Liste des médicaments commercialisés au Luxembourg - CNS
Liste des médicaments commercialisés au Luxembourg - CNS
Liste des médicaments commercialisés au Luxembourg - CNS
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<strong>Liste</strong> <strong>des</strong> <strong>médicaments</strong> <strong>commercialisés</strong> valable <strong>au</strong> 1er octobre 2012<br />
Cette liste se base sur <strong>des</strong> données qui sont de la compétence de la Direction de la Santé, Division de la Pharmacie<br />
et <strong>des</strong> Médicaments, du Ministère de la sécurité sociale et de la Caisse nationale de santé.<br />
mode de délivrance P: médicament non soumis à prescription médicale<br />
mode de délivrance R ou RR: médicament soumis à prescription médicale<br />
mode de délivrance S: médicament soumis à prescription médicale spéciale (stupéfiants)<br />
conditions de prescription restreinte H: usage strictement hospitalier<br />
conditions de prescription restreinte D: délivrance à partir de l'hôpital vers l'ambulatoire<br />
conditions de prescription restreinte C: prescription réservée à certains médecins spécialistes<br />
OD: médicament orphelin<br />
RPM: plan de gestion du risque obligatoire<br />
PCC: Prise en charge conditionnelle de la <strong>CNS</strong><br />
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
A01AA01 sodium fluoride<br />
0045694 FLUOR SMB GTTS 30 ML P<br />
0 0 1,78 3,06 80<br />
0131307 ZYMAFLUOR 0,25 MG 250 CPR P<br />
0 0 2,32 4,62 80<br />
0131324 ZYMAFLUOR 1 MG 250 CPR P<br />
0 0 3,61 6,95 80<br />
A01AA03 olaflur<br />
0038624 ELMEX FLUID 50 ML R<br />
0 0 0,00 16,16 0<br />
A01AA30 combinations<br />
0444332 ELMEX GELEE 38 G R<br />
0 0 4,15 0,00 0<br />
0141883 FLUOCARIL BIFL 250 ANIS 125 ML P<br />
0 0 3,11 5,33 0<br />
0136107 FLUOCARIL BIFL 250 ANIS 50 ML P<br />
0 0 0,00 2,77 0<br />
0136124 FLUOCARIL BIFL 250 ANIS 75 ML P<br />
0 0 2,26 3,88 0<br />
0141866 FLUOCARIL BIFL 250 MENTHE 125 ML P<br />
0 0 3,11 5,33 0<br />
0136091 FLUOCARIL BIFL 250 MENTHE 50 ML P<br />
0 0 0,00 2,77 0<br />
0136111 FLUOCARIL BIFL 250 MENTHE 75 ML P<br />
0 0 2,26 3,88 0<br />
A01AB03 chlorhexidine<br />
0302502 BAXIL 0,2% SPRAY 30 ML P<br />
0 0 0,00 5,78 0<br />
0248151 CORSODYL GEL 50 G P<br />
0 0 2,60 4,47 0<br />
0207727 CORSODYL SOL 200 ML P<br />
0 0 2,74 4,71 40<br />
0207731 CORSODYL SPRAY 60 ML P<br />
0 0 3,42 5,88 0<br />
A01AB09 miconazole<br />
0027634 DAKTARIN GEL ORAL 40 G 17392 R<br />
0 0 2,72 7,56 80<br />
0477056 LORAMYC 50 MG 14 CPR RR<br />
0 0 56,00 69,04 0<br />
A01AB11 various<br />
0022204 CIONAL KREUSSLER SOL BUCC 30 ML P<br />
0 0 0,00 4,47 0<br />
0140788 COLLUDOL 2 MG/ML AER 30 ML P<br />
0 0 4,50 7,73 0<br />
Page 1 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0038834 ELUDRIL COLLU SPRAY 55 ML P<br />
0 0 1,91 3,40 0<br />
0264303 ELUDRIL SOL 200 ML P P<br />
0 0 0,00 6,54 0<br />
0358699 ELUDRIL SOL 500 ML P<br />
0 0 0,00 11,89 0<br />
0229643 GIVALEX SOL 125 ML P<br />
0 0 3,25 5,58 0<br />
0229609 GIVALEX SPRAY 50 ML P<br />
0 0 4,88 8,38 0<br />
0201916 OROMEDINE COLLU 60 ML P<br />
0 0 0,00 3,47 0<br />
0103199 SEDEMOL LIQ 200 ML P<br />
0 0 2,32 3,98 0<br />
0111366 SULFASEDEMOL LIQ 200 ML P<br />
0 0 3,05 5,24 0<br />
A01AB12 hexetidine<br />
0053603 HEXTRIL COLLU LIQ 200 ML P<br />
0 0 3,08 5,30 40<br />
0368339 HEXTRIL COLLU LIQ 400 ML P<br />
0 0 5,54 9,52 0<br />
0219146 HEXTRIL SPRAY 40 ML P<br />
0 0 3,39 5,82 0<br />
A01AD11 various<br />
0438853 DENTINOX N GEL 10 G P<br />
0 0 0,00 4,57 0<br />
0048536 GELFOAM 1 EPONGE ST 100 CM2 (8*12,5 CM) P<br />
0 0 7,98 0,00 0<br />
0048522 GELFOAM 4 EPONGES ST 12 CM2 (2*6 CM) P<br />
0 0 9,35 0,00 0<br />
0049483 GLANDOSANE SPRAY 50 ML 35141-01 P<br />
0 0 4,82 9,23 0<br />
0152937 HERVIROS 10 ML P<br />
0 0 2,76 5,32 0<br />
0258869 PANSORAL GEL 15 G P<br />
0 0 0,00 5,63 0<br />
0095942 PYRALVEX GTTS 10 ML P<br />
0 0 3,41 5,87 0<br />
0180329 TEEJEL 30 G P<br />
0 0 4,21 7,23 0<br />
A02AA01 magnesium carbonate<br />
0368602 MAG 2 100 MG 60 CPR P<br />
0 0 3,09 8,12 80<br />
A02AB10 combinations<br />
0655811 MAALOX ANTACID 230/400 20 SACH 4,3 ML P<br />
0 0 4,75 8,16 0<br />
0655838 MAALOX ANTACID SS SUCRE 200/400 40 CPR P<br />
0 0 3,05 5,25 0<br />
A02AC01 calcium carbonate<br />
0415733 ZIRKULIN MAGENPASTILLEN 500 MG 10 CPR P<br />
0 0 1,00 1,78 0<br />
0415747 ZIRKULIN MAGENPASTILLEN 500 MG 40 CPR P<br />
0 0 2,17 3,87 0<br />
0415751 ZIRKULIN MAGENPASTILLEN 500 MG 90 CPR P<br />
0 0 4,13 7,35 0<br />
A02AD01 ordinary salt combinations<br />
0300279 GELOX 30 SACH P<br />
0 0 0,00 5,68 80<br />
0643421 MAALOX ANTACID 200/400 MG 100 CPR P<br />
0 0 5,32 9,13 80<br />
0643434 MAALOX ANTACID 200/400 MG 40 CPR P<br />
0 0 2,66 4,57 80<br />
0643451 MAALOX ANTACID 220/380 20 SACH 10 ML P<br />
0 0 4,30 7,38 80<br />
0643448 MAALOX ANTACID 220/380 SUSP BUV 355 ML P<br />
0 0 4,70 8,07 80<br />
0643479 MAALOX ANTACID FORTE 600/400 MG 40 CPR P<br />
0 0 4,64 7,97 0<br />
0643482 MAALOX ANTACID FORTE 900/600 20SACH 10ML P<br />
0 0 5,83 10,01 80<br />
0643496 MAALOX ANTACID FORTE 900/600 SUSP 355 ML P<br />
0 0 7,58 13,02 80<br />
0176245 MAGLID 48 CPR A SUCER P<br />
0 0 2,77 4,76 80<br />
0399593 MOXYDAR 30 CPR P<br />
0 0 0,00 4,21 0<br />
Page 2 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0602106 RENNIE COOL MINT 36 PAST P<br />
0 0 3,00 5,15 0<br />
0404242 RENNIE SANS SUCRE 48 PAST P<br />
0 0 2,94 5,05 0<br />
0255285 RENNIE SANS SUCRE 96 PAST P<br />
0 0 4,78 8,21 0<br />
0529491 RENNIE SANS SUCRE MENTHE 120 PAST P<br />
0 0 6,65 11,45 0<br />
0311272 RENNIE SANS SUCRE MENTHE 60 PAST P<br />
0 0 4,16 7,14 0<br />
A02AD02 magaldrate<br />
0255299 GASTRICALM 50 CPR A CROQUER P<br />
0 0 0,00 5,93 80<br />
0100197 RIOPAN SUSP BUV 800 MG 20 SACH 10 ML P<br />
0 0 5,06 8,70 80<br />
0511791 RIOPAN SUSP BUV 800 MG 50 SACH 10 ML P<br />
0 0 10,12 17,39 80<br />
0628021 RIOPAN SUSP BUV 800 MG/10 ML 250 ML P<br />
0 0 5,06 8,70 0<br />
A02AD04 hydrotalcite<br />
0253862 TALIDAT 100 CPR P<br />
0 0 8,91 16,01 80<br />
0253845 TALIDAT 20 CPR P<br />
0 0 2,26 4,50 80<br />
0253859 TALIDAT 50 CPR P<br />
0 0 4,96 9,50 80<br />
A02AF Antacids with antiflatulents<br />
0252977 KESTOMATINE 16 CPR P<br />
0 0 2,12 3,64 0<br />
A02AH Antacids with sodium bicarbonate<br />
0048150 GASTROPAX PDR 100 G P<br />
0 0 3,55 6,66 0<br />
0267161 MAGNESIE COMP LEHNING PDR 100 G P<br />
0 0 0,00 4,80 0<br />
0069083 MAGNESIE PLUS 40 PAST P<br />
0 0 0,00 4,22 0<br />
0069097 MAGNESIE PLUS 80 PAST P<br />
0 0 0,00 6,14 0<br />
A02AX Antacids, other combinations<br />
0074813 MUTHESA 50 CPR P<br />
0 0 0,00 3,73 80<br />
0074827 MUTHESA SIR 170 ML P<br />
0 0 0,00 4,97 80<br />
0156595 SYNGEL SIR 300 ML R<br />
0 0 6,51 11,17 80<br />
0176603 SYNGEL SIR 6*50 ML R<br />
0 0 6,99 0,00 0<br />
A02BA01 cimetidine<br />
0183561 CIMEHEXAL 200 MG 10 AMP 2 ML IV RR<br />
0 0 0,00 9,72 80<br />
0178951 CIMEHEXAL 800 MG 100 CPR R<br />
0 0 0,00 17,44 80<br />
0178947 CIMEHEXAL 800 MG 50 CPR R<br />
0 0 0,00 12,99 80<br />
0301195 CIMETIDINE EG 200 MG 100 CPR R<br />
0 0 6,57 12,37 80<br />
0301178 CIMETIDINE EG 200 MG 20 CPR R<br />
0 0 0,00 6,34 80<br />
0301201 CIMETIDINE EG 400 MG 56 CPR R<br />
0 0 8,44 14,70 80<br />
0301214 CIMETIDINE EG 800 MG 28 CPR R<br />
0 0 8,44 14,70 80<br />
0182435 H2 BLOCKER RATIO 200 MG 10 AMP INJ 2 ML RR<br />
0 0 0,00 9,72 80<br />
A02BA02 ranitidine<br />
0541353 ACIDINE 75 MG 20 CPR EFF (TUBE) P<br />
0 0 4,76 8,18 0<br />
0218555 RANITIC 150 MG 100 CPR R<br />
0 0 7,01 16,76 80<br />
0218538 RANITIC 150 MG 20 CPR R<br />
0 0 1,10 10,28 80<br />
0218541 RANITIC 150 MG 50 CPR R<br />
0 0 3,47 12,89 80<br />
Page 3 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0218524 RANITIC 300 MG 100 CPR R<br />
0 0 14,72 25,20 80<br />
0218507 RANITIC 300 MG 20 CPR R<br />
0 0 2,89 12,25 80<br />
0218511 RANITIC 300 MG 50 CPR R<br />
0 0 7,30 17,08 80<br />
0446628 RANITIDINE EG 150 MG 112 CPR R<br />
0 0 4,96 10,35 80<br />
0543926 RANITIDINE EG 150 MG 112 CPR EFF (TUBE) R<br />
0 0 11,71 18,77 80<br />
0286314 RANITIDINE EG 150 MG 56 CPR R<br />
0 0 4,10 9,29 80<br />
0543909 RANITIDINE EG 150 MG 56 CPR EFF (TUBE) R<br />
0 0 9,18 15,50 0<br />
0286328 RANITIDINE EG 300 MG 28 CPR R<br />
0 0 2,98 7,89 80<br />
0544047 RANITIDINE EG 300 MG 28 CPR EFF (TUBE) R<br />
0 0 8,87 15,24 80<br />
0446631 RANITIDINE EG 300 MG 56 CPR R<br />
0 0 3,35 8,35 80<br />
0544064 RANITIDINE EG 300 MG 56 CPR EFF (TUBE) R<br />
0 0 11,71 18,77 80<br />
0130828 ZANTAC 150 MG 56 CPR R<br />
0 0 4,14 9,33 80<br />
0154167 ZANTAC 150 MG/10 ML SIR 2*280 ML R<br />
0 0 9,18 15,62 80<br />
0130831 ZANTAC 300 MG 28 CPR R<br />
0 0 2,98 7,89 80<br />
0213447 ZANTAC 300 MG 28 CPR UD R<br />
0 0 2,98 0,00 0<br />
0130845 ZANTAC 50 MG 5 AMP 2 ML IV UD RR<br />
0 0 2,76 7,61 80<br />
0418511 ZANTAC SOLUBLE 150 MG 4*14 CPR EFF R<br />
0 0 9,18 15,62 80<br />
0419293 ZANTAC SOLUBLE 300 MG 2*14 CPR EFF R<br />
0 0 9,18 15,62 80<br />
A02BB01 misoprostol<br />
0027262 CYTOTEC 200 MCG 112 CPR RR<br />
0 0 27,79 37,01 80<br />
A02BC01 omeprazole<br />
0350995 DOCOMEPRA 20 MG 28 CAPS BLIST R<br />
0 0 7,44 13,45 80<br />
0351037 DOCOMEPRA 20 MG 56 CAPS BLIST R<br />
0 0 18,38 27,42 80<br />
0251904 LOSEC 40 MG PERF 5 FL IV RR H<br />
0 0 12,02 0,00 0<br />
0279077 LOSEC MUPS 10 MG 28 CPR R<br />
0 0 10,37 17,81 80<br />
0279081 LOSEC MUPS 10 MG 56 CPR R<br />
0 0 16,54 24,61 80<br />
0279113 LOSEC MUPS 20 MG 28 CPR R<br />
0 0 17,55 27,98 80<br />
0409543 LOSEC MUPS 20 MG 56 CPR R<br />
0 0 26,27 35,34 80<br />
0279144 LOSEC MUPS 40 MG 28 CPR R<br />
0 0 33,19 44,10 80<br />
0286037 OMEP 20 MG 100 CAPS R<br />
0 0 28,05 0,00 0<br />
0285981 OMEP 20 MG 15 CAPS R<br />
0 0 2,48 11,81 80<br />
0285995 OMEP 20 MG 30 CAPS R<br />
0 0 5,92 15,56 80<br />
0286023 OMEP 20 MG 60 CAPS R<br />
0 0 13,94 24,34 80<br />
0393671 OMEPRAZOL TEVA 10 MG 14 CAPS R<br />
0 0 7,60 10,73 0<br />
0393796 OMEPRAZOL TEVA 10 MG 28 CAPS (FL) R<br />
0 0 6,68 15,47 0<br />
0393698 OMEPRAZOL TEVA 10 MG 28 CAPS BLIST R<br />
0 0 5,90 13,67 0<br />
0393721 OMEPRAZOL TEVA 10 MG 56 CAPS R<br />
0 0 11,63 21,88 0<br />
0393829 OMEPRAZOL TEVA 20 MG 14 CAPS R<br />
0 0 6,55 14,46 0<br />
0393846 OMEPRAZOL TEVA 20 MG 28 CAPS (FL) R<br />
0 0 13,87 24,20 0<br />
0450746 OMEPRAZOL TEVA 20 MG 28 CAPS BLIST R<br />
0 0 12,84 23,13 0<br />
0446838 OMEPRAZOL TEVA 20 MG 50 CAPS R<br />
0 0 78,96 91,24 0<br />
0446886 OMEPRAZOL TEVA 20 MG 56 CAPS R<br />
0 0 21,07 32,10 0<br />
0446841 OMEPRAZOL TEVA 20 MG 60 CAPS R<br />
0 0 78,96 91,24 0<br />
Page 4 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0446936 OMEPRAZOL TEVA 40 MG 14 CAPS R<br />
0 0 13,50 23,77 0<br />
0446953 OMEPRAZOL TEVA 40 MG 28 CAPS R<br />
0 0 24,85 36,15 0<br />
0450732 OMEPRAZOL TEVA 40 MG 56 CAPS R<br />
0 0 40,11 52,70 0<br />
0378612 OMEPRAZOLE EG 10 MG 100 CAPS R<br />
0 0 12,00 0,00 0<br />
0378545 OMEPRAZOLE EG 10 MG 28 CAPS R<br />
0 0 3,57 8,63 80<br />
0378576 OMEPRAZOLE EG 10 MG 56 CAPS R<br />
0 0 8,35 14,58 80<br />
0421498 OMEPRAZOLE EG 20 MG 100 CAPS R<br />
0 0 18,48 26,76 80<br />
0421288 OMEPRAZOLE EG 20 MG 14 CAPS BLIST R<br />
0 0 3,46 8,48 80<br />
0421307 OMEPRAZOLE EG 20 MG 28 CAPS BLIST R<br />
0 0 7,46 13,47 80<br />
0421471 OMEPRAZOLE EG 20 MG 56 CAPS R<br />
0 0 14,27 21,96 80<br />
0421744 OMEPRAZOLE EG 40 MG 100 CAPS R<br />
0 0 39,49 49,91 80<br />
0421551 OMEPRAZOLE EG 40 MG 28 CAPS BLIST R<br />
0 0 13,85 21,45 80<br />
0421727 OMEPRAZOLE EG 40 MG 56 CAPS R<br />
0 0 32,20 41,86 80<br />
0421582 OMEPRAZOLE EG 40 MG 56 CAPS BLIST R<br />
0 0 40,12 52,70 80<br />
0321895 OMEPRAZOLE FAR 20 MG 28 CPR R<br />
0 0 13,00 23,30 80<br />
0321901 OMEPRAZOLE FAR 20 MG 30 CPR R<br />
0 0 5,58 13,43 0<br />
0321928 OMEPRAZOLE FAR 20 MG 56 CPR R<br />
0 0 20,80 31,93 80<br />
0395921 OMEPRAZOLE RATIO 10 MG 28 CAPS R<br />
0 0 4,42 9,68 80<br />
0395952 OMEPRAZOLE RATIO 10 MG 56 CAPS R<br />
0 0 11,30 18,26 80<br />
0354736 OMEPRAZOLE RATIO 20 MG 14 CAPS R<br />
0 0 4,28 9,50 80<br />
0354753 OMEPRAZOLE RATIO 20 MG 28 CAPS R<br />
0 0 8,56 14,84 80<br />
0354767 OMEPRAZOLE RATIO 20 MG 56 CAPS R<br />
0 0 16,33 24,39 80<br />
0396056 OMEPRAZOLE RATIO 40 MG 28 CAPS R<br />
0 0 17,13 25,26 80<br />
0396091 OMEPRAZOLE RATIO 40 MG 56 CAPS R<br />
0 0 36,16 46,22 80<br />
0370919 SEDACID 10 MG 14 CPR R<br />
0 0 2,49 7,29 80<br />
0370922 SEDACID 10 MG 28 CPR R<br />
0 0 3,97 9,13 80<br />
0370936 SEDACID 10 MG 56 CPR R<br />
0 0 8,34 14,58 80<br />
0482073 SEDACID 20 MG 100 CPR R<br />
0 0 18,88 27,21 80<br />
0370953 SEDACID 20 MG 14 CPR R<br />
0 0 3,97 9,13 80<br />
0370967 SEDACID 20 MG 28 CPR R<br />
0 0 8,34 14,58 80<br />
0370971 SEDACID 20 MG 56 CPR R<br />
0 0 13,95 21,57 80<br />
0389387 SEDACID 20 MG 7 CPR R<br />
0 0 0,00 11,66 0<br />
A02BC02 pantoprazole<br />
0643417 MAALOX CONTROL 20 MG 14 CPR P<br />
0 0 5,94 10,20 0<br />
0489804 PANTOMED 20 MG 100 CPR R<br />
0 0 20,52 0,00 0<br />
0489723 PANTOMED 20 MG 28 CPR R<br />
0 0 4,42 9,68 80<br />
0489754 PANTOMED 20 MG 56 CPR R<br />
0 0 9,40 15,90 80<br />
0489771 PANTOMED 20 MG 84 CPR R<br />
0 0 25,42 37,52 80<br />
0490061 PANTOMED 40 MG 100 CPR R<br />
0 0 36,48 0,00 0<br />
0489978 PANTOMED 40 MG 28 CPR R<br />
0 0 9,20 15,64 80<br />
0490013 PANTOMED 40 MG 56 CPR R<br />
0 0 20,42 28,89 80<br />
0490031 PANTOMED 40 MG 84 CPR R<br />
0 0 47,27 61,53 80<br />
0490139 PANTOMED IV 40 MG PDR 1*10 ML RR H<br />
0 0 2,20 0,00 0<br />
Page 5 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0573991 PANTOPRAL 20 MG 100 CPR R<br />
0 0 13,20 22,31 80<br />
0573956 PANTOPRAL 20 MG 30 CPR R<br />
0 0 6,67 11,27 80<br />
0573987 PANTOPRAL 20 MG 60 CPR R<br />
0 0 10,80 18,26 80<br />
0574077 PANTOPRAL 40 MG 100 CPR R<br />
0 0 21,55 36,44 80<br />
0574032 PANTOPRAL 40 MG 30 CPR R<br />
0 0 8,37 14,15 80<br />
0574063 PANTOPRAL 40 MG 60 CPR R<br />
0 0 13,49 22,80 80<br />
0491153 PANTOPRAZOL HEXAL 20 MG 100 CPR R<br />
0 0 15,99 0,00 0<br />
0490965 PANTOPRAZOL HEXAL 20 MG 15 CPR R<br />
0 0 2,31 11,61 0<br />
0490996 PANTOPRAZOL HEXAL 20 MG 30 CPR R<br />
0 0 3,90 13,35 80<br />
0491024 PANTOPRAZOL HEXAL 20 MG 60 CPR R<br />
0 0 11,19 21,33 80<br />
0490903 PANTOPRAZOL HEXAL 40 MG 100 CPR R<br />
0 0 22,45 0,00 0<br />
0490711 PANTOPRAZOL HEXAL 40 MG 15 CPR R<br />
0 0 3,10 12,48 0<br />
0490741 PANTOPRAZOL HEXAL 40 MG 30 CPR R<br />
0 0 7,30 17,08 80<br />
0490772 PANTOPRAZOL HEXAL 40 MG 60 CPR R<br />
0 0 15,48 26,03 80<br />
0493967 PANTOPRAZOL RATIO 20 MG 14 CPR GR BLIST R<br />
0 0 0,00 9,41 0<br />
0493971 PANTOPRAZOL RATIO 20 MG 15 CPR GR BLIST R<br />
0 0 0,00 10,08 0<br />
0493998 PANTOPRAZOL RATIO 20 MG 28 CPR GR BLIST R<br />
0 0 0,00 11,10 0<br />
0494009 PANTOPRAZOL RATIO 20 MG 30 CPR GR BLIST R<br />
0 0 6,65 11,86 80<br />
0494012 PANTOPRAZOL RATIO 20 MG 56 CPR GR BLIST R<br />
0 0 0,00 18,26 0<br />
0494026 PANTOPRAZOL RATIO 20 MG 60 CPR GR BLIST R<br />
0 0 10,78 19,22 80<br />
0493953 PANTOPRAZOL RATIO 20 MG 7 CPR GR BLIST R<br />
0 0 0,00 9,37 0<br />
0493757 PANTOPRAZOL RATIO 40 MG 14 CPR GR BLIST R<br />
0 0 0,00 9,94 0<br />
0493761 PANTOPRAZOL RATIO 40 MG 15 CPR GR BLIST R<br />
0 0 0,00 10,65 0<br />
0493774 PANTOPRAZOL RATIO 40 MG 28 CPR GR BLIST R<br />
0 0 0,00 14,03 0<br />
0493788 PANTOPRAZOL RATIO 40 MG 30 CPR GR BLIST R<br />
0 0 8,41 14,89 80<br />
0493807 PANTOPRAZOL RATIO 40 MG 56 CPR GR BLIST R<br />
0 0 12,70 22,63 0<br />
0493743 PANTOPRAZOL RATIO 40 MG 7 CPR GR BLIST R<br />
0 0 0,00 9,87 0<br />
0519626 PANTOPRAZOLE EG 20 MG 28 CPR R<br />
0 0 3,48 8,51 80<br />
0519643 PANTOPRAZOLE EG 20 MG 56 CPR R<br />
0 0 7,43 13,43 80<br />
0529636 PANTOPRAZOLE EG 20 MG 98 CPR BLIST R<br />
0 0 12,47 19,72 80<br />
0519691 PANTOPRAZOLE EG 40 MG 28 CPR R<br />
0 0 7,28 13,24 80<br />
0519707 PANTOPRAZOLE EG 40 MG 56 CPR R<br />
0 0 17,26 25,41 80<br />
0529975 PANTOPRAZOLE EG 40 MG 98 CPR BLIST R<br />
0 0 22,75 31,45 80<br />
0272451 PANTOZOL 20 MG 28 CPR BLIST R<br />
0 0 12,98 20,36 80<br />
0272465 PANTOZOL 20 MG 56 CPR BLIST R<br />
0 0 20,77 29,28 80<br />
0218121 PANTOZOL 40 MG 28 CPR R<br />
0 0 23,08 31,81 80<br />
0252574 PANTOZOL IV 40 MG PDR 1 FL IV RR H<br />
0 0 2,43 0,00 0<br />
A02BC03 lansoprazole<br />
0240119 DAKAR 15 MG 28 CAPS R<br />
0 0 7,47 13,49 0<br />
0240122 DAKAR 15 MG 56 CAPS R<br />
0 0 11,58 18,61 80<br />
0204837 DAKAR 30 MG 28 CAPS R<br />
0 0 12,86 20,21 80<br />
0231879 DAKAR 30 MG 28 CAPS UD R<br />
0 0 12,86 0,00 0<br />
0453197 LANSOPRAZOL DOC 15 MG 28 CAPS R<br />
0 0 5,24 10,53 80<br />
Page 6 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0453216 LANSOPRAZOL DOC 15 MG 56 CAPS R<br />
0 0 10,53 17,13 80<br />
0453099 LANSOPRAZOL DOC 30 MG 56 CAPS R<br />
0 0 20,02 28,33 80<br />
0397411 LANSOPRAZOL RATIO 15 MG 14 CAPS R<br />
0 0 1,06 7,33 80<br />
0397439 LANSOPRAZOL RATIO 15 MG 28 CAPS R<br />
0 0 2,52 11,85 80<br />
0397473 LANSOPRAZOL RATIO 15 MG 56 CAPS R<br />
0 0 5,98 15,63 80<br />
0397716 LANSOPRAZOL RATIO 30 MG 14 CAPS R<br />
0 0 1,68 10,91 80<br />
0397747 LANSOPRAZOL RATIO 30 MG 28 CAPS R<br />
0 0 3,99 13,45 80<br />
0397778 LANSOPRAZOL RATIO 30 MG 56 CAPS R<br />
0 0 9,45 19,42 80<br />
0410186 LANSOPRAZOLE EG 15 MG 28 CAPS R<br />
0 0 6,03 11,68 80<br />
0410205 LANSOPRAZOLE EG 15 MG 56 CAPS R<br />
0 0 10,81 17,65 80<br />
0410236 LANSOPRAZOLE EG 30 MG 28 CAPS R<br />
0 0 12,01 19,15 80<br />
0410253 LANSOPRAZOLE EG 30 MG 56 CAPS R<br />
0 0 20,08 28,51 80<br />
0410267 LANSOPRAZOLE EG 30 MG 98 CAPS R<br />
0 0 30,74 40,27 80<br />
A02BC04 rabeprazole<br />
0256587 PARIET 10 MG 28 CPR R<br />
0 0 13,98 21,60 80<br />
0256591 PARIET 10 MG 56 CPR 96110 R<br />
0 0 26,14 35,19 80<br />
0256671 PARIET 20 MG 28 CPR 96114 R<br />
0 0 26,14 35,19 80<br />
0256685 PARIET 20 MG 4*14 CPR R<br />
0 0 48,89 60,25 80<br />
A02BC05 esomeprazole<br />
0572721 ESOMEPRAZOL RATIO 20 MG 15 CAPS R<br />
0 0 1,28 7,15 80<br />
0630274 ESOMEPRAZOL RATIO 20 MG 15 CPR R<br />
0 0 4,01 7,15 80<br />
0572749 ESOMEPRAZOL RATIO 20 MG 30 CAPS R<br />
0 0 3,04 11,02 80<br />
0630291 ESOMEPRAZOL RATIO 20 MG 30 CPR R<br />
0 0 6,18 11,02 80<br />
0572783 ESOMEPRAZOL RATIO 20 MG 60 CAPS R<br />
0 0 7,22 16,98 80<br />
0630324 ESOMEPRAZOL RATIO 20 MG 60 CPR R<br />
0 0 9,57 17,06 80<br />
0572797 ESOMEPRAZOL RATIO 20 MG 90 CAPS R<br />
0 0 11,96 22,05 80<br />
0630338 ESOMEPRAZOL RATIO 20 MG 90 CPR R<br />
0 0 12,36 22,05 80<br />
0572881 ESOMEPRAZOL RATIO 40 MG 15 CAPS R<br />
0 0 1,93 8,23 80<br />
0630422 ESOMEPRAZOL RATIO 40 MG 15 CPR R<br />
0 0 4,62 8,23 80<br />
0572901 ESOMEPRAZOL RATIO 40 MG 30 CAPS R<br />
0 0 4,58 13,05 80<br />
0630453 ESOMEPRAZOL RATIO 40 MG 30 CPR R<br />
0 0 7,32 13,05 80<br />
0572931 ESOMEPRAZOL RATIO 40 MG 60 CAPS R<br />
0 0 10,86 20,97 80<br />
0630484 ESOMEPRAZOL RATIO 40 MG 60 CPR R<br />
0 0 13,41 23,91 80<br />
0572945 ESOMEPRAZOL RATIO 40 MG 90 CAPS R<br />
0 0 17,99 28,87 80<br />
0630498 ESOMEPRAZOL RATIO 40 MG 90 CPR R<br />
0 0 18,73 33,39 80<br />
0630051 ESOMEPRAZOLE MYLAN 20 MG 100 CAPS (FL) R<br />
0 0 20,24 28,68 0<br />
0629905 ESOMEPRAZOLE MYLAN 20 MG 28 CAPS R<br />
0 0 7,14 13,06 0<br />
0630095 ESOMEPRAZOLE MYLAN 40 MG 28 CAPS R<br />
0 0 10,02 16,66 0<br />
0284158 NEXIAM 20 MG 14 CPR BLIST R<br />
0 0 3,76 8,86 80<br />
0284161 NEXIAM 20 MG 28 CPR BLIST R<br />
0 0 7,14 13,07 80<br />
0284131 NEXIAM 20 MG 50 CPR UD BLIST R<br />
0 0 10,12 0,00 0<br />
0284175 NEXIAM 20 MG 56 CPR BLIST R<br />
0 0 11,95 19,06 80<br />
0284189 NEXIAM 20 MG 98 CPR BLIST R<br />
0 0 19,84 28,26 80<br />
Page 7 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0284239 NEXIAM 40 MG 14 CPR BLIST R<br />
0 0 31,45 42,30 0<br />
0284242 NEXIAM 40 MG 28 CPR BLIST R<br />
0 0 11,57 18,60 80<br />
0284306 NEXIAM 40 MG 50 CPR UD BLIST R<br />
0 0 20,66 0,00 0<br />
0366611 NEXIAM IV 40 MG PDR 1 FL PERF RR H<br />
0 0 4,92 0,00 0<br />
A02BX Other drugs for peptic ulcer and gastro-oesophageal reflux disease (GORD)<br />
0603358 GAVISCON ANTIACIDE-ANTIREFLUX SUSP 300ML P<br />
0 0 7,06 12,13 0<br />
A02BX02 sucralfate<br />
0139157 KEAL 1 G 30 CPR R<br />
0 0 0,00 8,03 80<br />
0150185 KEAL 1 G 30 SACH R<br />
0 0 0,00 8,03 80<br />
0190163 KEAL 2 G 15 SACH R<br />
0 0 0,00 7,71 80<br />
0122275 ULCOGANT 1 G/5 ML SUSP 250 ML R<br />
0 0 12,32 22,56 80<br />
0122261 ULCOGANT 1 G/5 ML SUSP 50 SACH R<br />
0 0 10,76 20,86 80<br />
A02BX13 alginic acid<br />
0364858 GAVISCON ADVANCE SUSP 300 ML P<br />
0 0 6,38 10,95 0<br />
0282851 GAVISCON ADVANCE SUSP 500 ML P<br />
0 0 9,44 16,22 80<br />
0592397 GAVISCON ANTIACIDE-ANTIREFLUX 32 CPR P<br />
0 0 4,97 8,53 0<br />
0631433 GAVISCON BABY 500/267MG/10ML SUSP 150 ML P<br />
0 0 3,17 5,44 0<br />
0436778 GAVISCON CITRON 250 MG 48 CPR P<br />
0 0 4,97 8,53 0<br />
0436828 GAVISCON MENTHE 250 MG 48 CPR P<br />
0 0 0,00 8,53 0<br />
0482218 GAVISCON MENTHE SUSP 300 ML P<br />
0 0 5,43 9,33 0<br />
0305258 GAVISCON MENTHE SUSP 500 ML P<br />
0 0 8,04 13,82 0<br />
0482235 GAVISCON SUSP 300 ML (ANIS) P<br />
0 0 5,43 9,33 0<br />
0258984 GAVISCON SUSP 500 ML (ANIS) P<br />
0 0 8,04 13,82 80<br />
0118174 TOPAAL 42 CPR P<br />
0 0 0,00 3,41 80<br />
A03AA04 mebeverine<br />
0195481 DUSPATALIN 135 MG 120 DRG R<br />
0 0 7,66 13,60 80<br />
0037434 DUSPATALIN 135 MG 40 DRG R<br />
0 0 4,09 9,15 80<br />
0400873 DUSPATALIN RET 200 MG 60 CAPS R<br />
0 0 12,30 21,12 0<br />
0238687 MEBEVERINE EG 135 MG 120 CPR R<br />
0 0 4,21 9,42 80<br />
0255738 MEBEVERINE EG 135 MG 40 CPR R<br />
0 0 2,02 6,73 80<br />
A03AB02 glycopyrronium<br />
0100488 ROBINUL 0,2 MG 5 AMP 1 ML IMIV R<br />
0 0 0,00 22,00 0<br />
A03AB06 otilonium bromide<br />
0151523 SPASMOMEN 40 MG 30 CPR R<br />
0 0 5,61 11,16 80<br />
0206845 SPASMOMEN 40 MG 60 CPR R<br />
0 0 8,95 15,32 80<br />
A03AE04 prucalopride<br />
0553371 RESOLOR 1 MG 28 CPR RR<br />
0 0 48,49 59,86 0<br />
0553385 RESOLOR 2 MG 28 CPR RR<br />
0 0 61,61 73,36 0<br />
A03AX08 alverine<br />
0285799 SPASMINE 60 MG 40 CAPS R<br />
0 0 7,07 12,14 80<br />
Page 8 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0348921 SPASMINE FORTE 120 MG 20 CAPS R<br />
0 0 0,00 18,27 0<br />
0348935 SPASMINE FORTE 120 MG 40 CAPS R<br />
0 0 11,55 19,83 80<br />
A03AX13 silicones<br />
0466066 IMONOGAS 240 MG 30 CAPS P<br />
0 0 5,52 9,47 0<br />
A03BA01 atropine<br />
0575673 ATROPINE SULFATE STRP 0,25 MG 10 AMP 1ML RR<br />
0 0 5,20 8,93 0<br />
0575691 ATROPINE SULFATE STRP 0,5 MG 100 AMP 1ML RR<br />
0 0 18,89 0,00 0<br />
0575687 ATROPINE SULFATE STRP 1 MG 10 AMP 1 ML RR<br />
0 0 6,04 10,37 0<br />
0009152 ATROPINSULFAT BRN 0,5 MG 10 AMP 1 ML V RR<br />
0 0 0,00 2,23 80<br />
0196381 STELLATROPINE 0,25 MG 100 AMP 1 ML IMIVS RR<br />
0 0 18,84 0,00 0<br />
0196394 STELLATROPINE 0,5 MG 10 AMP 1 ML IMIVSC RR<br />
0 0 5,35 9,18 0<br />
0196431 STELLATROPINE 1 MG 100 AMP 1 ML IMIVSC RR<br />
0 0 22,19 0,00 0<br />
A03BB01 butylscopolamine<br />
0016451 BUSCOPAN 10 MG 50 DRG R<br />
0 0 6,00 10,30 80<br />
0016482 BUSCOPAN 10 MG 6 SUPP R<br />
0 0 1,97 3,38 80<br />
0016465 BUSCOPAN 20 MG 6 AMP 1 ML IMIVSC RR<br />
0 0 3,30 5,67 80<br />
A03DB04 butylscopolamine and analgesics<br />
0016532 BUSCOPAN COMP 3 AMP 5 ML IMIV RR<br />
0 0 3,48 5,98 80<br />
A03FA01 metoclopramide<br />
0031783 DIBERTIL 10 MG 30 CAPS R<br />
0 0 3,84 6,60 80<br />
0031802 DIBERTIL 5 MG 30 CAPS R<br />
0 0 2,12 3,64 80<br />
0047931 GASTRONERTON 20 CPR R<br />
0 0 0,76 9,91 80<br />
0047945 GASTRONERTON 50 CPR R<br />
0 0 1,82 11,08 80<br />
0048004 GASTRONERTON GTTS 20 ML R<br />
0 0 0,42 9,54 80<br />
0048018 GASTRONERTON GTTS 50 ML R<br />
0 0 1,01 10,19 80<br />
0235654 MCP HEXAL 0.4% GTTS 100 ML R<br />
0 0 1,68 10,91 80<br />
0235641 MCP HEXAL 0.4% GTTS 30 ML R<br />
0 0 0,62 9,76 80<br />
0235668 MCP HEXAL 10 MG 20 CPR R<br />
0 0 0,17 2,45 80<br />
0235637 MCP HEXAL INJEKT 10 MG 5 AMP 2 ML RR<br />
0 0 1,02 10,20 80<br />
0070036 MCP RATIO 10 MG 20 CPR R<br />
0 0 0,81 4,12 80<br />
0252946 MCP RATIO 10 MG 25 SUPP R<br />
0 0 0,00 9,55 0<br />
0137068 MCP RATIO 10 MG 5 SUPP R<br />
0 0 0,98 4,50 80<br />
0070053 MCP RATIO 10 MG 50 CPR R<br />
0 0 1,96 9,27 80<br />
0070070 MCP RATIO GTTS 100 ML R<br />
0 0 2,09 11,38 80<br />
0070067 MCP RATIO GTTS 30 ML R<br />
0 0 0,65 9,80 80<br />
0136995 MCP RATIO RET 30 MG 10 CAPS R<br />
0 0 0,77 9,92 80<br />
0137006 MCP RATIO RET 30 MG 50 CAPS R<br />
0 0 3,71 13,16 80<br />
0173372 MCP RATIO SF 10 MG 5 AMP 2 ML IMIVSC RR<br />
0 0 0,92 10,09 80<br />
0173386 MCP RATIO SF 10 MG 50 AMP 2 ML IMIVSC RR<br />
0 0 10,20 0,00 0<br />
0178317 METOCLOPRAMIDE EG 10 MG 30 CAPS R<br />
0 0 1,08 5,71 80<br />
0152131 PRIMPERAN 10 MG 30 CPR R<br />
0 0 2,85 7,73 80<br />
Page 9 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0093724 PRIMPERAN 10 MG 6 AMP 2 ML IMIV RR<br />
0 0 1,17 5,81 80<br />
0093755 PRIMPERAN 10 MG 6 SUPP ENF R<br />
0 0 0,99 5,50 80<br />
0093741 PRIMPERAN 20 MG 6 SUPP AD R<br />
0 0 1,87 6,57 80<br />
0152145 PRIMPERAN 5 MG/5 ML SIR 200 ML R<br />
0 0 1,80 6,50 80<br />
0182564 PROKINYL LP 15 MG 30 CAPS R<br />
0 0 1,79 2,83 80<br />
A03FA03 domperidone<br />
0457747 DOMPERIDONE EG 10 MG 30 CPR R<br />
0 0 3,27 6,73 80<br />
0560931 DOMPERIDONE EG 10 MG 30 CPR ORODISP R<br />
0 0 4,26 8,78 80<br />
0073685 MOTILIUM 1 MG/ML SIR 200 ML 17482 R<br />
0 0 3,42 5,88 80<br />
0073654 MOTILIUM 10 MG 100 CPR R<br />
0 0 10,94 0,00 0<br />
0073640 MOTILIUM 10 MG 30 CPR 17473 R<br />
0 0 5,01 8,60 80<br />
0073699 MOTILIUM 10 MG 6 SUPP BB 17483 R<br />
0 0 1,82 3,13 80<br />
0073704 MOTILIUM 30 MG 6 SUPP ENF 17484 R<br />
0 0 2,82 4,85 80<br />
0073718 MOTILIUM 60 MG 6 SUPP AD 17485 R<br />
0 0 4,55 7,82 80<br />
0482283 MOTILIUM INSTANT 10 MG 30 CPR FONDANTS R<br />
0 0 6,47 11,13 80<br />
0235591 MOTILIUM PED 1 MG/ML SOL 100 ML 63138 R<br />
0 0 2,74 4,71 80<br />
0509633 OROPERIDYS 10 MG 30 CPR R<br />
0 0 3,81 8,75 80<br />
A03FA05 alizapride<br />
0066632 LITICAN 50 MG 20 CPR R<br />
0 0 4,13 9,32 80<br />
0488306 LITICAN 50 MG 20 CPR UD R<br />
0 0 4,13 0,00 0<br />
0066663 LITICAN 50 MG 6 AMP 2 ML R<br />
0 0 2,46 7,24 80<br />
A04A ANTIEMETICS AND ANTINAUSEANTS<br />
0451435 EMESAN K 20 MG 10 SUPP P<br />
0 0 2,88 5,73 40<br />
0451421 EMESAN K 20 MG 5 SUPP P<br />
0 0 1,71 3,42 40<br />
A04AA01 ondansetron<br />
0471603 ONDANSETRON EG 4 MG 5 AMP 2 ML IMIV RR H<br />
0 0 34,23 0,00 0<br />
0465797 ONDANSETRON EG 8 MG 10 CPR RR<br />
0 0 45,61 56,63 0<br />
0465802 ONDANSETRON EG 8 MG 15 CPR RR<br />
0 0 67,19 0,00 0<br />
0500137 ONDANSETRON EG 8 MG 5 AMP 4 ML IMIV RR H<br />
0 0 40,38 0,00 0<br />
0230806 ZOFRAN 16 MG 5 SUPP RR<br />
0 0 37,59 47,80 100<br />
0161693 ZOFRAN 4 MG 5 AMP 2 ML IV RR H<br />
0 0 26,22 0,00 0<br />
0162061 ZOFRAN 8 MG 5 AMP 4 ML IV RR H<br />
0 0 40,38 0,00 0<br />
0275677 ZOFRAN ZYDIS 8 MG 10 LYO RR<br />
0 0 45,61 56,63 100<br />
A04AA02 granisetron<br />
0472483 GRANISETRON IPS 3 MG 1 AMP 3 ML IV RR H<br />
0 0 10,20 0,00 0<br />
0220781 KYTRIL 1 MG 10 CPR RR<br />
0 0 44,83 55,79 100<br />
0185986 KYTRIL 3 MG 1 AMP 3 ML IV RR H<br />
0 0 9,85 0,00 0<br />
A04AA03 tropisetron<br />
0185549 NAVOBAN 5 MG 1 AMP 5 ML IV RR H<br />
0 0 21,73 0,00 0<br />
0185552 NAVOBAN 5 MG 5 AMP 5 ML IV RR H<br />
0 0 108,65 0,00 0<br />
0185583 NAVOBAN 5 MG 5 CAPS RR<br />
0 0 74,33 91,36 100<br />
Page 10 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
A04AD01 scopolamine<br />
0266034 SCOPODERM TTS 5 PATCH R<br />
0 0 15,40 25,95 0<br />
A04AD12 aprepitant<br />
0359603 EMEND 125 MG 1 CAPS + 80 MG 2 CAPS RR D<br />
0 0 55,38 0,00 0<br />
0359598 EMEND 125 MG 5 CAPS RR D<br />
0 0 100,00 0,00 0<br />
0359571 EMEND 80 MG 5 CAPS RR D<br />
0 0 100,00 0,00 0<br />
0575785 IVEMEND 150 MG PDR 1 FL 10 ML IV RR HC<br />
0 0 59,95 0,00 0<br />
A05A BILE THERAPY<br />
0052671 HEPADIAL 50 MG 40 CPR P<br />
0 0 0,00 4,49 0<br />
A05AA02 ursodeoxycholic acid<br />
0139773 URSOCHOL 150 MG 50 CPR R<br />
0 0 13,99 21,61 80<br />
0228311 URSOCHOL 300 MG 100 CPR R<br />
0 0 44,80 55,76 80<br />
0228307 URSOCHOL 300 MG 30 CPR R<br />
0 0 16,80 24,89 0<br />
0293076 URSOFALK 250 MG 100 CAPS R<br />
0 0 34,43 44,32 80<br />
0123823 URSOFALK 250 MG 50 CAPS R<br />
0 0 19,00 27,22 80<br />
A05AX02 hymecromone<br />
0018344 CANTABILINE 30 CAPS P<br />
0 0 4,01 6,88 40<br />
0018358 CANTABILINE 90 CAPS P<br />
0 0 9,77 16,76 40<br />
A05B LIVER THERAPY, LIPOTROPICS<br />
0143231 ESSENTIALE KAPSEL 300 MG 100 CAPS P<br />
0 0 35,08 54,01 0<br />
0041616 ESSENTIALE KAPSEL 300 MG 30 CAPS P<br />
0 0 0,00 14,23 0<br />
A05BA03 silymarin<br />
0301018 CEFASILYMARIN 105 MG 100 CPR P<br />
0 0 26,14 42,07 40<br />
0301004 CEFASILYMARIN 105 MG 60 CPR P<br />
0 0 15,28 25,88 40<br />
0064820 LEGALON FORTE 140 MG 60 CAPS P<br />
0 0 18,24 43,07 40<br />
0487195 LEGALON PROTECT MADAUS 100 CAPS P<br />
0 0 0,00 36,47 0<br />
A05BA06 ornithine oxoglurate<br />
0052735 HEPAMERZ 10 AMP 10 ML PERF RR<br />
0 0 57,40 86,09 40<br />
0246093 HEPAMERZ GRAN 3000 30 SACH 5 G P<br />
0 0 28,70 45,10 40<br />
0052718 HEPAMERZ GRAN 3000 50 SACH 5 G P<br />
0 0 45,70 70,13 40<br />
A06A LAXATIVES<br />
0154699 FUCA 30 DRG P<br />
0 0 2,22 3,82 0<br />
A06AA01 liquid paraffin<br />
0269151 LANSOYL PARAFFINE GELEE 225 G P<br />
0 0 3,11 5,34 40<br />
A06AB02 bisacodyl<br />
0451418 BISOLAX 5 MG 40 CPR P<br />
0 0 1,92 3,30 0<br />
0245664 DULCOLAX BISACODYL 10 MG 10 SUPP P<br />
0 0 3,78 6,49 40<br />
0245647 DULCOLAX BISACODYL 5 MG 40 DRG P<br />
0 0 3,60 6,18 40<br />
Page 11 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0207677 LAXANS RATIO 10 MG 10 SUPP P<br />
0 0 0,00 3,30 40<br />
0207663 LAXANS RATIO 10 MG 5 SUPP P<br />
0 0 0,00 1,71 40<br />
0216712 LAXANS RATIO 5 MG 30 CPR P<br />
0 0 0,00 2,03 40<br />
0197151 PURGO PIL NF 10 MG 30 DRG P<br />
0 0 3,39 5,83 40<br />
A06AB06 senna glycosi<strong>des</strong><br />
0268932 BEKUNIS SENNA TEE INST 240 ML P<br />
0 0 0,00 7,02 0<br />
0459979 GRAINS DE VALS SENNA 20 CPR P<br />
0 0 2,49 4,28 0<br />
0462246 SENOKOT 7,5 MG 40 CPR P<br />
0 0 3,00 5,07 40<br />
0621258 SIDROGA ABFUEHRTEE 20 SACH P<br />
0 0 2,24 3,99 0<br />
A06AB07 cascara<br />
0592822 LAXAFYTOL 25 MG 20 CAPS (FL) P<br />
0 0 4,41 7,58 0<br />
A06AB08 sodium picosulfate<br />
0064266 LAXOBERON 0,75% GTTS 15 ML P<br />
0 0 3,28 5,64 40<br />
0090381 VICHY NF 30 PILULES P<br />
0 0 2,45 4,22 0<br />
A06AB09 bisoxatin<br />
0130134 WYLAXINE 20 CPR P<br />
0 0 0,00 4,29 40<br />
A06AB20 contact laxatives in combination<br />
0169241 PREPACOL SET 4 CPR + SOL 30 ML R<br />
0 0 4,33 7,44 40<br />
0179183 SOFTENE 30 CPR P<br />
0 0 0,00 3,74 40<br />
A06AB56 senna glycosi<strong>des</strong>, combinations<br />
0281934 AGIOLAX GRAN 100 G P<br />
0 0 3,16 5,64 40<br />
0158152 AGIOLAX GRAN 250 G P<br />
0 0 5,30 9,45 40<br />
0209492 MIDRO 100 CPR P<br />
0 0 1,53 2,64 0<br />
0264611 MIDRO N TEE 48 G P<br />
0 0 1,49 2,99 0<br />
0095200 PRUNASINE SIR 1000 ML P<br />
0 0 17,61 0,00 0<br />
0095195 PRUNASINE SIR 200 ML P<br />
0 0 4,38 7,52 40<br />
A06AB57 cascara, combinations<br />
0036146 REX 40 DRG P<br />
0 0 3,43 6,43 40<br />
A06AB58 sodium picosulfate, combinations<br />
0581328 PICOPREP PDR 2 SACH R<br />
0 0 9,85 16,93 40<br />
A06AC01 ispaghula (psylla seeds)<br />
0175976 AGIOCUR GRAN 250 G P<br />
0 0 9,65 17,20 40<br />
0182578 PSYLIA PDR 20 SACH P<br />
0 0 1,98 3,53 40<br />
A06AC03 sterculia<br />
0225421 NORMACOL GRAN 30 SACH 10 G P<br />
0 0 6,10 10,48 40<br />
0079921 NORMACOL GRAN 375 G P<br />
0 0 6,10 10,48 40<br />
A06AC51 ispaghula, combinations<br />
0374161 PARAPSYLLIUM PDR 10 SACH P<br />
0 0 2,17 3,58 40<br />
Page 12 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
A06AD11 lactulose<br />
0013317 BIFITERAL 500 ML P<br />
0 0 3,95 8,98 40<br />
0203888 DUPHALAC DRY PDR 20 SACH P<br />
0 0 6,86 11,79 40<br />
0398064 DUPHALAC FRUIT 10 G 20 SACH 15 ML P<br />
0 0 5,84 10,04 40<br />
0306421 DUPHALAC SIR 1000 ML P<br />
0 0 11,34 19,48 0<br />
0156127 DUPHALAC SIR 20 SACH 15 ML P<br />
0 0 5,84 10,04 40<br />
0037059 DUPHALAC SIR 300 ML P<br />
0 0 4,66 8,00 40<br />
0037062 DUPHALAC SIR 500 ML P<br />
0 0 6,67 11,47 40<br />
0235171 LACTULOSE EG 670 MG/ML SIR 300 ML P<br />
0 0 0,00 6,40 40<br />
0235184 LACTULOSE EG 670 MG/ML SIR 500 ML P<br />
0 0 0,00 9,17 40<br />
0216757 LACTULOSE RATIO SIR 1000 ML P<br />
0 0 8,75 15,75 40<br />
0216726 LACTULOSE RATIO SIR 200 ML P<br />
0 0 2,13 4,25 40<br />
0216743 LACTULOSE RATIO SIR 500 ML P<br />
0 0 4,69 8,99 40<br />
A06AD12 lactitol<br />
0143423 IMPORTAL PDR 20 SACH 10 G P<br />
0 0 8,41 14,45 40<br />
A06AD15 macrogol<br />
0297125 FORLAX 20 SACH 10 G P<br />
0 0 7,86 13,51 40<br />
0360988 FORLAX JR 4 G 20 SACH P<br />
0 0 5,60 9,62 0<br />
A06AD17 sodium phosphate<br />
0511581 FLEET PHOSPHO SODA SOL 45 ML P<br />
0 0 0,00 7,85 40<br />
A06AD18 sorbitol<br />
0249775 SORBITOL DELALANDE 20 SACH 5 G P<br />
0 0 0,00 3,30 0<br />
A06AD65 macrogol, combinations<br />
0344273 COLOFORT 4 SACH R<br />
0 0 9,40 16,15 40<br />
0154007 COLOPEG PDR 1 SACH R<br />
0 0 2,08 3,58 40<br />
0608601 CURAPEG 13,7 G PDR 30 SACH P<br />
0 0 6,30 14,58 0<br />
0608614 CURAPEG 13,7 G PDR 50 SACH P<br />
0 0 12,06 22,34 0<br />
0399772 ENDOFALK 12*6 SACH R<br />
0 0 86,76 0,00 0<br />
0399769 ENDOFALK 6 SACH R<br />
0 0 7,23 12,42 40<br />
0184958 KLEAN PREP SHAKER 4 SACH R<br />
0 0 9,40 16,15 40<br />
0498821 LAXIDO NATURAL PDR 20 SACH P<br />
0 0 5,82 10,00 40<br />
0498848 LAXIDO NATURAL PDR 50 SACH P<br />
0 0 13,26 22,79 40<br />
0498767 LAXIDO ORANGE PDR 20 SACH P<br />
0 0 5,82 10,00 40<br />
0498784 LAXIDO ORANGE PDR 50 SACH P<br />
0 0 13,26 22,79 40<br />
0578398 MOLAXOLE PDR 20 SACH P<br />
0 0 4,34 9,70 40<br />
0578403 MOLAXOLE PDR 30 SACH P<br />
0 0 5,93 14,14 40<br />
0233663 MOVICOL 20 SACH P<br />
0 0 7,84 13,46 40<br />
0516462 MOVICOL CHOCOLATE 20 SACH P<br />
0 0 7,84 13,46 40<br />
0399688 MOVICOL JR AROME PDR 30 SACH P<br />
0 0 7,84 13,46 0<br />
0445861 MOVICOL JR NEUTRAL 30 SACH P<br />
0 0 7,84 13,46 40<br />
0625274 MOVICOL LIQ ORANGE 13,7 MG/25 ML 500 ML P<br />
0 0 7,84 13,46 40<br />
Page 13 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0516266 MOVICOL NEUTRAL 20 SACH P<br />
0 0 7,84 13,46 40<br />
0578997 MOVIPREP ORANGE PDR 4 SACH R<br />
0 0 10,15 17,43 40<br />
0453295 MOVIPREP PDR 4 SACH R<br />
0 0 10,15 17,43 40<br />
A06AG01 sodium phosphate<br />
0045081 FLEET ENEMA AD SOL 133 ML P<br />
0 0 1,45 2,50 80<br />
0045095 FLEET ENEMA PEDIATRIC SOL 66,6 ML P<br />
0 0 1,35 2,32 80<br />
0229366 LAVEMENT AU PHOSPHATE NORGINE 130 ML P<br />
0 0 1,67 2,88 80<br />
0092694 PRACTOCLYSS 1 LAV 120 ML P<br />
0 0 0,00 1,69 80<br />
A06AG04 glycerol<br />
0240735 BABYLAX GEL 10*3 TUBES P<br />
0 0 13,60 0,00 0<br />
0240721 BABYLAX GEL 2*3 TUBES P<br />
0 0 4,32 7,70 40<br />
0240718 BABYLAX GEL 3 TUBES P<br />
0 0 2,39 4,26 40<br />
A06AG10 docusate sodium, incl. combinations<br />
0163765 NORGALAX SOL 6 TUBES 10 G P<br />
0 0 3,73 6,40 80<br />
A06AG11 l<strong>au</strong>rilsulfate, incl. combinations<br />
0298041 MICROLAX GEL 12 TUBES P<br />
0 0 7,84 13,47 0<br />
0298038 MICROLAX GEL 4 TUBES P<br />
0 0 3,01 5,17 0<br />
0328493 MICROLAX GEL 60 TUBES P<br />
0 0 30,38 0,00 0<br />
A06AH01 methylnaltrexone bromide<br />
0486928 RELISTOR 12 MG 1 FL 0,6 ML SC RR<br />
0 0 30,78 41,62 80<br />
0486945 RELISTOR 12 MG 7 FL 0,6 ML+7 SRG+14 TAMP RR<br />
0 0 172,13 191,22 80<br />
A06AX02 carbon dioxide producing drugs<br />
0182547 EDUCTYL 12 SUPP AD P<br />
0 0 1,17 2,16 40<br />
0182533 EDUCTYL 12 SUPP ENF P<br />
0 0 0,00 1,24 40<br />
A07AA02 nystatin<br />
0017977 CANDIO HERMAL SUSP BUV 24 ML R<br />
0 0 2,95 5,86 80<br />
0078745 NILSTAT GTTS OR 30 ML RR<br />
0 0 2,34 7,08 80<br />
0081205 NYSTATINE SUSP LIQ 24 D RR<br />
0 0 2,20 6,93 80<br />
A07AA06 paromomycin<br />
0047380 GABBRORAL 250 MG 16 CAPS RR<br />
0 0 4,04 9,21 80<br />
A07AX03 nifuroxazide<br />
0231848 BACIFURANE 200 MG 16 CAPS R<br />
0 0 0,00 4,00 80<br />
0182595 PANFUREX 200 MG 28 CAPS R<br />
0 0 2,25 3,38 80<br />
0182601 PANFUREX GE 4% SUSP 90 ML R<br />
0 0 2,05 2,83 80<br />
A07BA01 medicinal charcoal<br />
0512589 CARBACTIVE 120 MG 30 CAPS P<br />
0 0 3,07 8,84 0<br />
0290253 KOHLE COMPRETTEN 250 MG 30 CPR P<br />
0 0 3,94 7,34 80<br />
0290267 KOHLE COMPRETTEN 250 MG 60 CPR P<br />
0 0 6,60 12,11 80<br />
0079899 NORIT 200 MG 30 CAPS P<br />
0 0 3,38 5,81 80<br />
Page 14 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0244913 NORIT CARBOMIX GRAN 50 G P<br />
0 0 0,00 11,06 0<br />
A07BA51 medicinal charcoal, combinations<br />
0018540 CARBOBEL SIMPLEX 30 CPR P<br />
0 0 0,00 5,53 80<br />
0018554 CARBOBEL SIMPLEX GRAN 70 G P<br />
0 0 0,00 6,33 80<br />
0018604 CARBOLACTANOSE 30 CAPS P<br />
0 0 3,91 6,71 40<br />
0134178 CARBOSYLANE 24 D 48 CAPS P<br />
0 0 0,00 4,15 80<br />
0134164 CARBOSYLANE 48 D 96 CAPS P<br />
0 0 0,00 6,75 80<br />
0380154 CARBOSYMAG 24 CAPS VERTES+24 CAPS ORANGE P<br />
0 0 0,00 4,09 0<br />
0380168 CARBOSYMAG 48 CAPS VERTES+48 CAPS ORANGE P<br />
0 0 0,00 6,42 0<br />
A07BC04 attapulgite<br />
0000482 ACTAPULGITE 30 SACH P<br />
0 0 1,18 5,82 80<br />
A07BC05 diosmectite<br />
0105632 SMECTA 30 SACH P<br />
0 0 0,00 5,63 80<br />
A07CA Oral rehydration salt formulations<br />
0038736 ELOTRANS 10 SACH 3660851 P<br />
0 0 0,00 4,07 80<br />
0203938 ORALPAEDON 240 10 BTL 3550521 P<br />
0 0 0,00 4,07 80<br />
0229383 ORALPAEDON 240 ERDBEERE 10 SACH 3552521 P<br />
0 0 0,00 4,07 80<br />
A07DA03 loperamide<br />
0224888 DYSPAGON 2 MG 6 CAPS P<br />
0 0 0,00 3,20 80<br />
0056135 IMODIUM 2 MG 20 CAPS 17469 P<br />
0 0 4,47 7,68 80<br />
0164857 IMODIUM 2 MG 200 CAPS 52344 P<br />
0 0 11,42 0,00 0<br />
0056149 IMODIUM 2 MG 60 CAPS 17471 P<br />
0 0 6,17 11,86 80<br />
0233968 IMODIUM INSTANT 2 MG 20 CPR 140829 P<br />
0 0 5,60 9,62 80<br />
0233971 IMODIUM INSTANT 2 MG 60 CPR 140831 P<br />
0 0 9,44 16,23 80<br />
0056166 IMODIUM SOL BUV 100 ML 27231 R<br />
0 0 2,04 6,75 80<br />
0176309 LOPEDIUM 2 MG 10 CAPS P<br />
0 0 0,00 1,90 80<br />
0197571 LOPEDIUM 2 MG 20 CAPS P<br />
0 0 0,76 3,80 80<br />
0176312 LOPEDIUM 2 MG 50 CAPS P<br />
0 0 2,43 7,11 80<br />
0187512 LOPEDIUM 2 MG/ML SOL 10 ML P<br />
0 0 0,00 3,87 80<br />
0187526 LOPEDIUM 2 MG/ML SOL 20 ML P<br />
0 0 0,00 6,99 80<br />
0182497 LOPERAMID RATIO 2 MG 10 CPR PELLIC P<br />
0 0 0,00 3,08 80<br />
0182502 LOPERAMID RATIO 2 MG 20 CPR PELLIC P<br />
0 0 0,00 5,43 80<br />
0182516 LOPERAMID RATIO 2 MG 50 CPR PELLIC P<br />
0 0 0,00 9,52 80<br />
0259799 LOPERAMID RATIO AKUT 2 MG 10 CPR P<br />
0 0 0,00 2,57 80<br />
0205168 LOPERAMIDE EG 2 MG 20 CAPS P<br />
0 0 2,87 5,91 80<br />
0252722 LOPERAMIDE EG 2 MG 200 CAPS P<br />
0 0 11,53 0,00 0<br />
0205171 LOPERAMIDE EG 2 MG 60 CAPS P<br />
0 0 3,38 8,39 80<br />
A07DA53 loperamide, combinations<br />
0474233 IMODIUM DUO 2/125 MG 18 CPR P<br />
0 0 5,68 9,77 0<br />
A07E INTESTINAL ANTIINFLAMMATORY AGENTS<br />
Page 15 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0567475 MUTAFLOR 100 CAPS P<br />
0 0 56,20 83,75 0<br />
0567458 MUTAFLOR 20 CAPS P<br />
0 0 11,32 19,29 0<br />
0567461 MUTAFLOR 50 CAPS P<br />
0 0 28,23 44,26 0<br />
0651582 MUTAFLOR SUSPENSION 100 MUFC/ML 10FL 1ML P<br />
0 0 22,59 36,66 0<br />
0651596 MUTAFLOR SUSPENSION 100 MUFC/ML 25FL 1ML P<br />
0 0 56,20 84,28 0<br />
0651615 MUTAFLOR SUSPENSION 100 MUFC/ML 25FL 5ML P<br />
0 0 121,39 182,05 0<br />
0651579 MUTAFLOR SUSPENSION 100 MUFC/ML 5FL 1ML P<br />
0 0 11,32 19,41 0<br />
0651601 MUTAFLOR SUSPENSION 100 MUFC/ML 5FL 5ML P<br />
0 0 24,45 39,68 0<br />
A07EA06 bu<strong>des</strong>onide<br />
0286278 BUDENOFALK 3 MG 100 CAPS RR<br />
0 0 62,22 74,84 80<br />
0286264 BUDENOFALK 3 MG 50 CAPS RR<br />
0 0 46,22 57,31 80<br />
0227991 ENTOCORT 3 MG 100 CAPS RR<br />
0 0 57,12 69,32 80<br />
0190213 ENTOCORT ENEMA LAVT 7 CPR + 7 FL P RR<br />
0 0 34,53 45,48 80<br />
A07EA07 beclometasone<br />
0503206 CLIPPER 5 MG 30 CPR RR<br />
0 0 67,90 81,71 0<br />
A07EC01 sulfasalazine<br />
0101776 SALAZOPYRINE 500 MG 100 CPR RR<br />
0 0 6,48 12,24 100<br />
0101809 SALAZOPYRINE EC 500 MG 100 DRG RR<br />
0 0 7,64 13,70 100<br />
0101812 SALAZOPYRINE EC 500 MG 300 DRG RR<br />
0 0 21,31 29,87 100<br />
A07EC02 mesalazine<br />
0022865 CLAVERSAL 250 MG 100 CPR R<br />
0 0 12,63 19,79 100<br />
0022896 CLAVERSAL 250 MG 120 SUPP R<br />
0 0 29,35 38,62 100<br />
0022882 CLAVERSAL 250 MG 30 SUPP R<br />
0 0 8,58 14,76 100<br />
0151281 CLAVERSAL 250 MG 300 CPR R<br />
0 0 29,84 39,15 100<br />
0296985 CLAVERSAL 500 MG 100 CPR R<br />
0 0 26,18 35,13 100<br />
0285639 CLAVERSAL 500 MG 120 SUPP R<br />
0 0 70,98 84,00 0<br />
0150771 CLAVERSAL 500 MG 15 SUPP R<br />
0 0 10,13 16,68 100<br />
0296999 CLAVERSAL 500 MG 300 CPR R<br />
0 0 57,92 70,08 100<br />
0150784 CLAVERSAL 500 MG 60 SUPP R<br />
0 0 36,45 46,43 100<br />
0210817 CLAVERSAL FOAM MOUSSE US RECT 1 FL 14 D R<br />
0 0 27,25 36,31 100<br />
0314548 COLITOFALK 250 MG 10 SUPP R<br />
0 0 3,31 8,19 0<br />
0023974 COLITOFALK 250 MG 100 CPR R<br />
0 0 12,41 19,64 100<br />
0024002 COLITOFALK 250 MG 120 SUPP R<br />
0 0 35,74 45,77 100<br />
0023988 COLITOFALK 250 MG 200 DRG R<br />
0 0 25,63 36,30 0<br />
0023991 COLITOFALK 250 MG 30 SUPP R<br />
0 0 9,93 16,55 100<br />
0168051 COLITOFALK 500 MG 10 SUPP R<br />
0 0 6,63 12,43 100<br />
0168101 COLITOFALK 500 MG 100 CPR R<br />
0 0 21,58 30,17 100<br />
0168081 COLITOFALK 500 MG 120 SUPP R<br />
0 0 60,19 72,68 100<br />
0189503 COLITOFALK 500 MG 20 CPR R<br />
0 0 5,47 10,99 100<br />
0168064 COLITOFALK 500 MG 30 SUPP R<br />
0 0 16,10 24,14 100<br />
0189517 COLITOFALK 500 MG 300 DRG R<br />
0 0 50,89 62,45 100<br />
0176925 COLITOFALK SUSP 2 G 7 LAV 60 G R<br />
0 0 21,60 30,19 100<br />
Page 16 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0136852 COLITOFALK SUSP 4 G 7 LAV 60 G R<br />
0 0 26,88 36,00 100<br />
0206988 PENTASA 1 G 14 SUPP R<br />
0 0 18,77 27,07 100<br />
0298525 PENTASA 1 G 150 SACH R<br />
0 0 90,20 104,50 100<br />
0298511 PENTASA 1 G 50 SACH R<br />
0 0 31,41 41,00 100<br />
0149198 PENTASA 10 MG/ML 7 LAVT 100 ML R<br />
0 0 19,58 27,97 100<br />
0557001 PENTASA 2 G 120 SACH R<br />
0 0 177,60 196,95 100<br />
0556986 PENTASA 2 G 60 SACH R<br />
0 0 75,60 89,03 100<br />
0181262 PENTASA 500 MG 300 CPR R<br />
0 0 105,27 118,33 100<br />
0181245 PENTASA 500 MG 90 CPR R<br />
0 0 22,55 31,23 100<br />
A07FA01 lactic acid producing organisms<br />
0211554 LACTEOL 20 CAPS P<br />
0 0 4,70 8,07 40<br />
A07FA02 saccharomyces boulardii<br />
0428812 ENTEROL 250 MG 10 CAPS P<br />
0 0 5,18 8,89 40<br />
0635981 ENTEROL 250 MG 10 CAPS BLIST P<br />
0 0 5,23 8,99 0<br />
0428861 ENTEROL 250 MG 10 SACH P<br />
0 0 5,18 8,89 40<br />
0428826 ENTEROL 250 MG 20 CAPS P<br />
0 0 9,59 16,47 40<br />
0635995 ENTEROL 250 MG 20 CAPS BLIST P<br />
0 0 9,90 17,00 0<br />
0428874 ENTEROL 250 MG 20 SACH P<br />
0 0 9,59 16,47 40<br />
0428843 ENTEROL 250 MG 50 CAPS P<br />
0 0 25,24 35,90 40<br />
0122678 ULTRALEVURE 20 CAPS P<br />
0 0 0,00 5,03 0<br />
0122681 ULTRALEVURE 50 CAPS P<br />
0 0 0,00 6,99 0<br />
A07XA01 albumin tannate<br />
0434045 TANNALBIN 250 MG 20 CAPS P<br />
0 0 2,58 4,68 0<br />
A07XA04 racecadotril<br />
0640334 TIORFAST 100 MG 20 CAPS R<br />
0 0 9,33 16,03 0<br />
0640379 TIORFAST BABY 10 MG GRAN 16 SACH R<br />
0 0 9,33 16,03 0<br />
0640432 TIORFAST JUNIOR 30 MG GRAN 16 SACH R<br />
0 0 9,33 16,03 0<br />
A07XA51 albumin tannate, combinations<br />
0394342 TANNACOMP 20 CPR P<br />
0 0 4,57 8,13 0<br />
0394356 TANNACOMP 50 CPR P<br />
0 0 10,27 18,05 0<br />
A08AB01 orlistat<br />
0601367 ALLI 27 MG 120 CPR CROQ P<br />
0 0 47,22 58,54 0<br />
0601336 ALLI 27 MG 84 CPR CROQ P<br />
0 0 35,43 46,40 0<br />
0585313 ALLI 60 MG 120 CAPS P<br />
0 0 53,70 65,22 0<br />
0511886 ALLI 60 MG 42 CAPS P<br />
0 0 21,50 32,06 0<br />
0511919 ALLI 60 MG 84 CAPS P<br />
0 0 38,98 50,06 0<br />
0253618 XENICAL 120 MG 84 CAPS BLIST RR<br />
0 0 65,76 77,64 0<br />
A09AA Enzyme preparations<br />
0044344 FERMENTO DUODENAL 50 CAPS P<br />
0 0 15,40 25,93 80<br />
A09AA02 multienzymes (lipase, protease etc.)<br />
Page 17 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0024369 COMBIZYM 100 DRG P<br />
0 0 0,00 22,48 80<br />
0024355 COMBIZYM 50 DRG P<br />
0 0 0,00 13,39 80<br />
0277539 CREON 150 MG 100 CAPS R<br />
0 0 12,38 19,49 80<br />
0298296 CREON FORTE 300 MG 100 CAPS R<br />
0 0 33,83 43,55 80<br />
0167876 PANZYTRAT 10000 100 CAPS R<br />
0 0 13,39 22,68 80<br />
0167751 PANZYTRAT 10000 50 CAPS R<br />
0 0 6,92 12,70 80<br />
0251286 PANZYTRAT 25000 U 100 CAPS R<br />
0 0 30,01 46,65 80<br />
0251272 PANZYTRAT 25000 U 50 CAPS R<br />
0 0 15,43 26,13 80<br />
A10AB01 insulin (human)<br />
0147016 HUMULINE REGULAR 100 U 1*10 ML R<br />
0 0 14,31 21,90 100<br />
0202474 HUMULINE REGULAR 100 U 5*3 ML CRT R<br />
0 0 23,57 32,24 100<br />
0365032 INSUL ACTRAPID 100 U 1*10 ML R<br />
0 0 10,36 17,09 100<br />
0365046 INSUL ACTRAPID PF 100 U 5*3 ML R<br />
0 0 22,15 30,79 100<br />
A10AB04 insulin lispro<br />
0221869 HUMALOG 100 U 1*10 ML R<br />
0 0 16,62 24,58 100<br />
0221872 HUMALOG 100 U 5*1,5 ML CRT R<br />
0 0 29,00 38,23 100<br />
0235265 HUMALOG 100 U 5*3 ML CRT R<br />
0 0 29,00 38,23 100<br />
A10AB05 insulin aspart<br />
0268946 INSUL NOVORAPID 100 U 1*10 ML R<br />
0 0 16,62 24,70 100<br />
0291474 INSUL NOVORAPID FLEXPEN 100U 5STYLOS 3ML R<br />
0 0 31,82 41,44 100<br />
0268977 INSUL NOVORAPID PF 100 U 5*3 ML R<br />
0 0 29,00 38,33 100<br />
A10AB06 insulin glulisine<br />
0388801 APIDRA 100 U/ML 1 FL 10 ML SC R<br />
0 0 15,79 23,79 100<br />
0388881 APIDRA 100 U/ML 5 CRT 3 ML SC R<br />
0 0 27,55 36,74 100<br />
0470928 APIDRA 100 U/ML 5 STYLOS SOLOSTAR 3ML SC R<br />
0 0 30,23 39,69 100<br />
A10AC01 insulin (human)<br />
0146974 HUMULINE NPH 100 U 1*10 ML R<br />
0 0 14,31 21,90 100<br />
0202491 HUMULINE NPH 100 U 5*3 ML CRT R<br />
0 0 23,57 32,24 100<br />
0336711 INSUL INSULATARD 100 U 1*10 ML R<br />
0 0 10,36 17,09 100<br />
0336769 INSUL INSULATARD PF 100 U 5*3 ML R<br />
0 0 22,15 30,79 100<br />
A10AD01 insulin (human)<br />
0146795 HUMULINE 30/70 100 U 1*10 ML R<br />
0 0 14,31 21,83 100<br />
0202538 HUMULINE 30/70 100 U 5*3 ML CRT R<br />
0 0 23,57 32,24 100<br />
A10AD04 Insulin lispro<br />
0511953 HUMALOG KWIKPEN 100 U 5*3 ML R<br />
0 0 31,82 41,34 100<br />
0259639 HUMALOG MIX 25 100 U 5*3 ML CRT R<br />
0 0 29,00 38,23 100<br />
0511971 HUMALOG MIX 25 KWIKPEN 100 U 5*3 ML R<br />
0 0 31,82 41,34 100<br />
0259656 HUMALOG MIX 50 100 U 5*3 ML CRT R<br />
0 0 29,00 38,23 100<br />
0511998 HUMALOG MIX 50 KWIKPEN 100 U 5*3 ML R<br />
0 0 31,82 41,34 100<br />
A10AD05 insulin aspart<br />
Page 18 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0291426 INSUL NOVOMIX 30 FLEXPEN 100U 5*3 ML R<br />
0 0 31,82 41,44 100<br />
0287678 INSUL NOVOMIX 30 PF 100U 5*3 ML R<br />
0 0 29,00 38,33 100<br />
0468348 INSUL NOVOMIX 50 FLEXPEN 100U 5*3 ML R<br />
0 0 31,82 41,44 100<br />
0468334 INSUL NOVOMIX 50 PF 100U 5*3 ML R<br />
0 0 29,00 38,33 100<br />
0468365 INSUL NOVOMIX 70 FLEXPEN 100U 5*3 ML R<br />
0 0 31,82 41,44 100<br />
0468351 INSUL NOVOMIX 70 PF 100U 5*3 ML R<br />
0 0 29,00 38,33 100<br />
A10AE04 insulin glargine<br />
0282167 LANTUS 100 U/ML 5 CRT 3 ML SC R<br />
0 0 46,83 57,98 100<br />
0441408 LANTUS 100U/ML 5CRT SOLOSTAR 3ML+5STYLOS R<br />
0 0 46,83 57,98 100<br />
A10AE05 insulin detemir<br />
0382386 LEVEMIR 100 U/ML 5 CRT PF 3 ML SC R<br />
0 0 52,50 64,22 100<br />
0382422 LEVEMIR 100 U/ML 5 STYLOS PRER FLEX 3ML R<br />
0 0 55,04 67,02 100<br />
A10BA02 metformin<br />
0194484 GLUCOPHAGE 500 MG 60 CPR R<br />
0 0 1,37 6,02 100<br />
0194498 GLUCOPHAGE 850 MG 100 CPR R<br />
0 0 2,74 7,59 100<br />
0289297 METFORMAX 850 MG 120 CPR R<br />
0 0 3,35 8,35 100<br />
0290396 METFORMAX 850 MG 120 CPR UD R<br />
0 0 3,35 0,00 0<br />
0289283 METFORMAX 850 MG 40 CPR R<br />
0 0 1,40 6,05 100<br />
A10BB01 glibenclamide<br />
0027892 DAONIL 5 MG 100 CPR R<br />
0 0 9,79 16,37 100<br />
0027889 DAONIL 5 MG 30 CPR R<br />
0 0 3,68 8,64 100<br />
0042370 EUGLUCON 5 100 CPR R<br />
0 0 9,66 16,21 100<br />
A10BB07 glipizide<br />
0049614 GLIBENESE 5 MG 100 CPR R<br />
0 0 8,95 15,32 100<br />
0072450 MINIDIAB 5 MG 90 CPR R<br />
