 B03BA51 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC/PVDC X 10 DRAJ. P-6L 20 19.04 0.952000 0.791900 0.79190063 B03BA51 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L 50 44.02 0.880400 0.791900 0.79190064 B03BA51 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. PVC/PVDC X 10 DRAJ. P-6L 100 79.19 0.791900 0.791900 0.79190065 B03BA51 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC/PVDC X 10 DRAJ. P-6L 20 19.04 0.952000 0.791900 0.79190066 B03BA51 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L 50 44.02 0.880400 0.791900 0.79190067 C02LA51 COMBINATII NEOCRYSTEPIN DRAJ. FARA CONCENTRATIE ZENTIVA AS CEHIA CUTIE X 2 BLIST. AL/PVC X 15 DRAJ. P-6L 30 8.01 0.267000 0.267000 0.267000

Pagina 2 din 8

Page 152: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

68 C04AE01 CODERGOCRINUM REDERGIN 1 mg/ml PICATURI ORALE-SOL. 0,1% LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLACON X 50 ML P-6L 1 11.09 11.090000 2.060000 2.06000069 C04AE01 CODERGOCRINUM CO-DERGOCRIN SOL. ORALA IN PICATURI 0,1% TERAPIA SA ROMANIA CUTIE X 1 FLACON CU DOP PICATOR X 50 ML PIC.ORALE, SOL. P-6L 1 5.12 5.120000 2.060000 2.06000070 C04AE01 CODERGOCRINUM SECATOXIN SOL. ORALA IN PICATURI 1mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON X 10 ML + PICATOR P-6L 1 2.06 2.060000 2.060000 2.06000071 C05AA01 COMBINATII HEMORZON UNGUENT FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 18 G P-RF 1 3.87 3.870000 3.870000 3.87000072 C05AA08 COMBINATII ULTRAPROCT (R) SUPOZ. FARA CONCENTRATIE INTENDIS GMBH GERMANIA CUTIE X 2 FOLII X 5 SUPOZ. P-RF 10 12.14 1.214000 1.214000 1.21400073 C05AA08 COMBINATII ULTRAPROCT (R) UNGUENT RECTAL FARA CONCENTRATIE INTENDIS GMBH GERMANIA CUTIE X 1 TUB X 15 G + 1 CANULA RECTALA P-RF 1 13.68 13.680000 13.680000 13.680000

74 C05AD01 COMBINATII DOXIPROCT UNGUENT RECTAL FARA CONCENTRATIE OM PORTUGUESA S.A. PORTUGALIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT RECTAL + CANULA APLICATOARE P-6L 1 20.96 20.960000 20.960000 20.960000

75 C05BX01 CALCII DOBESILAS DOXILEK CAPS. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC. X 10 CAPS. P-6L 30 20.15 0.671666 0.671666 0.67166676 C05CA54 TROXERUTINUM (COMBINATII) GINKOR FORT CAPS. FARA CONCENTRATIE BEAUFOUR IPSEN PHARMA FRANTA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 24.16 0.805333 0.805333 0.80533377 C07AB08 CELIPROLOLUM CELIPRES (R) COMPR. FILM. 100mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 7.40 0.740000 0.740000 0.74000078 C07AB08 CELIPROLOLUM CELIPRES (R) COMPR. FILM. 200mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 10.42 1.042000 1.042000 1.04200079 C07NAN1 COMBINATII DISTONOVAL COMPR. FARA CONCENTRATIE FABIOL S.A. ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 3.61 0.180500 0.180500 0.18050080 C07NAN1 COMBINATII DISTONOCALM (R) COMPR. FILM. FARA CONCENTRATIE ZENTIVA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 3.94 0.131333 0.131333 0.13133381 C08CA06 NIMODIPINUM NIMOTOP (R) COMPR. FILM. 30mg BAYER HEALTHCARE AG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L/S 100 105.73 1.057300 1.057300 1.05730082 C08CA06 NIMODIPINUM NIMOTOP (R) SOL. PERF. 10mg/50ml BAYER HEALTHCARE AG GERMANIA CUTIE X 5 CUTII X 1 FLACON DIN STICLA DE CULOARE BRUNA X 50 ML + 1 PERFUZOR DIN POLIETILENA S 5 285.20 57.040000 57.040000 57.040000

83 C10AD02 ACIDUM NICOTINICUM NIASPAN 1000 mg COMPR. ELIB. PREL. 1000mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB.PREL. P-6L 14 43.84 3.131428 2.771836 2.77183684 C10AD02 ACIDUM NICOTINICUM NIASPAN 1000 mg COMPR. ELIB. PREL. 1000mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB. PREL. P-6L 28 82.48 2.945714 2.771836 2.77183685 C10AD02 ACIDUM NICOTINICUM NIASPAN 1000 mg COMPR. ELIB. PREL. 1000mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB. PREL. P-6L 56 155.72 2.780714 2.771836 2.77183686 C10AD02 ACIDUM NICOTINICUM NIASPAN 1000 mg COMPR. ELIB. PREL. 1000mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 7 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB. PREL. P-6L 98 271.64 2.771836 2.771836 2.77183687 C10AD02 ACIDUM NICOTINICUM NIASPAN 375 mg COMPR. ELIB. PREL. 375mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB. PREL. P-6L 14 20.71 1.479285 1.246224 1.24622488 C10AD02 ACIDUM NICOTINICUM NIASPAN 375 mg COMPR. ELIB. PREL. 375mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB. PREL. P-6L 28 39.72 1.418571 1.246224 1.24622489 C10AD02 ACIDUM NICOTINICUM NIASPAN 375 mg COMPR. ELIB. PREL. 375mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB. PREL. P-6L 56 75.17 1.342321 1.246224 1.24622490 C10AD02 ACIDUM NICOTINICUM NIASPAN 375 mg COMPR. ELIB. PREL. 375mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 7 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB. PREL. P-6L 98 122.13 1.246224 1.246224 1.24622491 C10AD02 ACIDUM NICOTINICUM NIASPAN 500 mg COMPR. ELIB. PREL. 500mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB. PREL. P-6L 14 27.16 1.940000 1.665204 1.66520492 C10AD02 ACIDUM NICOTINICUM NIASPAN 500 mg COMPR. ELIB. PREL. 500mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB. PREL. P-6L 28 52.13 1.861785 1.665204 1.66520493 C10AD02 ACIDUM NICOTINICUM NIASPAN 500 mg COMPR. ELIB. PREL. 500mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB. PREL. P-6L 56 98.35 1.756250 1.665204 1.66520494 C10AD02 ACIDUM NICOTINICUM NIASPAN 500 mg COMPR. ELIB. PREL. 500mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 7 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB. PREL. P-6L 98 163.19 1.665204 1.665204 1.66520495 C10AD02 ACIDUM NICOTINICUM NIASPAN 750 mg COMPR. ELIB. PREL. 750mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB.PREL. P-6L 14 35.92 2.565714 2.223673 2.22367396 C10AD02 ACIDUM NICOTINICUM NIASPAN 750 mg COMPR. ELIB. PREL. 750mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB.PREL. P-6L 28 69.07 2.466785 2.223673 2.22367397 C10AD02 ACIDUM NICOTINICUM NIASPAN 750 mg COMPR. ELIB. PREL. 750mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB.PREL. P-6L 56 126.76 2.263571 2.223673 2.22367398 C10AD02 ACIDUM NICOTINICUM NIASPAN 750 mg COMPR. ELIB. PREL. 750mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 7 BLIST. PVC-CFE-PE/AL X 14 COMPR. ELIB.PREL. P-6L 98 217.92 2.223673 2.223673 2.22367399 D01AC05 ISOCONAZOLUM TRAVOGEN CREMA 10mg/1g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 20 G CREMA P-RF 1 10.91 10.910000 10.910000 10.910000

