SE ADAUGA SE MODIFICA

Anexa 6 (Anexa 2a la Ordinul CNAS 944/2015) SUBLISTA A - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 90% DIN PRETUL DE REFERINTA CONFORM DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE PERSONALA DIN HG NR. 720/2008 CU COMPLETARILE SI MODIFICARILE ULTERIOARE VALABILA INCEPAND CU 01 OCTOMBRIE 2016 Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP tara det. APP Amba compensare 90% din pretul de compensare 90% 1.145 A03AD01 PAPAVERINI HYDROCHLORIDUM PAPAVERINE SOPHARMA 20 mg/ml SOL INJ. 20mg/ml CN UNIFARM S.A. ROMANIA CUTIE CU 10 FIOLE X 1 ML SOL. INJ. PRF 10 1,772000 0,000000 1,594800 0,177200 1.146 C07AA07 SOTALOLUM DAROB 80 mg COMPR. 80mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,224650 0,292850 0,202185 0,315315 1.147 C07AB07 BISOPROLOLUM BISOGAMMA 5 mg COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 100 0,149800 0,000000 0,134820 0,014980 1.148 J01MA06 NORFLOXACINUM NORFLOXACINA ATB 400 mg COMPR. FILM. 400mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 20 0,809999 0,070001 0,728999 0,151001 1.149 M01AB16 ACECLOFENACUM ACOFAX 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 20 COMPR. FILM. P6L 20 0,137700 0,311300 0,123930 0,325070 1.150 N06AB03 FLUOXETINUM* FLUOXETIN ARENA 10 mg CAPS. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. PRF 100 0,288562 0,362938 0,259705 0,391795 1.151 N06AB03 FLUOXETINUM* FLUOXETIN ARENA 10 mg CAPS. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,288562 0,407438 0,259705 0,436295 1.152 N06AB03 FLUOXETINUM* FLUOXETIN ARENA 20 mg CAPS. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,577125 0,223875 0,519412 0,281588 1.153 N06AB03 FLUOXETINUM* FLUOXETIN ARENA 20 mg CAPS. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. PRF 100 0,577125 0,143575 0,519412 0,201288 1.154 R05DA04 CODEINUM CODEINA SLAVIA 15mg COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,169500 0,004000 0,152550 0,020950 173 C07AB02 METOPROLOLUM BETAPROL 100 mg COMPR. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,217449 0,078884 0,195704 0,100629 174 C07AB02 METOPROLOLUM EGILOK 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X, 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 0,217449 0,079051 0,195704 0,100796 175 C07AB02 METOPROLOLUM METOPROLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,217449 0,028551 0,195704 0,050296 176 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,217449 0,078884 0,195704 0,100629 177 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,217449 0,078884 0,195704 0,100629 178 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 100 mg COMPR. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,217449 0,079051 0,195704 0,100796 179 C07AB02 METOPROLOLUM METOPROLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,217449 0,024884 0,195704 0,046629 180 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,217449 0,073051 0,195704 0,094796 181 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 0,217449 0,078884 0,195704 0,100629 182 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 100 mg COMPR. 100mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L 30 0,217449 0,078884 0,195704 0,100629 183 C07AB02 METOPROLOLUM EGILOK 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 0,054362 0,044138 0,048925 0,049575 184 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,054362 0,044138 0,048925 0,049575 185 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,054362 0,044304 0,048925 0,049741 186 C07AB02 METOPROLOLUM METOPROLOL ARENA 25 MG COMPR. 25mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,054362 0,044304 0,048925 0,049741 187 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-6L 60 0,054362 0,043971 0,048925 0,049408 188 C07AB02 METOPROLOLUM BETAPROL 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,108724 0,073609 0,097851 0,084482 189 C07AB02 METOPROLOLUM EGILOK 50 mg COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 0,108724 0,073776 0,097851 0,084649 190 C07AB02 METOPROLOLUM METOPROLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,108724 0,055609 0,097851 0,066482 191 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,108724 0,073609 0,097851 0,084482 192 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,108724 0,135276 0,097851 0,146149 193 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 50 mg COMPR. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,108724 0,063776 0,097851 0,074649 194 C07AB02 METOPROLOLUM METOPROLOL ARENA 50 MG COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,108724 0,073609 0,097851 0,084482 195 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,108724 0,073776 0,097851 0,084649 196 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 0,108724 0,042942 0,097851 0,053815 197 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 50 mg COMPR. 50mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L 30 0,108724 0,073609 0,097851 0,084482 198 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mg COMPR. ELIB. MODIF. 190mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,413154 0,090846 0,371838 0,132162 199 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR. ELIB. MODIF. 47,5mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,103288 0,112378 0,092959 0,122707 200 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR. ELIB. MODIF. 95mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,206577 0,151756 0,185919 0,172414 201 C07AB02 METOPROLOLUM METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L 20 0,217449 0,079051 0,195704 0,100796 202 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 100 mg COMPR. FILM. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,217449 0,078884 0,195704 0,100629 203 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,108724 0,072609 0,097851 0,083482 Pagina 1 din 3

compensare 90% din pretul de compensare 90% tara det. Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Amba 204 C07AB02 METOPROLOLUM BETALOC (R) ZOK 100 mg COMPR. FILM. ELIB. PREL. 100mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 0,217449 0,238551 0,195704 0,260296 205 C07AB02 METOPROLOLUM BETALOC (R) ZOK 50 mg COMPR. FILM. ELIB. PREL. 50mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 0,108724 0,271276 0,097851 0,282149 206 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mg COMPR.FILM.ELIB.MOD. 190mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,413154 0,090846 0,371838 0,132162 207 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,103288 0,112378 0,092959 0,122707 208 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,206577 0,151756 0,185919 0,172414 215 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.FILM. P-6L 28 0,326174 0,029897 0,293556 0,062515 218 C07AB07 BISOPROLOLUM BISOPROLOL LPH 5mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,163087 0,089579 0,146778 0,105888 220 C07AB07 BISOPROLOLUM BOREZ 10 mg COMPR. FILM. 10 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 0,326174 0,036826 0,293556 0,069444 221 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 0,326174 0,556826 0,293556 0,589444 222 C07AB07 BISOPROLOLUM BISOGAMMA (R) 10 COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L/S 100 0,326174 0,175026 0,293556 0,207644 223 C07AB07 BISOPROLOLUM BISOGAMMA (R) 10 COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 0,326174 0,034492 0,293556 0,067110 224 C07AB07 BISOPROLOLUM BISOTENS 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,326174 0,020492 0,293556 0,053110 225 C07AB07 BISOPROLOLUM BISOPROLOL FUMARAT AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L 30 0,326174 0,033492 0,293556 0,066110 226 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,326174 0,759159 0,293556 0,791777 227 C07AB07 BISOPROLOLUM SOBYC 10 mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,326174 0,021159 0,293556 0,053777 228 C07AB07 BISOPROLOLUM BOREZ 2,5 mg COMPR. FILM. 2,5 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 0,081543 0,161790 0,073388 0,169945 229 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,081543 0,292790 0,073388 0,300945 230 C07AB07 BISOPROLOLUM SOBYC 2,5 mg COMPR. FILM. 2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,081543 0,127457 0,073388 0,135612 231 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 0,163087 0,351913 0,146778 0,368222 233 C07AB07 BISOPROLOLUM BISOGAMMA (R) 5 COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM. P-6L 100 0,163087 0,005813 0,146778 0,022122 234 C07AB07 BISOPROLOLUM BISOTENS 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,163087 0,043246 0,146778 0,059555 235 C07AB07 BISOPROLOLUM BISOPROLOL FUMARAT AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L 30 0,163087 0,042246 0,146778 0,058555 236 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,163087 0,226246 0,146778 0,242555 237 C07AB07 BISOPROLOLUM SOBYC 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,163087 0,043246 0,146778 0,059555 697 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,225800 0,851200 1,103220 0,973780 698 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,245160 3,625840 0,220644 3,650356 699 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,245160 3,158840 0,220644 3,183356 700 J01MA02 CIPROFLOXACINUM CIPROCIN 250 mg COMPR. FILM. 250mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,612900 0,070100 