0 0 8,04 14,21 100<br />
A10BB08 gliquidone<br />
0154069 GLURENORM 30 MG 100 CPR R<br />
0 0 6,61 12,41 100<br />
0254436 GLURENORM 30 MG 100 CPR UD R<br />
0 0 6,61 0,00 0<br />
0154055 GLURENORM 30 MG 40 CPR R<br />
0 0 3,32 8,31 100<br />
A10BB09 gliclazide<br />
0569841 DIAMICRON 60 MG 30 CPR R<br />
0 0 6,41 11,43 100<br />
0569886 DIAMICRON 60 MG 90 CPR R<br />
0 0 18,14 32,34 100<br />
A10BB12 glimepiride<br />
0244636 AMARYLLE 2 MG 30 CPR R<br />
0 0 2,57 7,38 100<br />
0244653 AMARYLLE 2 MG 90 CPR R<br />
0 0 7,63 13,68 100<br />
0351233 AMARYLLE 3 MG 30 CPR R<br />
0 0 3,85 8,97 100<br />
0351328 AMARYLLE 4 MG 30 CPR R<br />
0 0 5,13 10,57 100<br />
0416937 GLIMEPIRID HEXAL 1 MG 120 CPR R<br />
0 0 6,55 11,67 100<br />
0416891 GLIMEPIRID HEXAL 1 MG 30 CPR R<br />
0 0 0,00 4,80 100<br />
0416985 GLIMEPIRID HEXAL 2 MG 120 CPR R<br />
0 0 7,73 17,54 100<br />
Page 19 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0416954 GLIMEPIRID HEXAL 2 MG 30 CPR R<br />
0 0 0,96 7,37 100<br />
0417044 GLIMEPIRID HEXAL 3 MG 120 CPR R<br />
0 0 13,29 23,63 100<br />
0417013 GLIMEPIRID HEXAL 3 MG 30 CPR R<br />
0 0 0,00 9,00 100<br />
0417092 GLIMEPIRID HEXAL 4 MG 120 CPR R<br />
0 0 18,95 29,83 100<br />
0417061 GLIMEPIRID HEXAL 4 MG 30 CPR R<br />
0 0 2,80 10,57 100<br />
0417142 GLIMEPIRID HEXAL 6 MG 120 CPR R<br />
0 0 0,00 44,10 100<br />
0417111 GLIMEPIRID HEXAL 6 MG 30 CPR R<br />
0 0 8,77 15,64 100<br />
A10BD Combinations of oral blood glucose lowering drugs<br />
0644347 KOMBOGLYZE 2,5/1000 MG 196 CPR RR<br />
0 0 112,02 127,61 0<br />
0644302 KOMBOGLYZE 2,5/1000 MG 56 CPR RR<br />
0 0 36,96 47,10 0<br />
0644266 KOMBOGLYZE 2,5/850 MG 196 CPR RR<br />
0 0 112,02 127,61 0<br />
0644235 KOMBOGLYZE 2,5/850 MG 56 CPR RR<br />
0 0 36,96 47,10 0<br />
A10BD02 metformin and sulfonami<strong>des</strong><br />
0325748 GLUCOVANCE 500/2,5 MG 120 CPR R<br />
0 0 8,20 14,40 100<br />
0325877 GLUCOVANCE 500/5 MG 120 CPR R<br />
0 0 8,20 14,40 100<br />
A10BD07 metformin and sitagliptin<br />
0488161 JANUMET 50/1000 MG 196 CPR RR<br />
0 0 125,01 141,39 100<br />
0488131 JANUMET 50/1000 MG 56 CPR RR<br />
0 0 40,39 50,89 100<br />
0488081 JANUMET 50/850 MG 196 CPR RR<br />
0 0 125,01 141,39 100<br />
0488094 JANUMET 50/850 MG 50 CPR UD RR<br />
0 0 35,10 0,00 0<br />
0488046 JANUMET 50/850 MG 56 CPR RR<br />
0 0 40,39 50,89 100<br />
A10BD08 metformin and vildagliptin<br />
0474961 EUCREAS 50/1000 MG 180 CPR BLIST RR<br />
0 0 114,80 130,58 100<br />
0474944 EUCREAS 50/1000 MG 60 CPR BLIST RR<br />
0 0 43,28 54,07 100<br />
0474863 EUCREAS 50/850 MG 180 CPR BLIST RR<br />
0 0 114,80 130,58 100<br />
0474832 EUCREAS 50/850 MG 60 CPR BLIST RR<br />
0 0 43,28 54,07 100<br />
A10BF01 acarbose<br />
0173114 GLUCOBAY 100 MG 60 CPR R<br />
0 0 11,23 19,30 100<br />
0173101 GLUCOBAY 50 MG 120 CPR R<br />
0 0 15,36 25,73 100<br />
A10BG03 pioglitazone<br />
0287809 ACTOS 15 MG 28 CPR RR<br />
0 0 24,97 33,80 100<br />
0287826 ACTOS 15 MG 98 CPR RR<br />
0 0 71,62 84,69 100<br />
0287843 ACTOS 30 MG 28 CPR RR<br />
0 0 39,63 49,94 100<br />
0287861 ACTOS 30 MG 98 CPR RR<br />
0 0 112,47 127,97 100<br />
A10BH01 sitagliptin<br />
0453636 JANUVIA 100 MG 28 CPR RR<br />
0 0 35,12 45,09 100<br />
0453671 JANUVIA 100 MG 98 CPR RR<br />
0 0 122,93 139,19 100<br />
0453491 JANUVIA 25 MG 28 CPR RR<br />
0 0 35,12 45,08 100<br />
0453524 JANUVIA 25 MG 98 CPR RR<br />
0 0 122,93 139,18 100<br />
0453572 JANUVIA 50 MG 28 CPR RR<br />
0 0 35,12 45,08 100<br />
Page 20 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0453619 JANUVIA 50 MG 98 CPR RR<br />
0 0 122,93 139,18 100<br />
A10BH02 vildagliptin<br />
0470363 GALVUS 50 MG 180 CPR RR<br />
0 0 114,48 130,23 100<br />
0470329 GALVUS 50 MG 60 CPR RR<br />
0 0 43,28 54,07 100<br />
A10BH03 saxagliptin<br />
0603974 ONGLYZA 2,5 MG 28 CPR RR<br />
0 0 36,96 47,10 100<br />
0604002 ONGLYZA 2,5 MG 98 CPR RR<br />
0 0 112,02 127,61 100<br />
0528897 ONGLYZA 5 MG 28 CPR RR<br />
0 0 36,96 47,10 100<br />
0528933 ONGLYZA 5 MG 30*1 CPR UD RR<br />
0 0 35,52 0,00 0<br />
0528916<br />
A10BH05<br />
ONGLYZA 5 MG 98 CPR RR<br />
0 0 112,02 127,61 100<br />
0622028 TRAJENTA 5 MG 100 CPR RR<br />
0 0 112,00 127,59 100<br />
0621955 TRAJENTA 5 MG 30 CPR RR<br />
0 0 33,60 43,41 100<br />
A10BX02 repaglinide<br />
0256381 NOVONORM 0,5 MG 120 CPR RR<br />
0 0 6,64 12,46 100<br />
0256461 NOVONORM 1 MG 120 CPR RR<br />
0 0 6,64 12,46 100<br />
0256539 NOVONORM 2 MG 120 CPR RR<br />
0 0 6,64 12,46 100<br />
A10BX03 nateglinide<br />
0297836 STARLIX 120 MG 120 CPR RR<br />
0 0 45,32 58,68 100<br />
0297805 STARLIX 120 MG 30 CPR RR<br />
0 0 11,33 21,48 100<br />
0297755 STARLIX 60 MG 120 CPR RR<br />
0 0 45,32 58,68 100<br />
0297724 STARLIX 60 MG 30 CPR RR<br />
0 0 11,33 21,48 100<br />
A10BX04 exenatide<br />
0454163 BYETTA 10 MCG 1 STYLO 2,4 ML SC RR<br />
0 0 87,62 101,65 100<br />
0454177 BYETTA 10 MCG 3 STYLOS 2,4 ML SC RR<br />
0 0 87,62 101,65 0<br />
0454132 BYETTA 5 MCG 1 STYLO 1,2 ML SC RR<br />
0 0 87,62 101,65 100<br />
A10BX07 liraglutide<br />
0533852 VICTOZA 6 MG/ML 2 STYLOS 3 ML SC RR<br />
0 0 88,60 102,81 100<br />
A11AB Multivitamins, other combinations<br />
0189923 MERZ SPEZIAL SN 120 DRG P<br />
0 0 0,00 12,88 0<br />
A11CC03 alfacalcidol<br />
0258953 1 ALPHA LEO 0,25 MCG 30 CAPS R<br />
0 0 3,32 8,31 80<br />
0258967 1 ALPHA LEO 0,25 MCG 50 CAPS R<br />
0 0 0,00 11,30 80<br />
0258971 1 ALPHA LEO 1 MCG 50 CAPS BLIST R<br />
0 0 18,46 26,73 80<br />
0559876 1 ALPHA LEO 2 MCG/ML 10 AMP 0,5 ML RR<br />
0 0 34,65 45,60 80<br />
0559909 1 ALPHA LEO 2 MCG/ML GTTS 1 FL 10 ML R<br />
0 0 8,52 14,79 80<br />
A11CC04 calcitriol<br />
0330202 ROCALTROL 0,25 MCG 30 CAPS BLIST R<br />
0 0 5,80 11,40 80<br />
0330216 ROCALTROL 0,5 MCG 30 CAPS BLIST R<br />
0 0 9,30 15,77 80<br />
Page 21 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
A11CC05 colecalciferol<br />
0233341 D CURE 25000 U/ML 4 AMP R<br />
0 0 2,69 4,62 80<br />
0176729 D CURE GTTS 10 ML R<br />
0 0 2,12 3,64 80<br />
0193683 UVEDOSE 100000 U 1 AMP BUV 2 ML R<br />
0 0 0,00 1,78 80<br />
0643532 VIGANTOLETTEN 1000 U 100 CPR R<br />
0 0 3,49 6,76 0<br />
0127562 VIGANTOLETTEN 1000 U 90 CPR R<br />
0 0 3,14 6,24 80<br />
0643529 VIGANTOLETTEN 500 U 100 CPR R<br />
0 0 3,26 6,48 0<br />
0127576 VIGANTOLETTEN 500 U 90 CPR R<br />
0 0 2,99 5,95 80<br />
0241617 VITAM D3 B.O.N. 200000 U 1 AMP 1 ML R<br />
0 0 1,12 1,84 80<br />
A11CC20 combinations<br />
0045713 FLUOR VIGANTOLETTEN 1000 90 CPR R<br />
0 0 3,21 6,38 80<br />
0045727 FLUOR VIGANTOLETTEN 500 90 CPR R<br />
0 0 2,69 5,33 80<br />
A11DA01 thiamine (vit B1)<br />
0011987 BENERVA 300 MG 20 CPR P<br />
0 0 2,12 3,64 80<br />
0012760 BETAMINE 500 MG 50 DRG P<br />
0 0 4,15 7,13 80<br />
A11DB Vitamin B1 in combination with vitamin B6 and/or vitamin B12<br />
0269281 BEFACT FORTE B1 B2 B6 B12 100 DRG P<br />
0 0 12,73 21,86 80<br />
0226561 BEFACT FORTE B1 B2 B6 B12 30 DRG P<br />
0 0 4,89 8,41 80<br />
0278245 BETAPYR 50 DRG P<br />
0 0 5,88 10,11 0<br />
0078048 NEUROBION 3 AMP 3 ML R<br />
0 0 4,17 7,77 80<br />
0172666 NEUROBION N FORTE 100 DRG P<br />
0 0 12,73 21,61 80<br />
0172327 NEUROBION N FORTE 50 DRG P<br />
0 0 6,96 12,54 80<br />
0205512 NEUROTRAT S FORTE 60 DRG P<br />
0 0 5,52 10,58 80<br />
0107086 SOPALAMIN PDR 6 FL + S 2 ML IM R<br />
0 0 0,00 6,98 80<br />
A11EB Vitamin B-complex with vitamin C<br />
0454048 BECOZYME 30 CPR EFF P<br />
0 0 10,00 17,18 0<br />
0415621 BECOZYME 60 CPR P<br />
0 0 14,08 24,18 0<br />
A11GA01 ascorbic acid (vit C)<br />
0310146 ADDITIVA VIT C 1000 MG 20 CPR EFF P<br />
0 0 0,00 4,81 0<br />
0326373 C WILL 500 MG 20 CAPS P<br />
0 0 3,11 5,34 0<br />
0326391 C WILL 500 MG 60 CAPS P<br />
0 0 7,47 12,83 0<br />
0153724 CETAMINE 500 MG 50 CPR P<br />
0 0 4,29 7,37 0<br />
0337668 REDOXON CITRON 500 MG 30 CPR A SUCER P<br />
0 0 2,96 5,09 0<br />
0337671 REDOXON CITRON 500 MG 60 CPR A SUCER P<br />
0 0 5,29 9,09 0<br />
0355599 VITAMINE C QLPHR 500 MG 60 PAST P<br />
0 0 4,53 7,77 0<br />
0512575 VITASCORBOL 1 G 2*10 CPR EFF P<br />
0 0 2,72 6,31 0<br />
0506239 VITASCORBOL SS SUCRE TAMP 500MG 2*12 CPR P<br />
RM 0 0<br />
2,72 5,70 0<br />
A11GB Ascorbic acid (vitamin C), combinations<br />
0404676 REDOXON + ZINC 10 MG/1 G 30 CPR EFF P<br />
0 0 6,17 10,59 0<br />
0189047 REVITALOSE C 1000 14*2 AMP BUV P<br />
0 0 7,64 13,12 0<br />
Page 22 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0189033 REVITALOSE C 1000 7*2 AMP BUV P<br />
0 0 0,00 7,38 0<br />
0307977 REVITALOSE C 1000 GRAN 14*2 SACH-DOSES P<br />
0 0 7,27 12,49 0<br />
0307963 REVITALOSE C 1000 GRAN 7*2 SACH-DOSES P<br />
0 0 0,00 7,38 0<br />
0415702 SARGENOR VIT C 20 AMP BUV 5 ML P<br />
0 0 0,00 14,74 0<br />
0415666 SARGENOR VIT C 20 CPR A CROQUER P<br />
0 0 0,00 14,74 0<br />
0314145 SARGENOR VIT C 20 CPR EFF P<br />
0 0 0,00 14,74 0<br />
A11GB01 ascorbic acid (vit C) and calcium<br />
0117907 TONICALCIUM 20 AMP AD P<br />
0 0 0,00 5,58 0<br />
0136723 TONICALCIUM 20 AMP ENF P<br />
0 0 0,00 3,97 0<br />
A11HA01 nicotinamide<br />
0166073 UCEMINE PP 100 MG 50 CPR P<br />
0 0 2,77 4,76 80<br />
A11HA02 pyridoxine (vit B6)<br />
0096046 PYRIDOXINE 250 MG 20 CPR P<br />
0 0 0,00 4,91 80<br />
A11HA03 tocopherol (vit E)<br />
0136057 E VITAMIN RATIO 400 MG 30 CAPS P<br />
0 0 0,00 7,94 0<br />
0136061 E VITAMIN RATIO 400 MG 60 CAPS P<br />
0 0 0,00 13,50 0<br />
0286376 KLOSTERFRAU VIT E 800 U 50 CAPS P<br />
0 0 13,07 22,13 0<br />
A11JA Combinations of vitamins<br />
0241679 HYDROSOL POLYVIT BON 20 CAPS P<br />
0 0 0,00 7,93 0<br />
0241665 HYDROSOL POLYVIT BON GTTS 20 ML P<br />
0 0 0,00 6,20 0<br />
0095102 PROTOVIT GTTS 15 ML P<br />
0 0 2,48 4,26 0<br />
A11JC Vitamins, other combinations<br />
0229741 ARGINOTRI B 24 CPR P<br />
0 0 0,00 4,88 0<br />
0245423 CYSTINE B6 BAILLEUL 20 CPR P<br />
0 0 0,00 4,60 0<br />
0246188 CYSTINE B6 BAILLEUL 60 CPR P<br />
0 0 0,00 13,50 0<br />
0085915 PANTOVIGAR 300 CAPS P<br />
0 0 0,00 77,79 0<br />
0085901 PANTOVIGAR 90 CAPS P<br />
0 0 0,00 27,31 0<br />
0105856 SOLACY 45 CAPS R<br />
0 0 0,00 6,40 0<br />
A12AA04 calcium carbonate<br />
0211473 CALCICHEW 500 MG 100 CPR (FL) P<br />
0 0 13,69 23,52 80<br />
0241696 CALPEROS 500 MG 60 CPR P<br />
0 0 5,10 7,90 80<br />
0281609 STEOCAR ORANGE 500 MG 60 CPR A CROQ P<br />
0 0 8,56 14,70 0<br />
A12AA12 calcium acetate anhydrous<br />
0428907 CALCIUMACETAT NEFRO 500 MG 100 CPR RR C<br />
0 0 4,51 8,63 80<br />
0428911 CALCIUMACETAT NEFRO 500 MG 200 CPR RR C<br />
0 0 8,74 15,72 80<br />
0428938 CALCIUMACETAT NEFRO 700 MG 100 CPR RR C<br />
0 0 5,62 10,78 80<br />
0428941 CALCIUMACETAT NEFRO 700 MG 200 CPR RR C<br />
0 0 11,50 19,63 80<br />
0519772 PHOSPHOSORB 660 MG 200 CPR (FL) RR C<br />
0 0 21,42 31,97 0<br />
A12AA20 calcium (different salts in combination)<br />
Page 23 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0134151 CALCIFORTE 500 MG 30 AMP BUV 10 ML P<br />
0 0 3,34 6,79 80<br />
0017087 CALCIPOT 200 CPR P<br />
0 0 0,00 12,76 80<br />
0017073 CALCIPOT 50 CPR P<br />
0 0 0,00 4,36 80<br />
0017400 CALCIUM SDZ FORT 1000 MG 20 CPR EFF P<br />
0 0 0,00 8,40 80<br />
A12AX Calcium, combinations with other drugs<br />
0219048 CACIT VIT D3 1 G/880 U GRAN 30 SACH P<br />
0 0 10,51 18,06 80<br />
0219021 CACIT VIT D3 500 MG/440 U GRAN 30 SACH P<br />
0 0 5,26 9,04 80<br />
0421257 CAD 1000 MG 880 U CITROEN 30 SACH P<br />
0 0 0,00 15,65 80<br />
0421243 CAD 500 MG 440 U CITROEN 30 SACH P<br />
0 0 0,00 8,91 80<br />
0380106 CALCIFORTE VIT D3 500 MG 400 U 60 CPR P<br />
0 0 4,69 8,10 80<br />
0525671 CALCIGEN D FORTE 1000MG 880U 20 CPR EFF P<br />
0 0 3,77 10,71 80<br />
0525685 CALCIGEN D FORTE 1000MG 880U 40 CPR EFF P<br />
0 0 7,39 18,95 80<br />
0241648 CALPEROS D3 60 CPR A SUCER P<br />
0 0 5,20 8,04 80<br />
0252798 D VITAL 500/440 GRAN EFF 30 SACH P<br />
0 0 5,94 10,20 80<br />
0252803 D VITAL FORTE 1000/880 GRAN EFF 30 SACH P<br />
0 0 9,80 16,84 80<br />
0462666 D VITAL FORTE 1000/880 GRAN EFF 90 SACH P<br />
0 0 27,69 38,43 80<br />
0435011 EPTAVIT 1000 MG 880 U 30 CPR EFF P<br />
0 0 0,00 8,04 80<br />
0450831 EPTAVIT 1000 MG 880 U 90 CPR EFF P<br />
0 0 0,00 23,00 80<br />
0469023 STEOVIT D3 500 MG/400 U 168 CPR BLIST P<br />
0 0 22,36 32,94 0<br />
0468902 STEOVIT D3 500 MG/400 U 60 CPR P<br />
0 0 9,04 15,54 0<br />
0487052 STEOVIT D3 ORANGE 500MG/200U 60 CPR CROQ P<br />
0 0 8,56 14,70 0<br />
0554897 STEOVIT FORTE CITRON 1000MG/800U 28 CPR P<br />
0 0 8,54 14,67 80<br />
0554933 STEOVIT FORTE CITRON 1000MG/800U 84 CPR P<br />
0 0 24,81 35,47 80<br />
0555023 STEOVIT FORTE CITRON 1000MG/800U 90 CPR P<br />
0 0 26,65 37,36 0<br />
0505147 STEOVIT FORTE ORANGE 1000MG/880U 2*15CPR P<br />
0 0 9,15 15,72 80<br />
0505164 STEOVIT FORTE ORANGE 1000MG/880U 6*15CPR P<br />
0 0 26,65 37,36 80<br />
A12BA01 potassium chloride<br />
0021384 CHLOROPOTASSURYL 1 G 10 AMP BUV R<br />
0 0 2,60 4,47 80<br />
0060947 KALINOR RET P 600 MG 50 CAPS R<br />
0 0 3,89 7,46 80<br />
0203861 KALITRANS RET 600 MG 50 CAPS 3501501 R<br />
0 0 0,00 6,72 80<br />
A12BA04 potassium hydrogencarbonate<br />
0060883 KALINOR 15 CPR EFF R<br />
0 0 3,92 7,52 80<br />
0060897 KALINOR 30 CPR EFF R<br />
0 0 7,94 14,29 80<br />
A12BA05 potassium gluconate<br />
0122552 ULTRA K SOL 200 ML R<br />
0 0 0,00 4,45 80<br />
A12CB Zinc<br />
0362237 ZINKASPART 19,2 MG 100 CAPS P<br />
0 0 12,01 20,34 0<br />
0362206 ZINKASPART 19,2 MG 20 CAPS P<br />
0 0 0,00 4,85 0<br />
0362223 ZINKASPART 19,2 MG 50 CAPS P<br />
0 0 7,44 11,51 0<br />
A12CB02 zinc gluconate<br />
0329585 CEFAZINK 10 MG 100 CPR P<br />
0 0 7,05 12,85 0<br />
Page 24 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0329568 CEFAZINK 10 MG 20 CPR P<br />
0 0 2,08 4,15 0<br />
0329571 CEFAZINK 10 MG 50 CPR P<br />
0 0 4,00 7,66 0<br />
0329618 CEFAZINK 20 MG 100 CPR P<br />
0 0 9,13 16,42 0<br />
0329599 CEFAZINK 20 MG 20 CPR P<br />
0 0 2,59 5,16 0<br />
0329604 CEFAZINK 20 MG 50 CPR P<br />
0 0 5,40 10,35 0<br />
A12CC02 magnesium sulfate<br />
0107976 SPASMAG 30 AMP BUV 5 ML P<br />
0 0 3,16 5,50 80<br />
0107962 SPASMAG 60 CAPS P<br />
0 0 3,16 5,50 80<br />
A12CC03 magnesium gluconate<br />
0122700 ULTRA MAGNESIUM 162 MG 40 SACH P<br />
0 0 8,05 13,83 80<br />
A12CC05 magnesium aspartate<br />
0215195 MAGIUM 20 CPR A MACHER P<br />
0 0 0,00 3,30 80<br />
0272238 MAGNEROT A 100 MG 20 SACH P<br />
0 0 0,00 5,48 80<br />
0272241 MAGNEROT A 100 MG 50 SACH P<br />
0 0 0,00 12,15 80<br />
0272269 MAGNEROT A 300 MG 20 SACH P<br />
0 0 0,00 8,75 80<br />
0272272 MAGNEROT A 300 MG 50 SACH P<br />
0 0 0,00 20,25 80<br />
0272305 MAGNEROT A 500 MG 20 SACH P<br />
0 0 0,00 16,68 80<br />
0272319 MAGNEROT A 500 MG 50 SACH P<br />
0 0 0,00 36,04 80<br />
0210137 MAGNESIUM SDZ 20 CPR EFF 02610 P<br />
0 0 0,00 5,73 80<br />
A12CC06 magnesium lactate<br />
0069004 MAGNE B6 50 DRG P<br />
0 0 0,00 5,35 0<br />
A12CC08 magnesium pidolate<br />
0215794 MAG 2 184 MG 30 SACH P<br />
0 0 2,24 3,99 80<br />
0068914 MAG 2 30 AMP BUV P<br />
0 0 3,88 6,92 80<br />
0415084 MAG 2 SANS SUCRE 30 AMP BUV 10 ML P<br />
0 0 3,88 6,92 80<br />
0068931 MAGINJECTABLE 0,8% 12 AMP 10 ML RR<br />
0 0 3,65 4,21 80<br />
A12CC10 magnesium oxide<br />
0335324 MAGNOSANOL 50 CAPS P<br />
0 0 4,51 8,58 80<br />
A12CC30 magnesium (different salts in combination)<br />
0013799 BIOMAGNESIN 100 CPR P<br />
0 0 3,86 6,88 80<br />
A12CD01 sodium fluoride<br />
0137881 NATRIUMFLUORID BAER 25 MG 100 DRG R<br />
0 0 3,29 12,68 80<br />
0075953 NATRIUMFLUORID BAER 25 MG 50 DRG R<br />
0 0 1,78 3,17 80<br />
A12CE Selenium<br />
0337069 SELENASE PERORAL 100 MCG 20 AMP 2 ML P<br />
0 0 13,76 22,94 0<br />
0337072 SELENASE PERORAL 100 MCG 60 AMP 2 ML P<br />
0 0 39,29 50,03 0<br />
0337086 SELENASE PERORAL 100 MCG 90 AMP 2 ML P<br />
0 0 49,65 61,02 0<br />
0313537 SELENASE PRO INJ 100 MCG 10 AMP 2 ML RR<br />
0 0 11,23 20,99 0<br />
0313541 SELENASE PRO INJ 100 MCG 50 AMP 2 ML RR<br />
0 0 55,91 70,76 0<br />
Page 25 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0330846 SELENASE T PERORAL 500 MCG 10 FL 10 ML V P<br />
0 0 32,72 44,86 0<br />
0313604 SELENASE T PRO INJ 500 MCG 10 AMP 10 ML RR<br />
0 0 61,58 73,68 0<br />
0313599 SELENASE T PRO INJ 500 MCG 2 AMP 10 ML RR<br />
0 0 12,64 22,55 0<br />
A12CE02 sodium selenite<br />
0301066 CEFASEL 100 MCG 100 CPR P<br />
0 0 19,95 35,21 0<br />
0301049 CEFASEL 100 MCG 20 CPR P<br />
0 0 5,01 8,95 0<br />
0301052 CEFASEL 100 MCG 50 CPR P<br />
0 0 9,96 17,58 0<br />
0368213 CEFASEL 300 MCG 100 CPR P<br />
0 0 35,35 0,00 0<br />
0368194 CEFASEL 300 MCG 20 CPR P<br />
0 0 6,89 16,63 0<br />
0368227 CEFASEL 300 MCG 200 CPR P<br />
0 0 69,60 0,00 0<br />
0512043 CEFASEL 300 MCG 50 CPR P<br />
0 0 17,24 27,94 0<br />
0379878 CEFASEL 50 MCG 100 CPR P<br />
0 0 14,26 24,16 0<br />
0379851 CEFASEL 50 MCG 20 CPR P<br />
0 0 4,02 7,69 0<br />
0379864 CEFASEL 50 MCG 50 CPR P<br />
0 0 8,03 14,45 0<br />
A12CX Other mineral products<br />
0182693 OLIGOSTIM AL 40 CPR P<br />
0 0 0,00 5,21 0<br />
0182709 OLIGOSTIM CO 40 CPR P<br />
0 0 0,00 5,21 0<br />
0168731 OLIGOSTIM CU 40 CPR SL P<br />
0 0 0,00 5,21 0<br />
0168713 OLIGOSTIM CU-AU-AG 40 CPR SL P<br />
0 0 0,00 5,90 0<br />
0182712 OLIGOSTIM F 40 CPR P<br />
0 0 0,00 5,21 0<br />
0182726 OLIGOSTIM K 40 CPR P<br />
0 0 0,00 5,21 0<br />
0168646 OLIGOSTIM LI 40 CPR SL P<br />
0 0 0,00 5,21 0<br />
0168663 OLIGOSTIM MG 40 CPR SL P<br />
0 0 0,00 5,21 0<br />
0168681 OLIGOSTIM MN 40 CPR SL P<br />
0 0 0,00 5,21 0<br />
0168727 OLIGOSTIM MN-CO 40 CPR SL P<br />
0 0 0,00 6,00 0<br />
0168677 OLIGOSTIM MN-CU 40 CPR SL P<br />
0 0 0,00 6,00 0<br />
0182761 OLIGOSTIM MN-CU-CO 40 CPR P<br />
0 0 0,00 6,00 0<br />
0182743 OLIGOSTIM P 40 CPR P<br />
0 0 0,00 5,21 0<br />
0182757 OLIGOSTIM S 40 CPR P<br />
0 0 0,00 5,21 0<br />
0182869 OLIGOSTIM ZN 40 CPR P<br />
0 0 0,00 5,21 0<br />
0182774 OLIGOSTIM ZN-CU 40 CPR P<br />
0 0 0,00 6,00 0<br />
0168694 OLIGOSTIM ZN-NI-CO 40 CPR SL P<br />
0 0 0,00 6,00 0<br />
0250762 STIMUPLEX GTTS 30 ML P<br />
0 0 0,00 7,98 0<br />
A13A TONICS<br />
0188425 ACTI 5 30 AMP BUV 5 ML P<br />
0 0 0,00 15,37 0<br />
0319219 BIOVITAL CLASSIC SOL 1000 ML P<br />
0 0 0,00 21,42 0<br />
0319205 BIOVITAL CLASSIC SOL 650 ML P<br />
0 0 0,00 14,97 0<br />
0102580 SARGENOR 20 AMP BUV 5 ML P<br />
0 0 0,00 7,73 0<br />
0186627 SARGENOR 40 AMP BUV 5 ML P<br />
0 0 0,00 14,74 0<br />
0415649 SARGENOR ENF 0,5 G 40 AMP BUV 5 ML P<br />
0 0 0,00 8,53 0<br />
0236021 SARGENOR SANS SUCRE 1 G 20 CPR EFF P<br />
0 0 0,00 7,73 0<br />
0211425 SARGENOR SANS SUCRE 1 G 40 CPR EFF P<br />
0 0 0,00 14,74 0<br />
Page 26 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0462523 STIMOL 1 G 18 AMP BUV 10 ML P<br />
0 0 0,00 6,59 0<br />
A14AB01 nandrolone<br />
0368387 DECA DURABOLIN 25 MG 1 AMP 1 ML IM RR<br />
0 0 2,67 4,59 0<br />
0368391 DECA DURABOLIN 25 MG 6 FL 1 ML IM RR<br />
0 0 12,84 22,06 0<br />
0028452 DECA DURABOLIN 50 MG 2 ORGAJECT 1 ML IM RR<br />
0 0 8,39 14,41 80<br />
A16AA01 levocarnitine<br />
0399528 NEFROCARNIT 1 G 10 AMP 5 ML IV RR HC<br />
0 0 14,80 0,00 0<br />
0399545 NEFROCARNIT 1 G 100 AMP 5 ML IV RR HC<br />
0 0 148,00 0,00 0<br />
0399531 NEFROCARNIT 1 G 25 AMP 5 ML IV RR HC<br />
0 0 37,00 0,00 0<br />
0399501 NEFROCARNIT 1 G/3,3 ML 1 FL 50 ML R<br />
0 0 17,17 28,94 0<br />
0399514 NEFROCARNIT 1 G/3,3 ML 3 FL 50 ML R<br />
0 0 51,52 77,92 0<br />
A16AB02 imiglucerase<br />
0244264 CEREZYME 200 U PDR 1 FL PERF RR H<br />
0 0 792,41 0,00 0<br />
0244278 CEREZYME 200 U PDR 25 FL PERF RR H<br />
0 0 20.552,32 0,00 0<br />
0276769 CEREZYME 400 U PDR 1 FL IV RR H<br />
0 0 1.584,84 0,00 0<br />
0276786 CEREZYME 400 U PDR 25 FL IV RR H<br />
0 0 41.104,62 0,00 0<br />
0276772 CEREZYME 400 U PDR 5 FL IV RR H<br />
0 0 8.220,95 0,00 0<br />
A16AB04 agalsidase beta<br />
0450696 FABRAZYME 35 MG PDR 1 FL V IV RR H<br />
X 0 0<br />
3.650,09 0,00 0<br />
0450715 FABRAZYME 35 MG PDR 10 FL V IV RR H<br />
X 0 0<br />
37.436,00 0,00 0<br />
0450701 FABRAZYME 35 MG PDR 5 FL V IV RR H<br />
X 0 0<br />
18.718,00 0,00 0<br />
0338097 FABRAZYME 5 MG PDR 1 FL V IV RR H<br />
X 0 0<br />
521,43 0,00 0<br />
0338116 FABRAZYME 5 MG PDR 10 FL V IV RR H<br />
X 0 0<br />
6.150,20 0,00 0<br />
0338102 FABRAZYME 5 MG PDR 5 FL V IV RR H<br />
X 0 0<br />
3.075,10 0,00 0<br />
A16AB05 laronidase<br />
0349252 ALDURAZYME 500 U 1 FL 5 ML PERF RR H<br />
X 0 0<br />
614,07 0,00 0<br />
0349266 ALDURAZYME 500 U 10 FL 5 ML PERF RR H<br />
X 0 0<br />
6.370,00 0,00 0<br />
0349283 ALDURAZYME 500 U 25 FL 5 ML PERF RR H<br />
X 0 0<br />
15.925,00 0,00 0<br />
A16AB07 alglucosidase alfa<br />
0432671 MYOZYME 50 MG PDR 1 FL 20 ML IV RR H<br />
X 0 0<br />
525,00 0,00 0<br />
0432684 MYOZYME 50 MG PDR 10 FL 20 ML IV RR H<br />
X 0 0<br />
5.250,00 0,00 0<br />
0432698 MYOZYME 50 MG PDR 25 FL 20 ML IV RR H<br />
X 0 0<br />
13.125,00 0,00 0<br />
A16AB09 idursulfase<br />
0453461 ELAPRASE 2 MG/ML PERF 1 FL DIL 3 ML IV RR H<br />
X 0 0<br />
2.773,19 0,00 0<br />
A16AX02 anethole trithione<br />
0111335 SULFARLEM S25 60 DRG P<br />
0 0 2,79 4,79 40<br />
A16AX06 miglustat<br />
0361941 ZAVESCA 100 MG 84 CAPS RR DC X 0 0<br />
6.655,63 0,00 0<br />
A16AX07 sapropterin<br />
Page 27 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0558963 KUVAN 100 MG 120 CPR (FL) RR DC X 0 0<br />
2.660,00 0,00 0<br />
B01AA Vitamin K antagonists<br />
0218295 PREVISCAN 20 MG 30 CPR RR<br />
0 0 2,55 4,55 100<br />
B01AA03 warfarin<br />
0069620 MAREVAN 5 MG 25 CPR RR<br />
0 0 1,53 6,20 100<br />
B01AA04 phenprocoumon<br />
0069603 MARCOUMAR 3 MG 25 CPR RR<br />
0 0 1,26 5,91 100<br />
B01AA07 acenocoumarol<br />
0252624 SINTROM 1 MG 100 CPR 102241 RR<br />
0 0 1,73 6,41 100<br />
0105291 SINTROM 4 MG 20 CPR RR<br />
0 0 1,31 5,97 100<br />
B01AB01 heparin<br />
0156645 HEPARIN CA RATIO 12500 U 5 AMP 0,5 ML IV RR<br />
0 0 0,00 11,08 80<br />
0154833 HEPARIN CA RATIO 5000 U 10 SRG 0,2 ML IV RR<br />
0 0 0,00 14,97 80<br />
0154816 HEPARIN CA RATIO 5000 U 20 AMP 0,2ML IVS RR<br />
0 0 0,00 17,74 80<br />
0154802 HEPARIN CA RATIO 5000 U 5 AMP 0,2 ML IVS RR<br />
0 0 0,00 5,13 80<br />
0242709 HEPARIN LEO 100 U/ ML 10 FL 10 ML IV RR<br />
0 0 22,14 32,72 0<br />
0053018 HEPARIN LEO 25000 U 1 AMP 5 ML RR<br />
0 0 0,00 3,73 80<br />
0231865 HEPARIN LEO 25000 U 50 FL 5 ML IMIVSC RR<br />
0 0 126,71 0,00 0<br />
0053021 HEPARIN NA BRN 25000 U 10 FL 5 ML IVSC RR<br />
0 0 0,00 2,38 80<br />
0053035 HEPARIN NA BRN 5000 U 10 AMP 0,5 ML IVSC RR<br />
0 0 0,00 2,03 80<br />
0173968 HEPARIN NA RATIO 25000 U 5 FL 5 ML IVSC RR<br />
0 0 12,70 21,97 80<br />
0154508 HEPARIN NA RATIO 5000 U 10 SRG 0,2 ML IV RR<br />
0 0 0,00 14,97 80<br />
0154492 HEPARIN NA RATIO 5000 U 20 AMP 0,2 ML RR<br />
0 0 0,00 15,56 80<br />
0154489 HEPARIN NA RATIO 5000 U 5 AMP 0,2 ML IVS RR<br />
0 0 0,00 4,33 80<br />
0309601 MONO EMBOLEX 3000 IE 2 SRG 0,3 ML RR<br />
0 0 6,00 15,66 0<br />
B01AB04 dalteparin<br />
0206506 FRAGMIN 10000 U 10 FL 4 ML IV RR<br />
0 0 60,97 73,51 0<br />
0206523 FRAGMIN 10000 U 10 SRG 1 ML IV RR<br />
0 0 60,97 73,51 80<br />
0261914 FRAGMIN 12500 U 5 SRG 0,5 ML SC RR<br />
0 0 37,29 47,48 80<br />
0261931 FRAGMIN 15000 U 5 SRG 0,6 ML SC RR<br />
0 0 43,48 54,29 80<br />
0261959 FRAGMIN 18000 U 5 SRG 0,72 ML SC RR<br />
0 0 52,06 63,73 80<br />
0191742 FRAGMIN 2500 U 10 SRG 0,2 ML SC RR<br />
0 0 17,14 25,28 80<br />
0191756 FRAGMIN 5000 U 10 SRG 0,2 ML SC RR<br />
0 0 30,50 40,00 80<br />
0219972 FRAGMIN 7500 U 10 SRG 0,75 ML SC RR<br />
0 0 43,48 54,29 80<br />
B01AB05 enoxaparin<br />
0190485 CLEXANE 100 MG 10 SRG 1 ML IVSC RR<br />
0 0 45,20 56,18 80<br />
0316492 CLEXANE 120 MG 10 SRG 0,8 ML SCIV RR<br />
0 0 64,56 77,32 80<br />
0316489 CLEXANE 150 MG 10 SRG 1 ML SCIV RR<br />
0 0 67,79 80,74 80<br />
0173128 CLEXANE 20 MG 10 SRG 0,2 ML IVSCVI RR<br />
0 0 15,70 23,69 80<br />
0173145 CLEXANE 40 MG 10 SRG 0,4 ML IVSCVI RR<br />
0 0 28,55 37,84 80<br />
Page 28 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0267613 CLEXANE 60 MG 10 SRG 0,6 ML IVSC RR<br />
0 0 34,11 43,97 80<br />
0190454 CLEXANE 80 MG 10 SRG 0,8 ML IVSC RR<br />
0 0 39,64 50,06 80<br />
B01AB06 nadroparin<br />
0163829 FRAXIPARINE 10000U 10 SRG 0,4 ML SC RR<br />
0 0 21,97 30,60 80<br />
0046531 FRAXIPARINE 15000U 10 SRG 0,6 ML SC RR<br />
0 0 29,76 39,18 80<br />
0163846 FRAXIPARINE 20000 U 10 SRG 0,8 ML SC RR<br />
0 0 39,63 50,05 80<br />
0217741 FRAXIPARINE 25000 U 10 SRG 1 ML SC RR<br />
0 0 49,57 60,99 80<br />
0046609 FRAXIPARINE 7500U 10 SRG 0,3 ML SC RR<br />
0 0 16,72 24,82 80<br />
0300637 FRAXODI 19000 U/ML 10 AMP SRG 0,6 ML RR<br />
0 0 73,43 86,71 80<br />
0300641 FRAXODI 19000 U/ML 10 AMP SRG 0,8 ML RR<br />
0 0 97,92 112,67 80<br />
0300654 FRAXODI 19000 U/ML 10 AMP SRG 1 ML RR<br />
0 0 122,38 138,59 80<br />
B01AB09 danaparoid<br />
0239703 ORGARAN 750 U 10 AMP 0.6 ML SC RR H<br />
0 0 119,89 0,00 0<br />
B01AB10 tinzaparin<br />
0243978 INNOHEP 10000 U 10 SRG 0.5 ML SC RR<br />
0 0 59,50 71,93 80<br />
0636037 INNOHEP 10000 U 30 SRG 0,5 ML SC RR<br />
0 0 167,89 186,83 0<br />
0243981 INNOHEP 14000 U 10 SRG 0.7 ML SC RR<br />
0 0 83,27 97,15 80<br />
0636041 INNOHEP 14000 U 30 SRG 0,7 ML SC RR<br />
0 0 234,95 257,91 0<br />
0243995 INNOHEP 18000 U 10 SRG 0.9 ML SC RR<br />
0 0 107,09 122,40 80<br />
0642441 INNOHEP 18000 U 30 SRG 0.9 ML SC RR<br />
0 0 302,16 329,14 0<br />
0203857 INNOHEP 20000 U 10 FL 2 ML SC RR<br />
0 0 96,17 0,00 0<br />
0243916 INNOHEP 2500 U 10 SRG 0,25 ML SC RR<br />
0 0 16,73 24,83 80<br />
0243947 INNOHEP 3500 U 10 SRG 0.35 ML SC RR<br />
0 0 22,24 30,89 80<br />
0243964 INNOHEP 4500 U 10 SRG 0.45 ML SC RR<br />
0 0 27,11 36,26 80<br />
B01AC04 clopidogrel<br />
0629551 CLOPIDOGREL (HCL) SDZ 75 MG 28 CPR RR<br />
0 0 6,11 10,49 80<br />
0629581 CLOPIDOGREL (HCL) SDZ 75 MG 84 CPR RR<br />
0 0 30,08 39,53 0<br />
0629601 CLOPIDOGREL (HCL) SDZ 75 MG 98 CPR RR<br />
0 0 24,11 34,74 80<br />
0541837 CLOPIDOGREL DOC 75 MG 28 CPR RR<br />
0 0 7,26 13,05 80<br />
0560488 CLOPIDOGREL EG 75 MG 28 CPR RR<br />
0 0 7,13 13,06 80<br />
0560524 CLOPIDOGREL EG 75 MG 84 CPR RR<br />
0 0 30,19 39,65 80<br />
0560541 CLOPIDOGREL EG 75 MG 98 CPR RR<br />
0 0 23,40 34,01 0<br />
0537141 CLOPIDOGREL MYLAN 75 MG 100 CPR RR<br />
0 0 39,95 50,29 0<br />
0537073 CLOPIDOGREL MYLAN 75 MG 28 CPR RR<br />
0 0 7,67 13,61 0<br />
0537316 CLOPIDOGREL RATIO GMBH 75 MG 100 CPR RR<br />
0 0 27,58 32,28 80<br />
0537252 CLOPIDOGREL RATIO GMBH 75 MG 28 CPR RR<br />
0 0 13,74 18,63 80<br />
0531407 GREPID 75 MG 100 CPR RR<br />
0 0 28,15 0,00 0<br />
0531357 GREPID 75 MG 28 CPR RR<br />
0 0 13,12 21,88 0<br />
0531361 GREPID 75 MG 30 CPR RR<br />
0 0 14,06 23,45 0<br />
0482008 PLAVIX 300 MG 30 CPR RR<br />
0 0 76,09 89,44 0<br />
0253117 PLAVIX 75 MG 28 CPR RR<br />
0 0 18,33 26,60 80<br />
0297559 PLAVIX 75 MG 50 CPR UD RR<br />
0 0 26,21 0,00 0<br />
Page 29 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0253134 PLAVIX 75 MG 84 CPR RR<br />
0 0 44,02 54,89 80<br />
B01AC05 ticlopidine<br />
0116829 TICLID 250 MG 30 DRG RR<br />
0 0 9,34 15,81 80<br />
0171218 TICLID 250 MG 60 DRG RR<br />
0 0 15,78 23,77 80<br />
0451354 TICLOPIDINE EG 250 MG 30 CPR RR<br />
0 0 7,47 13,49 80<br />
0451368 TICLOPIDINE EG 250 MG 60 CPR RR<br />
0 0 9,56 16,09 80<br />
0451371 TICLOPIDINE EG 250 MG 90 CPR RR<br />
0 0 17,58 25,76 80<br />
B01AC06 acetylsalicylic acid<br />
0169271 ASAFLOW 160 MG 56 CPR P<br />
0 0 6,11 10,49 80<br />
0187543 ASAFLOW 160 MG 8*7 CPR UD P<br />
0 0 6,11 0,00 0<br />
0475911 ASAFLOW 80 MG 112 CPR P<br />
0 0 2,22 6,96 0<br />
0475924 ASAFLOW 80 MG 168 CPR P<br />
0 0 3,33 8,32 0<br />
0251952 ASAFLOW 80 MG 56 CPR P<br />
0 0 1,39 6,04 80<br />
0254534 ASAFLOW 80 MG 56 CPR UD P<br />
0 0 1,11 0,00 0<br />
0207128 CARDEGIC 160 PDR 30 SACH P<br />
0 0 2,38 4,09 80<br />
0207131 CARDEGIC 300 PDR 30 SACH P<br />
0 0 2,62 4,51 80<br />
0517456 CARDIOASPIRINE 100 MG 28 CPR P<br />
0 0 2,09 3,60 80<br />
0244667 CARDIOASPIRINE 100 MG 30 CPR P<br />
0 0 2,30 3,95 80<br />
0517487 CARDIOASPIRINE 100 MG 56 CPR P<br />
0 0 3,54 6,08 80<br />
0311791 CARDIOASPIRINE 100 MG 60 CPR P<br />
0 0 3,89 6,69 80<br />
0517506 CARDIOASPIRINE 100 MG 84 CPR P<br />
0 0 5,31 9,12 80<br />
0189405 HERZ ASS RATIO 100 MG 100 CPR P<br />
0 0 1,55 3,10 80<br />
0189386 HERZ ASS RATIO 100 MG 50 CPR P<br />
0 0 0,90 1,86 80<br />
B01AC07 dipyridamole<br />
0134648 DIPYRIDAMOLE EG 75 MG 100 DRG R<br />
0 0 1,71 6,39 80<br />
0088917 PERSANTINE 50 MG 25 AMP 10 ML PERF RR H<br />
0 0 10,69 0,00 0<br />
0088934 PERSANTINE 75 MG 100 DRG R<br />
0 0 4,10 9,29 80<br />
0274327 PERSANTINE 75 MG 100 DRG UD R<br />
0 0 15,20 0,00 0<br />
0231669 PERSANTINE RET 200 MG 50 CAPS UD R<br />
0 0 6,36 0,00 0<br />
0088982 PERSANTINE RET 200 MG 60 CAPS R<br />
0 0 6,84 12,70 80<br />
0231672 PERSANTINE RET GE 150 MG 50 CAPS UD R<br />
0 0 4,77 0,00 0<br />
0135208 PERSANTINE RET GE 150 MG 60 CAPS R<br />
0 0 4,73 10,08 80<br />
B01AC09 epoprostenol<br />
0286233 FLOLAN 1,5 MG PDR 1 FL + S 50 ML PERF(H) RR DC<br />
0 0 304,68 0,00 0<br />
0232926 FLOLAN 500 MCG PDR 1 FL+S 50 ML PERF(H) RR DC<br />
0 0 125,41 0,00 0<br />
B01AC11 iloprost<br />
0433289 VENTAVIS 10 MCG 168 AMP 1 ML INH RR DC<br />
0 0 2.396,92 0,00 0<br />
B01AC13 abciximab<br />
0436733 REOPRO 10 MG 1 FL 5 ML IV RR H<br />
0 0 200,48 0,00 0<br />
B01AC16 eptifibatide<br />
Page 30 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0266762 INTEGRILIN 20 MG 1 FL 10 ML PERF RR H<br />
0 0 20,00 0,00 0<br />
0266759 INTEGRILIN 75 MG 1 FL 100 ML PERF RR H<br />
0 0 63,00 0,00 0<br />
B01AC17 tirofiban<br />
0454181 AGGRASTAT 0,05 MG/ML 1 PP 250 ML PERF RR H<br />
0 0 186,51 0,00 0<br />
0267871 AGGRASTAT 0,25 MG/ML 1 FL 50 ML PERF RR H<br />
0 0 186,51 0,00 0<br />
B01AC21 treprostinil<br />
0415246 REMODULIN 100 MG PERF 1 FL 20 ML SC RR DC<br />
0 0 13.000,00 0,00 0<br />
0415229 REMODULIN 20 MG PERF 1 FL 20 ML SC RR DC<br />
0 0 2.600,00 0,00 0<br />
0415263 REMODULIN 200 MG PERF 1 FL 20 ML SC RR DC<br />
0 0 26.000,00 0,00 0<br />
0415232 REMODULIN 50 MG PERF 1 FL 20 ML SC RR DC<br />
0 0 6.500,00 0,00 0<br />
B01AC22 prasugrel<br />
0516977 EFIENT 10 MG 28 CPR RR<br />
RM 1 1<br />
44,80 55,64 80<br />
0517005 EFIENT 10 MG 84 CPR RR<br />
RM 1 1<br />
134,40 151,23 80<br />
0517019 EFIENT 10 MG 90 CPR RR<br />
RM 0 0<br />
144,00 161,40 0<br />
0516641 EFIENT 5 MG 28 CPR RR<br />
RM 1 1<br />
44,80 55,64 80<br />
0516672<br />
B01AC24<br />
EFIENT 5 MG 84 CPR RR<br />
RM 1 1<br />
134,40 151,23 80<br />
0591311 BRILIQUE 90 MG 100 CPR UD RR<br />
0 0 105,50 0,00 0<br />
0591307 BRILIQUE 90 MG 168 CPR RR<br />
1 1 177,24 196,75 80<br />
0591291 BRILIQUE 90 MG 56 CPR RR<br />
1 1 59,08 71,47 80<br />
B01AC30 combinations<br />
0289008<br />
B01AC56<br />
AGGRENOX 60 CAPS R<br />
0 0 10,02 16,66 80<br />
0628729 ASPAXA 81/20 MG 30 CAPS R<br />
0 0 9,90 17,00 0<br />
0628732 ASPAXA 81/20 MG 90 CAPS R<br />
0 0 23,40 34,01 0<br />
B01AD02 alteplase<br />
0138633 ACTILYSE 20 MG PDR 1 FL+S 20 ML IV RR H<br />
0 0 156,56 0,00 0<br />
0138647 ACTILYSE 50 MG PDR 1 FL+S 50 ML IV RR H<br />
0 0 391,42 0,00 0<br />
B01AD04 urokinase<br />
0145204 ACTOSOLV 100000 U PDR 1 FL 2 ML IV RR H<br />
0 0 60,52 0,00 0<br />
0177161 ACTOSOLV 600000 U PDR 1 FL IV RR H<br />
0 0 335,15 0,00 0<br />
B01AD07 reteplase<br />
0228873 RAPILYSIN 10 U 1 FL + SRG 10 ML IV RR H<br />
0 0 942,96 0,00 0<br />
B01AD11 tenecteplase<br />
0297349 METALYSE 10000 U PDR 1 FL + SRG IV RR H<br />
0 0 870,42 0,00 0<br />
0297335 METALYSE 8000 U PDR 1 FL + SRG IV RR H<br />
0 0 812,14 0,00 0<br />
B01AD12 protein C<br />
0311417 CEPROTIN 1000 U PDR 1 FL + S 10 ML IV RR H<br />
0 0 1.990,40 0,00 0<br />
Page 31 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0311403 CEPROTIN 500 U PDR 1 FL + S 5 ML IV RR H<br />
0 0 995,20 0,00 0<br />
B01AE06 bivalirudin<br />
0385388 ANGIOX 250 MG PDR 10 FL PERF RR HC<br />
0 0 4.200,00 0,00 0<br />
B01AE07 dabigatran etexilate<br />
0481871 PRADAXA 110 MG 10 CAPS RR<br />
RM 0 0<br />
11,81 18,89 80<br />
0622045 PRADAXA 110 MG 3*60 CAPS RR<br />
RM 0 0<br />
212,57 234,20 80<br />
0481885 PRADAXA 110 MG 30 CAPS RR<br />
RM 0 0<br />
74,85 91,94 0<br />
0481899 PRADAXA 110 MG 60 CAPS RR<br />
RM 0 0<br />
70,86 83,99 80<br />
0622093 PRADAXA 150 MG 3*60 CAPS RR<br />
RM 0 0<br />
212,57 234,20 80<br />
0622076 PRADAXA 150 MG 60 CAPS RR<br />
RM 0 0<br />
70,86 83,99 80<br />
0481837 PRADAXA 75 MG 10 CAPS RR<br />
RM 0 0<br />
11,81 18,89 80<br />
0481841 PRADAXA 75 MG 30 CAPS RR<br />
RM 0 0<br />
74,85 91,94 0<br />
0481854 PRADAXA 75 MG 60 CAPS RR<br />
RM 0 0<br />
70,86 83,99 80<br />
B01AX Other antithrombotic agents<br />
0612391 ELIQUIS 2,5 MG 20 CPR RR<br />
0 0 37,68 47,90 80<br />
0612407 ELIQUIS 2,5 MG 60 CPR RR<br />
0 0 112,50 126,01 80<br />
0612411 ELIQUIS 2,5 MG 60 CPR UD RR<br />
0 0 112,50 128,12 0<br />
B01AX05 fondaparinux<br />
0316381 ARIXTRA 2,5 MG 10 SRG 0,5 ML SC RR D<br />
0 0 42,80 0,00 0<br />
B01AX06 rivaroxaban<br />
0494253 XARELTO 10 MG 10 CPR RR<br />
RM 0 0<br />
37,28 47,46 80<br />
0494271 XARELTO 10 MG 100 CPR UD RR<br />
RM 0 0<br />
300,00 0,00 0<br />
0494267 XARELTO 10 MG 30 CPR RR<br />
RM 0 0<br />
90,00 104,27 80<br />
0635513 XARELTO 15 MG 100 CPR UD RR<br />
0 0 225,00 0,00 0<br />
0635463 XARELTO 15 MG 28 CPR RR<br />
0 0 78,68 92,29 80<br />
0635477 XARELTO 15 MG 42 CPR RR<br />
0 0 123,48 139,62 80<br />
0635481 XARELTO 15 MG 98 CPR RR<br />
0 0 220,50 242,59 80<br />
0635561 XARELTO 20 MG 100 CPR UD RR<br />
0 0 225,00 0,00 0<br />
0635531 XARELTO 20 MG 28 CPR RR<br />
0 0 78,68 92,29 80<br />
0635544 XARELTO 20 MG 98 CPR RR<br />
0 0 220,50 242,59 80<br />
B02AA02 tranexamic acid<br />
0043378 EXACYL 10 AMP BUV 10 ML R<br />
0 0 6,98 12,88 80<br />
0043350 EXACYL 250 MG 100 CPR R<br />
0 0 11,97 19,09 80<br />
0218301 EXACYL 250 MG 50 CPR R<br />
0 0 7,09 13,01 80<br />
0173825 EXACYL 500 MG 20 CPR R<br />
0 0 6,59 12,39 80<br />
0043381 EXACYL 500 MG 5 AMP 5 ML IV RR<br />
0 0 4,91 10,30 80<br />
B02BA01 phytomenadione<br />
0138499 KONAKION 10 MG 10 AMP 1 ML IMIV RR<br />
0 0 6,27 0,00 0<br />
0234254 KONAKION PED 2 MG 5 AMP 0,2 ML IMIVPO RR<br />
0 0 6,40 10,99 80<br />
0307994 VITAMON K GTTS 25 ML R<br />
0 0 4,90 8,41 0<br />
Page 32 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
B02BC Local hemostatics<br />
0382503 TACHOSIL 1 EPONGE 3*2,5 CM RR HC<br />
0 0 46,14 0,00 0<br />
0382484 TACHOSIL 1 EPONGE 9,5*4,8 CM RR HC<br />
0 0 240,30 0,00 0<br />
0382498 TACHOSIL 2 EPONGES 4,8*4,8 CM RR HC<br />
0 0 264,34 0,00 0<br />
0169108 TISSUCOL KIT 0,5 PDR 1 KIT RR H<br />
0 0 47,22 0,00 0<br />
0169111 TISSUCOL KIT 1 PDR 1 KIT RR H<br />
0 0 78,19 0,00 0<br />
0169125 TISSUCOL KIT 2 PDR 1 KIT RR H<br />
0 0 124,52 0,00 0<br />
0169139 TISSUCOL KIT 5 PDR 1 KIT RR H<br />
0 0 340,11 0,00 0<br />
B02BC02 oxidized cellulose<br />
0084269 OUATE HEMOSTATIQUE QUALIPHAR 10 G P<br />
0 0 4,53 7,77 80<br />
B02BD01 coagulation factor IX, II, VII and X in combination<br />
0525864 CONFIDEX 500 U PDR 1 FL + S IV RR DC<br />
0 0 291,13 0,00 0<br />
0376926 OCTAPLEX 500 U PDR 1 FL+S+SET 20 ML IV RR DC<br />
0 0 290,01 0,00 0<br />
0435316 PPSB SOLV DETERGENT 4% PDR 1 FL 20 ML IV RR DC<br />
0 0 0,58 0,00 0<br />
B02BD02 coagulation factor VIII<br />
0370693 ADVATE 1000 U PDR 1 FL + S + KIT IV RR DC<br />
0 0 892,42 0,00 0<br />
0370709 ADVATE 1500 U PDR 1 FL + S + KIT IV RR DC<br />
0 0 1.343,08 0,00 0<br />
0482638 ADVATE 2000 U PSV 1 FL + S + KIT IV RR DC<br />
0 0 1.667,00 0,00 0<br />
0370662 ADVATE 250 U PDR 1 FL + S + KIT IV RR DC<br />
0 0 227,27 0,00 0<br />
0482655 ADVATE 3000 U PSV 1 FL + S + KIT IV RR DC<br />
0 0 2.500,50 0,00 0<br />
0370676 ADVATE 500 U PDR 1 FL + S + KIT IV RR DC<br />
0 0 449,00 0,00 0<br />
0287181 HELIXATE NEXGEN 1000 U PSV 1 FL+S+NECESS RR DC<br />
0 0 874,58 0,00 0<br />
0287163 HELIXATE NEXGEN 250 U PSV 1 FL+S+NECESS RR DC<br />
0 0 222,71 0,00 0<br />
0287177 HELIXATE NEXGEN 500 U PSV 1 FL+S+NECESS RR DC<br />
0 0 440,04 0,00 0<br />
0381005 KOGENATE 1000 U PDR 1 FL + SRG IV RR DC<br />
0 0 892,43 0,00 100<br />
0287146 KOGENATE 1000 U PDR 1 FL+S 2,5ML+NECESS RR DC<br />
0 0 892,43 0,00 0<br />
0380981 KOGENATE 250 U PDR 1 FL + SRG IV RR DC<br />
0 0 227,26 0,00 0<br />
0287129 KOGENATE 250 U PDR 1 FL+S 2,5 ML+NECESS RR DC<br />
0 0 227,26 0,00 0<br />
0380994 KOGENATE 500 U PDR 1 FL + SRG IV RR DC<br />
0 0 449,02 0,00 0<br />
0287132 KOGENATE 500 U PDR 1 FL+S 2,5ML+NECESS RR DC<br />
0 0 449,02 0,00 0<br />
0450097 OCTANATE 1000 U 1 FL + S 10 ML IV RR DC<br />
0 0 799,97 0,00 0<br />
0450083 OCTANATE 250 U 1 FL + S 5 ML IV RR DC<br />
0 0 199,99 0,00 0<br />
0477347 OCTANATE 500 U 1 FL + S 10 ML IV RR DC<br />
0 0 399,99 0,00 0<br />
0512687 OCTANATE CRL 1000 U 1 FL 10 ML IV RR DC<br />
0 0 843,00 0,00 0<br />
0190714 RECOMBINATE 1000 U PDR 1 FL + S 10 ML IV RR DC<br />
0 0 892,42 0,00 0<br />
0190695 RECOMBINATE 250 U PDR 1 FL + S 10 ML IV RR DC<br />
0 0 227,27 0,00 0<br />
0190701 RECOMBINATE 500 U PDR 1 FL + S 10 ML IV RR DC<br />
0 0 449,01 0,00 0<br />
0264481 REFACTO AF 1000 U 1 FL + S 4 ML RR DC<br />
0 0 739,96 0,00 0<br />
0350172 REFACTO AF 2000 U 1 FL + S 4 ML RR DC<br />
0 0 1.480,00 0,00 0<br />
0264463 REFACTO AF 250 U 1 FL + S 4 ML RR DC<br />
0 0 184,97 0,00 0<br />
0264477 REFACTO AF 500 U 1 FL + S 4 ML RR DC<br />
0 0 369,98 0,00 0<br />
Page 33 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
B02BD04 coagulation factor IX<br />
0271701 MONONINE 1000 U PDR 1 FL + S 10 ML IV RR DC<br />
0 0 491,21 0,00 0<br />
0271681 MONONINE 500 U PDR 1 FL + S 5 ML IV RR DC<br />
0 0 250,62 0,00 0<br />
0311918 OCTANINE 1000 U 1 FL 10 ML RR DC<br />
0 0 439,98 0,00 0<br />
0311904 OCTANINE 500 U 1 FL 5 ML RR DC<br />
0 0 219,98 0,00 0<br />
B02BD06 von Willebrand factor and coagulation factor VIII in combination<br />
0137538 HAEMATE P 1200U/500U PDR 1 FL+S 10 ML IV RR DC<br />
0 0 240,71 0,00 0<br />
0137541 HAEMATE P 2400U/1000U PDR 1 FL+S 15ML IV RR DC<br />
0 0 481,38 0,00 0<br />
0469538 WILATE 450/400 U PDR 1 FL + S + SET IV RR DC<br />
0 0 359,99 0,00 0<br />
0469541 WILATE 900/800 U PDR 1 FL + S + SET IV RR DC<br />
0 0 719,98 0,00 0<br />
B02BD07 coagulation factor XIII<br />
0044828 FIBROGAMMIN 250U PSV 1 FL+S 4 ML IV RR DC<br />
0 0 88,94 0,00 0<br />
B02BD08 eptacog alfa (activated)<br />
0487343 NOVOSEVEN 100000 U PDR 1 FL+S 2,1 ML IV RR DC<br />
RM 0 0<br />
1.157,05 0,00 0<br />
0220201 NOVOSEVEN 120000 U PDR 1 FL+S 4,3ML IV RR DC<br />
RM 0 0<br />
1.388,38 0,00 0<br />
0220214 NOVOSEVEN 240000 U PDR 1 FL+S 8,5ML IV RR DC<br />
RM 0 0<br />
2.776,83 0,00 0<br />
0487357 NOVOSEVEN 250000 U PDR 1 FL+S 5,2 ML IV RR DC<br />
RM 0 0<br />
2.892,63 0,00 0<br />
0487326 NOVOSEVEN 50000 U PDR 1 FL+S 1,1 ML IV RR DC<br />
RM 0 0<br />
578,53 0,00 0<br />
0220195 NOVOSEVEN 60000 U PDR 1 FL+S 2,2 ML IV RR DC<br />
RM 0 0<br />
694,23 0,00 0<br />
B02BD09 nonacog alfa<br />
0241151 BENEFIX 1000 U PSV 1 FL + S 10 ML RR DC<br />
0 0 690,00 0,00 0<br />
0467435 BENEFIX 2000U PSV 1FL + 1COF + 1SRG 5 ML RR DC<br />
0 0 1.380,00 0,00 0<br />
0241133 BENEFIX 250 U PSV 1 FL + S 5 ML RR DC<br />
0 0 185,92 0,00 0<br />
0241147 BENEFIX 500 U PSV 1 FL + S 5 ML RR DC<br />
0 0 345,00 0,00 0<br />
B02BX01 etamsylate<br />
0032357 DICYNONE 20 CPR P<br />
0 0 0,00 3,86 80<br />
0032360 DICYNONE 50 CPR P<br />
0 0 5,02 8,62 80<br />
0032374 DICYNONE 6 AMP 2 ML IMIV RR<br />
0 0 1,42 2,42 80<br />
B02BX04 romiplostim<br />
0547956 NPLATE 250 MCG PDR 1 FL + KIT SC RR IC<br />
X RM 1 5<br />
602,50 647,46 100<br />
0547973 NPLATE 500 MCG PDR 1 FL + KIT SC RR IC<br />
X RM 1 5<br />
1.205,00 1.286,03 100<br />
B02BX05 eltrombopag<br />
0557918 REVOLADE 25 MG 28 CPR RR DC X RM 0 0<br />
1.022,00 0,00 0<br />
0557966 REVOLADE 50 MG 28 CPR RR DC X RM 0 0<br />
2.044,00 0,00 0<br />
B03AA01 ferrous glycine sulfate<br />
0410155 FERROSANOL 30 MG/ML GTTS 30 ML P<br />
0 0 1,87 3,70 80<br />
0044599 FERROSANOL DUODENAL 50 CAPS R<br />
0 0 0,00 12,72 80<br />
0272613 FERROSANOL GYN 50 CAPS R<br />
0 0 5,86 11,16 80<br />
B03AA03 ferrous gluconate<br />
Page 34 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0592285 FERROSANOL SIROP 200 ML R<br />
0 0 3,04 5,40 0<br />
0341609 LOSFERRON 80 MG 30 CPR EFF R<br />
0 0 5,48 9,42 0<br />
0180959 LOSFERRON 80 MG 60 CPR EFF R<br />
0 0 10,35 17,78 80<br />
B03AA07 ferrous sulfate<br />
0044537 FEROGRAD 500 (525 MG) 30 CPR R<br />
0 0 4,41 7,57 80<br />
0044540 FEROGRAD 500 (525 MG) 60 CPR R<br />
0 0 8,37 14,37 80<br />
0044361 FEROGRADUMET 30 CPR R<br />
0 0 2,35 4,04 80<br />
0044375 FEROGRADUMET 60 CPR R<br />
0 0 4,55 7,82 80<br />
0196489 TARDYFERON 80 MG 30 CPR R<br />
0 0 0,00 3,49 80<br />
B03AB02 saccharated iron oxide<br />
0191581 FERRICURE 150 MG 28 CAPS R<br />
0 0 5,88 10,11 80<br />
0273865 FERRICURE 150 MG 56 CAPS R<br />
0 0 9,65 16,58 80<br />
0273882 FERRICURE 150 MG 90 CAPS UD R<br />
0 0 15,12 0,00 0<br />
0355411 FERRICURE GTTS 200 ML R<br />
0 0 12,05 20,70 80<br />
0196041 FERRICURE GTTS 60 ML R<br />
0 0 5,15 8,85 80<br />
B03AC01 dextriferron<br />
0580303 INJECTAFER 50 MG/ML 5 FL 10 ML IV RR H<br />
0 0 550,00 0,00 0<br />
0580284 INJECTAFER 50 MG/ML 5 FL 2 ML IV RR H<br />
0 0 110,00 0,00 0<br />
B03AC02 saccharated iron oxide<br />
0574922 FERMED 100 MG PERF 5 AMP 5 ML IV RR H<br />
0 0 55,90 0,00 0<br />
0302404 VENOFER 100 MG 5 AMP 5 ML IV RR H<br />
0 0 69,00 0,00 0<br />
B03AD03 ferrous sulfate<br />
0198774 TARDYFERON B 9 30 CPR P<br />
0 0 0,00 3,67 80<br />
B03BB01 folic acid<br />
0309002 FOLAVIT 4 MG 40 CPR P<br />
0 0 0,00 7,42 80<br />
B03XA01 erythropoietin<br />
0470704 BINOCRIT 1000 U 6 SRG 0,5 ML IVSC RR HC<br />
RM 0 0<br />
41,66 0,00 0<br />
0470864 BINOCRIT 10000 U 6 SRG 1 ML IVSC RR HC<br />
RM 0 0<br />
398,08 0,00 0<br />
0470721 BINOCRIT 2000 U 6 SRG 1 ML IVSC RR HC<br />
RM 0 0<br />
83,39 0,00 0<br />
0539615 BINOCRIT 20000 U/ML 1 SRG 0,5 ML RR HC<br />
RM 0 0<br />
132,70 0,00 0<br />
0470749 BINOCRIT 3000 U 6 SRG 0,3 ML IVSC RR HC<br />
RM 0 0<br />
119,42 0,00 0<br />
0539713 BINOCRIT 30000 U/ML 1 SRG 0,75 ML RR HC<br />
RM 0 0<br />
199,10 0,00 0<br />
0470752 BINOCRIT 4000 U 6 SRG 0,4 ML IVSC RR HC<br />
RM 0 0<br />
159,23 0,00 0<br />
0539792 BINOCRIT 40000 U/ML 1 SRG 1 ML RR HC<br />
RM 0 0<br />
237,47 0,00 0<br />
0470797 BINOCRIT 5000 U 6 SRG 0,5 ML IVSC RR HC<br />
RM 0 0<br />
199,04 0,00 0<br />
0470816 BINOCRIT 6000 U 6 SRG 0,6 ML IVSC RR HC<br />
RM 0 0<br />
238,85 0,00 0<br />
0470847 BINOCRIT 8000 U 6 SRG 0,8 ML IVSC RR HC<br />
RM 0 0<br />
318,47 0,00 0<br />
0226333 EPREX 1000 U 6 SRG 0,5 ML SC RR C<br />
1 5 48,80 60,15 100<br />
0226378 EPREX 10000 U 6 SRG 1 ML SC RR C<br />
1 5 488,05 526,17 100<br />
0226347 EPREX 2000 U 6 SRG 0,5 ML SC RR C<br />
1 5 97,61 112,35 100<br />
Page 35 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0449391 EPREX 20000 U 1 SRG 0,5 ML SCIV RR C<br />
1 5 162,68 181,32 100<br />
0226351 EPREX 3000 U 6 SRG 0,3 ML SC RR C<br />
1 5 146,42 164,08 100<br />
0226364 EPREX 4000 U 6 SRG 0,4 ML SC RR C<br />
1 5 195,22 215,80 100<br />
0449356 EPREX 40000 U 1 SRG 1 ML SCIV RR C<br />
1 5 307,32 334,61 100<br />
0293434 EPREX 5000 U 6 SRG 0,5 ML RR C<br />
1 5 244,03 267,52 100<br />
0293448 EPREX 6000 U 6 SRG 0,6 ML RR C<br />
1 5 292,83 319,26 100<br />
0293465 EPREX 8000 U 6 SRG 0,8 ML RR C<br />
1 5 390,44 422,71 100<br />
0248943 NEORECORMON 10000 U 6 SRG 0,6 ML SCIV RR C<br />
1 5 481,20 518,91 100<br />
0248862 NEORECORMON 2000 U 6 SRG 0,3 ML SCIV RR C<br />
1 5 100,81 115,74 100<br />
0248845 NEORECORMON 3000 U 6 SRG 0,3 ML SCIV RR C<br />
1 5 151,21 169,15 100<br />
0364536 NEORECORMON 30000 U PDR 4 SRG 0,6ML IVSC RR C<br />
1 5 962,41 1.028,92 100<br />
0279368 NEORECORMON 4000 U PDR 6 SRG SC RR C<br />
1 5 192,48 212,89 100<br />
0248912 NEORECORMON 500 U 6 SRG 0,3 ML SCIV RR C<br />
1 5 25,20 34,16 100<br />
0248828 NEORECORMON 5000 U 6 SRG 0,3 ML SCIV RR C<br />
1 5 240,61 263,91 100<br />
0279341 NEORECORMON 6000 U PDR 6 SRG SC RR C<br />
1 5 288,72 314,90 100<br />
0476756 RETACRIT 1000 U 6 SRG 0,3 ML SCIV RR C<br />
RM 1 5<br />
42,49 53,08 100<br />
0476918 RETACRIT 10000 U 6 SRG 1 ML SCIV RR C<br />
RM 1 5<br />
406,00 439,09 100<br />
0476787 RETACRIT 2000 U 6 SRG 0,6 ML SCIV RR C<br />
RM 1 5<br />
85,05 98,93 100<br />
0476921 RETACRIT 20000 U 1 SRG 0,5 ML SCIV RR C<br />
RM 1 5<br />
135,34 152,23 100<br />
0476806 RETACRIT 3000 U 6 SRG 0,9 ML SCIV RR C<br />
RM 1 5<br />
121,79 137,86 100<br />
0476935 RETACRIT 30000 U 1 SRG 0,75 ML SCIV RR C<br />
RM 1 5<br />
203,06 224,01 100<br />
0476837 RETACRIT 4000 U 6 SRG 0,4 ML SCIV RR C<br />
RM 1 5<br />
162,40 180,90 100<br />
0476949 RETACRIT 40000 U 1 SRG 1 ML SCIV RR C<br />
RM 1 5<br />
242,19 265,47 100<br />
0476854 RETACRIT 5000 U 6 SRG 0,5 ML SCIV RR C<br />
RM 1 5<br />
203,00 223,93 100<br />
0476871 RETACRIT 6000 U 6 SRG 0,6 ML SCIV RR C<br />
RM 1 5<br />
243,60 266,96 100<br />
0476899 RETACRIT 8000 U 6 SRG 0,8 ML SCIV RR C<br />
RM 1 5<br />
324,80 353,04 100<br />
B03XA02 darbepoetin alfa<br />
0302564 ARANESP 10 MCG 4 SRG 0,4 ML SCIV RR C<br />
1 5 91,54 105,91 100<br />
0302726 ARANESP 100 MCG 1 STYLO 0,5 ML (SURCLIC) RR C<br />
1 5 225,00 247,36 100<br />
0530394 ARANESP 100 MCG 4 SRG SECURISEES SC RR C<br />
1 5 925,77 990,09 100<br />
0302757 ARANESP 150 MCG 1 STYLO 0,3 ML (SURCLIC) RR C<br />
1 5 337,34 366,43 100<br />
0530444 ARANESP 150 MCG 4 SRG SECURISEES SC RR C<br />
1 5 1.315,73 1.403,40 100<br />
0530265 ARANESP 20 MCG 4 SRG SECURISEES SC RR C<br />
1 5 182,18 201,98 100<br />
0530282 ARANESP 30 MCG 4 SRG SECURISEES SC RR C<br />
1 5 286,06 312,09 100<br />
0530458 ARANESP 300 MCG 1 SRG SECURISEE SC RR C<br />
1 5 650,91 698,77 100<br />
0302774 ARANESP 300 MCG 1 STYLO 0,6 ML (SURCLIC) RR C<br />
1 5 650,91 698,77 100<br />
0302631 ARANESP 40 MCG 1 STYLO 0,4 ML (SURCLIC) RR C<br />
1 5 90,91 105,25 100<br />
0530301 ARANESP 40 MCG 4 SRG SECURISEES SC RR C<br />
1 5 364,18 394,88 100<br />
0530329 ARANESP 50 MCG 4 SRG SECURISEES SC RR C<br />
1 5 476,77 514,21 100<br />
0530475 ARANESP 500 MCG 1 SRG SECURISEE SC RR C<br />
1 5 1.043,06 1.114,41 100<br />
0368441 ARANESP 500 MCG 1 STYLO 1 ML (SURCLIC) RR C<br />
1 5 1.043,08 1.114,43 100<br />
0302676 ARANESP 60 MCG 1 STYLO 0,3 ML (SURCLIC) RR C<br />
1 5 136,08 153,13 100<br />
0530346 ARANESP 60 MCG 4 SRG SECURISEES SC RR C<br />
1 5 572,12 615,27 100<br />
Page 36 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0302709 ARANESP 80 MCG 1 STYLO 0,4 ML (SURCLIC) RR C<br />
1 5 180,89 200,61 100<br />
0530377 ARANESP 80 MCG 4 SRG SECURISEES SC RR C<br />
1 5 762,83 817,40 100<br />
B03XA03 methoxy polyethylene glycol-epoetin beta<br />
0459674 MIRCERA 100 MCG/ML 1 SRG 0,3 ML IVSC RR C<br />
X RM 1 5<br />
253,75 277,85 100<br />
0488385 MIRCERA 120 MCG 1 SRG 0,3 ML IVSC RR C<br />
X RM 1 5<br />
349,20 381,25 100<br />
0459688 MIRCERA 150 MCG 1 SRG 0,3 ML IVSC RR C<br />
X RM 1 5<br />
380,63 412,32 100<br />
0459691 MIRCERA 200 MCG/ML 1 SRG 0,3 ML IVSC RR C<br />
X RM 1 5<br />
507,50 546,77 100<br />
0459707 MIRCERA 250 MCG 1 SRG 0,3 ML IVSC RR C<br />
X RM 1 5<br />
634,38 681,25 100<br />
0488354 MIRCERA 30 MCG 1 SRG 0,3 ML IVSC RR C<br />
X RM 1 5<br />
87,30 102,36 100<br />
0459657 MIRCERA 50 MCG/ML 1 SRG 0,3 ML IVSC RR C<br />
X RM 1 5<br />
126,88 143,36 100<br />
0459661 MIRCERA 75 MCG/ML 1 SRG 0,3 ML IVSC RR C<br />
X RM 1 5<br />
190,31 210,60 100<br />
B05 BLOOD SUBSTITUTES AND PERFUSION SOLUTIONS<br />
0605318 RUCONEST 2100 U PDR 1 FL V IV RR DC<br />
RM 0 0<br />
840,00 0,00 0<br />
B05AA01 albumin<br />
0370614 ALBUREX 20% 1 FL 100 ML PERF RR H<br />
0 0 48,11 0,00 0<br />
0370631 ALBUREX 5% 1 FL 100 ML PERF RR H<br />
0 0 11,18 0,00 0<br />
0370645 ALBUREX 5% 1 FL 250 ML PERF RR H<br />
0 0 27,95 0,00 0<br />
0370659 ALBUREX 5% 1 FL 500 ML PERF RR H<br />
0 0 55,90 0,00 0<br />
0474006 FLEXBUMINE 20% 1 FL P 100 ML IV RR H<br />
0 0 59,49 0,00 0<br />
0457506 HUMAN ALBUMIN BXT 20% 1 FL V 100 ML IV RR H<br />
0 0 23,04 0,00 0<br />
0457537 HUMAN ALBUMIN BXT 5% 1 FL V 250 ML IV RR H<br />
0 0 27,95 0,00 0<br />
0457568 HUMAN ALBUMIN BXT 5% 10 FL V 500 ML IV RR H<br />
0 0 55,99 0,00 0<br />
0316279 OCTALBIN 20% 1 FL 100 ML V PERF RR H<br />
0 0 53,01 0,00 0<br />
