Liste Positive - CNS

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Numéro national Dénomination abrégée Prise en charge conditionnelle Prix public Taux B01AA04 phenprocoumon 0069603 MARCOUMAR 3 MG 25 CPR 0 0 5,85 100 B01AA07 acenocoumarol 0252624 SINTROM 1 MG 100 CPR 102241 0 0 6,32 100 0105291 SINTROM 4 MG 20 CPR 0 0 5,87 100 B01AB01 heparin 0156645 HEPARIN CA RATIO 12500 U 5 AMP 0,5 ML IV 0 0 11,08 80 0154833 HEPARIN CA RATIO 5000 U 10 SRG 0,2 ML IV 0 0 14,97 80 0154816 HEPARIN CA RATIO 5000 U 20 AMP 0,2ML IVS 0 0 17,74 80 0154802 HEPARIN CA RATIO 5000 U 5 AMP 0,2 ML IVS 0 0 5,13 80 0053018 HEPARIN LEO 25000 U 1 AMP 5 ML 0 0 3,78 80 0053021 HEPARIN NA BRN 25000 U 10 FL 5 ML IVSC 0 0 2,38 80 0053035 HEPARIN NA BRN 5000 U 10 AMP 0,5 ML IVSC 0 0 2,03 80 0173968 HEPARIN NA RATIO 25000 U 5 FL 5 ML IVSC 0 0 21,97 80 0154508 HEPARIN NA RATIO 5000 U 10 SRG 0,2 ML IV 0 0 14,97 80 0154492 HEPARIN NA RATIO 5000 U 20 AMP 0,2 ML 0 0 15,56 80 0154489 HEPARIN NA RATIO 5000 U 5 AMP 0,2 ML IVS 0 0 4,33 80 0164518 MONO EMBOLEX 3000 IE 10 SRG 0,3 ML 0 0 43,67 80 0164485 MONO EMBOLEX NM 20 AMP 0,5 ML SC 0 0 79,56 80 B01AB04 dalteparin 0206523 FRAGMIN 10000 U 10 SRG 1 ML IV 0 0 74,36 80 0261914 FRAGMIN 12500 U 5 SRG 0,5 ML SC 0 0 47,98 80 0261931 FRAGMIN 15000 U 5 SRG 0,6 ML SC 0 0 54,89 80 0261959 FRAGMIN 18000 U 5 SRG 0,72 ML SC 0 0 64,46 80 0191742 FRAGMIN 2500 U 10 SRG 0,2 ML SC 0 0 25,51 80 0191756 FRAGMIN 5000 U 10 SRG 0,2 ML SC 0 0 40,40 80 0219972 FRAGMIN 7500 U 10 SRG 0,75 ML SC 0 0 54,89 80 B01AB05 enoxaparin 0190485 CLEXANE 100 MG 10 SRG 1 ML IVSC 0 0 56,81 80 0316492 CLEXANE 120 MG 10 SRG 0,8 ML SCIV 0 0 78,22 80 0316489 CLEXANE 150 MG 10 SRG 1 ML SCIV 0 0 81,69 80 0173128 CLEXANE 20 MG 10 SRG 0,2 ML IVSCVI 0 0 23,88 80 0173145 CLEXANE 40 MG 10 SRG 0,4 ML IVSCVI 0 0 38,22 80 0267613 CLEXANE 60 MG 10 SRG 0,6 ML IVSC 0 0 44,43 80 0190454 CLEXANE 80 MG 10 SRG 0,8 ML IVSC 0 0 50,60 80 B01AB06 nadroparin 0163829 FRAXIPARINE 10000U 10 SRG 0,4 ML SC 0 0 30,89 80 0046531 FRAXIPARINE 15000U 10 SRG 0,6 ML SC 0 0 39,58 80 0163846 FRAXIPARINE 20000 U 10 SRG 0,8 ML SC 0 0 50,59 80 0217741 FRAXIPARINE 25000 U 10 SRG 1 ML SC 0 0 61,68 80 0046609 FRAXIPARINE 7500U 10 SRG 0,3 ML SC 0 0 25,02 80 0300637 FRAXODI 19000 U/ML 10 AMP SRG 0,6 ML 0 0 87,73 80 0300641 FRAXODI 19000 U/ML 10 AMP SRG 0,8 ML 0 0 114,03 80 0300654 FRAXODI 19000 U/ML 10 AMP SRG 1 ML 0 0 140,30 80 B01AB10 tinzaparin 0243978 INNOHEP 10000 U 10 SRG 0.5 ML SC 0 0 72,76 80 0243981 INNOHEP 14000 U 10 SRG 0.7 ML SC 0 0 98,30 80 0243995 INNOHEP 18000 U 10 SRG 0.9 ML SC 0 0 123,89 80 0243916 INNOHEP 2500 U 10 SRG 0,25 ML SC 0 0 25,03 80 0243947 INNOHEP 3500 U 10 SRG 0.35 ML SC 0 0 31,18 80 0243964 INNOHEP 4500 U 10 SRG 0.45 ML SC 0 0 36,63 80 B01AC04 clopidogrel 0541837 CLOPIDOGREL DOC 75 MG 28 CPR 0 0 13,22 80 0541868 CLOPIDOGREL DOC 75 MG 84 CPR 0 0 29,51 80 0560488 CLOPIDOGREL EG 75 MG 28 CPR 0 0 29,73 80 0560524 CLOPIDOGREL EG 75 MG 84 CPR 0 0 42,21 80 0537316 CLOPIDOGREL RATIO GMBH 75 MG 100 CPR 0 0 49,16 80 0537252 CLOPIDOGREL RATIO GMBH 75 MG 28 CPR 0 0 24,49 80 0253117 PLAVIX 75 MG 28 CPR 0 0 31,13 80 0253134 PLAVIX 75 MG 84 CPR 0 0 65,82 80 B01AC05 ticlopidine 0116829 TICLID 250 MG 30 DRG 0 0 15,90 80 0171218 TICLID 250 MG 60 DRG 0 0 23,97 80 0451354 TICLOPIDINE EG 250 MG 30 CPR 0 0 15,90 80 Page 12 of 85