0,551610 0,131390 701 J01MA02 CIPROFLOXACINUM CIPRINOL 250 mg COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,612900 0,094100 0,551610 0,155390 702 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 250 mg COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,612900 0,070100 0,551610 0,131390 703 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,612900 0,096100 0,551610 0,157390 704 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 0,612900 0,107100 0,551610 0,168390 705 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,612900 0,068100 0,551610 0,129390 706 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,612900 0,025100 0,551610 0,086390 707 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 0,612900 0,087100 0,551610 0,148390 710 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 500 mg COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,225800 0,096200 1,103220 0,218780 711 J01MA02 CIPROFLOXACINUM CUMINOL 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,225800 0,145200 1,103220 0,267780 713 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,225800 0,145200 1,103220 0,267780 718 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 750 mg COMPR. FILM. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,838700 2,032300 1,654830 2,216170 720 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 2,451600 10,102685 2,206440 10,347845 721 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 1,225800 8,327533 1,103220 8,450113 722 J01MA03 PEFLOXACINUM PEFLOXACIN LAROPHARM COMPR. FILM. 400mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,225800 1,665200 1,103220 1,787780 723 J01MA06 NORFLOXACINUM NORFLOXACINA LPH 400 mg COMPR. FILM. 400mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,809999 0,006001 0,728999 0,087001 725 J01MA06 NORFLOXACINUM NORFLOXACIN HELCOR 400 mg COMPR. FILM. 400mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,809999 0,070001 0,728999 0,151001 780 M01AB01 INDOMETACINUM INDOMETACIN LAROPHARM 25 mg CAPS. 25mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST., PVC/AL, X 10 CAPS. P-6L 20 0,068850 0,015150 0,061965 0,022035 781 M01AB01 INDOMETACINUM INDOMETACIN ARENA 25 MG CAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,068850 0,005150 0,061965 0,012035 782 M01AB01 INDOMETACINUM INDOMETACIN ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 0,137700 0,045800 0,123930 0,059570 786 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L 20 0,413099 2,061401 0,371789 2,102711 787 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 0,206549 0,374451 0,185894 0,395106 788 M01AB05 DICLOFENACUM DICLOTARD 100 mg COMPR. CU ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL P-6L 20 0,275400 0,079100 0,247860 0,106640 790 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 0,275400 0,269600 0,247860 0,297140 791 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 0,275400 0,079100 0,247860 0,106640 792 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 0,137700 0,042800 0,123930 0,056570 795 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 0,137700 0,105300 0,123930 0,119070 796 M01AB05 DICLOFENACUM DICLOFENAC ARENA 25 mg DRAJ. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L 30 0,068850 0,128816 0,061965 0,135701 810 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 0,091799 0,258201 0,082619 0,267381 Pagina 2 din 3

compensare 90% din pretul de compensare 90% tara det. Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Amba 811 M01AB15 KETOROLACUM TROMETHAMIN KETANOV 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. FILM. P-6L 20 0,091799 0,434201 0,082619 0,443381 816 M01AB16 ACECLOFENACUM AFLAMIL 100mg COMPR. FILM. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR. P-6L 20 0,137700 0,597800 0,123930 0,611570 817 M01AB16 ACECLOFENACUM ACE-TAB 100 mg COMPR. FILM. 100mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM. P6L 20 0,137700 0,340800 0,123930 0,354570 818 M01AB16 ACECLOFENACUM AFLAMIL 100 mg PULB. PT.SUSP. ORALA 100mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 20 PLICURI UNIDOZA DIN MATERIAL COMPLEX DIN HARTIE DE TIP OPALINA LAMINATA PE UN STRAT DE ALUMINIU (20 ΜM) SI FILM DIN PEJD P6L 20 0,137700 1,200300 0,123930 1,214070 1.116 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,169500 0,030833 0,152550 0,047783 1.117 R05DA04 CODEINUM CODEINA FOSFORICA COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,169500 0,035700 0,152550 0,052650 1.119 R05DA04 CODEINUM CODEINA FOSFAT COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0,169500 0,004000 0,152550 0,020950 1.121 R05DA04 CODEINUM CODEINA FOSFAT MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,169500 0,020000 0,152550 0,036950 SE ELIMINA 171 C07AA07 SOTALOLUM DAROB 80 mg COMPR. 80mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PP/AL X 10 COMPR. P6L 20 0,224650 0,292850 0,202185 0,315315 266 C08CA01 AMLODIPINUM AMLODIPINA TEVA 10 mg COMPR. 10 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,123333 0,000000 0,110999 0,012334 276 C08CA01 AMLODIPINUM AMLODIPIN VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. P-6L 20 0,264299 0,029201 0,237869 0,055631 284 C08CA01 AMLODIPINUM AMLODIPINA TEVA 5 mg COMPR. 5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,125333 0,000000 0,112799 0,012534 294 C08CA01 AMLODIPINUM AMLODIPIN VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. P-6L 20 0,132149 0,237851 0,118934 0,251066 Pagina 3 din 3

Anexa 7 (Anexa 2b la Ordinul CNAS 944/2015) SUBLISTA B - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 50% DIN PRETUL DE REFERINTA CONFORM DENUMIRILOR COMUNE INTERNATIONALE (DCI) ALE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE PERSONALA DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE, VALABILA INCEPAND CU 01 OCTOMBRIE 2016 Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP Tara det. APP Amba (pt. asiguratii care Val. maxima suportata de compensare 50% din pretul de (pt. asiguratii care compensare 50% din pretul de Val. maxima suportata de compensare 90% din pretul de (pt. asiguratii care compensare 90% din pretul de 1.116 A02BX05 BISMUTHI SUBCITRAS ULCAMED 120 mg COMPR. FILM. 120mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. FILM. P6L 60 0,315200 0,683633 0,157600 0,841233 0,283680 0,715153 1.117 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 10 COMPR. FILM. PRF 10 1,541000 0,000000 0,770500 0,770500 1,386900 0,154100 1.118 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 5 COMPR. FILM. PRF 5 1,562000 0,000000 0,781000 0,781000 1,405800 0,156200 1.119 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 5 COMPR. FILM. PRF 5 4,422000 0,000000 2,211000 2,211000 3,979800 0,442200 1.120 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 10 COMPR. FILM. PRF 10 4,175000 0,000000 2,087500 2,087500 3,757500 0,417500 69 B01AB04 DALTEPARINUM**# FRAGMIN 2500 UI/0,2 ml SOL. INJ. 2500ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP X 0,2 ML SOLUTIE INJECTABILA S/P-RF 10 4,970291 1,228709 2,485145 3,713855 4,473261 1,725739 70 B01AB04 DALTEPARINUM**# FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 10 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,2 ML SOLUTIE INJECTABILA S/P-RF 10 9,940583 1,510417 4,970291 6,480709 8,946524 2,504476 72 B01AB05 ENOXAPARINUM**# CLEXANE 2000ui anti-xa/0,2ml SOL. INJ. 2000ui anti-xa/0,2ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML SOL. INJ. PR/PRF 10 4,970291 1,456709 2,485145 3,941855 4,473261 1,953739 73 B01AB05 ENOXAPARINUM**# CLEXANE 4000ui anti-xa/0,4ml SOL. INJ. 4000ui anti-xa/0,4ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML SOL. INJ. PR/PRF 10 9,940583 1,719417 4,970291 6,689709 8,946524 2,713476 74 B01AB05 ENOXAPARINUM**# CLEXANE 6000ui anti-xa/0,6ml SOL. INJ. 6000ui anti-xa/0,6ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. PR/PRF 10 14,910874 0,077126 7,455437 7,532563 13,419786 1,568214 77 B01AB06 NADROPARINUM**# FRAXIPARINE 2850 UI anti-factor Xa/0,3 ml SOL. INJ. 2850 ui AFXa/0,3ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,3 ML SOL. INJ. S/P-RF 10 4,970291 1,474709 2,485145 3,959855 4,473261 1,971739 79 B01AB06 NADROPARINUM**# FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ. S/P-RF 10 6,627053 1,869947 3,313526 5,183474 5,964347 2,532653 81 B01AB06 NADROPARINUM**# FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ. S/P-RF 10 9,940583 3,244417 4,970291 8,214709 8,946524 4,238476 83 B01AB06 NADROPARINUM**# FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AFXa/0,8ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ. S/P-RF 10 13,254107 2,763893 6,627053 9,390947 11,928696 4,089304 84 B01AB10 TINZAPARINUM**# INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN FLACOANE 10000UI anti-xa/ml LEO PHARMA A/S DANEMARCA PR/PRF 10 28,401662 24,409338 14,200831 38,610169 25,561495 27,249505 85 B01AB10 TINZAPARINUM**# INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN FLACOANE 20000 UI anti-xa/ml LEO PHARMA A/S DANEMARCA PR/PRF 10 56,803330 56,081670 28,401665 84,483335 51,122997 61,762003 CUTIE CU 10 SERINGI PREUMPLUTE X 0.35 ML (3500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC VERDE PR/PRF 10 4,970291 7,357709 2,485145 9,842855 4,473261 7,854739 86 B01AB10 TINZAPARINUM**# INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN SERINGI PREUMPLUTE 10000UI anti-xa/ml LEO PHARMA A/S