0316265 OCTALBIN 20% 1 FL 50 ML V PERF RR H<br />
0 0 26,50 0,00 0<br />
0316248 OCTALBIN 5% 1 FL 100 ML V PERF RR H<br />
0 0 11,18 0,00 0<br />
0316251 OCTALBIN 5% 1 FL 250 ML V PERF RR H<br />
0 0 27,95 0,00 0<br />
0512642 OCTALBINE CRL 20% 1 FL 100 ML PERF RR H<br />
0 0 53,01 0,00 0<br />
0512639 OCTALBINE CRL 5% 1 FL 250 ML PERF RR H<br />
0 0 27,95 0,00 0<br />
0435283 SOPP SSPP 4% PERF 1 FL 100 ML IV RR H<br />
0 0 11,18 0,00 0<br />
0435297 SOPP SSPP 4% PERF 1 FL 250 ML IV RR H<br />
0 0 27,95 0,00 0<br />
0435302 SOPP SSPP 4% PERF 1 FL 400 ML IV RR H<br />
0 0 44,72 0,00 0<br />
B05AA02 other plasma protein fractions<br />
0345205 OCTAPLAS LG 45-70 MG/ML 1 PP 200 ML PERF RR H<br />
0 0 77,08 0,00 0<br />
B05AA07 hydroxyethylstarch<br />
0198466 HEMOHES 10% 10 FL 500 ML P PERF RR H<br />
0 0 12,92 0,00 0<br />
0198452 HEMOHES 10% 10 FL 500 ML V PERF RR H<br />
0 0 12,92 0,00 0<br />
0198421 HEMOHES 6% 10 FL 500 ML P PERF RR H<br />
0 0 10,56 0,00 0<br />
0198418 HEMOHES 6% 10 FL 500 ML V PERF RR H<br />
0 0 10,56 0,00 0<br />
0512321 PLASMA VOLUME REDIBAG 6% PERF 10*500 ML RR H<br />
0 0 89,62 0,00 0<br />
0297416 VOLUVEN 500 ML FREEFLEX 1361521 RR H<br />
0 0 11,01 0,00 0<br />
0297451 VOLUVEN 500 ML P 1361221 RR H<br />
0 0 11,00 0,00 0<br />
Page 37 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
B05BA01 amino acids<br />
0190678 AMINOPLASMAL BRN 12,5% 1*500 ML PERF RR H<br />
0 0 21,74 0,00 0<br />
0143762 PRIMENE SOL 10% FL 100 ML G PERF RR H<br />
0 0 5,02 0,00 0<br />
0143809 PRIMENE SOL 10% FL 250 ML G PERF RR H<br />
0 0 7,83 0,00 0<br />
0196296 VAMINOLACT 1 FL 500 ML PERF RR H<br />
0 0 18,44 0,00 0<br />
B05BA02 fat emulsions<br />
0389181 CLINOLEIC 20% 10 PP 100 ML PERF RR H<br />
0 0 11,40 0,00 0<br />
0389194 CLINOLEIC 20% 24 PP 100 ML PERF RR H<br />
0 0 8,32 0,00 0<br />
0187669 INTRALIPID 20% 1 FL 500 ML V RR H<br />
0 0 20,05 0,00 0<br />
0066551 LIPOVENOES 20% 500 ML G 2159091 RR H<br />
0 0 46,99 0,00 0<br />
0245387 LIPOVENOES MCT 20% 250 ML G 2193061 RR H<br />
0 0 33,53 0,00 0<br />
0229352 LIPOVENOES MCT 20% 500 ML G 2193091 RR H<br />
0 0 51,45 0,00 0<br />
B05BA03 carbohydrates<br />
0050162 GLUCOSE 20% CLINTEC 500 ML RR H<br />
0 0 1,71 0,00 0<br />
0050176 GLUCOSE 30% CLINTEC 500 ML RR H<br />
0 0 2,04 0,00 0<br />
0162155 GLUCOSE 5% BRN 1 FL 250 ML V RR<br />
0 0 0,99 1,74 80<br />
0162169 GLUCOSE 5% BRN 1 FL 500 ML V RR<br />
0 0 1,41 2,50 80<br />
0050288 GLUCOSE 5% BRN 10 AMP 10 ML P RR<br />
0 0 4,02 7,11 80<br />
0155066 GLUCOSTERIL 10% 100 ML FREKA INJ 2710021 RR H<br />
0 0 1,21 0,00 0<br />
0155066 GLUCOSTERIL 10% 100 ML INF RR H<br />
0 0 1,21 0,00 0<br />
0155097 GLUCOSTERIL 10% 250 ML G 2710061 RR H<br />
0 0 1,54 0,00 0<br />
0155116 GLUCOSTERIL 10% 500 ML P 2710221 RR H<br />
0 0 1,94 0,00 0<br />
0155147 GLUCOSTERIL 20% 100 ML FREKA INJ 2720021 RR H<br />
0 0 1,58 0,00 0<br />
0155178 GLUCOSTERIL 20% 500 ML P 2720221 RR H<br />
0 0 2,89 0,00 0<br />
0155195 GLUCOSTERIL 40% 500 ML P 2730221 RR H<br />
0 0 3,19 0,00 0<br />
0275064 GLUCOSTERIL 5% 100 ML FREEFLEX B248081 RR<br />
0 0 1,83 2,74 0<br />
0154976 GLUCOSTERIL 5% 100 ML FREKA INJ-FLASCHE RR<br />
0 0 0,00 1,78 80<br />
0154959 GLUCOSTERIL 5% 100 ML GLAS-INF 2700031 RR<br />
0 0 0,00 2,49 80<br />
0643594 GLUCOSTERIL 5% 100 ML KABIPAC PK042E010D RR<br />
0 0 1,60 3,20 0<br />
0275095 GLUCOSTERIL 5% 1000 ML FREEFLEX 2700531 RR<br />
0 0 2,73 4,36 0<br />
0182081 GLUCOSTERIL 5% 1000 ML P 2700231 RR<br />
0 0 0,00 4,32 80<br />
0275078 GLUCOSTERIL 5% 250 ML FREEFLEX 2700511 RR<br />
0 0 1,44 2,21 0<br />
0154962 GLUCOSTERIL 5% 250 ML GLAS INF 2700061 RR<br />
0 0 0,00 2,58 80<br />
0182094 GLUCOSTERIL 5% 250 ML KABIPAC PK042E025D RR<br />
0 0 0,00 2,15 80<br />
0275081 GLUCOSTERIL 5% 500 ML FREEFLEX 2700521 RR<br />
0 0 2,96 4,61 0<br />
0155049 GLUCOSTERIL 5% 500 ML G 2700091 RR<br />
0 0 0,00 2,86 80<br />
0179748 GLUCOSTERIL 5% 500 ML P 2700221 RR<br />
0 0 0,00 2,74 80<br />
0155231 GLUCOSTERIL 50% 100 ML FREKA INJ 2262021 RR H<br />
0 0 2,33 0,00 0<br />
0155245 GLUCOSTERIL 50% 500 ML G 2262091 RR H<br />
0 0 5,05 0,00 0<br />
B05BA10 combinations<br />
0168582 CERNEVIT PDR 10 FL + S 5 ML IMIV RR H<br />
0 0 57,30 0,00 0<br />
0291782 CLINIMIX N14G30E 4 PP DBL 2 L RR H<br />
0 0 22,61 0,00 0<br />
Page 38 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0291765 CLINIMIX N14G30E 8 PP DBL 1 L RR H<br />
0 0 18,31 0,00 0<br />
0291832 CLINIMIX N17G35E 6 PP DBL 1,5 L RR H<br />
0 0 27,63 0,00 0<br />
0291829 CLINIMIX N17G35E 8 PP DBL 1 L RR H<br />
0 0 24,87 0,00 0<br />
0291653 CLINIMIX N9G15E 6 PP DBL 1,5 L RR H<br />
0 0 18,68 0,00 0<br />
0291636 CLINIMIX N9G15E 8 PP DBL 1 L RR H<br />
0 0 16,81 0,00 0<br />
0217558 KABIMIX 14 1 PP PERF RR H<br />
0 0 53,20 0,00 0<br />
0217544 KABIMIX 9 1 PP PERF RR H<br />
0 0 45,71 0,00 0<br />
0625288 NUMETZAH G13%E 10 PP 3 COMP 300 ML IV RR H<br />
0 0 84,00 0,00 0<br />
0625291 NUMETZAH G16%E 6 PP 3 COMP 500 ML IV RR H<br />
0 0 97,00 0,00 0<br />
0267062 NUTRIFLEX BASAL 5 PP 1 L PERF RR H<br />
0 0 16,93 0,00 0<br />
0267076 NUTRIFLEX BASAL 5 PP 2 L PERF RR H<br />
0 0 30,42 0,00 0<br />
0267143 NUTRIFLEX PERI 5 PP 1 L PERF RR H<br />
0 0 18,86 0,00 0<br />
0267157 NUTRIFLEX PERI 5 PP 2 L PERF RR H<br />
0 0 33,86 0,00 0<br />
0267093 NUTRIFLEX PLUS 5 PP 1 L PERF RR H<br />
0 0 20,60 0,00 0<br />
0267109 NUTRIFLEX PLUS 5 PP 2 L PERF RR H<br />
0 0 37,11 0,00 0<br />
0267112 NUTRIFLEX SPEC 5 TWINFLEX 1 L RR H<br />
0 0 25,26 0,00 0<br />
0267126 NUTRIFLEX SPEC 5 TWINFLEX 1,5 L RR H<br />
0 0 36,89 0,00 0<br />
0425547 OLICLINOMEL N4-550 1 PP 1 L RR H<br />
0 0 34,29 0,00 0<br />
0425551 OLICLINOMEL N4-550 1 PP 1,5 L RR H<br />
0 0 38,09 0,00 0<br />
0425564 OLICLINOMEL N4-550 1 PP 2 L RR H<br />
0 0 42,31 0,00 0<br />
0425578 OLICLINOMEL N4-550 1 PP 2,5 L RR H<br />
0 0 46,99 0,00 0<br />
0328896 OLICLINOMEL N4-550 2 PP 2,5 L RR H<br />
0 0 46,99 0,00 0<br />
0328901 OLICLINOMEL N4-550 4 PP 1,5 L RR H<br />
0 0 38,09 0,00 0<br />
0328915 OLICLINOMEL N4-550 4 PP 2 L RR H<br />
0 0 42,31 0,00 0<br />
0328929 OLICLINOMEL N4-550 6 PP 1 L RR H<br />
0 0 34,29 0,00 0<br />
0425581 OLICLINOMEL N4-550E 1 PP 1 L RR H<br />
0 0 34,99 0,00 0<br />
0425595 OLICLINOMEL N4-550E 1 PP 1,5 L RR H<br />
0 0 38,87 0,00 0<br />
0425601 OLICLINOMEL N4-550E 1 PP 2 L RR H<br />
0 0 43,17 0,00 0<br />
0425614 OLICLINOMEL N4-550E 1 PP 2,5 L RR H<br />
0 0 47,95 0,00 0<br />
0329071 OLICLINOMEL N4-550E 2 PP 2,5 L RR H<br />
0 0 47,95 0,00 0<br />
0425628 OLICLINOMEL N5-800 1 PP 1 L RR H<br />
0 0 34,84 0,00 0<br />
0425631 OLICLINOMEL N5-800 1 PP 1,5 L RR H<br />
0 0 38,73 0,00 0<br />
0425645 OLICLINOMEL N5-800 1 PP 2 L RR H<br />
0 0 43,02 0,00 0<br />
0425659 OLICLINOMEL N5-800 1 PP 2,5 L RR H<br />
0 0 47,77 0,00 0<br />
0329196 OLICLINOMEL N5-800 2 PP 2,5 L RR H<br />
0 0 47,78 0,00 0<br />
0329201 OLICLINOMEL N5-800 4 PP 1,5 L RR H<br />
0 0 38,73 0,00 0<br />
0329215 OLICLINOMEL N5-800 4 PP 2 L RR H<br />
0 0 43,02 0,00 0<br />
0329229 OLICLINOMEL N5-800 6 PP 1 L RR H<br />
0 0 34,84 0,00 0<br />
0425662 OLICLINOMEL N5-800E 1 PP 1 L RR H<br />
0 0 35,55 0,00 0<br />
0425676 OLICLINOMEL N5-800E 1 PP 1,5 L RR H<br />
0 0 39,52 0,00 0<br />
0425693 OLICLINOMEL N5-800E 1 PP 2 L RR H<br />
0 0 43,90 0,00 0<br />
0425709 OLICLINOMEL N5-800E 1 PP 2,5 L RR H<br />
0 0 48,75 0,00 0<br />
0329151 OLICLINOMEL N5-800E 2 PP 2,5 L RR H<br />
0 0 48,75 0,00 0<br />
0329165 OLICLINOMEL N5-800E 4 PP 1,5 L RR H<br />
0 0 39,52 0,00 0<br />
Page 39 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0329179 OLICLINOMEL N5-800E 4 PP 2 L RR H<br />
0 0 43,90 0,00 0<br />
0329182 OLICLINOMEL N5-800E 6 PP 1 L RR H<br />
0 0 35,55 0,00 0<br />
0425712 OLICLINOMEL N6-900 1 PP 1 L RR H<br />
0 0 35,43 0,00 0<br />
0425726 OLICLINOMEL N6-900 1 PP 1,5 L RR H<br />
0 0 39,35 0,00 0<br />
0425743 OLICLINOMEL N6-900 1 PP 2 L RR H<br />
0 0 43,73 0,00 0<br />
0425757 OLICLINOMEL N6-900 1 PP 2,5 L RR H<br />
0 0 48,59 0,00 0<br />
0330362 OLICLINOMEL N6-900 2 PP 2,5 L RR H<br />
0 0 48,59 0,00 0<br />
0330376 OLICLINOMEL N6-900 4 PP 1,5 L RR H<br />
0 0 39,35 0,00 0<br />
0330393 OLICLINOMEL N6-900 4 PP 2 L RR H<br />
0 0 43,73 0,00 0<br />
0330409 OLICLINOMEL N6-900 6 PP 1 L RR H<br />
0 0 35,43 0,00 0<br />
0425761 OLICLINOMEL N6-900E 1 PP 1 L RR H<br />
0 0 36,16 0,00 0<br />
0425774 OLICLINOMEL N6-900E 1 PP 1,5 L RR H<br />
0 0 40,14 0,00 0<br />
0425788 OLICLINOMEL N6-900E 1 PP 2 L RR H<br />
0 0 44,61 0,00 0<br />
0425791 OLICLINOMEL N6-900E 1 PP 2,5 L RR H<br />
0 0 49,58 0,00 0<br />
0329331 OLICLINOMEL N6-900E 2 PP 2,5 L RR H<br />
0 0 49,58 0,00 0<br />
0329344 OLICLINOMEL N6-900E 4 PP 1,5 L RR H<br />
0 0 40,15 0,00 0<br />
0329358 OLICLINOMEL N6-900E 4 PP 2 L RR H<br />
0 0 44,62 0,00 0<br />
0329361 OLICLINOMEL N6-900E 6 PP 1 L RR H<br />
0 0 36,16 0,00 0<br />
0425807 OLICLINOMEL N7-1000 1 PP 1 L RR H<br />
0 0 35,82 0,00 0<br />
0425811 OLICLINOMEL N7-1000 1 PP 1,5 L RR H<br />
0 0 39,81 0,00 0<br />
0425824 OLICLINOMEL N7-1000 1 PP 2 L RR H<br />
0 0 44,21 0,00 0<br />
0425838 OLICLINOMEL N7-1000 1 PP 2,5 L RR H<br />
0 0 49,10 0,00 0<br />
0329411 OLICLINOMEL N7-1000 2 PP 2,5 L RR H<br />
0 0 49,10 0,00 0<br />
0329425 OLICLINOMEL N7-1000 4 PP 1,5 L RR H<br />
0 0 38,26 0,00 0<br />
0329439 OLICLINOMEL N7-1000 4 PP 2 L RR H<br />
0 0 42,49 0,00 0<br />
0329442 OLICLINOMEL N7-1000 6 PP 1 L RR H<br />
0 0 34,42 0,00 0<br />
0425841 OLICLINOMEL N7-1000E 1 PP 1 L RR H<br />
0 0 36,55 0,00 0<br />
0425855 OLICLINOMEL N7-1000E 1 PP 1,5 L RR H<br />
0 0 40,62 0,00 0<br />
0425869 OLICLINOMEL N7-1000E 1 PP 2 L RR H<br />
0 0 45,11 0,00 0<br />
0425872 OLICLINOMEL N7-1000E 1 PP 2,5 L RR H<br />
0 0 50,10 0,00 0<br />
0329506 OLICLINOMEL N7-1000E 2 PP 2,5 L RR H<br />
0 0 50,10 0,00 0<br />
0329523 OLICLINOMEL N7-1000E 4 PP 1,5 L RR H<br />
0 0 40,62 0,00 0<br />
0329537 OLICLINOMEL N7-1000E 4 PP 2 L RR H<br />
0 0 45,11 0,00 0<br />
0329541 OLICLINOMEL N7-1000E 6 PP 1 L RR H<br />
0 0 36,55 0,00 0<br />
0350396 OLICLINOMEL N8-800 4 PP 2 L RR H<br />
0 0 42,95 0,00 0<br />
0573781 OLIMEL N5E 2 PP A 3 COMPART 2500 ML RR H<br />
0 0 52,55 0,00 0<br />
0573763 OLIMEL N5E 4 PP A 3 COMPART 1500 ML RR H<br />
0 0 42,55 0,00 0<br />
0573777 OLIMEL N5E 4 PP A 3 COMPART 2000 ML RR H<br />
0 0 47,30 0,00 0<br />
0573844 OLIMEL N7E 4 PP A 3 COMPART 1500 ML RR H<br />
0 0 45,76 0,00 0<br />
0573858 OLIMEL N7E 4 PP A 3 COMPART 2000 ML RR H<br />
0 0 47,82 0,00 0<br />
0573831 OLIMEL N7E 6 PP A 3 COMPART 1000 ML RR H<br />
0 0 38,74 0,00 0<br />
0573875 OLIMEL N9 4 PP A 3 COMPART 1500 ML RR H<br />
0 0 48,11 0,00 0<br />
0573889 OLIMEL N9 4 PP A 3 COMPART 2000 ML RR H<br />
0 0 50,28 0,00 0<br />
0573861 OLIMEL N9 6 PP A 3 COMPART 1000 ML RR H<br />
0 0 40,48 0,00 0<br />
Page 40 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0573908 OLIMEL N9E 4 PP A 3 COMPART 1500 ML RR H<br />
0 0 49,08 0,00 0<br />
0573911 OLIMEL N9E 4 PP A 3 COMPART 2000 ML RR H<br />
0 0 51,28 0,00 0<br />
0573892 OLIMEL N9E 6 PP A 3 COMPART 1000 ML RR H<br />
0 0 41,29 0,00 0<br />
0574287 PERIOLIMEL N4E 2 PP A 3 COMPART 2500 ML RR H<br />
0 0 50,83 0,00 0<br />
0574256 PERIOLIMEL N4E 4 PP A 3 COMPART 1500 ML RR H<br />
0 0 41,20 0,00 0<br />
0574273 PERIOLIMEL N4E 4 PP A 3 COMPART 2000 ML RR H<br />
0 0 45,76 0,00 0<br />
0574242 PERIOLIMEL N4E 6 PP A 3 COMPART 1000 ML RR H<br />
0 0 37,09 0,00 0<br />
0521865 SMOFKABIVEN PERIPHER 1206 ML IV RR H<br />
0 0 74,65 0,00 0<br />
0530511 SMOFKABIVEN PERIPHER 1448 ML IV RR H<br />
0 0 82,80 0,00 0<br />
0521882 SMOFKABIVEN PERIPHER 1904 ML IV RR H<br />
0 0 91,01 0,00 0<br />
0514566 SMOFKABIVEN ZENTRAL 1477 ML IV A 1 RR H<br />
0 0 126,53 0,00 0<br />
0514597 SMOFKABIVEN ZENTRAL 1970 ML IV A 1 RR H<br />
0 0 88,63 0,00 0<br />
0585281 SMOFKABIVEN ZENTRAL 493 ML IV RR H<br />
0 0 72,69 0,00 0<br />
0514549 SMOFKABIVEN ZENTRAL 986 ML IV RR H<br />
0 0 93,82 0,00 0<br />
0514485 SMOFKABIVEN ZENTRAL EL-FREI 1477ML IV A1 RR H<br />
0 0 126,53 0,00 0<br />
0514504 SMOFKABIVEN ZENTRAL EL-FREI 1970 ML IV RR H<br />
0 0 163,63 0,00 0<br />
0514468 SMOFKABIVEN ZENTRAL EL-FREI 986 ML IV RR H<br />
0 0 93,82 0,00 0<br />
0124798 VAMIN GLUCOSE 1 FL 1000 ML PERF RR H<br />
0 0 19,29 0,00 0<br />
0149525 VAMIN GLUCOSE 1 FL 750 ML PERF RR H<br />
0 0 15,69 0,00 0<br />
0193098 VITALIPID N ADULT 10*10 ML AMP 497560 RR H<br />
0 0 24,67 0,00 0<br />
0193103 VITALIPID N INFANT 10*10 ML AMP 497552 RR H<br />
0 0 24,67 0,00 0<br />
B05BB01 electrolytes<br />
0363945 HARTMANN VIAFLO 10 * 1 L PERF RR<br />
0 0 2,44 7,04 0<br />
0363931 HARTMANN VIAFLO 20 * 500 ML PERF RR<br />
0 0 2,11 6,68 0<br />
0245325 JONOSTERIL 1000 ML P 1340231 RR<br />
0 0 4,73 7,22 0<br />
0182127 KOCHSALZLSG ISOT 10 ML 20 AMP P B314085 RR<br />
0 0 0,00 8,79 80<br />
0275159 KOCHSALZLSG ISOT 100 ML FREEFLEX B248361 RR<br />
0 0 0,00 2,58 80<br />
0165322 KOCHSALZLSG ISOT 100 ML INF G 1310031 RR<br />
0 0 2,69 5,33 80<br />
0165238 KOCHSALZLSG ISOT 100 ML INJ G (1310021) RR<br />
0 0 2,52 5,03 80<br />
0643577 KOCHSALZLSG ISOT 100 ML KABIPAC RR<br />
0 0 1,05 2,16 0<br />
0165451 KOCHSALZLSG ISOT 1000 ML G (OLD 1310141) RR<br />
0 0 0,00 4,19 80<br />
0165465 KOCHSALZLSG ISOT 1000 ML GS 1310151 RR<br />
0 0 0,00 4,45 80<br />
0165479 KOCHSALZLSG ISOT 1000 ML P 1310231 RR<br />
0 0 0,00 3,85 80<br />
0275193 KOCHSALZLSG ISOT 1000ML FREEFLEX 1310531 RR<br />
0 0 2,38 3,87 0<br />
0165482 KOCHSALZLSG ISOT 1000ML PS PLASTIPUR RR<br />
0 0 0,00 3,87 80<br />
0165211 KOCHSALZLSG ISOT 20 ML 20 AMP P B314401 RR<br />
0 0 0,00 9,59 80<br />
0275162 KOCHSALZLSG ISOT 250 ML FREEFLEX RR<br />
0 0 1,34 2,06 0<br />
0165367 KOCHSALZLSG ISOT 250 ML G 1310061 RR<br />
0 0 0,00 2,38 80<br />
0165371 KOCHSALZLSG ISOT 250 ML KABIPAC (P) RR<br />
0 0 0,00 2,01 80<br />
0165224 KOCHSALZLSG ISOT 50 ML G 1310011 RR<br />
0 0 2,32 4,62 0<br />
0643546 KOCHSALZLSG ISOT 50/100 ML KABIPAC RR<br />
0 0 1,05 2,16 0<br />
0275176 KOCHSALZLSG ISOT 500 ML FREEFLEX 1310521 RR<br />
0 0 1,39 2,21 0<br />
0165403 KOCHSALZLSG ISOT 500 ML G B101353 RR<br />
0 0 0,00 2,57 80<br />
Page 41 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0165417 KOCHSALZLSG ISOT 500 ML GS 1310101 RR<br />
0 0 0,00 2,75 80<br />
0165421 KOCHSALZLSG ISOT 500 ML KABIPAC 1310221 RR<br />
0 0 0,00 2,46 80<br />
0075922 NA CHLORID 0,9% BRN 10 AMP 10 ML P RR<br />
0 0 0,00 7,06 80<br />
0075936 NA CHLORID 0,9% BRN 10 AMP 20 ML P RR<br />
0 0 0,00 7,31 80<br />
0075855 NA CHLORID 0,9% BRN 100 ML RR<br />
0 0 0,00 1,36 80<br />
0075841 NA CHLORID 0,9% BRN 50 ML RR<br />
0 0 0,00 1,29 80<br />
0161533 NA HYDROGENCARBONAT 8,4% 250ML G 2941061 RR<br />
0 0 4,24 6,53 0<br />
0161547 NA HYDROGENCARBONAT 8.4% 100ML G 2941031 RR<br />
0 0 5,12 7,76 0<br />
0062700 NACL BRN 0,9% 1 FL 250 ML V RR<br />
0 0 0,00 2,11 80<br />
0062714 NACL BRN 0,9% 1 FL 500 ML V RR<br />
0 0 0,00 2,26 80<br />
0177497 NACL BRN 0,9% 1 MINIFL 100 ML RR<br />
0 0 0,00 2,13 80<br />
0353708 NACL VIAFLO 0,9% 10 PP 1 L RR<br />
0 0 1,98 6,52 0<br />
0353692 NACL VIAFLO 0,9% 20 PP 500 ML RR<br />
0 0 1,57 6,06 0<br />
0353689 NACL VIAFLO 0,9% 30 PP 250 ML RR<br />
0 0 1,35 5,83 0<br />
0353661 NACL VIAFLO 0,9% 50 PP 100 ML RR<br />
0 0 1,27 5,74 0<br />
0538358 PLASMALYTE A VIAFLO 10 PP 1 L PERF RR<br />
0 0 36,88 46,85 0<br />
0538344 PLASMALYTE A VIAFLO 20 PP 500 ML PERF RR<br />
0 0 63,58 76,10 0<br />
0142099 RINGERINFUSLSG BRN 1 FL 1 L G RR<br />
0 0 0,00 4,29 80<br />
0142085 RINGERINFUSLSG BRN 1 FL 500 ML G RR<br />
0 0 0,00 2,26 80<br />
0340565 RINGERLACTAT 1000 ML P 2620231 RR<br />
0 0 4,94 7,50 0<br />
0392009 RINGERLACTAT 500 ML FREEFLEX 2620521 RR<br />
0 0 4,94 7,50 0<br />
0340551 RINGERLACTAT 500 ML P 2620221 RR<br />
0 0 3,47 5,34 0<br />
0145946 RINGERLACTATINFUSLSG BRN 1000 ML V RR<br />
0 0 0,00 3,89 80<br />
0145977 RINGERLACTATINFUSLSG BRN 500 ML P RR<br />
0 0 0,00 3,47 80<br />
0275307 RINGERLOESUNG 1000 ML FREEFLEX 2600531 RR<br />
0 0 4,36 6,71 0<br />
0149458 RINGERLOESUNG 1000 ML GS 2600151 RR<br />
0 0 0,00 9,69 80<br />
0149444 RINGERLOESUNG 1000 ML P 2600231 RR<br />
0 0 4,36 6,71 80<br />
0149511 RINGERLOESUNG 250 ML G 2600061 RR<br />
0 0 0,00 6,49 80<br />
0275291 RINGERLOESUNG 500 ML FREEFLEX 2600521 RR<br />
0 0 2,35 3,59 0<br />
0149475 RINGERLOESUNG 500 ML G 2600091 RR<br />
0 0 0,00 6,69 80<br />
0149492 RINGERLOESUNG 500 ML GS 2600101 RR<br />
0 0 0,00 3,64 80<br />
0149508 RINGERLOESUNG 500 ML P 2600221 RR<br />
0 0 2,47 4,01 80<br />
0109922 STEROFUNDIN G 5 1000 ML RR<br />
0 0 5,16 0,00 0<br />
0109919 STEROFUNDIN G5 500 ML RR<br />
0 0 3,77 0,00 0<br />
B05BB02 electrolytes with carbohydrates<br />
0342444 GLUCION 10% 1 PP 1 L PERF RR<br />
0 0 3,81 8,75 0<br />
0342431 GLUCION 10% 1 PP 500 ML PERF RR<br />
0 0 3,25 8,06 0<br />
0342427 GLUCION 5% 1 PP 1 L PERF RR<br />
0 0 3,69 8,59 0<br />
0342413 GLUCION 5% 1 PP 500 ML PERF RR<br />
0 0 3,15 7,92 0<br />
0353742 GLUCOSE 5% + KCL 0,15% VIAFLO 10 PP 1 L RR<br />
0 0 2,13 6,69 0<br />
0353725 GLUCOSE 5% + KCL 0,3% VIAFLO 10 PP 1 L RR<br />
0 0 2,23 6,79 0<br />
0050369 GLUCOSE 5% + NACL 0,45% BXT 1 L RR<br />
0 0 2,03 6,57 0<br />
0055432 HYPOTONAX 48 250 ML PP PERF RR<br />
0 0 3,22 8,01 0<br />
Page 42 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0182077 JONOSTERIL D 5 1000 ML P 1381231 RR<br />
0 0 4,73 6,08 0<br />
0150011 JONOSTERIL D 5 500 ML P 1381221 RR<br />
0 0 3,36 4,59 0<br />
0422948 NACL+GLC VIAFLO 0,3/3,3% 20 PP 500 ML RR<br />
0 0 1,50 6,00 0<br />
0422884 NACL+GLC VIAFLO 0,9/5% 10 PP 1 L RR<br />
0 0 1,99 6,53 0<br />
0422871 NACL+GLC VIAFLO 0,9/5% 20 PP 500 ML RR<br />
0 0 1,63 6,14 0<br />
0374841 PAEDIATRISCHE ELEKTROLYTLSG I 250 ML P RR H<br />
0 0 2,93 0,00 0<br />
0374854 PAEDIATRISCHE ELEKTROLYTLSG I 500 ML P RR H<br />
0 0 3,57 0,00 0<br />
0374904 PAEDIATRISCHE ELEKTROLYTLSG II 250 ML P RR H<br />
0 0 2,93 0,00 0<br />
0374918 PAEDIATRISCHE ELEKTROLYTLSG II 500 ML P RR H<br />
0 0 3,57 0,00 0<br />
0538389 PLASMALYTE 148 + GLC 5% 10 PP 1 L PERF RR H<br />
0 0 38,58 0,00 0<br />
0538375 PLASMALYTE 148 + GLC 5% 20 PP 500ML PERF RR H<br />
0 0 63,58 0,00 0<br />
B05BC01 mannitol<br />
0069469 MANNITOL BXT 15% 1 PP 500 ML RR H<br />
0 0 4,42 0,00 0<br />
0069472 MANNITOL BXT 20% 1 PP 500 ML RR H<br />
0 0 4,54 0,00 0<br />
0083941 OSMOSTERIL 20% 250 ML G 2360061 RR H<br />
0 0 6,36 0,00 0<br />
B05CA02 chlorhexidine<br />
0145834 UROTAINER CHLORHEXIDINE 10*100 ML R<br />
0 0 16,81 27,22 80<br />
B05CA06 mandelic acid<br />
0145817 UROTAINER AC,MANDEL 1% 10*100 ML PP R<br />
0 0 16,81 27,22 80<br />
B05CA07 noxytiolin<br />
0080709 NOXYFLEX PDR SOL INST 10 FL 20 ML RR H<br />
0 0 72,24 0,00 0<br />
B05CB01 sodium chloride<br />
0294901 MINIBAG NACL 0,9% 1 PP VFLX 100 ML RR<br />
0 0 0,98 5,43 0<br />
0294896 MINIBAG NACL 0,9% 1 PP VFLX 50 ML RR<br />
0 0 0,86 5,30 0<br />
0148738 NACL BXT 3% 1 PP VFLX 500 ML RR<br />
0 0 1,48 5,98 0<br />
B05CX10 combinations<br />
0342461 GLUCOSE 5% NACL 0.3% KCL 0,3% BXT 1L P RR<br />
0 0 3,69 8,59 0<br />
B05XA01 potassium chloride<br />
0180587 KAL CHLORID 7,46% 20 ML 20 AMP P B314415 RR H<br />
0 0 12,60 0,00 0<br />
B05XA03 sodium chloride<br />
0179779 NA CHLORID 5,85% 20 ML 20 AMP P B314425 RR<br />
0 0 8,74 15,72 0<br />
0284869 NACL MACO 0,9% 1 MACOPERF 1 L RR<br />
0 0 0,00 6,02 0<br />
0284824 NACL MACO 0,9% 1 MACOPERF 100 ML RR<br />
0 0 0,00 5,02 0<br />
0284841 NACL MACO 0,9% 1 MACOPERF 250 ML RR<br />
0 0 0,00 5,02 0<br />
0284811 NACL MACO 0,9% 1 MACOPERF 50 ML RR<br />
0 0 0,00 5,02 0<br />
0284855 NACL MACO 0,9% 1 MACOPERF 500 ML RR<br />
0 0 0,00 5,39 0<br />
0440462 NACL MACO 0,9% 1 MACOPERF DUO 100+100 ML RR<br />
0 0 0,00 21,00 0<br />
0440476 NACL MACO 0,9% 1 MACOPERF DUO 250+100 ML RR<br />
0 0 0,00 22,00 0<br />
0440459 NACL MACO 0,9% 1 MACOPERF DUO 50+100 ML RR<br />
0 0 0,00 20,00 0<br />
0284791 NACL MACO 0,9% 1 PP 1 L RR<br />
0 0 0,00 2,55 0<br />
Page 43 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0284757 NACL MACO 0,9% 1 PP 100 ML RR<br />
0 0 0,00 1,95 0<br />
0284807 NACL MACO 0,9% 1 PP 2 L RR<br />
0 0 0,00 4,28 0<br />
0284774 NACL MACO 0,9% 1 PP 250 ML RR<br />
0 0 0,00 1,95 0<br />
0284743 NACL MACO 0,9% 1 PP 50 ML RR<br />
0 0 0,00 1,95 0<br />
0284788 NACL MACO 0,9% 1 PP 500 ML RR<br />
0 0 0,00 2,10 0<br />
0291135 NACL MACO 0,9% 1PP BILUER 1L RR<br />
0 0 0,00 3,28 0<br />
0291118 NACL MACO 0,9% 1PP BILUER 250ML RR<br />
0 0 0,00 2,55 0<br />
0291149 NACL MACO 0,9% 1PP BILUER 2L RR<br />
0 0 0,00 5,02 0<br />
0291121 NACL MACO 0,9% 1PP BILUER 500ML RR<br />
0 0 0,00 2,77 0<br />
0291023 NACL MACO 0,9% 1PP MONOLUER 100ML RR<br />
0 0 0,00 2,35 0<br />
0291068 NACL MACO 0,9% 1PP MONOLUER 1L RR<br />
0 0 0,00 3,05 0<br />
0291041 NACL MACO 0,9% 1PP MONOLUER 250ML RR<br />
0 0 0,00 2,48 0<br />
0291054 NACL MACO 0,9% 1PP MONOLUER 500ML RR<br />
0 0 0,00 2,61 0<br />
0291006 NACL MACO 0,9% 1PP MONOLUER 50ML RR<br />
0 0 0,00 2,31 0<br />
0290947 NACL MACO 0,9% 1PP POLYOLE 100ML RR<br />
0 0 0,00 2,22 0<br />
0290981 NACL MACO 0,9% 1PP POLYOLE 1L RR<br />
0 0 0,00 2,81 0<br />
0290964 NACL MACO 0,9% 1PP POLYOLE 250ML RR<br />
0 0 0,00 2,22 0<br />
0290978 NACL MACO 0,9% 1PP POLYOLE 500ML RR<br />
0 0 0,00 2,35 0<br />
0290933 NACL MACO 0,9% 1PP POLYOLE 50ML RR<br />
0 0 0,00 2,22 0<br />
B05XA31 electrolytes in combination with other drugs<br />
0252607 ADDAMEL N 10 ML 20 AMP 57422128 RR<br />
0 0 33,79 0,00 0<br />
0274281 NONAN NOVUM 1 FL 40 ML PERF RR<br />
0 0 0,00 2,80 80<br />
0249498<br />
B06AC01<br />
TRACITRANS PLUS 10 ML 10 AMP G RR<br />
0 0 0,00 30,00 80<br />
0555717 BERINERT 500 U PDR 1 FL 10 ML + 1 SET IV RR HC<br />
0 0 530,00 0,00 0<br />
C01AA05 digoxin<br />
0063515 LANOXIN 0,05 MG/ML ELIXIR PED 60 ML R<br />
0 0 2,24 6,99 100<br />
0063451 LANOXIN 0,125 MG 60 CPR R<br />
0 0 1,33 5,99 100<br />
0063482 LANOXIN 0,250 MG 120 CPR R<br />
0 0 2,27 7,02 100<br />
0063479 LANOXIN 0,250 MG 60 CPR R<br />
0 0 1,43 6,10 100<br />
0192087 LANOXIN 0,5 MG 5 AMP 2 ML UD IMIV RR<br />
0 0 2,82 4,84 100<br />
0063465 LANOXIN 0.25 MG 50*5 CPR UD R<br />
0 0 5,18 0,00 0<br />
C01AA08 metildigoxin<br />
0063367 LANITOP 0,1 MG 50 CPR R<br />
0 0 0,00 2,36 100<br />
C01BA03 disopyramide<br />
0203308 RYTHMODAN 100 MG 120 CAPS R<br />
0 0 7,59 13,63 100<br />
0201544 RYTHMODAN LA 250 MG 40 CPR R<br />
0 0 7,75 13,84 100<br />
C01BB01 lidocaine<br />
0207856 XYLOCARD 100 MG 2% 5 AMP 5 ML IMIV RR<br />
0 0 0,00 9,82 100<br />
C01BC03 propafenone<br />
Page 44 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0101681 RYTMONORM 150 MG 100 CPR R<br />
0 0 9,37 19,34 100<br />
0101678 RYTMONORM 150 MG 50 CPR R<br />
0 0 4,88 14,42 100<br />
0101700 RYTMONORM 300 MG 100 CPR R<br />
0 0 18,40 29,22 100<br />
0101695 RYTMONORM 300 MG 50 CPR R<br />
0 0 9,77 19,78 100<br />
C01BC04 flecainide<br />
0363851 APOCARD RET 100 MG 60 CAPS R<br />
0 0 18,46 26,61 100<br />
0363914 APOCARD RET 150 MG 60 CAPS R<br />
0 0 27,37 36,43 100<br />
0363881 APOCARD RET 200 MG 60 CAPS R<br />
0 0 36,00 45,94 100<br />
0465668 FLECAINIDE EG 100 MG 100 CPR BLIST R<br />
0 0 16,95 25,06 100<br />
0113276 TAMBOCOR 100 MG 100 CPR R<br />
0 0 30,25 39,61 100<br />
0113262 TAMBOCOR 100 MG 40 CPR R<br />
0 0 13,37 20,74 100<br />
0113293 TAMBOCOR 150 MG 5 AMP 15 ML IV RR<br />
0 0 22,50 31,07 100<br />
C01BD01 amiodarone<br />
0153559 AMIODARONE EG 200 MG 60 CPR R<br />
0 0 4,52 9,80 100<br />
0025030 CORDARONE 150 MG 24 AMP 3 ML IV RR H<br />
0 0 13,29 0,00 0<br />
0571805 CORDARONE 150 MG 6 AMP 3 ML IV RR H<br />
0 0 3,41 0,00 0<br />
0024999 CORDARONE 200 MG 20 CPR R<br />
0 0 3,81 8,92 100<br />
0025013<br />
C01BD07<br />
CORDARONE 200 MG 60 CPR R<br />
0 0 8,00 14,14 100<br />
0539324 MULTAQ 400 MG 100 CPR RR C<br />
RM 0 0<br />
125,00 0,00 0<br />
0539311 MULTAQ 400 MG 60 CPR RR C<br />
RM 1 1<br />
75,00 89,27 100<br />
C01BG07 cibenzoline<br />
0158149 CIPRALAN 130 MG 100 CPR RR<br />
0 0 19,10 27,43 100<br />
0158135<br />
C01BG11<br />
CIPRALAN 130 MG 40 CPR RR<br />
0 0 9,55 16,08 100<br />
0575771 BRINAVESS 500 MG PERF 1 FL 25 ML RR HC<br />
RM 0 0<br />
396,56 0,00 0<br />
C01CA01 etilefrine<br />
0038199 EFFORTIL 0,75% GTTS 50 ML R<br />
0 0 7,90 13,57 80<br />
0038185 EFFORTIL 5 MG 50 CPR P<br />
0 0 4,91 8,43 80<br />
C01CA02 isoprenaline<br />
0060351 ISUPREL 0,2 MG 5 AMP 1 ML PERF RR<br />
0 0 0,00 9,54 80<br />
C01CA03 norepinephrine<br />
0065263 LEVOPHED 8 MG 10 AMP 4 ML IV RR<br />
0 0 0,00 21,39 80<br />
C01CA04 dopamine<br />
0037630 DYNATRA 200 MG 10 AMP 5 ML IV RR H<br />
0 0 17,19 0,00 0<br />
0037644 DYNATRA 50 MG 10 AMP 1,25 ML IV RR H<br />
0 0 5,38 0,00 0<br />
C01CA07 dobutamine<br />
0198533 DOBUTAMIN HEXAL 250 MG PDR 1FL IV RR H<br />
0 0 8,22 0,00 0<br />
0229531 DOBUTAMIN LIQ FRSN 250 MG 10FL 50ML PERF RR H<br />
0 0 88,64 0,00 0<br />
Page 45 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0250759 DOBUTAMINE EG 250 MG 10*20 ML PERF RR H<br />
0 0 41,60 0,00 0<br />
0149381 DOBUTREX 250 MG 1 AMP 20 ML PERF RR H<br />
0 0 5,30 0,00 0<br />
C01CA24 epinephrine<br />
0389468 ANAPEN 0,15 MG 1 SRG PREREMPL 0,3 ML IM RR<br />
0 0 0,00 44,24 0<br />
0389454 ANAPEN 0,3 MG 1 SRG PREREMPL 0,3 ML IM RR<br />
0 0 0,00 44,24 0<br />
0656477 FASTJEKT JUNIOR AUTOINJECTOR A 1 IM RR<br />
0 0 68,00 83,50 0<br />
0164244 FASTJEKT SENIOR AUTOINJECTOR A 1 IM RR<br />
0 0 68,00 83,50 80<br />
C01CE02 milrinone<br />
0149735 COROTROPE 10 MG 10 AMP 10 ML IV ( U.H.) RR H<br />
0 0 149,39 0,00 0<br />
C01DA02 glyceryl trinitrate<br />
0268401 DEPONIT NT 10 100 PATCH R<br />
0 0 62,54 77,53 80<br />
0268395 DEPONIT NT 10 30 PATCH R<br />
0 0 18,53 29,36 80<br />
0268378 DEPONIT NT 5 100 PATCH R<br />
0 0 49,70 63,48 80<br />
0268364 DEPONIT NT 5 30 PATCH R<br />
0 0 15,39 25,92 80<br />
0380509 DIAFUSOR 10 (80 MG) 30 PATCH R<br />
0 0 11,21 18,15 0<br />
0380512 DIAFUSOR 15 (120 MG) 30 PATCH R<br />
0 0 16,46 24,53 0<br />
0380493 DIAFUSOR 5 (40 MG) 30 PATCH R<br />
0 0 7,27 13,23 0<br />
0380526 DIAFUSOR 7,5 (60 MG) 30 PATCH R<br />
0 0 9,23 15,67 0<br />
0190955 MINITRAN 10 MG 30 PATCH R<br />
0 0 15,52 23,50 80<br />
0190969 MINITRAN 15 MG 30 PATCH R<br />
0 0 22,80 31,52 80<br />
0190941 MINITRAN 5 MG 30 PATCH R<br />
0 0 10,07 16,72 80<br />
0253747 NATISPRAY 0,3 MG/D SPRAY BU 18 ML R<br />
0 0 4,10 6,57 100<br />
0236391 NITRODERM TTS 10 100 PATCH R<br />
0 0 67,17 82,60 80<br />
0236361 NITRODERM TTS 5 100 PATCH R<br />
0 0 54,34 68,54 80<br />
0368485 NITROLINGUAL PUMPSPRAY 0,4 MG 250 D SL R<br />
0 0 4,46 9,62 100<br />
0223426 TRINIPATCH 10 30 PATCH R<br />
0 0 17,39 25,44 80<br />
0223457 TRINIPATCH 15 30 PATCH R<br />
0 0 25,04 33,86 80<br />
0223409 TRINIPATCH 5 30 PATCH R<br />
0 0 11,30 18,15 80<br />
C01DA08 isosorbide dinitrate<br />
0019565 CEDOCARD 5 MG 180 CPR R<br />
0 0 3,72 8,80 100<br />
0019551 CEDOCARD 5 MG 60 CPR R<br />
0 0 1,55 6,22 100<br />
0248635 ISOKET 10 MG 60 CPR R<br />
0 0 3,46 6,15 100<br />
0314758 ISOKET 10 MG 98 CPR R<br />
0 0 5,13 9,13 100<br />
0248974 ISOKET 5 MG 60 CPR R<br />
0 0 2,59 4,61 100<br />
0314744 ISOKET 5 MG 98 CPR R<br />
0 0 3,87 6,88 100<br />
0234965 ISOKET RET 120 MG 60 CAPS R<br />
0 0 12,44 22,33 100<br />
0314808 ISOKET RET 120 MG 98 CAPS R<br />
0 0 18,33 28,97 100<br />
0248649 ISOKET RET 20 MG 60 CPR R<br />
0 0 3,20 5,69 100<br />
0314761 ISOKET RET 20 MG 98 CPR R<br />
0 0 5,22 9,29 100<br />
0248652 ISOKET RET 40 MG 60 CPR R<br />
0 0 5,50 9,78 100<br />
0314775 ISOKET RET 40 MG 98 CPR R<br />
0 0 8,00 14,23 100<br />
0059302 ISOKET RET 60 MG 100 CPR R<br />
0 0 14,25 25,33 100<br />
Page 46 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0248666 ISOKET RET 60 MG 60 CPR R<br />
0 0 6,91 12,29 100<br />
0314789 ISOKET RET 60 MG 98 CPR R<br />
0 0 13,24 23,55 100<br />
0248683 ISOKET RET 80 MG 60 CPR R<br />
0 0 8,54 15,19 100<br />
0314792 ISOKET RET 80 MG 98 CPR R<br />
0 0 16,14 28,71 100<br />
0170045 ISOKET SPRAY 300 D 15 ML R<br />
0 0 12,20 22,05 100<br />
C01DA14 isosorbide mononitrate<br />
0038400 ELANTAN LONG 50 MG 100 CAPS R<br />
0 0 26,72 47,54 100<br />
C01DX12 molsidomine<br />
0335291 CORUNO 16 MG 28 CPR R<br />
0 0 23,54 32,32 80<br />
0355649 CORUNO 16 MG 42 CPR R<br />
0 0 31,79 41,41 80<br />
0353211 CORUNO 16 MG 42 CPR UD R<br />
0 0 31,79 0,00 0<br />
0156452 CORVATON 2 MG 100 CPR R<br />
0 0 10,01 16,65 80<br />
0025822 CORVATON 2 MG 50 CPR R<br />
0 0 5,32 10,81 80<br />
0160648 CORVATON 20 MG 1 AMP 10 ML PERF RR H<br />
0 0 5,28 0,00 0<br />
0025853 CORVATON 4 MG 120 CPR R<br />
0 0 26,95 37,65 80<br />
0025836 CORVATON 4 MG 60 CPR R<br />
0 0 14,72 25,08 80<br />
0337234 MOLSIKET RET 8 MG 98 CPR R<br />
0 0 10,35 18,41 80<br />
C01EA01 alprostadil<br />
0211828 PROSTAVASIN 20 MCG PDR 15 AMP IAIV RR H<br />
0 0 227,74 0,00 0<br />
0094878 PROSTIN VR 0,5 MG 1 AMP 1 ML IV RR H<br />
0 0 69,64 0,00 0<br />
C01EB10 adenosine<br />
0197018 ADENOCOR 6 MG 6 FL 2 ML IV RR H<br />
0 0 21,11 0,00 0<br />
C01EB15 trimetazidine<br />
0125313 VASTAREL 20 MG 60 CPR R<br />
0 0 0,00 12,22 0<br />
C01EB17 ivabradine<br />
0423833 PROCORALAN 5 MG 100 CPR RR<br />
0 0 83,34 98,15 0<br />
0423797 PROCORALAN 5 MG 56 CPR RR<br />
1 1 45,77 56,81 80<br />
0423901 PROCORALAN 7,5 MG 100 CPR RR<br />
0 0 83,34 98,15 0<br />
0423878 PROCORALAN 7,5 MG 56 CPR RR<br />
1 1 45,77 56,81 80<br />
C01EB19 icatibant<br />
0492746 FIRAZYR 30 MG 1 SRG 3 ML + 1 AIG RR DC X 0 0<br />
1.743,11 0,00 0<br />
C02AC01 clonidine<br />
0217883 CATAPRESSAN 150 0,15 MG 100 CPR R<br />
0 0 6,94 12,83 100<br />
0019193 CATAPRESSAN 150 0,15 MG 5 AMP IMIVSC R<br />
0 0 2,07 6,80 100<br />
0241777 CATAPRESSAN 150 0.15MG 50 CPR UD R<br />
0 0 3,51 0,00 0<br />
C02AC05 moxonidine<br />
0285396 MOXON 0,2 MG 28 CPR R<br />
0 0 5,54 10,96 100<br />
0285432 MOXON 0,4 MG 28 CPR R<br />
0 0 8,43 14,57 100<br />
0374949 MOXONIDINE EG 0,2 MG 28 CPR R<br />
0 0 3,60 8,66 100<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0455921 MOXONIDINE EG 0,2 MG 56 CPR R<br />
0 0 7,16 13,09 100<br />
0375154 MOXONIDINE EG 0,4 MG 28 CPR R<br />
0 0 5,76 11,35 100<br />
0455935 MOXONIDINE EG 0,4 MG 56 CPR R<br />
0 0 11,90 19,02 100<br />
C02AC06 rilmenidine<br />
0136951 HYPERIUM 1 MG 30 CPR R<br />
0 0 0,00 15,47 100<br />
C02CA01 prazosin<br />
0072500 MINIPRESS 1 MG 100 CPR R<br />
0 0 5,75 11,34 100<br />
0072528 MINIPRESS 2 MG 100 CPR R<br />
0 0 9,63 16,17 100<br />
0072545 MINIPRESS 5 MG 100 CPR R<br />
0 0 20,02 28,45 100<br />
C02CA06 urapidil<br />
0037952 EBRANTIL 50 MG 5 AMP 10 ML IV RR H<br />
0 0 19,29 0,00 0<br />
C02KX01 bosentan<br />
0328302 TRACLEER 125 MG 56 CPR RR DC X RM 0 0<br />
2.249,27 0,00 0<br />
0328283 TRACLEER 62,5 MG 56 CPR RR DC X RM 0 0<br />
2.249,27 0,00 0<br />
C02KX02 ambrisentan<br />
0485451 VOLIBRIS 10 MG 30 CPR RR DC X RM 0 0<br />
2.508,00 0,00 0<br />
0485433 VOLIBRIS 5 MG 30 CPR RR DC X RM 0 0<br />
2.508,00 0,00 0<br />
C02LA51 reserpine and diuretics, combinations with other drugs<br />
0203342 BRISERIN N 100 DRG R<br />
0 0 28,51 40,28 80<br />
C03AA03 hydrochlorothiazide<br />
0236214 ESIDRIX 25 MG 20 CPR R<br />
0 0 1,82 11,08 80<br />
C03BA04 chlortalidone<br />
0181679 HYGROTON 50 MG 100 CPR 02480 R<br />
0 0 6,87 15,63 0<br />
0236617 HYGROTON 50 MG 20 CPR 02478 R<br />
0 0 0,00 8,78 80<br />
0236621 HYGROTON 50 MG 50 CPR 02479 R<br />
0 0 3,78 12,35 80<br />
C03BA11 indapamide<br />
0224499 FLUDEX 1,5 MG 100 CPR LP UD R<br />
0 0 28,24 0,00 0<br />
0224485 FLUDEX 1,5 MG 30 CPR LP R<br />
0 0 0,00 12,79 80<br />
0045565 FLUDEX 2,5 MG 30 CPR R<br />
0 0 0,00 12,79 80<br />
0585781 INDAPAMIDE DOC 2,5 MG 60 CPR R<br />
0 0 3,58 8,46 80<br />
0205185 INDAPAMIDE EG 2,5 MG 20 DRG R<br />
0 0 1,48 6,15 80<br />
0205199 INDAPAMIDE EG 2,5 MG 60 DRG R<br />
0 0 3,55 8,59 80<br />
C03BX03 cicletanine<br />
0136012 TENSTATEN 50 MG 30 CAPS R<br />
0 0 0,00 16,76 80<br />
C03CA01 furosemide<br />
0170417 FURORESE 20 MG 5 AMP 2 ML IMIV RR<br />
0 0 0,00 2,58 80<br />
0047265 FURORESE 40 MG 20 CPR R<br />
0 0 0,49 9,63 80<br />
0136172 FUROSEMID RATIO 20 MG 5 AMP 2 ML IMIV RR<br />
0 0 1,15 5,20 80<br />
Page 48 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0143616 FUROSEMID RATIO 20 MG 50 AMP 2 ML IMIV RR<br />
0 0 12,92 0,00 0<br />
0136219 FUROSEMID RATIO 250 MG 5 AMP 25 ML PERF RR<br />
0 0 5,89 11,27 80<br />
0156029 FUROSEMID RATIO 40 MG 100 CPR R<br />
0 0 2,29 11,59 80<br />
0047296 FUROSEMID RATIO 40 MG 20 CPR R<br />
0 0 0,49 2,55 80<br />
0047301 FUROSEMID RATIO 40 MG 50 CPR R<br />
0 0 1,18 8,21 80<br />
0136947 FUROSEMIDE EG 40 MG 50 CPR SEC R<br />
0 0 2,16 6,89 80<br />
0304832 FUROSEMIDE MYLAN 40 MG 50 CPR R<br />
0 0 2,16 6,89 80<br />
0063935 LASIX 20 MG 5 AMP 2 ML IMIV RR<br />
0 0 1,53 6,20 80<br />
0063952 LASIX 250 MG 5 AMP 25 ML PERF RR<br />
0 0 11,03 0,00 0<br />
0063899 LASIX 40 MG 12 CPR R<br />
0 0 1,34 5,88 80<br />
0063904 LASIX 40 MG 50 CPR R<br />
0 0 4,25 9,47 80<br />
0656544 LASIX 40 MG 50 CPR UD R<br />
0 0 4,25 9,47 0<br />
0063921 LASIX 500 MG 20 CPR R C<br />
0 0 14,61 22,27 80<br />
0064039 LASIX P 30 MG 30 CAPS R<br />
0 0 2,99 7,90 80<br />
C03CA02 bumetanide<br />
0248568 BURINEX 1 MG 30 CPR R<br />
0 0 2,86 7,73 80<br />
0400311 BURINEX 1 MG 50 CPR UD R<br />
0 0 4,78 0,00 0<br />
0160571 BURINEX 2 MG 5 AMP 4 ML IMIV RR<br />
0 0 3,84 8,96 80<br />
0160553 BURINEX 5 MG 20 CPR R<br />
0 0 6,54 12,33 80<br />
0400324 BURINEX 5 MG 50 CPR UD R<br />
0 0 16,36 0,00 0<br />
C03CA04 torasemide<br />
0361291 TORASEMID HEXAL 10 MG 100 CPR R<br />
0 0 0,00 17,71 0<br />
0361261 TORASEMID HEXAL 10 MG 30 CPR R<br />
0 0 1,48 10,72 0<br />
0361274 TORASEMID HEXAL 10 MG 50 CPR R<br />
0 0 0,00 13,51 0<br />
0361095 TORASEMID HEXAL 2,5 MG 100 CPR R<br />
0 0 0,00 11,00 0<br />
0361047 TORASEMID HEXAL 2,5 MG 20 CPR R<br />
0 0 0,00 2,60 0<br />
0361078 TORASEMID HEXAL 2,5 MG 50 CPR R<br />
0 0 0,00 6,72 0<br />
0361386 TORASEMID HEXAL 20 MG 100 CPR R<br />
0 0 0,00 22,05 0<br />
0361355 TORASEMID HEXAL 20 MG 30 CPR R<br />
0 0 0,00 13,22 0<br />
0361369 TORASEMID HEXAL 20 MG 50 CPR R<br />
0 0 0,00 15,91 0<br />
0361193 TORASEMID HEXAL 5 MG 100 CPR R<br />
0 0 0,00 14,64 0<br />
0361159 TORASEMID HEXAL 5 MG 30 CPR R<br />
0 0 0,97 10,14 0<br />
0361162 TORASEMID HEXAL 5 MG 50 CPR R<br />
0 0 0,00 11,81 0<br />
0268574 TORREM 10 MG 20 CPR R<br />
0 0 5,41 10,81 80<br />
0275758 TORREM 2,5 MG 56 CPR R<br />
0 0 4,04 9,10 80<br />
C03DA01 spironolactone<br />
0002554 ALDACTONE 100 MG 30 CPR RR<br />
0 0 7,30 13,27 80<br />
0002568 ALDACTONE 100 MG 50 CPR RR<br />
0 0 10,94 17,81 80<br />
0002599 ALDACTONE 25 MG 50 CPR RR<br />
0 0 3,70 8,78 80<br />
0229593 ALDACTONE 50 MG 30 CPR RR<br />
0 0 4,43 9,69 80<br />
0156046 SPIRONOLACTON RATIO 100 MG 100 CPR RR<br />
0 0 15,01 25,52 80<br />
0108908 SPIRONOLACTON RATIO 100 MG 20 CPR RR<br />
0 0 3,14 7,16 80<br />
Page 49 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0108911 SPIRONOLACTON RATIO 100 MG 50 CPR RR<br />
0 0 7,65 15,63 80<br />
0178271 SPIRONOLACTONE EG 100 MG 30 CPR RR<br />
0 0 5,75 11,34 80<br />
0202393 SPIRONOLACTONE EG 100 MG 50 CPR RR<br />
0 0 9,15 15,58 80<br />
0178298 SPIRONOLACTONE EG 25 MG 50 CPR RR<br />
0 0 2,92 7,82 80<br />
0292759 SPIRONOLACTONE MYLAN 100 MG 50 CPR RR<br />
0 0 9,42 15,92 80<br />
0292745 SPIRONOLACTONE MYLAN 25 MG 50 CPR RR<br />
0 0 3,98 8,76 80<br />
C03DA02 potassium canrenoate<br />
0018294 CANRENOL 100 MG 50 CPR RR<br />
0 0 9,21 15,55 80<br />
0487682 CANRENOL 25 MG 50 CPR RR<br />
0 0 3,00 7,79 0<br />
0018313 CANRENOL 50 MG 50 CPR RR<br />
0 0 4,94 10,22 80<br />
0106142 SOLDACTONE 200 MG 6 AMP RR<br />
0 0 7,12 13,05 80<br />
C03DA04 eplerenone<br />
0385245 INSPRA 25 MG 30 CPR RR IC<br />
6 6 60,00 71,71 80<br />
C03DB02 triamterene<br />
0350219 DYTAC 50 MG 28 CAPS R<br />
0 0 3,44 8,29 80<br />
C03EA Low-ceiling diuretics and potassium-sparing agents<br />
0195464 DEHYDROSANOL TRI 30 DRG RR<br />
0 0 6,05 15,71 80<br />
0028855 DEHYDROSANOL TRI 50 DRG RR<br />
0 0 9,59 19,58 80<br />
0317679 DEHYDROSANOL TRI MITE 50 DRG R<br />
0 0 7,44 17,22 80<br />
C03EA01 hydrochlorothiazide and potassium-sparing agents<br />
0004321 AMILORETIK 100 CPR R<br />
0 0 3,57 12,99 80<br />
0225594 AMILORETIK 30 CPR R<br />
0 0 0,00 1,00 80<br />
0004318 AMILORETIK 50 CPR R<br />
0 0 0,00 2,00 80<br />
0037787 DYTENZIDE 112 CPR R<br />
0 0 11,28 18,23 80<br />
0037773 DYTENZIDE 28 CPR R<br />
0 0 3,53 8,57 80<br />
0073170 MODURETIC 112 CPR (EMB CALENDRIER) R<br />
0 0 2,60 7,41 80<br />
0073167 MODURETIC 56 CPR (EMB CALENDRIER) R<br />
0 0 1,29 5,95 80<br />
0292731 SPIRONOLACTON HCTZ MYLAN 56 CPR RR<br />
0 0 5,09 10,51 80<br />
C03EA03 epitizide and potassium-sparing agents<br />
0037742 DYTA URESE 28 CAPS R<br />
0 0 3,62 8,51 80<br />
0037756 DYTA URESE 56 CAPS R<br />
0 0 5,78 11,20 80<br />
C03EA04 altizide and potassium-sparing agents<br />
0002537 ALDACTAZINE 28 CPR RR<br />
0 0 3,73 8,82 80<br />
0002540 ALDACTAZINE 98 CPR RR<br />
0 0 10,44 17,19 80<br />
C03EB01 furosemide and potassium-sparing agents<br />
0142328 FRUSAMIL 28 CPR R<br />
0 0 3,34 8,34 80<br />
0150526 FRUSAMIL 56 CPR R<br />
0 0 5,35 10,83 80<br />
0108780 SPIRO COMP FORTE RATIO 100 CPR RR<br />
0 0 27,92 39,64 80<br />
0108763 SPIRO COMP FORTE RATIO 20 CPR RR<br />
0 0 5,97 15,62 80<br />
0108777 SPIRO COMP FORTE RATIO 50 CPR RR<br />
0 0 14,48 24,94 80<br />
Page 50 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0193961 SPIRO COMP RATIO 20 CPR RR<br />
0 0 3,45 12,86 80<br />
0194193 SPIRO COMP RATIO 50 CPR RR<br />
0 0 8,45 18,33 80<br />
C04AD03 pentoxifylline<br />
0132612 PENTOXIFYLLIN RATIO RET 400 MG 100 CAPS R<br />
0 0 9,33 16,63 0<br />
0132593 PENTOXIFYLLIN RATIO RET 400 MG 20 CAPS R<br />
0 0 0,00 5,94 0<br />
0132609 PENTOXIFYLLIN RATIO RET 400 MG 50 CAPS R<br />
0 0 7,19 12,81 0<br />
0467595 TORENTAL 400 MG 60 CPR R<br />
0 0 10,92 18,75 0<br />
C04AE01 ergoloid mesylates<br />
0054743 HYDERGIN 0,1% GTTS 100 ML R<br />
0 0 13,33 23,33 0<br />
0054757 HYDERGIN FORTE 0,2% GTTS 100 ML R<br />
0 0 21,49 32,53 0<br />
0054791 HYDERGIN SPEZIAL 4 MG 100 CPR R<br />
0 0 34,55 46,91 0<br />
0054788 HYDERGIN SPEZIAL 4 MG 20 CPR R<br />
0 0 0,00 13,86 0<br />
0166611 IBEXONE 4,5 MG 30 CPR R<br />
0 0 6,38 10,96 0<br />
0110193 STOFILAN FORTE 30 CPR R<br />
0 0 8,24 14,16 0<br />
C04AE54 dihydroergocristine, combinations<br />
0058899 ISKEDYL 6 AMP 2,5 ML IMIV RR<br />
0 0 0,00 3,31 0<br />
0248148 ISKEDYL FORT 28 CPR R<br />
0 0 0,00 5,01 0<br />
0058885 ISKEDYL GTTS 30 ML R<br />
0 0 0,00 2,64 0<br />
C04AX21 naftidrofuryl<br />
0135175 PRAXILENE 100 MG 50 CPR R<br />
0 0 8,40 14,43 0<br />
0171963 PRAXILENE 200 MG 60 CPR R<br />
0 0 14,40 24,73 0<br />
0231476 PRAXILENE 200 MG 90 CPR R<br />
0 0 19,24 29,72 0<br />
C05AA Corticosteroids<br />
0119929 TRIANAL 10 SUPP RR<br />
0 0 4,02 6,90 80<br />
0119915 TRIANAL POM 20 G RR<br />
0 0 5,00 8,60 80<br />
C05AA04 prednisolone<br />
0052556 HEMOSEDAN POM 30 G RR<br />
0 0 4,18 7,19 80<br />
0311434 SCHERIPROCT POM 10*30 G RR<br />
0 0 48,00 0,00 0<br />
0102689 SCHERIPROCT POM 30 G RR<br />
0 0 5,29 9,09 80<br />
C05AA08 fluocortolone<br />
0122728 ULTRAPROCT POM 30 GR RR<br />
0 0 4,71 8,09 80<br />
C05AD Local anesthetics<br />
0059123 ISOCHINOL SALBE 30 G P<br />
0 0 0,00 5,18 80<br />
0097317 RECTOVASOL POM 20 G QUALIPHAR P<br />
0 0 3,54 6,08 0<br />
C05AD03 benzocaine<br />
0519612 SEDORRHOIDE CRISE HEMORROID 8 SUPP P<br />
0 0 3,12 7,03 0<br />
0512592 SEDORRHOIDE CRISE HEMORROID CREME 30 G P<br />
0 0 3,18 11,97 0<br />
C05AE01 glyceryl trinitrate<br />
0460899 RECTOGESIC 0,4% POM 30 G R<br />
0 0 43,00 55,09 0<br />
Page 51 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
C05AX02 bismuth preparations, combinations<br />
0389289 ANUSOL 18 SUPP P<br />
0 0 5,84 10,04 0<br />
C05AX03 other preparations, combinations<br />
0288773 COSE ANAL POM 20 G P<br />
0 0 3,82 6,56 80<br />
C05BA01 organo-heparinoid<br />
0264446 HEMERAN CREME 50 G P<br />
0 0 4,47 7,68 0<br />
0054032 HIRUDOID CREME 100 G P<br />
0 0 8,02 13,78 0<br />
0338522 HIRUDOID CREME 50 G P<br />
0 0 5,09 8,75 0<br />
0054015 HIRUDOID GEL 100 G P<br />
0 0 8,02 13,78 0<br />
0338519 HIRUDOID GEL 50 G P<br />
0 0 5,09 8,75 0<br />
C05BA03 heparin<br />
0052850 HEPARIN RATIO 30000 POM 100 G P<br />
0 0 0,00 6,31 0<br />
0206828 HEPARIN RATIO 30000 POM 150 G P<br />
0 0 0,00 8,58 0<br />
0547133 THROMBONOR 60000 U CREME 100 G P<br />
0 0 4,75 9,11 0<br />
0547147 THROMBONOR 60000 U GEL 100 G P<br />
0 0 4,75 9,11 0<br />
C05BB Sclerosing agents for local injection<br />
0444038 SCLEREMO 5 AMP 2 ML IV RR<br />
0 0 0,00 7,90 0<br />
C05BB02 polidocanol<br />
0001395 AETHOXYSKLEROL 0,5% 5 AMP 2 ML RR<br />
0 0 4,80 8,25 0<br />
0001400 AETHOXYSKLEROL 1% 5 AMP 2 ML RR<br />
0 0 5,62 9,66 0<br />
0001414 AETHOXYSKLEROL 2% 5 AMP 2 ML RR<br />
0 0 6,44 11,07 0<br />
0001428 AETHOXYSKLEROL 3% 5 AMP 2 ML RR<br />
0 0 7,02 12,06 0<br />
C05C CAPILLARY STABILIZING AGENTS<br />
0329652 MEDIAVEN FORTE 30 MG 30 CPR P<br />
0 0 12,42 21,33 0<br />
0597068 MEDIAVEN FORTE 30 MG 60 CPR P<br />
0 0 25,76 36,44 0<br />
C05CA Bioflavonoids<br />
0275341 CEMAFLAVONE 20 AMP BUV P<br />
0 0 0,00 3,89 0<br />
0136558 CYCLO 3 CREME 100 G P<br />
0 0 0,00 6,32 0<br />
0260397 CYCLO 3 CREME 40 G P<br />
0 0 0,00 2,18 0<br />
0170031 CYCLO 3 FORT 30 AMP BUV 5 ML P<br />
0 0 0,00 6,10 0<br />
0170028 CYCLO 3 FORT 30 CAPS P<br />
0 0 0,00 6,10 0<br />
0141544 CYCLO 3 FORT 60 CAPS P<br />
0 0 0,00 11,82 0<br />
0136074 DAFLON 500 MG 30 CPR P<br />
0 0 8,05 13,83 0<br />
0413613 DAFLON 500 MG 30 CPR UD P<br />
0 0 8,05 0,00 0<br />
0377937 DAFLON 500 MG 60 CPR P<br />
0 0 12,87 22,11 0<br />
0492763 DAFLON 500 MG 90 CPR P<br />
0 0 19,36 29,85 0<br />
0300878 GINKOR FORT 30 CAPS P<br />
0 0 0,00 7,86 0<br />
C05CA01 rutoside<br />
0339841 VENORUTON 1 G 14 SACH P<br />
0 0 8,28 14,23 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0339855 VENORUTON 1 G 30 SACH P<br />
0 0 15,30 25,67 0<br />
0126095 VENORUTON 2% GEL 100 G P<br />
0 0 6,53 11,21 0<br />
0585327 VENORUTON FORTE 500 MG 10 CPR P<br />
0 0 25,98 36,67 0<br />
0585331 VENORUTON FORTE 500 MG 100 CPR P<br />
0 0 27,76 38,51 0<br />
0126145 VENORUTON FORTE 500 MG 30 CPR P<br />
0 0 9,34 16,04 0<br />
0126159 VENORUTON FORTE 500 MG 60 CPR P<br />
0 0 15,30 25,67 0<br />
C05CA03 diosmin<br />
0209749 DIOSMIL 300 MG 30 CPR P<br />
0 0 0,00 6,22 0<br />
0147646 DIOSMIL 300 MG 60 CPR P<br />
0 0 0,00 12,05 0<br />
C05CA04 troxerutin<br />
0235931 VEINAMITOL 1 G 14 SACH P<br />
0 0 0,00 8,79 0<br />
0125568 VEINAMITOL 1 G 30 SACH P<br />
0 0 0,00 15,08 0<br />
C05CA54 troxerutin, combinations<br />
0297111 GINKOR FORT 30 SACH P<br />
0 0 0,00 7,86 0<br />
C05CX Other capillary stabilizing agents<br />
0005234 AMPECYCLAL 300 MG 30 CAPS P<br />
0 0 0,00 5,53 0<br />
0005248 AMPECYCLAL 300 MG 90 CAPS P<br />
0 0 0,00 15,74 0<br />
0244135 AMPECYCLAL 600 MG 30 CAPS P<br />
0 0 0,00 9,67 0<br />
0196492 DIFRAREL 100 MG 20 CPR P<br />
0 0 4,34 7,74 0<br />
0196508 DIFRAREL 100 MG 4*20 CPR P<br />
0 0 16,84 30,02 0<br />
0278505 DIFRAREL E 24 CPR P<br />
0 0 4,60 8,20 0<br />
0302421 ESCINOGEL GEL 45 G P<br />
0 0 0,00 2,33 0<br />
0144286 MEDIAVEN 10 MG 100 CPR P<br />
0 0 14,79 25,14 0<br />
0532466 REPARIL DRAGEES 20 MG 20 CPR P<br />
0 0 3,34 5,96 0<br />
0532483 REPARIL DRAGEES 20 MG 50 CPR P<br />
0 0 6,94 12,38 0<br />
0098359 REPARIL GEL N 100 G P<br />
0 0 6,70 11,94 0<br />
0338469 VENOSTASIN CREME 50 G P<br />
0 0 0,00 6,17 0<br />
C07AA05 propranolol<br />
0056474 INDERAL 10 MG 50 CPR R<br />
0 0 1,26 5,91 100<br />
0056507 INDERAL 40 MG 100 CPR R<br />
0 0 3,68 8,76 100<br />
0056569 INDERAL RET 160 MG 56 CAPS R<br />
0 0 8,00 14,14 100<br />
0056572 INDERAL RET MITIS 80 MG 42 CAPS R<br />
0 0 4,48 9,76 100<br />
0246739 INDERAL RET MITIS 80 MG 42 CAPS UD R<br />
0 0 4,70 0,00 0<br />
0167961 PROPRANOLOL EG 40 MG 100 CPR R<br />
0 0 2,78 7,65 100<br />
0167957 PROPRANOLOL RET EG 160 MG 56 CAPS R<br />
0 0 6,08 11,75 100<br />
C07AA07 sotalol<br />
0530203 SOTALEX 160 MG 50 CPR R<br />
0 0 5,36 10,84 100<br />
C07AB02 metoprolol<br />
0211974 METOHEXAL 100 MG 30 CPR R<br />
0 0 1,20 10,40 100<br />
0167281 METOHEXAL 100 MG 50 CPR R<br />
0 0 1,72 10,96 100<br />
Page 53 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0208451 METOHEXAL 50 MG 30 CPR R<br />
0 0 0,00 4,31 100<br />
0167263 METOHEXAL 50 MG 50 CPR R<br />
0 0 1,13 10,33 100<br />
0204336 METOHEXAL RET 200 MG 100 CPR R<br />
0 0 9,55 17,00 100<br />
0208464 METOHEXAL RET 200 MG 30 CPR R<br />
0 0 5,55 9,90 100<br />
0204322 METOHEXAL RET 200 MG 50 CPR R<br />
0 0 6,74 12,00 100<br />
0401576 METOHEXAL SUCC 142,5 MG 100 CPR BLIST R<br />
0 0 0,00 19,97 100<br />
0401559 METOHEXAL SUCC 142,5 MG 30 CPR BLIST R<br />
0 0 0,00 12,00 100<br />
0401562 METOHEXAL SUCC 142,5 MG 50 CPR BLIST R<br />
0 0 0,00 15,00 100<br />
0401711 METOHEXAL SUCC 190 MG 100 CPR BLIST R<br />
0 0 0,00 21,27 100<br />
0401691 METOHEXAL SUCC 190 MG 30 CPR BLIST R<br />
0 0 0,00 12,00 100<br />
0401707 METOHEXAL SUCC 190 MG 50 CPR BLIST R<br />
0 0 0,00 15,74 100<br />
0401173 METOHEXAL SUCC 23,75 MG 100 CPR BLIST R<br />
0 0 3,20 12,59 100<br />
0401142 METOHEXAL SUCC 23,75 MG 30 CPR BLIST R<br />
0 0 0,00 6,30 100<br />
0401156 METOHEXAL SUCC 23,75 MG 50 CPR BLIST R<br />
0 0 1,86 11,12 100<br />
0401304 METOHEXAL SUCC 47,5 MG 100 CPR BLIST R<br />
0 0 4,10 13,57 100<br />
0401285 METOHEXAL SUCC 47,5 MG 30 CPR BLIST R<br />
0 0 0,00 6,30 100<br />
0401299 METOHEXAL SUCC 47,5 MG 50 CPR BLIST R<br />
0 0 0,00 10,00 100<br />
0401451 METOHEXAL SUCC 95 MG 100 CPR BLIST R<br />
0 0 9,26 16,50 100<br />
0401433 METOHEXAL SUCC 95 MG 30 CPR BLIST R<br />
0 0 0,00 9,60 100<br />
0401447 METOHEXAL SUCC 95 MG 50 CPR BLIST R<br />
0 0 0,00 13,00 100<br />
0527581 METOPROLOL EG 100 MG 28 CPR R<br />
0 0 3,16 8,10 100<br />
0527614 METOPROLOL EG 100 MG 56 CPR R<br />
0 0 5,29 10,77 100<br />
0527631 METOPROLOL EG 200 MG 28 CPR R<br />
0 0 4,60 9,91 100<br />
0527662 METOPROLOL EG 200 MG 56 CPR R<br />
0 0 7,38 13,38 100<br />
0213111 METOPROLOL RATIO 100 MG 100 CPR R<br />
0 0 0,00 15,09 100<br />
0213092 METOPROLOL RATIO 100 MG 30 CPR R<br />
0 0 0,00 6,27 100<br />
0213108 METOPROLOL RATIO 100 MG 50 CPR R<br />
0 0 0,00 10,52 100<br />
0213142 METOPROLOL RATIO 50 MG 100 CPR R<br />
0 0 0,00 9,30 100<br />
0213125 METOPROLOL RATIO 50 MG 30 CPR R<br />
0 0 0,00 4,30 100<br />
0213139 METOPROLOL RATIO 50 MG 50 CPR R<br />
0 0 0,00 6,93 100<br />
0237046 PRELIS 200 MG 100 CPR 02191 R<br />
0 0 8,27 17,12 100<br />
0236942 PRELIS 200 MG 30 CPR 02947 R<br />
0 0 0,00 22,34 100<br />
0236956 PRELIS 200 MG 50 CPR 02163 R<br />
0 0 4,94 13,59 100<br />
0103560 SELOKEN 100 MG 100 CPR R<br />
0 0 9,44 15,95 100<br />
0103607 SELOKEN 5 MG 5 AMP 5 ML IV RR<br />
0 0 4,12 7,07 100<br />
0135726 SELOZOK 190 MG 28 CPR R<br />
0 0 7,18 13,12 100<br />
0404971 SELOZOK 25 MG 28 CPR R<br />
0 0 3,61 8,68 100<br />
0152193 SELOZOK 95 MG 28 CPR R<br />
0 0 4,80 10,15 100<br />
0183057 SELOZOK 95 MG 28 CPR UD R<br />
0 0 4,80 0,00 0<br />
C07AB03 atenolol<br />
0155617 ATEHEXAL 100 MG 100 CPR R<br />
0 0 9,21 19,17 100<br />
0208304 ATEHEXAL 100 MG 30 CPR R<br />
0 0 0,00 9,84 100<br />
0155603 ATEHEXAL 100 MG 50 CPR R<br />
0 0 5,04 14,60 100<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0237967 ATENOLOL EG 100 MG 28 CPR R<br />
0 0 4,49 9,77 100<br />
0237971 ATENOLOL EG 100 MG 56 CPR R<br />
0 0 7,55 13,58 100<br />
0237998 ATENOLOL EG 25 MG 28 CPR R<br />
0 0 1,32 5,98 100<br />
0238009 ATENOLOL EG 25 MG 56 CPR R<br />
0 0 2,63 7,44 100<br />
0238026 ATENOLOL EG 50 MG 28 CPR R<br />
0 0 2,49 7,27 100<br />
0238043 ATENOLOL EG 50 MG 56 CPR R<br />
0 0 4,75 10,10 100<br />
0299018 DOCATENO 100 MG 56 CPR R<br />
0 0 6,57 12,19 100<br />
0298993 DOCATENO 50 MG 56 CPR R<br />
0 0 4,25 9,30 100<br />
0215844 TENORMIN 100 MG 56 CPR R<br />
0 0 11,86 18,96 100<br />
0229786 TENORMIN 100 MG 56 CPR UD R<br />
0 0 11,86 0,00 0<br />
0219695 TENORMIN MINOR 25 MG 56 CPR R<br />
0 0 3,47 8,50 100<br />
0231851 TENORMIN MINOR 25 MG 56 CPR UD R<br />
0 0 3,47 0,00 0<br />
0215827 TENORMIN MITIS 50 MG 56 CPR R<br />
0 0 6,59 12,39 100<br />
0320853 TENORMIN MITIS 50 MG 56 CPR UD R<br />
0 0 6,59 0,00 0<br />
C07AB04 acebutolol<br />
0102966 SECTRAL 400 MG 28 CPR R<br />
