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AANEXA 1SUBLISTA A - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 90% DIN PRETUL DE REFERINTA CONFORMDENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU CONTRIBUTIE PERSONALA DIN HG NR. 720/2008 CU COMPLETARILE SI MODIFICARILE ULTERIOARE VALABILA INCEPAND CU1 IANUARIE 2014Nr crt.Cod_Comercialcod ATCDCIDenumire Comercialaforma farm.concentratieDetinator APPtara det. APPAmbalajPrescriptiecant/ambalajPret 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. Adultisublista?1W05395003A02BA02RANITIDINUMRANITIDIN ARENA 150mgCOMPR.150mgARENA GROUP SAROMANIACUTIE X 2 BLIST. PVC/AL X 10 COMPR.P-6L204.550.2275000.1922990.173069ANu2W05401002A02BA02RANITIDINUMRANITIDINA 150 mgCOMPR.150mgMAGISTRA C&C S.R.L.ROMANIACUTIE X 2 BLIST. AL/PVC X 10 COMPR.P-6L204.560.2280000.1922990.173069ANu3W07339001A02BA02RANITIDINUMRANITIDINCOMPR.150mgSLAVIA PHARM SRLROMANIACUTIE X 2 BLIST. AL/PVC X 10 COMPR.P-6L204.550.2275000.1922990.173069ANu4W05408001A02BA02RANITIDINUMZANTAC 150 mgCOMPR. FILM.150mgGLAXO WELLCOME UK LTD.MAREA BRITANIECUTIE X 2 BLIST. AL/AL X 10 COMPR. FILM.P-6L207.010.3505000.1922990.173069ANu5W05386002A02BA02RANITIDINUMN - RANITIDINCOMPR. FILM.150mgMEDUMAN SAROMANIACUTIE X 1 FLAC. PE X 20 COMPR. FILM.P-6L203.990.1995000.1922990.173069ANu6W42410001A02BA02RANITIDINUMRANITIDINA LAROPHARM 150 mgCOMPR. FILM.150mgLAROPHARM SRLROMANIACUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM.P-6L204.550.2275000.1922990.173069ANu7W42722001A02BA02RANITIDINUMRANITIDINA LPH 150 mgCOMPR. FILM.150mgLABORMED PHARMA SAROMANIACUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.P-6L204.560.2280000.1922990.173069ANu8W53915001A02BA02RANITIDINUMRANITIDINA ATB 150 MGCOMPR. FILM.150mgANTIBIOTICE SAROMANIACUTIE X 2 BLIST. X 10 COMPR. FILM.P-6L204.550.2275000.1922990.173069ANu9W42721001A02BA02RANITIDINUMRANITIDINA LPH 300 mgCOMPR. FILM.300mgLABORMED PHARMA SAROMANIACUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.P-6L3013.000.4333330.3845990.346139ANu10W54029002A02BA02RANITIDINUMRANITIDINA ATB 300 mgCOMPR. FILM.300mgANTIBIOTICE S.A.ROMANIACUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM.P-6L208.660.4330000.3845990.346139ANu11W06812001A02BA02RANITIDINUMARNETINSOL. INJ.25mg/mlMEDOCHEMIE LTD.CIPRUCUTIE X 5 FIOLE X 2 MLP-RF512.672.5340001.6789451.511050ANu12W03078002A02BA03FAMOTIDINUMFAMODIN 20COMPR. FILM.20mgAC HELCOR PHARMA SRLROMANIACUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.P-6L308.890.2963330.1922990.173069ANu13W42868002A02BA03FAMOTIDINUMFAMOTIDINA ZENTIVA 20mgCOMPR. FILM.20mgZENTIVA S.AROMANIACUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.P-6L305.860.1953330.1922990.173069ANu14W54838001A02BA03FAMOTIDINUMQUAMATEL 20 mgCOMPR. FILM.20mgGEDEON RICHTER ROMANIA SAROMANIACUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM.P-6L289.450.3375000.1922990.173069ANu15W42867001A02BA03FAMOTIDINUMFAMOTIDINA ZENTIVA 40 mgCOMPR. FILM.40mgZENTIVA S.AROMANIACUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.P-6L307.720.2573330.2573330.231599ADa16W03079002A02BA03FAMOTIDINUMFAMODIN 40COMPR. FILM.40mgAC HELCOR PHARMA SRLROMANIACUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.P-6L3012.310.4103330.3845990.346139ANu17W54839001A02BA03FAMOTIDINUMQUAMATEL 20 mgPULB+SOLV. PT. SOL. INJ./PERF.20mgGEDEON RICHTER ROMANIA SAROMANIACUTIE X 5 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERFUZ. + 