100 D01AC08 KETOCONAZOLUM NIZORAL CREMA 2% JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 TUB X 15 G P-RF 1 8.57 8.570000 5.560000 5.560000101 D01AC08 KETOCONAZOLUM KETOCONAZOL CREMA 2% TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB PEJD X 15 G P-RF 1 7.75 7.750000 5.560000 5.560000102 D01AC08 KETOCONAZOLUM KETOCONAZOL MK CREMA 2% FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB AL X 20 G P-RF 1 7.23 7.230000 5.560000 5.560000103 D01AC08 KETOCONAZOLUM KETOCONAZOL CREMA CREMA 20mg/g SC HYPERION SA ROMANIA CUTIE X 1 TUB DIN AL X 20 MG CREMA P-RF 1 7.46 7.460000 5.560000 5.560000104 D01AC08 KETOCONAZOLUM KEFUNGIN 2mg/100mg CREMA 2mg/100mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 5.56 5.560000 5.560000 5.560000105 D01AC52 COMBINATII MYCOHEAL (R) HC CREMA FARA CONCENTRATIE DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 TUB AL X 15 G P-RF 1 6.02 6.020000 6.020000 6.020000106 D05AXN1 COMBINATII ASORIAN SOL. CUT. FARA CONCENTRATIE BIOFARM SA ROMANIA CUTIE X 1 FLACON X 100 ML P-RF 1 9.54 9.540000 9.540000 9.540000107 D07AB10 ALCLOMETAZONUM AFLODERM CREMA 0,5mg/g A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB AL X 40 G P-RF 1 29.89 29.890000 19.410000 19.410000

108 D07AB10 ALCLOMETAZONUM AFLODERM CREMA 0,5mg/g A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB AL X 20 G P-RF 1 19.41 19.410000 19.410000 19.410000

109 D07AB10 ALCLOMETAZONUM AFLODERM UNGUENT 0,5mg/g A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB AL X 40 G P-RF 1 29.89 29.890000 19.410000 19.410000

110 D07AB10 ALCLOMETAZONUM AFLODERM UNGUENT 0,5mg/g A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB AL X 20 G P-RF 1 19.41 19.410000 19.410000 19.410000

111 D07AC04 FLUOCINOLONI ACETONIDUM FLUOCINOLON ACETONID 0,025% UNGUENT 0,025% LAROPHARM SRL ROMANIA CUTIE X 1 TUB AL X 20 G P-RF 1 4.05 4.050000 4.050000 4.050000112 D07AC05 FLUOCORTOLONUM ULTRALAN CREMA CREMA 0,25% INTENDIS GMBH GERMANIA CUTIE X 1 TUB X 15 G P-RF 1 11.56 11.560000 11.560000 11.560000

Pagina 3 din 8

Page 153: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

113 D07AC05 FLUOCORTOLONUM ULTRALAN UNGUENT UNGUENT 0,25% SCHERING AG GERMANIA CUTIE X 1 TUB X 15 G UNGUENT P-RF 1 12.00 12.000000 12.000000 12.000000

114 D07CB01 COMBINATII NIDOFLOR CREMA FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 3.87 3.870000 3.870000 3.870000115 D07CB01 COMBINATII PANDERM UNGUENT FARA CONCENTRATIE GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 7.20 7.200000 7.200000 7.200000116 D07CC02 COMBINATII FLUOCINOLON G MK CREMA FARA CONCENTRATIE FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 20 G CREMA P-RF 1 1.39 1.390000 1.390000 1.390000117 D07CC02 COMBINATII FLUOCINOLON N UNGUENT FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 18 G P-RF 1 3.62 3.620000 3.620000 3.620000118 D07XB02 COMBINATII TRIAMCINOLON S CREMA FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 3.87 3.870000 3.870000 3.870000119 D07XC01 COMBINATII DIPROSALIC SOL. CUT. FARA CONCENTRATIE SCHERING-PLOUGH EUROPE BELGIA CUTIE X 1 FLACON DIN PEID X 30 ML SOL. CUT., PREVAZUT CU PICURATOR P-RF 1 15.16 15.160000 15.160000 15.160000

120 D07XC01 COMBINATII BELOSALIC SOL. CUT. FARA CONCENTRATIE A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 FLAC. PEID X 50 ML, PREVAZUT CU PICURATOR P-RF 1 19.72 19.720000 15.160000 15.160000

121 D07XC01 COMBINATII DIPROSALIC UNGUENT FARA CONCENTRATIE SCHERING-PLOUGH EUROPE BELGIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 10.11 10.110000 10.110000 10.110000

122 D07XC01 COMBINATII BELOSALIC UNGUENT FARA CONCENTRATIE A & G MED TRADING S.R.L. ROMANIA CUTIE X 1 TUB AL X 30 G P-RF 1 12.14 12.140000 10.110000 10.110000