0 0 6,68 12,50 100<br />
0102983 SECTRAL 400 MG 70 CPR R<br />
0 0 12,55 19,81 100<br />
0150378 SECTRAL GE 200 MG 28 CPR R<br />
0 0 4,08 9,14 100<br />
0150381 SECTRAL GE 200 MG 56 CPR R<br />
0 0 6,03 11,68 100<br />
C07AB05 betaxolol<br />
0204742 KERLON 20 MG 28 CPR R<br />
0 0 6,38 12,02 100<br />
0204756 KERLON 20 MG 56 CPR R<br />
0 0 10,21 16,90 100<br />
C07AB07 bisoprolol<br />
0301584 BISOPROLOL EG 10 MG 28 CPR R<br />
0 0 4,89 10,27 100<br />
0301598 BISOPROLOL EG 10 MG 56 CPR R<br />
0 0 6,22 11,92 100<br />
0301567 BISOPROLOL EG 5 MG 28 CPR R<br />
0 0 2,65 7,48 100<br />
0301571 BISOPROLOL EG 5 MG 56 CPR R<br />
0 0 3,42 8,43 100<br />
0024579 CONCOR 10 MG 100 CPR R<br />
0 0 14,62 25,08 100<br />
0024551 CONCOR 10 MG 30 CPR R<br />
0 0 6,26 15,93 100<br />
0024601 CONCOR 5 MG 100 CPR R<br />
0 0 9,31 19,27 100<br />
0024582 CONCOR 5 MG 30 CPR R<br />
0 0 4,42 13,93 100<br />
0273588 CONCOR COR 2,5 MG 100 CPR R<br />
0 0 5,87 15,50 100<br />
0273561 CONCOR COR 2,5 MG 30 CPR R<br />
0 0 2,95 12,31 100<br />
C07AB08 celiprolol<br />
0137099 SELECTOL 200 MG 28 CPR R<br />
0 0 3,87 8,99 100<br />
0137104 SELECTOL 200 MG 56 CPR R<br />
0 0 6,20 11,89 100<br />
0226297 SELECTOL 400 MG 28 CPR R<br />
0 0 6,20 11,89 100<br />
C07AB09 esmolol<br />
0607679 BREVIBLOC 100 MG 5 FL V 10 ML IV RR HC<br />
0 0 8,33 0,00 0<br />
C07AB12 nebivolol<br />
0486539 NEBIVOLOL EG 5 MG 28 CPR R<br />
0 0 6,02 11,67 100<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
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0486573 NEBIVOLOL EG 5 MG 56 CPR R<br />
0 0 8,54 14,71 100<br />
0486591 NEBIVOLOL EG 5 MG 98 CPR R<br />
0 0 13,28 0,00 0<br />
0495264 NEBIVOLOL HEXAL 5 MG 100 CPR R<br />
0 0 0,00 12,85 100<br />
0495183 NEBIVOLOL HEXAL 5 MG 30 CPR R<br />
0 0 0,00 10,05 100<br />
0495197 NEBIVOLOL HEXAL 5 MG 50 CPR R<br />
0 0 0,00 10,95 100<br />
0530508 NOBITEN 5 MG 100 CPR R<br />
0 0 19,34 27,70 100<br />
0628701 NOBITEN 5 MG 100 CPR UD R<br />
0 0 19,34 0,00 0<br />
0306482 NOBITEN 5 MG 28 CPR R<br />
0 0 6,78 12,63 100<br />
0306496 NOBITEN 5 MG 56 CPR R<br />
0 0 10,82 17,66 100<br />
0306501 NOBITEN 5 MG 56 CPR UD R<br />
0 0 19,76 0,00 0<br />
C07AG01 labetalol<br />
0118756 TRANDATE 100 MG 5 AMP 20 ML IV RR<br />
0 0 12,30 0,00 0<br />
0118725 TRANDATE 100 MG 75 CPR R<br />
0 0 6,41 12,17 100<br />
0118739 TRANDATE 200 MG 75 CPR R<br />
0 0 10,26 16,97 100<br />
C07AG02 carvedilol<br />
0396249 CARVEDILOL EG 25 MG 56 CPR R<br />
0 0 8,79 15,13 100<br />
0395093 CARVEDILOL EG 6,25 MG 56 CPR R<br />
0 0 2,88 7,75 100<br />
0356534 CARVEDILOL RATIO 25 MG 60 CPR BLIST R<br />
0 0 17,49 27,92 0<br />
0356601 CARVEDILOL RATIO 6,25 MG 14 CPR R<br />
0 0 0,00 3,41 0<br />
0356663 CARVEDILOL RATIO 6,25 MG 60 CPR R<br />
0 0 0,00 11,25 0<br />
0171669 DIMITONE 25 MG 56 CPR R<br />
0 0 11,97 19,09 100<br />
0376781 DOCCARVEDILOL 25 MG 56 CPR R<br />
0 0 11,97 18,99 100<br />
0376604 DOCCARVEDILOL 6,25 MG 56 CPR R<br />
0 0 2,69 7,35 100<br />
0234092 KREDEX 12,5 MG 14 CPR R<br />
0 0 1,95 6,67 100<br />
0164549 KREDEX 25 MG 56 CPR R<br />
0 0 11,97 19,09 100<br />
0234089 KREDEX 6,25 MG 56 CPR R<br />
0 0 3,90 9,05 100<br />
C07BB Beta blocking agents, selective, and thiazi<strong>des</strong><br />
0522831 NOBIRETIC 5/12,5 MG 28 CPR R<br />
0 0 12,35 19,57 100<br />
0522859 NOBIRETIC 5/12,5 MG 56 CPR R<br />
0 0 19,76 28,16 100<br />
0522862 NOBIRETIC 5/12,5 MG 90 CPR R<br />
0 0 31,75 41,37 100<br />
0522909 NOBIRETIC 5/25 MG 28 CPR R<br />
0 0 12,35 19,57 100<br />
0522926 NOBIRETIC 5/25 MG 56 CPR R<br />
0 0 19,76 28,16 100<br />
0522943 NOBIRETIC 5/25 MG 90 CPR R<br />
0 0 31,75 41,37 100<br />
C07BB02 metoprolol and thiazi<strong>des</strong><br />
0193281 METOHEXAL COMP 100 CPR R<br />
0 0 0,00 17,20 100<br />
0193263 METOHEXAL COMP 30 CPR R<br />
0 0 1,40 10,61 100<br />
0193277 METOHEXAL COMP 50 CPR R<br />
0 0 0,00 11,72 100<br />
0206121 ZOKZID 28 CPR R<br />
0 0 4,49 9,77 100<br />
C07BB04 acebutolol and thiazi<strong>des</strong><br />
0102997 SECTRAZIDE 28 CPR R<br />
0 0 7,78 13,88 100<br />
0103008 SECTRAZIDE 70 CPR R<br />
0 0 15,27 23,20 100<br />
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délivrance prescription<br />
C07BB07 bisoprolol and thiazi<strong>des</strong><br />
0348272 COBISOPROLOL EG 10/25 MG 28 CPR R<br />
0 0 4,26 9,48 100<br />
0348319 COBISOPROLOL EG 10/25 MG 56 CPR R<br />
0 0 5,58 11,14 100<br />
0348031 COBISOPROLOL EG 5/12,5 MG 28 CPR R<br />
0 0 2,69 7,52 100<br />
0348062 COBISOPROLOL EG 5/12,5 MG 56 CPR R<br />
0 0 3,09 8,03 100<br />
0194968 CONCOR 10 PLUS 30 CPR R<br />
0 0 7,81 17,63 100<br />
0194937 CONCOR 5 PLUS 30 CPR R<br />
0 0 4,51 14,02 100<br />
C07CB02 metoprolol and other diuretics<br />
0237032 PRELIS COMP 100 CPR 02206 R<br />
0 0 114,13 129,42 80<br />
0236746 PRELIS COMP 30 CPR 02949 R<br />
0 0 0,00 51,59 80<br />
0236763 PRELIS COMP 50 CPR 02203 R<br />
0 0 60,77 72,81 80<br />
C07CB03 atenolol and other diuretics<br />
0238061 ATENOLOL/CHLORTALIDONE EG 28 CPR R<br />
0 0 4,38 9,63 100<br />
0238074 ATENOLOL/CHLORTALIDONE EG 56 CPR R<br />
0 0 8,77 15,11 100<br />
0218622 TENORETIC 100/25 56 CPR R<br />
0 0 12,71 20,03 100<br />
0218653 TENORETIC MITIS 50/12,5 56 CPR R<br />
0 0 7,12 13,05 100<br />
C07FB02 metoprolol and other antihypertensives<br />
0209007 LOGIMAT 10 MG 28 CPR PL R<br />
0 0 4,30 9,54 100<br />
0208996 LOGIMAT 5 MG 28 CPR PL R<br />
0 0 2,69 7,52 100<br />
C07FB03 atenolol and other antihypertensives<br />
0154394 TENIF 28 CAPS R<br />
0 0 6,61 12,41 100<br />
C08CA01 amlodipine<br />
0445388 AMLODIPIN HEXAL 10 MG 100 CPR R<br />
0 0 0,00 14,02 0<br />
0445309 AMLODIPIN HEXAL 10 MG 100 CPR BLIST R<br />
0 0 5,39 14,98 100<br />
0445343 AMLODIPIN HEXAL 10 MG 20 CPR R<br />
0 0 0,00 9,58 0<br />
0445245 AMLODIPIN HEXAL 10 MG 20 CPR BLIST R<br />
0 0 1,17 10,37 100<br />
0445361 AMLODIPIN HEXAL 10 MG 50 CPR R<br />
0 0 0,00 11,47 0<br />
0445276 AMLODIPIN HEXAL 10 MG 50 CPR BLIST R<br />
0 0 0,00 11,47 100<br />
0445777 AMLODIPIN HEXAL 5 MG 100 CPR R<br />
0 0 0,00 12,40 0<br />
0445696 AMLODIPIN HEXAL 5 MG 100 CPR BLIST R<br />
0 0 3,81 13,26 100<br />
0445729 AMLODIPIN HEXAL 5 MG 20 CPR R<br />
0 0 0,00 8,00 0<br />
0445648 AMLODIPIN HEXAL 5 MG 20 CPR BLIST R<br />
0 0 0,66 8,00 100<br />
0445746 AMLODIPIN HEXAL 5 MG 50 CPR R<br />
0 0 0,00 10,67 0<br />
0445679 AMLODIPIN HEXAL 5 MG 50 CPR BLIST R<br />
0 0 1,96 11,23 100<br />
0445584 AMLODIPIN HEXAL 7,5 MG 100 CPR R<br />
0 0 0,00 13,63 0<br />
0445505 AMLODIPIN HEXAL 7,5 MG 100 CPR BLIST R<br />
0 0 0,00 13,63 100<br />
0445536 AMLODIPIN HEXAL 7,5 MG 20 CPR R<br />
0 0 0,00 9,50 0<br />
0445441 AMLODIPIN HEXAL 7,5 MG 20 CPR BLIST R<br />
0 0 0,00 9,50 100<br />
0445567 AMLODIPIN HEXAL 7,5 MG 50 CPR R<br />
0 0 0,00 11,10 0<br />
0445472 AMLODIPIN HEXAL 7,5 MG 50 CPR BLIST R<br />
0 0 0,00 11,10 100<br />
0491508 AMLODIPIN N RATIO 10 MG 100 CPR R<br />
0 0 3,31 12,70 100<br />
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délivrance prescription<br />
0491427 AMLODIPIN N RATIO 10 MG 20 CPR R<br />
0 0 0,85 9,57 100<br />
0491458 AMLODIPIN N RATIO 10 MG 50 CPR R<br />
0 0 1,84 11,10 100<br />
0491329 AMLODIPIN N RATIO 5 MG 100 CPR R<br />
0 0 2,38 11,68 100<br />
0491248 AMLODIPIN N RATIO 5 MG 20 CPR R<br />
0 0 0,61 8,00 100<br />
0491279 AMLODIPIN N RATIO 5 MG 50 CPR R<br />
0 0 1,32 10,42 100<br />
0466732 AMLODIPINE BESILATE EG 10 MG 100 CPR R<br />
0 0 20,49 28,98 100<br />
0466679 AMLODIPINE BESILATE EG 10 MG 30 CPR R<br />
0 0 6,48 12,24 100<br />
0466536 AMLODIPINE BESILATE EG 5 MG 28 CPR R<br />
0 0 5,57 11,13 100<br />
0466571 AMLODIPINE BESILATE EG 5 MG 56 CPR R<br />
0 0 6,94 12,83 100<br />
0466598 AMLODIPINE BESILATE EG 5 MG 98 CPR R<br />
0 0 15,49 23,47 100<br />
0418993 AMLODIPINE EG 10 MG 100 CPR R<br />
0 0 20,49 28,98 0<br />
0418895 AMLODIPINE EG 10 MG 30 CPR R<br />
0 0 6,48 12,24 0<br />
0418671 AMLODIPINE EG 5 MG 28 CPR R<br />
0 0 5,57 11,13 0<br />
0418718 AMLODIPINE EG 5 MG 56 CPR R<br />
0 0 6,94 12,83 0<br />
0418766 AMLODIPINE EG 5 MG 98 CPR R<br />
0 0 15,49 23,47 0<br />
0512061 AMLOGAL DIVULE 10 MG 28 CPR R<br />
0 0 9,61 16,03 0<br />
0512074 AMLOGAL DIVULE 10 MG 98 CPR R<br />
0 0 25,76 34,60 0<br />
0590019 AMLOR 10 MG 100 CAPS R<br />
0 0 27,48 36,67 100<br />
0158314 AMLOR 10 MG 30 CAPS R<br />
0 0 10,30 17,01 100<br />
0291461 AMLOR 10 MG 30 CAPS UD R<br />
0 0 11,17 0,00 0<br />
0158301 AMLOR 5 MG 28 CAPS R<br />
0 0 6,01 11,66 100<br />
0589991 AMLOR 5 MG 56 CAPS R<br />
0 0 9,62 16,16 100<br />
C08CA02 felodipine<br />
0325409 FELODIPIN RATIO 10 MG 20 CPR PL R<br />
0 0 0,00 9,32 100<br />
0325412 FELODIPIN RATIO 10 MG 50 CPR PL R<br />
0 0 12,78 21,40 100<br />
0325362 FELODIPIN RATIO 5 MG 20 CPR PL R<br />
0 0 0,00 5,91 100<br />
0325376 FELODIPIN RATIO 5 MG 50 CPR PL R<br />
0 0 9,23 17,97 100<br />
0333333 FELODIPINE EG 10 MG 28 CPR PL R<br />
0 0 5,76 11,35 100<br />
0333171 FELODIPINE EG 5 MG 28 CPR PL R<br />
0 0 3,48 8,51 100<br />
0239931 PLENDIL RET 10 MG 28 CPR R<br />
0 0 9,55 16,08 100<br />
0239894 PLENDIL RET 5 MG 28 CPR R<br />
0 0 5,95 11,59 100<br />
0143681 RENEDIL 10 MG 28 CPR PL R<br />
0 0 9,89 16,38 0<br />
0151331 RENEDIL 5 MG 28 CPR PL R<br />
0 0 6,49 12,15 0<br />
C08CA04 nicardipine<br />
0192865 RYDENE 5 MG 10 AMP 5 ML IV RR H<br />
0 0 41,64 0,00 0<br />
0181151 RYDENE RET 45 MG 60 CAPS R<br />
0 0 14,41 22,14 100<br />
C08CA05 nifedipine<br />
0183544 ADALAT OROS 30 MG 28 CPR R<br />
0 0 6,54 12,33 100<br />
0380141 ADALAT OROS 60 MG 56 CPR R<br />
0 0 20,19 28,64 100<br />
0000787 ADALAT RET 20 MG 30 CPR R<br />
0 0 5,04 10,46 100<br />
0260755 HYPAN 40 MG 28 CPR R<br />
0 0 8,47 14,73 100<br />
0260769 HYPAN 40 MG 56 CPR R<br />
0 0 13,38 20,86 100<br />
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délivrance prescription<br />
0078633 NIFEDIPIN RATIO 10 MG 100 CAPS R<br />
0 0 6,78 12,09 100<br />
0078602 NIFEDIPIN RATIO 10 MG 30 CAPS R<br />
0 0 0,00 6,00 100<br />
0078616 NIFEDIPIN RATIO 10 MG 50 CAPS R<br />
0 0 0,00 7,99 100<br />
0135953 NIFEDIPIN RATIO 20 MG/ML GTTS 30 ML R<br />
0 0 0,00 8,12 100<br />
0156032 NIFEDIPIN RATIO GTTS 100 ML R<br />
0 0 12,49 22,26 100<br />
C08CA06 nimodipine<br />
0078762 NIMOTOP 10 MG 1 FL 50 ML PERF RR H<br />
0 0 9,01 0,00 0<br />
0078759 NIMOTOP 30 MG 50 CPR R<br />
0 0 12,31 19,52 0<br />
C08CA07 nisoldipine<br />
0237824 SULAR 10 MG 28 CPR R<br />
0 0 7,78 13,88 100<br />
0246001 SULAR 10 MG 56 CPR R<br />
0 0 12,46 19,71 100<br />
0259866 SULAR 10 MG 56 CPR UD R<br />
0 0 12,46 0,00 0<br />
0237838 SULAR 20 MG 28 CPR R<br />
0 0 12,46 19,71 100<br />
0246014 SULAR 20 MG 56 CPR R<br />
0 0 19,93 28,34 100<br />
0259883 SULAR 20 MG 56 CPR UD R<br />
0 0 25,21 0,00 0<br />
0231011 SYSCOR 10 MG 28 CPR PL R<br />
0 0 7,78 13,88 100<br />
0231025 SYSCOR 20 MG 28 CPR PL R<br />
0 0 12,46 19,71 100<br />
C08CA08 nitrendipine<br />
0011116 BAYPRESS 20 MG 14 CPR R<br />
0 0 6,20 11,89 100<br />
0011133 BAYPRESS MITIS 10 MG 28 CPR R<br />
0 0 6,20 11,89 100<br />
C08CA09 lacidipine<br />
0181696 MOTENS 4 MG 28 CPR R<br />
0 0 8,59 14,89 100<br />
0230238 MOTENS 4 MG 50 CPR UD R<br />
0 0 23,06 0,00 0<br />
C08CA12 barnidipine<br />
0288675 VASEXTEN 10 MG 28 CAPS R<br />
0 0 12,93 20,17 100<br />
0288689 VASEXTEN 10 MG 56 CAPS R<br />
0 0 20,69 29,07 100<br />
0288692 VASEXTEN 20 MG 28 CAPS R<br />
0 0 20,86 29,26 100<br />
0288708 VASEXTEN 20 MG 56 CAPS R<br />
0 0 33,38 43,06 100<br />
C08CA13 lercanidipine<br />
0566948 LERCANIDIPINE EG 10 MG 28 CPR R<br />
0 0 5,40 10,91 100<br />
0566996 LERCANIDIPINE EG 10 MG 98 CPR R<br />
0 0 13,35 20,81 100<br />
0567055 LERCANIDIPINE EG 20 MG 28 CPR R<br />
0 0 9,79 16,37 100<br />
0567119 LERCANIDIPINE EG 20 MG 98 CPR R<br />
0 0 20,96 29,49 100<br />
0228941 ZANIDIP 10 MG 28 CPR R<br />
0 0 5,93 11,56 100<br />
0524853 ZANIDIP 10 MG 56 CPR R<br />
0 0 10,55 17,33 100<br />
0376845 ZANIDIP 20 MG 28 CPR R<br />
0 0 10,01 16,65 100<br />
0524867 ZANIDIP 20 MG 56 CPR R<br />
0 0 16,01 24,04 100<br />
C08DA01 verapamil<br />
0059817 ISOPTIN 120 MG 100 DRG R<br />
0 0 7,41 17,19 100<br />
0059803 ISOPTIN 120 MG 50 DRG R<br />
0 0 4,27 13,75 100<br />
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délivrance prescription<br />
0059834 ISOPTIN 80 MG 100 DRG R<br />
0 0 5,05 14,62 100<br />
0059820 ISOPTIN 80 MG 50 DRG R<br />
0 0 2,90 12,26 100<br />
0182971 ISOPTIN KHK RET 120 MG 100 CPR R<br />
0 0 10,65 20,75 100<br />
0182967 ISOPTIN KHK RET 120 MG 50 CPR R<br />
0 0 5,71 15,34 100<br />
0059882 ISOPTIN MITE 40 MG 100 DRG R<br />
0 0 2,66 11,99 100<br />
0059879 ISOPTIN MITE 40 MG 50 DRG R<br />
0 0 1,57 10,80 100<br />
0059896 ISOPTIN RR RET 240 MG 50 CPR R<br />
0 0 10,69 20,78 100<br />
0328753 ISOPTIN RR RET 240 MG 98 CPR R<br />
0 0 19,17 30,05 100<br />
C08DA51 verapamil, combinations<br />
0392317 TARKA 180/2 MG 28 CPR R<br />
0 0 17,24 27,94 100<br />
0392334 TARKA 180/2 MG 98 CPR R<br />
0 0 51,82 65,79 100<br />
C08DB01 diltiazem<br />
0191501 DILTAHEXAL RET 90 MG 100 CPR R<br />
0 0 5,65 15,28 100<br />
0191496 DILTAHEXAL RET 90 MG 50 CPR R<br />
0 0 0,00 12,14 100<br />
0253151 PROGOR 120 MG 28 CAPS R<br />
0 0 3,56 8,50 100<br />
0253165 PROGOR 180 MG 28 CAPS R<br />
0 0 5,02 10,31 100<br />
0364567 PROGOR 180 MG 56 CAPS R<br />
0 0 6,59 12,28 100<br />
0253179 PROGOR 240 MG 28 CAPS R<br />
0 0 6,08 11,64 100<br />
0488578 PROGOR 240 MG 56 CAPS R<br />
0 0 9,72 16,18 100<br />
0231333 PROGOR 300 MG 28 CAPS PL R<br />
0 0 6,64 12,34 100<br />
0364553 PROGOR 300 MG 56 CAPS R<br />
0 0 10,88 17,63 100<br />
0253182 PROGOR 360 MG 28 CAPS R<br />
0 0 7,47 13,37 100<br />
0116992 TILDIEM 60 MG 100 CPR R<br />
0 0 7,23 13,19 100<br />
0116989 TILDIEM 60 MG 50 CPR R<br />
0 0 4,82 10,07 100<br />
0231896 TILDIEM RET 200 MG 28 CAPS R<br />
0 0 8,03 14,19 100<br />
0180641 TILDIEM RET 300 MG 28 CAPS R<br />
0 0 9,69 16,26 100<br />
0241522 VIAZEM 120 MG 30 CAPS R<br />
0 0 0,00 12,88 100<br />
0241536 VIAZEM 180 MG 30 CAPS R<br />
0 0 0,00 18,10 100<br />
0241553 VIAZEM 240 MG 30 CAPS R<br />
0 0 0,00 21,94 100<br />
0241567 VIAZEM 300 MG 30 CAPS R<br />
0 0 0,00 24,94 100<br />
0241571 VIAZEM 360 MG 30 CAPS R<br />
0 0 15,77 26,92 100<br />
C09AA01 captopril<br />
0230577 CAPOTEN 25 MG 60 CPR R<br />
0 0 11,35 18,33 100<br />
0230581 CAPOTEN 50 MG 60 CPR R<br />
0 0 17,92 26,13 100<br />
0214184 CAPTOHEXAL 25 MG 100 CPR R<br />
0 0 1,90 11,17 100<br />
0214167 CAPTOHEXAL 25 MG 20 CPR R<br />
0 0 0,00 4,21 100<br />
0214171 CAPTOHEXAL 25 MG 50 CPR R<br />
0 0 0,00 6,22 100<br />
0214217 CAPTOHEXAL 50 MG 100 CPR R<br />
0 0 2,86 12,21 100<br />
0214198 CAPTOHEXAL 50 MG 20 CPR R<br />
0 0 0,00 5,40 100<br />
0214203 CAPTOHEXAL 50 MG 50 CPR R<br />
0 0 0,00 9,84 100<br />
0214248 CAPTOHEXAL COR 12,5 MG 100 CPR R<br />
0 0 0,00 7,31 100<br />
0214221 CAPTOHEXAL COR 12,5 MG 20 CPR R<br />
0 0 0,00 2,95 100<br />
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délivrance prescription<br />
0214234 CAPTOHEXAL COR 12,5 MG 50 CPR R<br />
0 0 0,00 4,24 100<br />
0451385 CAPTOPRIL EG 100 MG 30 CPR R<br />
0 0 9,38 15,87 100<br />
0451404 CAPTOPRIL EG 100 MG 60 CPR R<br />
0 0 15,05 22,94 100<br />
0455949 CAPTOPRIL EG 25 MG 60 CPR R<br />
0 0 5,46 10,98 100<br />
0482414 CAPTOPRIL EG 50 MG 60 CPR R<br />
0 0 8,54 14,82 100<br />
0314565 CAPTOPRIL RATIO 25 MG 45 CPR R<br />
0 0 0,00 13,52 0<br />
0304149 CAPTOPRIL RATIO 25 MG 60 CPR R<br />
0 0 0,00 17,77 0<br />
0314579 CAPTOPRIL RATIO 50 MG 45 CPR R<br />
0 0 0,00 20,09 0<br />
0304278 CAPTOPRIL RATIO 50 MG 60 CPR R<br />
0 0 0,00 23,49 0<br />
0298851 DOCCAPTOPRI 100 MG 30 CPR R<br />
0 0 3,98 8,96 100<br />
0298864 DOCCAPTOPRI 100 MG 60 CPR R<br />
0 0 15,14 22,86 100<br />
0298816 DOCCAPTOPRI 25 MG 60 CPR R<br />
0 0 5,06 10,31 100<br />
0298847 DOCCAPTOPRI 50 MG 60 CPR R<br />
0 0 8,43 14,57 100<br />
C09AA02 enalapril<br />
0098233 RENITEC 20 MG 28 CPR R<br />
0 0 4,96 10,35 100<br />
0229917 RENITEC 20 MG 56 CPR R<br />
0 0 7,95 14,08 100<br />
0252851 RENITEC 20 MG 98 CPR R<br />
0 0 13,83 21,42 100<br />
0098247 RENITEC 5 MG 28 CPR R<br />
0 0 1,50 6,17 100<br />
C09AA03 lisinopril<br />
0351829 LISINOPRIL EG 20 MG 28 CPR R<br />
0 0 5,88 11,50 100<br />
0351863 LISINOPRIL EG 20 MG 56 CPR R<br />
0 0 10,00 16,64 100<br />
0351881 LISINOPRIL EG 20 MG 98 CPR R<br />
0 0 20,58 29,06 100<br />
0351671 LISINOPRIL EG 5 MG 28 CPR R<br />
0 0 1,83 6,53 100<br />
0351703 LISINOPRIL EG 5 MG 56 CPR R<br />
0 0 3,17 8,12 100<br />
0309274 LISINOPRIL RATIO 20 MG 100 CPR R<br />
0 0 4,38 13,43 100<br />
0309257 LISINOPRIL RATIO 20 MG 30 CPR R<br />
0 0 1,66 10,30 100<br />
0309261 LISINOPRIL RATIO 20 MG 50 CPR R<br />
0 0 2,48 11,27 100<br />
0309338 LISINOPRIL RATIO 5 MG 100 CPR R<br />
0 0 2,17 11,46 100<br />
0309311 LISINOPRIL RATIO 5 MG 30 CPR R<br />
0 0 0,84 5,99 100<br />
0309324 LISINOPRIL RATIO 5 MG 50 CPR R<br />
0 0 1,26 10,46 100<br />
0146201 ZESTRIL 20 MG 28 CPR R<br />
0 0 6,22 11,92 100<br />
0211571 ZESTRIL 20 MG 56 CPR R<br />
0 0 12,44 19,69 100<br />
0328509 ZESTRIL 20 MG 56 CPR UD R<br />
0 0 12,44 0,00 0<br />
0146196 ZESTRIL 5 MG 28 CPR R<br />
0 0 1,94 6,66 100<br />
0246791 ZESTRIL 5 MG 28 CPR UD R<br />
0 0 1,94 0,00 0<br />
C09AA04 perindopril<br />
0406278 COVERSYL 10 MG 60 CPR R<br />
0 0 25,12 34,07 100<br />
0406281 COVERSYL 10 MG 90 CPR R<br />
0 0 34,59 44,49 100<br />
0279709 COVERSYL 4 MG 30 CPR UD R<br />
0 0 7,91 0,00 0<br />
0406121 COVERSYL 5 MG 30 CPR R<br />
0 0 7,11 13,04 100<br />
0406152 COVERSYL 5 MG 90 CPR R<br />
0 0 17,39 25,56 100<br />
0353581 COVERSYL 8 MG 100 CPR R<br />
0 0 46,64 58,94 0<br />
Page 61 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
C09AA05 ramipril<br />
0365922 TRITACE 10 MG 28 CPR BLIST R<br />
0 0 11,56 18,58 100<br />
0492781 TRITACE 10 MG 50 CPR UD R<br />
0 0 16,51 0,00 0<br />
0368471 TRITACE 10 MG 56 CPR R<br />
0 0 22,70 33,28 0<br />
0196928 TRITACE 2,5 MG 28 CPR R<br />
0 0 3,62 8,69 100<br />
0196931 TRITACE 5 MG 28 CPR R<br />
0 0 6,42 12,18 100<br />
0492777 TRITACE 5 MG 50 CPR UD R<br />
0 0 9,18 0,00 0<br />
0241987 TRITACE 5 MG 56 CPR R<br />
0 0 12,30 21,12 0<br />
C09AA06 quinapril<br />
0163881 ACCUPRIL 20 MG 28 CPR R<br />
0 0 5,32 10,81 100<br />
0249663 ACCUPRIL 20 MG 28 CPR UD R<br />
0 0 5,77 0,00 0<br />
0273087 ACCUPRIL 40 MG 56 CPR R<br />
0 0 19,35 27,71 100<br />
0286846 ACCUPRIL 40 MG 56 CPR UD R<br />
0 0 20,98 0,00 0<br />
0163877 ACCUPRIL 5 MG 28 CPR R<br />
0 0 1,66 6,35 100<br />
0248117 ACCUPRIL 5 MG 28 CPR UD R<br />
0 0 1,80 0,00 0<br />
0412499 QUINAPRIL EG 20 MG 28 CPR R<br />
0 0 5,27 10,75 100<br />
0412521 QUINAPRIL EG 20 MG 56 CPR R<br />
0 0 9,25 15,71 100<br />
0412275 QUINAPRIL EG 5 MG 28 CPR R<br />
0 0 1,64 6,33 100<br />
0412308 QUINAPRIL EG 5 MG 56 CPR R<br />
0 0 2,88 7,75 100<br />
C09AA07 benazepril<br />
0215181 CIBACEN 10 MG 28 CPR R<br />
0 0 5,94 10,58 100<br />
0236584 CIBACEN 10 MG 280 CPR R<br />
0 0 10,64 0,00 0<br />
0236567 CIBACEN 10 MG 42 CPR R<br />
0 0 6,48 11,54 100<br />
0236571 CIBACEN 10 MG 98 CPR R<br />
0 0 8,46 15,08 100<br />
0254811 CIBACEN 20 MG 28 CPR R<br />
0 0 6,43 11,47 100<br />
0254825 CIBACEN 20 MG 42 CPR R<br />
0 0 7,20 12,82 100<br />
0257116 CIBACEN 20 MG 98 CPR R<br />
0 0 9,96 17,74 100<br />
0215178 CIBACEN 5 MG 28 CPR R<br />
0 0 5,56 9,90 100<br />
0236201 CIBACEN 5 MG 280 CPR R<br />
0 0 61,55 0,00 0<br />
0236181 CIBACEN 5 MG 42 CPR R<br />
0 0 5,93 10,56 100<br />
0236195 CIBACEN 5 MG 98 CPR R<br />
0 0 7,32 13,05 100<br />
C09AA08 cilazapril<br />
0523582 INHIBACE 0,5 MG 30 CPR SEC R<br />
0 0 1,95 6,67 100<br />
0182192 INHIBACE 5 MG 28 CPR SEC R<br />
0 0 10,14 16,81 100<br />
C09AA09 fosinopril<br />
0185021 FOSINIL 20 MG 28 CPR R<br />
0 0 13,55 21,07 100<br />
C09AA10 trandolapril<br />
0425953 UDRIK 2 MG 100 CAPS R<br />
0 0 14,85 24,24 100<br />
0425922 UDRIK 2 MG 20 CAPS R<br />
0 0 0,00 10,40 100<br />
C09BA02 enalapril and diuretics<br />
Page 62 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0350558 CO ENALAPRIL EG 20/12,5 MG 28 CPR R<br />
0 0 3,10 8,05 0<br />
0350589 CO ENALAPRIL EG 20/12,5 MG 56 CPR R<br />
0 0 4,35 9,59 0<br />
0350625 CO ENALAPRIL EG 20/12,5 MG 98 CPR R<br />
0 0 7,71 13,79 0<br />
0247963 CO RENITEC 56 CPR R<br />
0 0 8,18 14,37 100<br />
0252834 CO RENITEC 98 CPR R<br />
0 0 14,32 22,02 100<br />
C09BA03 lisinopril and diuretics<br />
0420053 COLISINOPRIL EG 20/12,5 MG 28 CPR R<br />
0 0 6,11 11,80 100<br />
0420098 COLISINOPRIL EG 20/12,5 MG 56 CPR R<br />
0 0 8,60 14,90 100<br />
0358184 LISINOPRIL RATIO COMP 10/12,5 MG 100 CPR R<br />
0 0 19,36 0,00 0<br />
0358153 LISINOPRIL RATIO COMP 10/12,5 MG 30 CPR R<br />
0 0 0,00 6,95 100<br />
0358167 LISINOPRIL RATIO COMP 10/12,5 MG 50 CPR R<br />
0 0 7,54 13,44 100<br />
0358072 LISINOPRIL RATIO COMP 20/12,5 MG 100 CPR R<br />
0 0 22,72 0,00 0<br />
0358024 LISINOPRIL RATIO COMP 20/12,5 MG 30 CPR R<br />
0 0 6,50 11,58 100<br />
0358038 LISINOPRIL RATIO COMP 20/12,5 MG 50 CPR R<br />
0 0 7,92 14,12 100<br />
0166798 ZESTORETIC 28 CPR R<br />
0 0 6,53 12,31 100<br />
0248084 ZESTORETIC 56 CPR R<br />
0 0 13,06 20,45 100<br />
0262875 ZESTORETIC 56 CPR UD R<br />
0 0 13,06 0,00 0<br />
C09BA04 perindopril and diuretics<br />
0544261 COVERSYL PLUS 10/2,5 MG 60 CPR (FL) R<br />
0 0 24,11 32,96 100<br />
0544274 COVERSYL PLUS 10/2,5 MG 90 CPR (FL) R<br />
0 0 33,24 43,02 100<br />
0471987 COVERSYL PLUS 2,5/0,625 MG 30 CPR R<br />
0 0 11,33 18,12 100<br />
0472029 COVERSYL PLUS 2,5/0,625 MG 90 CPR R<br />
0 0 27,21 36,20 100<br />
0436568 COVERSYL PLUS 4/1,25 MG 30 CPR R<br />
0 0 11,33 18,12 100<br />
0471875 COVERSYL PLUS 5/1,25 MG 30 CPR R<br />
0 0 10,05 16,70 100<br />
0471911 COVERSYL PLUS 5/1,25 MG 90 CPR R<br />
0 0 24,13 32,98 100<br />
0471763 PRETERAX 2,5/0,625 MG 30 CPR R<br />
0 0 15,55 25,93 0<br />
0471813 PRETERAX 2,5/0,625 MG 90 CPR R<br />
0 0 37,16 48,89 0<br />
0252445 PRETERAX 2/0,625 MG 30 CPR SEC R<br />
0 0 10,33 16,87 80<br />
0471651 PRETERAX 5/1,25 MG 30 CPR R<br />
0 0 17,06 27,48 0<br />
0471696 PRETERAX 5/1,25 MG 90 CPR R<br />
0 0 40,76 52,71 0<br />
C09BA05 ramipril and diuretics<br />
0209038 TRITAZIDE 28 CPR R<br />
0 0 6,94 12,83 100<br />
0230627 TRITAZIDE 56 CPR R<br />
0 0 11,09 18,00 100<br />
C09BA06 quinapril and diuretics<br />
0197201 ACCURETIC 10/12,5 28 CPR R<br />
0 0 4,60 9,91 80<br />
0197214 ACCURETIC 20/12,5 28 CPR R<br />
0 0 5,95 11,59 100<br />
0419763 COQUINAPRIL 20/12,5 MG 28 CPR R<br />
0 0 4,76 10,11 100<br />
0419813 COQUINAPRIL 20/12,5 MG 56 CPR R<br />
0 0 8,14 14,31 100<br />
C09BA07 benazepril and diuretics<br />
0254842 CIBADREX 10/12,5 MG 28 CPR R<br />
0 0 0,00 12,22 100<br />
0254856 CIBADREX 10/12,5 MG 42 CPR R<br />
0 0 0,00 14,42 100<br />
Page 63 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0254873 CIBADREX 10/12,5 MG 98 CPR R<br />
0 0 0,00 23,83 100<br />
C09BA08 cilazapril and diuretics<br />
0206408 CO INHIBACE 28 CPR R<br />
0 0 12,14 19,30 100<br />
C09BB02 enalapril and lercanidipine<br />
0514129 LERCAPREL 10/10 MG 28 CPR R<br />
0 0 12,82 22,02 0<br />
0514017 LERCAPREL 10/20 MG 28 CPR R<br />
0 0 12,82 22,02 0<br />
0505228 ZANICOMBO 10/10 MG 28 CPR R<br />
0 0 10,44 17,19 100<br />
0505276 ZANICOMBO 10/10 MG 56 CPR R<br />
0 0 16,70 24,79 100<br />
0505357 ZANICOMBO 20/10 MG 28 CPR R<br />
0 0 10,44 17,19 100<br />
0505407 ZANICOMBO 20/10 MG 56 CPR R<br />
0 0 16,70 24,79 100<br />
C09BB04 perindopril and amlodipine<br />
0500252 COVERAM 10/10 MG 60 CPR R<br />
0 0 50,12 61,61 100<br />
0500266 COVERAM 10/10 MG 90 CPR R<br />
0 0 75,18 88,58 100<br />
0500722 COVERAM 10/5 MG 60 CPR R<br />
0 0 44,03 54,90 100<br />
0500736 COVERAM 10/5 MG 90 CPR R<br />
0 0 66,06 78,92 100<br />
0500381 COVERAM 5/10 MG 30 CPR R<br />
0 0 20,13 28,57 100<br />
0500428 COVERAM 5/10 MG 90 CPR R<br />
0 0 48,31 59,61 100<br />
0500543 COVERAM 5/5 MG 30 CPR R<br />
0 0 14,85 22,69 100<br />
0500588 COVERAM 5/5 MG 90 CPR R<br />
0 0 35,65 45,66 100<br />
C09BB05 ramipril and felodipine<br />
0446595 TAZKO 5/5 MG 28 CPR R<br />
0 0 12,14 19,30 100<br />
0444427 TAZKO 5/5 MG 98 CPR R<br />
0 0 34,01 43,85 100<br />
C09CA01 losartan<br />
0329683 COZAAR 100 MG 28 CPR R<br />
0 0 30,74 42,06 100<br />
0329702 COZAAR 100 MG 98 CPR R<br />
0 0 51,05 62,63 100<br />
0341447 COZAAR 100 MG 98 CPR UD R<br />
0 0 100,94 0,00 0<br />
0511466 COZAAR 2,5 MG/ML PDR 200 ML R<br />
0 0 50,00 62,51 0<br />
0209171 COZAAR 50 MG 28 CPR R<br />
0 0 9,68 16,24 100<br />
0209184 COZAAR 50 MG 56 CPR R<br />
0 0 17,28 25,43 100<br />
0249646 COZAAR 50 MG 98 CPR R<br />
0 0 30,23 39,69 100<br />
0345284 LOORTAN 100 MG 98 CPR R<br />
0 0 27,54 36,73 100<br />
0252915 LOORTAN 50 MG 98 CPR R<br />
0 0 26,87 35,99 100<br />
0562112 LOSARTAN EG 100 MG 98 CPR R<br />
0 0 19,45 27,82 100<br />
0562059 LOSARTAN EG 50 MG 28 CPR R<br />
0 0 8,53 14,81 100<br />
0562062 LOSARTAN EG 50 MG 56 CPR R<br />
0 0 12,56 19,83 100<br />
0562076 LOSARTAN EG 50 MG 98 CPR R<br />
0 0 19,45 27,82 100<br />
0508295 LOSARTAN RATIO 100 MG 28 CPR R<br />
0 0 14,09 23,73 100<br />
0479758 LOSARTAN RATIO 100 MG 56 CPR R<br />
0 0 19,96 27,93 100<br />
0479761 LOSARTAN RATIO 100 MG 98 CPR R<br />
0 0 28,23 36,15 100<br />
0508278 LOSARTAN RATIO 50 MG 28 CPR R<br />
0 0 7,76 14,01 100<br />
0479873 LOSARTAN RATIO 50 MG 56 CPR R<br />
0 0 12,19 17,82 100<br />
Page 64 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0479887 LOSARTAN RATIO 50 MG 98 CPR R<br />
0 0 19,35 25,45 100<br />
C09CA02 eprosartan<br />
0281643 TEVETEN 600 MG 28 CPR R<br />
0 0 15,01 22,88 100<br />
0328705 TEVETEN 600 MG 98 CPR R<br />
0 0 42,01 52,68 100<br />
C09CA03 valsartan<br />
0567492 DIOVAN 3 MG/ML SOL 160 ML R<br />
0 0 7,09 16,84 0<br />
0310938 DIOVAN 80 MG 28 CPR R<br />
0 0 13,55 23,92 100<br />
0310941 DIOVAN 80 MG 98 CPR R<br />
0 0 49,54 63,30 100<br />
0310972 DIOVAN PROTECT 160 MG 28 CPR R<br />
0 0 16,44 27,08 100<br />
0311001 DIOVAN PROTECT 160 MG 98 CPR R<br />
0 0 60,09 74,84 100<br />
0575236 VALSARTAN RATIO 160 MG 28 CPR R<br />
0 0 6,31 11,27 100<br />
0575267 VALSARTAN RATIO 160 MG 56 CPR R<br />
0 0 7,61 13,56 100<br />
0575284 VALSARTAN RATIO 160 MG 98 CPR R<br />
0 0 11,91 21,23 100<br />
0621339 VALSARTAN RATIO 320 MG 28 CPR R<br />
0 0 7,05 12,56 100<br />
0621356 VALSARTAN RATIO 320 MG 56 CPR R<br />
0 0 9,21 16,41 100<br />
0621391 VALSARTAN RATIO 320 MG 98 CPR R<br />
0 0 14,54 25,92 100<br />
0574998 VALSARTAN RATIO 40 MG 28 CPR R<br />
0 0 5,28 9,41 100<br />
0575111 VALSARTAN RATIO 80 MG 28 CPR R<br />
0 0 5,85 10,42 100<br />
0575138 VALSARTAN RATIO 80 MG 56 CPR R<br />
0 0 6,62 11,79 100<br />
0575155 VALSARTAN RATIO 80 MG 98 CPR R<br />
0 0 10,15 18,09 100<br />
C09CA04 irbesartan<br />
0240959 APROVEL 150 MG 28 CPR R<br />
0 0 18,21 26,46 100<br />
0240993 APROVEL 300 MG 28 CPR R<br />
0 0 29,13 38,48 100<br />
0241018 APROVEL 300 MG 98 CPR R<br />
0 0 81,56 95,34 100<br />
0240928 APROVEL 75 MG 28 CPR R<br />
0 0 18,57 29,02 0<br />
0631822 IRBESARTAN SDZ 150 MG 28 CPR R<br />
0 0 11,04 17,83 100<br />
0631853 IRBESARTAN SDZ 150 MG 56 CPR R<br />
0 0 19,69 27,98 100<br />
0631898 IRBESARTAN SDZ 150 MG 98 CPR R<br />
0 0 34,46 44,24 100<br />
0631982 IRBESARTAN SDZ 300 MG 28 CPR R<br />
0 0 11,04 17,83 100<br />
0632007 IRBESARTAN SDZ 300 MG 56 CPR R<br />
0 0 19,69 27,98 100<br />
0632041 IRBESARTAN SDZ 300 MG 98 CPR R<br />
0 0 34,46 44,24 100<br />
0631661 IRBESARTAN SDZ 75 MG 28 CPR R<br />
0 0 11,04 17,83 100<br />
0631688 IRBESARTAN SDZ 75 MG 56 CPR R<br />
0 0 19,69 27,98 100<br />
0631724 IRBESARTAN SDZ 75 MG 98 CPR R<br />
0 0 34,46 44,24 100<br />
C09CA06 can<strong>des</strong>artan<br />
0245096 ATACAND 16 MG 28 CPR R<br />
0 0 18,36 26,62 100<br />
0272112 ATACAND 16 MG 56 CPR R<br />
0 0 29,36 38,74 100<br />
0319432 ATACAND 16 MG 98 CPR R<br />
0 0 51,39 63,00 100<br />
0319446 ATACAND 16 MG 98 CPR UD R<br />
0 0 51,39 0,00 0<br />
0382209 ATACAND 32 MG 98 CPR R<br />
0 0 65,07 77,87 100<br />
0245082 ATACAND 8 MG 28 CPR R<br />
0 0 14,80 22,62 100<br />
0272093 ATACAND 8 MG 56 CPR R<br />
0 0 23,70 32,50 100<br />
Page 65 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0342525 ATACAND 8 MG 98 CPR R<br />
0 0 41,48 52,09 100<br />
0342539 ATACAND 8 MG 98 CPR UD R<br />
0 0 41,48 0,00 0<br />
0602591 CANDESARTAN RATIO 16 MG 28 CPR R<br />
0 0 10,55 20,63 100<br />
0602611 CANDESARTAN RATIO 16 MG 56 CPR R<br />
0 0 20,74 31,77 100<br />
0602641 CANDESARTAN RATIO 16 MG 98 CPR R<br />
0 0 29,76 41,65 100<br />
0602672 CANDESARTAN RATIO 32 MG 28 CPR R<br />
0 0 13,84 24,24 100<br />
0602705 CANDESARTAN RATIO 32 MG 56 CPR R<br />
0 0 26,40 37,98 100<br />
0602736 CANDESARTAN RATIO 32 MG 98 CPR R<br />
0 0 37,74 50,38 100<br />
0602414 CANDESARTAN RATIO 4 MG 28 CPR R<br />
0 0 5,60 15,22 100<br />
0602431 CANDESARTAN RATIO 4 MG 56 CPR R<br />
0 0 11,84 22,05 100<br />
0602462 CANDESARTAN RATIO 4 MG 98 CPR R<br />
0 0 17,29 28,01 100<br />
0602509 CANDESARTAN RATIO 8 MG 28 CPR R<br />
0 0 8,36 18,23 100<br />
0602526 CANDESARTAN RATIO 8 MG 56 CPR R<br />
0 0 10,52 20,60 100<br />
0602561 CANDESARTAN RATIO 8 MG 98 CPR R<br />
0 0 14,45 24,90 100<br />
C09CA07 telmisartan<br />
0353434 KINZALMONO 20 MG 28 CPR R<br />
0 0 0,00 16,45 0<br />
0353353 KINZALMONO 40 MG 28 CPR R<br />
0 0 18,22 26,47 100<br />
0353398 KINZALMONO 80 MG 28 CPR R<br />
0 0 29,18 38,53 100<br />
0353403 KINZALMONO 80 MG 56 CPR R<br />
0 0 46,64 57,78 100<br />
0353417 KINZALMONO 80 MG 98 CPR R<br />
0 0 73,48 86,76 100<br />
0260965 MICARDIS 40 MG 28 CPR R<br />
0 0 16,54 24,61 100<br />
0338571 MICARDIS 40 MG 28 CPR UD R<br />
0 0 16,54 0,00 0<br />
0261007 MICARDIS 80 MG 28 CPR R<br />
0 0 26,49 35,57 100<br />
0338567 MICARDIS 80 MG 28 CPR UD R<br />
0 0 19,06 0,00 0<br />
0261011 MICARDIS 80 MG 56 CPR R<br />
0 0 42,34 53,04 100<br />
0261024 MICARDIS 80 MG 98 CPR R<br />
0 0 66,70 79,59 100<br />
C09CA08 olmesartan medoxomil<br />
0359696 BELSAR 10 MG 14 CPR R<br />
0 0 0,00 16,02 0<br />
0359701 BELSAR 10 MG 28 CPR R<br />
0 0 14,92 22,78 100<br />
0359732 BELSAR 10 MG 50 CPR UD R<br />
0 0 26,64 0,00 0<br />
0359746 BELSAR 20 MG 14 CPR R<br />
0 0 0,00 19,14 0<br />
0359763 BELSAR 20 MG 28 CPR R<br />
0 0 17,83 26,04 100<br />
0359794 BELSAR 20 MG 50 CPR UD R<br />
0 0 25,47 0,00 0<br />
0359781 BELSAR 20 MG 98 CPR R<br />
0 0 49,92 61,39 100<br />
0359813 BELSAR 40 MG 14 CPR R<br />
0 0 0,00 23,61 0<br />
0359827 BELSAR 40 MG 28 CPR R<br />
0 0 21,99 30,62 100<br />
0359858 BELSAR 40 MG 50 CPR UD R<br />
0 0 31,41 0,00 0<br />
0359844 BELSAR 40 MG 98 CPR R<br />
0 0 61,59 74,18 100<br />
0357254 OLMETEC 10 MG 14 CPR R<br />
0 0 0,00 16,02 0<br />
0357268 OLMETEC 10 MG 28 CPR R<br />
0 0 14,92 22,78 100<br />
0357299 OLMETEC 10 MG 50 CPR UD R<br />
0 0 26,64 0,00 0<br />
0357304 OLMETEC 20 MG 14 CPR R<br />
0 0 0,00 19,14 0<br />
0357318 OLMETEC 20 MG 28 CPR R<br />
0 0 17,83 26,04 100<br />
Page 66 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0357349 OLMETEC 20 MG 50 CPR UD R<br />
0 0 25,47 0,00 0<br />
0357335 OLMETEC 20 MG 98 CPR R<br />
0 0 49,92 61,39 100<br />
0357352 OLMETEC 40 MG 14 CPR R<br />
0 0 0,00 23,61 0<br />
0357366 OLMETEC 40 MG 28 CPR R<br />
0 0 21,99 30,62 100<br />
0357402 OLMETEC 40 MG 50 CPR UD R<br />
0 0 31,41 0,00 0<br />
0357397 OLMETEC 40 MG 98 CPR R<br />
0 0 61,59 74,18 100<br />
C09D ANGIOTENSIN II ANTAGONISTS, COMBINATIONS<br />
0447351 EXFORGE 10/160 MG 28 CPR R<br />
0 0 29,96 41,87 100<br />
0447396 EXFORGE 10/160 MG 98 CPR R<br />
0 0 89,89 107,45 100<br />
C09DA01 losartan and diuretics<br />
0539954 COZAAR PLUS 100/12,5 MG 98 CPR R<br />
0 0 57,78 70,84 100<br />
0244345 COZAAR PLUS 28 CPR R<br />
0 0 10,16 16,83 100<br />
0244359 COZAAR PLUS 56 CPR R<br />
0 0 17,28 25,43 100<br />
0249632 COZAAR PLUS 98 CPR R<br />
0 0 30,23 39,69 100<br />
0315545 COZAAR PLUS FORTE 100/25 MG 28 CPR R<br />
0 0 30,74 42,07 100<br />
0315562 COZAAR PLUS FORTE 100/25 MG 98 CPR R<br />
0 0 51,05 62,63 100<br />
0264589 LOORTAN PLUS 50/12,5 MG 98 CPR R<br />
0 0 26,87 35,99 100<br />
0322991 LOORTAN PLUS FORTE 100/25 MG 98 CPR R<br />
0 0 27,54 36,73 100<br />
0562157 LOSARTAN PLUS EG 50/12,5 MG 28 CPR R<br />
0 0 8,53 14,81 100<br />
0562174 LOSARTAN PLUS EG 50/12,5 MG 56 CPR R<br />
0 0 12,56 19,83 100<br />
0562207 LOSARTAN PLUS EG 50/12,5 MG 98 CPR R<br />
0 0 19,45 27,82 100<br />
0562417 LOSARTAN PLUS FORTE EG 100/25 MG 98 CPR R<br />
0 0 19,45 27,82 100<br />
C09DA02 eprosartan and diuretics<br />
0389681 TEVETEN PLUS 600/12,5 MG 28 CPR R<br />
0 0 18,53 26,70 100<br />
0389695 TEVETEN PLUS 600/12,5 MG 56 CPR R<br />
0 0 52,80 64,44 0<br />
0389701 TEVETEN PLUS 600/12,5 MG 98 CPR R<br />
0 0 51,90 63,45 100<br />
C09DA03 valsartan and diuretics<br />
0353841 CODIOVAN 160/12,5 MG 28 CPR R<br />
0 0 20,03 31,00 100<br />
0353868 CODIOVAN 160/12,5 MG 98 CPR R<br />
0 0 67,91 83,40 100<br />
0474653 CODIOVAN 320/12,5 MG 28 CPR R<br />
0 0 27,82 39,53 100<br />
0474667 CODIOVAN 320/12,5 MG 56 CPR R<br />
0 0 52,60 67,02 100<br />
0474671 CODIOVAN 320/12,5 MG 98 CPR R<br />
0 0 87,97 105,35 100<br />
0253523 CODIOVAN 80/12,5 MG 28 CPR R<br />
0 0 16,62 27,27 100<br />
0253541 CODIOVAN 80/12,5 MG 98 CPR R<br />
0 0 56,33 70,72 100<br />
0389731 CODIOVAN FORTE 160/25 MG 28 CPR R<br />
0 0 24,27 35,63 100<br />
0389759 CODIOVAN FORTE 160/25 MG 98 CPR R<br />
0 0 82,27 99,11 100<br />
0474765 CODIOVAN FORTE 320/25 MG 98 CPR R<br />
0 0 97,20 115,46 100<br />
0646789 COVALSARTAN SDZ 160/12,5 MG 28 CPR R<br />
0 0 8,94 15,31 0<br />
0646825 COVALSARTAN SDZ 160/12,5 MG 56 CPR R<br />
0 0 15,95 23,97 0<br />
0646873 COVALSARTAN SDZ 160/12,5 MG 98 CPR R<br />
0 0 27,91 37,14 0<br />
0646968 COVALSARTAN SDZ 160/25 MG 28 CPR R<br />
0 0 8,94 15,31 0<br />
0647013 COVALSARTAN SDZ 160/25 MG 56 CPR R<br />
0 0 15,95 23,97 0<br />
Page 67 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0647058 COVALSARTAN SDZ 160/25 MG 98 CPR R<br />
0 0 27,91 37,14 0<br />
0646601 COVALSARTAN SDZ 80/12,5 MG 28 CPR R<br />
0 0 8,94 15,31 0<br />
0646646 COVALSARTAN SDZ 80/12,5 MG 56 CPR R<br />
0 0 15,95 23,97 0<br />
0646694 COVALSARTAN SDZ 80/12,5 MG 98 CPR R<br />
0 0 27,91 37,14 0<br />
0627296 VALSARTAN RATIO COMP 160/12,5 MG 28 CPR R<br />
0 0 3,95 13,40 0<br />
0627315 VALSARTAN RATIO COMP 160/12,5 MG 56 CPR R<br />
0 0 6,76 16,48 0<br />
0627346 VALSARTAN RATIO COMP 160/12,5 MG 98 CPR R<br />
0 0 15,16 25,68 0<br />
0627431 VALSARTAN RATIO COMP 160/25 MG 28 CPR R<br />
0 0 3,88 13,33 0<br />
0627458 VALSARTAN RATIO COMP 160/25 MG 56 CPR R<br />
0 0 7,60 17,41 0<br />
0627489 VALSARTAN RATIO COMP 160/25 MG 98 CPR R<br />
0 0 15,70 26,27 0<br />
0641197 VALSARTAN RATIO COMP 320/12,5MG 28 CPR R<br />
0 0 5,24 14,82 0<br />
0641233 VALSARTAN RATIO COMP 320/12,5MG 56 CPR R<br />
0 0 9,67 19,67 0<br />
0641278 VALSARTAN RATIO COMP 320/12,5MG 98 CPR R<br />
0 0 19,90 30,87 0<br />
0641328 VALSARTAN RATIO COMP 320/25MG 28 CPR R<br />
0 0 6,12 15,78 0<br />
0641359 VALSARTAN RATIO COMP 320/25MG 56 CPR R<br />
0 0 11,22 21,36 0<br />
0641409 VALSARTAN RATIO COMP 320/25MG 98 CPR R<br />
0 0 22,52 33,73 0<br />
0627171 VALSARTAN RATIO COMP 80/12,5 MG 28 CPR R<br />
0 0 3,02 12,39 0<br />
0627198 VALSARTAN RATIO COMP 80/12,5 MG 56 CPR R<br />
0 0 4,99 14,55 0<br />
0627217 VALSARTAN RATIO COMP 80/12,5 MG 90 CPR R<br />
0 0 7,06 12,58 0<br />
0627221 VALSARTAN RATIO COMP 80/12,5 MG 98 CPR R<br />
0 0 12,03 22,24 0<br />
C09DA04 irbesartan and diuretics<br />
0258273 COAPROVEL 150/12,5 28 CPR R<br />
0 0 19,10 27,43 100<br />
0258306 COAPROVEL 300/12,5 28 CPR R<br />
0 0 29,13 38,48 100<br />
0258337 COAPROVEL 300/12,5 98 CPR R<br />
0 0 81,56 95,34 100<br />
0441491 COAPROVEL 300/25 28 CPR R<br />
0 0 29,13 38,48 100<br />
0441541 COAPROVEL 300/25 56 CPR UD R<br />
0 0 46,61 0,00 0<br />
0441537 COAPROVEL 300/25 98 CPR R<br />
0 0 81,56 95,34 100<br />
C09DA06 can<strong>des</strong>artan and diuretics<br />
0278621 ATACAND PLUS 16/12,5 28 CPR R<br />
0 0 12,49 19,74 100<br />
0278634 ATACAND PLUS 16/12,5 56 CPR R<br />
0 0 20,61 29,10 100<br />
0278648 ATACAND PLUS 16/12,5 98 CPR R<br />
0 0 34,97 44,92 100<br />
0347857 ATACAND PLUS 16/12,5 98 CPR UD R<br />
0 0 34,97 0,00 0<br />
0629158 CANDESARTAN COMP RATIO 16/12,5 MG 28 CPR R<br />
0 0 12,27 18,95 0<br />
0629175 CANDESARTAN COMP RATIO 16/12,5 MG 56 CPR R<br />
0 0 23,40 27,76 0<br />
0629208 CANDESARTAN COMP RATIO 16/12,5 MG 98 CPR R<br />
0 0 33,10 40,78 0<br />
0629063 CANDESARTAN COMP RATIO 8/12,5 MG 28 CPR R<br />
0 0 10,37 20,44 0<br />
0629081 CANDESARTAN COMP RATIO 8/12,5 MG 56 CPR R<br />
0 0 20,08 31,06 0<br />
0629127 CANDESARTAN COMP RATIO 8/12,5 MG 98 CPR R<br />
0 0 28,46 40,23 0<br />
C09DA07 telmisartan and diuretics<br />
0353286 KINZALKOMB 40/12,5 MG 28 CPR R<br />
0 0 20,08 28,51 100<br />
0353305 KINZALKOMB 40/12,5 MG 56 CPR R<br />
0 0 45,13 56,12 0<br />
0353319 KINZALKOMB 40/12,5 MG 98 CPR R<br />
0 0 78,65 92,25 0<br />
Page 68 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0353238 KINZALKOMB 80/12,5 MG 28 CPR R<br />
0 0 30,66 40,17 100<br />
0353241 KINZALKOMB 80/12,5 MG 56 CPR R<br />
0 0 45,13 55,94 100<br />
0353255 KINZALKOMB 80/12,5 MG 98 CPR R<br />
0 0 78,65 92,08 100<br />
0492696 KINZALKOMB 80/25 MG 28 CPR R<br />
0 0 30,66 40,17 100<br />
0492665 KINZALKOMB 80/25 MG 28 CPR UD R<br />
0 0 30,65 41,99 0<br />
0492679 KINZALKOMB 80/25 MG 56 CPR R<br />
0 0 45,13 56,12 100<br />
0492682 KINZALKOMB 80/25 MG 98 CPR R<br />
0 0 78,65 92,25 100<br />
0319951 MICARDIS PLUS 40/12,5 28 CPR R<br />
0 0 20,08 28,51 100<br />
0320027 MICARDIS PLUS 80/12,5 28 CPR R<br />
0 0 30,66 40,17 100<br />
0320044 MICARDIS PLUS 80/12,5 28 CPR UD R<br />
0 0 24,08 0,00 0<br />
0320013 MICARDIS PLUS 80/12,5 56 CPR R<br />
0 0 49,00 60,37 100<br />
0319995 MICARDIS PLUS 80/12,5 98 CPR R<br />
0 0 78,65 92,25 100<br />
0482123 MICARDIS PLUS 80/25 28 CPR R<br />
0 0 30,66 40,17 100<br />
0482154 MICARDIS PLUS 80/25 56 CPR R<br />
0 0 45,13 56,12 100<br />
0482171 MICARDIS PLUS 80/25 98 CPR R<br />
0 0 78,65 92,25 100<br />
C09DA08 olmesartan medoxomil and diuretics<br />
0422514 BELSAR PLUS 20/12,5 MG 14 CPR R<br />
0 0 11,14 18,84 0<br />
0422528 BELSAR PLUS 20/12,5 MG 28 CPR R<br />
0 0 17,83 26,04 100<br />
0422545 BELSAR PLUS 20/12,5 MG 98 CPR R<br />
0 0 49,92 61,39 100<br />
0422464 BELSAR PLUS 20/25 MG 14 CPR R<br />
0 0 11,14 18,84 0<br />
0422478 BELSAR PLUS 20/25 MG 28 CPR R<br />
0 0 17,83 26,04 100<br />
0422495 BELSAR PLUS 20/25 MG 98 CPR R<br />
0 0 49,92 61,39 100<br />
0569581 BELSAR PLUS 40/12,5 MG 28 CPR R<br />
0 0 21,99 30,62 100<br />
0569601 BELSAR PLUS 40/12,5 MG 98 CPR R<br />
0 0 61,59 74,18 100<br />
0569631 BELSAR PLUS 40/25 MG 28 CPR R<br />
0 0 21,99 30,62 100<br />
0569659 BELSAR PLUS 40/25 MG 98 CPR R<br />
0 0 61,59 74,18 100<br />
0422741 OLMETEC PLUS 20/12,5 MG 14 CPR R<br />
0 0 11,14 18,84 0<br />
0422755 OLMETEC PLUS 20/12,5 MG 28 CPR R<br />
0 0 17,83 26,04 100<br />
0422772 OLMETEC PLUS 20/12,5 MG 98 CPR R<br />
0 0 49,92 61,39 100<br />
0422691 OLMETEC PLUS 20/25 MG 14 CPR R<br />
0 0 11,14 18,84 0<br />
0422707 OLMETEC PLUS 20/25 MG 28 CPR R<br />
0 0 17,83 26,04 100<br />
0422724 OLMETEC PLUS 20/25 MG 98 CPR R<br />
0 0 49,92 61,39 100<br />
0570288 OLMETEC PLUS 40/12,5 MG 28 CPR R<br />
0 0 21,99 30,62 100<br />
0570307 OLMETEC PLUS 40/12,5 MG 98 CPR R<br />
0 0 61,59 74,18 100<br />
0570338 OLMETEC PLUS 40/25 MG 28 CPR R<br />
0 0 21,99 30,62 100<br />
0570355 OLMETEC PLUS 40/25 MG 98 CPR R<br />
0 0 61,59 74,18 100<br />
C09DB01 valsartan and amlodipine<br />
0447284 EXFORGE 5/160 MG 28 CPR R<br />
0 0 29,40 41,26 100<br />
0447321 EXFORGE 5/160 MG 98 CPR R<br />
0 0 88,38 105,80 100<br />
0447172 EXFORGE 5/80 MG 28 CPR R<br />
0 0 22,96 34,21 100<br />
0447222 EXFORGE 5/80 MG 98 CPR R<br />
0 0 73,29 89,29 100<br />
C09DB02 olmesartan medoxomil and amlodipine<br />
Page 69 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0497191 FORZATEN 20/5 MG 28 CPR R<br />
0 0 21,38 29,94 100<br />
0497211 FORZATEN 20/5 MG 98 CPR R<br />
0 0 59,94 72,42 100<br />
0497305 FORZATEN 40/10 MG 28 CPR R<br />
0 0 32,54 42,24 100<br />
0497322 FORZATEN 40/10 MG 98 CPR R<br />
0 0 91,09 105,44 100<br />
0497241 FORZATEN 40/5 MG 28 CPR R<br />
0 0 29,42 38,81 100<br />
0497269 FORZATEN 40/5 MG 98 CPR R<br />
0 0 82,36 96,18 100<br />
0495961 SEVIKAR 20/5 MG 28 CPR R<br />
0 0 21,38 29,94 100<br />
0495989 SEVIKAR 20/5 MG 98 CPR R<br />
0 0 59,94 72,42 100<br />
0496065 SEVIKAR 40/10 MG 28 CPR R<br />
0 0 32,54 42,24 100<br />
0496082 SEVIKAR 40/10 MG 98 CPR R<br />
0 0 91,09 105,44 100<br />
0496017 SEVIKAR 40/5 MG 28 CPR R<br />
0 0 29,42 38,81 100<br />
0496034 SEVIKAR 40/5 MG 98 CPR R<br />
0 0 82,36 96,18 100<br />
C09DB04 telmisartan and amlodipine<br />
0575964 TWYNSTA 40/10 MG 28 CPR R<br />
0 0 23,41 32,17 100<br />
0576006 TWYNSTA 40/10 MG 98 CPR R<br />
0 0 65,63 78,45 100<br />
0575883 TWYNSTA 40/5 MG 28 CPR R<br />
0 0 21,17 29,71 100<br />
0575933 TWYNSTA 40/5 MG 98 CPR R<br />
0 0 59,34 71,76 100<br />
0576118 TWYNSTA 80/10 MG 28 CPR R<br />
0 0 32,21 41,88 100<br />
0576152 TWYNSTA 80/10 MG 98 CPR R<br />
0 0 90,18 104,48 100<br />
0576041 TWYNSTA 80/5 MG 28 CPR R<br />
0 0 29,13 38,48 100<br />
0576085<br />
C09DX03<br />
TWYNSTA 80/5 MG 98 CPR R<br />
0 0 81,54 95,31 100<br />
0612083 FORZATEN HCT 20/5/12,5 MG 28 CPR R<br />
0 0 21,38 29,83 0<br />
0612178 FORZATEN HCT 20/5/12,5 MG 98 CPR R<br />
0 0 59,94 72,30 0<br />
0612469 FORZATEN HCT 40/10/12,5 MG 28 CPR R<br />
0 0 32,54 42,12 0<br />
0612567 FORZATEN HCT 40/10/12,5 MG 98 CPR R<br />
0 0 91,09 105,33 0<br />
0612794 FORZATEN HCT 40/10/25 MG 28 CPR R<br />
0 0 32,54 42,12 0<br />
0612889 FORZATEN HCT 40/10/25 MG 98 CPR R<br />
0 0 91,09 105,33 0<br />
0612245 FORZATEN HCT 40/5/12,5 MG 28 CPR R<br />
0 0 29,42 38,70 0<br />
0612343 FORZATEN HCT 40/5/12,5 MG 98 CPR R<br />
0 0 82,36 96,07 0<br />
0612634 FORZATEN HCT 40/5/25 MG 28 CPR R<br />
0 0 29,42 38,70 0<br />
0612715 FORZATEN HCT 40/5/25 MG 98 CPR R<br />
0 0 82,36 96,07 0<br />
0605352 SEVIKAR HCT 20/5/12,5 MG 28 CPR R<br />
0 0 21,38 29,94 0<br />
0605451 SEVIKAR HCT 20/5/12,5 MG 98 CPR R<br />
0 0 59,94 72,42 0<br />
0605691 SEVIKAR HCT 40/10/12,5 MG 28 CPR R<br />
0 0 32,55 42,25 0<br />
0605772 SEVIKAR HCT 40/10/12,5 MG 98 CPR R<br />
0 0 91,10 105,45 0<br />
0606007 SEVIKAR HCT 40/10/25 MG 28 CPR R<br />
0 0 32,55 42,25 0<br />
0606086 SEVIKAR HCT 40/10/25 MG 98 CPR R<br />
0 0 91,10 105,45 0<br />
0605528 SEVIKAR HCT 40/5/12,5 MG 28 CPR R<br />
0 0 29,43 38,82 0<br />
0605612 SEVIKAR HCT 40/5/12,5 MG 98 CPR R<br />
0 0 82,36 96,18 0<br />
0605853 SEVIKAR HCT 40/5/25 MG 28 CPR R<br />
0 0 29,43 38,82 0<br />
0605934 SEVIKAR HCT 40/5/25 MG 98 CPR R<br />
0 0 82,36 96,18 0<br />
Page 70 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
C09XA02 aliskiren<br />
0468043 RASILEZ 150 MG 28 CPR RR<br />
0 0 22,83 34,08 80<br />
0468107 RASILEZ 150 MG 98 CPR RR<br />
0 0 79,89 96,51 80<br />
0468141 RASILEZ 300 MG 28 CPR RR<br />
0 0 27,39 39,05 80<br />
0468219 RASILEZ 300 MG 98 CPR RR<br />
0 0 95,87 114,00 80<br />
C09XA52 aliskiren and hydrochlorothiazide<br />
0502579 RASILEZ HCT 150/12,5 MG 28 CPR PELLIC RR<br />
0 0 22,83 34,08 80<br />
0502596 RASILEZ HCT 150/12,5 MG 98 CPR PELLIC RR<br />
0 0 79,89 96,51 80<br />
0502629 RASILEZ HCT 150/25 MG 28 CPR PELLIC RR<br />
0 0 22,83 34,08 80<br />
0502646 RASILEZ HCT 150/25 MG 98 CPR PELLIC RR<br />
0 0 79,89 96,51 80<br />
0502681 RASILEZ HCT 300/12,5 MG 28 CPR PELLIC RR<br />
0 0 27,39 39,05 80<br />
0502713 RASILEZ HCT 300/12,5 MG 98 CPR PELLIC RR<br />
0 0 95,87 114,00 80<br />
0512964 RASILEZ HCT 300/25 MG 28 CPR PELLIC RR<br />
0 0 27,39 39,05 80<br />
0513037 RASILEZ HCT 300/25 MG 98 CPR PELLIC RR<br />
0 0 95,87 114,00 80<br />
C10A LIPID MODIFYING AGENTS, PLAIN<br />
0066517 LIPOSTABIL 300 MG 100 CAPS P<br />
0 0 34,37 52,93 0<br />
0066503 LIPOSTABIL 300 MG 50 CAPS P<br />
0 0 0,00 25,02 0<br />
0066470 LIPOSTABIL N IV 250 MG 5 AMP 5 ML RR<br />
0 0 19,50 34,76 0<br />
C10AA01 simvastatin<br />
0310776 SIMVAHEXAL 10 MG 100 CPR R<br />
0 0 5,15 14,72 80<br />
0310745 SIMVAHEXAL 10 MG 30 CPR R<br />
0 0 1,30 10,51 80<br />
0310762 SIMVAHEXAL 10 MG 50 CPR R<br />
0 0 2,31 11,61 80<br />
0310695 SIMVAHEXAL 20 MG 100 CPR R<br />
0 0 10,82 20,93 80<br />
0310664 SIMVAHEXAL 20 MG 30 CPR R<br />
0 0 2,27 10,30 80<br />
0310681 SIMVAHEXAL 20 MG 50 CPR R<br />
0 0 4,80 14,33 80<br />
0310602 SIMVAHEXAL 30 MG 100 CPR R<br />
0 0 14,63 25,09 0<br />
0310566 SIMVAHEXAL 30 MG 30 CPR R<br />
0 0 7,07 12,60 80<br />
0310597 SIMVAHEXAL 30 MG 50 CPR R<br />
0 0 6,63 16,35 80<br />
0310521 SIMVAHEXAL 40 MG 100 CPR R<br />
0 0 15,35 24,00 80<br />
0310485 SIMVAHEXAL 40 MG 30 CPR R<br />
0 0 4,15 12,36 80<br />
0310504 SIMVAHEXAL 40 MG 50 CPR R<br />
0 0 8,08 17,22 80<br />
0310874 SIMVAHEXAL 5 MG 100 CPR R<br />
0 0 3,65 13,07 80<br />
0310843 SIMVAHEXAL 5 MG 30 CPR R<br />
0 0 5,29 9,42 80<br />
0310861 SIMVAHEXAL 5 MG 50 CPR R<br />
0 0 1,65 10,89 80<br />
0324771 SIMVASTATIN RATIO 10 MG 100 CPR R<br />
0 0 3,13 12,52 80<br />
0324723 SIMVASTATIN RATIO 10 MG 30 CPR R<br />
0 0 0,81 9,98 80<br />
0324737 SIMVASTATIN RATIO 10 MG 50 CPR R<br />
0 0 1,44 10,67 80<br />
0324463 SIMVASTATIN RATIO 20 MG 100 CPR R<br />
0 0 7,08 16,83 80<br />
0324401 SIMVASTATIN RATIO 20 MG 30 CPR R<br />
0 0 1,84 7,80 80<br />
0324415 SIMVASTATIN RATIO 20 MG 50 CPR R<br />
0 0 3,26 12,65 80<br />
0324284 SIMVASTATIN RATIO 40 MG 100 CPR R<br />
0 0 13,82 24,00 80<br />
0324222 SIMVASTATIN RATIO 40 MG 30 CPR R<br />
0 0 3,59 11,40 80<br />
Page 71 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0324236 SIMVASTATIN RATIO 40 MG 50 CPR R<br />
0 0 6,36 15,84 80<br />
0324589 SIMVASTATIN RATIO 5 MG 100 CPR R<br />
0 0 2,11 11,40 80<br />
0328431 SIMVASTATIN RATIO 5 MG 30 CPR R<br />
0 0 0,55 9,69 80<br />
0328445 SIMVASTATIN RATIO 5 MG 50 CPR R<br />
0 0 0,97 10,14 80<br />
0494303 SIMVASTATINE MYLAN 20 MG 28 CPR R<br />
0 0 4,37 9,62 80<br />
0494321 SIMVASTATINE MYLAN 20 MG 84 CPR R<br />
0 0 7,97 14,11 80<br />
0494365 SIMVASTATINE MYLAN 40 MG 56 CPR R<br />
0 0 5,82 11,43 80<br />
0494379 SIMVASTATINE MYLAN 40 MG 98 CPR R<br />
0 0 13,25 20,70 80<br />
0158541 ZOCOR 20 MG 28 CPR R<br />
0 0 4,53 9,83 80<br />
0223152 ZOCOR 20 MG 84 CPR R<br />
0 0 10,87 17,72 80<br />
0249534 ZOCOR 40 MG 28 CPR R<br />
0 0 6,04 11,70 80<br />
0252879 ZOCOR 40 MG 98 CPR R<br />
0 0 16,91 25,02 80<br />
C10AA02 lovastatin<br />
0328669 LOVAHEXAL 10 MG 100 CPR R<br />
0 0 8,97 15,99 80<br />
0328624 LOVAHEXAL 10 MG 30 CPR R<br />
0 0 5,78 10,30 80<br />
0328638 LOVAHEXAL 10 MG 50 CPR R<br />
0 0 6,65 11,84 80<br />
0325099 LOVAHEXAL 20 MG 100 CPR R<br />
0 0 12,15 22,38 80<br />
0325054 LOVAHEXAL 20 MG 30 CPR R<br />
0 0 6,66 11,87 80<br />
0325068 LOVAHEXAL 20 MG 50 CPR R<br />
0 0 8,20 14,61 80<br />
0325202 LOVAHEXAL 40 MG 100 CPR R<br />
0 0 20,49 31,51 80<br />
0325152 LOVAHEXAL 40 MG 30 CPR R<br />
0 0 8,04 14,33 80<br />
0325166 LOVAHEXAL 40 MG 50 CPR R<br />
0 0 10,64 18,97 80<br />
C10AA03 pravastatin<br />
0516574 PRAREDUCT 20 MG 28 CPR R<br />
0 0 8,14 14,31 80<br />
0516588 PRAREDUCT 20 MG 98 CPR R<br />
0 0 22,82 31,54 80<br />
0516607 PRAREDUCT 40 MG 28 CPR R<br />
0 0 13,03 20,42 80<br />
0516611 PRAREDUCT 40 MG 98 CPR R<br />
0 0 36,51 46,62 80<br />
0180119 PRAVASINE 20 MG 28 CPR R<br />
0 0 14,42 22,15 80<br />
0275311 PRAVASINE 20 MG 50 CPR UD R<br />
0 0 20,01 0,00 0<br />
0253005 PRAVASINE 20 MG 98 CPR R<br />
0 0 41,49 52,11 80<br />
0259531 PRAVASINE 40 MG 28 CPR R<br />
0 0 23,31 32,08 80<br />
0275324 PRAVASINE 40 MG 50 CPR UD R<br />
0 0 32,00 0,00 0<br />
0259835 PRAVASINE 40 MG 98 CPR R<br />
0 0 66,36 79,23 80<br />
0366981 PRAVASTATIN HEXAL 10 MG 100 CPR R<br />
0 0 8,97 15,99 0<br />
0366852 PRAVASTATIN HEXAL 10 MG 20 CPR R<br />
0 0 5,37 9,58 0<br />
0366897 PRAVASTATIN HEXAL 10 MG 50 CPR R<br />
0 0 6,65 11,84 0<br />
0367149 PRAVASTATIN HEXAL 20 MG 100 CPR R<br />
0 0 10,82 20,93 80<br />
0367041 PRAVASTATIN HEXAL 20 MG 20 CPR R<br />
0 0 1,69 10,93 80<br />
0367071 PRAVASTATIN HEXAL 20 MG 50 CPR R<br />
0 0 4,80 14,33 80<br />
0367328 PRAVASTATIN HEXAL 30 MG 100 CPR R<br />
0 0 15,83 26,41 80<br />
0367202 PRAVASTATIN HEXAL 30 MG 20 CPR R<br />
0 0 6,32 11,26 80<br />