DANEMARCA 87 B01AB10 TINZAPARINUM**# INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN SERINGI PREUMPLUTE 10000UI anti-xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 SERINGI PREUMPLUTE X 0.45 ML (4500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ALBASTRU PR/PRF 10 6,390373 9,463627 3,195186 12,658814 5,751335 10,102665 88 B01AB10 TINZAPARINUM**# INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 2 SERINGI PREUMPLUTE X 0,50 ML (10000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ROSU PR/PRF 2 7,100414 29,889586 3,550207 33,439793 6,390372 30,599628 89 B01AB10 TINZAPARINUM**# INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 2 SERINGI PREUMPLUTE X 0,70 ML (14000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC GALBEN PR/PRF 2 19,881166 30,538834 9,940583 40,479417 17,893049 32,526951 90 B01AB10 TINZAPARINUM**# INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 2 SERINGI PREUMPLUTE X 0,90 ML (18000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ALBASTRU PR/PRF 2 25,561499 34,213501 12,780749 46,994251 23,005349 36,769651 91 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 1,854700 0,209700 0,927350 1,137050 1,669230 0,395170 92 B01AB11 SULODEXIDUM** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFA WASSERMANN SPA ITALIA CUTIE X 3 BLIST. PVDC-PVC/AL-PVDC A CATE 20 CAPS. MOI P-RF 60 1,854700 0,209800 0,927350 1,137150 1,669230 0,395270 93 B01AB11 SULODEXIDUM** COREFLUX 250 ULS CAPS. MOI 250ULS SANIENCE S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. MOI PRF 50 1,645000 0,000000 0,822500 0,822500 1,480500 0,164500 94 B01AB11 SULODEXIDUM** COREFLUX 600 ULS/2 ml SOL INJ. 600ULS/2ml SANIENCE S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. PRF 10 6,486000 0,000000 3,243000 3,243000 5,837400 0,648600 95 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 6,841749 1,067251 3,420874 4,488126 6,157574 1,751426 678 J01MA12 LEVOFLOXACINUM TAVANIC 250 mg COMPR. FILM. 250mg TERAPIA S.A. ROMANIA CUTIE X1 BLIST. PVC/AL. X 7 COMPR. FILM. P-RF 7 2,451600 1,399828 1,225800 2,625628 2,206440 1,644988 680 J01MA12 LEVOFLOXACINUM LEVALOX 250 mg COMPR. FILM. 250mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 7 COMPR. FILM. PRF 7 2,451600 0,052685 1,225800 1,278485 2,206440 0,297845 683 J01MA12 LEVOFLOXACINUM TAVANIC 500 mg COMPR. FILM. 500mg TERAPIA S.A. ROMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF 7 4,903200 1,688228 2,451600 4,139828 4,412880 2,178548 686 J01MA14 MOXIFLOXACINUM AVELOX 400 mg COMPR. FILM. 400mg BAYER PHARMA GERMANIA CUTIE X 1 BLIST. TRANSPARENT PP/AL X 5 COMPR. FILM. P-RF 5 4,903200 6,180800 2,451600 8,632400 4,412880 6,671120 AG 687 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA COMPR. FILM. 400mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR. FILM. PRF 5 4,903200 2,302800 2,451600 4,754400 4,412880 2,793120 AUROBINDO 400 mg 688 J01MA14 MOXIFLOXACINUM MOFINACIN 400 mg COMPR. FILM. 400mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. OPA-AL-PVC/AL X 5 COMPR. FILM PRF 5 4,903200 2,302800 2,451600 4,754400 4,412880 2,793120 689 J01MA14 MOXIFLOXACINUM MOFIL 400 mg COMPR. FILM. 400mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 5 COMPR. FILM. PRF 5 4,903200 2,302800 2,451600 4,754400 4,412880 2,793120 690 J01MA14 MOXIFLOXACINUM MOFLAXA 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONAINÂND 5 COMPRIMATE FILMATE PRF 5 4,903200 2,302800 2,451600 4,754400 4,412880 2,793120 1.013 R03DC03 MONTELUKASTUM* MONTELUKAST AUROBINDO COMPR. MAST. 4mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,527428 0,191143 0,263714 0,454857 0,474685 0,243886 4 mg 1.027 R03DC03 MONTELUKASTUM* MONTELUKAST AUROBINDO 5 mg COMPR. MAST. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,659285 0,114286 0,329642 0,443929 0,593356 0,180215 1.086 B01AB05 ENOXAPARINUM**# CLEXANE 2000 UI anti-xa/0,2ml SOL. INJ. 2000UI SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,2 ML SOL INJ. PR/PRF 10 4,970291 1,456709 2,485145 3,941855 4,473261 1,953739 anti-xa/0,2ml ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,4 ML SOL INJ. PR/PRF 10 9,940583 1,719417 4,970291 6,689709 8,946524 2,713476 1.087 B01AB05 ENOXAPARINUM**# CLEXANE 4000 UI anti-xa/0,4ml SOL. INJ. 4000UI anti-xa/0,4ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,6 ML SOL INJ. PR/PRF 10 14,910874 0,077126 7,455437 7,532563 13,419786 1,568214 1.088 B01AB05 ENOXAPARINUM**# CLEXANE 6000 UI anti-xa/0,6ml SOL. INJ. 6000UIanti-Xa/0,6ml SANOFI ROMANIA S.R.L. SE ELIMINA 76 B01AB06 NADROPARINUM**# FRAXIPARINE 2850 UI anti-factor Xa/0,3 ml SOL. INJ. 2850 ui AFXa/0,3ml GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,3 ML SOL. INJ. S/P-RF 10 4,995999 