5 FIOLE DIN STCLA INCOLORA X 5S/P-RF524.644.9280004.9280004.435200ADa18W53668001A02BA04NIZATIDINUMNIZATIDIN VIM SPECTRUM 150 mgCAPS.150mgVIM SPECTRUM SRLROMANIACUTIE X 2 BLIST. AL/PVC X 10 CAPS.P-6L2018.230.9115000.1922990.173069ANu19W57294002A02BC01OMEPRAZOLUMOMEPRAZOL AUROBINDO 10 mgCAPS. GASTROREZ.10mgAUROBINDO PHARMA (MALTA) LIMITEDMACEDONIACUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 14 CAPS. GASTROREZ.P6L144.610.3292850.3292850.296356ADa20W07481003A02BC01OMEPRAZOLUMULTOPCAPS. GASTROREZ.20mgKRKA D.D.SLOVENIACUTIE X 1 FLAC. PE X 14 CAPS. GASTROREZ.P-6L1414.451.0321420.6675740.600816ANu21W42129001A02BC01OMEPRAZOLUMOMEPRAZOL 20 mgCAPS. GASTROREZ.20mgGEDEON RICHTER ROMANIA SAROMANIACUTIE X 2 BLIST. PVC-AL-PA/AL X 7 CAPS. GASTROREZ.P-6L1414.451.0321420.6675740.600816ANu22W42284001A02BC01OMEPRAZOLUMOMEPRAZOL LPH 20 mgCAPS. GASTROREZ.20mgLABORMED PHARMA SAROMANIACUTIE X 2 BLIST. AL/PVC X 10 CAPS. GASTROREZ.P-6L2012.800.6400000.6400000.576000ADa23W43709002A02BC01OMEPRAZOLUMOMERAN 20CAPS. GASTROREZ.20mgEUROPHARM SAROMANIACUTIE X 4 BLIST. AL/AL X 7 CAPS. GASTROREZ.P-6L2821.420.7650000.6675740.600816ANu24W51990001A02BC01OMEPRAZOLUMOMEPRAZOL 20 mgCAPS. GASTROREZ.20mgSLAVIA PHARM SRLROMANIACUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ.P-6L3022.680.7560000.6675740.600816ANu25W52044001A02BC01OMEPRAZOLUMOMEPRAZOL TERAPIA 20 mgCAPS. GASTROREZ.20mgTERAPIA SAROMANIACUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ.P-6L3022.530.7510000.6675740.600816ANu26W52887001A02BC01OMEPRAZOLUMOMEPRAZOL ARENA 20 mgCAPS. GASTROREZ.20mgARENA GROUP S.A.ROMANIACUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ.P-6L3022.020.7340000.6675740.600816ANu27W53138001A02BC01OMEPRAZOLUMOMEPRAZOL FARMEX 20 mgCAPS. GASTROREZ.20mgFARMEX COMPANY SRLROMANIACUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ.P-6L3020.850.6950000.6675740.600816ANu28W53340001A02BC01OMEPRAZOLUMNOVOGAST 20 mgCAPS. GASTROREZ.20mgANTIBIOTICE S.A.ROMANIACUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR.P-6L2015.040.7520000.6675740.600816ANu29W42284003A02BC01OMEPRAZOLUMOMEPRAZOL LPH 20 mgCAPS. GASTROREZ.20mgLABORMED PHARMA SAROMANIACUTIE X 1 BLIST. PVC/AL X 10CAPS. GASTROREZP-6L106.490.6490000.6490000.584100ADa30W55651001A02BC01OMEPRAZOLUMOMEPRAZOL ROMPHARM 20 mgCAPS. GASTROREZ.20mgROMPHARM COMPANY SRLROMANIACUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ.P-6L3022.160.7386660.6675740.600816ANu31W56195002A02BC01OMEPRAZOLUMORTANOL 20 mgCAPS. GASTROREZ.20mgLEK PHARMACEUTICALS D.D.SLOVENIACUTIE CU 2 BLIST. AL/AL X 7 CAPS. GASTROREZ.P-6L148.070.5764280.5764280.518785ADa32W57109001A02BC01OMEPRAZOLUMHELICID 20CAPS. GASTROREZ.20mgZENTIVA K.S.CEHIACUTIE X 1 FLAC. DIN STICLA X 14 CAPS. GASTROREZ.P-6L1410.060.7185710.6675740.600816ANu33W57109002A02BC01OMEPRAZOLUMHELICID 20CAPS. GASTROREZ.20mgZENTIVA K.S.CEHIACUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ.P-6L2818.380.6564280.6564280.590785ADa34W58105001A02BC01OMEPRAZOLUMOMEZ 20mgCAPS. GASTROREZ.20mgDR. REDDY'S LABORATORIESROMANIACUTIE X 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ.P-6L3021.420.7140000.6675740.600816ANu35W57295005A02BC01OMEPRAZOLUMOMEPRAZOL AUROBINDO 20 mgCAPS. GASTROREZ.20mgAUROBINDO PHARMA (MALTA) LIMITEDMACEDONIACUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 28 CAPS. GASTROREZ.P6L288.940.3192850.3192850.287356ADa36W58851001A02BC01OMEPRAZOLUMOMZATOL 20 