0367247 PRAVASTATIN HEXAL 30 MG 50 CPR R<br />
0 0 9,28 16,53 80<br />
0367507 PRAVASTATIN HEXAL 40 MG 100 CPR R<br />
0 0 19,35 30,26 80<br />
Page 72 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0367376 PRAVASTATIN HEXAL 40 MG 20 CPR R<br />
0 0 3,00 12,36 80<br />
0367412 PRAVASTATIN HEXAL 40 MG 50 CPR R<br />
0 0 8,77 18,69 80<br />
0413207 PRAVASTATINE EG 20 MG 28 CPR R<br />
0 0 3,98 9,13 80<br />
0413241 PRAVASTATINE EG 20 MG 98 CPR R<br />
0 0 18,24 26,49 80<br />
0413305 PRAVASTATINE EG 40 MG 28 CPR R<br />
0 0 11,43 18,41 80<br />
0413353 PRAVASTATINE EG 40 MG 98 CPR R<br />
0 0 29,09 38,44 80<br />
C10AA04 fluvastatin<br />
0259771 LOCOL 20 MG 100 CAPS R<br />
0 0 5,15 14,72 80<br />
0258998 LOCOL 20 MG 30 CAPS R<br />
0 0 5,54 9,87 80<br />
0211019 LOCOL 20 MG 50 CAPS R<br />
0 0 2,31 11,61 80<br />
0259785 LOCOL 40 MG 100 CAPS R<br />
0 0 10,82 20,93 80<br />
0259009 LOCOL 40 MG 30 CAPS R<br />
0 0 6,45 11,49 80<br />
0211053 LOCOL 40 MG 50 CAPS R<br />
0 0 4,80 14,33 80<br />
0309761 LOCOL 80 MG 100 CPR R<br />
0 0 19,35 30,26 80<br />
0309744 LOCOL 80 MG 30 CPR R<br />
0 0 4,83 14,37 80<br />
0309758 LOCOL 80 MG 50 CPR R<br />
0 0 8,77 18,69 80<br />
C10AA05 atorvastatin<br />
0590456 ATORVASTATINE RATIO 10 MG 100 CPR R<br />
0 0 8,26 14,72 80<br />
0590389 ATORVASTATINE RATIO 10 MG 30 CPR R<br />
0 0 5,90 10,52 80<br />
0590392 ATORVASTATINE RATIO 10 MG 50 CPR R<br />
0 0 6,51 11,61 80<br />
0590618 ATORVASTATINE RATIO 20 MG 100 CPR R<br />
0 0 11,74 20,93 80<br />
0590541 ATORVASTATINE RATIO 20 MG 30 CPR R<br />
0 0 6,72 11,97 80<br />
0590554 ATORVASTATINE RATIO 20 MG 50 CPR R<br />
0 0 8,04 14,33 80<br />
0590778 ATORVASTATINE RATIO 40 MG 100 CPR R<br />
0 0 16,26 28,98 80<br />
0590697 ATORVASTATINE RATIO 40 MG 30 CPR R<br />
0 0 7,88 14,05 80<br />
0590702 ATORVASTATINE RATIO 40 MG 50 CPR R<br />
0 0 10,17 18,12 80<br />
0590943 ATORVASTATINE RATIO 80 MG 100 CPR R<br />
0 0 25,16 44,84 80<br />
0590859 ATORVASTATINE RATIO 80 MG 30 CPR R<br />
0 0 10,20 18,18 80<br />
0590862 ATORVASTATINE RATIO 80 MG 50 CPR R<br />
0 0 14,27 25,43 80<br />
0233713 LIPITOR 10 MG 28 CPR R<br />
0 0 12,51 19,77 80<br />
0577616 LIPITOR 10 MG 30 CPR CROQUER R<br />
0 0 24,68 35,33 0<br />
0241925 LIPITOR 10 MG 84 CPR R<br />
0 0 33,76 43,59 80<br />
0260271 LIPITOR 10 MG 84 CPR UD R<br />
0 0 33,76 0,00 0<br />
0233731 LIPITOR 20 MG 28 CPR R<br />
0 0 19,58 27,97 80<br />
0577633 LIPITOR 20 MG 30 CPR CROQUER R<br />
0 0 38,64 49,71 0<br />
0241939 LIPITOR 20 MG 84 CPR R<br />
0 0 52,85 64,61 80<br />
0260285 LIPITOR 20 MG 84 CPR UD R<br />
0 0 52,85 0,00 0<br />
0241942 LIPITOR 40 MG 84 CPR R<br />
0 0 89,87 104,15 80<br />
0260299 LIPITOR 40 MG 84 CPR UD R<br />
0 0 89,87 0,00 0<br />
0312896 LIPITOR 80 MG 98 CPR R<br />
0 0 104,84 120,01 80<br />
0640625 TOTALIP 10 MG 100 CPR R<br />
0 0 19,45 27,82 0<br />
0640561 TOTALIP 10 MG 30 CPR R<br />
0 0 6,48 12,24 0<br />
0640799 TOTALIP 20 MG 100 CPR R<br />
0 0 30,44 39,94 0<br />
Page 73 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0640737 TOTALIP 20 MG 30 CPR R<br />
0 0 10,15 16,82 0<br />
0640964 TOTALIP 40 MG 100 CPR R<br />
0 0 51,60 63,24 0<br />
0641121 TOTALIP 80 MG 100 CPR R<br />
0 0 51,58 63,22 0<br />
C10AA07 rosuvastatin<br />
0346721 CRESTOR 10 MG 100 CPR BLIST R<br />
0 0 71,32 0,00 0<br />
0346636 CRESTOR 10 MG 28 CPR R<br />
0 0 22,68 31,39 80<br />
0346717 CRESTOR 10 MG 98 CPR R<br />
0 0 69,90 82,97 80<br />
0346881 CRESTOR 20 MG 100 CPR BLIST R<br />
0 0 114,11 0,00 0<br />
0346796 CRESTOR 20 MG 28 CPR R<br />
0 0 35,52 45,52 80<br />
0346877 CRESTOR 20 MG 98 CPR R<br />
0 0 111,83 127,42 80<br />
0347051 CRESTOR 40 MG 100 CPR BLIST R<br />
0 0 182,57 0,00 0<br />
0346975 CRESTOR 40 MG 28 CPR R<br />
0 0 63,89 76,61 80<br />
0347048 CRESTOR 40 MG 98 CPR R<br />
0 0 178,92 198,52 80<br />
0412129 CRESTOR 5 MG 28 CPR R<br />
0 0 16,55 24,62 0<br />
C10AB02 bezafibrate<br />
0389373 BEZAFIBRAT HEXAL RET 400 MG 100 CPR R<br />
0 0 14,18 24,61 80<br />
0389356 BEZAFIBRAT HEXAL RET 400 MG 30 CPR R<br />
0 0 4,25 13,73 80<br />
0268591 CEDUR 200 MG 60 CPR R<br />
0 0 4,73 9,90 80<br />
0268588 EULITOP 400 MG 30 CPR R<br />
0 0 4,73 9,90 80<br />
C10AB05 fenofibrate<br />
0336061 FEGENOR 200 MG 30 CAPS R<br />
0 0 0,00 10,75 80<br />
0336058 FEGENOR 67 MG 60 CAPS R<br />
0 0 0,00 8,18 0<br />
0301097 FENOGAL 200 MG LIDOSE 30 CAPS R<br />
0 0 3,62 8,57 80<br />
0301102 FENOGAL 200 MG LIDOSE 98 CAPS R<br />
0 0 7,71 13,68 80<br />
0400422 FENOGAL 267 MG LIDOSE 30 CAPS R<br />
0 0 3,86 8,80 80<br />
0400471 FENOGAL 267 MG LIDOSE 90 CAPS R<br />
0 0 11,61 18,47 80<br />
0192994 LIPANTHYL MICRON 200 MG 30 CAPS R<br />
0 0 5,87 11,37 80<br />
0270667 LIPANTHYL MICRON 267 MG 30 CAPS R<br />
0 0 6,88 12,64 80<br />
0270671 LIPANTHYL MICRON 267 MG 90 CAPS R<br />
0 0 15,38 23,22 80<br />
0270619 LIPANTHYL MICRON 67 MG 30 CAPS R<br />
0 0 2,49 7,08 80<br />
0270622 LIPANTHYL MICRON 67 MG 90 CAPS R<br />
0 0 5,29 10,65 80<br />
0430144 LIPANTHYL NANO 145 MG 30 CPR R<br />
0 0 5,87 11,37 80<br />
0430175 LIPANTHYL NANO 145 MG 90 CPR R<br />
0 0 14,04 21,57 80<br />
C10AB08 ciprofibrate<br />
0055253 HYPERLIPEN 100 MG 30 CAPS R<br />
0 0 6,19 11,88 80<br />
C10AC01 colestyramine<br />
0096337 QUESTRAN 50 SACH 4 G R<br />
0 0 16,93 25,04 80<br />
C10AC02 colestipol<br />
0023652 COLESTID PDR 50 SACH 5 G R<br />
0 0 15,68 23,67 80<br />
C10AC04 colesevelam<br />
Page 74 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0371061 CHOLESTAGEL 625 MG 180 CPR RR<br />
0 0 120,00 135,42 80<br />
C10AD06 acipimox<br />
0209458 OLBETAM 250 MG 90 CAPS R<br />
0 0 15,31 23,25 80<br />
C10AD52 nicotinic acid, combinations<br />
0488242 TREDAPTIVE 1000/20 MG 196 CPR RR<br />
0 0 117,60 133,37 80<br />
0488192 TREDAPTIVE 1000/20 MG 28 CPR RR<br />
0 0 22,40 30,89 80<br />
C10AX06 omega-3-triglyceri<strong>des</strong> incl. other esters and acids<br />
0347258 OMACOR 1 G 28 CAPS P<br />
0 0 21,00 31,53 0<br />
C10AX09 ezetimibe<br />
0348515 EZETROL 10 MG 98 CPR RR<br />
0 0 117,61 133,55 80<br />
C10BA02 simvastatin and ezetimibe<br />
0390035 INEGY 10/20 MG 98 CPR RR<br />
0 0 147,00 164,69 80<br />
0390195 INEGY 10/40 MG 98 CPR RR<br />
0 0 171,50 190,67 80<br />
0390343 INEGY 10/80 MG 98 CPR RR<br />
0 0 181,30 201,04 80<br />
C10BA03 pravastatin and fenofibrate<br />
0622594 PRAVAFENIX 40/160 MG 30 CAPS (FL) R<br />
0 0 15,10 22,88 0<br />
0622627 PRAVAFENIX 40/160 MG 90 CAPS (FL) R<br />
0 0 36,24 46,20 0<br />
D DERMATOLOGICALS<br />
0413421 LIPACTIN GEL 3 G P<br />
0 0 4,47 7,68 0<br />
D01AA01 nystatin<br />
0017915 CANDIO HERMAL CREME 20 G R<br />
0 0 3,10 6,16 80<br />
D01AA20 combinations<br />
0074939 MYCOLOG POM 15 G RR<br />
0 0 2,74 7,59 0<br />
D01AC01 clotrimazole<br />
0183267 ANTIFUNGOL 1% 1 FL DOS 30 ML P<br />
0 0 0,00 3,93 80<br />
0152517 FUNGIZID RATIO 1% SPRAY 40 ML P<br />
0 0 2,68 5,32 80<br />
D01AC02 miconazole<br />
0027620 DAKTARIN CREME 30 G 17398 P<br />
0 0 3,73 6,41 80<br />
0027651 DAKTARIN PDR 20 G 17397 P<br />
0 0 1,60 6,29 80<br />
0347911 DAKTARIN SPRAY 2%/D 1 FL 8 G P<br />
0 0 4,33 7,43 80<br />
0027679 DAKTARIN TEINTURE 30 ML 17395 P<br />
0 0 3,62 6,22 80<br />
D01AC03 econazole<br />
0269215 DERMAZOL 1% PDR 30 G P<br />
0 0 2,96 5,68 80<br />
0256167 DERMAZOL 1% SOL 30 G P<br />
0 0 2,22 3,92 80<br />
0256136 DERMAZOL GE 1% CREME 30 G P<br />
0 0 1,65 3,07 80<br />
0256153 DERMAZOL GE 1% EMULSION 30 G P<br />
0 0 1,85 3,35 80<br />
0089427 PEVARYL LAIT DERMATO 30 ML 191589 P<br />
0 0 2,28 3,92 80<br />
Page 75 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
D01AC05 isoconazole<br />
0119350 TRAVOGENE CREME 20 G P<br />
0 0 1,75 6,45 80<br />
D01AC08 ketoconazole<br />
0503092 NIZORAL 2% CREME 30 G P<br />
0 0 2,59 7,39 80<br />
D01AC09 sulconazole<br />
0043431 MYK 1 1% CREME 30 G P<br />
0 0 2,58 7,28 80<br />
0180122 MYK 1 1% SOL 20 ML P<br />
0 0 0,00 4,24 80<br />
D01AC10 bifonazole<br />
0385147 CANESTENE DERM BIFONAZOLE 1% CREME 15 G P<br />
0 0 5,80 9,96 80<br />
D01AC20 combinations<br />
0027584 DAKTACORT CREME 15 G 17396 P<br />
0 0 1,86 6,56 80<br />
0027598 DAKTACORT CREME 30 G 27332 R<br />
0 0 2,96 7,86 80<br />
0089461 PEVISONE 15 G CREME 191216 RR<br />
0 0 1,62 6,31 80<br />
D01AC52 miconazole, combinations<br />
0177631 DAKTOZIN 0,25% PATE 90 G 52490 P<br />
0 0 4,78 8,21 80<br />
D01AE12 salicylic acid<br />
0104599 SICOMBYL GRAN 10 G P<br />
0 0 2,55 4,37 80<br />
D01AE13 selenium sulfide<br />
0655726 SELSUN SHAMP 2,5 % 120 ML P<br />
0 0 4,69 8,07 0<br />
D01AE14 ciclopirox<br />
0154381 MYCOSTER 1% CREME 30 G R<br />
0 0 0,00 4,97 80<br />
0247381 MYCOSTER 1% PDR 30 G R<br />
0 0 0,00 4,88 80<br />
0154363 MYCOSTER 1% SOL 30 ML R<br />
0 0 0,00 4,98 80<br />
0214346 MYCOSTER 8% SOL 3 ML R<br />
0 0 0,00 14,97 80<br />
D01AE15 terbinafine<br />
0174237 LAMISIL 1% CREME 15 G 03337 P<br />
0 0 5,34 9,17 80<br />
0468236 LAMISIL 1% SPRAY 15 ML P<br />
0 0 6,03 10,36 80<br />
0262312 LAMISIL DERMGEL 1% GEL 15 G P<br />
0 0 5,79 9,95 80<br />
0458212 LAMISIL ONCE 1% TUBE 4 G P<br />
0 0 7,35 12,62 0<br />
D01AE16 amorolfine<br />
0205087 LOCERYL 5% VERNIS 5 ML R<br />
0 0 31,06 41,89 80<br />
D01BA02 terbinafine<br />
0457022 DOCTERBINAFINE 250 MG 14 CPR R<br />
0 0 13,49 20,80 80<br />
0457053 DOCTERBINAFINE 250 MG 56 CPR R<br />
0 0 43,19 53,79 80<br />
0174173 LAMISIL 250 MG 28 CPR R<br />
0 0 109,69 129,13 80<br />
0400503 MYCONORMIN 250 MG 14 CPR R<br />
0 0 9,80 19,80 80<br />
0400517 MYCONORMIN 250 MG 28 CPR R<br />
0 0 19,97 30,94 80<br />
0409378 MYCONORMIN 250 MG 42 CPR R<br />
0 0 30,28 42,22 80<br />
Page 76 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0435848 TERBINAFINE TEVA 250 MG 14 CPR R<br />
0 0 13,23 20,66 80<br />
0435896 TERBINAFINE TEVA 250 MG 56 CPR UD R<br />
0 0 40,16 0,00 0<br />
D02AB Zinc products<br />
0258341 CALAMINE GEL 50 ML P<br />
0 0 3,07 6,00 80<br />
0257097 INOTYOL POM 90 G P<br />
0 0 4,13 7,09 80<br />
0270023 MITOSYL POM 150 G P<br />
0 0 4,75 8,16 80<br />
0230305 MITOSYL POM 65 G P<br />
0 0 2,81 4,83 80<br />
D02AC Soft paraffin and fat products<br />
0010637 BALNEUM HERMAL F HUILEUSE 200 ML P<br />
0 0 4,74 9,09 0<br />
0010640 BALNEUM HERMAL F HUILEUSE 500 ML P<br />
0 0 9,29 16,66 0<br />
0357206 DEXERYL CREME 250 G P<br />
0 0 0,00 4,38 0<br />
D02AE Carbamide products<br />
0219728 OPTIDERM CREME 100 G P<br />
0 0 8,42 15,15 0<br />
0231981 OPTIDERM CREME 200 G SPENDER P<br />
0 0 17,58 29,43 0<br />
0219714 OPTIDERM CREME 50 G P<br />
0 0 4,61 8,83 0<br />
D02AX Other emollients and protectives<br />
0076706 NEOCUTIGENOL POM 100 G P<br />
0 0 3,45 5,93 80<br />
0622238 NEOCUTIGENOL POM 150 G P<br />
0 0 5,48 9,43 0<br />
0076690 NEOCUTIGENOL POM 50 G P<br />
0 0 2,32 3,98 80<br />
D02BB01 betacarotene<br />
0019002 CAROTABEN 100 CAPS R<br />
0 0 21,82 35,40 80<br />
D03A CICATRIZANTS<br />
0287731 BIAFINE 186 G P<br />
0 0 3,68 6,56 0<br />
0287728 BIAFINE 93 G P<br />
0 0 2,06 3,67 0<br />
D03AA Cod-liver oil ointments<br />
0122924 UNGUENTOLAN POM 100 G P<br />
0 0 5,74 9,28 80<br />
0122907 UNGUENTOLAN POM 20 G P<br />
0 0 2,09 3,49 80<br />
0122910 UNGUENTOLAN POM 50 G P<br />
0 0 3,57 5,95 80<br />
0292065 VITAMURUINE 445000 U POM 45 G P<br />
0 0 0,00 5,07 80<br />
D03AX Other cicatrizants<br />
0151246 CONTRACTUBEX COMP GEL 100 G P<br />
0 0 17,00 28,74 0<br />
0297661 CONTRACTUBEX COMP GEL 30 G P<br />
0 0 8,65 15,56 0<br />
0024761 CONTRACTUBEX COMP GEL 50 G P<br />
0 0 13,26 22,46 0<br />
0180881 MADECASSOL 1% CREME 25 G P<br />
0 0 4,35 7,47 0<br />
0180895 MADECASSOL 1% CREME 40 G P<br />
0 0 5,57 9,57 0<br />
D03AX03 dexpanthenol<br />
0645294 BEPANTHEN AUGEN-UND NASENSALBE 5% 2*5 G P<br />
0 0 3,05 5,09 0<br />
D03AX10 enoxolone<br />
0334697 DERMANOX 20 MG/G CREME 100 G P<br />
0 0 0,00 14,48 0<br />
Page 77 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0334683 DERMANOX 20 MG/G CREME 40 G P<br />
0 0 3,62 6,24 0<br />
D03BA52 collagenase, combinations<br />
0283391 IRUXOL POM 30 G P<br />
0 0 0,00 23,47 80<br />
D04AA13 dimetindene<br />
0151179 FENISTIL 0,1% GEL 20 G P<br />
0 0 2,38 4,73 40<br />
0151182 FENISTIL 0,1% GEL 50 G P<br />
0 0 4,73 9,07 40<br />
D04AA15 bamipine<br />
0394387 SOVENTOL 2% GEL 20 G P<br />
0 0 2,37 4,22 40<br />
0394391 SOVENTOL 2% GEL 50 G P<br />
0 0 4,82 8,58 40<br />
D04AA22 isothipendyl<br />
0512608 SEDERMYL 0,75% CREME 35 G P<br />
0 0 2,85 7,20 0<br />
D04AA32 diphenhydramine<br />
0016921 CALADRYL CREME 42 G P<br />
0 0 3,31 5,68 40<br />
0016935 CALADRYL LOT 100 ML P<br />
0 0 3,54 6,07 40<br />
0316461 DIPHAMINE MOUSSE 60 G P<br />
0 0 3,78 7,00 0<br />
D04AA34 chlorphenoxamine<br />
0112783 SYSTRAL CREME 20 G P<br />
0 0 1,93 3,85 40<br />
0112766 SYSTRAL GEL 20 G P<br />
0 0 0,00 3,40 40<br />
D04AB01 lidocaine<br />
0179586 XYLOCAINE ASTRA 2% GEL 10 SRG 10 G R<br />
0 0 0,00 15,97 80<br />
0130456 XYLOCAINE ASTRA 2% GEL 10*30 ML R<br />
0 0 26,55 0,00 0<br />
0130442 XYLOCAINE ASTRA 2% GEL 30 ML R<br />
0 0 0,00 5,66 80<br />
0130487 XYLOCAINE ASTRA 5% POM 35 G R<br />
0 0 0,00 6,34 80<br />
0130568 XYLOCAINE ASTRA SPRAY 10% 1 FL PULV 50ML R<br />
0 0 0,00 23,70 80<br />
D05A ANTIPSORIATICS FOR TOPICAL USE<br />
0517361 QUALIPHAR BITHIOL 10% POM 22 G P<br />
0 0 3,51 6,03 0<br />
0517375 QUALIPHAR BITHIOL 20% POM 22 G P<br />
0 0 3,80 6,52 0<br />
D05AX04 tacalcitol<br />
0428017 CURATODERM EMULSION 4 MCG/G 20 ML R<br />
0 0 13,69 24,06 0<br />
0428034 CURATODERM EMULSION 4 MCG/G 50 ML R<br />
0 0 34,13 46,45 0<br />
D05AX52 calcipotriol, combinations<br />
0501117 DOVOBET 50 MCG/G 0,5 MG/G GEL 60 G RR<br />
0 0 36,66 46,77 80<br />
0313375 DOVOBET POM 60 G RR<br />
0 0 36,66 46,77 80<br />
0500803 XAMIOL 50 MCG/G 0,5 MG/G GEL 60 G RR<br />
0 0 36,66 46,77 80<br />
D05BB02 acitretin<br />
0147999 NEOTIGASON 10 MG 30 CAPS RR<br />
RM 0 0<br />
18,26 26,33 80<br />
0148013 NEOTIGASON 25 MG 30 CAPS RR<br />
RM 0 0<br />
36,52 46,46 80<br />
D06AA03 oxytetracycline<br />
Page 78 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0076429 NEOBACITRACINE POM 20 G RR<br />
0 0 3,18 5,46 80<br />
0180685 TERRAMYCINE POM 15 G RR<br />
0 0 3,25 5,59 80<br />
D06AA04 tetracycline<br />
0140032 IMEX 3% SALBE 20 G RR<br />
0 0 9,07 19,02 80<br />
D06AX01 fusidic acid<br />
0656527 AFFUSINE 20 MG/G CREME 15 G RR<br />
0 0 4,21 7,23 0<br />
0656531 AFFUSINE 20 MG/G CREME 30 G RR<br />
0 0 7,43 12,76 0<br />
0154248 FUCIDIN 2% CREME 15 G RR<br />
0 0 4,95 8,50 80<br />
0144692 FUCIDIN POM 15 G (ONGUENT) RR<br />
0 0 4,95 8,50 80<br />
0154413 FUCITHALMIC 1% GEL 5 G RR<br />
0 0 4,26 7,32 80<br />
D06AX07 gentamicin<br />
0048911 GEOMYCINE CREME 15 G RR<br />
0 0 2,93 5,03 80<br />
0048925 GEOMYCINE POM 15 G RR<br />
0 0 2,93 5,03 80<br />
D06AX08 tyrothricin<br />
0281559 TYROSUR GEL 5 G P<br />
0 0 2,15 4,28 80<br />
0122079 TYROSUR PDR 5 G P<br />
0 0 2,49 4,98 80<br />
D06AX09 mupirocin<br />
0485139 BACTROBAN 2% POM 15 G RR<br />
0 0 5,34 9,16 80<br />
D06AX13 retapamulin<br />
0467323 ALTARGO 1% POM 5 G R<br />
0 0 10,19 17,50 0<br />
D06BA Sulfonami<strong>des</strong><br />
0006388 ANTEBOR SOLUTION 200 ML P<br />
0 0 5,16 8,86 80<br />
0092128 POLYSEPTOL POM 22 G P<br />
0 0 3,96 6,80 80<br />
D06BA01 silver sulfadiazine<br />
0044991 FLAMMACERIUM CREME 500 G RR<br />
0 0 19,18 0,00 0<br />
0045002 FLAMMAZINE CREME 50 G P<br />
0 0 4,41 7,58 80<br />
0045033 FLAMMAZINE CREME 500 G (POT) P<br />
0 0 16,69 0,00 0<br />
D06BB02 tromantadine<br />
0128203 VIRU MERZ SEROL 5 G R<br />
0 0 4,12 9,22 0<br />
D06BB03 aciclovir<br />
0455997 ACICLOVIR EG 5% CREME 15 G R<br />
0 0 0,00 37,60 0<br />
0455952 ACICLOVIR EG 5% CREME 2 G P<br />
0 0 0,00 6,17 0<br />
0455966 ACICLOVIR EG 5% CREME 3 G P<br />
0 0 0,00 11,03 0<br />
0539471 ACICLOVIR RATIO 5% CREME 2 G P<br />
0 0 2,21 3,95 0<br />
0539498 ACICLOVIR RATIO 5% CREME 20 G R<br />
0 0 9,75 17,38 0<br />
0539484 ACICLOVIR RATIO 5% CREME 5 G R<br />
0 0 4,57 8,14 0<br />
0576278 ACICLOVIR RATIO LIPHERPES 5% CREME 2 G P<br />
0 0 1,93 3,45 0<br />
0311496 ZOVIRAX 5% CREME 10 G R<br />
0 0 18,49 28,96 0<br />
0205476 ZOVIRAX LABIALIS 5% CREME 2 G P<br />
0 0 4,72 8,11 0<br />
Page 79 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0231008 ZOVIRAX LABIALIS 5% POMPE 2 G P<br />
0 0 0,00 8,31 0<br />
D06BB06 penciclovir<br />
0228891 VECTAVIR 1% CREME 2 G 141062 P<br />
0 0 4,84 8,32 0<br />
D06BB07 lysozyme<br />
0074682 MURAZYME 2% POM 25 G P<br />
0 0 0,00 5,62 0<br />
D06BB10 imiquimod<br />
0256749 ALDARA 5% CREME 12 SACH 250 MG RR C<br />
0 0 61,73 74,15 80<br />
D06BX01 metronidazole<br />
0389034 ROSACED 0,75% CREME 30 G R<br />
0 0 4,38 7,53 80<br />
0247039 ROZEX 0,75% CREME 30 G R<br />
0 0 0,00 8,00 80<br />
0544551 ROZEX 0,75% CREME 50 G R<br />
0 0 7,48 13,50 0<br />
0275548 ROZEX 0,75% EMULS 30 G TUBE R<br />
0 0 0,00 8,00 80<br />
0544565 ROZEX 0,75% EMULS 50 G TUBE R<br />
0 0 7,48 13,50 0<br />
0194873 ROZEX 0,75% GEL 30 G R<br />
0 0 0,00 8,00 80<br />
D07AA02 hydrocortisone<br />
0512625 CORTISEDERMYL 0,5% CREME 15 G R<br />
0 0 3,88 6,92 0<br />
0026220 CREMICORT H 1% CREME 20 G R<br />
0 0 4,52 7,76 0<br />
0568925 PANNOCORT 1% CREME 30 G R<br />
0 0 4,60 7,90 0<br />
0278201 PANNOCORT 1% CREME 5 G R<br />
0 0 0,00 1,59 80<br />
0596298 SOVENTOL 0,5% SPRAY 30 ML P<br />
0 0 4,79 8,52 0<br />
D07AB01 clobetasone<br />
0042515 EUMOVATE CREME 30 G RR<br />
0 0 3,57 8,63 80<br />
0042529 EUMOVATE ONG 30 G RR<br />
0 0 3,57 8,63 80<br />
D07AB02 hydrocortisone butyrate<br />
0212131 LOCOID CRELO 0,1% EMUL 100 G R<br />
0 0 7,28 13,24 80<br />
0203924 LOCOID CRELO 0,1% EMUL 30 G R<br />
0 0 2,72 7,56 80<br />
0067027 LOCOID CREME 30 G R<br />
0 0 2,72 7,56 80<br />
0067030 LOCOID LIPOCREME 30 G R<br />
0 0 2,72 7,56 80<br />
0067044 LOCOID LOT 0,1% 30 ML R<br />
0 0 2,72 7,56 80<br />
0067058 LOCOID ONG DERM 30 G R<br />
0 0 2,72 7,56 80<br />
D07AB07 fluprednidene<br />
0028547 DECODERM CREME 20 G RR<br />
0 0 2,92 12,27 80<br />
0028550 DECODERM CREME 50 G RR<br />
0 0 6,91 16,64 80<br />
0028564 DECODERM SALBE 20 G RR<br />
0 0 2,92 12,27 80<br />
D07AB08 <strong>des</strong>onide<br />
0243897 LOCAPRED 0,1% CREME 15 G RR<br />
0 0 0,00 2,61 80<br />
0243852 LOCATOP 0,1 % CREME 30 G RR<br />
0 0 0,00 3,11 80<br />
D07AB09 triamcinolone<br />
0028984 DELPHI 0,1% CREME 30 G RR<br />
0 0 4,86 10,23 80<br />
Page 80 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
D07AC01 betamethasone<br />
0012886 BETNELAN V 0,1% CREME 30 G RR<br />
0 0 1,93 6,65 80<br />
0012919 BETNELAN V 0,1% LOTION 30 ML RR<br />
0 0 1,93 6,65 80<br />
0012936 BETNELAN V 0,1% ONG 30 G RR<br />
0 0 1,93 6,65 80<br />
0033337 DIPROLENE 0,05% CREME 30 G RR<br />
0 0 2,77 7,63 80<br />
0033418 DIPROSONE CREME 30 G RR<br />
0 0 2,77 7,63 80<br />
0033421 DIPROSONE LOTION 30 ML RR<br />
0 0 2,77 7,63 80<br />
0033435 DIPROSONE POM 30 G RR<br />
0 0 2,77 7,63 80<br />
D07AC06 diflucortolone<br />
0077605 NERISONA CREME 15 G RR<br />
0 0 1,38 6,03 80<br />
0077619 NERISONA CREME 30 G RR<br />
0 0 2,19 6,92 80<br />
0077636 NERISONA POM 30 G RR<br />
0 0 2,19 6,92 80<br />
0077667 NERISONA POM GRASSE 30 G RR<br />
0 0 2,19 6,92 80<br />
D07AC11 amcinonide<br />
0004299 AMICLA CREME 30 G RR<br />
0 0 2,59 7,40 80<br />
D07AC13 mometasone<br />
0182872 ELOCOM 0,1% CREME 20 G RR<br />
0 0 2,55 7,35 80<br />
0182905 ELOCOM 0,1% LOT 20 ML RR<br />
0 0 2,55 7,35 80<br />
0182886 ELOCOM 0,1% ONG 20 G RR<br />
0 0 2,55 7,35 80<br />
D07AC14 methylprednisolone aceponate<br />
0186059 ADVANTAN 0,1% CREME 15 G RR<br />
0 0 1,91 6,63 80<br />
0186031 ADVANTAN 0,1% POM 15 G RR<br />
0 0 1,91 6,63 80<br />
0186045 ADVANTAN 0,1% POM GRASSE 15 G RR<br />
0 0 1,91 6,63 80<br />
D07AC17 fluticasone<br />
0192767 CUTIVATE 0,005% POM 30 G RR<br />
0 0 2,96 7,86 80<br />
0192736 CUTIVATE 0,05% CREME 30 G RR<br />
0 0 2,96 7,86 80<br />
D07AD01 clobetasol<br />
0426186 CLARELUX 0,05% MOUSSE 100 G RR<br />
0 0 8,84 15,20 80<br />
0457599 CLOBEX 500 MCG/G SHAMP 125 ML RR<br />
0 0 12,85 20,20 80<br />
0030268 DERMOVATE 0,05% CREME 30 G RR<br />
0 0 3,07 8,01 80<br />
0030271 DERMOVATE 0,05% LOTION 30 ML RR<br />
0 0 3,07 8,01 80<br />
0030299 DERMOVATE 0,05% ONG 30 G RR<br />
0 0 3,07 8,01 80<br />
D07CA01 hydrocortisone and antibiotics<br />
0253666 FUCIDIN HYDROCORTISONE CREME 15 G RR<br />
0 0 4,98 8,55 80<br />
0180671 TERRACORTRIL POM 15 G RR<br />
0 0 4,82 8,28 80<br />
D07CB02 fluprednidene and antibiotics<br />
0028600 DECODERM COMP CREME 20 G RR<br />
0 0 10,37 20,44 80<br />
0028614 DECODERM COMP CREME 50 G RR<br />
0 0 22,95 34,20 80<br />
0028631 DECODERM COMP SALBE 20 G RR<br />
0 0 10,37 20,44 80<br />
Page 81 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0028645 DECODERM COMP SALBE 50 G RR<br />
0 0 22,95 34,20 80<br />
D07CC01 betamethasone and antibiotics<br />
0158281 FUCICORT CREME 15 G RR<br />
0 0 5,18 8,90 80<br />
0158295 FUCICORT CREME 30 G RR<br />
0 0 8,81 15,14 0<br />
D07XB03 fluprednidene<br />
0444217 DECODERM TRI CREME 25 G RR<br />
0 0 9,68 19,67 0<br />
0192137 DECODERM TRI CREME 50 G RR<br />
0 0 20,03 31,00 80<br />
D07XC01 betamethasone<br />
0033399 DIPROSALIC LOTION 30 ML RR<br />
0 0 4,56 7,83 80<br />
0033404 DIPROSALIC ONG 30 G RR<br />
0 0 4,56 7,83 80<br />
0067898 LOTRIDERM CREME 30 G RR<br />
0 0 3,29 8,27 80<br />
D08AC02 chlorhexidine<br />
0137412 ASTREXINE PDR 30 G P<br />
0 0 2,15 3,69 80<br />
0511046 CEDIUM CHLORHEXIDIUM 0,05% 24 FL 10 ML P<br />
0 0 5,49 9,43 0<br />
0212159 HIBIDIL 0,05% SOL 10*15 ML UD P<br />
0 0 0,00 6,75 80<br />
0212176 HIBIDIL 0,05% SOL 120*50 ML UD P<br />
0 0 133,43 0,00 0<br />
0212162 HIBIDIL 0,05% SOL 240*15 ML UD P<br />
0 0 89,01 0,00 0<br />
0212193 HIBIDIL 0,05% SOL 8*50 ML UD P<br />
0 0 0,00 16,20 80<br />
0258919 HIBISCRUB 4% 24 FL UD 25 ML P<br />
0 0 18,50 0,00 0<br />
0258886 HIBISCRUB 4% 4 FL UD 25 ML P<br />
0 0 0,00 5,29 80<br />
0053729 HIBISCRUB 4% SOL 250 ML P<br />
0 0 0,00 5,84 80<br />
0053746 HIBISCRUB 4% SOL 5 L P<br />
0 0 38,53 0,00 0<br />
0053732 HIBISCRUB 4% SOL 500 ML P<br />
0 0 5,38 0,00 0<br />
0133752 HIBITANE 5% SOL 10 SACH 15 ML P<br />
0 0 0,00 7,05 80<br />
0053813 HIBITANE 5% SOL 250 ML P<br />
0 0 0,00 5,86 80<br />
0053827 HIBITANE 5% SOL 5 L P<br />
0 0 42,46 0,00 0<br />
0135273 HIBITANE 5% SOL 50 SACH 15 ML P<br />
0 0 19,68 0,00 0<br />
0053830 HIBITANE ANTISEPT LUBRIF 250 ML P<br />
0 0 0,00 4,88 80<br />
0183321 MEFREN INCOLORE SOL 50 ML P<br />
0 0 2,71 4,65 80<br />
0139286 SEPTEAL 0,5 % SOL 250 ML P<br />
0 0 0,00 3,67 80<br />
D08AC04 hexamidine<br />
0053584 HEXOMEDINE SOL 250 ML P<br />
0 0 3,50 6,01 0<br />
0053570 HEXOMEDINE SOL 45 ML P<br />
0 0 2,12 3,64 0<br />
0053598 HEXOMEDINE TRANSCUT SOL 45 ML P<br />
0 0 3,03 5,20 80<br />
D08AC52 chlorhexidine, combinations<br />
0182211 CETAVLEX CREME 60 G P<br />
0 0 2,46 4,23 80<br />
0027164 CYTEAL SOL ANTISEPTIQUE 250 ML P<br />
0 0 0,00 3,78 80<br />
0027178 CYTEAL SOL ANTISEPTIQUE 500 ML P<br />
0 0 0,00 6,80 80<br />
0051402 HAC SOL 250 ML P<br />
0 0 3,01 5,18 80<br />
0051416 HAC SOL 5 L P<br />
0 0 30,35 0,00 0<br />
Page 82 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
D08AE Phenol and derivatives<br />
0077216 NEOSABENYL 10 L P<br />
0 0 40,16 0,00 0<br />
0077202 NEOSABENYL 200 ML P<br />
0 0 4,49 7,72 0<br />
D08AE05 chloroxylenol<br />
0524223 DETTOLMEDICAL CHLOROXYLENOL 4,9% 1 L P<br />
0 0 6,52 11,19 0<br />
0524191 DETTOLMEDICAL CHLOROXYLENOL 4,9% 100 ML P<br />
0 0 1,98 3,40 0<br />
0524241 DETTOLMEDICAL CHLOROXYLENOL 4,9% 25 L P<br />
0 0 94,78 0,00 0<br />
0524237 DETTOLMEDICAL CHLOROXYLENOL 4,9% 5 L P<br />
0 0 23,12 0,00 0<br />
0524206 DETTOLMEDICAL CHLOROXYLENOL 4,9% 500 ML P<br />
0 0 4,07 7,00 0<br />
D08AF01 nitrofural<br />
0047167 FURACINE 200 MG/100 ML SOL 200 ML R<br />
0 0 0,00 7,98 0<br />
0462331 FURACINE 200 MG/100 ML SOL 250 ML R<br />
0 0 6,42 11,02 0<br />
0047170 FURACINE 200 MG/100 ML SOL 500 ML R<br />
0 0 10,11 0,00 0<br />
0161984 FURACINE POM 30 G R<br />
0 0 5,07 8,71 0<br />
0047136 FURACINE POM 375 G R<br />
0 0 19,21 0,00 0<br />
D08AG02 povidone-iodine<br />
0014944 BRAUNODERM 1/100 G SOL 1000 ML P<br />
0 0 0,00 11,70 80<br />
0014927 BRAUNODERM 1/100 G SOL 150 ML P<br />
0 0 0,00 2,83 80<br />
0014958 BRAUNODERM 9 MG/ML SOL 5 L P<br />
0 0 27,89 0,00 0<br />
0014992 BRAUNOL 7,5/100 G SOL 1000 ML P<br />
0 0 0,00 8,30 80<br />
0014989 BRAUNOL 7,5/100 G SOL 250 ML P<br />
0 0 0,00 6,42 80<br />
0186594 BRAUNOL 7,5/100 G SOL 30 ML P<br />
0 0 0,00 2,12 80<br />
0015065 BRAUNOVIDON 10% 10*20 CM 10 GAZES P<br />
0 0 0,00 35,05 80<br />
0015048 BRAUNOVIDON 10% 7,5*10 CM 10 GAZES P<br />
0 0 0,00 23,80 80<br />
0015115 BRAUNOVIDON POM 100 G P<br />
0 0 0,00 10,31 80<br />
0015101 BRAUNOVIDON POM 20 G P<br />
0 0 0,00 3,97 80<br />
0174657 IODEX DERMAL 10% SOL 30 ML P<br />
0 0 2,60 4,47 80<br />
0058384 IODEX SIMPLE POM 23 G P<br />
0 0 3,85 6,61 80<br />
0269943 ISOBETADINE 10% GEL 100 G P<br />
0 0 4,67 8,03 80<br />
0269957 ISOBETADINE 10% GEL 30 G P<br />
0 0 3,73 6,41 0<br />
0389437 ISOBETADINE 7,5% SAVON 125 ML P<br />
0 0 3,99 6,85 80<br />
0404466 ISOBETADINE DERM 10% SOL 10*5 ML UD P<br />
0 0 3,09 5,31 80<br />
0194727 ISOBETADINE DERM 10% SOL 125 ML P<br />
0 0 3,17 5,44 80<br />
0194758 ISOBETADINE DERM 10% SOL 50*10 ML UD P<br />
0 0 21,88 0,00 0<br />
0393636 ISOBETADINE HYDROALCOOLIQUE 5% 125 ML P<br />
0 0 3,44 5,91 80<br />
0621762 ISOBETADINE HYDROALCOOLIQUE 5% 40*10MLUD P<br />
0 0 29,25 0,00 0<br />
0059025 ISOBETADINE SAV GERM 7,5% 500 ML P<br />
0 0 5,74 9,86 80<br />
0059090 ISOBETADINE TULLE 10% 10*10 CM 10 COMPR P<br />
0 0 6,71 11,52 80<br />
0306112 ISOBETADINE TULLE 10% 10*10 CM 5 COMPR P<br />
0 0 4,14 7,11 0<br />
0059106 ISOBETADINE TULLE 10% 10*10 CM 50 COMPR P<br />
0 0 26,84 0,00 0<br />
0241746 ISOBETADINE UNIWASH 7,5% 10 FL UD 10 ML P<br />
0 0 4,44 7,62 80<br />
0241763 ISOBETADINE UNIWASH 7,5% 50 FL UD 10 ML P<br />
0 0 17,73 0,00 0<br />
Page 83 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
D08AJ Quaternary ammonium compounds<br />
0321394 BIOGAZE SPRAY 40 ML P<br />
0 0 0,00 5,93 0<br />
D08AJ01 benzalkonium<br />
0019548 CEDIUM BENZAL SOL 30 ML P<br />
0 0 2,66 4,58 0<br />
0199138 CEDIUM BENZAL SPRAY 50 ML P<br />
0 0 4,07 7,00 0<br />
0546167 DETTOLMEDICAL BENZALKONIUM 0,2% 100 ML P<br />
0 0 3,56 6,12 0<br />
D08AJ57 octenidine, combinations<br />
0334764 OCTENIDERM FARBLOS SOL 1 L P<br />
0 0 14,64 0,00 0<br />
0345706 OCTENIDERM FARBLOS SOL 250 ML P<br />
0 0 6,42 11,02 0<br />
0235251 OCTENISEPT SOL 1 L P<br />
0 0 12,41 21,02 0<br />
0409381 OCTENISEPT SOL 15 ML (UROLOGIE) P<br />
0 0 1,35 2,31 0<br />
0235234 OCTENISEPT SOL 250 ML P<br />
0 0 5,12 9,82 0<br />
0477981 OCTENISEPT SOL 50 ML SPRUEFLASCHE R<br />
0 0 2,85 4,86 0<br />
0477994 OCTENISEPT SOL 500 ML R<br />
0 0 8,07 14,52 0<br />
D08AK04 mercurochrome<br />
0070196 MEDICHROME ALC 30 ML P<br />
0 0 2,66 4,57 0<br />
0186367 MEDICHROME AQUEUX 30 ML P<br />
0 0 2,55 4,37 0<br />
D08AX02 eosin<br />
0168503 EOSINE CPB 2% SOL 100 ML P<br />
0 0 0,00 3,26 0<br />
D08AX03 propanol<br />
0334733 P<br />
0 0 70,50 0,00 0<br />
0334751 P<br />
0 0 8,82 0,00 0<br />
0478005 P<br />
0 0 6,53 11,22 0<br />
D08AX04 tosylchloramide sodium<br />
0020860 CHLORAMINE PURA 250 MG 60 CPR P<br />
0 0 0,00 3,55 80<br />
0021241 CHLORAZOL 500 MG 20 CPR P<br />
0 0 2,66 4,57 80<br />
D08AX07 sodium hypochlorite<br />
0181276 DAKIN COOPER STABILISE 250 ML P<br />
0 0 0,00 5,34 80<br />
D08AX53 propanol, combinations<br />
0235363 KODAN TINKTUR FORTE SOL.1*1 SOL. 2000 M P<br />
0 0 26,10 0,00 0<br />
0235394 KODAN TINKTUR FORTE SOL.1*1 SOL. 2000 M P<br />
0 0 20,34 0,00 0<br />
0235332 KODAN TINKTUR FORTE SOL.1*1 SOL. 250 ML P<br />
0 0 5,37 9,22 0<br />
0235377 KODAN TINKTUR FORTE SOL.1*1 SOL. 250 ML P<br />
0 0 4,38 7,52 0<br />
0235413 KODAN TINKTUR FORTE SOL.1*5 FL. 6 ML P<br />
0 0 5,15 10,82 0<br />
D09AA02 fusidic acid<br />
0046982 FUCIDIN INTERTULLE COMPR 10*10 RR<br />
0 0 6,39 10,98 80<br />
0046996 FUCIDIN INTERTULLE COMPR 10*30 RR<br />
0 0 0,00 13,24 80<br />
D10AD01 tretinoin<br />
Page 84 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0066856 LOCACID CREME 30 G RR<br />
0 0 0,00 5,75 80<br />
0066873 LOCACID LOT 15 ML RR<br />
0 0 0,00 5,35 80<br />
D10AD03 adapalene<br />
0252025 DIFFERIN 0,1% CREME 30 G RR<br />
0 0 0,00 9,83 80<br />
0380459 DIFFERIN 0,1% CREME 60 G RR<br />
0 0 0,00 17,68 80<br />
0217169 DIFFERIN 0,1% GEL 30 G RR<br />
0 0 0,00 9,83 80<br />
0380462 DIFFERIN 0,1% GEL 60 G RR<br />
0 0 0,00 17,68 80<br />
D10AD04 isotretinoin<br />
0197858 ISOTREX 0,05% GEL 50 G RR<br />
0 0 0,00 20,11 80<br />
D10AD51 tretinoin, combinations<br />
0181486 WIDMER CARBAMID VAS CREME 30 G RR<br />
0 0 5,82 15,45 80<br />
D10AD53 adapalene, combinations<br />
0479288 EPIDUO 0,1%/2,5% GEL 30 G RR<br />
0 0 14,09 24,20 0<br />
D10AD54 isotretinoin, combinations<br />
0260867 ISOTREXIN 0,05/2% GEL 50 G RR<br />
0 0 0,00 18,96 80<br />
D10AE01 benzoyl peroxide<br />
0001980 AKNEROXID 100 MG/G GEL 50 G P<br />
0 0 0,00 7,44 80<br />
0001994 AKNEROXID 50 MG/G GEL 50 G P<br />
0 0 3,48 6,74 80<br />
0145221 AKNEROXID L 40 MG/G SUSP 100 G P<br />
0 0 5,09 9,75 0<br />
0183107 BENZAC 10% GEL 40 G P<br />
0 0 0,00 6,38 80<br />
0183111 BENZAC 5% GEL 40 G P<br />
0 0 0,00 6,14 80<br />
0227876 BENZAC WASH 5 % 100 G P<br />
0 0 0,00 8,91 0<br />
0038042 ECLARAN 10 GEL 45 G P<br />
0 0 0,00 3,22 80<br />
0038056 ECLARAN 5 GEL 45 G P<br />
0 0 0,00 3,22 80<br />
0102708 SCHEROGEL 10% GEL 30 G P<br />
0 0 0,00 3,76 80<br />
0102711 SCHEROGEL 5% GEL 30 G P<br />
0 0 0,00 3,61 80<br />
D10AE51 benzoyl peroxide, combinations<br />
0269277 ACNEPLUS CREME 30 G P<br />
0 0 5,03 8,51 80<br />
D10AF01 clindamycin<br />
0239748 DALACIN TOPICAL 1% LOTIO 30 ML RR<br />
0 0 0,00 11,85 80<br />
0343648 ZINDACLIN 1% GEL 30 G RR<br />
0 0 9,79 16,82 80<br />
D10AF02 erythromycin<br />
0196279 ACNERYNE 4% GEL 30 G RR<br />
0 0 0,00 14,33 80<br />
0001977 AKNEMYCIN 2% SOL 25 ML RR<br />
0 0 2,66 11,99 80<br />
0146473 AKNEMYCIN 2000 POM 2% 25 G RR<br />
0 0 2,66 11,99 80<br />
0001963 AKNEMYCIN EMULSION 25 G RR<br />
0 0 0,00 14,41 80<br />
0040913 ERYFLUID LOTION 100 ML RR<br />
0 0 0,00 7,73 80<br />
0259107 ERYTHROMYCINE BAILLEUL 4% SOL 100 ML RR<br />
0 0 3,27 4,56 80<br />
0161189 INDERM SOL 50 ML RR<br />
0 0 10,24 17,59 0<br />
Page 85 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
D10AF03 chloramphenicol<br />
0254503 CHLORAMPHENICOL ERFA 1% CREME 20 G RR<br />
0 0 0,00 4,03 80<br />
D10AF52 erythromycin, combinations<br />
0523579 BENZADERMINE GEL 1 POT + S RR<br />
0 0 14,00 24,05 80<br />
0131128 ZINERYT LOT 30 ML RR<br />
0 0 10,98 18,86 80<br />
D10AX03 azelaic acid<br />
0163071 SKINOREN 20% CREME 30 G R<br />
0 0 8,70 14,95 80<br />
D10BA01 isotretinoin<br />
0472984 CURACNE 40 MG 30 CAPS RR C<br />
RM 0 0<br />
0,00 49,47 80<br />
0427927 CURACNE GE 10 MG 30 CAPS MOLLES RR C<br />
RM 0 0<br />
0,00 16,56 80<br />
0427975 CURACNE GE 20 MG 30 CAPS MOLLES RR C<br />
RM 0 0<br />
0,00 28,29 80<br />
0427863 CURACNE GE 5 MG 30 CAPS MOLLES RR C<br />
RM 0 0<br />
0,00 10,02 80<br />
0100393 ROACCUTANE 10 MG 30 CAPS RR C<br />
RM 0 0<br />
9,94 16,56 80<br />
0100409 ROACCUTANE 20 MG 30 CAPS RR C<br />
RM 0 0<br />
17,25 25,40 80<br />
D11AA Antihidrotics<br />
0006696 ANTIHYDRAL POM 70 G P<br />
0 0 2,68 5,32 0<br />
D11AC30 others<br />
0144532 NIZORAL 2% SHAMP 100 ML 47042 P<br />
0 0 6,45 11,08 0<br />
D11AF Wart and anti-corn preparations<br />
0007130 APORIL SOL 10 ML P<br />
0 0 3,85 6,61 0<br />
0178785 DUOFILM SOL 15 G P<br />
0 0 3,95 6,79 80<br />
0444221 VERRUMAL 14 ML RR<br />
0 0 9,11 19,06 80<br />
0130084 W TROPFEN 10 ML P<br />
0 0 2,21 4,43 0<br />
D11AH01 tacrolimus<br />
0317004 PROTOPIC 0,03% POM 30 G RR C<br />
0 0 19,92 28,33 80<br />
0317018 PROTOPIC 0,03% POM 60 G RR C<br />
0 0 35,33 45,31 80<br />
0317021 PROTOPIC 0,1% POM 30 G RR C<br />
0 0 21,89 30,51 80<br />
0317035 PROTOPIC 0,1% POM 60 G RR C<br />
0 0 39,41 49,81 80<br />
D11AH02 pimecrolimus<br />
0334473 ELIDEL 1% CREME 100 G RR C<br />
0 0 76,75 136,79 0<br />
0334439 ELIDEL 1% CREME 15 G RR C<br />
0 0 15,37 25,63 80<br />
0334442 ELIDEL 1% CREME 30 G RR C<br />
0 0 27,60 39,14 80<br />
D11AX Other dermatologicals<br />
0204689 99999BALNEUM HERMAL DUSCHBAD 150 ML P<br />
0 0 0,00 5,21 0<br />
0010587 BALNEUM HERMAL 200 ML P<br />
0 0 4,61 8,83 0<br />
0010590 BALNEUM HERMAL 500 ML P<br />
0 0 8,75 15,75 0<br />
0140614 BALNEUM HERMAL PLUS 200 ML P<br />
0 0 4,90 9,39 0<br />
0140628 BALNEUM HERMAL PLUS 500 ML P<br />
0 0 10,60 18,61 0<br />
0026315 CRINOHERMAL FEM 225 ML R<br />
0 0 20,94 32,00 0<br />
Page 86 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0026301 CRINOHERMAL FEM 95 ML R<br />
0 0 12,29 22,54 0<br />
0028581 DECODERM BASISCREME 50 G P<br />
0 0 0,00 5,27 0<br />
0341495 PERCUTAFEINE 5% GEL 200 ML P<br />
0 0 8,27 13,96 0<br />
0232201 PERCUTAFEINE 5% GEL 75 ML P<br />
0 0 0,00 9,62 0<br />
0181472 PIGMANORM CREME 15 G RR<br />
0 0 7,68 17,49 0<br />
0154797 ROCHE POSAY CERAT INALTERABLE 50 ML P<br />
0 0 0,00 4,09 0<br />
0154783 ROCHE POSAY COLD CREAM POT 100 ML P<br />
0 0 0,00 7,44 0<br />
0154766 ROCHE POSAY COLD CREAM TUBE 50 ML P<br />
0 0 0,00 4,09 0<br />
0227961 TANNOSYNT FLUESSIG BADEZUSATZ 100 G P<br />
0 0 5,01 9,61 0<br />
0227974 TANNOSYNT FLUESSIG BADEZUSATZ 250 G P<br />
0 0 10,08 17,87 0<br />
0227988 TANNOSYNT FLUESSIG BADEZUSATZ 500 G P<br />
0 0 17,80 29,69 0<br />
D11AX01 minoxidil<br />
0233193 ALOPEXY 2% SOL 3*60 ML P<br />
0 0 0,00 33,50 0<br />
0182306 ALOPEXY 2% SOL 60 ML P<br />
0 0 0,00 18,76 0<br />
0501893 ALOPEXY 5% 1 FL 60 ML P<br />
0 0 0,00 23,32 0<br />
0501909 ALOPEXY 5% 3 FL 60 ML P<br />
0 0 0,00 43,26 0<br />
0433387 MINOXIDIL BAILLEUL 2% 3*60 ML P<br />
0 0 0,00 28,00 0<br />
0433356 MINOXIDIL BAILLEUL 5% 3*60 ML P<br />
0 0 0,00 66,00 0<br />
0252591 NEOXIDIL 2 % SOL 1 FL HDPE 60 ML P<br />
0 0 16,11 26,50 0<br />
D11AX04 lithium succinate<br />
0233453 EFALITH LIPOCREME 20 G R<br />
0 0 0,00 10,20 0<br />
D11AX10 finasteride<br />
0321802 PROPECIA 1 MG 28 CPR RR<br />
0 0 0,00 56,47 0<br />
D11AX18 diclofenac<br />
0348367 SOLARAZE 3% GEL 25 G R C<br />
0 0 0,00 42,70 0<br />
D11AX19 alitretinoin<br />
0501974 TOCTINO 10 MG 30 CAPS MOLLES RR C<br />
RM 0 0<br />
445,15 483,41 80<br />
0501988 TOCTINO 30 MG 30 CAPS RR C<br />
RM 0 0<br />
445,15 483,41 80<br />
G01AA10 clindamycin<br />
0203289 DALACIN VAG 2% CREME 40 G RR<br />
0 0 14,88 25,23 80<br />
G01AC05 dequalinium<br />
0603327 FLUOMIZIN 10 MG 6 CPR VAG P<br />
0 0 6,70 11,51 0<br />
G01AD01 lactic acid<br />
0063112 LACTAGYNECOGEL POM 60 G + APPL P<br />
0 0 5,39 9,25 80<br />
G01AF01 metronidazole<br />
0044926 FLAGYL 500 MG 10 OV RR<br />
0 0 1,60 6,29 80<br />
G01AF02 clotrimazole<br />
0051223 CANESTENE GYN CLOTRIMAZ 2% CR 20G +3APPL P<br />
0 0 4,61 7,92 80<br />
0051187 CANESTENE GYN CLOTRIMAZOLE 100 MG 6 CPR P<br />
0 0 3,11 7,88 80<br />
Page 87 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0146294 FUNGIZID RATIO 1% CREME 20 G P<br />
0 0 1,87 3,72 80<br />
0146313 FUNGIZID RATIO 1% CREME 50 G P<br />
0 0 3,84 7,36 80<br />
0217155 FUNGIZID RATIO 1% CREME VAG 35 G + APPL P<br />
0 0 2,39 11,71 80<br />
0146246 FUNGIZID RATIO 100 MG 6 CPR VAG + APPL P<br />
0 0 2,66 11,99 80<br />
0146277 FUNGIZID RATIO 200 MG 3 CPR VAG + APPL P<br />
0 0 2,79 5,54 80<br />
0169237 FUNGIZID RATIO KOMBI 3 CPR+CR 20 G+APPL P<br />
0 0 3,36 6,60 80<br />
G01AF04 miconazole<br />
0051240 GYNODAKTARIN 1200 MG 1 OV 34198 R<br />
0 0 3,59 8,65 80<br />
0051254 GYNODAKTARIN 200 MG 7 OV 17442 P<br />
0 0 4,84 10,20 80<br />
0051237 GYNODAKTARIN CREME VAG 78 G 17399 P<br />
0 0 5,39 10,89 80<br />
G01AF12 fenticonazole<br />
0431091 GYNOXIN 2% CREME 35 G R<br />
0 0 3,27 8,25 80<br />
0431088 GYNOXIN 200 MG 3 OV R<br />
0 0 3,11 8,06 80<br />
0431074 GYNOXIN 600 MG 1 OV R<br />
0 0 3,14 8,08 80<br />
G01AF15 butoconazole<br />
0199253 GYNOMYK 100 MG 3 OV R<br />
0 0 3,09 7,91 80<br />
0199267 GYNOMYK 2% CREME VAG 20 G + 3 APPL R<br />
0 0 3,29 8,16 80<br />
G01AX11 povidone-iodine<br />
0391953 ISOBETADINE GYN 10% SOL 500 ML P P<br />
0 0 6,07 10,43 80<br />
0217012 ISOBETADINE UNIGYN SOL VAG 5 FL UD 10 ML P<br />
0 0 6,39 10,97 80<br />
G01AX14 lactobacillus fermentum<br />
0235539 GYNOFLOR 12 CPR VAG RR<br />
0 0 8,08 13,88 80<br />
G01BD Antiseptics and corticosteroids<br />
0435611 TERGYNAN 10 CPR RR<br />
0 0 0,00 3,74 0<br />
G02AB01 methylergometrine<br />
0071680 METHERGIN 0,2 MG 100 AMP 1 ML R<br />
0 0 46,01 0,00 0<br />
0071677 METHERGIN 0,2 MG 5 AMP 1 ML R<br />
0 0 2,89 12,25 80<br />
G02AD02 dinoprostone<br />
0141737 PREPIDIL GEL 1 SRG 3 G RR H<br />
0 0 24,67 0,00 0<br />
0242811 PROPESS 10 MG 5 DISPOS VAG RR H<br />
0 0 323,92 0,00 0<br />
0094833 PROSTIN E2 0,5 MG 10 CPR OR RR H<br />
0 0 22,62 0,00 0<br />
0094847 PROSTIN E2 1 MG 1 AMP 1 ML PERF RR H<br />
0 0 15,24 0,00 0<br />
0094850 PROSTIN E2 10 MG 1 AMP 1 ML PERF RR H<br />
0 0 35,33 0,00 0<br />
0139241 PROSTIN E2 3 MG 4 CPR VAG RR H<br />
0 0 43,95 0,00 0<br />
G02AD04 carboprost<br />
0152713 PROSTIN 15M 0,25 MG 1 AMP 1 ML IM RR H<br />
0 0 17,10 0,00 0<br />
G02BA03 plastic IUD with progestogen<br />
0205333 MIRENA 1 PO + DISP IU RR<br />
0 0 127,03 140,75 0<br />
Page 88 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
G02BB Intravaginal contraceptives<br />
0176634 PHARMATEX 10 OV P<br />
0 0 0,00 7,73 0<br />
0176648 PHARMATEX 20 OV P<br />
0 0 0,00 14,08 0<br />
0176651 PHARMATEX 6 TAMP P<br />
0 0 0,00 11,45 0<br />
0176621 PHARMATEX CREME GYN 6*4,5 G UD P<br />
0 0 0,00 6,72 0<br />
0176617 PHARMATEX CREME GYN 72 G P<br />
0 0 0,00 7,09 0<br />
G02BB01 vaginal ring with progestogen and estrogen<br />
0305177 NUVARING 1 DISPO VAG R<br />
6 14 10,15 17,44 80<br />
0305181 NUVARING 3 DISPO VAG R<br />
6 14 26,04 36,73 80<br />
G02CA01 ritodrine<br />
0342606 PREPAR 10 MG 40 CPR R<br />
0 0 17,45 25,51 0<br />
0342591 PREPAR 50 MG 10 AMP 5 ML IV RR H<br />
0 0 27,50 0,00 0<br />
G02CB01 bromocriptine<br />
0086392 PRAVIDEL 2,5 MG 10 CPR RR<br />
0 0 0,00 13,29 80<br />
0086411 PRAVIDEL 2,5 MG 100 CPR RR<br />
0 0 41,42 54,59 100<br />
0086408 PRAVIDEL 2,5 MG 30 CPR RR<br />
0 0 12,81 22,75 80<br />
G02CB03 cabergoline<br />
0191319 DOSTINEX 0,5 MG 2 CPR R<br />
0 0 18,22 28,67 80<br />
0235766 SOSTILAR 0,5 MG 8 CPR RR<br />
0 0 24,35 33,22 80<br />
G02CB04 quinagolide<br />
0205039 NORPROLAC 150 MCG 30 CPR 001786 RR<br />
0 0 0,00 111,92 80<br />
0205025 NORPROLAC 25/50 MCG 3 + 3 CPR 001789 RR<br />
0 0 3,45 8,47 80<br />
0205042 NORPROLAC 75 MCG 30 CPR 001783 RR<br />
0 0 27,66 36,87 80<br />
G02CX01 atosiban<br />
0275601 TRACTOCILE 7,5 MG/ML 1 FL 0,9 ML IV RR H<br />
0 0 25,57 0,00 0<br />
0275615 TRACTOCILE 7,5 MG/ML 1 FL DIL 5 ML IV RR H<br />
0 0 79,32 0,00 0<br />
G03AA05 norethisterone and estrogen<br />
0084482 OVYSMEN 3*21 CPR 193051 R<br />
6 14 4,56 9,85 80<br />
G03AA07 levonorgestrel and estrogen<br />
0319138 LOWETTE 0,02/0,1 MG 3*21 CPR R<br />
6 14 13,67 23,48 80<br />
0357612 LUDEAL 0,03/0,15 MG 3*21 CPR R<br />
6 14 0,00 5,10 80<br />
0433616 MICROGYNON 20 0,02/0,1 MG 21 CPR R<br />
0 0 0,00 6,59 0<br />
0433633 MICROGYNON 20 0,02/0,1 MG 3*21 CPR R<br />
6 14 10,36 17,79 80<br />
0575737 MICROGYNON 30 0,03/0,15 MG 13*21 DRG R<br />
6 14 20,89 31,42 80<br />
0072075 MICROGYNON 30 0,03/0,15 MG 3*21 DRG R<br />
6 14 4,39 9,65 80<br />
0072092 MICROGYNON 50 0,05/0,125 MG 3*21 DRG R<br />
6 14 4,21 9,42 80<br />
0596271 NORANELLE 20/100 MG 13*21 CPR R<br />
6 14 24,44 35,08 80<br />
0596253 NORANELLE 20/100 MG 3*21 CPR R<br />
6 14 7,36 12,65 80<br />
0596267 NORANELLE 20/100 MG 6*21 CPR R<br />
6 14 11,78 20,24 80<br />
Page 89 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0109550 STEDIRIL 30 3*21 DRG R<br />
6 14 5,55 9,53 80<br />
G03AA09 <strong>des</strong>ogestrel and estrogen<br />
0517263 DESO 20 0,15/0,02 MG 13*21 CPR R<br />
6 14 19,79 28,20 80<br />
0517232 DESO 20 0,15/0,02 MG 3*21 CPR R<br />
6 14 5,71 11,29 80<br />
0517246 DESO 20 0,15/0,02 MG 6*21 CPR R<br />
6 14 9,13 15,55 80<br />
0525901 DESO 30 0,03/0,15 MG 13*21 CPR R<br />
6 14 17,98 26,20 80<br />
0525881 DESO 30 0,03/0,15 MG 3*21 CPR R<br />
6 14 5,06 10,48 80<br />
0525895 DESO 30 0,03/0,15 MG 6*21 CPR R<br />
6 14 8,30 14,52 80<br />
0339886 DESORELLE 0,02/0,15 MG 3*21 CPR R<br />
6 14 5,82 11,07 80<br />
0339919 DESORELLE 0,03/0,15 MG 3*21 CPR R<br />
6 14 5,29 10,06 80<br />
0419312 MARVELON 13*21 CPR R<br />
6 14 37,18 48,91 80<br />
0069715 MARVELON 3*21 CPR R<br />
6 14 7,72 13,80 80<br />
0069729 MARVELON 6*21 CPR R<br />
6 14 17,50 27,95 80<br />
0399741 MERCILON 13*21 CPR R<br />
6 14 40,91 52,86 80<br />
0139191 MERCILON 3*21 CPR R<br />
6 14 8,43 14,68 80<br />
G03AA10 gestodene and estrogen<br />
0526102 DOCGESTRADIOL 20/75 MCG 3*21 CPR R<br />
6 14 5,90 10,05 80<br />
0526116 DOCGESTRADIOL 20/75 MCG 6*21 CPR R<br />
6 14 10,67 18,16 80<br />
0526147 DOCGESTRADIOL 30/75 MCG 3*21 CPR R<br />
6 14 5,90 10,05 80<br />
0526151 DOCGESTRADIOL 30/75 MCG 6*21 CPR R<br />
6 14 10,67 18,16 80<br />
0517439 FEMODENE 13*21 DRG R<br />
6 14 41,73 52,89 80<br />
0143521 FEMODENE 3*21 DRG R<br />
6 14 9,90 17,00 80<br />
0143535 FEMODENE 6*21 DRG R<br />
6 14 19,26 29,74 80<br />
0467399 GESTODELLE 0,075/0,02 MG 13*21 CPR R<br />
6 14 25,18 34,13 80<br />
0443626 GESTODELLE 0,075/0,02 MG 3*21 CPR R<br />
6 14 5,72 11,31 80<br />
0467385 GESTODELLE 0,075/0,02 MG 6*21 CPR R<br />
6 14 10,66 17,46 80<br />
0467371 GESTOFEME 0,075/0,03 MG 13*21 CPR R<br />
6 14 25,18 34,13 80<br />
0443643 GESTOFEME 0,075/0,03 MG 21 CPR R<br />
0 0 0,00 12,50 0<br />
0443657 GESTOFEME 0,075/0,03 MG 3*21 CPR R<br />
6 14 5,72 11,31 80<br />
0467368 GESTOFEME 0,075/0,03 MG 6*21 CPR R<br />
6 14 10,66 17,46 80<br />
0223667 HARMONET 3*21 DRG R<br />
6 14 8,72 14,98 80<br />
0572234 MELIANE 13*21 DRG R<br />
6 14 41,73 52,89 80<br />
0213884 MELIANE 3*21 DRG R<br />
6 14 9,90 17,00 80<br />
0213898 MELIANE 6*21 DRG R<br />
6 14 19,26 29,74 80<br />
0147971 MINULET 3*21 DRG R<br />
6 14 8,72 14,98 80<br />
0284385 MIRELLE 3*28 CPR R<br />
6 14 14,09 24,20 80<br />
G03AA11 norgestimate and estrogen<br />
0153501 CILEST 3*21 CPR 193044 R<br />
6 14 7,83 13,92 80<br />
G03AA12 drospirenone and estrogen<br />
0645331 ANNABELLE 0,02/3 MG 13*21 CPR R<br />
6 14 63,12 74,92 80<br />
0645344 ANNABELLE 0,02/3 MG 3*21 CPR R<br />
6 14 15,06 25,42 80<br />
0645327 ANNABELLE 0,02/3 MG 6*21 CPR R<br />
6 14 29,87 40,68 80<br />
Page 90 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0614821 ANNAIS 0,03/3 MG 13*21 CPR R<br />
6 14 68,56 80,52 80<br />
0614804 ANNAIS 0,03/3 MG 3*21 CPR R<br />
6 14 16,20 26,60 80<br />
0614818 ANNAIS 0,03/3 MG 6*21 CPR R<br />
6 14 31,71 42,56 80<br />
0547178 YASMIN 3/0,03 MG 13*21 CPR R<br />
6 14 99,85 112,76 80<br />
0287115 YASMIN 3/0,03 MG 3*21 CPR R<br />
6 14 22,66 33,25 80<br />
0547164 YASMIN 3/0,03 MG 6*21 CPR R<br />
6 14 46,08 57,37 80<br />
0446032 YASMINELLE 3/0,02 MG 13*21 CPR R<br />
6 14 91,98 104,65 80<br />
0446015 YASMINELLE 3/0,02 MG 3*21 CPR R<br />
6 14 21,23 31,77 80<br />
0446029 YASMINELLE 3/0,02 MG 6*21 CPR R<br />
6 14 42,45 53,63 80<br />
0572221 YAZ 3/0,02 MG 13*28 CPR R<br />
6 14 100,62 113,54 80<br />
0492536 YAZ 3/0,02 MG 3*28 CPR R<br />
6 14 23,22 33,82 80<br />
0492553 YAZ 3/0,02 MG 6*28 CPR R<br />
6 14 46,44 57,74 80<br />
G03AA13 norelgestromin and estrogen<br />
0342024 EVRA 6/0,6 MG 9 PATCH R<br />
6 14 22,50 33,09 80<br />
G03AA14 nomegestrol and estrogen<br />
0656883 ZOELY 2,5/1,5 MG 13*28 CPR R<br />
6 14 97,50 110,34 80<br />
0635396 ZOELY 2,5/1,5 MG 3*28 CPR R<br />
6 14 22,50 33,09 80<br />
0656866<br />
G03AA15<br />
ZOELY 2,5/1,5 MG 6*28 CPR R<br />
6 14 45,00 56,26 80<br />
0530587 BELLISSIMA 0,03/2 MG 21 CPR R<br />
0 0 4,99 14,55 0<br />
0530591 BELLISSIMA 0,03/2 MG 3*21 CPR R<br />
6 14 15,83 26,41 80<br />
0530606 BELLISSIMA 0,03/2 MG 6*21 CPR R<br />
6 14 28,75 40,55 80<br />
0638305 HELEN 0,03/2 MG 13*21 CPR R<br />
6 14 55,92 67,50 80<br />
0638272 HELEN 0,03/2 MG 3*21 CPR R<br />
6 14 14,16 24,34 80<br />
0638286 HELEN 0,03/2 MG 6*21 CPR R<br />
6 14 28,19 38,95 80<br />
0575561 VERANA RATIO 2/0,03 MG 21 CPR R<br />
0 0 7,07 12,60 0<br />
0575575 VERANA RATIO 2/0,03 MG 3*21 CPR R<br />
6 14 13,41 23,90 80<br />
0575589 VERANA RATIO 2/0,03 MG 6*21 CPR R<br />
6 14 22,58 40,25 80<br />
G03AB03 levonorgestrel and estrogen<br />
0357593 DAILY 3*21 CPR R<br />
6 14 0,00 5,10 80<br />
0120186 TRIGYNON 3*21 DRG R<br />
6 14 6,57 12,37 80<br />
0120530 TRINORDIOL 3*21 DRG R<br />
6 14 8,26 14,19 80<br />
G03AB04 norethisterone and estrogen<br />
0120575 TRINOVUM 3*21 CPR 193054 R<br />
6 14 7,06 12,98 80<br />
G03AB05 <strong>des</strong>ogestrel and estrogen<br />
0195612 GRACIAL 1*22 CPR R<br />
0 0 4,38 7,53 0<br />
0436621 GRACIAL 13*22 CPR R<br />
6 14 48,79 60,17 80<br />
0192607 GRACIAL 3*22 CPR R<br />
6 14 11,85 20,37 80<br />
G03AB06 gestodene and estrogen<br />
0148061 TRIMINULET 3*21 DRG R<br />
6 14 10,39 17,13 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0145025<br />
G03AB08<br />
TRIODENE 3*21 DRG R<br />
6 14 7,54 13,57 80<br />
0519921 QLAIRA 3*28 CPR R<br />
6 14 27,47 38,21 80<br />
G03AC03 levonorgestrel<br />
0072139 MICROLUT 3*35 DRG R<br />
6 14 4,70 10,03 80<br />
G03AC06 medroxyprogesterone<br />
0029835 DEPO PROVERA 150 MG 1 SRG 1 ML IM RR<br />
0 0 3,30 8,29 0<br />
0590795 SAYANA 104 MG 1 SRG PREREMPLIE 0,65 ML RR<br />
0 0 13,00 22,33 0<br />
G03AC08 etonogestrel<br />
0262651 IMPLANON NXT 68 MG 1 SET RR<br />
RM 0 0<br />
125,84 139,53 0<br />
G03AC09 <strong>des</strong>ogestrel<br />
0643689 CELEA 75 MCG 13*28 CPR R<br />
6 14 43,81 55,04 80<br />
0574645 CELEA 75 MCG 28 CPR R<br />
0 0 4,81 8,27 0<br />
0574659 CELEA 75 MCG 3*28 CPR R<br />
6 14 11,55 19,84 80<br />
0643675 CELEA 75 MCG 6*28 CPR R<br />
6 14 21,21 31,76 80<br />
0252414 CERAZETTE 75 MCG 28 CPR R<br />
0 0 6,02 10,34 0<br />
0252428<br />
G03AD01<br />
CERAZETTE 75 MCG 3*28 CPR R<br />
6 14 15,60 25,97 80<br />
0280209 NORLEVO 0,75 MG 2 CPR P<br />
0 0 0,00 9,57 0<br />
0409736 NORLEVO 1,5 MG 1 CPR P<br />
0 0 5,58 9,58 0<br />
0295523 POSTINOR 0,75 MG 2 CPR P<br />
0 0 5,06 8,70 0<br />
0421761<br />
G03AD02<br />
POSTINOR 1,5 MG 1 CPR P<br />
0 0 5,57 9,57 0<br />
0520756 ELLAONE 30 MG 1 CPR RR<br />
0 0 18,59 29,05 0<br />
G03BA03 testosterone<br />
0326552 ANDROGEL 50 MG 10 SACH 5 G RR<br />
0 0 18,83 29,30 0<br />
0326597 ANDROGEL 50 MG 30 SACH 5 G RR<br />
0 0 43,68 55,10 0<br />
0465851 ITNOGEN 2% GEL 60 G RR<br />
0 0 38,05 49,10 0<br />
0456981 NEBIDO 250 MG/ML 1 AMP 4 ML IM RR C<br />
0 0 100,00 112,91 80<br />
0482428 SUSTANON 250 MG 1 AMP 1 ML RR<br />
0 0 4,74 10,09 80<br />
0314681 SUSTANON 250 MG 6 FL 1 ML RR<br />
0 0 28,44 37,61 80<br />
0398582 TESTIM 50 MG GEL 30 TUBES 5 G RR<br />
0 0 43,86 55,09 0<br />
0338472 TESTOCAPS 40 MG 120 CAPS RR<br />
0 0 33,54 44,46 0<br />
0338411 TESTOCAPS 40 MG 60 CAPS RR<br />
0 0 20,96 31,50 80<br />
G03BB01 mesterolone<br />
0095164 PROVIRON 25 MG 50 CPR RR<br />
0 0 0,00 10,19 80<br />
G03BB02 androstanolone<br />
0143969 ANDRACTIM 2,5% GEL 80 G RR<br />
0 0 11,99 20,60 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
G03CA03 estradiol<br />
0290821 AERODIOL 150 MCG/D SPRAY 3 FL 60 D RR<br />
0 0 28,06 39,42 0<br />
0260447 CLIMARA 50 12 PATCH RR<br />
0 0 18,13 28,59 80<br />
0220729 CLIMARA 50 4 PATCH RR<br />
0 0 0,00 12,98 80<br />
0226168 DERMESTRIL 100 8 PATCH RR<br />
0 0 9,80 16,83 80<br />
0350321 DERMESTRIL 25 26 PATCH RR<br />
0 0 12,99 22,32 80<br />
0350334 DERMESTRIL 50 26 PATCH RR<br />
0 0 18,24 28,69 80<br />
0269071 DERMESTRIL SEPTEM 25 12 PATCH RR<br />
0 0 11,01 18,91 80<br />
0269098 DERMESTRIL SEPTEM 50 12 PATCH RR<br />
0 0 15,43 25,80 80<br />
0256928 ESTRAMON 100 8 MG 6 PATCH RR<br />
0 0 6,10 15,76 80<br />
0256864 ESTRAMON 25 2 MG 6 PATCH RR<br />
0 0 2,99 12,35 80<br />
0256895 ESTRAMON 50 4 MG 6 PATCH RR<br />
0 0 4,29 13,78 80<br />
0262505 ESTREVA 0,1 % GEL 50 G RR<br />
0 0 2,39 7,04 80<br />
0238575 ESTROFEM 1 MG 3*28 CPR RR<br />
0 0 16,37 26,77 80<br />
0176438 ESTROFEM 2 MG 3*28 CPR RR<br />
0 0 16,37 26,77 80<br />
0444346 OESTROGEL 0,06% GEL 2*100 G RR<br />
0 0 6,81 12,66 80<br />