1,449001 2,497999 3,947001 4,496399 1,948601 78 B01AB06 NADROPARINUM**# FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4ml GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ. S/P-RF 10 6,661331 1,835669 3,330665 5,166335 5,995197 2,501803 80 B01AB06 NADROPARINUM**# FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6ml GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ. S/P-RF 10 9,991999 3,193001 4,995999 8,189001 8,992799 4,192201 82 B01AB06 NADROPARINUM**# FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AFXa/0,8ml GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ. S/P-RF 10 13,322663 2,695337 6,661331 9,356669 11,990396 4,027604 861 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM CIPLA 10 mg COMPR. FILM. 10mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. PRF 28 0,848928 0,000000 0,424464 0,424464 0,764035 0,084893 1.046 R06AE09 LEVOCETIRIZINUM LEVOCETIRIZINA CIPLA 5 mg COMPR. FILM. 5mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,561333 0,000000 0,280666 0,280667 0,505199 0,056134 Pagina 1 din 1

CU 1 FLAC. DIN PEÎD CU CAPAC CAPAC PREVAZUT CU SISTEM SECURIZAT PENTRU COPII DIN PP SI RECIPIENT CU DESICANT, A 30 COMPR. FILM. PR CU 1 FLAC. DIN PEÎD CU PERETII ÎNGROSATI CU CAPAC PREVAZUT CU SISTEM SECURIZAT PENTRU COPII DIN PP SI RECIPIENT CU DESICANT, A 30 COMPR. FILM. PR SECŢIUNEA C1 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% DIN PREŢUL DE REFERINŢĂ CONFORM DCI-urilor UTILIZATE ÎN TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOLI DIN H.G. NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE; MEDICAMENTELE DIN ACEASTĂ SUBLISTĂ SE ELIBEREAZĂ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZĂ DE PRESCRIPŢIE MEDICALĂ CU REŢINERE ÎN FARMACIE VALABILĂ ÎNCEPÂND CU 01 OCTOMBRIE 2016 Anexa 8 (Anexa 2c la Ordinul CNAS 944/2015) NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP TARA DET. APP AMBALAJ din pretul de 1.INSUFICIENTA CARDIACA CRONICA(CLASA III SAU IV NYHA) - G 1 256 C07AB07 BISOPROLOLUM BISOGAMMA 5 mg COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 100 0,146799 0,146799 0,003001 4. HEPATITELE CRONICE DE ETIOLOGIE VIRALA B, C şi D - G4 40 J05AF05 LAMIVUDINUM**** LAMIVUDINE TEVA 100 mg COMPR. FILM. 100 mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 2,836666 2,836666 0,000000 41 J05AF07 TENOFOVIRUM DISOPROXIL**** VIROFOB 245 mg COMPR. FILM. 245mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. PEID CU CAPAC DIN PP X 30 COMPR. FILM. PR 30 27,475333 27,475333 0,000000 5 J05AB04 RIBAVIRINUM**** RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 1,966369 1,966369 0,000000 11 J05AF07 TENOFOVIRUM DISOPROXIL**** 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 32,970399 32,970399 8,027267 12 J05AF07 TENOFOVIRUM DISOPROXIL**** TENOFOVIR DISOPROXIL TEVA 245 mg COMPR. FILM. 245mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE 30 27,475333 27,475333 0,000000 13 J05AF07 TENOFOVIRUM DISOPROXIL**** TENOFOVIR DISOPROXIL TEVA 245 mg COMPR. FILM. 245mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE 30 27,475333 27,475333 0,000000 7. CIROZA HEPATICA - G7 63 J05AF05 LAMIVUDINUM**** LAMIVUDINE TEVA 100 mg COMPR. FILM. 100 mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 2,836666 2,836666 0,000000 29 J05AB04 RIBAVIRINUM**** REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 2,359642 2,359642 5,522429 30 J05AB04 RIBAVIRINUM**** COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168 2,359642 2,359642 5,438215 31 J05AB04 RIBAVIRINUM**** RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 1,966369 1,966369 0,000000 32 J05AB04 RIBAVIRINUM**** MODERIBA 200 mg COMPR. FILM. 200mg ABBVIE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 168 COMPR. PRF 168 2,359642 2,359642 2,847203 8. Leucemii, limfoame, aplazie medulara, gamapatii monoclonale maligne, mieloproliferari cronice si tumori maligne, sindroame mielodisplazice - G10 190 A04AA05 PALONOSETRONUM** PALONOSETRON ACCORD 250 micrograme SOL INJ. 250micrograme ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. CARE CONTINE 5 ML SOLUTIE PALONOSETRON PRF 1 214,310000 214,310000 0,000000 Pagina 1 din 5