mgCAPS. GASTROREZ.20mgROMASTRU TRADING S.R.L.ROMANIACUTIE X 2 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ.P-6L1410.710.7650000.6675740.600816ANu37W58851002A02BC01OMEPRAZOLUMOMZATOL 20 mgCAPS. GASTROREZ.20mgROMASTRU TRADING S.R.L.ROMANIACUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ.P-6L2821.420.7650000.6675740.600816ANu38W59906006A02BC01OMEPRAZOLUMOMEPRAZOL ZENTIVA 20 mgCAPS. GASTROREZ.20mgZENTIVA, K.S.REPUBLICA CEHACUTIE CU 1 FLAC. DIN STICLA BRUNA, CU CAPACITATEA DE 40 ML X 28 CAPS. GASTROREZ.P6L2818.380.6564280.6564280.590785ADa39W60233001A02BC01OMEPRAZOLUMOMZATOL 20 mgCAPS. GASTROREZ.20mgNEOLA PHARMA S.R.L.ROMANIACUTIE X 2 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ.P-6L1410.710.7650000.6675740.600816ANu40W60233002A02BC01OMEPRAZOLUMOMZATOL 20 mgCAPS. GASTROREZ.20mgNEOLA PHARMA S.R.L.ROMANIACUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ.P-6L2821.420.7650000.6675740.600816ANu41W14125001A02BC01OMEPRAZOLUMORTANOL 40 mgCAPS. GASTROREZ.40mgLEK PHARMACEUTICALS D.D.SLOVENIACUTIE X 1 BLIST. AL/AL X 7 CAPS. GASTROREZ.P-6L78.031.1471421.1471421.032427ADa42W57296002A02BC01OMEPRAZOLUMOMEPRAZOL AUROBINDO 40 mgCAPS. GASTROREZ.40mgAUROBINDO PHARMA (MALTA) LIMITEDMACEDONIACUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 14 CAPS. GASTROREZ.P6L1412.760.9114280.9114280.820285ADa43W52018001A02BC01OMEPRAZOLUMOMEDAR (R)COMPR. FILM. GASTROREZ.20mgDAR AL DAWA PHARMA S.R.L.ROMANIACUTIE X 1 FLAC. DE STICLA BRUNA X 14 COMPR. FILM. GASTROREZ.P-6L1414.451.0321420.6675740.600816ANu44W59361021A02BC01OMEPRAZOLUMLOSEC MUPS 10 mgCOMPR. GASTROREZ.10mgASTRAZENECA ABSUEDIACUTIE CU 1 FLAC. PEID X 14 COMPR. GASTROREZ.P6L1433.192.3707140.3337870.300408ANu45W57994002A02BC01OMEPRAZOLUMOMEDAR 20 mgCOMPR. GASTROREZ.20mgDAR AL DAWA PHARMA S.R.L.ROMANIACUTIE X 1 FLAC. DE STICLA BRUNA X 28 COMPR. FILM. GASTROREZ.P-6L2814.450.5160710.5160710.464463ADa46W59610021A02BC01OMEPRAZOLUMLOSEC MUPS 20 mgCOMPR. GASTROREZ.20mgASTRAZENECA ABSUEDIACUTIE CU 1 FLAC. PEID X 7 COMPR. GASTROREZ.P6L724.963.5657140.6675740.600816ANu47W04649001A02BC01OMEPRAZOLUMLOSEC 40 mgLIOF. PT. SOL. PERF.40mgASTRAZENECA ABSUEDIACUTIE X 5 FLAC. X 45 MG LIOF. PT. SOL. PERF.S/P-RF5114.7222.94400021.51270019.361430ANu48W56141001A02BC01OMEPRAZOLUMOMEZ PULBERE PENTRU SOLUTIE PERFUZABILAPULB. PT. SOL. PERF.40mgDR. REDDY'S LABORATORIESROMANIACUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATE DE 15 ML CU PULB.PT. SOL. PERF.S/P-RF116.2216.22000016.22000014.598000ADa49W57030001A02BC01OMEPRAZOLUMHELICID 40 INFPULB. PT. SOL. PERF.FARA CONCENTRATIEZENTIVA K.S.CEHIACUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF.S/P-RF119.4319.43000019.43000017.487000ADa50W42951001A02BC03LANSOPRAZOLUMLEVANT 15 mgCAPS. GASTROREZ.15mgRANBAXY UK LTD.MAREA BRITANIECUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ.P-6L146.560.4685710.3337870.300408ANu51W03936001A02BC03LANSOPRAZOLUMLANZULCAPS. GASTROREZ.30mgKRKA D.D. NOVO MESTOSLOVENIACUTIE X 2 BLIST. PVC-PE-PVDC/AL X 7 CAPS. GASTROREZ.P-6L1413.130.9378570.6675740.600816ANu52W42952001A02BC03LANSOPRAZOLUMLEVANT 30 mgCAPS. GASTROREZ.30mgRANBAXY UK LTD.MAREA BRITANIECUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ.P-6L1411.360.8114280.6675740.600816ANu53W56144004A02BC03LANSOPRAZOLUMLANZAP 30mgCAPS. GASTROREZ.30mgDR. REDDY'S LABORATORIESROMANIACUTIE X 2 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ.P-6L2016.660.8330000.6675740.600816ANu