123 D07XC04 COMBINATII TRAVOCORT CREMA FARA CONCENTRATIE INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 11.96 11.960000 11.960000 11.960000

124 D07XDN1 COMBINATII FLUOCINOLON D MK CREMA FARA CONCENTRATIE FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB AL X 20G P-RF 1 3.65 3.650000 3.650000 3.650000125 D10AD01 TRETINOINUM RETIN - A (R) CREMA 0,05% JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 1 TUB X 30 G P-RF 1 13.16 13.160000 13.160000 13.160000

126 D10AF02 ERYTHROMYCINUM ERYFLUID SOL. CUT. 4g/30ml PIERRE FABRE DERMATOLOGIE FRANTA CUTIE X 1 FLACON X 100 ML SOL. CUT. P-RF 1 19.74 19.740000 7.600000 7.600000127 D10AF02 ERYTHROMYCINUM ERYFLUID SOL. CUT. 4g/30ml PIERRE FABRE DERMATOLOGIE FRANTA CUTIE X 1 FLACON X 30 ML SOL. CUT. P-RF 1 7.60 7.600000 7.600000 7.600000128 D10AF52 COMBINATII ZINERYT PULB. + SOLV. SOL. CUT. 40mg/12mg/ml ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 FLAC. DIN PEID PULB. PT. SOL. CUTANATA + APLICATOR DIN PP CU SOLV. PT 30 ML SOL. CUTANATA P-RF 1 30.51 30.510000 30.510000 30.510000

129 D11AX15 PIMECROLIMUS ELIDEL 1% CREMA 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 TUB AL X 15 G CREMA P-RF 1 77.89 77.890000 77.890000 77.890000

130 G01AF01 METRONIDAZOLUM FLAGYL OVULE 500mg LAB. AVENTIS FRANTA CUTIE X 2 BLIST. X 5 OVULE P-RF 10 8.03 0.803000 0.803000 0.803000131 G01AXN1 COMBINATII COLPOSEPTINE (R) COMPR. VAG. FARA CONCENTRATIE LAB. THERAMEX MONACO CUTIE X 3 BLIST. X 6 COMPR. VAG. P-RF 18 16.58 0.921111 0.921111 0.921111132 G01BDN1 COMBINATII TERGYNAN COMPR. VAG. FARA CONCENTRATIE LAB. BOUCHARA-RECORDATI FRANTA CUTIE X 1 FOLIE HARTIE/PE/AL/PE X 10 COMPR. VAG. P-RF 10 20.57 2.057000 2.057000 2.057000133 G03AC06 MEDROXYPROGESTERONUM DEPO-PROVERA SUSP. INJ. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 1 ML SUSP. INJ. S/P-RF 1 12.30 12.300000 12.300000 12.300000

134 G03DB04 NOMEGESTROLUM LUTENYL (R) COMPR. 5mg LAB. THERAMEX MONACO CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 29.58 2.958000 2.958000 2.958000135 G03GA01 GONADOTROPHINUM CHORIONICUM PREGNYL 5000 LIOF. + SOLV. PT. SOL. INJ. 5000ui/ml NV ORGANON OLANDA CUTIE X 3 FIOLE CU LIOF. PREVAZUTE CU INEL DE RUPERE + 3 FIOLE X 1 ML SOLV. PREVAZUTE CU INEL DE RUP S/P-RF 3 40.16 13.386666 13.386666 13.386666

136 G03GA02 MENOTROPINUM MENOPUR LIOF. + SOLV. PT. SOL. INJ. FARA CONCENTRATIE FERRING LAEGEMIDLER A/S DANEMARCA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU LIOF. + 10 FIOLE X 1 ML SOLV. PT. SOL. INJ. S/P-RF 10 790.16 79.016000 79.016000 79.016000

137 G04BCN1 COMBINATII URALYT-U GRANULE FARA CONCENTRATIE MADAUS GMBH GERMANIA CUTIE X 1 FLAC. PP X 280 G GRANULE + 1 LINGURITA DOZATOARE + 1 CALENDAR DE CONTROL + HARTIE INDICATO P-6L 1 53.46 53.460000 53.460000 53.460000

138 H03AA03 COMBINATII NOVOTHYRAL (R) 100 COMPR. 100mcg+20mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-6L 100 27.18 0.271800 0.271800 0.271800139 J01CR50 COMBINATII AMPICLOX 250mg/250mg CAPS. 250mg+250 mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 6 CAPS. P-RF 12 7.69 0.640833 0.640833 0.640833140 J01CR50 COMBINATII SULPERAZON (R) 2 g PULB. PT. SOL. INJ. FARA CONCENTRATIE PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC X 2 G S/P-RF 1 35.28 35.280000 35.280000 35.280000

141 J01DB04 CEFAZOLINUM LYZOLIN PULB. PT. SOL. INJ. 1g MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 1 FLAC/. PULB. S/P-RF 1 3.24 3.240000 3.240000 3.240000142 J01DE02 CEFPIROMUM CEFROM (R) 1 g PULB. PT. SOL. INJ./PERF. 1g LAB. AVENTIS FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. INJ./PERF. S/P-RF 1 71.15 71.150000 71.150000 71.150000

143 J01DE02 CEFPIROMUM CEFROM (R) 2 g PULB. PT. SOL. INJ./PERF. 2g LAB. AVENTIS FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. INJ./PERF. S/P-RF 1 123.77 123.770000 123.770000 123.770000

144 J01EB05 SULFAFURAZOLUM SULFAFURAZOL COMPR. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 4.58 0.229000 0.229000 0.229000145 J01FA06 ROXITHROMYCINUM ROXAMED (R) 150 COMPR. FILM. 150mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 14.30 1.430000 1.430000 1.430000146 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 6.70 0.670000 0.670000 0.670000147 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 38.95 0.779000 0.635000 0.635000148 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 9.00 0.900000 0.635000 0.635000149 J01GB03 GENTAMICINUM PAN - GENTAMICINE SOL.INJ. 80mg/2ml LAB. PANPHARMA FRANTA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF 10 6.35 0.635000 0.635000 0.635000150 J01GB07 NETILMICINUM NETROMYCINE (R) SOL. INJ. 150mg/1,5ml SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 FLACON X 1,5 ML S/P-RF 1 17.98 17.980000 17.980000 17.980000