din pretul de TARA NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ 191 J02AC03 VORICONAZOLUM** VORICONAZOL FRESENIUS KABI 200 mg PULB. PT. SOL. PERF. 200mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA TIP I, CU CAPACITATEA DE 25 ML, CU PULBERE PT. SOL. PERF. PRF 1 354,010000 354,010000 0,000000 192 R05DA04 CODEINUM CODEINA SLAVIA 15mg COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,173500 0,173500 0,000000 16 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 1 257,172000 257,172000 72,548000 176 R05DA04 CODEINUM CODEINA FOSFAT COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0,173500 0,173500 0,000000 9. EPILEPSIE - G11 136 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM TORRENT 750 mg COMPR. FILM. 750 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 2,362000 2,362000 0,000000 137 N03AX14 LEVETIRACETAMUM** MYAKELL 750 mg COMPR. FILM. 750mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 2,834400 2,834400 0,423600 142 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM DESITIN 750 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 750mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 60 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 60 2,834400 2,834400 0,042766 SE ELIMINA 110 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM CIPLA 1000 mg COMPR. FILM. 1000mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 1,878799 1,878799 0,049867 122 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM CIPLA 250 mg COMPR. FILM. 250mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 0,477666 0,477666 0,000000 135 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM CIPLA 500 mg COMPR. FILM. 500mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 0,644666 0,644666 0,000000 138 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM CIPLA 750 mg COMPR. FILM. 750mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 1,425000 1,425000 0,000000 10. BOALA PARKINSON - G12 107 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,782500 1,782500 0,000000 108 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 125 mg/31,25 mg/200 mg COMPR. FILM. 125mg/31,25mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,782500 1,782500 0,000000 109 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,822800 1,822800 0,000000 110 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 175 mg/43,75 mg/200 mg COMPR. FILM. 175mg/43,75mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,730800 1,730800 0,000000 111 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,730800 1,730800 0,000000 112 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,646200 1,646200 0,000000 113 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,75mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,846300 1,846300 0,000000 114 N04BD02 RASAGILINUM*** HIPERAVIA 1 mg COMPR. 1mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 6,445999 6,445999 2,148334 115 N04BD02 RASAGILINUM*** SAGILIA 1 mg COMPR. 1mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. PRF 30 6,445999 6,445999 3,153667 116 N04BD02 RASAGILINUM*** AZILECT 1mg COMPR. 1mg TEVA BV OLANDA CUTIE X 30 COMPR.(BLIST. AL/AL) P-RF 30 6,445999 6,445999 1,411334 82 N04BD02 RASAGILINUM*** AZILECT 1mg COMPR. 1mg TEVA PHARMA GMBH GERMANIA CUTIE X 30 COMPR.(BLIST. AL/AL) P-RF 30 6,445999 6,445999 1,411334 13. BOLI PSIHICE (SCHIZOFRENIE, TULBURĂRI SCHIZOTIPALE ŞI DELIRANTE, TULBURĂRI AFECTIVE MAJORE, TULBURĂRI PSIHOTICE ACUTE ŞI BOLI PSIHICE COPII, AUTISM, TULBURĂRI CU DEFICIT DE ATENŢIE/HIPERREACTIVITATE) - G15 SE ELIMINA Pagina 2 din 5

CU 1 FLAC. ALB, OPAC DIN PE DE DENSITATE MEDIE, CU CAPACITATEA DE 10 ML, PREVAZUT CU PICURATOR SIGILAT SI UN CAPAC ASAMBLATE DIN 2 PIESE, CU 5 ML PIC. OFT., SOL. P6L CU 1 FLAC. DE TIP OCUMETER PLUS ALCATUIT DINTR-UN FLAC. TRANSLUCID DIN PEÎD,CU CAPACITATEA DE 8 ML,CU PICURATOR DIN PEÎD,ÎNCHIS CU UN CAPAC ALCATUIT DIN 2 COMPONENTE SI PREVAZUT CU BANDA DE SIGURANTA, CA PARTE A ETICHETEI PROD.X5 ML SOL.OFT. P6L CU 1 FLAC. DE TIP OCUMETER PLUS ALCATUIT DINTR-UN FLAC. TRANSLUCID DIN PE D,CU CAPACITATEA DE 8 ML,CU PICURATOR DIN PE D,ŒNCHIS CU UN CAPAC ALCATUIT DIN 2 COMPONENTE SI PREVAZUT CU BANDA DE SIGURANTA, CA PARTE A ETICHETEI PROD.X5 ML SOL.OFT. P-6L NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP TARA DET. APP AMBALAJ din pretul de 232 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM CIPLA 10 mg COMPR. FILM. 10mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. PRF 28 0,848928 0,848928 0,000000 16. POLIARTRITA REUMATOIDA, ARTROPATIA PSORIAZICA SI ARTRITA JUVENILA - G 18 55 L01BA01 METHOTREXATUM NAMAXIR 10 mg SOL INJ. IN SERINGA PREUMPLUTA 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE 56 L01BA01 METHOTREXATUM NAMAXIR 15 mg SOL INJ. IN SERINGA PREUMPLUTA 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE 57 L01BA01 METHOTREXATUM NAMAXIR 25 mg SOL INJ. IN SERINGA PREUMPLUTA 25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE 58 L01BA01 METHOTREXATUM NAMAXIR 7,5 mg SOL INJ. IN SERINGA PREUMPLUTA 7,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,40 ML SOL. INJ. PR CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,38 ML SOL. INJ. PR CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,63 