0081513 OESTROGEL 0,06% GEL 80 G RR<br />
0 0 2,21 6,94 80<br />
0328462 PROGYNOVA 1 MG 3*28 DRG RR<br />
0 0 3,26 8,24 80<br />
0328476 PROGYNOVA 2 MG 3*28 DRG RR<br />
0 0 4,08 9,26 80<br />
0539341 SYSTEN TTS 3,2 MG 24 PATCH RR<br />
0 0 20,29 30,80 80<br />
0157625 VAGIFEM 25 MCG 15 CPR VAG + APPL RR<br />
0 0 11,26 19,35 80<br />
0183754 ZUMENON 2 MG 3*28 CPR RR<br />
0 0 15,24 25,60 80<br />
G03CA04 estriol<br />
0000112 AACIFEMINE 0,5 MG 15 OV RR<br />
0 0 3,73 6,41 80<br />
0000076 AACIFEMINE 2 MG 30 CPR RR<br />
0 0 3,41 8,42 80<br />
0000109 AACIFEMINE CREME 15 G RR<br />
0 0 5,97 10,26 80<br />
0186689 ORTHOGYNEST DEPOT 6 OV 193552 RR<br />
0 0 5,43 9,33 80<br />
G03CX01 tibolone<br />
0500821 HERIA 2,5 MG 28 CPR RR<br />
0 0 10,67 20,90 0<br />
0508541 HERIA 2,5 MG 3*28 CPR RR<br />
0 0 37,24 46,64 0<br />
0508555 HERIA 2,5 MG 6*28 CPR RR<br />
0 0 64,91 74,63 0<br />
0524884 LIVIAL 2,5 MG 28 CPR RR<br />
0 0 14,54 24,89 0<br />
0211618 LIVIAL 2,5 MG 3*28 CPR RR<br />
0 0 36,12 47,11 0<br />
G03DA02 medroxyprogesterone<br />
0095116 PROVERA 10 MG 30 CPR RR<br />
0 0 4,59 9,90 80<br />
0139496 PROVERA 5 MG 24 CPR RR<br />
0 0 2,28 7,03 80<br />
G03DA04 progesterone<br />
0252981 CRINONE 8% GEL VAG 15 APPL RR<br />
0 0 37,50 48,54 0<br />
0094251 PROGESTOGEL GEL 80 G RR<br />
0 0 3,22 5,54 80<br />
0123966 UTROGESTAN 100 MG 30 CAPS RR<br />
0 0 4,33 9,57 80<br />
0123983 UTROGESTAN 100 MG 90 CAPS RR<br />
0 0 12,91 20,27 80<br />
Page 93 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0461879 UTROGESTAN 200 MG 45 CAPS RR<br />
0 0 12,91 20,27 80<br />
0262441 UTROGESTAN VAGINAL 100 MG 90 CAPS RR<br />
0 0 13,17 20,48 80<br />
G03DB01 dydrogesterone<br />
0171624 DUPHASTON 10 MG 42 CPR RR<br />
0 0 9,56 15,97 80<br />
G03DB04 nomegestrol<br />
0309999 LUTENYL 5 MG 30 CPR RR<br />
0 0 8,58 14,76 80<br />
0525279 LUTENYL 5 MG 90 CPR RR<br />
0 0 20,22 28,55 80<br />
0497921 NOGEST 5 MG 30 CPR RR<br />
0 0 8,41 14,66 80<br />
0497949 NOGEST 5 MG 60 CPR RR<br />
0 0 13,99 21,61 80<br />
0497966 NOGEST 5 MG 90 CPR RR<br />
0 0 19,82 28,23 80<br />
G03DC02 norethisterone<br />
0093674 PRIMOLUT NOR FORTE 10 MG 30 CPR RR<br />
0 0 2,93 7,83 80<br />
G03DC03 lynestrenol<br />
0083289 ORGAMETRIL 5 MG 30 CPR RR<br />
0 0 2,00 6,71 80<br />
G03FA01 norethisterone and estrogen<br />
0252543 ACTIVELLE 3*28 CPR RR<br />
0 0 36,10 47,10 80<br />
0200533 KLIOGEST 3*28 CPR RR<br />
0 0 30,21 41,03 80<br />
G03FA14 dydrogesterone and estrogen<br />
0293062 FEMOSTON CONTI 3*28 CPR RR<br />
0 0 30,36 41,18 80<br />
0569967 FEMOSTON LOW 0,5/2,5 MG 84 CPR RR<br />
0 0 30,36 40,54 80<br />
G03FA15 dienogest and estrogen<br />
0308473 CLIMODIEN 2/2 3*28 CPR RR<br />
0 0 29,06 39,84 80<br />
G03FA17 drospirenone and estrogen<br />
0354798 ANGELIQ 1/2 MG 28 CPR RR<br />
0 0 17,85 28,30 0<br />
0354803 ANGELIQ 1/2 MG 3*28 CPR RR<br />
0 0 41,36 52,51 0<br />
G03FB Progestogens and estrogens, sequential preparations<br />
0370287 NAEMIS 1,5/3,75 MG 3*24 CPR RR<br />
0 0 36,83 48,54 0<br />
G03FB01 norgestrel and estrogen<br />
0026864 CYCLOCUR 3*21 DRG RR<br />
0 0 4,33 9,57 80<br />
G03FB05 norethisterone and estrogen<br />
0310911 NOVOFEM 3*28 CPR RR<br />
0 0 22,04 32,61 0<br />
0255805 TRISEQUENS 2 MG 3*28 CPR RR<br />
0 0 9,09 15,50 80<br />
G03FB06 medroxyprogesterone and estrogen<br />
0250258 DIVIPLUS 3*28 CPR RR<br />
0 0 7,21 13,17 80<br />
0173811 DIVIVA 3*21 CPR RR<br />
0 0 5,74 11,33 80<br />
G03FB08 dydrogesterone and estrogen<br />
0305471 FEMOSTON 1/10 3*28 CPR RR<br />
0 0 20,29 30,80 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0229921 FEMOSTON 2/10 3*28 CPR RR<br />
0 0 20,29 30,80 80<br />
G03GA01 chorionic gonadotrophin<br />
0093206 PREGNYL 1500 U 3 AMP + S 1 ML IM RR C<br />
0 0 4,57 9,88 80<br />
0511761 PREGNYL 5000 U 1 AMP + S 1 ML IM RR C<br />
0 0 3,93 8,96 80<br />
0093237 PREGNYL 5000 U 3 AMP + S 1 ML IM RR C<br />
0 0 8,74 14,95 80<br />
G03GA02 human menop<strong>au</strong>sal gonadotrophin<br />
0330913 MENOPUR FERRING 75 U PDR 10 FL + S IMSC RR C<br />
0 0 174,02 189,15 80<br />
G03GA04 urofollitropin<br />
0434001 FOSTIMON 150 U/ML PDR 1 FL + S IMSC RR C<br />
0 0 32,94 44,41 80<br />
0434028 FOSTIMON 150 U/ML PDR 10 FL + S IMSC RR C<br />
0 0 329,44 360,90 80<br />
0433969 FOSTIMON 75 U/ML PDR 1 FL + S IMSC RR C<br />
0 0 16,47 22,75 80<br />
0433986 FOSTIMON 75 U/ML PDR 10 FL + S IMSC RR C<br />
0 0 164,72 184,97 80<br />
G03GA05 follitropin alfa<br />
0365239 GONAL F 300 U 1 STYLO 0,5 ML + 8 AIG RR C<br />
0 0 101,41 116,37 80<br />
0365242 GONAL F 450 U 1 STYLO 0,75 ML + 7 AIG RR C<br />
0 0 151,10 169,05 80<br />
0215231 GONAL F 75 U PDR 1 AMP+S 1 ML SC RR C<br />
0 0 25,98 35,02 80<br />
0365256 GONAL F 900 U 1 STYLO 1,5 ML + 20 AIG RR C<br />
0 0 298,95 325,74 80<br />
G03GA06 follitropin beta<br />
0279435 PUREGON 300 U 1 CRT 0,36 ML SC RR C<br />
0 0 91,37 105,73 80<br />
0279449 PUREGON 600 U 1 CRT 0,72 ML SC RR C<br />
0 0 173,59 192,88 80<br />
0389082 PUREGON 900 U 1 CRT 1,08 ML + AIG RR C<br />
0 0 260,32 284,80 80<br />
G03GA08 choriogonadotropin alfa<br />
0297061 OVITRELLE 250 MCG SOL 1 FL + S SC RR C<br />
0 0 56,56 68,16 80<br />
G03GA09 corifollitropin alfa<br />
0555815 ELONVA 100 MG 1 SRG 0,5 ML + 1 AIG SC RR C<br />
0 0 544,54 570,79 80<br />
0558767 ELONVA 150 MG 1 SRG 0,5 ML + 1 AIG SC RR C<br />
0 0 544,54 570,79 80<br />
G03GA30 combinations<br />
0462733 PERGOVERIS 150 U PDR 10 FL + S 1 ML SC RR C<br />
0 0 724,40 756,04 80<br />
G03GB02 clomifene<br />
0023070 CLOMID 50 MG 10 CPR RR C<br />
0 0 3,85 8,97 80<br />
0088495 PERGOTIME 50 MG 10 CPR RR C<br />
0 0 4,15 7,13 0<br />
0088481 PERGOTIME 50 MG 5 CPR RR C<br />
0 0 4,10 9,17 80<br />
G03HA01 cyproterone<br />
0006049 ANDROCUR 10 MG 45 CPR RR<br />
0 0 0,00 19,51 80<br />
0006035 ANDROCUR 50 MG 50 CPR RR<br />
0 0 20,02 28,45 80<br />
0442548 CYPROPLEX 50 MG 50 CPR RR<br />
0 0 20,57 31,09 0<br />
G03HB01 cyproterone and estrogen<br />
0186093 CLIMEN 3*21 DRG RR<br />
0 0 19,03 29,51 80<br />
Page 95 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0450911 DAPHNE 2 MG 13*21 CPR RR<br />
0 0 25,29 0,00 0<br />
0381281 DAPHNE 2 MG 3*21 CPR RR<br />
0 0 7,35 13,33 80<br />
0409137 DAPHNE 2 MG 6*21 CPR RR<br />
0 0 12,08 19,23 80<br />
0139997 DIANE 35 3*21 DRG RR<br />
0 0 13,59 23,35 80<br />
0426205 DIANE 35 6*21 DRG RR<br />
0 0 14,91 25,26 0<br />
G03X OTHER SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM<br />
0434062 ABUFENE 400 MG 30 CPR P<br />
0 0 0,00 4,41 0<br />
G03XA01 danazol<br />
0226963 DANATROL 200 MG 100 CAPS RR<br />
0 0 74,16 87,50 0<br />
G03XB01 mifepristone<br />
0286894 MIFEGYNE 200 MG 3 CPR RR DC<br />
0 0 54,87 0,00 0<br />
G03XC01 raloxifene<br />
0254033 EVISTA 60 MG 14 CPR RR<br />
0 0 15,57 25,94 80<br />
0254051 EVISTA 60 MG 84 CPR RR<br />
0 0 70,25 83,35 80<br />
G04BC Urinary concrement solvents<br />
0366804 BLANEL 48 CPR EFF P<br />
0 0 13,10 22,19 80<br />
0366818 BLANEL 96 CPR EFF P<br />
0 0 24,62 39,94 80<br />
0335016 URALYT U GRAN 280 G P<br />
0 0 20,01 46,19 80<br />
G04BD02 flavoxate<br />
0123319 URISPAS 200 MG 100 DRG R<br />
0 0 8,09 14,25 80<br />
0141835 URISPAS 200 MG 40 DRG R<br />
0 0 4,06 9,24 80<br />
G04BD04 oxybutynin<br />
0134522 DITROPAN 5 MG 100 CPR R<br />
0 0 6,72 12,55 80<br />
0134519 DITROPAN 5 MG 30 CPR R<br />
0 0 2,89 7,76 80<br />
0134505 DITROPAN 5 MG/5 ML SIR 473 ML R<br />
0 0 6,75 12,48 80<br />
0400257 KENTERA 36 MG 8 PATCH R<br />
0 0 33,60 44,51 80<br />
0395532 OXYBUTYNINE EG 5 MG 100 CPR R<br />
0 0 3,62 8,69 80<br />
0395482 OXYBUTYNINE EG 5 MG 30 CPR R<br />
0 0 1,37 6,02 80<br />
G04BD06 propiverine<br />
0488418 MICTONORM 15 MG 28 CPR R<br />
0 0 15,59 25,87 0<br />
0482543 MICTONORM 15 MG 49 CPR R<br />
0 0 27,19 38,67 0<br />
0482557 MICTONORM 15 MG 98 CPR R<br />
0 0 50,80 65,07 0<br />
G04BD07 tolterodine<br />
0244474 DETRUSITOL 2 MG 56 CPR R<br />
0 0 35,15 46,11 80<br />
0303706 DETRUSITOL RET 4 MG 28 CAPS R<br />
0 0 39,19 49,57 80<br />
G04BD08 solifenacin<br />
0386306 VESICARE 5 MG 30 CPR R<br />
0 0 42,00 53,17 80<br />
0386341 VESICARE 5 MG 90 CPR R<br />
0 0 97,07 111,78 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
G04BD09 trospium<br />
0234903 SPASMEX 15 MG 30 CPR R<br />
0 0 13,62 22,79 80<br />
0234934 SPASMEX 5 MG 30 CPR R<br />
0 0 10,44 20,50 80<br />
0197889 SPASMO URGENIN TC 100 DRG R<br />
0 0 29,37 41,23 80<br />
0197875 SPASMO URGENIN TC 50 DRG R<br />
0 0 16,05 26,66 80<br />
0224861 SPASMOLYT 20 MG 100 DRG R<br />
0 0 35,96 48,43 80<br />
0224857 SPASMOLYT 20 MG 50 DRG R<br />
0 0 20,19 31,19 80<br />
0294414 URAPLEX 20 MG 30 CPR R<br />
0 0 14,93 23,10 0<br />
G04BD11 fesoterodine<br />
0467922 TOVIAZ 4 MG 28 CPR RR<br />
0 0 38,36 48,65 80<br />
0477817 TOVIAZ 4 MG 84 CPR RR<br />
0 0 92,40 106,82 80<br />
0467984 TOVIAZ 8 MG 28 CPR RR<br />
0 0 43,11 53,88 80<br />
0477821 TOVIAZ 8 MG 84 CPR RR<br />
0 0 103,49 118,58 80<br />
G04BE01 alprostadil<br />
0211599 CAVERJECT 10 MCG PDR 1 FL + SRG 1 ML RR<br />
0 0 9,61 16,51 0<br />
0236049 CAVERJECT 10 MCG PDR 5 FL + 5 SRG 1 ML RR<br />
0 0 45,10 56,36 0<br />
0211585 CAVERJECT 20 MCG PDR 1 FL + SRG 1 ML RR<br />
0 0 14,63 24,98 0<br />
0236052 CAVERJECT 20 MCG PDR 5 FL + 5 SRG 1 ML RR<br />
0 0 67,39 79,32 0<br />
0244586 CAVERJECT 5 MCG PDR 1 FL + SRG 1 ML RR<br />
0 0 0,00 12,43 0<br />
G04BE03 sildenafil<br />
0420541 REVATIO 20 MG 90 CPR RR DC X 0 0<br />
484,20 0,00 0<br />
0255061 VIAGRA 100 MG 12 CPR RR<br />
0 0 110,88 124,11 0<br />
0255044 VIAGRA 100 MG 4 CPR RR<br />
0 0 36,96 47,97 0<br />
0254954 VIAGRA 25 MG 4 CPR RR<br />
0 0 26,51 37,22 0<br />
0255027 VIAGRA 50 MG 12 CPR RR<br />
0 0 97,68 110,52 0<br />
0254999 VIAGRA 50 MG 4 CPR RR<br />
0 0 32,56 43,44 0<br />
G04BE04 yohimbine<br />
0365953 YOCORAL 5 MG 100 CPR R<br />
0 0 23,20 33,81 0<br />
0365936 YOCORAL 5 MG 50 CPR R<br />
0 0 14,46 24,80 0<br />
G04BE08 tadalafil<br />
0617501 ADCIRCA 20 MG 56 CPR RR C<br />
0 0 532,56 573,23 0<br />
0340632 CIALIS 10 MG 4 CPR RR<br />
0 0 40,47 51,60 0<br />
0459464 CIALIS 2,5 MG 28 CPR RR<br />
0 0 75,00 87,16 0<br />
0389096 CIALIS 20 MG 12 CPR RR<br />
0 0 115,36 128,73 0<br />
0340615 CIALIS 20 MG 4 CPR RR<br />
0 0 40,47 51,60 0<br />
0340629 CIALIS 20 MG 8 CPR RR<br />
0 0 76,91 89,12 0<br />
0459481 CIALIS 5 MG 28 CPR RR<br />
0 0 81,09 93,43 0<br />
G04BE09 vardenafil<br />
0345379 LEVITRA 10 MG 12 CPR RR<br />
0 0 48,28 59,63 0<br />
0341948 LEVITRA 10 MG 4 CPR RR<br />
0 0 13,61 23,38 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0341951 LEVITRA 10 MG 8 CPR RR<br />
0 0 29,19 39,98 0<br />
0342007 LEVITRA 20 MG 12 CPR RR<br />
0 0 106,17 119,27 0<br />
0341982 LEVITRA 20 MG 4 CPR RR<br />
0 0 35,77 46,75 0<br />
0341996 LEVITRA 20 MG 8 CPR RR<br />
0 0 69,02 79,95 0<br />
0341921 LEVITRA 5 MG 12 CPR RR<br />
0 0 24,43 35,07 0<br />
0341903 LEVITRA 5 MG 4 CPR RR<br />
0 0 6,80 11,69 0<br />
G04BX Other urologicals<br />
0246174 CYSTINOL LONG 60 CAPS P<br />
0 0 12,76 21,61 0<br />
G04CA01 alfuzosin<br />
0225398 XATRAL RET 5 MG 56 CPR R<br />
0 0 24,24 34,86 80<br />
0304961 XATRAL UNO 10 MG 30 CPR R<br />
0 0 25,98 36,66 80<br />
G04CA02 tamsulosin<br />
0437131 DOCTAMSULOSINE 0,4 MG 90 CAPS R<br />
0 0 24,32 36,81 80<br />
0410995 OMIC OCAS 0,4 MG 30 CPR R<br />
0 0 28,54 39,31 80<br />
0411041 OMIC OCAS 0,4 MG 90 CPR R<br />
0 0 76,12 88,31 80<br />
0414493 TAMSULOSIN EG 0,4 MG 30 CAPS R<br />
0 0 0,00 18,95 80<br />
0414543 TAMSULOSIN EG 0,4 MG 90 CAPS R<br />
0 0 26,61 37,31 80<br />
0414817 TAMSULOSIN HEXAL 0,4 MG 100 CAPS R<br />
0 0 15,22 25,74 80<br />
0414736 TAMSULOSIN HEXAL 0,4 MG 20 CAPS R<br />
0 0 3,71 13,16 80<br />
0414771 TAMSULOSIN HEXAL 0,4 MG 50 CAPS R<br />
0 0 7,72 17,53 80<br />
0433423 TAMSULOSINE HCL YAMA-PH 0,4 MG 30 CAPS R<br />
0 0 13,01 22,35 80<br />
0433454 TAMSULOSINE HCL YAMA-PH 0,4 MG 90 CAPS R<br />
0 0 37,08 48,10 80<br />
0433809 TAMSULOSINE RATIO 0,4 MG 100 CAPS R<br />
0 0 15,22 25,74 80<br />
0433762 TAMSULOSINE RATIO 0,4 MG 20 CAPS R<br />
0 0 3,71 13,16 80<br />
0433793 TAMSULOSINE RATIO 0,4 MG 50 CAPS R<br />
0 0 7,72 17,53 80<br />
G04CA03 terazosin<br />
0055480 HYTRIN 1 MG 10 CPR R<br />
0 0 1,56 6,01 80<br />
0055494 HYTRIN 10 MG 28 CPR R<br />
0 0 18,25 26,39 80<br />
0055513 HYTRIN 2 MG 28 CPR R<br />
0 0 6,24 11,84 80<br />
0055527 HYTRIN 5 MG 28 CPR R<br />
0 0 12,24 19,33 80<br />
0296923 TERAZOSAB 1 MG 10 CPR R<br />
0 0 0,00 2,35 80<br />
0296954 TERAZOSAB 10 MG 28 CPR R<br />
0 0 17,34 27,77 80<br />
0296937 TERAZOSAB 2 MG 28 CPR R<br />
0 0 0,00 11,38 80<br />
0296941 TERAZOSAB 5 MG 28 CPR R<br />
0 0 0,00 21,66 80<br />
0272501 UROHYTRIN 10 MG 28 CPR R<br />
0 0 30,12 40,93 0<br />
0272482 UROHYTRIN 2 MG 28 CPR R<br />
0 0 0,00 16,48 0<br />
0272496 UROHYTRIN 5 MG 28 CPR R<br />
0 0 20,13 30,64 0<br />
0272515 UROHYTRIN STARTER 3*1 MG+11*2 MG CPR R<br />
0 0 0,00 8,58 0<br />
G04CA04 silodosin<br />
0557631 SILODYX 4 MG 30 CAPS RR<br />
RM 0 0<br />
15,00 25,36 0<br />
0557708 SILODYX 8 MG 30 CAPS RR<br />
RM 0 0<br />
15,00 25,36 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0557725 SILODYX 8 MG 90 CAPS RR<br />
RM 0 0<br />
36,00 46,99 0<br />
G04CA52 tamsulosin and dutasteride<br />
0569081 COMBODART 0,5/0,4 MG 30 CAPS (FL) R<br />
0 0 32,67 43,56 80<br />
0569094 COMBODART 0,5/0,4 MG 90 CAPS (FL) R<br />
0 0 78,41 90,67 80<br />
G04CB01 finasteride<br />
0467046 FINASTERID RATIO 5 MG 100 CPR R<br />
0 0 42,23 55,30 80<br />
0467015 FINASTERID RATIO 5 MG 30 CPR R<br />
0 0 13,74 24,12 80<br />
0467029 FINASTERID RATIO 5 MG 50 CPR R<br />
0 0 22,13 33,31 80<br />
0460255 FINASTERIDE EG 5 MG 100 CPR R<br />
0 0 45,36 57,62 80<br />
0460211 FINASTERIDE EG 5 MG 30 CPR R<br />
0 0 17,30 27,73 80<br />
0460238 FINASTERIDE EG 5 MG 60 CPR R<br />
0 0 27,74 38,48 80<br />
0187882 PROSCAR 5 MG 28 CPR R<br />
0 0 26,30 37,00 80<br />
G04CB02 dutasteride<br />
0343438 AVODART 0,5 MG 30 CAPS R<br />
0 0 28,87 39,65 80<br />
G04CX02 serenoa repens<br />
0183933 PERMIXON 160 MG 60 CAPS R<br />
0 0 0,00 31,98 80<br />
0219244 PROSTA URGENIN UNO 320 MG 120 CAPS P<br />
0 0 20,22 36,04 80<br />
0219231 PROSTA URGENIN UNO 320 MG 60 CAPS P<br />
0 0 11,44 20,39 80<br />
0233095 PROSTASERENE 320 MG 30 CAPS P<br />
0 0 10,34 17,78 80<br />
H01AA02 tetracosactide<br />
0112377 SYNACTHEN 0,25 MG 1 AMP RR<br />
0 0 1,25 5,72 80<br />
0112394 SYNACTHEN DEP 1 MG 1 AMP RR<br />
0 0 1,65 6,05 80<br />
H01AC01 somatropin<br />
0607195 GENOTONORM 12 MG 1 GOQUICK SC RR C<br />
1 5 279,04 304,52 100<br />
0180136 GENOTONORM 12 MG PDR 1 FL 2 CPT SC P PEN RR C<br />
1 5 279,04 304,64 100<br />
0607178 GENOTONORM 5,3 MG 1 GOQUICK SC RR C<br />
1 5 137,75 154,78 100<br />
0607181 GENOTONORM 5,3 MG 5 GOQUICK SC RR C<br />
1 5 688,72 738,73 100<br />
0164311 GENOTONORM 5,3 MG PDR 1 FL 2CPT SC P PEN RR C<br />
1 5 137,75 154,89 100<br />
0198208 HUMATROPE 12 MG PDR 1 CRT+SRG S IMSC RR C<br />
1 5 225,80 248,09 100<br />
0198192 HUMATROPE 6 MG PDR 1 CRT + SRG S IMSC RR C<br />
1 5 122,00 138,08 100<br />
0377954 NORDITROPIN NORDIFLEX 15 MG 1 PEN 1,5 ML RR C<br />
0 0 387,34 419,25 100<br />
0274196 NORDITROPIN SPXX 10 MG 3 CRT 1,5 ML SC RR C<br />
1 5 774,69 829,97 100<br />
0274179 NORDITROPIN SPXX 5 MG 3 CRT 1,5 ML SC RR C<br />
1 5 387,34 419,42 100<br />
0364889 NUTROPIN AQ 10 MG 1 CRT 2 ML SC RR C<br />
1 5 204,79 225,95 100<br />
0364892 NUTROPIN AQ 10 MG 3 CRT 2 ML SC RR C<br />
1 5 614,40 660,07 100<br />
0455631 OMNITROPE 3,3 MG SOL INJ 5 CRT 1,5 ML SC RR C<br />
1 5 504,54 543,52 100<br />
0575849 OMNITROPE 6,7 MG SOL INJ 5 CRT 1,5 ML SC RR C<br />
1 5 1.009,09 1.078,28 100<br />
0194517 ZOMACTON 4 MG PDR 12 U 1 FL + S 3,5 ML RR C<br />
1 5 103,32 118,40 100<br />
H01AC03 mecasermin<br />
0469118 INCRELEX 10 MG/ML 1 FL 4 ML V SC RR C<br />
X RM 0 0<br />
598,50 643,23 0<br />
Page 99 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
H01AX01 pegvisomant<br />
0340579 SOMAVERT 10 MG PDR 30 FL + S 8 ML RR DC X 1 5<br />
2.250,00 0,00 0<br />
0340582 SOMAVERT 15 MG PDR 30 FL + S 8 ML RR DC X 1 5<br />
3.375,50 0,00 0<br />
0353207 SOMAVERT 20 MG PDR 1 FL + S 8 ML RR DC X 0 0<br />
4.495,00 0,00 0<br />
0340596 SOMAVERT 20 MG PDR 30 FL + S 8 ML RR DC X 1 5<br />
4.500,00 0,00 0<br />
H01BA02 <strong>des</strong>mopressin<br />
0459559 DESMOPRESSING FERRING 0,2 MG 100 CPR RR<br />
0 0 66,67 79,55 80<br />
0459531 DESMOPRESSING FERRING 0,2 MG 15 CPR RR<br />
0 0 11,15 19,16 80<br />
0209069 MINIRIN 0,1 MG/ML 1 FL 2,5 ML IN RR<br />
0 0 12,78 20,10 80<br />
0192821 MINIRIN SPRAY 0,1 MG/ML 1 FL 2,5 ML IN RR<br />
0 0 12,59 19,87 80<br />
H01BA04 terlipressin<br />
0188635 GLYPRESSIN 1 MG PDR 5 FL+S 5 ML IV RR H<br />
0 0 93,52 0,00 0<br />
H01BB02 oxytocin<br />
0112735 SYNTOCINON 10 U 100 AMP 1 ML RR H<br />
0 0 88,36 0,00 0<br />
0112718 SYNTOCINON 3 U 100 AMP 1 ML RR H<br />
0 0 31,66 0,00 0<br />
H01BB03 carbetocin<br />
0476174 PABAL 100 MCG 5 AMP 1 ML IV RR HC<br />
0 0 125,00 0,00 0<br />
H01CA Gonadotropin-releasing hormones<br />
0285205 DECAPEPTYL 0,1 MG PDR 7 FL + S SC RR<br />
0 0 30,13 40,95 80<br />
H01CA03 histrelin<br />
0554754 VANTASSE 50 MG 1 IMPLANT + 1 DISPO RR<br />
0 0 1.228,39 1.310,71 100<br />
H01CB02 octreotide<br />
0182824 SANDOSTATIN 100 MCG 5 AMP 1 ML SC RR C<br />
0 0 60,36 75,14 100<br />
0182838 SANDOSTATIN 500 MCG 5 AMP 1 ML SC RR C<br />
0 0 298,75 336,01 100<br />
0246241 SANDOSTATIN LAR 20 MG 1 FL+SRG 2 ML(C) RR C<br />
0 0 1.838,55 1.999,71 100<br />
0246272 SANDOSTATIN LAR 30 MG 1 FL+SRG 2 ML(C) RR C<br />
0 0 2.362,43 2.555,49 100<br />
H01CB03 lanreotide<br />
0340811 SOMATULINE AUTOGEL 120 MG 1 SRG 0,5ML SC RR C<br />
0 0 1.252,24 1.335,93 100<br />
0340792 SOMATULINE AUTOGEL 60 MG 1 SRG 0,3 ML SC RR C<br />
0 0 818,85 876,59 100<br />
0340808 SOMATULINE AUTOGEL 90 MG 1 SRG 0,3 ML SC RR C<br />
0 0 981,26 1.048,73 100<br />
0314467 SOMATULINE PR 40 MG PDR 1 COFFERT 1 FL RR C<br />
0 0 409,41 442,65 100<br />
H01CC01 ganirelix<br />
0282184 ORGALUTRAN 0,25 MG 1 SRG 0,5 ML SC RR C<br />
0 0 37,87 48,92 80<br />
0282198 ORGALUTRAN 0,25 MG 5 SRG 0,5 ML SC RR C<br />
0 0 189,30 204,88 80<br />
H01CC02 cetrorelix<br />
0264981 CETROTIDE 0,25 MG 7 FL + 7 SRG SC RR C<br />
0 0 235,18 252,15 80<br />
0264978 CETROTIDE 0,25 MG PDR 1 FL + SRG SC RR C<br />
0 0 40,90 52,03 80<br />
0264995 CETROTIDE 3 MG PDR 1 FL + SRG SC RR C<br />
0 0 233,70 250,62 0<br />
Page 100 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
H02AA02 fludrocortisone<br />
0195772 ASTONIN H 50 CPR R<br />
0 0 24,71 36,14 80<br />
H02AB01 betamethasone<br />
0019873 CELESTONE 0,5 MG 30 CPR RR<br />
0 0 1,13 5,77 80<br />
0019890 CELESTONE 0,5 MG/ML GTTS 30 ML RR<br />
0 0 1,59 6,28 80<br />
0019906 CELESTONE 1 AMP 4 MG 1 ML IMIV RR<br />
0 0 0,76 5,36 80<br />
0019923 CELESTONE CHRONODOSE 1 FL 1 ML IM M.D. RR<br />
0 0 2,79 7,66 80<br />
0230045 DIPROPHOS 2 MG + 5 MG 1 FL 5 ML IMIAID RR<br />
0 0 12,39 21,28 0<br />
0033371 DIPROPHOS DS 2MG+5MG 1 SRG 1 ML IMIAID RR<br />
0 0 2,83 7,70 80<br />
0033385 DIPROPHOS DS 4MG+10MG 1 SRG 2 ML IMIAID RR<br />
0 0 4,42 9,68 80<br />
H02AB02 dexamethasone<br />
0311384 AACIDEXAM 5 MG 1 AMP 1 ML IMIV RR<br />
0 0 1,65 6,34 80<br />
0197391 FORTECORTIN 0,5 MG 20 CPR RR<br />
0 0 1,69 10,93 80<br />
0197411 FORTECORTIN 4 MG 20 CPR RR<br />
0 0 10,51 20,59 80<br />
0235038 FORTECORTIN 8 MG 20 CPR RR<br />
0 0 17,38 28,11 80<br />
0046139 FORTECORTIN INJEKT 100MG 10ML FERTIGSPR RR<br />
0 0 31,30 43,35 80<br />
0046173 FORTECORTIN INJEKT 40 MG 5ML 1 FERTIGSPR RR<br />
0 0 13,39 23,74 80<br />
0046142 FORTECORTIN INJEKT 4MG 3 AMP 1ML RR<br />
0 0 1,48 10,72 80<br />
0046187 FORTECORTIN INJEKT 8 MG 3 AMP 2 ML RR<br />
0 0 2,33 11,63 80<br />
H02AB04 methylprednisolone<br />
0029611 DEPO MEDROL 200 MG 1 AMP 5 ML IMTO RR<br />
0 0 15,19 23,12 80<br />
0029589 DEPO MEDROL 40 MG 1 AMP 1 ML IMTO RR<br />
0 0 4,01 9,16 80<br />
0029639 DEPO MEDROL 40 MG 1 SRG 1 ML IMTO RR<br />
0 0 4,01 9,16 80<br />
0029592 DEPO MEDROL 40 MG 3 AMP 1 ML IMTO RR<br />
0 0 10,76 17,58 80<br />
0029625 DEPO MEDROL 40 MG 3 SRG 1 ML IMTO RR<br />
0 0 10,76 17,58 80<br />
0029608 DEPO MEDROL 80 MG 1 AMP 2 ML IMTO RR<br />
0 0 7,61 13,66 80<br />
0029642 DEPO MEDROL 80 MG 1 SRG 2 ML IMTO RR<br />
0 0 7,61 13,66 80<br />
0029673 DEPO MEDROL LIDO 40 MG 1 FL 1 ML IMTO RR<br />
0 0 4,11 9,30 80<br />
0029690 DEPO MEDROL LIDO 40 MG 3 FL 1 ML IMTO RR<br />
0 0 11,03 17,92 80<br />
0029687 DEPO MEDROL LIDO 80 MG 1 FL 2 ML IMTO RR<br />
0 0 7,80 13,90 80<br />
0070280 MEDROL 32 MG 20 CPR RR<br />
0 0 11,43 18,41 80<br />
0070327 MEDROL 4 MG 100 CPR UD RR<br />
0 0 8,27 0,00 0<br />
0070313 MEDROL 4 MG 30 CPR RR<br />
0 0 2,92 7,82 80<br />
0070330 MEDROL A 16 MG 14 CPR RR<br />
0 0 5,20 10,65 80<br />
0070344 MEDROL A 16 MG 50 CPR RR<br />
0 0 14,84 22,68 80<br />
0070361 MEDROL PACK 4 MG 21 CPR RR<br />
0 0 2,18 6,91 80<br />
0551685 METHYLPREDNISOLONE ORION 16MG 50CPR (FL) RR<br />
0 0 15,42 23,27 0<br />
0106576 SOLUMEDROL 1 G PDR + S 16 ML IV RR<br />
0 0 56,65 68,80 80<br />
0134858 SOLUMEDROL 125 MG 1 MIX 2 ML IMIV RR<br />
0 0 8,71 15,04 80<br />
0106609 SOLUMEDROL 40 MG 1 MIX 1 ML IMIV RR<br />
0 0 3,65 8,73 80<br />
0106612 SOLUMEDROL 40 MG 3 MIX 1 ML IMIV RR<br />
0 0 9,36 15,84 80<br />
0106626 SOLUMEDROL 500 MG PDR 1 FL + S 8 ML IV RR<br />
0 0 31,48 41,07 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0106531 SOLUMEDROL SAB 125 MG PDR 1 FL + S 2 ML RR<br />
0 0 8,71 15,04 80<br />
0106562 SOLUMEDROL SAB 40 MG 3 MIX 1 ML IMIV RR<br />
0 0 9,36 15,84 80<br />
0106559 SOLUMEDROL SAB 40 MG PDR 1 FL + S 1 ML RR<br />
0 0 3,65 8,73 80<br />
H02AB06 prednisolone<br />
0106321 SOLUDECORTIN H 25 MG 3 AMP IMIVSC RR<br />
0 0 3,62 13,04 80<br />
0106352 SOLUDECORTIN H 50 MG 3 AMP IMIVSC RR<br />
0 0 7,20 16,96 80<br />
H02AB07 prednisone<br />
0514275 LODOTRA 1 MG 100 CPR RR<br />
0 0 56,23 67,82 0<br />
0514261 LODOTRA 1 MG 30 CPR RR<br />
0 0 16,87 27,29 0<br />
0514308 LODOTRA 2 MG 100 CPR RR<br />
0 0 56,23 67,82 0<br />
0514292 LODOTRA 2 MG 30 CPR RR<br />
0 0 16,87 27,29 0<br />
0514339 LODOTRA 5 MG 100 CPR RR<br />
0 0 56,23 67,82 0<br />
0514325 LODOTRA 5 MG 30 CPR RR<br />
0 0 16,87 27,29 0<br />
H02AB08 triamcinolone<br />
0002201 ALBICORT 10 MG 1 FL 5 ML IM RR<br />
0 0 4,28 9,50 80<br />
0061961 KENACORT A 10 50 MG 1 FL 5 ML IAID RR<br />
0 0 3,80 8,91 80<br />
H02AB09 hydrocortisone<br />
0288577 HYDROCORTISONE ERFA 20 MG 20 CPR RR<br />
0 0 2,76 7,61 80<br />
0106285 SOLUCORTEF 100 MG 1 FL 2 ML IMIV RR<br />
0 0 1,99 6,70 80<br />
0106304 SOLUCORTEF 250 MG 1 FL 2 ML IMIV RR<br />
0 0 4,31 9,55 80<br />
H02AB13 deflazacort<br />
0063546 CALCORT 30 MG 10 CPR RR<br />
0 0 17,35 30,46 80<br />
0156063 CALCORT 30 MG 20 CPR RR<br />
0 0 32,96 57,87 80<br />
0063563 CALCORT 6 MG 20 CPR RR<br />
0 0 8,68 15,24 80<br />
0154749 CALCORT 6 MG 60 CPR RR<br />
0 0 24,75 43,46 80<br />
H03AA01 levothyroxine sodium<br />
0038803 ELTHYRONE 100 MCG 100 CPR R<br />
0 0 1,84 6,42 80<br />
0150414 ELTHYRONE 150 MCG 100 CPR SEC R<br />
0 0 2,47 7,14 80<br />
0038820 ELTHYRONE 200 MCG 100 CPR R<br />
0 0 3,01 7,80 80<br />
0150428 ELTHYRONE 25 MCG 100 CPR SEC R<br />
0 0 0,84 5,33 80<br />
0038784 ELTHYRONE 50 MCG 100 CPR R<br />
0 0 1,14 5,66 80<br />
0192025 EUTHYROX 100 MCG 100 DRG R<br />
0 0 3,80 13,24 80<br />
0192039 EUTHYROX 125 MCG 100 CPR R<br />
0 0 4,32 13,81 80<br />
0192042 EUTHYROX 150 MCG 100 DRG R<br />
0 0 4,80 14,33 80<br />
0300671 EUTHYROX 175 MCG 100 CPR R<br />
0 0 5,29 14,87 80<br />
0192056 EUTHYROX 200 MCG 100 CPR R<br />
0 0 5,76 15,39 80<br />
0192851 EUTHYROX 25 MCG 100 CPR R<br />
0 0 1,65 10,89 80<br />
0192008 EUTHYROX 50 MCG 100 DRG R<br />
0 0 2,47 11,80 80<br />
0192011 EUTHYROX 75 MCG 100 CPR R<br />
0 0 3,14 12,52 80<br />
0195451 JODTHYROX 100 MCG 100 CPR R<br />
0 0 9,32 19,28 80<br />
0277847 L THYROXINE CHRST 100 MCG 112 CPR R<br />
0 0 3,76 8,86 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0305809 L THYROXINE CHRST 100 MCG 112 CPR UD R<br />
0 0 3,76 0,00 0<br />
0277851 L THYROXINE CHRST 125 MCG 112 CPR R<br />
0 0 4,40 9,66 80<br />
0277864 L THYROXINE CHRST 150 MCG 112 CPR R<br />
0 0 5,06 10,48 80<br />
0366382 L THYROXINE CHRST 175 MCG 112 CPR R<br />
0 0 5,86 11,48 80<br />
0277878 L THYROXINE CHRST 200 MCG 112 CPR R<br />
0 0 6,15 11,84 80<br />
0277816 L THYROXINE CHRST 25 MCG 112 CPR R<br />
0 0 1,72 6,40 80<br />
0305776 L THYROXINE CHRST 25 MCG 112 CPR UD R<br />
0 0 1,72 0,00 0<br />
0277833 L THYROXINE CHRST 50 MCG 112 CPR R<br />
0 0 2,32 7,06 80<br />
0305793 L THYROXINE CHRST 50 MCG 112 CPR UD R<br />
0 0 2,32 0,00 0<br />
0366379 L THYROXINE CHRST 75 MCG 112 CPR R<br />
0 0 3,18 8,13 80<br />
H03AA03 combinations of levothyroxine and liothyronine<br />
0080645 NOVOTHYRAL 100 MCG 100 CPR R<br />
0 0 16,81 27,48 80<br />
0192981 NOVOTHYRAL 75 MCG 100 CPR R<br />
0 0 14,72 25,20 80<br />
H03BA02 propylthiouracil<br />
0094718 PROPYLTHIOURACIL CHRST 50 MG 60 CPR R<br />
0 0 4,50 7,73 80<br />
H03BB02 thiamazole<br />
0110646 STRUMAZOL 10 MG 100 CPR R<br />
0 0 3,86 8,98 80<br />
0192915 THYROZOL 10 MG 50 CPR R<br />
0 0 3,20 12,59 80<br />
0192932 THYROZOL 20 MG 20 CPR R<br />
0 0 1,81 11,07 80<br />
0192946 THYROZOL 20 MG 50 CPR R<br />
0 0 3,89 13,34 80<br />
0192882 THYROZOL 5 MG 50 CPR R<br />
0 0 2,65 11,98 80<br />
H03CA Iodine therapy<br />
0140341 JODID MERCK 100 MCG 100 CPR R<br />
0 0 1,88 3,76 80<br />
0244832 JODID MERCK 200 MCG 100 CPR R<br />
0 0 2,93 5,82 80<br />
H04AA01 glucagon<br />
0225501 GLUCAGEN 1 MG PSV 10 FL + S IMIVSC RR<br />
0 0 130,52 0,00 0<br />
0225496 GLUCAGEN HYPOKIT 1 MG PDR + SRG IMIVSC RR<br />
0 0 15,55 23,52 80<br />
H05AA02 teriparatide<br />
0350429 FORSTEO 20 MCG/D 1 STYLO SC RR<br />
0 0 320,00 347,94 80<br />
H05BX01 cinacalcet<br />
0386709 MIMPARA 30 MG 28 CPR RR C<br />
0 0 169,99 189,05 100<br />
0386757 MIMPARA 60 MG 28 CPR RR C<br />
0 0 318,00 345,92 100<br />
0386791 MIMPARA 90 MG 28 CPR RR C<br />
0 0 456,48 492,70 100<br />
H05BX02 paricalcitol<br />
0396381 ZEMPLAR 5 MCG 5 AMP 1 ML IV RR HC<br />
0 0 93,00 0,00 0<br />
J01AA Tetracyclines<br />
0167635 AMBRODOXY 10 CAPS RR<br />
0 0 0,00 4,88 80<br />
0167649 AMBRODOXY 20 CAPS RR<br />
0 0 0,00 8,58 80<br />
J01AA02 doxycycline<br />
Page 103 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0304815 DOCDOXYCY DISPERS 100 MG 10 CPR RR<br />
0 0 0,00 6,25 80<br />
0304801 DOCDOXYCY DISPERS 200 MG 10 CPR RR<br />
0 0 0,00 8,49 80<br />
0169805 DOXY M RATIO 100 MG 10 CPR RR<br />
0 0 0,41 6,66 80<br />
0169819 DOXY M RATIO 100 MG 20 CPR RR<br />
0 0 1,18 10,39 80<br />
0169822 DOXY M RATIO 200 MG 10 CPR RR<br />
0 0 0,70 9,85 80<br />
0245101 DOXY M RATIO 200 MG 20 CPR RR<br />
0 0 2,04 11,31 80<br />
0185843 DOXYCYCLIN RATIO SF 2 AMP 5 ML IV RR<br />
0 0 4,51 9,49 80<br />
0185857 DOXYCYCLIN RATIO SF 5 AMP 5 ML IV RR<br />
0 0 12,28 22,53 80<br />
0238091 DOXYCYCLINE EG 100 MG 10 CPR RR<br />
0 0 1,94 6,66 80<br />
0238088 DOXYCYCLINE EG 200 MG 10 CPR RR<br />
0 0 3,47 8,50 80<br />
0191353 DOXYHEXAL SF SULFITFREI 100 MG 2 AMP 5ML RR<br />
0 0 0,00 9,49 80<br />
0191367 DOXYHEXAL SF SULFITFREI 100 MG 5 AMP 5ML RR<br />
0 0 12,28 22,53 80<br />
0170384 DOXYHEXAL TABS 100 MG 10 CPR RR<br />
0 0 0,29 6,66 80<br />
0170398 DOXYHEXAL TABS 100 MG 20 CPR RR<br />
0 0 1,19 10,40 80<br />
0170367 DOXYHEXAL TABS 200 MG 10 CPR RR<br />
0 0 0,71 9,86 80<br />
0170371 DOXYHEXAL TABS 200 MG 20 CPR RR<br />
0 0 2,05 11,32 80<br />
0036034 DOXYLETS 100 MG 10 CAPS RR<br />
0 0 2,05 6,80 80<br />
0036048 DOXYLETS 200 MG 10 CAPS RR<br />
0 0 3,47 8,50 80<br />
0176083 DOXYTAB 100 MG 10 CAPS RR<br />
0 0 0,00 8,67 80<br />
0307915 DOXYTAB 100 MG 10 CPR RR<br />
0 0 0,00 8,67 0<br />
0127271 VIBRATAB 100 MG 10 CPR RR<br />
0 0 1,94 6,66 80<br />
J01AA04 lymecycline<br />
0302435 TETRALYSAL 300 MG 28 CAPS RR<br />
0 0 12,14 19,30 80<br />
0223931 TETRALYSAL 300 MG 56 CAPS RR<br />
0 0 19,40 27,77 80<br />
J01AA08 minocycline<br />
0248331 KLINOTAB 100 MG 30 CPR RR<br />
0 0 11,56 18,58 80<br />
0072626 MINO 50 MG 20 CPR RR<br />
0 0 4,58 9,89 80<br />
0191899 MINO 50 MG 42 CPR RR<br />
0 0 8,42 14,66 80<br />
0251305 MINOCIN 100 MG 10 CAPS MICROGRAN RR<br />
0 0 5,28 10,76 80<br />
0251319 MINOCIN 100 MG 20 CAPS MICROGRAN RR<br />
0 0 0,00 23,58 80<br />
0457331 MINOCYCLINE EG 50 MG 20 CAPS RR<br />
0 0 3,12 8,07 80<br />
0457344 MINOCYCLINE EG 50 MG 42 CAPS RR<br />
0 0 6,83 12,68 80<br />
0145624 MINOTAB 100 MG 10 CPR RR<br />
0 0 5,28 10,76 80<br />
J01AA12 tigecycline<br />
0435607 TYGACIL 50 MG PDR 10 FL IV RR HC<br />
0 0 418,87 0,00 0<br />
J01BA02 thiamphenicol<br />
0123238 URFAMYCINE 500 MG PDR 3 AMP IMIV RR<br />
0 0 3,29 8,27 80<br />
0123210 URFAMYCINE 750 MG PDR 3 AMP IMIV RR<br />
0 0 4,95 10,34 80<br />
J01CA01 ampicillin<br />
0088058 PENTREXYL 1 G PDR 25 FL IMIV RR<br />
0 0 25,94 0,00 0<br />
0139451 PENTREXYL 2 G 1 AMP IV RR<br />
0 0 2,27 7,02 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0088111 PENTREXYL 250 MG PDR 25 FL IMIV RR<br />
0 0 10,95 0,00 0<br />
J01CA04 amoxicillin<br />
0149573 AMOXICILLIN 250 TS RATIO GRAN 100G=200ML RR<br />
0 0 2,62 8,65 80<br />
0005105 AMOXICILLIN 250 TS RATIO GRAN 50G=100ML RR<br />
0 0 1,28 4,49 80<br />
0267255 AMOXICILLIN RATIO 1 G 14 CPR RR<br />
0 0 2,64 11,47 80<br />
0005086 AMOXICILLIN RATIO 1 G 20 CPR PELLIC RR<br />
0 0 4,27 10,94 80<br />
0218216 AMOXICILLIN RATIO 1 G 30 CPR RR<br />
0 0 7,08 16,37 80<br />
0005122 AMOXICILLIN RATIO 500 MG 20 CPR PELLIC RR<br />
0 0 2,77 8,17 80<br />
0005153 AMOXICILLIN RATIO 750 MG 20 CPR PELLIC RR<br />
0 0 3,59 12,52 80<br />
0249985 AMOXICILLIN RATIO 750 MG 30 CPR PELLIC RR<br />
0 0 5,93 15,12 80<br />
0458632 AMOXICILLINE EG 1 G 20 CPR EFF RR<br />
0 0 8,37 14,50 80<br />
0237936 AMOXICILLINE EG 1 G 8 CPR RR<br />
0 0 2,75 7,60 80<br />
0458629 AMOXICILLINE EG 1 G 8 CPR EFF RR<br />
0 0 2,75 7,60 80<br />
0459299 AMOXICILLINE EG 1000 MG 20 CPR RR<br />
0 0 0,00 19,76 0<br />
0475701 AMOXICILLINE EG 250 MG/5 ML PDR 100 ML RR<br />
0 0 2,17 6,90 80<br />
0158586 AMOXICILLINE EG 250 MG/5 ML PDR 80 ML RR<br />
0 0 0,00 4,41 80<br />
0146134 AMOXICILLINE EG 500 MG 16 CAPS RR<br />
0 0 1,95 6,67 80<br />
0459304 AMOXICILLINE EG 500 MG 30 CAPS RR<br />
0 0 6,49 12,25 80<br />
0139823 AMOXIHEXAL 250 MG/5 ML SIR 100 ML RR<br />
0 0 1,28 10,48 80<br />
0197682 AMOXIHEXAL 250 MG/5 ML SIR 2*100 ML RR<br />
0 0 2,62 11,94 80<br />
0005203 AMOXIHEXAL 500 MG 10 CPR PELLIC RR<br />
0 0 0,49 4,17 80<br />
0162351 AMOXIHEXAL 500 MG 20 CPR PELLIC RR<br />
0 0 1,87 8,17 80<br />
0157741 AMOXYPEN 250 MG/5 ML SIR 80 ML RR<br />
0 0 0,00 4,69 80<br />
0157723 AMOXYPEN 500 MG 16 CAPS RR<br />
0 0 0,00 8,18 80<br />
0325247 AMOXYPEN 750 MG 16 CPR RR<br />
0 0 0,00 11,56 0<br />
0208125 CLAMOXYL 1 G PDR 30 FL + S 5 ML IMIV RR<br />
0 0 31,55 0,00 0<br />
0022705 CLAMOXYL 125 MG/5 ML SIR 80 ML RR<br />
0 0 1,28 5,94 80<br />
0140466 CLAMOXYL 250 MG/5 ML SIR 80 ML RR<br />
0 0 2,22 6,96 80<br />
0022638 CLAMOXYL 500 MG 100 CAPS RR<br />
0 0 11,82 0,00 0<br />
0022624 CLAMOXYL 500 MG 16 CAPS RR<br />
0 0 1,89 6,59 80<br />
0022722 CLAMOXYL 500 MG 16 SACH RR<br />
0 0 1,89 6,59 80<br />
0385049 CLAMOXYL TABS 1 G 24 CPR RR<br />
0 0 8,08 14,25 80<br />
0196623 CLAMOXYL TABS 1 G 8 CPR RR<br />
0 0 2,70 7,54 80<br />
0389292 FLEMOXIN 250 MG/5 ML SUSP 100 ML RR<br />
0 0 2,17 6,90 80<br />
0331678 FLEMOXIN SOLUTAB 1 G 20 CPR RR<br />
0 0 12,42 21,34 80<br />
0459271 FLEMOXIN SOLUTAB 1 G 24 CPR RR<br />
0 0 8,08 14,25 80<br />
0341661 FLEMOXIN SOLUTAB 500 MG 30 CPR RR<br />
0 0 6,49 12,25 80<br />
0242158 GRAMIDIL 1 G PDR 14 SACH RR<br />
0 0 0,00 5,54 80<br />
0242144 GRAMIDIL 1 G PDR 6 SACH RR<br />
0 0 0,00 2,70 80<br />
0050744 GRAMIDIL 500 MG 12 CAPS RR<br />
0 0 0,00 2,07 80<br />
0141589 GRAMIDIL 500 MG/5 ML PDR SIR 60 ML RR<br />
0 0 0,00 2,49 80<br />
0050758 GRAMIDIL PDR 125 MG/5 ML SIR 60 ML RR<br />
0 0 0,00 1,88 80<br />
0050761 GRAMIDIL PDR SUSP 250 MG 60 ML RR<br />
0 0 0,00 2,01 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
J01CA17 temocillin<br />
0076205 NEGABAN 1 G PDR 1 FL IMIV RR H<br />
0 0 17,31 0,00 0<br />
0076219 NEGABAN 2 G PDR 1 FL IV RR H<br />
0 0 31,34 0,00 0<br />
J01CE01 benzylpenicillin<br />
0087212 PENADUR LA 1,2 MIO U PDR 1 FL+S 5 ML I RR<br />
0 0 10,88 18,69 80<br />
0297562 PENICILLINE CNTL 1 MIO U PDR 100 FL IMIV RR<br />
0 0 54,00 0,00 0<br />
0297576 PENICILLINE CNTL 2 MIO U PDR 100 FL IMIV RR<br />
0 0 64,00 0,00 0<br />
0142751 PENICILLINE CNTL 5 MIO U PDR 100 FL RR<br />
0 0 163,16 0,00 0<br />
J01CE02 phenoxymethylpenicillin<br />
0215777 MEGACILLIN 1 MIO U 10 CPR RR<br />
0 0 2,27 4,04 80<br />
0215781 MEGACILLIN 1 MIO U 30 CPR RR<br />
0 0 5,08 9,05 80<br />
0172411 MEGACILLIN 300000 U/5 ML SIR 100 ML RR<br />
0 0 3,82 6,82 80<br />
0206893 MEGACILLIN 300000 U/5 ML SIR 2*100 ML RR<br />
0 0 6,50 11,58 80<br />
0215746 MEGACILLIN MEGA 1,5 MIO U 10 CPR RR<br />
0 0 2,90 5,18 80<br />
0215763 MEGACILLIN MEGA 1,5 MIO U 20 CPR RR<br />
0 0 4,77 8,50 80<br />
0306157 PENHEXAL MEGA 1 MIO U 10 CPR RR<br />
0 0 0,00 3,85 0<br />
0211991 PENHEXAL MEGA 1 MIO U 30 CPR RR<br />
0 0 1,89 11,16 80<br />
0087663 PENI ORAL 1 MIO U 15 CPR RR<br />
0 0 4,62 7,94 80<br />
J01CF04 oxacillin<br />
0087808 PENSTAPHO 1 G PDR 25 FL IM RR H<br />
0 0 64,39 0,00 0<br />
J01CF05 flucloxacillin<br />
0267319 FLOXAPEN 1 G PSV 10 FL IMIV RR D<br />
0 0 29,10 0,00 0<br />
0196573 FLOXAPEN 1 G PSV 3 FL + S IMIV RR D<br />
0 0 8,73 0,00 0<br />
0267336 FLOXAPEN 250 MG PSV 10 FL IMIV RR H<br />
0 0 7,72 0,00 0<br />
0193801 FLOXAPEN 500 MG 16 CAPS RR<br />
0 0 8,11 14,18 80<br />
0267322 FLOXAPEN 500 MG PSV 10 FL IMIV RR H<br />
0 0 14,42 0,00 0<br />
0174416 STAPHYCID 250 MG/5 ML SIR 1 FL 80 ML RR<br />
0 0 4,57 9,88 80<br />
0109306 STAPHYCID 500 MG 16 CAPS RR<br />
0 0 7,64 13,70 80<br />
J01CR02 amoxicillin and enzyme inhibitor<br />
0462294 AMOCLANE 125/31,25 MG PDR SUSP OR 100 ML RR<br />
0 0 1,69 6,37 80<br />
0462277 AMOCLANE 250/62,5 MG PDR 100 ML RR<br />
0 0 3,23 8,20 80<br />
0388121 AMOCLANE 500/125 MG 16 CPR RR<br />
0 0 4,99 10,40 80<br />
0459254 AMOCLANE 500/125 MG 32 CPR RR<br />
0 0 8,15 14,32 80<br />
0378416 AMOCLANE 875/125 MG 10 CPR BLIST RR<br />
0 0 4,50 9,79 80<br />
0378451 AMOCLANE 875/125 MG 20 CPR BLIST RR<br />
0 0 8,44 14,70 80<br />
0451761 AMOXICLAV TEVA 1000/100MG PDR 1 FL 50 ML RR H<br />
0 0 1,69 0,00 0<br />
0451788 AMOXICLAV TEVA 1000/200MG PDR 1 FL 20 ML RR H<br />
0 0 2,51 0,00 0<br />
0451824 AMOXICLAV TEVA 2000/200MG PDR 1 FL 100ML RR H<br />
0 0 3,38 0,00 0<br />
0451659 AMOXICLAV TEVA 500/125 MG 16 CPR RR<br />
0 0 5,00 9,71 0<br />
0451709 AMOXICLAV TEVA 500/125 MG 16 CPR (FL) RR<br />
0 0 5,00 9,71 0<br />
0451712 AMOXICLAV TEVA 500/50 MG PDR 1 FL 20 ML RR H<br />
0 0 0,90 0,00 0<br />
Page 106 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0451533 AMOXICLAV TEVA 875/125 MG 10 CPR RR<br />
0 0 5,20 9,63 0<br />
0451449 AMOXICLAV TEVA 875/125 MG 10 CPR (FL) RR<br />
0 0 5,20 9,63 0<br />
0451564 AMOXICLAV TEVA 875/125 MG 20 CPR RR<br />
0 0 9,60 18,44 0<br />
0451483 AMOXICLAV TEVA 875/125 MG 20 CPR (FL) RR<br />
0 0 9,60 18,44 0<br />
0009300 AUGMENTIN 125/31,25 MG/5 ML SIR 80 ML RR<br />
0 0 1,70 6,38 80<br />
0009314 AUGMENTIN 250/62,5 MG/5 ML SIR 80 ML RR<br />
0 0 3,07 8,01 80<br />
0187848 AUGMENTIN 500/125 MG 100 SACH RR<br />
0 0 4,99 0,00 0<br />
0009328 AUGMENTIN 500/125 MG 16 CPR RR<br />
0 0 4,99 10,40 80<br />
0187834 AUGMENTIN 500/125 MG 16 SACH RR<br />
0 0 4,99 10,11 80<br />
0265569 AUGMENTIN 875/125 MG 10 CPR RR<br />
0 0 4,50 9,79 80<br />
0311773 AUGMENTIN 875/125 MG 20 CPR RR<br />
0 0 8,44 14,70 80<br />
0340033 AUGMENTIN RET 1 G/62,5 MG 28 CPR RR<br />
0 0 11,00 17,88 80<br />
0340047 AUGMENTIN RET 1 G/62,5 MG 40 CPR RR<br />
0 0 15,38 23,34 80<br />
0340471 CLAVUCID SOLUTAB 500/125 MG 20 CPR RR<br />
0 0 6,21 11,91 80<br />
0376036 CLAVUCID SOLUTAB 875/125 MG 20 CPR RR<br />
0 0 8,44 14,70 80<br />
J01CR05 piperacillin and enzyme inhibitor<br />
0604064 PIPERACILLIN/TAZ KABI 4/0,5 G 10 FL 50ML RR HC<br />
0 0 189,12 0,00 0<br />
0540776 PIPERACILLINE/TAZ EG 2/0,25G PDR 1*20ML RR HC<br />
0 0 5,05 0,00 0<br />
0540826 PIPERACILLINE/TAZ EG 4/0,5G PDR 1*50ML RR HC<br />
0 0 9,14 0,00 0<br />
0633536 PIPERACILLINE/TAZ SDZ 2/0,25 G 10 FL RR HC<br />
0 0 63,10 0,00 0<br />
0633472 PIPERACILLINE/TAZ SDZ 4/0,5 G 10 FL RR HC<br />
0 0 114,30 0,00 0<br />
0267174 TAZOCIN 2 G/250 MG PDR 1 FL IMIV RR HC<br />
0 0 6,31 0,00 0<br />
0267188 TAZOCIN 4 G/500 MG PDR 1 FL IMIV RR HC<br />
0 0 11,43 0,00 0<br />
J01DB01 cefalexin<br />
0061748 KEFORAL 500 MG 100 CPR RR<br />
0 0 36,17 0,00 0<br />
0061734 KEFORAL 500 MG 16 CPR RR<br />
0 0 0,00 11,15 80<br />
J01DB04 cefazolin<br />
0586792 CEPHAZOLIN FRES 1 G PDR 10 FL 15 ML IV RR<br />
0 0 45,88 59,52 0<br />
0587304 CEPHAZOLIN FRES 2 G PDR 10 FL 15 ML IV RR<br />
0 0 91,37 110,26 0<br />
0061832 KEFZOL 1 G PDR 3 AMP IM RR<br />
0 0 0,00 12,31 80<br />
0273039 KEFZOL 2 G PDR 1 FL IMIV RR H<br />
0 0 6,45 0,00 0<br />
J01DB05 cefadroxil<br />
0037305 DURACEF 500 MG 100 CAPS RR<br />
0 0 24,82 0,00 0<br />
0037286 DURACEF 500 MG 16 CAPS RR<br />
0 0 5,78 11,38 80<br />
0217608 DURACEF 500 MG/5 ML PDR SIR 80 ML RR<br />
0 0 5,32 10,81 80<br />
0037322 DURACEF HD 250 MG/5 ML SIR 80 ML RR<br />
0 0 3,64 8,72 80<br />
J01DB09 cefradine<br />
0265829 ZEEFRA GE 500 MG 12 CAPS RR<br />
0 0 3,72 5,13 80<br />
J01DC02 cefuroxime<br />
0508488 CEFURIM 1500 MG PDR 1 FL IV RR<br />
0 0 3,11 8,06 0<br />
0501232 CEFURIM 1500 MG PDR 10 FL IV RR<br />
0 0 4,49 4,63 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0508474 CEFURIM 750 MG PDR 1 FL IVIM RR<br />
0 0 1,56 6,23 0<br />
0501229 CEFURIM 750 MG PDR 10 FL IVIM RR<br />
0 0 2,24 2,31 0<br />
0611685 CEFUROXIM FRES 1500 MG PDR 1 FL 20ML INJ RR<br />
0 0 67,03 83,11 0<br />
0611685 CEFUROXIM FRES 1500 MG PDR 1 FL 50ML INF RR<br />
0 0 67,03 83,11 0<br />
0611685 CEFUROXIM FRES 1500 MG PDR 10 FL 20 ML RR<br />
0 0 67,03 83,11 0<br />
0611704 CEFUROXIM FRES 1500 MG PDR 10 FL 50 ML RR<br />
0 0 67,03 83,11 0<br />
0611654 CEFUROXIM FRES 750 MG PDR 1 FL RR<br />
0 0 41,56 54,70 0<br />
0394454 CEFUROXIM MYLAN 250 MG 10 CPR RR<br />
0 0 2,75 7,49 80<br />
0394485 CEFUROXIM MYLAN 250 MG 24 CPR RR<br />
0 0 6,60 12,29 80<br />
0394521 CEFUROXIM MYLAN 500 MG 10 CPR RR<br />
0 0 5,65 11,21 80<br />
0394552 CEFUROXIM MYLAN 500 MG 24 CPR RR<br />
0 0 12,20 19,39 80<br />
0211121 ZINACEF BOLUS 1,5 G 1 FL UD IV RR<br />
0 0 3,11 8,06 80<br />
0513345 ZINACEF BOLUS 750 MG PDR 1 FL IMIV RR<br />
0 0 1,56 6,23 80<br />
0211151 ZINACEF PERF 1,5 G PDR 1 FL UD IV RR<br />
0 0 3,11 8,06 80<br />
0154301 ZINNAT 250 MG 10 CPR RR<br />
0 0 2,75 7,60 80<br />
0238804 ZINNAT 250 MG/5 ML SIR 100 ML RR<br />
0 0 5,65 11,21 80<br />
0157771 ZINNAT 500 MG 10 CPR RR<br />
0 0 5,42 10,93 80<br />
0274974 ZINNAT 500 MG 20 CPR RR<br />
0 0 10,17 16,85 80<br />
J01DC03 cefamandole<br />
0069407 MANDOL 1 G PDR 3 FL 10 ML MTD PERF RR<br />
0 0 0,00 18,00 80<br />
J01DC04 cefaclor<br />
0220066 CEC 125 MG/5 ML GRAN 1 FL 100 ML RR<br />
0 0 3,09 12,47 80<br />
0220083 CEC FORTE 250 MG/5 ML GRAN 1 FL 100 ML RR<br />
0 0 5,45 15,05 80<br />
0496826 DOCCEFACLO 250 MG/5 ML PDR SUSP 100 ML RR<br />
0 0 0,00 8,08 0<br />
0496843 DOCCEFACLO 500 MG 15 CAPS RR<br />
0 0 6,41 12,05 80<br />
J01DD01 cefotaxime<br />
0476045 CEFOTAXIME TEVA 1000 MG PDR 1 FL IVIM RR H<br />
0 0 2,85 0,00 0<br />
0476059 CEFOTAXIME TEVA 1000 MG PDR 5 FL IVIM RR H<br />
0 0 3,63 0,00 0<br />
0476076 CEFOTAXIME TEVA 2000 MG PDR 1 FL IVIM RR H<br />
0 0 5,41 0,00 0<br />
0476093 CEFOTAXIME TEVA 2000 MG PDR 5 FL IVIM RR H<br />
0 0 6,88 0,00 0<br />
0206716 CLAFORAN 1000 MG PDR 1 FL + S IMIV RR<br />
0 0 5,27 10,75 80<br />
0206733 CLAFORAN 2000 MG PDR 1 FL + S IV RR<br />
0 0 9,26 15,72 80<br />
J01DD02 ceftazidime<br />
0525797 CEFTAZIDIM KABI 1 G PDR 10 FL 10 ML INJ RR<br />
0 0 57,20 0,00 0<br />
0525802 CEFTAZIDIM KABI 2 G PDR 1 FL 50 ML PERF RR<br />
0 0 114,00 135,52 0<br />
0211201 GLAZIDIM BOLUS 1 G PDR 1 FL IMIV RR<br />
0 0 5,55 11,10 80<br />
0211215 GLAZIDIM BOLUS 2 G PDR 1 FL IV RR<br />
0 0 10,96 17,83 80<br />
0211196 GLAZIDIM BOLUS 500 MG PDR 1 FL IMIV RR<br />
0 0 2,86 7,73 80<br />
0211179 GLAZIDIM PERF 1 G PDR 1 FL UD IMIV RR<br />
0 0 5,55 11,10 80<br />
0211182 GLAZIDIM PERF 2 G PDR 1 FL UD IV RR<br />
0 0 10,96 17,83 80<br />
J01DD04 ceftriaxone<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0100622 ROCEPHINE 1 G PDR 1 FL + S 10 ML IV RR<br />
0 0 4,83 10,18 80<br />
0100619 ROCEPHINE 1 G PDR 1 FL + S 3,5 ML IM RR<br />
0 0 4,83 10,18 80<br />
0100636 ROCEPHINE 2 G PDR 1 FL PERF RR<br />
0 0 9,55 16,08 80<br />
J01DE01 cefepime<br />
0200757 MAXIPIME 1 G 3 FL IMIV RR<br />
0 0 21,92 30,54 80<br />
0200761 MAXIPIME 2 G 3 FL IMIV RR<br />
0 0 43,35 54,14 80<br />
J01DF01 aztreonam<br />
0009880 AZACTAM 1 G PDR 1 FL IMIV RR<br />
0 0 8,22 14,42 0<br />
0009894 AZACTAM 2 G PDR 1 FL IV RR H<br />
0 0 16,23 0,00 0<br />
0536224 CAYSTON 75 MG PDR 84 FL + S IH RR DC X 0 0<br />
2.886,89 0,00 0<br />
J01DH02 meropenem<br />
0206764 MERONEM 1 G PDR 1 FL IV RR<br />
0 0 12,00 19,12 80<br />
0206781 MERONEM 500 MG PDR 1 FL IV RR<br />
0 0 6,67 12,49 80<br />
0603957 MEROPENEM HOSPIRA 1 G PDR 10 FL 30 ML RR HC<br />
0 0 141,20 0,00 0<br />
0603943 MEROPENEM HOSPIRA 500 MG PDR 10 FL 20 ML RR HC<br />
0 0 78,50 0,00 0<br />
J01DH03 ertapenem<br />
0322858 INVANZ 1 G 1 FL IMIV RR D<br />
0 0 45,00 0,00 0<br />
J01DH04 doripenem<br />
0492648 DORIBAX 500 MG PDR 10 FL 20 ML IV RR HC<br />
0 0 266,73 0,00 0<br />
J01EE01 sulfamethoxazole and trimethoprim<br />
0010346 BACTRIM FORTE 10 CPR RR<br />
0 0 2,16 6,89 80<br />
0010315 BACTRIM SIR 100 ML RR<br />
0 0 1,55 6,22 80<br />
0025996 COTRIM FORTE RATIO 10 CPR RR<br />
0 0 0,71 5,85 80<br />
0026007 COTRIM FORTE RATIO 20 CPR RR<br />
0 0 1,18 10,39 80<br />
0203504 COTRIM HEXAL FORTE 10 CPR RR<br />
0 0 0,15 1,90 80<br />
0203518 COTRIM HEXAL FORTE 20 CPR RR<br />
0 0 0,54 3,61 80<br />
0043039 EUSAPRIM 10 AMP 5 ML IV RR H<br />
0 0 8,24 0,00 0<br />
0042966 EUSAPRIM 20 CPR AD RR<br />
0 0 2,03 6,74 80<br />
0042983 EUSAPRIM 50 CPR AD RR<br />
0 0 3,89 9,02 80<br />
0043056 EUSAPRIM FORTE 10 CPR RR<br />
0 0 2,03 6,74 80<br />
0043087 EUSAPRIM FORTE 200 CPR RR<br />
0 0 27,60 0,00 0<br />
0043073 EUSAPRIM FORTE 30 CPR RR<br />
0 0 4,14 9,33 80<br />
0043025 EUSAPRIM SIR PED 100 ML RR<br />
0 0 1,45 6,12 80<br />
J01FA01 erythromycin<br />
0040832 ERY 125 MG 24 SACH RR<br />
0 0 1,89 3,40 80<br />
0040846 ERY 250 MG 24 SACH RR<br />
0 0 1,89 3,40 80<br />
0040863 ERY 500 MG 20 CPR SEC RR<br />
0 0 2,90 4,04 80<br />
0183236 ERYHEXAL 1000 MG 12 SACH RR<br />
0 0 5,19 14,76 80<br />
0183253 ERYHEXAL 1000 MG 20 SACH RR<br />
0 0 8,26 18,12 80<br />
0140001 ERYHEXAL 200 MG/5 ML GRAN P SIR 100 ML RR<br />
0 0 1,88 11,15 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0187221 ERYHEXAL 200 MG/5 ML GRAN P SIR 2*100 ML RR<br />
0 0 3,40 12,81 80<br />
0167232 ERYHEXAL 500 MG 10 CPR RR<br />
0 0 1,45 10,68 80<br />
0198001 ERYHEXAL 500 MG 20 CPR RR<br />
0 0 3,71 13,16 80<br />
0208352 ERYHEXAL 500 MG 30 CPR RR<br />
0 0 5,63 15,25 80<br />
0198015 ERYHEXAL 500 MG 50 CPR RR<br />
0 0 8,91 18,84 80<br />
0041020 ERYTHROCINE 1 G PDR 1 FL + S 20 ML IV RR<br />
0 0 0,00 12,69 80<br />
0252963 ERYTHROCINE 250 MG/5 ML SIR 80 ML RR<br />
0 0 0,00 7,24 80<br />
0169447 ERYTHROFORTE 1000 MG 10 SACH RR<br />
0 0 0,00 13,18 80<br />
0041101 ERYTHROFORTE 500 MG 16 CPR RR<br />
0 0 0,00 10,31 80<br />
0041115 ERYTHROFORTE 500 MG 16 SACH RR<br />
0 0 0,00 10,31 80<br />
0167974 ERYTHROMYCINE RATIO 1000 DB 12 SACH RR<br />
0 0 0,00 14,39 80<br />
0167988 ERYTHROMYCINE RATIO 1000 DB 20 SACH RR<br />
0 0 0,00 18,82 80<br />
0168016 ERYTHROMYCINE RATIO 250 DB 20 SACH RR<br />
0 0 0,00 5,21 80<br />
0167991 ERYTHROMYCINE RATIO 500 DB 10 SACH RR<br />
0 0 0,00 10,55 80<br />
0168002 ERYTHROMYCINE RATIO 500 DB 20 SACH RR<br />
0 0 0,00 12,67 80<br />
0163099 MONOMYCIN 200 MG/5 ML SIR 100 ML RR<br />
0 0 4,46 7,96 80<br />
0163104 MONOMYCIN 200 MG/5 ML SIR 2*100 ML RR<br />
0 0 7,65 13,63 80<br />
0163085 MONOMYCIN 200 MG/5 ML SIR 60 ML RR<br />
0 0 2,99 5,33 80<br />
J01FA02 spiramycin<br />
0101194 ROVAMYCINE 1,5 MIO U 16 CPR RR<br />
0 0 4,02 9,17 80<br />
J01FA06 roxithromycin<br />
0315402 ROXITHROMYCINE EG 150 MG 10 CPR RR<br />
0 0 3,03 7,94 80<br />
0183981 RULID 100 MG 10 CPR RR<br />
0 0 4,41 9,67 80<br />
0199691 RULID 150 MG 10 CPR RR<br />
0 0 5,70 11,28 80<br />
J01FA09 clarithromycin<br />
0205509 BICLAR 125 BEBE SIR 60 ML RR<br />
0 0 3,22 8,18 80<br />
0225465 BICLAR 125 JR SIR 120 ML RR<br />
0 0 5,16 10,60 80<br />
0171154 BICLAR 250 MG 10 CPR RR<br />
0 0 3,75 8,85 80<br />
0221323 BICLAR 500 MG PDR 1 FL IV RR<br />
0 0 8,38 14,63 80<br />
0221337 BICLAR FORTE 500 MG 10 CPR RR<br />
0 0 6,32 12,05 80<br />
0289395 BICLAR KIDS 250 MG/5 ML GRAN SUSP 80 ML RR<br />
0 0 6,87 12,73 80<br />
0409509 BICLAR UNO 500 MG 10 CPR RR<br />
0 0 7,17 13,11 80<br />
0409512 BICLAR UNO 500 MG 20 CPR RR<br />
0 0 13,73 21,29 80<br />
0378853 CLARITHROMYCIN HEXAL 250 MG 10 CPR RR<br />
0 0 1,72 9,11 80<br />
0378867 CLARITHROMYCIN HEXAL 250 MG 12 CPR RR<br />
0 0 0,00 10,70 80<br />
0378903 CLARITHROMYCIN HEXAL 250 MG 20 CPR RR<br />
0 0 7,27 12,97 80<br />
0378979 CLARITHROMYCIN HEXAL 500 MG 14 CPR RR<br />
0 0 4,97 14,52 80<br />
0379007 CLARITHROMYCIN HEXAL 500 MG 20 CPR RR<br />
0 0 6,76 16,48 80<br />
0375347 CLARITHROMYCIN RATIO 250 MG 10 CPR RR<br />
0 0 2,16 9,09 80<br />
0375351 CLARITHROMYCIN RATIO 250 MG 12 CPR RR<br />
0 0 0,00 14,40 0<br />
0375395 CLARITHROMYCIN RATIO 250 MG 20 CPR RR<br />
0 0 3,95 12,92 80<br />
0375607 CLARITHROMYCIN RATIO 500 MG 14 CPR RR<br />
0 0 4,96 14,12 80<br />
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délivrance prescription<br />
0375638 CLARITHROMYCIN RATIO 500 MG 20 CPR RR<br />
0 0 6,75 15,99 80<br />
0399871 CLARITHROMYCINE ABBOTT 250 MG 10 CPR RR<br />
0 0 3,75 8,85 0<br />
0399853 CLARITHROMYCINE ABBOTT FORTE 500MG 10CPR RR<br />
0 0 6,32 12,05 0<br />
0400341 CLARITHROMYCINE ABBOTT UNO 500 MG 10 CPR RR<br />
0 0 8,38 13,15 80<br />
0400355 CLARITHROMYCINE ABBOTT UNO 500 MG 20 CPR RR<br />
0 0 13,95 21,45 80<br />
0398114 CLARITHROMYCINE EG 250 MG 10 CPR RR<br />
0 0 3,75 8,85 80<br />
0398324 CLARITHROMYCINE EG 500 MG 10 CPR RR<br />
0 0 5,29 10,77 80<br />
0398369 CLARITHROMYCINE EG 500 MG 21 CPR RR<br />
0 0 15,86 23,86 80<br />
0221291 HELICLAR 500 MG 21 CPR RR<br />
0 0 15,86 23,86 80<br />
0221341 MACLAR 500 MG 60 CPR RR<br />
0 0 55,16 67,05 0<br />
0496441 MONOCLARIUM 200 MG 10 CAPS RR<br />
0 0 4,88 10,13 0<br />
J01FA10 azithromycin<br />
0461235 AZITHROMYCIN HEXAL 200MG/5ML PDR 15 ML RR<br />
0 0 1,82 11,08 80<br />
0461266 AZITHROMYCIN HEXAL 200MG/5ML PDR 30 ML RR<br />
0 0 3,07 12,89 80<br />
0461283 AZITHROMYCIN HEXAL 200MG/5ML PDR 37,5 ML RR<br />
0 0 3,69 13,13 80<br />
0366107 AZITHROMYCIN HEXAL 250 MG 6 CPR RR<br />
0 0 2,71 9,63 80<br />
0366155 AZITHROMYCIN HEXAL 500 MG 3 CPR RR<br />
0 0 2,71 9,63 80<br />
0420571 AZITHROMYCIN RATIO 250 MG 6 CPR RR<br />
0 0 3,68 8,90 80<br />
0420604 AZITHROMYCIN RATIO 500 MG 3 CPR RR<br />
0 0 3,68 8,90 80<br />
0483246 AZITHROMYCINE EG 250 MG 6 CPR RR<br />
0 0 4,30 9,54 80<br />
0483327 AZITHROMYCINE EG 500 MG 3 CPR RR<br />
0 0 4,30 9,54 80<br />
0483331 AZITHROMYCINE EG 500 MG 6 CPR RR<br />
0 0 8,48 0,00 0<br />
0305504 ZITROMAX 1500 MG PDR SUSP 37,5 ML RR<br />
0 0 5,14 10,58 80<br />
0252297 ZITROMAX 250 MG 6 CPR RR<br />
0 0 4,26 9,48 80<br />
0252333 ZITROMAX 500 MG 3 CPR SEC RR<br />
0 0 4,26 9,48 80<br />
0206165 ZITROMAX 600 MG PDR SUSP 15 ML RR<br />
0 0 2,05 6,76 80<br />
0206179 ZITROMAX 900 MG PDR SUSP 22,5 ML RR<br />
0 0 3,09 8,03 80<br />
J01FA11 miocamycin<br />
0230126 MERCED 500 MG/10 ML GRAN SUSP 120 ML RR<br />
0 0 2,20 6,93 80<br />
J01FA15 telithromycin<br />
0306711 KETEK 400 MG 10 CPR RR<br />
0 0 8,88 15,25 80<br />
0306739 KETEK 400 MG 20 CPR RR<br />
0 0 17,75 25,94 80<br />
J01FF01 clindamycin<br />
0519187 CLINDAMYCIN KABI 300 MG 10 AMP 2 ML RR<br />
0 0 31,60 0,00 0<br />
0519206 CLINDAMYCIN KABI 600 MG 10 AMP 4 ML RR<br />
0 0 54,24 0,00 0<br />
0519206 CLINDAMYCIN KABI 900 MG 10 AMP 4 ML RR<br />
0 0 54,24 0,00 0<br />