151 J01GB07 NETILMICINUM NETROMYCINE (R) SOL. INJ. 200mg/2ml SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 FLACON X 2 ML S/P-RF 1 22.79 22.790000 22.790000 22.790000

152 J01GB07 NETILMICINUM NETROMYCINE (R) SOL. INJ. 50mg/2ml SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 FLACON X 2 ML S/P-RF 1 7.13 7.130000 7.130000 7.130000153 J01XB01 COLISTINUM COLISTINA ANTIBIOTICE 1000000 UI PULB. PT. SOL. INJ./PERF. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S 100 1684.22 16.842200 16.842200 16.842200

154 J01XB01 COLISTINUM COLISTINA ANTIBIOTICE 1000000 UI PULB. PT. SOL. INJ./PERF. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S 50 877.54 17.550800 16.842200 16.842200

155 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3682.94 131.533571 131.533571 131.533571

156 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 973.64 34.772857 34.772857 34.772857

157 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 P-RF 1 2295.40 2295.400000 2295.400000 2295.400000Pagina 4 din 8

Page 154: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

158 M01AA01 PHENYLBUTAZONUM FENILBUTAZONA 250 mg SUPOZ. 250mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 2.77 0.277000 0.277000 0.277000159 M01AB55 COMBINATII NEODOLPASSE SOL. PERF. FARA CONCENTRATIE FRESENIUS KABI AUSTRIA GMBH AUSTRIA CUTIE X 10 FLACOANE X 250 ML S 10 205.73 20.573000 20.573000 20.573000

160 M01AB55 COMBINATII ACECLOFEN SUPOZ. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE AL/PE X 3 SUPOZ. P-6L 6 2.88 0.480000 0.480000 0.480000161 M01AB55 DICLOFENACUM+MISOPROSTOLUM ARTHROTEC 75 COMPR. GASTROREZ. 75mg+0,200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL X 10 COMPR. GASTROREZ. P-6L 20 26.81 1.340500 1.340500 1.340500162 M01AB55 DICLOFENACUM+MISOPROSTOLUM ARTHROTEC 75 COMPR. GASTROREZ. 75mg+0,200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL X 10 COMPR. GASTROREZ. P-6L 10 15.64 1.564000 1.340500 1.340500163 M01AE01 IBUPROFENUM PADUDEN (R) SR 300 mg CAPS. ELIB. PREL. 300mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. X 10 CAPS. ELIB. PREL. P-6L 30 19.85 0.661666 0.661666 0.661666164 M01AE01 IBUPROFENUM PADUDEN (R) SR 300 mg CAPS. ELIB. PREL. 300mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. ELIB. PREL. P-6L 10 10.75 1.075000 0.661666 0.661666165 M01AE01 IBUPROFENUM PROFINAL COMPR. FILM. 400mg GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 2 BLIST. X 12 COMPR. FILM. P-6L 24 10.94 0.455833 0.134000 0.134000166 M01AE01 IBUPROFENUM REUPROFEN (R) 400 mg COMPR. FILM. 400mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 7.12 0.237333 0.134000 0.134000167 M01AE01 IBUPROFENUM IBUPROFEN 400 COMPR. FILM. 400mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 2.68 0.134000 0.134000 0.134000168 M01AE01 IBUPROFENUM PROFINAL COMPR. FILM. 600mg GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 12.51 0.625500 0.230500 0.230500169 M01AE01 IBUPROFENUM IBUPROFEN 600 COMPR. FILM. 600mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 4.61 0.230500 0.230500 0.230500170 M01AE01 IBUPROFENUM NUROFEN FORTE DRAJ. 400mg RECKITT BENCKISER HEALTHCARE INTERNATIONAL LTD. MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 12 DRAJ. P-6L 12 11.36 0.946666 0.946666 0.946666171 M01AE01 IBUPROFENUM NUROFEN (R) PENTRU COPII, cu aroma de portocala SUSP. ORALA 100mg/5ml RECKITT BENCKISER HEALTHCARE INTERNATIONAL LTD. MAREA BRITANIE CUTIE X 1 FLAC. PE TEREFTALAT X 100 ML + 1 SERINGA DOZATOARE PP CU PISTON DIN PE P-RF 1 6.92 6.920000 6.920000 6.920000172 M01AE01 IBUPROFENUM NUROFEN (R) PENTRU COPII, cu aroma de capsuni SUSP. ORALA 100mg/5ml RECKITT BENCKISER HEALTHCARE INTERNATIONAL LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN TEREFTALAT DE POLIETILENA X 100 ML SUSP. ORALA + SERINGA DOZAT. PP + PISTON PE P-RF 1 6.92 6.920000 6.920000 6.920000173 M01AE02 NAPROXENUM REUXEN 250 mg COMPR. 250mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 8.72 0.436000 0.436000 0.436000174 M01AE02 NAPROXENUM REUXEN 500 mg COMPR. 500mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 15.75 0.787500 0.787500 0.787500175 M01AG01 ACIDUM MEFENAMICUM VIDAN COMPR. FILM. 500mg VIANEX SA GRECIA CUTIE X 3 BLIST. AL/PVC X 8 COMPR. FILM. P-6L 24 9.38 0.390833 0.390833 0.390833176 M01AH04 PARECOXIBUM DYNASTAT 40mg PULB. + SOLV. PT. SOL. INJ. 40mg PFIZER LIMITED MAREA BRITANIE CUTIE X 5 FLAC. PULB. X 40 MG + 5 FIOLE X 2 ML SOLV. S/P-RF 5 138.25 27.650000 27.260000 27.260000

177 M01AH04 PARECOXIBUM DYNASTAT 40mg PULB. PT. SOL. INJ. 40mg PFIZER LIMITED MAREA BRITANIE CUTIE X 10 FLAC. X 40 MG PULB. PT. SOL. INJ. S/P-RF 10 272.60 27.260000 27.260000 27.260000

