Liste positive des médicaments valable au 1er avril 2010 ... - CNS

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Numéro national Dénomination abrégée Prise en charge conditionnelle Prix public T<strong>au</strong>x 0081351 OCULOTECT COLLY 10 ML 0 0 4,75 80 % 0233261 OCULOTECT COLLY 3*10 ML 0 0 9,87 80 % S01XA12 dexpanthenol 0187561 CORNEREGEL 10 G 0 0 4,47 80 % S01XA20 artificial tears and other indifferent preparations 0223782 ALCON EYE GEL 10 G 0 0 6,59 40 % 0182341 ARTELAC COLLY 1 FL 10 ML 450 0 0 4,18 40 % 0225451 ARTELAC EDO COLLY 120 * 0,6 ML 0 0 31,83 40 % 0225434 ARTELAC EDO COLLY 30 * 0,6 ML 0 0 11,57 40 % 0225448 ARTELAC EDO COLLY 60 * 0,6 ML 0 0 19,70 40 % 0164017 DISPATENOL COLLY 10 ML 0 0 4,45 40 % 0233226 DISPATENOL COLLY 3*10 ML 0 0 6,40 40 % 0160746 ISOPTO TEARS COLLY 15 ML 0 0 4,14 40 % 0063059 LACRYPOS 3% COLLY 10 ML 0 0 3,27 40 % 0210302 LACRYTUBE CUSI POM OPHT 5 G 0 0 6,43 40 % 0066596 LIQUIFILM TEARS 15 ML 0 0 5,01 40 % 0294168 OCUGEL 0,25% GEL 10 G 0 0 7,88 40 % 0419469 PVP AUGENTROPFEN DR MANN 10 ML 0 0 2,95 40 % 0224681 SICCAGENT 2 % COLLY 10 ML 0 0 4,88 40 % 0166851 TEARS NATURAL 15 ML 0 0 4,73 40 % 0222186 THILO TEARS GEL OPHT 10 G 0 0 6,59 40 % 0279273 VIDISIC EDO GEL 120*0,6 ML 0 0 31,83 40 % 0279242 VIDISIC EDO GEL 30*0,6 ML 0 0 11,57 40 % 0279256 VIDISIC EDO GEL 60*0,6 ML 0 0 19,70 40 % 0140273 VIDISIC GEL 10 G 431 0 0 4,18 40 % 0140287 VIDISIC GEL 3*10 G 432 0 0 8,52 40 % S02AA Antiinfectives 0144448 OTOFA GTTS 200000 U 1 FL 10 ML 0 0 3,51 80 % S02AA30 antiinfectives, combinations 0076432 NEOBACITRACINE INSTILLATION 0 0 3,51 80 % S02CA05 fluocinolone acetonide and antiinfectives 0112492 SYNALAR BI OTIC GTTS 5 ML 0 0 3,06 80 % S02CA06 dexamethasone and antiinfectives 0092050 POLYDEXA GTTS AURICUL 10 ML 0 0 2,44 80 % S02DA01 lidocaine 0084112 OTIPAX 16 G 0 0 2,63 80 % S02DC Indifferent preparations 0020308 CERULYX GTTS 10 ML 0 0 5,83 80 % 0130375 SPACES XERUMENEX GTTES AURICUL 0 0 4,33 80 % 0486928 RELISTOR 12 MG 1 FL 0,6 ML SC 0 0 42,16 80 % 0486945 RELISTOR 12 MG 7 FL 0,6 ML+7 SRG+14 TAMP 0 0 193,66 80 % V01AA20 various 0213206 ALLERGOVIT 1 FL B (ENTRETIEN) 1*3 ML 0 0 221,76 80 % 0213191 ALLERGOVIT ST A+B / 2*3 ML 0 0 242,64 80 % 0080600 NOVO HELISEN DEP EB ST 1-3 3*4,5 ML 0 0 115,78 80 % 0080628 NOVO HELISEN DEP FS ST 3 1*4,5 ML 0 0 69,37 80 % 0487987 NOVO HELISEN DEP FS ST 3 2*4,5 ML 0 0 120,16 80 % 0080564 NOVO HELISEN ORAL FS ST 3 3*30 ML 0 0 163,09 0 % 0536059 NOVO-HELISEN DEPOT EB ST 1-3 3*4,5 ML 0 0 115,78 80 % 0536031 NOVO-HELISEN DEPOT FL ENTRETIEN 1*4,5 ML 0 0 69,37 80 % 0536045 NOVO-HELISEN DEPOT FL ENTRETIEN 2*4,5 ML 0 0 120,16 80 % V03AB Antidotes 0147101 LEGALON SIL 350 MG PDR 4 FL+S 5 ML IV 0 0 564,85 80 % V03AB14 protamine 0246028 PROTAMINE 1000 ROCHE 5000 U 5 AMP 5 ML 0 0 10,00 80 % 0140337 PROTAMINE SULF LEO 10 MG/ML 1 FL 5 ML 0 0 6,98 80 % 0536112 PROTAMINE SULF LEO 1400 U/ML 1 FL 5 ML 0 0 6,98 80 % V03AC01 deferoxamine 0030545 DESFERAL 500 MG PDR 10 FL+S 0 0 40,03 100 % V03AC02 deferiprone 0269487 FERRIPROX 500 MG 100 CPR 0 0 245,82 100 % V03AC03 deferasirox Page 84 of 85