0519237 CLINDAMYCIN KABI 900 MG 10 AMP 6 ML RR<br />
0 0 81,60 0,00 0<br />
0027763 DALACIN C 150 MG 16 CAPS RR<br />
0 0 3,62 8,69 80<br />
0027780 DALACIN C 300 MG 16 CAPS RR<br />
0 0 6,42 12,18 80<br />
0155991 DALACIN C 300 MG 3 AMP 2 ML RR<br />
0 0 8,23 14,43 80<br />
0665705 DALACIN C 300 MG 5 AMP 2 ML RR<br />
0 0 13,72 0,00 0<br />
0156001 DALACIN C 600 MG 3 AMP 4 ML RR<br />
0 0 15,07 22,96 80<br />
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0665753 DALACIN C 600 MG 5 AMP 4 ML RR<br />
0 0 25,12 0,00 0<br />
0665798 DALACIN C 900 MG 1 AMP 6 ML RR<br />
0 0 6,91 0,00 0<br />
0156015 DALACIN C 900 MG 3 AMP 6 ML RR<br />
0 0 20,73 29,23 80<br />
0027794 DALACIN C SIR 80 ML RR<br />
0 0 4,27 9,49 80<br />
J01FF02 lincomycin<br />
0065781 LINCOCIN 500 MG 16 CAPS RR<br />
0 0 7,25 13,22 80<br />
0139398 LINCOCIN 600 MG 6 SRG 2 ML IM RR<br />
0 0 11,52 18,54 80<br />
J01GB01 tobramycin<br />
0081298 OBRACIN 80 MG 25 FL 2 ML RR<br />
0 0 93,26 0,00 0<br />
0081284 OBRACIN 80 MG 3 FL 2 ML RR<br />
0 0 6,56 12,23 80<br />
0287549 TOBI 300 MG 4*14 AMP UD 5 ML IH RR<br />
0 0 1.901,82 2.024,58 80<br />
0492794 TOBRAMYCINE HSP 80 MG 5 FL 2 ML IMIV RR<br />
0 0 11,87 0,00 0<br />
J01GB03 gentamicin<br />
0204935 DURACOLL 130 MG 1 IMPLANT RR H<br />
0 0 94,57 0,00 0<br />
0201481 GENTAMICIN HEXAL SF 80 MG 20 AMP IMIV RR<br />
0 0 38,04 0,00 0<br />
0201477 GENTAMICIN HEXAL SF 80 MG 5 AMP IMIV RR<br />
0 0 9,69 0,00 0<br />
0048956 GEOMYCINE 80 MG 25 AMP 2 ML IMIV RR<br />
0 0 45,62 0,00 0<br />
J01GB06 amikacin<br />
0224731 AMUKIN 1 G 2 FL 4 ML IMIV RR<br />
0 0 36,28 46,36 80<br />
0005573 AMUKIN 100 MG 2 FL 2 ML IMIV RR<br />
0 0 4,36 9,60 80<br />
0005590 AMUKIN 500 MG 2 FL 2 ML IMIV RR<br />
0 0 18,16 26,41 80<br />
J01GB09 dibekacin<br />
0028239 DEBEKACYL 75 MG 1 SRG 1,5 ML IMIVSC RR<br />
0 0 0,00 3,17 80<br />
J01MA01 ofloxacin<br />
0369918 OFLOXACINE EG 200 MG 10 CPR RR<br />
0 0 4,16 9,35 80<br />
0369966 OFLOXACINE EG 200 MG 50 CPR RR<br />
0 0 4,90 8,53 0<br />
0369773 OFLOXACINE EG 400 MG 10 CPR RR<br />
0 0 6,01 11,66 80<br />
0369742 OFLOXACINE EG 400 MG 5 CPR RR<br />
0 0 4,02 9,17 80<br />
0113486 TARIVID 200 MG 10 CPR RR<br />
0 0 4,50 9,79 80<br />
0258936 TARIVID 400 MG 10 CPR SEC RR<br />
0 0 6,30 12,03 80<br />
0217531 TARIVID 400 MG 5 CPR RR<br />
0 0 4,20 9,41 80<br />
0177709 TARIVID IV 200 MG 5 FL 100 ML PERF RR H<br />
0 0 60,98 0,00 0<br />
0217527 TARIVID IV 400 MG 5 FL 200 ML PERF RR H<br />
0 0 131,52 0,00 0<br />
J01MA02 ciprofloxacin<br />
0587044 CIPROFLOXACIN KABI 200 MG 1 FL 100 ML RR H<br />
0 0 10,33 0,00 0<br />
0587044 CIPROFLOXACIN KABI 200 MG 1 FL 100 ML P RR H<br />
0 0 10,33 0,00 0<br />
0587191 CIPROFLOXACIN KABI 400 MG 1 FL 200 ML RR H<br />
0 0 11,70 0,00 0<br />
0587191 CIPROFLOXACIN KABI 400 MG 1 FL 200 ML P RR H<br />
0 0 11,70 0,00 0<br />
0316881 CIPROFLOXACIN RATIO 250 MG 10 CPR RR<br />
0 0 2,06 8,45 80<br />
0316895 CIPROFLOXACIN RATIO 250 MG 20 CPR RR<br />
0 0 4,38 13,43 80<br />
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0316851 CIPROFLOXACIN RATIO 500 MG 10 CPR RR<br />
0 0 4,38 13,43 80<br />
0316864 CIPROFLOXACIN RATIO 500 MG 20 CPR RR<br />
0 0 8,18 17,63 80<br />
0316816 CIPROFLOXACIN RATIO 750 MG 10 CPR RR<br />
0 0 6,34 15,56 80<br />
0316833 CIPROFLOXACIN RATIO 750 MG 20 CPR RR<br />
0 0 0,00 37,35 80<br />
0358959 CIPROFLOXACINE EG 250 MG 10 CPR RR<br />
0 0 3,56 8,61 80<br />
0359083 CIPROFLOXACINE EG 500 MG 20 CPR RR<br />
0 0 10,51 17,28 80<br />
0359178 CIPROFLOXACINE EG 750 MG 20 CPR RR<br />
0 0 16,89 25,00 80<br />
0555721 CIPROFLOXACINE TEVA 200 MG 1 PP 100 ML RR H<br />
0 0 8,30 0,00 0<br />
0555751 CIPROFLOXACINE TEVA 200 MG 10 PP 100 ML RR H<br />
0 0 83,00 0,00 0<br />
0555734 CIPROFLOXACINE TEVA 400 MG 1 PP 200 ML RR H<br />
0 0 15,85 0,00 0<br />
0555748 CIPROFLOXACINE TEVA 400 MG 10 PP 200 ML RR H<br />
0 0 141,10 0,00 0<br />
0316928 CIPROHEXAL 250 MG 10 CPR RR<br />
0 0 1,61 8,85 80<br />
0316539 CIPROHEXAL 250 MG 20 CPR RR<br />
0 0 4,39 13,89 80<br />
0316591 CIPROHEXAL 500 MG 10 CPR RR<br />
0 0 4,39 13,89 80<br />
0316637 CIPROHEXAL 500 MG 20 CPR RR<br />
0 0 8,19 18,05 80<br />
0316704 CIPROHEXAL 750 MG 10 CPR RR<br />
0 0 6,35 16,04 80<br />
0316735 CIPROHEXAL 750 MG 20 CPR RR<br />
0 0 12,32 22,56 80<br />
0135601 CIPROXIN 0,2% 1 FL 100 ML IV RR H<br />
0 0 8,01 0,00 0<br />
0135645 CIPROXIN 250 MG 10 CPR RR<br />
0 0 3,73 8,82 80<br />
0180346 CIPROXIN 500 MG 120 CPR UD RR<br />
0 0 105,18 0,00 0<br />
0135709 CIPROXIN 500 MG 20 CPR RR<br />
0 0 10,51 17,28 80<br />
0321282 CIPROXINE 5% 2 FL MICROCPS + S RR<br />
0 0 17,39 25,56 80<br />
0286409 CIPROXINE IV FLEXI GLC 5% 200 MG 100 ML RR H<br />
0 0 14,62 0,00 0<br />
0286426 CIPROXINE IV FLEXI GLC 5% 400 MG 200 ML RR H<br />
0 0 13,62 0,00 0<br />
J01MA04 enoxacin<br />
0195545 ENOXOR 200 MG 10 CPR RR<br />
0 0 0,00 9,12 80<br />
J01MA06 norfloxacin<br />
0286202 NORFLOXACINE EG 400 MG 20 CPR RR<br />
0 0 1,70 6,38 80<br />
0286183 NORFLOXACINE EG 400 MG 6 CPR RR<br />
0 0 0,63 5,22 80<br />
0131193 ZOROXIN 400 MG 20 CPR RR<br />
0 0 2,42 7,19 80<br />
0131176 ZOROXIN 400 MG 6 CPR RR<br />
0 0 0,90 5,51 80<br />
J01MA12 levofloxacin<br />
0625078 LEVOFLOXACINE ACTAVIS 500MG PERF 5*100ML RR HC<br />
0 0 80,00 0,00 0<br />
0546704 LEVOFLOXACINE TEVA 250 MG PERF 1*50 ML RR HC<br />
0 0 8,00 0,00 0<br />
0546735 LEVOFLOXACINE TEVA 500 MG PERF 1*100 ML RR HC<br />
0 0 16,00 0,00 0<br />
0247087 TAVANIC 250 MG 10 CPR RR<br />
0 0 8,44 14,70 80<br />
0247141 TAVANIC 500 MG 1 FL 100 ML PERF RR HC<br />
0 0 16,00 0,00 0<br />
0247137 TAVANIC 500 MG 10 CPR RR<br />
0 0 14,00 21,63 80<br />
J01MA14 moxifloxacin<br />
0281075 AVELOX 400 MG 10 CPR RR<br />
0 0 31,97 37,06 80<br />
0292924 AVELOX 400 MG 5 CPR RR<br />
0 0 15,98 21,39 80<br />
0339385 AVELOX 400 MG 5 FL PERF RR H<br />
0 0 155,46 0,00 0<br />
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0292986 AVELOX 400 MG 80 CPR UD RR<br />
0 0 255,79 0,00 0<br />
0288868 PROFLOX 400 MG 10 CPR RR<br />
0 0 30,72 40,24 80<br />
0288854 PROFLOX 400 MG 5 CPR RR<br />
0 0 15,34 23,30 80<br />
0292911 PROFLOX 400 MG 80 CPR UD RR<br />
0 0 260,81 0,00 0<br />
J01XA01 vancomycin<br />
0595984 VAMYSIN 1000 MG PDR 1 FL IV RR D<br />
0 0 12,86 0,00 0<br />
0364701 VAMYSIN 500 MG PDR 1 FL IV RR D<br />
0 0 7,14 0,00 0<br />
0176732 VANCOCIN 1000 MG PDR 1 FL IV RR D<br />
0 0 12,86 0,00 0<br />
0176746 VANCOCIN 500 MG PDR 1 FL IV RR D<br />
0 0 7,14 0,00 0<br />
0641457 VANCOMYCIN ACTAVIS 500 MG PDR 1 FL IV RR D<br />
0 0 8,92 0,00 0<br />
0641461 VANCOMYCIN ACTAVIS 500 MG PDR 10 FL IV RR D<br />
0 0 16,08 0,00 0<br />
0634726 VANCOMYCINE SDZ 1000 MG PDR 10 FL IV RR D<br />
0 0 160,80 0,00 0<br />
0634676 VANCOMYCINE SDZ 500 MG PDR 10 FL IV RR D<br />
0 0 89,20 0,00 0<br />
J01XA02 teicoplanin<br />
0158461 TARGOCID 200 MG PDR 1 FL+S 3,2 ML IMIV RR<br />
0 0 12,08 19,23 80<br />
0158474 TARGOCID 400 MG PDR 1 FL+S 3,2ML IMIV RR<br />
0 0 23,02 31,76 80<br />
J01XB01 colistin<br />
0023831 COLIMYCINE 1 MIO U PDR 1 FL IM RR<br />
0 0 12,90 22,99 80<br />
J01XC01 fusidic acid<br />
0247008 FUCIDIN IV 500 MG PDR 1 FL+S 10 ML PERF RR H<br />
0 0 8,27 0,00 0<br />
J01XD01 metronidazole<br />
0044957 FLAGYL 0,5% 1 POCHE VIAFLEX 100 ML RR H<br />
0 0 2,99 0,00 0<br />
0044960 FLAGYL 0,5% 1 POCHE VIAFLEX 300 ML RR H<br />
0 0 6,96 0,00 0<br />
0044912 FLAGYL 500 MG 20 CPR RR<br />
0 0 2,50 7,29 80<br />
J01XD02 tinidazole<br />
0043896 FASIGYN 500 MG 4 CPR RR<br />
0 0 2,69 7,52 80<br />
J01XD03 ornidazole<br />
0137264 TIBERAL 1 G 1 AMP 6 ML IV RR H<br />
0 0 9,95 0,00 0<br />
0171204 TIBERAL 500 MG 10 CPR RR<br />
0 0 5,83 10,03 80<br />
0181794 TIBERAL 500 MG 10 CPR UD RR<br />
0 0 5,83 0,00 0<br />
0116751 TIBERAL 500 MG 3 CPR RR<br />
0 0 2,04 3,43 80<br />
J01XE01 nitrofurantoin<br />
0047198 FURADANTINE MC 100 MG 50 CAPS R<br />
0 0 4,46 9,74 80<br />
0047203 FURADANTINE MC 50 MG 50 CAPS R<br />
0 0 2,60 7,41 80<br />
0078986 NITROFURANTOIN RATIO RET 100 MG 50 CAPS R<br />
0 0 5,30 9,45 80<br />
J01XE02 nifurtoinol<br />
0123191 URFADYN 100 MG 50 CAPS PL R<br />
0 0 5,03 10,44 80<br />
J01XX01 fosfomycin<br />
0219258 MONURIL 3 G PDR 1 SACH RR<br />
0 0 3,97 9,12 80<br />
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J01XX04 spectinomycin<br />
0120981 TROBICIN 2 G 1 FL 3,2 ML IM RR<br />
0 0 7,64 13,70 80<br />
J01XX08 linezolid<br />
0307333 ZYVOXID 2 MG/ML 300 ML PERF RR H<br />
0 0 62,10 0,00 0<br />
0307316 ZYVOXID 20 MG/ML GRAN SIR 150 ML RR DC<br />
0 0 310,49 0,00 0<br />
0307185 ZYVOXID 600 MG 20 CPR BL RR DC<br />
0 0 1.241,95 0,00 0<br />
J02AA01 amphotericin B<br />
0342265 ABELCET 100 MG 10 AMP 20 ML IV RR H<br />
0 0 1.111,74 0,00 0<br />
0319074 AMBISOME 50 MG PDR 10 FL PERF RR H<br />
0 0 1.033,25 0,00 0<br />
J02AB02 ketoconazole<br />
0079255 NIZORAL 200 MG 10 CPR 22958 R<br />
0 0 6,48 12,24 80<br />
0079269 NIZORAL 200 MG 30 CPR 27335 R<br />
0 0 15,54 23,52 80<br />
J02AC01 fluconazole<br />
0434161 CANDIZOLE 150 MG 1 CAPS RR<br />
0 0 1,79 6,21 80<br />
0434143 CANDIZOLE 200 MG 10 CAPS RR<br />
0 0 23,45 32,23 80<br />
0434157 CANDIZOLE 200 MG 20 CAPS RR<br />
0 0 61,05 73,60 80<br />
0434188 CANDIZOLE 50 MG 10 CAPS RR<br />
0 0 6,99 12,88 80<br />
0163068 DIFLUCAN 150 MG 1 CAPS RR<br />
0 0 1,79 6,46 80<br />
0178222 DIFLUCAN 200 MG 10 CAPS RR<br />
0 0 23,45 32,23 80<br />
0178236 DIFLUCAN 200 MG 20 CAPS RR<br />
0 0 61,05 73,61 80<br />
0481918 DIFLUCAN 200 MG PERF 1 FL 100 ML IV RR HC<br />
0 0 8,81 0,00 0<br />
0471083 DIFLUCAN 200 MG PERF 1 FLEXBAG 100 ML IV RR HC<br />
0 0 8,81 0,00 0<br />
0244703 DIFLUCAN 200 MG/5 ML PDR SIR 1 FL 35 ML RR<br />
0 0 23,85 32,67 80<br />
0471097 DIFLUCAN 400 MG PERF 1 FLEXBAG 200 ML IV RR HC<br />
0 0 17,61 0,00 0<br />
0165918 DIFLUCAN 50 MG 10 CAPS RR<br />
0 0 6,99 12,88 80<br />
0244717 DIFLUCAN 50 MG/5 ML PDR SIR 1 FL 35 ML RR<br />
0 0 7,06 12,98 80<br />
0353997 FLUCONAZOL HEXAL 100 MG 20 CAPS RR<br />
0 0 59,77 74,49 80<br />
0418637 FLUCONAZOL HEXAL 100 MG 50 CAPS RR<br />
0 0 146,13 168,99 80<br />
0377209 FLUCONAZOL HEXAL 150 MG 1 CAPS RR<br />
0 0 3,59 13,01 80<br />
0377261 FLUCONAZOL HEXAL 200 MG 20 CAPS RR<br />
0 0 65,98 77,25 80<br />
0377288 FLUCONAZOL HEXAL 200 MG 50 CAPS RR<br />
0 0 123,44 220,00 80<br />
0353921 FLUCONAZOL HEXAL 50 MG 20 CAPS RR<br />
0 0 30,89 42,89 80<br />
0353949 FLUCONAZOL HEXAL 50 MG 50 CAPS RR<br />
0 0 75,50 91,71 80<br />
0608841 FLUCONAZOL KABI 200 MG PERF 1FL 100ML KP RR HC<br />
0 0 24,23 0,00 0<br />
0608869 FLUCONAZOL KABI 400 MG PERF 1FL 200ML KP RR HC<br />
0 0 43,45 0,00 0<br />
0335341 FLUCONAZOL RATIO 150 MG 1 CAPS RR<br />
0 0 3,24 5,77 80<br />
0335484 FLUCONAZOL RATIO 200 MG 20 CAPS RR<br />
0 0 55,77 65,81 80<br />
0335372 FLUCONAZOL RATIO 50 MG 14 CAPS RR<br />
0 0 8,47 13,55 80<br />
0449096 FLUCONAZOLE EG 150 MG 1 CAPS RR<br />
0 0 1,79 6,49 80<br />
0449115 FLUCONAZOLE EG 200 MG 10 CAPS RR<br />
0 0 23,45 32,23 0<br />
0449129 FLUCONAZOLE EG 200 MG 20 CAPS RR<br />
0 0 61,05 73,61 0<br />
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0449079 FLUCONAZOLE EG 50 MG 10 CAPS RR<br />
0 0 6,99 12,88 0<br />
0460112 FLUCONAZOLE REDIBAG 100 MG 10 FL 50 ML RR HC<br />
0 0 5,54 0,00 0<br />
0460143 FLUCONAZOLE REDIBAG 200 MG 10 FL 100 ML RR HC<br />
0 0 11,09 0,00 0<br />
0460161 FLUCONAZOLE REDIBAG 400 MG 10 FL 200 ML RR HC<br />
0 0 22,17 0,00 0<br />
0438661 FLUCONAZOLE TEVA 150 MG 1 CAPS RR<br />
0 0 2,53 5,78 80<br />
0531276 FLUCONAZOLE TEVA 2 MG/ML 1 PO 100 ML IV RR HC<br />
0 0 10,31 0,00 0<br />
0531312 FLUCONAZOLE TEVA 2 MG/ML 1 PO 200 ML IV RR HC<br />
0 0 20,61 0,00 0<br />
0531293 FLUCONAZOLE TEVA 2 MG/ML 10 PO 100 ML IV RR HC<br />
0 0 88,10 0,00 0<br />
0531309 FLUCONAZOLE TEVA 2 MG/ML 10 PO 200 ML IV RR HC<br />
0 0 176,10 0,00 0<br />
0438576 FLUCONAZOLE TEVA 50 MG 10 CAPS RR<br />
0 0 9,20 19,39 80<br />
J02AC02 itraconazole<br />
0422609 ITRACONAZOL RATIO 100 MG 14 CAPS RR<br />
0 0 0,00 19,50 0<br />
0422612 ITRACONAZOL RATIO 100 MG 15 CAPS RR<br />
0 0 0,00 19,50 0<br />
0422643 ITRACONAZOL RATIO 100 MG 28 CAPS RR<br />
0 0 0,00 20,96 0<br />
0422657 ITRACONAZOL RATIO 100 MG 30 CAPS RR<br />
0 0 0,00 20,96 0<br />
0431365 ITRACONAZOLE EG 100 MG 15 CAPS RR<br />
0 0 9,01 15,40 80<br />
0431396 ITRACONAZOLE EG 100 MG 28 CAPS RR<br />
0 0 13,87 21,46 80<br />
0431317 ITRACONAZOLE EG 100 MG 4 CAPS RR<br />
0 0 2,70 7,54 80<br />
0431429 ITRACONAZOLE EG 100 MG 60 CAPS RR<br />
0 0 38,37 48,67 80<br />
0246899 SPORANOX 1% SOL 150 ML 87572 RR<br />
0 0 41,51 52,13 80<br />
0151229 SPORANOX 100 MG 15 CAPS 52083 RR<br />
0 0 9,01 15,40 80<br />
0225532 SPORANOX 100 MG 28 CAPS 87578 RR<br />
0 0 13,87 21,46 80<br />
0151201 SPORANOX 100 MG 4 CAPS 52082 RR<br />
0 0 2,70 7,54 80<br />
0239671 SPORANOX 100 MG 60 CAPS RR<br />
0 0 38,37 48,67 80<br />
0606637 SPOZOLE 100 MG 15 CAPS RR<br />
0 0 7,96 14,10 80<br />
0606641 SPOZOLE 100 MG 28 CAPS RR<br />
0 0 13,20 20,63 80<br />
0606623 SPOZOLE 100 MG 4 CAPS RR<br />
0 0 2,66 7,49 80<br />
0606654 SPOZOLE 100 MG 60 CAPS RR<br />
0 0 35,51 45,52 80<br />
J02AC03 voriconazole<br />
0318029 VFEND 10 MG/ML 1 FL V PERF RR HC<br />
0 0 147,70 0,00 0<br />
0318001 VFEND 200 MG 30 CPR RR DC<br />
0 0 1.192,43 0,00 0<br />
0317942 VFEND 200 MG 30 CPR BLIST RR DC<br />
0 0 1.192,43 0,00 0<br />
0317956 VFEND 200 MG 50 CPR BLIST RR DC<br />
0 0 1.987,39 0,00 0<br />
0365564 VFEND 40 MG/ML PDR 1 FL 45 G RR DC<br />
0 0 637,00 0,00 0<br />
0317827 VFEND 50 MG 30 CPR BLIST RR DC<br />
0 0 341,26 0,00 0<br />
0317831 VFEND 50 MG 50 CPR BLIST RR DC<br />
0 0 621,05 0,00 0<br />
J02AC04 posaconazole<br />
0416825 NOXAFIL 40 MG/ML SUSP 105 ML RR DC<br />
0 0 631,00 0,00 0<br />
J02AX04 caspofungin<br />
0350061 CANCIDAS 50 MG PDR 1 FL 10 ML + 1 SDT RR HC<br />
0 0 477,99 0,00 0<br />
0350074 CANCIDAS 50 MG PDR 1 FL 10 ML PERF RR HC<br />
0 0 456,49 0,00 0<br />
0350088 CANCIDAS 70 MG PDR 1 FL 10 ML PERF RR HC<br />
0 0 580,64 0,00 0<br />
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J02AX06 anidulafungin<br />
0467354 ECALTA 100 MG PERF 1 FL + S 30 ML IV RR HC<br />
0 0 404,96 0,00 0<br />
J04AB02 rifampicin<br />
0099745 RIFADINE 150 MG 100 CAPS RR<br />
0 0 22,39 31,06 100<br />
0201091 RIFADINE 300 MG 50 CAPS RR<br />
0 0 22,39 31,06 100<br />
J04AB03 rifamycin<br />
0099857 RIFOCINE 500 MG 2 AMP 10 ML IV RR<br />
0 0 3,70 8,78 100<br />
J04AB04 rifabutin<br />
0225899 MYCOBUTIN 150 MG 100 CAPS RR<br />
0 0 207,86 229,19 100<br />
J04AC01 isoniazid<br />
0358461 NICOTIBINE 300 MG 30 CAPS R<br />
0 0 3,62 8,57 100<br />
J04AK01 pyrazinamide<br />
0113729 TEBRAZID 500 MG 100 CPR RR<br />
0 0 9,17 15,43 100<br />
J04AK02 ethambutol<br />
0074861 MYAMBUTOL 400 MG 100 CPR RR<br />
0 0 21,38 29,94 100<br />
J05AB01 aciclovir<br />
0301438 ACICLOVIR EG 200 MG 25 CPR R<br />
0 0 11,20 18,14 80<br />
0459965 ACICLOVIR EG 250 MG PDR 10 FL IV RR H<br />
0 0 59,50 0,00 0<br />
0459948 ACICLOVIR EG 500 MG PDR 10 FL IV RR H<br />
0 0 119,00 0,00 0<br />
0301469 ACICLOVIR EG 800 MG 35 CPR R<br />
0 0 58,30 70,61 80<br />
0536109 ACICLOVIR HOSPIRA 1 G 1 FL 40 ML PERF RR H<br />
0 0 29,59 0,00 0<br />
0536076 ACICLOVIR HOSPIRA 250 MG 5 FL 10 ML PERF RR H<br />
0 0 36,99 0,00 0<br />
0536093 ACICLOVIR HOSPIRA 500 MG 5 FL 20 ML PERF RR H<br />
0 0 73,99 0,00 0<br />
0298878 ACICLOVIR MYLAN 200 MG 25 CPR R<br />
0 0 6,31 12,04 80<br />
0298881 ACICLOVIR MYLAN 800 MG 35 CPR R<br />
0 0 13,94 21,55 80<br />
0539517 ACICLOVIR RATIO 800 MG 35 CPR R<br />
0 0 12,37 22,04 80<br />
0217642 ACICLOVIR VON CT 200 MG 25 CPR R<br />
0 0 0,00 11,54 80<br />
0217673 ACICLOVIR VON CT 800 MG 35 CPR R<br />
0 0 0,00 22,47 80<br />
0444431 ZOVIRAX 200 MG 25 CPR R<br />
0 0 13,39 20,87 80<br />
0131260 ZOVIRAX 250 MG PDR 5 FL PERF/IV RR H<br />
0 0 23,80 0,00 0<br />
0190731 ZOVIRAX 400 MG/5 ML SIR 100 ML R<br />
0 0 14,34 22,05 80<br />
0444444 ZOVIRAX 800 MG 35 CPR R<br />
0 0 58,89 71,26 80<br />
J05AB04 ribavirin<br />
0336612 COPEGUS 200 MG 168 CPR RR C<br />
0 0 588,61 632,75 100<br />
0445925 COPEGUS 400 MG 56 CPR RR C<br />
0 0 389,53 421,75 100<br />
0264544 REBETOL 200 MG 140 CAPS RR C<br />
0 0 512,42 555,04 100<br />
0264558 REBETOL 200 MG 168 CAPS RR C<br />
0 0 501,32 540,23 100<br />
0264531 REBETOL 200 MG 84 CAPS RR C<br />
0 0 307,44 336,78 100<br />
0186076 VIRAZOLE PDR 6 G 3 FL INH RR HC<br />
0 0 589,59 0,00 0<br />
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J05AB06 ganciclovir<br />
0467581 CYMEVENE 500 MG PDR 1 FL PERF RR H<br />
0 0 25,99 0,00 0<br />
J05AB11 valaciclovir<br />
0220357 ZELITREX 500 MG 10 CPR RR<br />
0 0 27,34 38,06 80<br />
0218703 ZELITREX 500 MG 42 CPR RR<br />
0 0 61,80 74,39 80<br />
J05AB12 cidofovir<br />
0235542 VISTIDE 375 MG 1 FL 5 ML PERF RR H<br />
0 0 501,86 0,00 0<br />
J05AB14 valganciclovir<br />
0321072 VALCYTE 450 MG 60 CPR RR C<br />
0 0 1.367,51 1.458,28 80<br />
J05AB15 brivudine<br />
0316203 ZERPEX 125 MG 7 CPR RR<br />
0 0 68,11 82,79 80<br />
J05AD01 foscarnet<br />
0192395 FOSCAVIR 24 MG/ML 1 FL 250 ML PERF RR H<br />
0 0 33,68 0,00 0<br />
J05AE Protease inhibitors<br />
0627749 INCIVO 375 MG 4*42 CPR (FL) RR C<br />
RM 6 29<br />
8.333,34 8.841,15 100<br />
0617482 VICTRELIS 200 MG 4*84 CAPS RR C<br />
RM 6 29<br />
2.997,04 3.185,37 100<br />
J05AE01 saquinavir<br />
0402234 INVIRASE 500 MG 120 CPR RR C<br />
0 0 253,98 278,08 100<br />
J05AE02 indinavir<br />
0226526 CRIXIVAN 200 MG 360 CAPS RR C<br />
0 0 232,23 255,03 100<br />
0226557 CRIXIVAN 400 MG 180 CAPS RR C<br />
0 0 232,23 255,03 100<br />
J05AE03 ritonavir<br />
0568942 NORVIR 100 MG 3*30 CPR (FL) RR C<br />
0 0 67,46 80,28 100<br />
0226185 NORVIR 80 MG/ML SOL 5 FL 90 ML RR C<br />
0 0 279,78 307,32 100<br />
0481935 NORVIR 80 MG/ML SOL 5 FL 90 ML + DOS RR C<br />
0 0 279,78 305,32 0<br />
J05AE06 lopinavir<br />
0436618 KALETRA 200/50 MG 120 CPR BLIST RR C<br />
0 0 359,10 389,50 0<br />
0299195 KALETRA 5 FL 60 ML + 5 SRG RR C<br />
0 0 359,10 389,50 100<br />
J05AE07 fosamprenavir<br />
0377971 TELZIR 50 MG/ML SUSP BUV 225ML + SRG DOS RR C<br />
0 0 83,97 97,89 100<br />
0377968 TELZIR 700 MG 60 CPR RR C<br />
0 0 325,54 353,92 100<br />
J05AE08 atazanavir<br />
0364942 REYATAZ 150 MG 60 CAPS RR C<br />
0 0 360,09 390,54 100<br />
0364973 REYATAZ 200 MG 60 CAPS RR C<br />
0 0 360,09 390,54 100<br />
0481983 REYATAZ 300 MG 30 CAPS RR C<br />
0 0 360,09 390,54 100<br />
J05AE09 tipranavir<br />
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0416842 APTIVUS 250 MG 120 CAPS RR C<br />
0 0 690,00 740,20 100<br />
J05AE10 darunavir<br />
0524089 PREZISTA 150 MG 240 CPR (FL) RR C<br />
0 0 660,00 708,41 100<br />
0508393 PREZISTA 400 MG 60 CPR RR C<br />
0 0 440,10 475,35 100<br />
0508409 PREZISTA 600 MG 60 CPR RR C<br />
0 0 660,00 708,41 100<br />
0524075 PREZISTA 75 MG 480 CPR (FL) RR C<br />
0 0 660,00 708,41 100<br />
J05AF01 zidovudine<br />
0172165 RETROVIR 10 MG/ML SIR 200 ML + SRG 10 ML RR C<br />
0 0 18,49 26,77 100<br />
0133671 RETROVIR 100 MG 100 CAPS RR C<br />
0 0 92,38 106,80 100<br />
0205493 RETROVIR 200 MG 5 AMP 20 ML PERF RR H<br />
0 0 37,76 0,00 0<br />
0134892 RETROVIR 250 MG 40 CAPS RR C<br />
0 0 92,38 106,80 100<br />
0219406 RETROVIR 300 MG 60 CPR RR C<br />
0 0 149,64 167,50 100<br />
J05AF02 didanosine<br />
0178141 VIDEX 2 G PDR P SOL OR 1 FL RR C<br />
0 0 25,21 34,16 100<br />
0287745 VIDEX EC 125 MG 30 CAPS RR C<br />
0 0 47,28 58,49 100<br />
0287759 VIDEX EC 200 MG 30 CAPS RR C<br />
0 0 75,65 89,08 100<br />
0287762 VIDEX EC 250 MG 30 CAPS RR C<br />
0 0 94,57 109,13 100<br />
0287776 VIDEX EC 400 MG 30 CAPS RR C<br />
0 0 151,30 169,25 100<br />
J05AF04 stavudine<br />
0221824 ZERIT 1 MG/ML SOL 200 ML RR C<br />
0 0 14,31 22,01 100<br />
0221791 ZERIT 30 MG 56 CAPS BLIST RR C<br />
0 0 120,09 136,17 100<br />
0221811 ZERIT 40 MG 56 CAPS BLIST RR C<br />
0 0 128,09 144,66 100<br />
J05AF05 lamivudine<br />
0224292 EPIVIR 10 MG/ML GTTS 240 ML RR C<br />
0 0 33,78 43,61 100<br />
0224308 EPIVIR 150 MG 60 CPR RR C<br />
0 0 108,60 124,00 100<br />
0309372 EPIVIR 300 MG 30 CPR RR C<br />
0 0 108,60 124,00 100<br />
0266874 ZEFFIX 100 MG 84 CPR RR C<br />
0 0 121,98 138,18 100<br />
0266888 ZEFFIX 5 MG/ML SIR 240 ML RR C<br />
0 0 21,78 30,39 100<br />
J05AF06 abacavir<br />
0266793 ZIAGEN 20 MG/ML SIR 1 FL 240 ML RR C<br />
0 0 66,81 79,70 100<br />
0266776 ZIAGEN 300 MG 60 CPR RR C<br />
0 0 225,25 247,64 100<br />
J05AF07 tenofovir disoproxil<br />
0330314 VIREAD 245 MG 30 CPR RR C<br />
0 0 322,61 350,83 100<br />
J05AF08 adefovir dipivoxil<br />
0342508 HEPSERA 10 MG 30 CPR RR C<br />
0 0 323,07 351,31 100<br />
J05AF09 emtricitabine<br />
0355988 EMTRIVA 200 MG 30 CAPS RR C<br />
0 0 180,22 199,72 100<br />
J05AF10 entecavir<br />
0437162 BARACLUDE 0,5 MG 30 CPR RR C<br />
0 0 368,57 399,53 100<br />
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0437193 BARACLUDE 1 MG 30 CPR RR C<br />
0 0 459,55 495,96 100<br />
J05AG Non-nucleoside reverse transcriptase inhibitors<br />
0634998 EDURANT 25 MG 30 CPR (FL) RR C<br />
0 0 234,18 257,10 0<br />
J05AG01 nevirapine<br />
0627914 VIRAMUNE 100 MG 90 CPR RR C<br />
0 0 175,86 195,17 100<br />
0547987 VIRAMUNE 200 MG 14 CPR RR C<br />
0 0 54,69 66,63 100<br />
0247154 VIRAMUNE 200 MG 60 CPR RR C<br />
0 0 234,38 257,31 100<br />
0627931 VIRAMUNE 400 MG 30 CPR RR C<br />
0 0 234,38 257,19 100<br />
0265152 VIRAMUNE 50 MG/5 ML SIR 240 ML RR C<br />
0 0 46,91 58,06 100<br />
J05AG03 efavirenz<br />
0266597 STOCRIN 100 MG 30 CAPS RR C<br />
0 0 43,38 54,61 100<br />
0517067 STOCRIN 200 MG 90 CPR RR C<br />
0 0 234,18 257,10 100<br />
0266583 STOCRIN 50 MG 30 CAPS RR C<br />
0 0 21,69 31,75 100<br />
0333591 STOCRIN 600 MG 30 CPR (FL) RR C<br />
0 0 234,18 257,10 100<br />
J05AG04 etravirine<br />
0488341 INTELENCE 100 MG 120 CPR RR C<br />
0 0 387,52 419,61 100<br />
0635009 INTELENCE 200 MG 60 CPR (FL) RR C<br />
0 0 387,52 419,61 0<br />
J05AH01 zanamivir<br />
0268218 RELENZA 5 MG 5 RTD + 5 DISKHALER RR<br />
0 0 17,01 27,41 0<br />
J05AH02 oseltamivir<br />
0467192 TAMIFLU 30 MG 10 CAPS RR<br />
0 0 9,10 15,63 0<br />
0467208 TAMIFLU 45 MG 10 CAPS RR<br />
0 0 18,20 28,66 0<br />
0320562 TAMIFLU 75 MG 10 CAPS RR<br />
0 0 18,20 28,66 0<br />
J05AR01 zidovudine and lamivudine<br />
0252753 COMBIVIR 150 MG 60 CPR BLIST RR C<br />
0 0 354,92 385,06 100<br />
J05AR02 lamivudine and abacavir<br />
0391824 KIVEXA 600/300 MG 30 CPR RR C<br />
0 0 366,84 397,70 0<br />
0391838 KIVEXA 600/300 MG 30 CPR BLIST RR C<br />
0 0 366,84 397,52 100<br />
J05AR03 tenofovir disoproxil and emtricitabine<br />
0396624 TRUVADA 200/245 MG 30 CPR RR C<br />
0 0 513,30 552,93 100<br />
J05AR04 zidovudine, lamivudine and abacavir<br />
0293935 TRIZIVIR 60 CPR BLIST RR C<br />
0 0 615,09 660,81 100<br />
J05AR06 emtricitabine, tenofovir disoproxil and efavirenz<br />
0476353<br />
J05AR08<br />
ATRIPLA 30 CPR RR C<br />
0 0 776,09 831,28 100<br />
0635365 EVIPLERA 25/200/245 MG 30 CPR (FL) RR C<br />
0 0 760,31 814,72 100<br />
J05AX05 inosine pranobex<br />
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0059798 ISOPRINOSINE 500 MG 40 CPR R<br />
0 0 10,25 16,96 80<br />
J05AX07 enfuvirtide<br />
0347714 FUZEON 90 MG/ML PDR 60 FL + S + 60 SRG RR C<br />
0 0 1.650,00 1.757,68 100<br />
J05AX08 raltegravir<br />
0472676 ISENTRESS 400 MG 60 CPR RR C<br />
0 0 720,90 772,96 100<br />
J05AX09 maraviroc<br />
0467113 CELSENTRI 150 MG 60 CPR RR C<br />
0 0 840,00 899,18 100<br />
0467161 CELSENTRI 300 MG 60 CPR RR C<br />
0 0 840,00 899,18 100<br />
J06BA01 immunoglobulins, normal human, for extravascular adm.<br />
0624036 HIZENTRA 200 MG/ML 1 FL 10 ML SC RR DC<br />
0 0 84,08 0,00 0<br />
0624103 HIZENTRA 200 MG/ML 1 FL 20 ML SC RR DC<br />
0 0 168,16 0,00 0<br />
0624005 HIZENTRA 200 MG/ML 1 FL 5 ML SC RR DC<br />
0 0 42,04 0,00 0<br />
0482803 VIVAGLOBIN 16% 1 FL 10 ML SC RR DC<br />
0 0 61,46 0,00 0<br />
J06BA02 immunoglobulins, normal human, for intravascular adm.<br />
0340954 MULTIGAM 1 AMP 20 ML IVIT RR H<br />
0 0 35,05 0,00 0<br />
0341562 MULTIGAM 1 FL 100 ML IVIT RR H<br />
0 0 171,05 0,00 0<br />
0340968 MULTIGAM 1 FL 50 ML IVIT RR H<br />
0 0 85,82 0,00 0<br />
0485688 PRIVIGEN 100 MG/ML 1 FL 100 ML IV RR H<br />
0 0 420,40 0,00 0<br />
0485691 PRIVIGEN 100 MG/ML 1 FL 200 ML IV RR H<br />
0 0 840,80 0,00 0<br />
0525394 PRIVIGEN 100 MG/ML 1 FL 25 ML IV RR H<br />
0 0 105,10 0,00 0<br />
0485674 PRIVIGEN 100 MG/ML 1 FL 50 ML IV RR H<br />
0 0 210,20 0,00 0<br />
J06BB01 anti-D (rh) immunoglobulin<br />
0268771 RHOGAM ULTRA FILTERED 300 MCG 1FL 1ML IM RR<br />
0 0 31,48 40,90 80<br />
J06BB09 cytomegalovirus immunoglobulin<br />
0214315 IVEGAM CMV 1 AMP 10 ML IV RR H<br />
0 0 79,55 0,00 0<br />
0214329 IVEGAM CMV 1 AMP 20 ML IV RR H<br />
0 0 169,51 0,00 0<br />
0214332 IVEGAM CMV 1 FL 50 ML IV RR H<br />
0 0 429,65 0,00 0<br />
J06BB16 palivizumab<br />
0268526 SYNAGIS 100 MG PDR 1 FL + S 1 ML IM RR DC<br />
0 0 905,00 0,00 0<br />
0268512 SYNAGIS 50 MG PDR 1 FL + S 1 ML IM RR DC<br />
0 0 545,00 0,00 0<br />
J07AE01 cholera, inactivated, whole cell<br />
0375283 DUKORAL 2 SACH 5,6 G + 2 FL V R<br />
0 0 27,53 38,27 0<br />
J07AG01 hemophilus influenzae B, purified antigen conjugated<br />
0182984 ACT HIB 1 FL 1 D+S 0,5 ML IM R<br />
0 0 14,57 22,22 0<br />
0234058 HIBERIX 1 FL UD + S 0,5 ML IM R<br />
0 0 0,00 18,40 0<br />
J07AG52 hemophilus influenzae B, combinations with pertussis and toxoids<br />
0253456 INFANRIX HIB 1 FL 1 D + SRG IM R<br />
0 0 18,84 29,32 0<br />
J07AH Meningococcal vaccines<br />
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0312526 NEIS VAC C 1 SRG 0,5 ML IM R<br />
0 0 25,61 36,28 0<br />
J07AH04 meningococcus, tetravalent purified polysacchari<strong>des</strong> antigen<br />
0193036 MENCEVAX ACWY PDR 1 FL UD SC R<br />
0 0 21,50 32,06 0<br />
J07AH08 meningococcus, tetravalent purified polysacchari<strong>des</strong> antigen conjugated<br />
0617479 MENVEO 5 FL PDR + 5 FL SOL 0,5 ML R<br />
0 0 40,00 51,11 0<br />
0652031 NIMENRIX PSV 1 FL + 1 SRG PRER + 2 AIG R<br />
0 0 40,00 51,11 0<br />
J07AJ51 pertussis, inactivated, whole cell, combinations with toxoids<br />
0210848 INFANRIX DTPA 1 SRG 0,5 ML IM R<br />
0 0 0,00 16,86 0<br />
J07AJ52 pertussis, purified antigen, combinations with toxoids<br />
0293563 BOOSTRIX 1 SRG UD 0,5 ML IM R<br />
0 0 11,72 18,78 0<br />
J07AL01 pneumococcus, purified polysacchari<strong>des</strong> antigen<br />
0508314 PNEUMO 23 25 MCG 1 SRG 0,5 ML IMSC R<br />
0 0 17,17 27,60 0<br />
0303348 PNEUMOVAX 23 1 FL 0,5 ML IMSC R<br />
0 0 17,17 27,60 0<br />
J07AL02 pneumococcus, purified polysacchari<strong>des</strong> antigen conjugated<br />
0380821 PREVENAR 1 FL + SRG + 2 AIG R<br />
0 0 54,79 66,34 0<br />
0300086 PREVENAR 1 FL 0,5 ML IM R<br />
0 0 54,79 66,34 0<br />
0539243 PREVENAR 13 1 SRG + AIG SEP R<br />
0 0 60,71 72,44 0<br />
J07AM51 tetanus toxoid, combinations with diphtheria toxoid<br />
0195979 TEDIVAX PRO ADULTO 1 SRG 0,5 ML IM R<br />
0 0 3,01 7,92 0<br />
J07AP01 typhoid, oral, live attenuated<br />
0611041 VIVOTIF 3 CAPS R<br />
0 0 11,51 19,76 0<br />
J07AP03 typhoid, purified polysaccharide antigen<br />
0266048 TYPHERIX 1 SRG UD 0,5 ML IM R<br />
0 0 0,00 23,38 0<br />
0188036 TYPHIM VI 0,025 MG 1 SRG 0,5 ML IMSC R<br />
0 0 14,93 25,28 0<br />
0472614 TYPHIM VI 0,025MG 1SRG SS AIG 0,5ML+1AIG R<br />
0 0 14,93 25,28 0<br />
J07AX Other bacterial vaccines<br />
0015986 BRONCHOVAXOM AD 10 CAPS R<br />
0 0 9,63 16,55 0<br />
0016000 BRONCHOVAXOM AD 30 CAPS R<br />
0 0 23,11 33,72 0<br />
0016014 BRONCHOVAXOM ENF 10 CAPS R<br />
0 0 6,49 11,15 0<br />
0016028 BRONCHOVAXOM ENF 30 CAPS R<br />
0 0 15,58 25,96 0<br />
0187865 LUIVAC 3 MG 28 CPR R<br />
0 0 0,00 22,73 0<br />
0187879 LUIVAC 3 MG 56 CPR R<br />
0 0 0,00 42,24 0<br />
0143731 UROVAXOM 6 MG 30 CAPS R<br />
0 0 29,01 39,79 0<br />
0143745 UROVAXOM 6 MG 90 CAPS R<br />
0 0 69,63 81,62 0<br />
J07BA01 encephalitis, tick borne, inactivated, whole virus<br />
0395791 FSME IMMUN 2,4 MCG 1 SRG 0,5 ML IM R<br />
0 0 22,93 33,52 0<br />
0395742 FSME IMMUN JR 1,2 MCG 1 SRG 0,25 ML IM R<br />
0 0 18,34 28,80 0<br />
J07BA02 encephalitis, Japanese, inactivated, whole virus<br />
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0521638 IXIARO SUSP 1 SRG 0,5 ML IMSC RR<br />
0 0 68,95 80,92 0<br />
J07BB02 influenza, inactivated, split virus or surface antigen<br />
0152727 ALPHA RIX 1 SRG 0,5 ML IMSC R<br />
6 3 5,13 8,79 100<br />
0421176 INFLEXAL-V 1 SRG IMSC R<br />
6 3 5,13 8,79 100<br />
0421193 INFLEXAL-V 10 SRG IMSC R<br />
0 0 6,13 0,00 0<br />
0057146 INFLUVAC S 1 SRG 0,5 ML UD IMSC R<br />
6 3 5,13 8,79 100<br />
0513197 INTANZA 0,15 MCG 1 SRG 0,1 ML R<br />
0 0 6,13 11,64 0<br />
0246966 MUTAGRIP S 1 SRG 0,5 ML IMSC R<br />
0 0 0,00 8,79 0<br />
0125361 VAXIGRIP 1 SRG 0,5 ML IMSC R<br />
6 3 5,12 8,79 100<br />
J07BC01 hepatitis B, purified antigen<br />
0039599 ENGERIX B 20 MCG 1 FL 1 D 0,5 ML + SRG R<br />
0 0 17,72 25,92 0<br />
0205459 ENGERIX B JR 10 MCG 1 SRG UD 0,5 ML IM R<br />
0 0 9,85 16,45 0<br />
0436327 HBVAXPRO 40 MCG 1 FL 1 ML IM R<br />
0 0 48,54 59,69 0<br />
0362058 HBVAXPRO 5 MCG 1 SRG + AIG 0,5 ML IM R<br />
0 0 7,59 13,46 0<br />
0362075 HBVAXPRO 5 MCG 1 SRG SS AIG 0,5 ML IM R<br />
0 0 8,58 14,73 0<br />
J07BC02 hepatitis A, inactivated, whole virus<br />
0287048 EPAXAL 1 D 0,5 ML IM R<br />
0 0 27,72 38,46 0<br />
0206067 HAVRIX 1440 U 1 SRG 1 ML IM R<br />
0 0 33,45 44,36 0<br />
0230224 HAVRIX JR 720 U 1 SRG 0,5 ML IM R<br />
0 0 18,72 29,18 0<br />
J07BC20 combinations<br />
0228162 TWINRIX AD 1 SRG UD IM R<br />
0 0 41,89 53,05 0<br />
0232215 TWINRIX ENF 1 SRG UD IM R<br />
0 0 29,11 39,89 0<br />
J07BD52 measles, combinations with mumps and rubella, live attenuated<br />
0251935 PRIORIX PDR 1 D 0,5 ML SC R<br />
0 0 13,74 21,30 0<br />
J07BF03 poliomyelitis, trivalent, inactivated, whole virus<br />
0056202 IMOVAX POLIO 1 SRG 0,5 ML IMSC R<br />
0 0 5,46 9,38 0<br />
J07BG01 rabies, inactivated, whole virus<br />
0388796 RABIPUR PDR 1 FL + 1 SRG + S IM R<br />
0 0 34,15 45,09 0<br />
J07BH01 rota virus, live attenuated<br />
0488449 ROTARIX SP BUV 1 APPLIC ADM OR 1,5 ML R<br />
0 0 56,98 69,16 0<br />
0430449 ROTARIX SP BUV 1 FL + 1 SRG + 1 ADAPT R<br />
0 0 61,80 74,29 0<br />
0488497 ROTARIX SP BUV 1 TUBE SOUPLE 1,5 ML R<br />
0 0 56,98 68,98 0<br />
0436876 ROTATEQ GTTS 2 ML R<br />
0 0 41,20 51,61 0<br />
J07BK01 varicella, live attenuated<br />
0376246 PROVARIVAX 1350 U 1 FL 0,5MG + SRG + AIG R<br />
0 0 39,93 51,03 0<br />
0125022 VARILRIX PDR 1D + S R<br />
0 0 36,96 47,10 0<br />
J07BK02 zoster, live attenuated<br />
0436019 ZOSTAVAX PDR 1 FL + 1 SRG + 2 AIG 0,65ML R<br />
0 0 120,00 137,16 0<br />
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J07BL01 yellow fever, live attenuated<br />
0432944 STAMARIL PDR 10FL + 10SRG SS AIG + 20AIG R<br />
0 0 17,96 28,40 0<br />
J07BM01 papillomavirus (human types 6, 11, 16, 18)<br />
0441263 GARDASIL 1 SRG 0,5 ML + 1 DISPO + 2 AIG RR<br />
6 12 102,12 117,13 100<br />
J07BM02 papillomavirus (human types 16, 18)<br />
0467483 CERVARIX 20/20 MCG 1 SRG 0,5 ML + 1 AIG R<br />
6 12 94,92 109,50 100<br />
J07CA01 diphtheria-poliomyelitis-tetanus<br />
0271714 REVAXIS 1 SRG IMSC R<br />
0 0 0,00 11,87 0<br />
0432846 REVAXIS 1 SRG SS AIG + 1 AIG IMSC R<br />
0 0 11,41 19,60 0<br />
J07CA02 diphtheria-pertussis-poliomyelitis-tetanus<br />
0278522 INFANRIX IPV 1 SRG UD 0,5 ML R<br />
0 0 18,76 29,22 0<br />
J07CA05 diphtheria-hepatitis B-pertussis-tetanus<br />
0235976 TRITANRIX HEPB 1 FL 0,5 ML IM R<br />
0 0 0,00 15,03 0<br />
J07CA06 diphtheria-Hemophilus influenzae B-pertussis-poliomyelitis-tetanus<br />
0253473 INFANRIX IPV + HIB SET 1 FL 1 D + SRG IM R<br />
0 0 21,67 32,23 0<br />
L01 ANTINEOPLASTIC AGENTS<br />
0554821 EVOLTRA 20 MG 1 FL 20 ML PERF RR HC<br />
0 0 1.675,00 0,00 0<br />
0438819 EVOLTRA 20 MG 4 FL 20 ML PERF RR HC<br />
0 0 6.700,00 0,00 0<br />
L01AA01 cyclophosphamide<br />
0039263 ENDOXAN 1 G 1 AMP IV RR HC<br />
0 0 10,40 0,00 0<br />
0039280 ENDOXAN 200 MG 10 FL IMIV RR HC<br />
0 0 7,25 0,00 0<br />
0039246 ENDOXAN 50 MG 50 DRG RR C<br />
0 0 10,25 16,84 100<br />
0039294 ENDOXAN 500 MG 1 AMP IMIV RR HC<br />
0 0 5,35 0,00 0<br />
L01AA02 chlorambucil<br />
0316086 LEUKERAN 2 MG 50 CPR RR C<br />
0 0 4,18 9,39 100<br />
L01AA03 melphalan<br />
0003050 ALKERAN 2 MG 25 CPR RR C<br />
0 0 4,63 9,94 100<br />
0220231 ALKERAN 50 MG PDR 1 AMP+S 10 ML IVIA RR HC<br />
0 0 6,62 0,00 0<br />
L01AA06 ifosfamide<br />
0131839 HOLOXAN 1 G PDR 1 FL IV RR HC<br />
0 0 25,83 0,00 0<br />
L01AA09 bendamustine<br />
0592948 LEVACT 150 MG PDR PERF 5 FL 60 ML IV RR HC<br />
0 0 1.374,55 0,00 0<br />
0592921 LEVACT 65 MG PDR PERF 20 FL 26 ML IV RR HC<br />
0 0 1.374,55 0,00 0<br />
0592903 LEVACT 65 MG PDR PERF 5 FL 26 ML IV RR HC<br />
0 0 343,64 0,00 0<br />
L01AB01 busulfan<br />
0075046 MYLERAN 2 MG 100 CPR RR C<br />
0 0 8,13 14,30 100<br />
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L01AD05 fotemustine<br />
0198709 MUPHORAN 200 MG PDR 1 FL + S 4 ML IV RR H<br />
0 0 425,05 0,00 0<br />
L01AX03 temozolomide<br />
0512138 TEMODAL 100 MG 5 CAPS UD RR C<br />
0 0 240,66 263,97 100<br />
0512155 TEMODAL 140 MG 5 CAPS UD RR C<br />
0 0 331,80 360,56 100<br />
0512172 TEMODAL 180 MG 5 CAPS UD RR C<br />
0 0 420,26 454,31 100<br />
0512091 TEMODAL 2,5 MG/0,1 ML PDR 1 FL G IV RR HC<br />
0 0 281,98 0,00 0<br />
0512124 TEMODAL 20 MG 20 CAPS UD RR C<br />
0 0 214,36 236,09 100<br />
0512111 TEMODAL 20 MG 5 CAPS UD RR C<br />
0 0 53,59 65,43 100<br />
0512205 TEMODAL 250 MG 5 CAPS UD RR C<br />
0 0 567,55 610,43 100<br />
0524576 TEMODAL 5 MG 20 CAPS UD RR C<br />
0 0 56,96 69,13 100<br />
0524562 TEMODAL 5 MG 5 CAPS UD RR C<br />
0 0 14,24 21,93 100<br />
0568411 TEMOZOLOMIDE SANDOZ 100 MG 5 CAPS (FL) RR C<br />
0 0 383,12 414,78 0<br />
0568407 TEMOZOLOMIDE SANDOZ 20 MG 20 CAPS (FL) RR C<br />
0 0 323,83 351,94 0<br />
0568391 TEMOZOLOMIDE SANDOZ 20 MG 5 CAPS (FL) RR C<br />
0 0 80,96 94,53 0<br />
0568472 TEMOZOLOMIDE SANDOZ 250 MG 5 CAPS (FL) RR C<br />
0 0 903,53 966,33 0<br />
0568388 TEMOZOLOMIDE SANDOZ 5 MG 20 CAPS (FL) RR C<br />
0 0 85,31 99,14 0<br />
0568374 TEMOZOLOMIDE SANDOZ 5 MG 5 CAPS (FL) RR C<br />
0 0 21,33 29,71 0<br />
L01BA01 methotrexate<br />
0501067 EMTHEXATE 1000 MG 1 FL 40 ML RR H<br />
0 0 82,68 0,00 0<br />
0500946 EMTHEXATE 5 MG 1 FL 2 ML RR<br />
0 0 1,38 6,03 0<br />
0500963 EMTHEXATE 5 MG 10 FL 2 ML RR<br />
0 0 13,74 21,30 0<br />
0501019 EMTHEXATE 50 MG 1 FL 2 ML RR H<br />
0 0 7,25 0,00 0<br />
0501036 EMTHEXATE 500 MG 1 FL 20 ML RR H<br />
0 0 45,92 0,00 0<br />
0500994 EMTHEXATE 5000 MG 1 FL 50 ML RR H<br />
0 0 358,06 0,00 0<br />
0341643 LEDERTREXATE 2,5 MG 30 CPR RR<br />
0 0 2,76 7,61 100<br />
0283102 LEDERTREXATE 5 MG 1 FL 2 ML RR C<br />
0 0 1,97 6,69 100<br />
0216953 LEDERTREXATE CONC 1 G 1 FL 10 ML RR HC<br />
0 0 83,13 0,00 0<br />
0216967 LEDERTREXATE CONC 5 G 1 FL 50 ML RR HC<br />
0 0 374,10 0,00 0<br />
L01BA03 raltitrexed<br />
0230031 TOMUDEX 2 MG PDR 3 FL PERF RR HC<br />
0 0 279,55 0,00 0<br />
L01BA04 pemetrexed<br />
0386466 ALIMTA 500 MG PDR 1 FL PERF RR HC<br />
0 0 1.253,39 0,00 0<br />
L01BB02 mercaptopurine<br />
0095679 PURI NETHOL 25 CPR RR C<br />
0 0 7,24 13,09 100<br />
L01BB04 cladribine<br />
0222348 LEUSTATIN 10 MG 7 FL 10 ML PERF RR HC<br />
0 0 2.160,39 0,00 0<br />
0369708 LITAK 10 MG 1 FL 5 ML SC RR H<br />
X 0 0<br />
330,00 0,00 0<br />
0369711 LITAK 10 MG 5 FL 5 ML SC RR H<br />
X 0 0<br />
1.590,00 0,00 0<br />
L01BB05 fludarabine<br />
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délivrance prescription<br />
0321458 FLUDARA ORAL 10 MG 15 CPR RR C<br />
0 0 372,89 403,93 100<br />
0321461 FLUDARA ORAL 10 MG 20 CPR RR C<br />
0 0 497,32 535,81 100<br />
0526164 FLUDARABINE SDZ 25 MG/ML 1 FL 2 ML RR HC<br />
0 0 88,67 0,00 0<br />
0469569 FLUDARABINE TEVA 25 MG PDR 1 FL 1 ML IV RR HC<br />
0 0 47,25 0,00 0<br />
L01BB07 nelarabine<br />
0467239 ATRIANCE 5 MG/ML PERF 6 FL 50 ML IV RR HC X 0 0<br />
1.986,00 0,00 0<br />
L01BC01 cytarabine<br />
0492827 CYTARABINE HSP 1 G 1 ONCOTAIN 10 ML RR HC<br />
0 0 18,62 0,00 0<br />
0492831 CYTARABINE HSP 2 G 1 ONCOTAIN 20 ML RR HC<br />
0 0 33,51 0,00 0<br />
0230403 CYTOSAR CYTOSAFE 1 G 1 FL 10 ML IV RR HC<br />
0 0 12,95 0,00 0<br />
0230417 CYTOSAR CYTOSAFE 100 MG 1 FL 5 ML IMSCTR RR HC<br />
0 0 1,78 0,00 0<br />
0230398 CYTOSAR CYTOSAFE 2 G 1 FL 20 ML IV RR HC<br />
0 0 23,30 0,00 0<br />
0230421 CYTOSAR CYTOSAFE 500 MG 1 FL 25 ML IV RR HC<br />
0 0 7,19 0,00 0<br />
0404256 DEPOCYTE 50 MG 1 FL 5 ML RR HC<br />
0 0 1.612,80 0,00 0<br />
L01BC02 fluorouracil<br />
0038266 EFUDIX ONG 20 G RR C<br />
0 0 13,11 20,52 80<br />
0420442 FLURACEDYL 1 G 1 FL 20 ML IVIA RR HC<br />
0 0 3,16 0,00 0<br />
0420425 FLURACEDYL 5 G 1 FL 100 ML IVIA RR HC<br />
0 0 16,16 0,00 0<br />
0238771 FLUROBLASTINE 1000 MG 1 FL 20 ML IV RR HC<br />
0 0 3,23 0,00 0<br />
0045789 FLUROBLASTINE 500 MG 1 FL 10 ML IV RR HC<br />
0 0 1,71 0,00 0<br />
L01BC05 gemcitabine<br />
0566501 GEMCITABIN SDZ 1 G 1 FL 100 ML IV RR HC<br />
0 0 60,99 0,00 0<br />
0566447 GEMCITABIN SDZ 200 MG 1 FL 20 ML IV RR HC<br />
0 0 13,16 0,00 0<br />
0566478 GEMCITABIN SDZ 500 MG 1 FL 50 ML IV RR HC<br />
0 0 32,90 0,00 0<br />
0555846 GEMCITABINE ACTAVIS 1 G PDR 1 FL PERF RR HC<br />
0 0 60,99 0,00 0<br />
0556101 GEMCITABINE ACTAVIS 200 MG PDR 1 FL PERF RR HC<br />
0 0 13,16 0,00 0<br />
0540441 GEMCITABINE EG 38 MG/ML 1 FL DIL 1000 MG RR HC<br />
0 0 47,16 0,00 0<br />
0540454 GEMCITABINE EG 38 MG/ML 1 FL DIL 1500 MG RR HC<br />
0 0 70,73 0,00 0<br />
0540437 GEMCITABINE EG 38 MG/ML 1 FL DIL 200 MG RR HC<br />
0 0 10,18 0,00 0<br />
0540468 GEMCITABINE EG 38 MG/ML 1 FL DIL 2000 MG RR HC<br />
0 0 94,32 0,00 0<br />
0612956 GEMCITABINE HOSPIRA 38 MG/ML 1 FL 26,3ML RR HC<br />
0 0 46,24 0,00 0<br />
0612942 GEMCITABINE HOSPIRA 38 MG/ML 1 FL 5,3 ML RR HC<br />
0 0 9,98 0,00 0<br />
0612973 GEMCITABINE HOSPIRA 38 MG/ML 1 FL 52,6ML RR HC<br />
0 0 92,48 0,00 0<br />
0647951 GEMCITABINE TEVA 40 MG/ML 1 FL 25 ML RR HC<br />
0 0 47,16 0,00 0<br />
0647948 GEMCITABINE TEVA 40 MG/ML 1 FL 5 ML RR HC<br />
0 0 10,18 0,00 0<br />
0647965 GEMCITABINE TEVA 40 MG/ML 1 FL 50 ML RR HC<br />
0 0 94,32 0,00 0<br />
L01BC06 capecitabine<br />
0297092 XELODA 150 MG 60 CPR RR C<br />
0 0 56,41 68,53 100<br />
0297108 XELODA 500 MG 120 CPR RR C<br />
0 0 374,44 405,75 100<br />
L01BC07 azacitidine<br />
0508491 VIDAZA 100 MG PDR 1 FL 4 ML RR HC X 0 0<br />
342,99 0,00 0<br />
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délivrance prescription<br />
L01C PLANT ALKALOIDS AND OTHER NATURAL PRODUCTS<br />
0133296 HELIXOR A 1 MG 50 AMP 1 ML SER I RR HC<br />
0 0 230,97 0,00 0<br />
0133282 HELIXOR A 1 MG 8 AMP 1 ML ROUGE RR HC<br />
0 0 38,96 0,00 0<br />
0133381 HELIXOR A 10 MG 50 AMP 1 ML SER I RR HC<br />
0 0 230,97 0,00 0<br />
0133377 HELIXOR A 10 MG 8 AMP 1 ML ROUGE RR HC<br />
0 0 38,96 0,00 0<br />
0133573 HELIXOR A 100 MG 50 AMP 2 ML ROUGE RR HC<br />
0 0 346,42 0,00 0<br />
0133556 HELIXOR A 100 MG 8 AMP 2 ML ROUGE RR HC<br />
0 0 57,64 0,00 0<br />
0133444 HELIXOR A 20 MG 50 AMP 1 ML SER II RR HC<br />
0 0 230,97 0,00 0<br />
0133431 HELIXOR A 20 MG 8 AMP 1 ML ROUGE RR HC<br />
0 0 38,96 0,00 0<br />
0133492 HELIXOR A 30 MG 50 AMP 1 ML SER II RR HC<br />
0 0 238,54 0,00 0<br />
0133489 HELIXOR A 30 MG 8 AMP 1 ML ROUGE RR HC<br />
0 0 41,39 0,00 0<br />
0133332 HELIXOR A 5 MG 50 AMP 1 ML SER I RR HC<br />
0 0 230,97 0,00 0<br />
0133329 HELIXOR A 5 MG 8 AMP 1 ML ROUGE RR HC<br />
0 0 38,96 0,00 0<br />
0133539 HELIXOR A 50 MG 50 AMP 1 ML ROUGE RR HC<br />
0 0 247,94 0,00 0<br />
0133525 HELIXOR A 50 MG 8 AMP 1 ML ROUGE RR HC<br />
0 0 42,62 0,00 0<br />
0138275 HELIXOR A SERIE I ROUGE RR HC<br />
0 0 35,85 0,00 0<br />
0138289 HELIXOR A SERIE II ROUGE RR HC<br />
0 0 36,25 0,00 0<br />
0138292 HELIXOR A SERIE III ROUGE RR HC<br />
0 0 35,85 0,00 0<br />
0138308 HELIXOR A SERIE IV ROUGE RR HC<br />
0 0 36,25 0,00 0<br />
0133038 HELIXOR M 1 MG 50 AMP 1 ML SER I RR HC<br />
0 0 230,97 0,00 0<br />
0133024 HELIXOR M 1 MG 8 AMP 1 ML VERT RR HC<br />
0 0 38,96 0,00 0<br />
0133122 HELIXOR M 10 MG 50 AMP 1 ML SER I RR HC<br />
0 0 230,97 0,00 0<br />
0133119 HELIXOR M 10 MG 8 AMP 1 ML VERT RR HC<br />
0 0 38,96 0,00 0<br />
0133279 HELIXOR M 100 MG 50 AMP 2 ML VERT RR HC<br />
0 0 346,42 0,00 0<br />
0133265 HELIXOR M 100 MG 8 AMP 2 ML VERT RR HC<br />
0 0 57,64 0,00 0<br />
0135323 HELIXOR M 20 MG 50 AMP 1 ML SER II RR HC<br />
0 0 230,97 0,00 0<br />
0133171 HELIXOR M 20 MG 8 AMP 1 ML VERT RR HC<br />
0 0 38,96 0,00 0<br />
0133198 HELIXOR M 30 MG 50 AMP 1 ML SER II RR HC<br />
0 0 238,54 0,00 0<br />
0133184 HELIXOR M 30 MG 8 AMP 1 ML VERT RR HC<br />
0 0 41,39 0,00 0<br />
0133072 HELIXOR M 5 MG 50 AMP 1 ML SER I RR HC<br />
0 0 230,97 0,00 0<br />
0133069 HELIXOR M 5 MG 8 AMP 1 ML VERT RR HC<br />
0 0 38,96 0,00 0<br />
0133234 HELIXOR M 50 MG 50 AMP 1 ML VERT RR HC<br />
0 0 247,94 0,00 0<br />
0133221 HELIXOR M 50 MG 8 AMP 1 ML VERT RR HC<br />
0 0 42,62 0,00 0<br />
0138311 HELIXOR M SERIE I 7 AMP SC RR HC<br />
0 0 35,85 0,00 0<br />
0138325 HELIXOR M SERIE II 7 AMP SC VERT RR HC<br />
0 0 36,25 0,00 0<br />
0138339 HELIXOR M SERIE III 7 AMP SC VERT RR HC<br />
0 0 35,85 0,00 0<br />
0138342 HELIXOR M SERIE IV 7 AMP SC VERT RR HC<br />
0 0 36,25 0,00 0<br />
0132772 HELIXOR P 1 MG 50 AMP 1 ML SER I RR HC<br />
0 0 230,97 0,00 0<br />
0132769 HELIXOR P 1 MG 8 AMP 1 ML VIOLET RR HC<br />
0 0 38,96 0,00 0<br />
0132871 HELIXOR P 10 MG 50 AMP 1 ML SER I RR HC<br />
0 0 230,97 0,00 0<br />
0132867 HELIXOR P 10 MG 8 AMP 1 ML VIOLET RR HC<br />
0 0 38,96 0,00 0<br />
0135404 HELIXOR P 100 MG 50 AMP 2 ML VIOLET RR HC<br />
0 0 346,42 0,00 0<br />
0135399 HELIXOR P 100 MG 8 AMP 2 ML VIOLET RR HC<br />
0 0 57,64 0,00 0<br />
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délivrance prescription<br />
0132921 HELIXOR P 20 MG 50 AMP 1 ML SER II RR HC<br />
0 0 230,97 0,00 0<br />
0132917 HELIXOR P 20 MG 8 AMP 1 ML VIOLET RR HC<br />
0 0 38,96 0,00 0<br />
0135368 HELIXOR P 30 MG 50 AMP 1 ML SER II RR HC<br />
0 0 238,54 0,00 0<br />
0132965 HELIXOR P 30 MG 8 AMP 1 ML VIOLET RR HC<br />
0 0 41,39 0,00 0<br />
0132822 HELIXOR P 5 MG 50 AMP 1 ML SER I RR HC<br />
0 0 230,97 0,00 0<br />
0132819 HELIXOR P 5 MG 8 AMP 1 ML VIOLET RR HC<br />
0 0 38,96 0,00 0<br />
0132982 HELIXOR P 50 MG 50 AMP 1 ML VIOLET RR HC<br />
0 0 247,94 0,00 0<br />
0132979 HELIXOR P 50 MG 8 AMP 1 ML VIOLET RR HC<br />
0 0 42,62 0,00 0<br />
0138356 HELIXOR P SERIE I 7 AMP VIOLET RR HC<br />
0 0 35,85 0,00 0<br />
0138373 HELIXOR P SERIE II 7 AMP VIOLET RR HC<br />
0 0 36,25 0,00 0<br />
0138387 HELIXOR P SERIE III 7 AMP VIOLET RR HC<br />
0 0 35,85 0,00 0<br />
0138391 HELIXOR P SERIE IV 7 AMP VIOLET RR HC<br />
0 0 36,25 0,00 0<br />
L01CA01 vinblastine<br />
0513507 VINBLASTINE TEVA 10 MG 1 FL 10 ML IV RR HC<br />
0 0 8,01 0,00 0<br />
L01CA02 vincristine<br />
0302971 VINCRISIN 1 MG 1 FL 1 ML IV RR HC<br />
0 0 6,25 0,00 0<br />
0302984 VINCRISIN 2 MG 1 FL 2 ML IV RR HC<br />
0 0 10,33 0,00 0<br />
L01CA03 vin<strong>des</strong>ine<br />
0038459 ELDISINE 5 MG PDR 1 FL IV RR HC<br />
0 0 85,52 0,00 0<br />
L01CA04 vinorelbine<br />
0193974 NAVELBINE 10 MG 1 FL 1 ML IV RR HC<br />
0 0 39,14 0,00 0<br />
0193988 NAVELBINE 10 MG 10 FL 1 ML IV RR HC<br />
0 0 328,56 0,00 0<br />
0195951 NAVELBINE 50 MG 1 FL 5 ML IV RR HC<br />
0 0 194,05 0,00 0<br />
0196641 NAVELBINE 50 MG 10 FL 5 ML IV RR HC<br />
0 0 1.567,43 0,00 0<br />
0565372 VINORELBIN ACTAVIS 10 MG 1 FL DIL 1 ML RR HC<br />
0 0 132,53 0,00 0<br />
0565419 VINORELBIN ACTAVIS 10 MG 10 FL DIL 1 ML RR HC<br />
0 0 629,49 0,00 0<br />
0544341 VINORELBINE SDZ 10 MG 1 FL 1 ML IV RR HC<br />
0 0 81,42 0,00 0<br />
0544355 VINORELBINE SDZ 50 MG 1 FL 5 ML IV RR HC<br />
0 0 386,75 0,00 0<br />
0544694 VINORELBINE TEVA 10 MG 1 FL 1 ML DIL RR HC<br />
0 0 15,97 0,00 0<br />
0544713 VINORELBINE TEVA 50 MG 1 FL 5 ML DIL RR HC<br />
0 0 75,84 0,00 0<br />
L01CA05 vinflunine<br />
0538103 JAVLOR 250 MG PERF 1 FL 10 ML DIL IV RR HC<br />
0 0 850,00 0,00 0<br />
0538067 JAVLOR 50 MG PERF 1 FL 2 ML DIL IV RR HC<br />
0 0 170,00 0,00 0<br />
L01CB01 etoposide<br />
0500879 EPOSIN 100 MG PERF 1 FL SOL A DIL 5 ML RR H<br />
0 0 6,02 0,00 0<br />
0500896 EPOSIN 500 MG PERF 1 FL SOL A DIL 25ML RR H<br />
0 0 31,81 0,00 0<br />
0392298 ETOPOSID SDZ 1 G 1 FL 50 ML PERF RR HC<br />
0 0 75,84 0,00 0<br />
0392267 ETOPOSID SDZ 100 MG 1 FL 5 ML PERF RR HC<br />
0 0 7,58 0,00 0<br />
0392271 ETOPOSID SDZ 200 MG 1 FL 10 ML PERF RR HC<br />
0 0 15,17 0,00 0<br />
0392284 ETOPOSID SDZ 400 MG 1 FL 20 ML PERF RR HC<br />
0 0 30,33 0,00 0<br />
0126419 VEPESID 100 MG 10 CPR RR C<br />
0 0 47,69 58,92 100<br />
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L01CB03<br />
0516722 EPIRUBICINE TEVA 2 MG/ML 1 FL 10 ML RR HC<br />
0 0 14,86 0,00 0<br />
0516767 EPIRUBICINE TEVA 2 MG/ML 1 FL 100 ML RR HC<br />
0 0 148,65 0,00 0<br />
0516736 EPIRUBICINE TEVA 2 MG/ML 1 FL 25 ML RR HC<br />
0 0 37,16 0,00 0<br />
0516719 EPIRUBICINE TEVA 2 MG/ML 1 FL 5 ML RR HC<br />
0 0 7,43 0,00 0<br />
0516753 EPIRUBICINE TEVA 2 MG/ML 1 FL 75 ML RR HC<br />
0 0 111,49 0,00 0<br />
L01CD Taxanes<br />
0601305 JEVTANA 60 MG PERF 1 FL 1,5 ML + S RR HC<br />
0 0 3.834,00 0,00 0<br />
L01CD01 paclitaxel<br />
0458663 PACLITAXEL EG 100 MG PERF 16,7 ML IV RR HC<br />
0 0 114,74 0,00 0<br />
0458677 PACLITAXEL EG 150 MG PERF 25 ML IV RR HC<br />
0 0 171,78 0,00 0<br />
0458646 PACLITAXEL EG 30 MG PERF 5 ML IV RR HC<br />
0 0 34,87 0,00 0<br />
0458681 PACLITAXEL EG 300 MG PERF 50 ML IV RR HC<br />
0 0 350,41 0,00 0<br />
0531682 PACLITAXEL KABI 100 MG 16,7 ML 1 FL G RR HC<br />
0 0 410,70 0,00 0<br />
0531665 PACLITAXEL KABI 30 MG 5 ML 1 FL G RR HC<br />
0 0 123,21 0,00 0<br />
0531701 PACLITAXEL KABI 300 MG 50 ML 1 FL G RR HC<br />
0 0 1.234,04 0,00 0<br />
0527757 PACLITAXEL SDZ 100 MG 1 FL 16,7 ML DIL RR HC<br />
0 0 243,56 0,00 0<br />
0527761 PACLITAXEL SDZ 150 MG 1 FL 25 ML DIL RR HC<br />
0 0 370,80 0,00 0<br />
0527743 PACLITAXEL SDZ 30 MG 1 FL 5 ML DIL RR HC<br />
0 0 72,61 0,00 0<br />
0527774 PACLITAXEL SDZ 300 MG 1 FL 50 ML DIL RR HC<br />
0 0 730,94 0,00 0<br />
0419584 PACLITAXIN 100 MG 1 FL 16,7 ML PERF RR HC<br />
0 0 114,74 0,00 0<br />
0487598 PACLITAXIN 150 MG 1 FL 25 ML PERF RR HC<br />
0 0 171,78 0,00 0<br />
0419571 PACLITAXIN 30 MG 1 FL 5 ML PERF RR HC<br />
0 0 34,87 0,00 0<br />
0419598 PACLITAXIN 300 MG 1 FL 50 ML PERF RR HC<br />
0 0 350,41 0,00 0<br />
L01CD02 docetaxel<br />
0596785 DOCETAXEL ACTAVIS 140 MG PERF 1 FL 7 ML RR HC<br />
0 0 560,07 0,00 0<br />
0596768 DOCETAXEL ACTAVIS 20 MG PERF 1 FL 1 ML RR HC<br />
0 0 80,02 0,00 0<br />
0596771 DOCETAXEL ACTAVIS 80 MG PERF 1 FL 4 ML RR HC<br />
0 0 320,04 0,00 0<br />
0587299 DOCETAXEL HOSPIRA 160 MG PERF 1 FL 16 ML RR HC<br />
0 0 659,88 0,00 0<br />
0587271 DOCETAXEL HOSPIRA 20 MG PERF 1 FL 2 ML RR HC<br />
0 0 80,02 0,00 0<br />
0587285 DOCETAXEL HOSPIRA 80 MG PERF 1 FL 8 ML RR HC<br />
0 0 320,04 0,00 0<br />
0565792 DOCETAXEL SDZ 20 MG PERF 5 FL DIL 2 ML RR HC<br />
0 0 516,62 0,00 0<br />
0565825 DOCETAXEL SDZ 80 MG PERF 5 FL DIL 8 ML RR HC<br />
0 0 2.066,32 0,00 0<br />
0555765 DOCETAXEL TEVA 20 MG PERF 1 FL DIL 0,5ML RR HC<br />
0 0 103,32 0,00 0<br />
0555779 DOCETAXEL TEVA 80 MG PERF 1 FL DIL 2 ML RR HC<br />
0 0 413,26 0,00 0<br />
0565579 TAXOTERE 160 MG 1 FL A DIL 8 ML IV RR HC<br />
0 0 547,34 0,00 0<br />
0219065 TAXOTERE 20 MG/0,5 ML 1 FL + S 1.5 ML RR HC<br />
0 0 80,02 0,00 0<br />
0544731 TAXOTERE 80 MG 1 FL A DIL 4 ML IV RR HC<br />
0 0 273,67 0,00 0<br />
0219079 TAXOTERE 80 MG/2 ML 1 FL + S 6 ML IV RR HC<br />
0 0 320,04 0,00 0<br />
L01CX01 trabectedin<br />
0469636 YONDELIS 0,25 MG PDR 1 FL V PERF RR HC X 0 0<br />
445,80 0,00 0<br />
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délivrance prescription<br />
0469653 YONDELIS 1 MG PDR 1 FL V PERF RR HC X 0 0<br />
1.677,20 0,00 0<br />
L01DB01 doxorubicin<br />
0201111 ADRIBLASTINA 10 MG PDR 5 FL IV RR HC<br />
0 0 31,64 0,00 0<br />
0201138 ADRIBLASTINA RTU 10MG 1 CYTOSAFE 5ML IV RR HC<br />
0 0 7,11 0,00 0<br />
0201169 ADRIBLASTINA RTU 200MG 1 CYTOSAFE 100ML RR HC<br />