178 M03BB03 CHLORZOXAZONUM CLORZOXAZON 250 mg COMPR. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.42 0.121000 0.120000 0.120000179 M03BB03 CHLORZOXAZONUM CLORZOXAZONA COMPR. 250mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.40 0.120000 0.120000 0.120000180 M03BB03 CHLORZOXAZONUM CLORZOXAZONA 250 mg COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3.62 0.120666 0.120000 0.120000181 M03BX04 TOLPERISONUM MYDOCALM COMPR. FILM. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 13.68 0.456000 0.456000 0.456000182 M03BX04 TOLPERISONUM MYDOCALM COMPR. FILM. 50mg GEDEON RICHTER PLC. UNGARIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 6.84 0.228000 0.228000 0.228000183 M03BX04 TOLPERISONUM TOLPERISON 50 mg DRAJ. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-6L 30 4.95 0.165000 0.165000 0.165000184 M03BX04 TOLPERISONUM MYDOCALM SOL. INJ. 100mg/ml GEDEON RICHTER PLC. UNGARIA CUTIE X 5 FIOLE DIN STICLA X 1 ML SOL. INJ. P-RF 5 6.47 1.294000 1.294000 1.294000185 M09AX01 ACIDUM HIALURONICUM HYALGAN (R) SOL. INJ. 20mg/2ml CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 2 ML P-RF 1 134.66 134.660000 134.660000 134.660000

186 N02AA59 COMBINATII PARADOREN 500mg/30mg COMPR. 30mg+500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 11.96 0.598000 0.598000 0.598000187 N02AA59 COMBINATII PARADOREN 500mg/60mg COMPR. 60mg+500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 18.61 0.930500 0.930500 0.930500188 N02BA71 COMBINATII FASCONAL P COMPR. FARA CONCENTRATIE GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 4.35 0.217500 0.217500 0.217500189 N02BA71 COMBINATII FASCOREM COMPR. FARA CONCENTRATIE REMEDIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4.35 0.217500 0.217500 0.217500190 N02BB02 METAMIZOLUM NATRIUM NEVRALGIN PIC. ORALE, SOL. 500mg/ml TERAPIA SA ROMANIA CUTIE X 1 FLACON X 10 ML PIC. ORALE, SOL. P-RF 1 5.82 5.820000 5.820000 5.820000191 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN (R) 1 g/2 ml SOL. INJ. 1g/2ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 3.70 0.740000 0.740000 0.740000192 N05BA05 CLORAZEPAT DIKALII TRANXENE 10 mg CAPS. 10mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 CAPS. P-RF 30 5.93 0.197666 0.197666 0.197666193 N05BA05 CLORAZEPAT DIKALII TRANXENE 5 mg CAPS. 5mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 CAPS. P-RF 30 5.42 0.180666 0.180666 0.180666194 N05BA23 TOFISOPAMUM GRANDAXIN COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-RF 20 5.04 0.252000 0.252000 0.252000195 N05CD08 MIDAZOLAMUM DORMICUM (R) COMPR. FILM. 7,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 10 5.24 0.524000 0.524000 0.524000196 N05CD08 MIDAZOLAMUM DORMICUM (R) 7,5 mg COMPR. FILM. 7,5mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 10 9.92 0.992000 0.524000 0.524000197 N05CD08 MIDAZOLAMUM DORMICUM (R) SOL. INJ. 1mg/ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 10 FIOLE X 5 ML S/P-RF 10 27.37 2.737000 2.243000 2.243000198 N05CD08 MIDAZOLAMUM MIDAZOLAM TORREX 1 mg/ml SOL. INJ. 1mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 10 FIOLE X 2 ML SOL. INJ. S/P-RF 10 22.43 2.243000 2.243000 2.243000199 N05CD08 MIDAZOLAMUM MIDAZOLAM TORREX 1 mg/ml SOL. INJ. 1mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 10 FIOLE X 5 ML SOL. INJ. S/P-RF 10 32.08 3.208000 2.243000 2.243000200 N05CD08 MIDAZOLAMUM FULSED 5 mg/ml SOL. INJ. 5mg/ml TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 1 ML SOL. INJ. S/P-RF 10 30.96 3.096000 3.096000 3.096000201 N05CD08 MIDAZOLAMUM MIDAZOLAM 5 mg/ml SOL. INJ. 5mg/ml TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 1 ML SOL. INJ. S/P-RF 10 31.88 3.188000 3.096000 3.096000202 N05CD08 MIDAZOLAMUM MIDAZOLAM TORREX 5 mg/ml SOL. INJ. 5mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 10 FIOLE X 1 ML SOL. INJ. S/P-RF 10 32.08 3.208000 3.096000 3.096000

Pagina 5 din 8

Page 155: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

203 N05CD08 MIDAZOLAMUM MIDAZOLAM TORREX 5 mg/ml SOL. INJ. 5mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 10 FIOLE X 10 ML SOL. INJ. S/P-RF 10 184.08 18.408000 3.096000 3.096000204 N05CD08 MIDAZOLAMUM MIDAZOLAM TORREX 5 mg/ml SOL. INJ. 5mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 10 FIOLE X 3 ML SOL. INJ. S/P-RF 10 62.21 6.221000 3.096000 3.096000205 N05CD13 CINOLAZEPAMUM GERODORM (R) COMPR. 40mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-RF 30 21.63 0.721000 0.721000 0.721000206 N06BA04 METHYLFENIDATUM*** CONCERTA 18 mg COMPR. FILM. ELIB. PREL. 18mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. P-RF/R 30 180.68 6.022666 6.022666 6.022666207 N06BA04 METHYLFENIDATUM*** CONCERTA 36 mg COMPR. FILM. ELIB. PREL. 36mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. P-RF/R 30 215.24 7.174666 7.174666 7.174666208 N06BA04 METHYLFENIDATUM*** CONCERTA 54 mg COMPR. FILM. ELIB. PREL. 54mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. P-RF/R 30 278.74 9.291333 9.291333 9.291333209 N06BA09 ATOMOXETINUM*** STRATTERA 10 mg CAPS. 10mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 7 97.03 13.861428 13.861428 13.861428

210 N06BA09 ATOMOXETINUM*** STRATTERA 18 mg CAPS. 18mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 7 97.03 13.861428 13.861428 13.861428

211 N06BA09 ATOMOXETINUM*** STRATTERA 25 mg CAPS. 25mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 28 366.80 13.100000 13.100000 13.100000

212 N06BA09 ATOMOXETINUM*** STRATTERA 40 mg CAPS. 40mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 28 366.80 13.100000 13.100000 13.100000

213 N06BA09 ATOMOXETINUM*** STRATTERA 60 mg CAPS. 60mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 28 366.80 13.100000 13.100000 13.100000