Numéro national Dénomination abrégée Prise en charge conditionnelle Prix public Taux 0451368 TICLOPIDINE EG 250 MG 60 CPR 0 0 19,20 80 0451371 TICLOPIDINE EG 250 MG 90 CPR 0 0 30,90 80 B01AC06 acetylsalicylic acid 0169271 ASAFLOW 160 MG 56 CPR 0 0 9,43 80 0251952 ASAFLOW 80 MG 56 CPR ENTEROSOL 0 0 6,01 80 0207128 CARDEGIC 160 PDR 30 SACH 0 0 4,14 80 0207131 CARDEGIC 300 PDR 30 SACH 0 0 4,57 80 0517456 CARDIOASPIRINE 100 MG 28 CPR 0 0 3,64 80 0244667 CARDIOASPIRINE 100 MG 30 CPR 0 0 4,00 80 0517487 CARDIOASPIRINE 100 MG 56 CPR 0 0 6,16 80 0311791 CARDIOASPIRINE 100 MG 60 CPR 0 0 6,77 80 0517506 CARDIOASPIRINE 100 MG 84 CPR 0 0 9,24 80 0189405 HERZ ASS RATIO 100 MG 100 CPR 0 0 3,08 80 0189386 HERZ ASS RATIO 100 MG 50 CPR 0 0 1,85 80 B01AC07 dipyridamole 0134648 DIPYRIDAMOLE EG 75 MG 100 DRG 0 0 6,84 80 0088934 PERSANTINE 75 MG 100 DRG 0 0 9,29 80 0088982 PERSANTINE RET 200 MG 60 CAPS 0 0 12,69 80 0135208 PERSANTINE RET GE 150 MG 60 CAPS 0 0 10,09 80 B01AC22 prasugrel 0516977 EFIENT 10 MG 28 CPR 1 1 56,37 80 0517005 EFIENT 10 MG 84 CPR 1 1 153,20 80 0516641 EFIENT 5 MG 28 CPR 1 1 56,37 80 0516672 EFIENT 5 MG 84 CPR 1 1 153,20 80 B01AC30 combinations 0289008 AGGRENOX 60 CAPS 0 0 16,71 80 B01AE07 dabigatran etexilate 0481871 PRADAXA 110 MG 10 CAPS 1 13 27,23 80 0481899 PRADAXA 110 MG 60 CAPS 1 13 129,62 80 0481837 PRADAXA 75 MG 10 CAPS 1 13 27,23 80 0481854 PRADAXA 75 MG 60 CAPS 1 13 129,62 80 B01AX06 rivaroxaban 0494253 XARELTO 10 MG 10 CPR 1 13 58,37 80 0494267 XARELTO 10 MG 30 CPR 1 13 129,68 80 B02AA02 tranexamic acid 0043378 EXACYL 10 AMP BUV 10 ML 0 0 12,93 80 0043350 EXACYL 250 MG 100 CPR 0 0 19,24 80 0218301 EXACYL 250 MG 50 CPR 0 0 13,06 80 0173825 EXACYL 500 MG 20 CPR 0 0 12,44 80 0043381 EXACYL 500 MG 5 AMP 5 ML IV 0 0 10,32 80 B02BA01 phytomenadione 0234254 KONAKION PED 2 MG 5 AMP 0,2 ML IMIVPO 0 0 11,13 80 B02BC02 oxidized cellulose 0084269 OUATE HEMOSTATIQUE QUALIPHAR 10 G 0 0 7,38 80 B02BX01 etamsylate 0032357 DICYNONE 20 CPR 0 0 3,91 80 0032360 DICYNONE 50 CPR 0 0 8,73 80 0032374 DICYNONE 6 AMP 2 ML IMIV 0 0 2,45 80 B02BX04 romiplostim 0547956 NPLATE 250 MCG PDR 1 FL + KIT SC 1 5 655,81 100 0547973 NPLATE 500 MCG PDR 1 FL + KIT SC 1 5 1.302,74 100 B03AA01 ferrous glycine sulfate 0410155 FERROSANOL 30 MG/ML GTTS 30 ML 0 0 3,70 80 0044599 FERROSANOL DUODENAL 50 CAPS 0 0 12,72 80 0272613 FERROSANOL GYN 50 CAPS 0 0 11,16 80 B03AA03 ferrous gluconate 0180959 LOSFERRON 80 MG 60 CPR EFF 0 0 18,01 80 B03AA07 ferrous sulfate 0044537 FEROGRAD 500 (525 MG) 30 CPR 0 0 7,67 80 0044540 FEROGRAD 500 (525 MG) 60 CPR 0 0 14,56 80 0044361 FEROGRADUMET 30 CPR 0 0 4,10 80 0044375 FEROGRADUMET 60 CPR 0 0 7,92 80 0196489 TARDYFERON 80 MG 30 CPR 0 0 3,49 80 Page 13 of 85
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Liste Positive - CNS

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