ML SOL. INJ. PR CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,30 ML SOL. INJ. PR 4 39,762500 39,762500 0,000000 4 39,762500 39,762500 0,000000 4 66,270000 66,270000 0,000000 4 29,767500 29,767500 0,000000 9 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ PR 1 35,721000 35,721000 26,159000 12 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 47,715000 47,715000 31,985000 14 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÃ PARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 47,715000 47,715000 22,305000 15 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÃ PARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 79,524000 79,524000 31,156000 16 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.30ML SOLUTIA INJECTABILA PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 47,715000 47,715000 27,165000 18. BOLI ENDOCRINE (GUŞĂ ENDEMICĂ, INSUFICIENŢĂ SUPRARENALĂ CRONICĂ, DIABETUL INSIPID, MIXEDEMUL ADULTULUI, TUMORI HIPOFIZARE CU EXPANSIUNE SUPRASELARĂ, TUMORI NEUROENDOCRINE ŞI 43 H05AA02 TERIPARATIDUM** FORSTEO 20µg/80µl SOL. INJ. 20µg/80µl ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 2,4 ML (28 DOZE X 20 ΜCG/80ΜCL) P-RF 1 1.417,480000 1.417,480000 0,000000 21. GLAUCOM - G 26 32 S01EC03 DORZOLAMIDUM DORZOLAMIDA ARENA 20 mg/ml PIC. OFT., SOL. 20mg/ml ARENA GROUP S.A. ROMANIA CUTIE 1 14,530000 14,530000 0,000000 33 S01EC03 DORZOLAMIDUM TRUSOPT 20 mg/ml PIC. OFT., SOL. 20mg/ml SANTEN OY FINLANDA CUTIE 1 17,436000 17,436000 4,904000 34 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM) COSOPT 20 mg/l + 5 mg/ml PIC. OFT.-SOL. 20mg/ml+5mg/ml SANTEN OY FINLANDA CUTIE CU 1 FLACON DE TIP OCUMETER PLUS X 5 ML PIC. OFT., SOL. P6L 1 31,716000 31,716000 4,204000 2 S01EC03 DORZOLAMIDUM TRUSOPT SOL. OFT. 20mg/ml MERCK SHARP & DOHME ROMANIA CUTIE 1 17,436000 17,436000 4,904000 15 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM) COSOPT PIC. OFT.-SOL. 20mg/ml+5mg/ml MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DE TIP OCUMETER PLUS X 5ML PIC. OFT., SOL. P-6L 1 31,716000 31,716000 4,204000 Pagina 3 din 5

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP 26. POLIARTITRITA REUMATOIDA - G31b TARA DET. APP AMBALAJ din pretul de 25 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000 26 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000 9 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000 10 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000 27. ARTROPATIA PSORIAZICA - G31c 13 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000 14 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000 4 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000 5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000 28. SPONDILITA ANKILOZANTA - G 31d 14 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000 15 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000 4 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000 5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000 29. ARTRITA JUVENILA - G 31e 14 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000 15 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000 Pagina 4 din 5

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP TARA DET. APP AMBALAJ din pretul de 5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000 6 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000 30. PSORIAZIS CRONIC SEVER - G 31f 11 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000 12 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000 4 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000 5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000 Pagina 5 din 5

Anexa 9 (Anexa 2d la Ordinul CNAS 944/2015) SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% DIN PREȚUL DE REFERINȚĂ - CONFORM DCI-URILOR, ALTELE DECÂT CELE DIN SUBLISTELE A, B, SUBLISTA C SECŢIUNEA C1 ŞI SUBLISTA D, CORESPUNZĂTOARE MEDICAMENTELOR, DE CARE BENEFICIAZĂ COPIII PÂNĂ LA 18 ANI, TINERII DE LA 18 LA 26 DE ANI DACĂ SUNT ELEVI, UCENICI SAU STUDENŢI, DACĂ NU REALIZEAZĂ VENITURI, PRECUM ŞI GRAVIDE ŞI LEHUZE, ÎN TRATAMENTUL AMBULATORIU, DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE, VALABILĂ ÎNCEPÂND CU 01 OCTOMBRIE 2016 Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP Tara det. APP Amba l aj din pretul de 210 A11DA03 BENFOTIAMINUM NEUROSSEN 300 mg COMPR. FILM. 300mg AAA-PHARMA GMBH GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 30 2,566333 2,566333 0,000000 211 A11DBN1 COMBINATII NEUROSSEN INJEKT SOL. INJ. FARA CONCENTRATIE AAA-PHARMA GMBH GERMANIA CUTIE X 10 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML SOL. INJ. PRF 10 3,713000 3,713000 0,000000 Pagina 1 din 1