214 N06BX02 PYRITINOLUM ENCEPHABOL (R) 100 mg DRAJ. 100mg MERCK KGAA GERMANIA CUTIE X 5 BLIST. X 10 DRAJ. P-6L 50 31.31 0.626200 0.563333 0.563333215 N06BX02 PYRITINOLUM PIRITINOL ARENA 100 mg DRAJ. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. X 10 DRAJ. P-6L 30 16.90 0.563333 0.563333 0.563333216 N06BX02 PYRITINOLUM ENCEPHABOL (R) FORTE DRAJ. 200mg MERCK KGAA GERMANIA CUTIE X 5 BLIST. X 10 DRAJ. P-6L 50 56.96 1.139200 1.139200 1.139200217 N06BX02 PYRITINOLUM ENCEPHABOL (R) SUSPENSIE SUSP. ORALA 80,5mg/5ml MERCK KGAA GERMANIA CUTIE X 1 FLACON X 200 ML P-6L 1 38.11 38.110000 38.110000 38.110000

218 N06BX03 PIRACETAMUM PIRACETAM 400 mg COMPR. 400 mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2.20 0.110000 0.091500 0.091500219 N06BX03 PIRACETAMUM PIRACETAM 400 mg COMPR. 400mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 2.36 0.118000 0.091500 0.091500220 N06BX03 PIRACETAMUM N - PIRACETAM COMPR. 400mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. PE X 40 COMPR. P-6L 40 3.79 0.094750 0.091500 0.091500221 N06BX03 PIRACETAMUM MEMOTAL 400mg COMPR. 400mg ZENTIVA S.A ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 2.02 0.101000 0.091500 0.091500222 N06BX03 PIRACETAMUM PIRACETAM SLAVIA 400 mg COMPR. 400mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. DIN PVC/AL X 10 COMPR. P-6L 40 4.35 0.108750 0.091500 0.091500223 N06BX03 PIRACETAMUM PIRACETAM LAROPHARM 400 mg COMPR. 400mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 1.83 0.091500 0.091500 0.091500224 N06BX03 PIRACETAMUM PIRACETAM COMPR. 400mg FABIOL SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2.76 0.092000 0.091500 0.091500225 N06BX03 PIRACETAMUM PIRACETAM FARMEX 400 mg COMPR. 400mg FARMEX COMPANY SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 4.18 0.104500 0.091500 0.091500226 N06BX03 PIRACETAMUM PIRACETAM MCC 400mg COMPR. 400mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 2.20 0.110000 0.091500 0.091500227 N06BX03 PIRACETAMUM LUCETAM (R) 1200 mg COMPR. FILM. 1200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 20 COMPR. FILM. P-6L 20 8.40 0.420000 0.420000 0.420000228 N06BX03 PIRACETAMUM NOOTROPIL (R) 1200 mg COMPR. FILM. 1200mg U.C.B. SA BELGIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L 100 46.94 0.469400 0.420000 0.420000229 N06BX03 PIRACETAMUM PIRACETAM 400 mg COMPR. FILM. 400mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 2.20 0.110000 0.110000 0.110000230 N06BX03 PIRACETAMUM PIRACETAM LPH (R) 400 mg COMPR. FILM. 400mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 60 6.63 0.110500 0.110000 0.110000231 N06BX03 PIRACETAMUM LUCETAM COMPR. FILM. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 60 COMPR.FILM. P-6L 60 10.35 0.172500 0.110000 0.110000232 N06BX03 PIRACETAMUM NEUROSTIM 400 mg COMPR. FILM. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 2.20 0.110000 0.110000 0.110000233 N06BX03 PIRACETAMUM NOOTROPIL (R) 800 mg COMPR. FILM. 800mg U.C.B. SA BELGIA CUTIE X 6 BLIST. X 15 COMPR. FILM. P-6L 90 31.23 0.347000 0.205500 0.205500234 N06BX03 PIRACETAMUM PIRACETAM 800 mg COMPR. FILM. 800mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 4.11 0.205500 0.205500 0.205500235 N06BX03 PIRACETAMUM PIRACETAM LPH 800 mg COMPR. FILM. 800mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 6.27 0.209000 0.205500 0.205500236 N06BX03 PIRACETAMUM LUCETAM COMPR. FILM. 800mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.FILM. P-6L 30 9.51 0.317000 0.205500 0.205500237 N06BX03 PIRACETAMUM NEUROSTIM 800 mg COMPR. FILM. 800mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 20 4.14 0.207000 0.205500 0.205500238 N06BX03 PIRACETAMUM NOOTROPIL SOL. INJ. 1g U.C.B. SA BELGIA CUTIE X 12 FIOLE DIN STICLA X 5 ML SOL. INJ. P-RF 12 15.78 1.315000 0.862000 0.862000239 N06BX03 PIRACETAMUM MEMOTAL1 g/5 ml SOL. INJ. 1g/5ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF 5 4.31 0.862000 0.862000 0.862000240 N06BX03 PIRACETAMUM NOOTROPIL (R) SOL. ORALA 20% U.C.B. SA BELGIA CUTIE X 1 FLACON DIN STICLA BRUNA X 125 ML + 1 MASURA DOZATOARE P-6L 1 12.48 12.480000 12.480000 12.480000

241 N06BX03 PIRACETAMUM NOOTROPIL SOL. PERF. 12g U.C.B. SA BELGIA CUTIE X 1 FLACON DIN STICLA X 60 ML SOL. PERF. S 1 15.78 15.780000 15.780000 15.780000

242 N07CA02 CINNARIZINUM STUGERON 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. X 10 COMPR. P-6L 40 6.61 0.165250 0.068000 0.068000243 N07CA02 CINNARIZINUM CINARIZIN 25 mg COMPR. 25mg LAROPHARM SRL ROMANIA CUTIE X 3 BLIST. X 20 COMPR. P-6L 60 4.25 0.070833 0.068000 0.068000244 N07CA02 CINNARIZINUM N-CINARIZINA COMPR. 25mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. PE X 20 COMPR. P-6L 20 1.36 0.068000 0.068000 0.068000245 P01AX08 TENONITROZOLUM ATRICAN 250 mg CAPS. MOI GASTROREZ. 250mg LAB. INNOTECH INT. FRANTA CUTIE X 1 BLIST. AL/PVC X 8 CAPS. MOI GASTROREZ. P-RF 8 10.85 1.356250 1.356250 1.356250246 P02CC01 PYRANTELUM HELMINTOX (R) 125 mg COMPR. FILM. 125mg LAB. INNOTECH INT. FRANTA CUTIE X 2 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 6 3.25 0.541666 0.541666 0.541666247 P02CC01 PYRANTELUM HELMINTOX (R) 250 mg COMPR. FILM. 250mg LAB. INNOTECH INT. FRANTA CUTIE X 1 BLIST. X 3 COMPR. FILM. P-RF 3 3.25 1.083333 1.083333 1.083333