Numéro national Dénomination abrégée Prise en charge conditionnelle Prix public T<strong>au</strong>x 0441991 EXJADE 125 MG 84 CPR 1 5 694,50 100 % 0442016 EXJADE 250 MG 84 CPR 1 5 1.380,70 100 % 0442047 EXJADE 500 MG 84 CPR 1 5 2.683,10 100 % V03AE01 polystyrene sulfonate 0061622 KAYEXALATE CALCIUM PDR 300 G 0 0 21,49 100 % 0061636 KAYEXALATE SODIUM PDR 450 G 0 0 24,82 100 % 0107170 SORBISTERIT CA PDRE 500G 3400711 0 0 41,50 100 % V03AE02 sevelamer 0319379 RENAGEL 800 MG 180 CPR 0 0 193,75 100 % 0519593 RENVELA 2,4 G PDR 60 SACH 0 0 184,30 100 % 0519545 RENVELA 800 MG 180 CPR (FL) 0 0 184,30 100 % V03AE03 lanthanum carbonate 0403522 FOSRENOL 500 MG 90 CPR A CROQ 0 0 195,32 100 % 0403603 FOSRENOL 750 MG 90 CPR A CROQ 0 0 245,62 100 % V03AF03 calcium folinate 0438898 RESCUVOLIN 15 MG 10 CPR 0 0 39,65 100 % 0438903 RESCUVOLIN 15 MG 50 CPR 0 0 132,00 100 % V03AF04 calcium levofolinate 0213531 ELVORINE 7,5 MG 10 CPR 0 0 29,40 100 % V03AN01 oxygen 0243155 OXYGENE MEDICAL BT 100 L 0 0 5,60 80 % 0243205 OXYGENE MEDICAL BT 1000 L 0 0 5,60 80 % 0243236 OXYGENE MEDICAL BT 10500 L 0 0 55,26 80 % 0243169 OXYGENE MEDICAL BT 200 L 0 0 5,60 80 % 0243219 OXYGENE MEDICAL BT 2100 L 0 0 11,80 80 % 0243172 OXYGENE MEDICAL BT 300 L 0 0 5,60 80 % 0243186 OXYGENE MEDICAL BT 400 L 0 0 5,60 80 % 0243222 OXYGENE MEDICAL BT 4200 L 0 0 23,60 80 % 0243141 OXYGENE MEDICAL BT 74 L 0 0 5,60 80 % V04CX Other diagnostic agents 0137975 BLEU PATENTE 5 AMP 2 ML SC 0 0 13,78 80 % V07AB Solvents and diluting agents, incl. irrigating solutions 0007340 AQUA AD INJ BRN 10 AMP 20 ML P 0 0 7,46 80 % 0007337 AQUA AD INJ BRN 10 MINI PL 10 ML 0 0 7,06 80 % 0007256 AQUA AD INJ BRN 100 ML V 0 0 1,39 80 % V08AA01 diatrizoic acid 0123434 UROGRAFINE 76% 1 FL 100 ML PERF 0 0 12,38 80 % V08AB02 iohexol 0081883 OMNIPAQUE 300 MG/ML 1 FL 10 ML IV 0 0 8,91 80 % 0081964 OMNIPAQUE 300 MG/ML 1 FL 100 ML IV 0 0 41,28 80 % 0081902 OMNIPAQUE 300 MG/ML 1 FL 20 ML IV 0 0 12,10 80 % 0081947 OMNIPAQUE 300 MG/ML 1 FL 50 ML IV 0 0 24,04 80 % 0180394 OMNIPAQUE 300 MG/ML 1 FL PLAST 50 ML IV 0 0 26,12 80 % V08AB05 iopromide 0132031 ULTRAVIST 300 1 AMP 20 ML IVIA 0 0 11,69 80 % 0132304 ULTRAVIST 300 1 AMP INJ 10 ML 0 0 9,10 80 % 0132075 ULTRAVIST 300 1 FL 100 ML IVIA 0 0 41,51 80 % 0192333 ULTRAVIST 300 1 FL 150 ML IVIA 0 0 57,35 80 % 0192347 ULTRAVIST 300 1 FL 200 ML IVIA 0 0 74,32 80 % 0132058 ULTRAVIST 300 1 FL 50 ML IVIA 0 0 26,27 80 % V08BA01 barium sulfate with suspending agents 0154024 MICROPAQUE SCANNER SUSP 150 ML 0 0 6,54 80 % Page 85 of 85
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Liste positive des médicaments valable au 1er avril 2010 ... - CNS

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