Pagina 6 din 8

Page 156: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

248 P03AAN1 SULFUR UNGUENT CU SULF 8% UNGUENT 8% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB AL X 40G P-RF 1 1.80 1.800000 1.800000 1.800000249 P03AX01 BENZYLUM BENZOICUM BENZOAT DE BENZIL MK CREMA 25% FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 35 G CREMA P-RF 1 3.59 3.590000 3.590000 3.590000250 P03AX01 BENZYLUM BENZOICUM BENZOAT DE BENZIL MK CREMA 25% FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 50 G CREMA P-RF 1 5.15 5.150000 3.590000 3.590000251 R01AD07 TIXOCORTOLUM PIVALONE 1% SUSP. NAZALA 1% PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLACON X 10 ML + POMPA DOZATOARE + APLICATOR NAZAL P-RF 1 9.83 9.830000 9.830000 9.830000252 R01ADN1 COMBINATII BIORINIL SPRAY NAZ.,SUSP. FARA CONCENTRATIE FARMILA FARMACEUTICI ITALIA CUTIE X 1 FLACON X 10 ML SPRAY NAZAL, SUSP. PREVAZUT CU NEBULIZATOR P-RF 1 24.28 24.280000 24.280000 24.280000

253 R01BA52 COMBINATII CLARINASE (R) COMPR. ELIB. MODIF. FARA CONCENTRATIE SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 BLIST. X 7 COMPR. ELIB. MODIF. P-6L 7 8.71 1.244285 1.244285 1.244285254 R02AB03 FUSAFUNGINUM BIOPAROX SPRAY BUCOFARINGIAN SI NAZAL-SOL. 50mg/10ml LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLACON PRESURIZAT DIN AL X 10 ML SOL. + 3 APLIC. DIN PE: 1 APLIC. BUCAL (ALB) + 2 APLIC. P-RF 1 18.80 18.800000 18.800000 18.800000

255 R03CA02 EPHEDRINI HYDROCHLORIDUM EFEDRINA ARENA COMPR. 50mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 8.81 0.293666 0.293666 0.293666256 R03CA02 EPHEDRINI HYDROCHLORIDUM EFEDRINA 50 mg/ ml SOL. INJ. 50mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE CU INEL DE RUPERE X 1ML SOL. INJ S 5 3.33 0.666000 0.666000 0.666000257 R05CB01 ACETYLCYSTEINUM ACC INJECT 300mg/3ml SOL. INJ. 300mg/3ml HEXAL AG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. S/P-RF 5 7.09 1.418000 1.418000 1.418000258 R05CB03 CARBOCISTEINUM HUMEX EXPECTORANT PENTRU COPII SI SUGARI SIROP 100mg/5ml LAB. URGO FRANTA CUTIE X 1 FLACON X 125ML SIROP + MASURA DOZATOARE A 5 ML P-RF 1 7.52 7.520000 7.520000 7.520000259 R05CB03 CARBOCISTEINUM RHINATHIOL 2% pentru copii si sugari SIROP 2% SANOFI-AVENTIS OTC FRANTA CUTIE X 1 FLACON DIN STICLA INCOLORA X 125 ML SIROP + LINGURITA DOZATOARE P-RF 1 8.63 8.630000 7.520000 7.520000260 R05CB03 CARBOCISTEINUM MUCOTREIS SIROP 20mg/ml ECOBI PHARMACEUTICI ITALIA CUTIE X 1 FLACON DIN STICLA BRUNA X 150 ML SIROP + MASURA DOZATOARE A 10 ML P-RF 1 8.26 8.260000 7.520000 7.520000261 R05CB03 CARBOCISTEINUM FLUIDOL 100mg/5ml SOL. ORALA 100mg/5ml TIS FARMACEUTIC SA ROMANIA CUTIE X 1 FLACON DIN PVC X 100 ML SIROP + LINGURITA DUBLA GRADATA LA 2,5 SI 5 ML P-RF 1 3.31 3.310000 3.310000 3.310000262 R06AD02 PROMETHAZINUM PROMETAZINA ARENA 30 mg COMPR. FILM. 30mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 14.10 0.705000 0.705000 0.705000263 R06AD02 PROMETHAZINUM ROMERGAN SIROP 5mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 ML SIROP + MASURA DOZATOARE P-RF 1 2.19 2.190000 2.190000 2.190000264 R06AD07 MEQUITAZINUM PRIMALAN (R) 10 mg COMPR. 10mg LAB. PIERRE FABRE FRANTA CUTIE X 1 BLIST. AL/PVC X 14 COMPR. P-RF 14 15.10 1.078571 1.078571 1.078571265 R06AE05 MECLOZINUM EMETOSTOP COMPR. 30mg SPECIFAR SA GRECIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 3.36 0.336000 0.336000 0.336000266 R06AX02 CYPROHEPTADINUM PERITOL COMPR. 4mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3.07 0.153500 0.153000 0.153000267 R06AX02 CYPROHEPTADINUM CIPROHEPTADINA 4 mg COMPR. 4mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4.59 0.153000 0.153000 0.153000268 R06AX02 CYPROHEPTADINUM PERITOL SIROP 2mg/5ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON X 100 ML + MASURA DOZATOARE PP P-6L 1 5.24 5.240000 5.240000 5.240000269 R06AX02 CYPROHEPTADINUM BIOHEPT SIROP 2mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SIROP + MASURA DOZATOARE P-6L 1 5.45 5.450000 5.240000 5.240000270 R06AX13 LORATADINUM SYMPHORAL (R) 1 mg/ml SIROP 1mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON X 120 ML + LINGURITA DOZATOARE P-6L 1 16.15 16.150000 6.660000 6.660000271 R06AX13 LORATADINUM CLARITINE SIROP 1mg/ml SCHERING-PLOUGH EUROPE BELGIA CUTIE X 1 FLACON X 60 ML + LINGURITA DOZATOARE P-6L 1 8.49 8.490000 6.660000 6.660000272 R06AX13 LORATADINUM CLARITINE SIROP 1mg/ml SCHERING-PLOUGH EUROPE BELGIA CUTIE X 1 FLACON X 120 ML + LINGURITA DOZATOARE P-6L 1 16.98 16.980000 6.660000 6.660000273 R06AX13 LORATADINUM LORATADINA BIOFARM 5mg/5ml SIROP 5mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SIROP + MASURA DOZATOARE DIN PE CU GRADATII DE LA 2,5 LA 2 P-RF 1 6.66 6.660000 6.660000 6.660000274 R06AX13 LORATADINUM FLONIDAN SUSP. ORALA 5mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLACON DIN STICLA BRUNA X 120 ML SUSP. ORALA + LINGURITA DOZATOARE P-6L 1 11.26 11.260000 6.660000 6.660000275 S01AA01 CHLORAMPHENICOLUM SIFICETINA PULB. + SOLV. PT. SOL. OFT. 0,4% S.I.F.I. SPA ITALIA CUTIE X 1 FLAC. STICLA BRUNA X 5 ML SOLV. + O PUNGA X UN REZERVOR CU PULB. + UN PICURATOR P-RF 1 5.98 5.980000 5.980000 5.980000276 S01AA13 ACIDUM FUSIDICUM FUCITHALMIC 10mg/g GEL OFT. 10mg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB AL CU CANULA APLICATOARE X 5 G GEL OFTALMIC P-6L 1 14.05 14.050000 14.050000 14.050000

277 S01AA24 KANAMYCINUM KANAMICINA SULFAT 1% UNG. OFT. 1% ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB AL X 6 G P-RF 1 2.36 2.360000 2.360000 2.360000278 S01AA30 COMBINATII ANTIBIOPTAL PICATURI OFT.-SOL. FARA CONCENTRATIE FARMILA FARMACEUTICI ITALIA CUTIE X 1 FLACON PICURATOR X 10 ML P-RF 1 12.33 12.330000 12.330000 12.330000

279 S01AA30 COMBINATII COLBIOCIN PULB. + SOLV. PT. SOL. OFT. FARA CONCENTRATIE S.I.F.I. SPA ITALIA CUTIE X 1 FLACON X 5 ML SOLV. + PLIC REZERVOR PULBERE + DISP. PICURARE P-RF 1 6.72 6.720000 6.720000 6.720000280 S01BA07 FLUOROMETHOLONUM FLUMETOL S PICATURI OFT.SUSP. 2mg/ml FARMILA - THEA FARMACEUTICI SPA ITALIA CUTIE X 1 FLACON PEJD X 10ML PIC. OFT. SUSP. P-RF 1 30.08 30.080000 30.080000 30.080000

281 S01BA07 FLUOROMETHOLONUM FLUMETOL S UNGUENT OFTALMIC UNG. OFT. 1mg/g FARMILA - THEA FARMACEUTICI SPA ITALIA CUTIE X 1 TUB X 5G P-RF 1 9.49 9.490000 9.490000 9.490000282 S01BA11 DESONIDUM PRENACID PICATURI OFT.-SOL. 0,25% S.I.F.I. SPA ITALIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML, PREVAZUT CU PICURATOR P-RF 1 6.35 6.350000 6.350000 6.350000283 S01BC01 INDOMETACINUM INDOCOLLYRE (R) 0,1% PICATURI OFT.-SOL. 0,1% LAB. CHAUVIN FRANTA CUTIE X 1 FLACON PICURATOR DIN POLIETILENA X 5 ML P-6L 1 13.62 13.620000 13.620000 13.620000

284 S01BC06 PIROXICAMUM BRUXICAM 0,5% PIC. OFT., SOL. 0,5% BRUSCHETTINI S.R.L. ITALIA CUTIE X 1 FLAC. DIN PEJD PREVAZUT CU PICURATOR X 10 ML PIC. OFT., SOL. P-6L 1 15.72 15.720000 15.720000 15.720000

285 S02CA05 COMBINATII SOLUTIE AURICULARA CU CLORAMFENICOL SI FLUOCINOLON SOL. AURICULARA FARA CONCENTRATIE BIOFARM SA ROMANIA CUTIE X 1 FLAC DIN STICLA BRUNA+APLICATOR TIP PIPETA X 10 ML SOL. AURICULARA P-RF 1 2.67 2.670000 2.670000 2.670000B03AA02 FERROSI FUMARASC01EA01 ALPROSTADILUM**D03AX03 DEXPANTHENOLUMD05AC01 DITHRANOLUMD10AE01 BENZOYLIS PEROXIDUM

G01AX12 CICLOPIROXUMJ01XC01 ACIDUM FUSIDICUM

Pagina 7 din 8

Page 157: ANEXA 1 - Reumatism52 a03aa04 mebeverinum duspatalin 200 mg caps. elib. prel. 200mg solvay pharmaceuticals bv olanda cutie x 3 blist. x 10 caps. elib. prel. p-6l 30 26.07 0.869000

M01AX02 ACIDUM NIFLUMICUMM02AA07 PIROXICAMUMM02AA13 IBUPROFENUMM02AA17 ACIDUM NIFLUMICUMM02AA23 INDOMETACINUMM02ACN3 COMBINATIIP03AC04 PERMETHRINUMR03CC03 TERBUTALINUMR03DX05 OMALIZUMABUM**R06AA04 CLEMASTINUMS01EB01 PILOCARPINUMS01GX06 EMEDASTINUMS01GX08 KETOTIFENUMS01KA01 ACIDUM HIALURONICUM

S01XA11 NANDROLONUMS01XA12 DEXPANTHENOLUM

NOTA:

Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se face pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MSP si cu aprobarea comisiilor de la nivelul Caselor Judetene de Asigurari de Sanatate;

Medicamentele din această sublistă corespund DCI-urilor din CANAMED altele decât cele din sublistele A, B si C1. Pentru categoriile de asigurati mentionate in aceasta sublista, medicamentele corespunzatoare denumirilor comune internationale din sublista A, sublista B, sectiunea C1 a sublistei C, se vor acorda in regim de compensare de 100% la pret de referinta, indiferent de indicatia pentru care sunt prevazute in aceste subliste .

Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MSP;

Pagina 8 din 8