0 0 113,17 0,00 0<br />
0201155 ADRIBLASTINA RTU 50MG 1 CYTOSAFE 25ML IV RR HC<br />
0 0 31,64 0,00 0<br />
0232988 CAELYX 2 MG/ML 1 FL 10 ML RR HC<br />
0 0 329,95 0,00 0<br />
0288739 CAELYX 2 MG/ML 1 FL 25 ML RR HC<br />
0 0 783,64 0,00 0<br />
0525914 DOXORUBICINE SDZ 10 MG 1 FL 5 ML DIL RR HC<br />
0 0 11,05 0,00 0<br />
0525931 DOXORUBICINE SDZ 100 MG 1 FL 50 ML DIL RR HC<br />
0 0 96,19 0,00 0<br />
0525945 DOXORUBICINE SDZ 200 MG 1 FL 100 ML DIL RR HC<br />
0 0 175,53 0,00 0<br />
0525928 DOXORUBICINE SDZ 50 MG 1 FL 25 ML DIL RR HC<br />
0 0 49,07 0,00 0<br />
0550402 DOXORUBICINE TEVA 10 MG 1 FL DIL 5 ML RR HC<br />
0 0 7,11 0,00 0<br />
0550447 DOXORUBICINE TEVA 200 MG 1 FL DIL 100ML RR HC<br />
0 0 113,17 0,00 0<br />
0550433 DOXORUBICINE TEVA 50 MG 1 FL DIL 25 ML RR HC<br />
0 0 31,64 0,00 0<br />
0285883 MYOCET 50 MG PDR 2 SETS IV RR HC<br />
0 0 1.334,93 0,00 0<br />
L01DB02 d<strong>au</strong>norubicin<br />
0020289 CERUBIDINE 20 MG PDR 1 FL + S 4 ML IV RR H<br />
0 0 8,20 0,00 0<br />
L01DB03 epirubicin<br />
0561017 EPIRUBICIN ACTAVIS 2 MG/ML 1 FL 100 ML RR HC<br />
0 0 192,25 0,00 0<br />
0560992 EPIRUBICIN ACTAVIS 2 MG/ML 1 FL 25 ML RR HC<br />
0 0 48,06 0,00 0<br />
0560975 EPIRUBICIN ACTAVIS 2 MG/ML 1 FL 5 ML RR HC<br />
0 0 7,83 0,00 0<br />
0525993 EPIRUBICINE SDZ 2 MG/ML 1 FL 100 ML RR HC<br />
0 0 189,01 0,00 0<br />
0525962 EPIRUBICINE SDZ 2 MG/ML 1 FL 25 ML RR HC<br />
0 0 47,25 0,00 0<br />
0525959 EPIRUBICINE SDZ 2 MG/ML 1 FL 5 ML RR HC<br />
0 0 9,45 0,00 0<br />
0525976 EPIRUBICINE SDZ 2 MG/ML 1 FL 50 ML RR HC<br />
0 0 107,20 0,00 0<br />
0526004 EPIRUBICINE SDZ 2 MG/ML 5 FL 5 ML RR HC<br />
0 0 48,23 0,00 0<br />
0043865 FARMORUBICINE 10 MG PDR 1 FL IV RR HC<br />
0 0 7,43 0,00 0<br />
0043879 FARMORUBICINE 50 MG PDR 1 FL IV RR HC<br />
0 0 37,16 0,00 0<br />
0253814 FARMORUBICINE CYTOV 10 MG 1 FL CS 5 ML RR HC<br />
0 0 7,43 0,00 0<br />
0321413 FARMORUBICINE CYTOV 200 MG 1 CS 100 ML RR HC<br />
0 0 148,65 0,00 0<br />
0253831 FARMORUBICINE CYTOV 50 MG 1 FL CS 25 ML RR HC<br />
0 0 37,16 0,00 0<br />
L01DB06 idarubicin<br />
0201396 ZAVEDOS 10 MG 1 FL IV RR HC<br />
0 0 83,67 0,00 0<br />
0233016 ZAVEDOS 5 MG 1 CAPS RR C<br />
0 0 23,72 32,52 100<br />
L01DB07 mitoxantrone<br />
0401092 MITOXANTRON SDZ 10 MG 1 FL 5 ML PERF RR H<br />
0 0 43,88 0,00 0<br />
0401108 MITOXANTRON SDZ 20 MG 1 FL 10 ML PERF RR H<br />
0 0 87,76 0,00 0<br />
0368096 XANTROSIN 20 MG 1 FL 10 ML PERF RR HC<br />
0 0 87,76 0,00 0<br />
0368129 XANTROSIN 25 MG 1 FL 12,5 ML PERF RR HC<br />
0 0 109,70 0,00 0<br />
L01DC01 bleomycin<br />
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délivrance prescription<br />
0014412 BLEOMYCINE 1500 U 1 AMP IMIVIA RR HC<br />
0 0 12,32 0,00 0<br />
0531729 BLEOMYCINE TEVA 15000 U 1 FL 10 ML IVIM RR HC<br />
0 0 9,20 0,00 0<br />
L01DC03 mitomycin<br />
0131887 MITOMYCINE C KYOWA 10 MG PDR 3 FL IV RR HC<br />
0 0 67,90 0,00 0<br />
0072898 MITOMYCINE C KYOWA 2 MG PDR 10FL 20ML IV RR HC<br />
0 0 53,49 0,00 0<br />
0131891 MITOMYCINE C KYOWA 20 MG PDR 2 FL IV RR HC<br />
0 0 84,21 0,00 0<br />
L01XA01 cisplatin<br />
0492858 CISPLATINE HSP 100 MG 1 ONCOTAIN 100 ML RR HC<br />
0 0 82,99 0,00 0<br />
0492844 CISPLATINE HSP 50 MG 1 ONCOTAIN 50 ML RR HC<br />
0 0 41,50 0,00 0<br />
0511189 CISPLATINE TEVA 10 MG PERF 10 ML IV RR HC<br />
0 0 5,97 0,00 0<br />
0511208 CISPLATINE TEVA 100 MG PERF 100 ML IV RR HC<br />
0 0 46,28 0,00 0<br />
0511192 CISPLATINE TEVA 50 MG PERF 50 ML IV RR HC<br />
0 0 26,08 0,00 0<br />
L01XA02 carboplatin<br />
0230482 CARBOPLATIN PFIZER 150 MG 1 FL 15 ML IV RR HC<br />
0 0 54,61 0,00 0<br />
0230465 CARBOPLATIN PFIZER 450 MG 1 FL 45 ML IV RR H<br />
0 0 147,40 0,00 0<br />
0230479 CARBOPLATIN PFIZER 50 MG 1 FL 5 ML IV RR HC<br />
0 0 20,48 0,00 0<br />
0492875 CARBOPLATINE HSP 150MG 1 ONCOTAIN 15 ML RR HC<br />
0 0 95,95 0,00 0<br />
0492889 CARBOPLATINE HSP 450MG 1 ONCOTAIN 45 ML RR H<br />
0 0 259,12 0,00 0<br />
0492861 CARBOPLATINE HSP 600MG 1 ONCOTAIN 60 ML RR H<br />
0 0 42,86 0,00 0<br />
0436649 CARBOSIN 150 MG 1 FL 15 ML PERF RR HC<br />
0 0 53,13 0,00 0<br />
0436652 CARBOSIN 450 MG 1 FL 45 ML PERF RR HC<br />
0 0 146,42 0,00 0<br />
0436635 CARBOSIN 50 MG 1 FL 5 ML PERF RR HC<br />
0 0 19,92 0,00 0<br />
0436666 CARBOSIN 600 MG 1 FL 60 ML PERF RR HC<br />
0 0 195,22 0,00 0<br />
L01XA03 oxaliplatin<br />
0422335 ELOXATIN 100 MG PERF 1 FL 20 ML RR HC<br />
0 0 108,85 0,00 0<br />
0436599 ELOXATIN 200 MG PERF 1 FL 40 ML RR HC<br />
0 0 217,69 0,00 0<br />
0422321 ELOXATIN 50 MG PERF 1 FL 10 ML RR HC<br />
0 0 54,42 0,00 0<br />
0632993 OXALIPLATIN ACTAVIS 100 MG 1 FL 20 ML RR HC<br />
0 0 216,73 0,00 0<br />
0633004 OXALIPLATIN ACTAVIS 200 MG 1 FL 40 ML RR HC<br />
0 0 433,46 0,00 0<br />
0632976 OXALIPLATIN ACTAVIS 50 MG 1 FL 10 ML RR HC<br />
0 0 108,38 0,00 0<br />
0615247 OXALIPLATIN HOSPIRA 100 MG 1 FL 20 ML RR HC<br />
0 0 197,63 0,00 0<br />
0615251 OXALIPLATIN HOSPIRA 200 MG 1 FL 40 ML RR HC<br />
0 0 395,25 0,00 0<br />
0615233 OXALIPLATIN HOSPIRA 50 MG 1 FL 10 ML RR HC<br />
0 0 98,82 0,00 0<br />
0470881 OXALIPLATINE TEVA 100 MG 1 FL 20ML PERF RR HC<br />
0 0 201,56 0,00 0<br />
0482771 OXALIPLATINE TEVA 200 MG 1 FL 40ML PERF RR HC<br />
0 0 403,12 0,00 0<br />
0470878 OXALIPLATINE TEVA 50 MG 1 FL 10ML PERF RR HC<br />
0 0 100,79 0,00 0<br />
L01XC Monoclonal antibodies<br />
0617062 YERVOY 200 MG PERF 1 FL 40 ML RR HC<br />
RM 0 0<br />
17.000,00 0,00 0<br />
0617059 YERVOY 50 MG PERF 1 FL 10 ML RR HC<br />
RM 0 0<br />
4.250,00 0,00 0<br />
L01XC02 rituximab<br />
0251479 MABTHERA 100 MG 2 AMP 10 ML PERF RR HC<br />
0 0 509,14 0,00 0<br />
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0251482 MABTHERA 500 MG 1 AMP 50 ML PERF RR HC<br />
0 0 1.283,89 0,00 0<br />
L01XC03 trastuzumab<br />
0287955 HERCEPTIN 150 MG PDR 1 FL IV RR HC<br />
0 0 623,89 0,00 0<br />
L01XC04 alemtuzumab<br />
0331664 MABCAMPATH 30 MG 3 FL 3 ML PERF RR HC<br />
RM 0 0<br />
998,87 0,00 0<br />
L01XC06 cetuximab<br />
0376389 ERBITUX 100 MG PERF 1 VIAL 50 ML IV RR HC<br />
0 0 210,94 0,00 0<br />
0450889 ERBITUX 40 MG PERF 1 FL 20 ML IV RR HC<br />
0 0 207,64 0,00 0<br />
L01XC07 bevacizumab<br />
0391811 AVASTIN 25 MG/ML PERF 1 FL 16 ML RR HC<br />
0 0 1.226,51 0,00 0<br />
0391807 AVASTIN 25 MG/ML PERF 1 FL 4 ML RR HC<br />
0 0 323,08 0,00 0<br />
L01XC08 panitumumab<br />
0472659 VECTIBIX 20 MG/ML PERF 1 FL 10 ML IV RR HC<br />
RM 0 0<br />
870,00 0,00 0<br />
0472662 VECTIBIX 20 MG/ML PERF 1 FL 20 ML IV RR HC<br />
RM 0 0<br />
1.448,30 0,00 0<br />
0472645 VECTIBIX 20 MG/ML PERF 1 FL 5 ML IV RR HC<br />
RM 0 0<br />
361,24 0,00 0<br />
L01XC09 catumaxomab<br />
0517666 REMOVAB 10 MCG 1 SRG A DIL + 1 CAN RR HC<br />
0 0 500,00 0,00 0<br />
0547875 REMOVAB 50 MCG 1 SRG A DIL + 1 CAN RR HC<br />
0 0 2.500,00 0,00 0<br />
L01XD03 methyl aminolevulinate<br />
0313649 METVIX 16% CREME 2 G RR C<br />
0 0 280,00 308,61 0<br />
L01XE Protein kinase inhibitors<br />
0643515 ZELBORAF 240 MG 56 CPR RR DC<br />
0 0 2.181,00 0,00 0<br />
L01XE01 imatinib<br />
0359621 GLIVEC 100 MG 60 CPR RR C<br />
X 1 5<br />
1.435,33 1.571,93 100<br />
0359648 GLIVEC 400 MG 30 CPR RR C<br />
X 1 5<br />
2.733,65 2.949,31 100<br />
L01XE02 gefitinib<br />
0524187 IRESSA 250 MG 3*10 CPR RR DC<br />
0 0 2.215,00 0,00 0<br />
L01XE03 erlotinib<br />
0409459 TARCEVA 100 MG 30 CPR RR C<br />
1 5 1.785,41 1.901,20 100<br />
0409462 TARCEVA 150 MG 30 CPR RR C<br />
1 5 2.199,50 2.340,08 100<br />
0409445 TARCEVA 25 MG 30 CPR RR C<br />
1 5 514,00 539,33 100<br />
L01XE04 sunitinib<br />
0441067 SUTENT 12,5 MG 30 CAPS RR C<br />
0 0 1.301,52 1.414,97 100<br />
0441071 SUTENT 25 MG 30 CAPS RR C<br />
0 0 2.603,04 2.820,52 100<br />
0441084 SUTENT 50 MG 30 CAPS RR C<br />
0 0 5.206,08 5.631,63 100<br />
L01XE05 sorafenib<br />
0439671 NEXAVAR 200 MG 112 CPR RR C<br />
X 1 5<br />
3.578,00 3.800,92 100<br />
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L01XE06 dasatinib<br />
0512271 SPRYCEL 100 MG 30 CPR BLIST RR DC X 0 0<br />
4.010,00 0,00 0<br />
0446533 SPRYCEL 20 MG 56 CPR RR DC X 0 0<br />
1.939,28 0,00 0<br />
0446497 SPRYCEL 20 MG 60 CPR RR DC X 0 0<br />
2.077,80 0,00 0<br />
0446547 SPRYCEL 20 MG 60 CPR UD RR DC X 0 0<br />
2.135,78 0,00 0<br />
0446551 SPRYCEL 50 MG 56 CPR RR DC X 0 0<br />
3.986,80 0,00 0<br />
0446502 SPRYCEL 50 MG 60 CPR RR DC X 0 0<br />
4.271,57 0,00 0<br />
0446564 SPRYCEL 50 MG 60 CPR UD RR DC X 0 0<br />
4.271,57 0,00 0<br />
0446578 SPRYCEL 70 MG 56 CPR RR DC X 0 0<br />
3.986,80 0,00 0<br />
0446516 SPRYCEL 70 MG 60 CPR RR DC X 0 0<br />
4.271,57 0,00 0<br />
0446581 SPRYCEL 70 MG 60 CPR UD RR DC X 0 0<br />
4.271,57 0,00 0<br />
L01XE07 lapatinib<br />
0602039 TYVERB 250 MG 140 CPR (FL) RR DC<br />
0 0 2.411,71 0,00 0<br />
0482851 TYVERB 250 MG 140 CPR BLIST RR DC<br />
0 0 2.411,71 0,00 0<br />
L01XE08 nilotinib<br />
0598843 TASIGNA 150 MG 112 CAPS RR DC X RM 0 0<br />
3.007,02 0,00 0<br />
0474619 TASIGNA 200 MG 112 CAPS RR DC X RM 0 0<br />
4.321,84 0,00 0<br />
L01XE09 temsirolimus<br />
0469071 TORISEL 25 MG/ML PERF 1 FL + S IV RR HC X 0 0<br />
874,04 0,00 0<br />
L01XE10 everolimus<br />
0524125 AFINITOR 10 MG 30 CPR RR DC<br />
0 0 3.518,46 0,00 0<br />
0524092 AFINITOR 5 MG 30 CPR RR DC<br />
0 0 3.518,46 0,00 0<br />
L01XE11 pazopanib<br />
0569032 VOTRIENT 200 MG 90 CPR (FL) RR DC<br />
0 0 2.498,40 0,00 0<br />
0569063<br />
L01XE12<br />
VOTRIENT 400 MG 60 CPR (FL) RR DC<br />
0 0 3.331,21 0,00 0<br />
0646243 CAPRELSA 100 MG 30 CPR RR DC<br />
RM 0 0<br />
2.000,00 0,00 0<br />
0646257 CAPRELSA 300 MG 30 CPR RR DC<br />
RM 0 0<br />
4.800,00 0,00 0<br />
L01XX05 hydroxycarbamide<br />
0054810 HYDREA 500 MG 20 CAPS RR C<br />
0 0 3,69 8,76 100<br />
L01XX11 estramustine<br />
0041681 ESTRACYT 140 MG 100 CAPS RR C<br />
0 0 111,26 126,82 100<br />
0041700 ESTRACYT 300 MG PDR 10 FL + S IV RR HC<br />
0 0 62,10 0,00 0<br />
L01XX14 tretinoin<br />
0226073 VESANOID 10 MG 100 CAPS RR C<br />
0 0 176,42 195,87 100<br />
L01XX17 topotecan<br />
0482199 HYCAMTIN 0,25 MG 10 CAPS RR DC<br />
0 0 63,84 0,00 0<br />
0482204 HYCAMTIN 1 MG 10 CAPS RR DC<br />
0 0 255,36 0,00 0<br />
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0330881 HYCAMTIN 1 MG/ML PDR 5 FL 3 ML PERF RR HC<br />
0 0 157,62 0,00 0<br />
0233162 HYCAMTIN 4 MG PDR 1 FL 5 ML PERF RR HC<br />
0 0 260,09 0,00 0<br />
L01XX19 irinotecan<br />
0227621 CAMPTO 100 MG 1 FL 5 ML PERF RR HC<br />
0 0 70,22 0,00 0<br />
0482087 CAMPTO 300 MG 1 FL 15 ML PERF RR HC<br />
0 0 238,82 0,00 0<br />
0227618 CAMPTO 40 MG 1 FL 2 ML PERF RR HC<br />
0 0 28,08 0,00 0<br />
0491718 IRINOSIN 100 MG PERF 5 FL 5 ML IV RR HC<br />
0 0 70,22 0,00 0<br />
0491704 IRINOSIN 40 MG PERF 5 FL 2 ML IV RR HC<br />
0 0 28,08 0,00 0<br />
0500056 IRINOSIN 500 MG PERF 1 FL A DIL 25 ML RR HC<br />
0 0 398,04 0,00 0<br />
0559926 IRINOTECAN ACTAVIS 100 MG 1 FL 5 ML DIL RR HC<br />
0 0 514,77 0,00 0<br />
0559912 IRINOTECAN ACTAVIS 40 MG 1 FL 2 ML DIL RR HC<br />
0 0 36,32 0,00 0<br />
0559943 IRINOTECAN ACTAVIS 500 MG 1 FL 25 ML DIL RR HC<br />
0 0 90,81 0,00 0<br />
0543294 IRINOTECAN EG 100 MG 1 FL 5 ML DIL IV RR HC<br />
0 0 57,84 0,00 0<br />
0543331 IRINOTECAN EG 300 MG 1 FL 15 ML DIL IV RR HC<br />
0 0 169,28 0,00 0<br />
0543281 IRINOTECAN EG 40 MG 1 FL 2 ML DIL IV RR HC<br />
0 0 24,40 0,00 0<br />
0516509 IRINOTECAN HOSPIRA 100 MG 1 FL 5 ML IV RR HC<br />
0 0 68,85 0,00 0<br />
0516493 IRINOTECAN HOSPIRA 40 MG 1 FL 2 ML IV RR HC<br />
0 0 27,53 0,00 0<br />
0516512 IRINOTECAN HOSPIRA 500 MG 1 FL 25ML IV RR HC<br />
0 0 390,28 0,00 0<br />
0607228 IRINOTECAN KABI 100 MG 5 ML 1 FL RR HC<br />
0 0 185,74 0,00 0<br />
0607214 IRINOTECAN KABI 40 MG 2 ML FL IV RR HC<br />
0 0 74,29 0,00 0<br />
0607245 IRINOTECAN KABI 500 MG 25 ML 1 FL IV RR HC<br />
0 0 928,68 0,00 0<br />
L01XX25 bexarotene<br />
0299634 TARGRETIN 75 MG 100 CAPS RR DC<br />
0 0 1.090,79 0,00 0<br />
L01XX27 arsenic trioxide<br />
0315237 TRISENOX 1 MG/ML 10 AMP A D PERF RR HC X 0 0<br />
3.730,11 0,00 0<br />
L01XX32 bortezomib<br />
0569113 VELCADE 1 MG PDR 1 FL IV RR HC<br />
0 0 327,00 0,00 0<br />
0368566 VELCADE 3,5 MG PDR 1 FL IV RR HC<br />
0 0 1.097,28 0,00 0<br />
L01XX35 anagrelide<br />
0389441<br />
L01XX41<br />
XAGRID 0,5 MG 100 CAPS RR C<br />
X 1 5<br />
456,98 493,12 100<br />
0623981 HALAVEN 0,88 MG 1 FL V 2 ML IV RR HC<br />
0 0 400,00 0,00 0<br />
L02AA02 polyestradiol phosphate<br />
0041728 ESTRADURINE 80 MG PDR 1 FL + S 2 ML IM RR<br />
0 0 3,85 8,79 100<br />
L02AB01 megestrol<br />
0141186 MEGACE 160 MG 30 CPR RR<br />
0 0 31,83 41,46 100<br />
L02AB02 medroxyprogesterone<br />
0029866 DEPO PROVERA 500 MG 1 AMP 3,3 ML IM RR<br />
0 0 6,61 12,41 100<br />
0095133 PROVERA 100 MG 50 CPR RR<br />
0 0 13,98 21,60 100<br />
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0095147 PROVERA 250 MG 40 CPR RR<br />
0 0 25,14 34,10 100<br />
0144403 PROVERA 400 MG 25 CPR RR<br />
0 0 22,83 31,55 100<br />
0450925 PROVERA 500 MG 30 CPR RR<br />
0 0 33,52 43,31 100<br />
0144899 PROVERA 500 MG/5 ML SIR 100 ML RR<br />
0 0 30,29 39,76 100<br />
L02AE01 buserelin<br />
0158197 SUPREFACT NASAL 0,1 MG/D 1 FL 100 D RR<br />
0 0 31,51 41,10 100<br />
0111870 SUPREFACT NASAL 0,1 MG/D 4 FL 100 D RR<br />
0 0 126,74 143,22 100<br />
L02AE02 leuprorelin<br />
0393099 DEPO ELIGARD 22,5 MG PDR 1 SRG + S SC RR C<br />
0 0 184,85 204,81 100<br />
0470461 DEPO ELIGARD 45 MG PDR 1 SRG + S SC RR C<br />
0 0 369,73 400,77 100<br />
0393118 DEPO ELIGARD 7,5 MG PDR 1 SRG + S SC RR C<br />
0 0 86,41 100,47 100<br />
0554835 LUCRIN DEPOT 11,25 MG 1 SRG PREREMPLIE RR C<br />
0 0 178,07 197,62 100<br />
0400159 LUCRIN DEPOT 3,75 MG 1 SRG PREREMPLIE RR C<br />
0 0 88,84 103,05 100<br />
L02AE03 goserelin<br />
0141818 ZOLADEX DEPOT 3,6 MG 1 SRG SC RR<br />
0 0 115,00 130,78 100<br />
0216841 ZOLADEX LA 10,8 MG 1 SRG SC RR<br />
0 0 296,05 322,68 100<br />
L02AE04 triptorelin<br />
0299956 DECAPEPTYL SR 11,25 MG 1 SRG + S 2 ML RR<br />
0 0 253,64 277,72 100<br />
0591517 DECAPEPTYL SR 22,5 MG 1 FL + S RR<br />
0 0 466,02 502,81 100<br />
0299942 DECAPEPTYL SR 3,75 MG 1 SRG + S 2 ML RR<br />
0 0 111,78 127,37 100<br />
L02BA01 tamoxifen<br />
0217768 NOLVADEX 10 MG 98 CPR RR<br />
0 0 11,75 18,82 100<br />
0217771 NOLVADEX D 20 MG 56 CPR RR<br />
0 0 15,13 23,03 100<br />
0206697 NOLVADEX D 20 MG 90 CPR UD RR<br />
0 0 24,32 0,00 0<br />
0172604 TAMIZAM 20 MG 60 CPR RR<br />
0 0 17,22 25,37 100<br />
0209508 TAMIZAM 20 MG 90 CPR RR<br />
0 0 24,02 32,86 100<br />
L02BA02 toremifene<br />
0257214 FARESTON 60 MG 100 CPR RR<br />
0 0 72,32 85,36 100<br />
L02BA03 fulvestrant<br />
0568939 FASLODEX 250 MG 2 SRG PRER 5 ML + 2 AIG RR<br />
0 0 485,00 522,93 100<br />
L02BB01 flutamide<br />
0325006 FLUTAMIDE EG 250 MG 100 CPR RR<br />
0 0 41,02 51,58 100<br />
0459285 FLUTAMIDE EG 250 MG 200 CPR RR<br />
0 0 82,04 95,84 0<br />
0242354 FLUTAPLEX 250 MG 100 CPR RR<br />
0 0 39,61 50,02 100<br />
0242368 FLUTAPLEX 250 MG 200 CPR RR<br />
0 0 73,80 87,11 100<br />
L02BB03 bicalutamide<br />
0461333 BICALUTAMID RATIO 50 MG 30 CPR RR<br />
0 0 44,79 58,10 100<br />
0461364 BICALUTAMID RATIO 50 MG 90 CPR RR<br />
0 0 129,78 151,11 100<br />
0519965 BICALUTAMIDE EG 50 MG 100 CPR RR<br />
0 0 203,06 224,12 100<br />
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0519948 BICALUTAMIDE EG 50 MG 28 CPR RR<br />
0 0 61,14 73,69 100<br />
0466151 BICALUTAMIDE TEVA 50 MG 56 CPR RR<br />
0 0 121,63 137,82 100<br />
0329751 CASODEX 150 MG 28 CPR RR C<br />
0 0 154,07 172,19 100<br />
0329764 CASODEX 150 MG 28 CPR UD RR C<br />
0 0 180,18 0,00 0<br />
0216211 CASODEX 50 MG 28 CPR RR<br />
0 0 61,14 73,69 100<br />
0216225 CASODEX 50 MG 28 CPR UD RR<br />
0 0 61,14 0,00 0<br />
L02BG03 anastrozole<br />
0495801 ANASTROZOL RATIO 1 MG 100 CPR RR C<br />
0 0 102,07 120,79 100<br />
0495765 ANASTROZOL RATIO 1 MG 30 CPR RR C<br />
0 0 32,14 44,26 100<br />
0652206 ANASTROZOL SDZ 1 MG 28 CPR RR C<br />
0 0 47,97 59,23 0<br />
0652285 ANASTROZOL SDZ 1 MG 98 CPR RR C<br />
0 0 134,30 151,24 0<br />
0565713 ANASTROZOLE EG 1 MG 28 CPR RR C<br />
0 0 50,25 61,75 100<br />
0565758 ANASTROZOLE EG 1 MG 98 CPR RR C<br />
0 0 140,62 157,94 100<br />
0215151 ARIMIDEX 1 MG 28 CPR RR C<br />
0 0 48,02 59,28 100<br />
0330927 ARIMIDEX 1 MG 84 CPR RR C<br />
0 0 115,26 131,05 100<br />
0330931 ARIMIDEX 1 MG 84 CPR UD RR C<br />
0 0 115,26 0,00 0<br />
0560765 ASTROZOL 1 MG 98 CPR RR C<br />
0 0 71,69 121,14 0<br />
L02BG04 letrozole<br />
0231351 FEMARA 2,5 MG 100 CPR RR C<br />
0 0 457,43 509,67 100<br />
0231347 FEMARA 2,5 MG 30 CPR RR C<br />
0 0 144,59 167,31 100<br />
L02BG06 exemestane<br />
0271485 AROMASIN 25 MG 30 CPR RR C<br />
0 0 54,40 66,32 100<br />
0618981 EXEMAROM 25 MG 100 CPR RR C<br />
0 0 164,01 182,72 100<br />
0619005 EXEMAROM 25 MG 120 CPR RR C<br />
0 0 196,81 217,48 100<br />
0618946 EXEMAROM 25 MG 30 CPR RR C<br />
0 0 53,34 65,15 100<br />
0647772 EXEMESTAN RATIO 25 MG 100 CPR RR C<br />
0 0 111,53 131,13 0<br />
0647755 EXEMESTAN RATIO 25 MG 30 CPR RR C<br />
0 0 32,20 44,32 0<br />
L02BX Other hormone antagonists and related agents<br />
0622631 ZYTIGA 250 MG 120 CPR (FL) RR<br />
1 5 3.300,00 3.506,46 100<br />
L02BX02 degarelix<br />
0513099 FIRMAGON 120 MG PSV 2FL+2SRG+4AIG+S 6ML RR C<br />
RM 0 0<br />
221,00 243,12 0<br />
0513085<br />
L02CD02<br />
FIRMAGON 80 MG PSV 1FL+1SRG+2AIG+S 6ML RR C<br />
RM 0 0<br />
121,40 137,55 0<br />
0544727 TAXOTERE 20 MG 1 FL A DIL 1 ML IV RR HC<br />
0 0 68,43 0,00 0<br />
L03AA02 filgrastim<br />
0169031 NEUPOGEN 30 MIO U 5 AMP 1 ML IVSC RR C<br />
0 0 363,94 394,62 100<br />
0314372 NEUPOGEN 30 MIO U 5 SRG PREREMPL 0,5 ML RR C<br />
0 0 363,94 394,62 100<br />
0314386 NEUPOGEN 48 MIO U 5 SRG PREREMPL 0,5 ML RR C<br />
0 0 512,50 552,07 100<br />
0506354 RATIOGRASTIM 30 MIO U PERF 5 SRG 0,5 ML RR C<br />
0 0 217,09 386,92 100<br />
0506399 RATIOGRASTIM 48 MIO U PERF 5 SRG 0,8 ML RR C<br />
0 0 303,75 541,36 100<br />
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0493211 TEVAGRASTIM 30 MIO U 5 SRG 0,5 ML SCIV RR C<br />
0 0 298,92 325,70 100<br />
0493256 TEVAGRASTIM 48 MIO U 5 SRG 0,8 ML SCIV RR C<br />
0 0 421,64 455,78 100<br />
0511239 ZARZIO 30 MIO U 5 SRG 0,5 ML RR C<br />
0 0 298,92 325,70 0<br />
0511287 ZARZIO 48 MIO U 5 SRG 0,5 ML RR C<br />
0 0 421,64 455,78 0<br />
L03AA10 lenograstim<br />
0246417 GRANOCYTE 33,6 MIO U PDR 5 FL+SRG 1 ML RR C<br />
0 0 370,07 401,13 100<br />
L03AA13 pegfilgrastim<br />
0529359 NEULASTA 6 MG 1 SRG SECURISEE 0,6 ML SC RR C<br />
0 0 1.155,56 1.233,64 100<br />
L03AB03 interferon gamma<br />
0185356 IMMUKINE 2 MIO U 6 FL 0,5 ML SC RR C<br />
0 0 483,87 521,73 100<br />
L03AB04 interferon alfa-2a<br />
0274022 ROFERON A 3 MIO U 6 SRG 0,5 ML IMSC RR C<br />
0 0 91,57 105,95 100<br />
0274067 ROFERON A 6 MIO U 6 SRG 0,5 ML IMSC RR C<br />
0 0 174,99 194,36 100<br />
0274084 ROFERON A 9 MIO U 6 SRG 0,5 ML IMSC RR C<br />
0 0 262,35 286,95 100<br />
L03AB05 interferon alfa-2b<br />
0208724 INTRON A 10 MIO U PDR 1 FL+S IMSC RR C<br />
0 0 62,83 76,31 100<br />
0175508 INTRON A 10 MIO U PDR 6 FL+S IMIVSC RR C<br />
0 0 363,37 396,34 100<br />
0278052 INTRON A ALB FREE 25 MIO U 2 FL 2,5 ML RR C<br />
0 0 269,29 294,31 100<br />
0243415 INTRON A PEN 18 MIO U 1 STYLO MTD 1,2 ML RR C<br />
0 0 89,60 103,86 100<br />
0243429 INTRON A PEN 30 MIO U 1 STYLO MTD 1,2 ML RR C<br />
0 0 167,60 186,54 100<br />
0243432 INTRON A PEN 60 MIO U 1 STYLO MTD 1,2 ML RR C<br />
0 0 323,14 351,39 100<br />
L03AB07 interferon beta-1a<br />
0233629 AVONEX 30 MCG (6MIO) PDR 4 FL UD 3 ML IM RR C<br />
0 0 738,83 791,95 100<br />
0624134 AVONEX 30 MCG 4 PEN 0,5ML+4AIG+4CAPUC RR C<br />
0 0 924,97 989,07 100<br />
0355375 AVONEX 30 MCG 4 SRG PRER 0,5 ML + 4 AIG RR C<br />
0 0 885,12 964,34 100<br />
0265216 REBIF 12 MIO U/0,5 ML (44MCG) 12 SRG SC RR C<br />
0 0 1.049,23 1.120,95 100<br />
0513118 REBIF 12 MIO U/0,5ML (44MCG) 4 CRT 1,5ML RR C<br />
0 0 1.049,23 1.120,95 100<br />
0249971 REBIF 6 MIO U/0,5 ML (22MCG) 12 SRG SC RR C<br />
0 0 783,57 839,38 100<br />
0513104 REBIF 6 MIO U/0,5 ML (22MCG) 4 CRT 1,5ML RR C<br />
0 0 783,57 839,38 100<br />
L03AB08 interferon beta-1b<br />
0274957 BETAFERON 8 MIO U PDR 15 FL + 15 SRG SC RR C<br />
0 0 828,60 891,72 100<br />
0217138 BETAFERON 8 MIO U PDR 15 FL + S 2 ML SC RR C<br />
0 0 840,36 901,01 100<br />
0441456 BETAFERON 8 MIO U PDR 15FL+15SRG+15ADAPT RR C<br />
0 0 671,20 720,28 100<br />
L03AB10 peginterferon alfa-2b<br />
0282591 PEGINTRON 100 MCG PSV 1 FL + S + 1 SET RR C<br />
0 0 182,97 204,24 100<br />
0320139 PEGINTRON 100 MCG PSV 1 STYLO + 1 AIG RR C<br />
0 0 178,40 197,97 100<br />
0282623 PEGINTRON 100 MCG PSV 4 FL + S + 4 SETS RR C<br />
0 0 713,58 765,19 0<br />
0320142 PEGINTRON 100 MCG PSV 4 STYLOS + 4 AIG RR C<br />
0 0 713,58 765,19 100<br />
0282654 PEGINTRON 120 MCG PSV 1 FL + S + 1 SET RR C<br />
0 0 219,55 243,19 100<br />
0320187 PEGINTRON 120 MCG PSV 1 STYLO + 1 AIG RR C<br />
0 0 214,06 235,77 100<br />
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0282671 PEGINTRON 120 MCG PSV 4 FL + S + 4 SETS RR C<br />
0 0 856,26 916,42 0<br />
0320191 PEGINTRON 120 MCG PSV 4 STYLOS + 4 AIG RR C<br />
0 0 856,26 916,42 100<br />
0282704 PEGINTRON 150 MCG PSV 1 FL + S + 1 SET RR C<br />
0 0 274,47 301,67 100<br />
0320237 PEGINTRON 150 MCG PSV 1 STYLO + 1 AIG RR C<br />
0 0 267,61 292,53 100<br />
0282721 PEGINTRON 150 MCG PSV 4 FL + S + 4 SETS RR C<br />
0 0 1.070,44 1.143,43 0<br />
0320241 PEGINTRON 150 MCG PSV 4 STYLOS + 4 AIG RR C<br />
0 0 1.070,44 1.143,43 100<br />
0282489 PEGINTRON 50 MCG PSV 1 FL + S + 1 SET RR C<br />
0 0 91,48 106,82 100<br />
0320058 PEGINTRON 50 MCG PSV 1 STYLO + 1 AIG RR C<br />
0 0 89,19 103,42 100<br />
0282508 PEGINTRON 50 MCG PSV 4 FL + S + 4 SETS RR C<br />
0 0 356,77 389,30 0<br />
0320061 PEGINTRON 50 MCG PSV 4 STYLOS + 4 AIG RR C<br />
0 0 356,77 387,03 100<br />
0282539 PEGINTRON 80 MCG PSV 1 FL + S + 1 SET RR C<br />
0 0 146,39 165,29 100<br />
0320092 PEGINTRON 80 MCG PSV 1 STYLO + 1 AIG RR C<br />
0 0 142,73 160,17 100<br />
0282556 PEGINTRON 80 MCG PSV 4 FL + S + 4 SETS RR C<br />
0 0 570,93 614,01 0<br />
0320108 PEGINTRON 80 MCG PSV 4 STYLOS + 4 AIG RR C<br />
0 0 570,93 614,01 100<br />
L03AB11 peginterferon alfa-2a<br />
0323578 PEGASYS 135 MCG 4 SRG 0,5 ML SC RR C<br />
0 0 650,20 698,02 100<br />
0621678 PEGASYS 135 MCG/ML 4 STYLOS PRER 0,5 ML RR C<br />
0 0 714,51 766,07 100<br />
0323595 PEGASYS 180 MCG 4 SRG 0,5 ML SC RR C<br />
0 0 753,62 807,64 100<br />
0621701 PEGASYS 180 MCG/ML 4 STYLOS PRER 0,5 ML RR C<br />
0 0 828,16 886,53 100<br />
L03AC01 al<strong>des</strong>leukin<br />
0161273 PROLEUKIN S 18 MIO U/ML PDR 1 FL IVSC RR H<br />
0 0 296,92 0,00 0<br />
L03AX03 BCG vaccine<br />
0340873 IMMUCYST 81 MG SUSP 1 FL + S 3 ML VE RR<br />
0 0 54,35 66,14 100<br />
0375803 ONCOTICE PDR 1 FL VE RR<br />
0 0 46,94 58,10 100<br />
L03AX13 glatiramer acetate<br />
0370291 COPAXONE 20 MG/ML 28 SRG PRERPL SC RR C<br />
0 0 774,72 830,00 100<br />
L03AX15 mifamurtide<br />
0513491 MEPACT 4 MG PDR 1 FL + FILTRE IV RR HC X 0 0<br />
2.816,46 0,00 0<br />
L03AX16 plerixafor<br />
0528995 MOZOBIL 20 MG/ML 1 FL 2 ML RR HC X 0 0<br />
5.800,62 0,00 0<br />
L04AA04 antithymocyte immunoglobulin (rabbit)<br />
0398551 THYMOGLOBULINE 25 MG 1 FL + S 5 ML IV RR HC<br />
0 0 157,66 0,00 0<br />
L04AA06 mycophenolic acid<br />
0264111 CELLCEPT 1 G/5 ML PDR 110 G RR C<br />
0 0 79,39 93,04 100<br />
0224566 CELLCEPT 250 MG 3*100 CAPS RR C<br />
0 0 145,98 163,61 100<br />
0224552 CELLCEPT 500 MG 3*50 CPR RR C<br />
0 0 145,98 163,61 100<br />
0257536 CELLCEPT 500 MG PDR 4 FL PERF RR HC<br />
0 0 43,94 0,00 0<br />
0479341 MYFENAX 250 MG 300 CAPS RR C<br />
0 0 145,98 163,61 0<br />
0479369 MYFENAX 500 MG 150 CPR RR C<br />
0 0 145,98 163,61 0<br />
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L04AA10 sirolimus<br />
0317424 RAPAMUNE 1 MG 100 CPR RR C<br />
0 0 402,00 434,96 100<br />
0344483 RAPAMUNE 2 MG 30 CPR RR C<br />
0 0 241,20 264,54 100<br />
0301228 RAPAMUNE 60 MG 1 FL 60 ML + 1 SET RR C<br />
0 0 241,20 264,54 100<br />
L04AA13 leflunomide<br />
0270832 ARAVA 10 MG 100 CPR RR C<br />
RM 0 0<br />
85,52 99,53 100<br />
0270829 ARAVA 10 MG 30 CPR RR C<br />
RM 0 0<br />
32,07 41,61 100<br />
0285382 ARAVA 100 MG 3 CPR RR C<br />
RM 0 0<br />
17,83 26,04 100<br />
0270881 ARAVA 20 MG 100 CPR RR C<br />
RM 0 0<br />
98,64 113,45 100<br />
0270877 ARAVA 20 MG 30 CPR RR C<br />
RM 0 0<br />
36,98 47,13 100<br />
L04AA23 natalizumab<br />
0436909 TYSABRI 20 MG/ML 1 FL PERF RR HC<br />
RM 0 0<br />
1.579,12 0,00 0<br />
L04AA24 abatacept<br />
0465976 ORENCIA 250 MG PERF 1 FL + S IV RR HC<br />
RM 0 0<br />
347,24 0,00 0<br />
L04AA25 eculizumab<br />
0466083<br />
L04AA26<br />
SOLIRIS 300 MG PERF 1 FL 30 ML IV RR HC X RM 0 0<br />
4.450,00 0,00 0<br />
0621647 BENLYSTA 120 MG PDR 1 FL 5 ML RR HC<br />
0 0 130,20 0,00 0<br />
0621651<br />
L04AA27<br />
BENLYSTA 400 MG PDR 1 FL 20 ML RR HC<br />
0 0 434,00 0,00 0<br />
0607276 GILENYA 0,5 MG 28 CAPS RR DC<br />
RM 0 0<br />
1.690,71 0,00 0<br />
L04AB01 etanercept<br />
0443951 ENBREL 25 MG PDR 4 SRG PREREMPL 0,5 ML RR C<br />
0 0 508,01 547,31 100<br />
0462263 ENBREL 25 MG PDR 4FL+4SRG+20AIG+4ADAPT+T RR C<br />
0 0 508,01 547,31 100<br />
0524903 ENBREL 50 MG PDR 4 MYCLIC 1 ML + 8 TAMP RR C<br />
0 0 1.016,02 1.085,75 100<br />
0443996 ENBREL 50 MG PDR 4 SRG PREREMPL 1 ML RR C<br />
0 0 1.016,02 1.085,75 100<br />
0636054 ENBREL PED 10 MG 4 SRG PREREMPL 1 ML RR C<br />
0 0 220,89 237,42 0<br />
L04AB02 infliximab<br />
0267417 REMICADE 100 MG PDR 1 FL V 20 ML IV RR HC<br />
0 0 547,72 0,00 0<br />
L04AB04 adalimumab<br />
0353001 HUMIRA 40 MG 2 SRG 0,8 ML SC RR C<br />
0 0 988,47 1.056,43 100<br />
0444301 HUMIRA 40 MG 2 STYLOS 0,8 ML + 2 TAMP RR C<br />
0 0 988,47 1.056,43 100<br />
L04AB05 certolizumab pegol<br />
0541272 CIMZIA 200 MG 2 SRG 1 ML SC RR C<br />
RM 0 0<br />
946,40 1.011,78 100<br />
L04AB06 golimumab<br />
0528951 SIMPONI 50 MG 1 SRG 0,5 ML RR C<br />
RM 0 0<br />
1.077,38 1.150,67 100<br />
0528978 SIMPONI 50 MG 1 STYLO 0,5 ML RR C<br />
RM 0 0<br />
1.077,38 1.150,78 100<br />
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L04AC01 daclizumab<br />
0264107 ZENAPAX 5 MG/ML 3 FL 5 ML RR H<br />
0 0 949,88 0,00 0<br />
L04AC02 basiliximab<br />
0257083 SIMULECT 20 MG PDR 1 FL + S PERF RR H<br />
0 0 1.022,58 0,00 0<br />
L04AC05 ustekinumab<br />
0567976 STELARA 45 MG 1 SRG PREREMPL 0,5 ML SC RR C<br />
RM 0 0<br />
3.000,00 3.188,50 100<br />
0567993 STELARA 90 MG 1 SRG PREREMPL 1 ML SC RR C<br />
RM 0 0<br />
3.400,00 3.612,44 100<br />
L04AC07 tocilizumab<br />
0503142 ROACTEMRA 200 MG PERF 4 FL 10 ML IV RR HC<br />
RM 0 0<br />
1.397,19 0,00 0<br />
0503187 ROACTEMRA 400 MG PERF 4 FL 20 ML IV RR HC<br />
RM 0 0<br />
2.794,54 0,00 0<br />
0503139 ROACTEMRA 80 MG PERF 4 FL 4 ML IV RR HC<br />
RM 0 0<br />
558,68 0,00 0<br />
L04AC08 canakinumab<br />
0535308 ILARIS 150 MG PDR 1 FL SC RR C<br />
X RM 0 0<br />
11.000,00 3.156,34 0<br />
L04AD01 ciclosporin<br />
0170661 SANDIMMUN 100 MG 50 CAPS RR<br />
0 0 178,16 204,04 100<br />
0170644 SANDIMMUN 25 MG 50 CAPS RR<br />
0 0 48,92 62,61 100<br />
0306563 SANDIMMUN INF 250 MG 10 AMP 5 ML PERF RR<br />
0 0 136,14 161,44 100<br />
0266051 SANDIMMUN OPTORAL 10 MG 100 CAPS RR<br />
0 0 34,27 46,58 100<br />
0317164 SANDIMMUN OPTORAL 100 MG 50 CAPS RR<br />
0 0 171,84 197,13 100<br />
0317097 SANDIMMUN OPTORAL 25 MG 50 CAPS RR<br />
0 0 41,36 54,34 100<br />
0317133 SANDIMMUN OPTORAL 50 MG 50 CAPS RR<br />
0 0 84,30 101,34 100<br />
0198131 SANDIMMUN OPTORAL GTTS 50 ML RR<br />
0 0 171,84 197,13 100<br />
L04AD02 tacrolimus<br />
0477798 ADVAGRAF 0,5 MG 100 CAPS RR C<br />
0 0 65,14 77,94 100<br />
0477767 ADVAGRAF 1 MG 100 CAPS RR C<br />
0 0 109,70 125,16 100<br />
0555149 ADVAGRAF 3 MG 100 CAPS RR C<br />
0 0 320,48 348,56 100<br />
0477803 ADVAGRAF 5 MG 100 CAPS RR C<br />
0 0 519,76 559,78 100<br />
0308926 PROGRAFT 0,5 MG 100 CAPS RR C<br />
0 0 65,14 77,94 100<br />
0250518 PROGRAFT 1 MG 100 CAPS RR C<br />
0 0 109,70 125,16 100<br />
0250552 PROGRAFT 5 MG 10 AMP 1 ML PERF RR H<br />
0 0 455,28 0,00 0<br />
0250549 PROGRAFT 5 MG 100 CAPS RR C<br />
0 0 519,76 559,78 100<br />
L04AX Other immunosuppressants<br />
0622644 ESBRIET 267 MG 21 CAPS + 42 CAPS RR DC X RM 0 0<br />
692,30 0,00 0<br />
0622658 ESBRIET 267 MG 4*63 CAPS RR DC X RM 0 0<br />
2.769,23 0,00 0<br />
L04AX01 azathioprine<br />
0265992 IMURAN 50 MG 1 FL PERF RR H<br />
0 0 6,61 0,00 0<br />
0056443 IMURAN 50 MG 100 CPR RR C<br />
0 0 18,07 26,29 100<br />
0168114 IMURAN MITIS 25 MG 100 CPR RR C<br />
0 0 10,23 16,93 100<br />
L04AX02 thalidomide<br />
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0485142 THALIDOMIDE PHARMION 50 MG 28 CAPS RR DC X RM 0 0<br />
392,00 0,00 0<br />
L04AX04 lenalidomide<br />
0459352 REVLIMID 10 MG 21 CAPS RR DC X RM 0 0<br />
5.246,89 0,00 0<br />
0459366 REVLIMID 15 MG 21 CAPS RR DC X RM 0 0<br />
5.246,89 0,00 0<br />
0459383 REVLIMID 25 MG 21 CAPS RR DC X RM 0 0<br />
5.246,89 0,00 0<br />
0459349 REVLIMID 5 MG 21 CAPS RR DC X RM 0 0<br />
5.203,62 0,00 0<br />
M01AB01 indometacin<br />
0034530 DOLCIDIUM 100 MG 12 SUPP R<br />
0 0 3,07 7,83 80<br />
0034544 DOLCIDIUM GE 50 MG 12 SUPP R<br />
0 0 1,93 6,47 80<br />
0185911 INDOMET RATIO 100 MG 10 SUPP R<br />
0 0 0,00 4,17 80<br />
0185924 INDOMET RATIO 100 MG 50 SUPP R<br />
0 0 0,00 18,24 80<br />
0056877 INDOMET RATIO 25 MG 100 CAPS R<br />
0 0 0,00 6,95 80<br />
0056846 INDOMET RATIO 25 MG 20 CAPS R<br />
0 0 0,00 2,03 80<br />
0056863 INDOMET RATIO 25 MG 50 CAPS R<br />
0 0 0,00 4,68 80<br />
0056913 INDOMET RATIO 50 MG 100 CAPS R<br />
0 0 0,00 9,80 80<br />
0056880 INDOMET RATIO 50 MG 20 CAPS R<br />
0 0 0,00 2,36 80<br />
0056894 INDOMET RATIO 50 MG 50 CAPS R<br />
0 0 0,00 5,30 80<br />
0056927 INDOMET RATIO RET 75 MG 20 CAPS RET R<br />
0 0 0,00 4,50 80<br />
0056930 INDOMET RATIO RET 75 MG 50 CAPS RET R<br />
0 0 0,00 9,09 80<br />
M01AB05 diclofenac<br />
0154525 CATAFLAM 50 MG 30 DRG R<br />
0 0 4,62 9,93 80<br />
0031895 DICLAC 100 MG 10 SUPP R<br />
0 0 1,02 10,20 80<br />
0416311 DICLAC 100 MG 30 SUPP R<br />
0 0 0,00 9,90 0<br />
0031928 DICLAC 25 MG 100 CPR R<br />
0 0 2,32 11,62 80<br />
0162365 DICLAC 25 MG 20 CPR R<br />
0 0 0,06 1,49 80<br />
0031914 DICLAC 25 MG 50 CPR R<br />
0 0 1,07 10,25 80<br />
0031959 DICLAC 50 MG 10 SUPP R<br />
0 0 0,63 9,77 80<br />
0031945 DICLAC 50 MG 100 CPR R<br />
0 0 3,64 13,06 80<br />
0162379 DICLAC 50 MG 20 CPR R<br />
0 0 0,37 9,49 80<br />
0208335 DICLAC 50 MG 30 SUPP R<br />
0 0 2,22 11,51 80<br />
0031931 DICLAC 50 MG 50 CPR R<br />
0 0 1,33 10,53 80<br />
0031878 DICLAC 75 MG 1 AMP 3 ML IM R<br />
0 0 0,33 9,44 80<br />
0175881 DICLAC 75 MG 150 SRG 3 ML IM RR<br />
0 0 16,86 0,00 0<br />
0031881 DICLAC 75 MG 5 AMP 3 ML IM R<br />
0 0 1,45 10,68 80<br />
0162382 DICLAC 75 MG 50 AMP 3 ML IM R<br />
0 0 9,17 0,00 0<br />
0175895 DICLAC 75 MG 500 SRG 3 ML IM RR<br />
0 0 33,50 0,00 0<br />
0155519 DICLAC RET 100 MG 100 CPR R<br />
0 0 5,19 14,76 80<br />
0155486 DICLAC RET 100 MG 20 CPR R<br />
0 0 1,19 10,40 80<br />
0155505 DICLAC RET 100 MG 50 CPR R<br />
0 0 2,65 11,98 80<br />
0451886 DICLOFENAC EG 100 MG 12 SUPP R<br />
0 0 1,59 6,28 80<br />
0451872 DICLOFENAC EG 100 MG 30 CPR RR<br />
0 0 4,31 9,55 80<br />
0182662 DICLOFENAC EG 25 MG 100 CPR R<br />
0 0 3,57 8,63 80<br />
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0182659 DICLOFENAC EG 25 MG 30 CPR R<br />
0 0 1,33 5,99 80<br />
0182676 DICLOFENAC EG 50 MG 50 CPR R<br />
0 0 3,57 8,63 80<br />
0451841 DICLOFENAC EG 75 MG 6 AMP 3 ML IVIM RR<br />
0 0 1,64 6,33 80<br />
0451869 DICLOFENAC EG RET 75 MG 60 CPR RR<br />
0 0 5,82 11,43 80<br />
0304782 DICLOFENAC MYLAN 75 MG 60 CPR R<br />
0 0 5,82 11,43 80<br />
0032021 DICLOFENAC RATIO 100 MG 10 SUPP R<br />
0 0 1,02 10,20 80<br />
0032035 DICLOFENAC RATIO 100 MG 50 SUPP R<br />
0 0 7,22 16,52 80<br />
0032066 DICLOFENAC RATIO 25 MG 100 CPR PELLIC R<br />
0 0 2,34 10,31 80<br />
0032049 DICLOFENAC RATIO 25 MG 20 CPR PELLIC R<br />
0 0 0,36 2,79 80<br />
0032052 DICLOFENAC RATIO 25 MG 50 CPR PELLIC R<br />
0 0 1,11 6,20 80<br />
0032147 DICLOFENAC RATIO 50 MG 10 SUPP R<br />
0 0 0,63 9,77 80<br />
0032133 DICLOFENAC RATIO 50 MG 100 CPR PELLIC R<br />
0 0 3,64 13,06 80<br />
0032102 DICLOFENAC RATIO 50 MG 20 CPR PELLIC R<br />
0 0 0,37 9,49 80<br />
0032116 DICLOFENAC RATIO 50 MG 50 CPR PELLIC R<br />
0 0 1,33 10,53 80<br />
0032150 DICLOFENAC RATIO 50 MG 50 SUPP R<br />
0 0 3,33 11,51 80<br />
0173405 DICLOFENAC RATIO SF 75 MG 1 AMP 2 ML IM R<br />
0 0 0,32 9,43 80<br />
0267269 DICLOFENAC RATIO SF 75 MG 10 AMP 2 ML R<br />
0 0 2,33 11,53 80<br />
0173436 DICLOFENAC RATIO SF 75 MG 150 AMP 2ML IM RR<br />
0 0 15,65 0,00 0<br />
0173422 DICLOFENAC RATIO SF 75 MG 30 AMP 2 ML IM R<br />
0 0 4,58 14,09 80<br />
0304796 DICLOFENAC RET MYLAN 100 MG 30 CPR R<br />
0 0 3,75 8,68 80<br />
0032228 DICLOFENAC RET RATIO 100 MG 100 CAPS RET R<br />
0 0 5,19 13,51 80<br />
0032200 DICLOFENAC RET RATIO 100 MG 20 CAPS RET R<br />
0 0 1,19 10,40 80<br />
0032214 DICLOFENAC RET RATIO 100 MG 50 CAPS RET R<br />
0 0 2,65 11,98 80<br />
0345531 MOTIFENE 75 MG 28 CAPS RET R<br />
0 0 6,37 12,12 80<br />
0235011 MOTIFENE 75 MG 56 CAPS RET R<br />
0 0 9,33 15,80 80<br />
0176147 POLYFLAM 50 MG 50 CPR R<br />
0 0 0,00 10,78 80<br />
0236858 VOLTAREN 100 MG 10 SUPP R<br />
0 0 4,07 13,55 80<br />
0237161 VOLTAREN 100 MG 50 SUPP R<br />
0 0 18,63 0,00 0<br />
0237189 VOLTAREN 25 MG 50 DRG R<br />
0 0 4,31 13,81 80<br />
0237242 VOLTAREN 50 MG 100 DRG R<br />
0 0 14,94 25,15 80<br />
0237239 VOLTAREN 50 MG 20 DRG R<br />
0 0 3,22 12,61 80<br />
0236939 VOLTAREN 50 MG 50 DRG R<br />
0 0 7,62 17,42 80<br />
0269182 VOLTAREN INJEKT 75 MG 1 AMP 3 ML IM R<br />
0 0 1,04 9,67 80<br />
0269196 VOLTAREN INJEKT 75 MG 30 AMP 3 ML IM R<br />
0 0 18,13 0,00 0<br />
0337945 VOLTAREN RESINAT 100 CAPS R<br />
0 0 4,96 14,52 80<br />
0337928 VOLTAREN RESINAT 20 CAPS R<br />
0 0 0,87 10,04 80<br />
0337931 VOLTAREN RESINAT 50 CAPS R<br />
0 0 2,30 11,60 80<br />
0237158 VOLTAREN RET 100 MG 100 DRG R<br />
0 0 30,78 42,77 80<br />
0237144 VOLTAREN RET 100 MG 50 DRG R<br />
0 0 14,78 25,27 80<br />
M01AB11 acemetacin<br />
0096693 RANTUDIL FORTE 60 MG 20 CAPS R<br />
0 0 0,00 11,20 80<br />
0096709 RANTUDIL FORTE 60 MG 50 CAPS R<br />
0 0 0,00 14,97 80<br />
0096712 RANTUDIL RET 90 MG 20 CAPS R<br />
0 0 0,00 19,33 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0096726 RANTUDIL RET 90 MG 50 CAPS R<br />
0 0 24,79 36,13 80<br />
M01AB14 proglumetacin<br />
0157348 TOLINDOL 150 MG 60 CAPS R<br />
0 0 6,05 11,72 80<br />
M01AB15 ketorolac<br />
0176991 TARADYL 10 MG 5 AMP 1 ML IM RR<br />
0 0 2,78 7,65 80<br />
M01AB16 aceclofenac<br />
0523291 ACECLOFENAC EG 100 MG 20 CPR R<br />
0 0 2,93 7,83 80<br />
0523324 ACECLOFENAC EG 100 MG 60 CPR R<br />
0 0 7,05 12,97 80<br />
0228471 AIRTAL 100 MG 20 CPR R<br />
0 0 4,59 9,90 80<br />
0228484 AIRTAL 100 MG 60 CPR R<br />
0 0 10,14 16,81 80<br />
0228341 BIOFENAC 100 MG 20 CPR R<br />
0 0 4,59 9,90 80<br />
0228355 BIOFENAC 100 MG 60 CPR R<br />
0 0 10,14 16,81 80<br />
M01AB55 diclofenac, combinations<br />
0241861 ARTHROTEC 75 30 CPR RR<br />
0 0 13,98 21,49 80<br />
M01AC01 piroxicam<br />
0177662 BREXINE 20 MG 30 CPR R<br />
0 0 7,65 13,71 80<br />
0267627 BREXINE DRYFIZ 20 MG 30 CPR EFF R<br />
0 0 7,65 13,71 80<br />
0134201 FELDENE 10 MG 30 CAPS R<br />
0 0 3,47 8,50 80<br />
0044019 FELDENE 20 MG 12 SUPP R<br />
0 0 3,05 7,97 80<br />
0134195 FELDENE 20 MG 30 CAPS R<br />
0 0 6,59 12,39 80<br />
0142622 FELDENE 20 MG 6 AMP 1 ML IM R<br />
0 0 2,82 7,69 80<br />
0136481 FELDENE DIS 20 MG 30 CPR R<br />
0 0 6,59 12,39 80<br />
0212503 FELDENE LYOTABS 20 MG 30 CPR R<br />
0 0 9,06 15,47 80<br />
0457358 PIROXICAM EG 20 MG 30 CAPS R<br />
0 0 1,34 6,00 80<br />
0457375 PIROXICAM EG 20 MG 30 CPR R<br />
0 0 1,34 6,00 80<br />
0457361 PIROXICAM EG 20 MG 6 AMP 1 ML IM R<br />
0 0 2,23 6,97 80<br />
0205669 PIROXICAM HEXAL 10 MG TABS 100 CPR R<br />
0 0 8,43 0,00 0<br />
0205641 PIROXICAM HEXAL 10 MG TABS 20 CPR R<br />
0 0 0,00 3,99 80<br />
0205655 PIROXICAM HEXAL 10 MG TABS 50 CPR R<br />
0 0 0,00 9,45 80<br />
0205719 PIROXICAM HEXAL 20 MG TABS 100 CPR R<br />
0 0 0,00 19,28 80<br />
0205686 PIROXICAM HEXAL 20 MG TABS 20 CPR R<br />
0 0 0,00 6,83 80<br />
0205705 PIROXICAM HEXAL 20 MG TABS 50 CPR R<br />
0 0 0,00 13,82 80<br />
0411071 PIROXICAM TEVA 20 MG 30 CPR R<br />
0 0 5,25 10,72 80<br />
0308991 POLYDENE 20 MG 30 CPR DISP R<br />
0 0 0,00 16,89 0<br />
0260349 SOLICAM 20 MG 14 CAPS R<br />
0 0 3,08 7,90 80<br />
0243804 SOLICAM 20 MG 28 CAPS R<br />
0 0 6,15 11,72 80<br />
0243818 SOLICAM 20 MG 56 CAPS R<br />
0 0 12,30 19,40 80<br />
M01AC02 tenoxicam<br />
0140239 TILCOTIL 20 MG 30 CPR R<br />
0 0 5,12 10,56 80<br />
0158183 TILCOTIL 20 MG 60 CPR R<br />
0 0 8,19 14,38 80<br />
0181781 TILCOTIL 20 MG 60 CPR UD R<br />
0 0 8,19 0,00 0<br />
Page 143 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
M01AC06 meloxicam<br />
0461771 MELOXICAM EG 15 MG 30 CPR R<br />
0 0 4,56 9,85 80<br />
0417903 MELOXICAM HEXAL 15 MG 20 CPR R<br />
0 0 1,21 6,54 80<br />
0417836 MELOXICAM HEXAL 7,5 MG 10 CPR R<br />
0 0 0,77 9,92 80<br />
0417853 MELOXICAM HEXAL 7,5 MG 20 CPR R<br />
0 0 1,12 10,32 80<br />
0216256 MOBIC 15 MG 30 CPR R<br />
0 0 4,74 10,09 80<br />
0305356 MOBIC 15 MG 5 AMP 1,5 ML IM R<br />
0 0 3,45 8,47 80<br />
0218264 MOBIC 15 MG 50 CPR MND R<br />
0 0 8,10 0,00 0<br />
M01AE01 ibuprofen<br />
0016109 BRUFEN 400 MG 100 DRG P<br />
0 0 5,83 11,32 80<br />
0016126 BRUFEN FORTE 600 MG 30 CPR R<br />
0 0 3,69 8,65 80<br />
0512057 BRUFEN FORTE 600 MG 60 CPR R<br />
0 0 5,39 10,79 80<br />
0180718 BRUFEN RET 800 MG 28 CPR R<br />
0 0 4,22 9,31 80<br />
0201978 BRUFEN RET 800 MG 60 CPR R<br />
0 0 7,31 13,18 80<br />
0166719 DISMENOL N 200 MG 20 CPR P<br />
0 0 0,00 3,56 0<br />
0174741 DOLGIT 600 MG 100 DRG R<br />
0 0 5,66 15,29 80<br />
0174724 DOLGIT 600 MG 20 DRG R<br />
0 0 1,23 10,43 80<br />
0174738 DOLGIT 600 MG 50 DRG R<br />
0 0 2,86 12,21 80<br />
0170627 DOLGIT 800 MG 20 CPR R<br />
0 0 1,49 10,72 80<br />
0170631 DOLGIT 800 MG 50 CPR R<br />
0 0 3,54 12,96 80<br />
0307929 DOLOFIN 200 MG 30 DRG P<br />
0 0 0,00 3,26 0<br />
0202782 DOLOFIN 400 MG 100 DRG P<br />
0 0 0,00 7,09 80<br />
0202779 DOLOFIN 400 MG 30 DRG P<br />
0 0 0,00 2,69 80<br />
0457751 IBU RATIO 2% SIR 100 ML P<br />
0 0 1,44 2,88 80<br />
0463792 IBU RATIO 200 MG 100 CPR P<br />
0 0 0,00 7,50 80<br />
0463775 IBU RATIO 200 MG 20 CPR P<br />
0 0 1,60 3,20 80<br />
0463789 IBU RATIO 200 MG 50 CPR P<br />
0 0 0,00 7,04 80<br />
0454339 IBU RATIO 400 MG 100 CPR P<br />
0 0 4,10 9,76 80<br />
0454311 IBU RATIO 400 MG 20 CPR P<br />
0 0 0,93 3,89 80<br />
0454325 IBU RATIO 400 MG 50 CPR P<br />
0 0 2,18 6,32 80<br />
0454373 IBU RATIO 600 MG 100 CPR R<br />
0 0 5,65 13,21 80<br />
0454342 IBU RATIO 600 MG 20 CPR R<br />
0 0 1,22 4,62 80<br />
0454356 IBU RATIO 600 MG 50 CPR R<br />
0 0 2,85 7,98 80<br />
0454406 IBU RATIO 800 MG 100 CPR R<br />
0 0 7,75 16,70 80<br />
0454387 IBU RATIO 800 MG 20 CPR R<br />
0 0 1,64 5,35 80<br />
0454391 IBU RATIO 800 MG 50 CPR R<br />
0 0 3,96 11,20 80<br />
0518324 IBU RATIO LYSINAT 500 MG 10 CPR P<br />
0 0 0,00 3,26 0<br />
0518338 IBU RATIO LYSINAT 500 MG 20 CPR P<br />
0 0 0,00 5,08 0<br />
0155679 IBUHEXAL 400 MG 100 CPR P<br />
0 0 2,34 8,32 80<br />
0155651 IBUHEXAL 400 MG 20 CPR P<br />
0 0 0,36 3,89 80<br />
0155665 IBUHEXAL 400 MG 50 CPR P<br />
0 0 2,19 11,49 80<br />
0155648 IBUHEXAL 600 MG 100 CPR R<br />
0 0 5,66 15,29 80<br />
0155621 IBUHEXAL 600 MG 20 CPR R<br />
0 0 1,23 10,43 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0155634 IBUHEXAL 600 MG 50 CPR R<br />
0 0 2,86 12,21 80<br />
0200855 IBUHEXAL 800 MG 100 CPR R<br />
0 0 6,95 16,70 80<br />
0200838 IBUHEXAL 800 MG 20 CPR R<br />
0 0 1,49 10,72 80<br />
0200841 IBUHEXAL 800 MG 50 CPR R<br />
0 0 3,54 12,96 80<br />
0176519 IBUHEXAL RET 800 MG 100 CPR R<br />
0 0 0,00 17,20 80<br />
0176486 IBUHEXAL RET 800 MG 20 CPR R<br />
0 0 1,49 10,72 80<br />
0176505 IBUHEXAL RET 800 MG 50 CPR R<br />
0 0 3,02 10,98 80<br />
0619585 IBULYSIN RATIO-684 400 MG 10 CPR P<br />
0 0 2,04 4,07 0<br />
0619621 IBULYSIN RATIO-684 400 MG 20 CPR P<br />
0 0 3,52 6,79 0<br />
0386497 IBUPROFEN CT 500 MG 10 SUPP R<br />
0 0 0,00 3,10 80<br />
0386581 IBUPROFEN RET CT 400 MG 20 CAPS P<br />
0 0 0,00 5,70 80<br />
0136964 IBUPROFENE EG 400 MG 100 DRG P<br />
0 0 3,19 8,14 80<br />
0202216 IBUPROFENE EG 400 MG 30 DRG P<br />
0 0 1,20 5,84 80<br />
0301411 IBUPROFENE EG 600 MG 30 CPR R<br />
0 0 1,83 6,53 0<br />
0301424 IBUPROFENE EG 600 MG 50 CPR R<br />
0 0 3,83 8,94 0<br />
0213501 MALAFENE 100 MG/5 ML SIR 100 ML P<br />
0 0 0,00 3,73 80<br />
0340193 NUROFEN 200 MG 12 CPR FONDANTS P<br />
0 0 1,69 2,92 0<br />
0472631 NUROFEN 200 MG 30 DRG P<br />
0 0 3,58 6,15 0<br />
0211957 NUROFEN 200 MG 48 DRG P<br />
0 0 4,68 8,04 80<br />
0487908 NUROFEN 400 MG 30 DRG P<br />
0 0 0,00 8,45 0<br />
0445052 NUROFEN ENF 125 MG 10 SUPP R<br />
0 0 3,07 5,28 0<br />
0345334 NUROFEN ENF 200 MG 24 CPR P<br />
0 0 2,55 4,38 80<br />
0444847 NUROFEN ENF 60 MG 10 SUPP R<br />
0 0 2,34 4,00 0<br />
0253702 NUROFEN ENF SS SUCRE 100MG/5ML SIR 200ML P<br />
0 0 5,07 8,72 80<br />
0521624 NUROFEN ENF SS SUCRE ROUGE 2% SIR 200 ML P<br />
0 0 5,07 8,72 80<br />
0588556 NUROFEN ENF SS SUCRE ROUGE 4% SIR 100 ML P<br />
0 0 5,07 8,72 0<br />
0588573 NUROFEN ENF SS SUCRE ROUGE 4% SIR 150 ML P<br />
0 0 7,61 13,08 0<br />
0505584 NUROFEN FASTCAPS 400 MG 20 CAPS MOLLES P<br />
0 0 4,74 8,14 0<br />
0614978 NUROFEN FASTPOWDER 400 MG 10 SACH P<br />
0 0 2,82 4,84 0<br />
0525086 NUROFEN FASTTAPS 400 MG 24 CPR PELLIC P<br />
0 0 3,78 6,61 80<br />
0444203 PERDOFEMINA 400 MG 20 CPR P<br />
0 0 5,35 9,18 0<br />
0571836 PERDOFEMINA 400 MG 30 CPR P<br />
0 0 5,35 9,18 0<br />
0198029 SCHMERZDOLGIT 400 MG 30 CAPS P<br />
0 0 1,37 10,58 80<br />
0300221 SPIDIFEN 200 MG 24 SACH P<br />
0 0 2,40 4,12 80<br />
0339953 SPIDIFEN 400 MG 24 CPR P<br />
0 0 3,95 6,79 80<br />
M01AE02 naproxen<br />
0284421 ALEVE 220 MG 30 CPR P<br />
0 0 4,09 7,03 80<br />
0007158 APRANAX 275 MG 30 CPR R<br />
0 0 3,91 9,06 80<br />
0169433 APRANAX 550 MG 30 CPR R<br />
0 0 5,87 11,49 80<br />
0314422 NAPROFLAM 500 MG 30 CPR R<br />
0 0 0,00 11,20 80<br />
0176262 NAPROSYNE EC 250 MG 50 CPR R<br />
0 0 5,58 11,14 80<br />
0176276 NAPROSYNE EC 500 MG 30 CPR R<br />
0 0 6,56 12,35 80<br />
0148447 NAPROXENE EG 250 MG 50 CPR R<br />
0 0 3,22 8,18 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0148464 NAPROXENE EG 500 MG 12 SUPP R<br />
0 0 2,55 7,23 80<br />
0148451 NAPROXENE EG 500 MG 30 CPR R<br />
0 0 3,87 8,99 80<br />
M01AE03 ketoprofen<br />
0140693 BIROFENID 150 MG 30 CPR R<br />
0 0 4,93 10,32 80<br />
0614592 KETOPROFENE MACO 100MG PERF 10PP 100ML RR H<br />
0 0 108,00 0,00 0<br />
0100751 ROFENID 100 MG 12 SUPP R<br />
0 0 1,94 6,54 80<br />
0197973 ROFENID LA 200 MG 28 CAPS R<br />
0 0 6,00 11,65 80<br />
0100748 ROFENID READY MIX 100 MG 6 AMP 2 ML IM R<br />
0 0 4,20 9,41 80<br />
M01AE11 tiaprofenic acid<br />
0395739 FLANID 100 MG 30 CPR R<br />
0 0 0,00 3,59 0<br />
0391788 FLANID 200 MG 15 CPR R<br />
0 0 0,00 3,72 0<br />
M01AE12 oxaprozin<br />
0037398 DURAPROX 600 MG 30 CPR R<br />
0 0 6,98 12,70 0<br />
0037403 DURAPROX 600 MG 60 CPR R<br />
0 0 11,17 17,92 0<br />
M01AE16 alminoprofen<br />
0185861 MINALFENE 300 MG 15 CPR R<br />
0 0 2,66 4,72 80<br />
M01AE17 dexketoprofen<br />
0265703<br />
M01AE52<br />
KETESSE 25 MG 30 CPR R<br />
0 0 6,72 12,38 0<br />
0609741 VIMOVO 500/20 MG 60 CPR (FL) R<br />
0 0 19,66 28,05 0<br />
M01AG Fenamates<br />
0168873 RHEUMON IM 1 AMP 2 ML IM R<br />
0 0 1,46 2,60 80<br />
M01AH01 celecoxib<br />
0281108 CELEBREX 100 MG 60 CAPS RR<br />
0 0 19,94 28,35 80<br />
0298011 CELEBREX 200 MG 10 CAPS RR<br />
0 0 0,00 18,42 80<br />
0281125 CELEBREX 200 MG 30 CAPS RR<br />
0 0 19,94 28,35 80<br />
M01AH05 etoricoxib<br />
0332837 ARCOXIA 120 MG 14 CPR RR<br />
0 0 15,02 25,37 80<br />
0332854 ARCOXIA 120 MG 28 CPR RR<br />
0 0 30,04 40,85 80<br />
0476367 ARCOXIA 30 MG 28 CPR RR<br />
0 0 16,73 24,83 80<br />
0656902 ARCOXIA 30 MG 7 CPR RR<br />
0 0 4,71 8,09 0<br />
0332532 ARCOXIA 60 MG 28 CPR RR<br />
0 0 30,04 40,85 80<br />
0332496 ARCOXIA 60 MG 7 CPR RR<br />
0 0 7,51 12,89 0<br />
0332577 ARCOXIA 60 MG 98 CPR RR<br />
0 0 107,87 121,02 0<br />
0332692 ARCOXIA 90 MG 28 CPR RR<br />
0 0 30,04 39,48 80<br />
0332644 ARCOXIA 90 MG 5 CPR RR<br />
0 0 5,36 9,21 0<br />
0476371 RANACOX 30 MG 28 CPR RR<br />
0 0 17,92 28,36 0<br />
M01AX01 nabumetone<br />
0472712 GAMBARAN 500 MG 60 CPR R<br />
0 0 6,61 12,23 80<br />
Page 146 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
M01AX05 glucosamine<br />
0576233 DOLENIO 1500 MG 30 CPR P<br />
0 0 10,18 17,49 0<br />
0576251 DOLENIO 1500 MG 60 CPR P<br />
0 0 19,58 30,07 0<br />
0531164 DOLENIO 1500 MG 90 CPR (FL) P<br />
0 0 28,07 38,82 0<br />
0531228 DONA 1500 MG PDR 30 SACH P<br />
0 0 24,08 42,92 0<br />
0531231 DONA 1500 MG PDR 90 SACH P<br />
0 0 62,69 111,74 0<br />
M01AX25 chondroitin sulfate<br />
0308425 STRUCTUM 500 MG 60 CAPS R<br />
0 0 0,00 16,51 0<br />
M01CC01 penicillamine<br />
0139403 METALCAPTASE 300 MG 20 CPR R<br />
0 0 9,00 16,03 100<br />
M02AA Antiinflammatory preparations, non-steroids for topical use<br />
0073024 MOBILISIN CREME 100 G P<br />
0 0 7,46 12,81 40<br />
0180928 MOBILISIN CREME 50 G P<br />
0 0 4,66 8,01 40<br />
M02AA06 etofenamate<br />
0098989 RHEUMON CREME 100 G P<br />
0 0 0,00 8,62 40<br />
0161161 RHEUMON LOTIO 100 G P<br />
0 0 0,00 8,62 40<br />
0199592 THERMORHEUMON CREME 100 G P<br />
0 0 5,61 9,98 40<br />
0119235 TRAUMON 10% GEL 100 G P<br />
0 0 0,00 8,62 40<br />
0199608 TRAUMON 10% GEL 50 G P<br />
0 0 0,00 5,06 40<br />
0364598 TRAUMON 5% GEL 100 G P<br />
0 0 0,00 8,53 40<br />
M02AA07 piroxicam<br />
0164861 FELDENE GEL 0,5% 50 G P<br />
0 0 0,00 8,11 40<br />
M02AA08 felbinac<br />
0181911 FLEXFREE GEL 100 G P<br />
0 0 0,00 14,38 40<br />
0173534 FLEXFREE GEL 50 G P<br />
0 0 0,00 8,39 40<br />
0197066 FLEXFREE MOUSSE SPRAY 100 G P<br />
0 0 0,00 12,78 40<br />
M02AA10 ketoprofen<br />
0306143 FASTUM 2,5% GEL 30 G R<br />
RM 0 0<br />
3,88 6,67 0<br />
0195707 FASTUM 2,5% GEL 60 G R<br />
RM 0 0<br />
5,80 9,96 40<br />
0239734 FASTUM 2,5% GEL DISP 120 G R<br />
RM 0 0<br />
9,79 16,82 40<br />
M02AA13 ibuprofen<br />
0034592 DOLGIT 5% CREME 100 G P<br />
0 0 6,00 11,49 40<br />
0034589 DOLGIT 5% CREME 50 G P<br />
0 0 3,26 6,48 40<br />
0236004 DOLGIT MIKROGEL 5% GEL 100 G P<br />
0 0 6,00 11,49 40<br />
0237001 DOLGIT MIKROGEL 5% GEL 50 G P<br />
0 0 3,26 6,48 40<br />
0223622 DOLOFIN 5% GEL 50 G P<br />
0 0 0,00 6,82 40<br />
0223779 IBUTOP 5% GEL 100 G P<br />
0 0 8,26 14,19 40<br />
0223765 IBUTOP 5% GEL 50 G P<br />
0 0 5,22 8,97 40<br />
M02AA15 diclofenac<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0302273 FLECTOR TISSUGEL 10 COMPR P<br />
0 0 14,24 24,47 0<br />
0302256 FLECTOR TISSUGEL 5 COMPR P<br />
0 0 7,86 13,51 0<br />
0309906 PENNSAID 1,5% 30 ML P<br />
0 0 0,00 12,03 0<br />
0329635 VOLTAPATCH TISSUGEL 1% 10 COMPR P<br />
0 0 13,71 23,54 0<br />
0329621 VOLTAPATCH TISSUGEL 1% 5 COMPR P<br />
0 0 7,86 13,51 0<br />
0189548 VOLTAREN EMULGEL 1% 100 G P<br />
0 0 2,89 5,15 40<br />
0627802 VOLTAREN EMULGEL 1% 120 G P<br />
0 0 10,18 17,48 40<br />
0129777 VOLTAREN EMULGEL 1% 50 G P<br />
0 0 1,75 3,13 40<br />
0627797 VOLTAREN EMULGEL 1% 60 G P<br />
0 0 7,29 12,53 40<br />
M02AA17 niflumic acid<br />
0231042 NIFLUGEL 2,5% GEL 60 G P<br />
0 0 4,74 8,14 0<br />
M02AA23 indometacin<br />
0136253 INDOMET RATIO 1% GEL 100 G P<br />
0 0 0,00 6,58 40<br />
0136236 INDOMET RATIO 1% GEL 50 G P<br />
0 0 0,00 4,17 40<br />
0469068 SPORTFLEX 1% SPRAY 100 ML P<br />
0 0 9,65 16,58 40<br />
0469054 SPORTFLEX 1% SPRAY 50 ML P<br />
0 0 6,09 10,46 40<br />
M02AB Capsaicin and similar agents<br />
0345415 HANSAPLAST ABC WAERMEPFLASTER A 1 P<br />
0 0 0,00 5,77 0<br />
0347907 HANSAPLAST ABC WAERMEPFLASTER A 2 P<br />
0 0 0,00 5,77 0<br />
0434918 HANSAPLAST WAERME CREME 0,075% 50 G P<br />
0 0 0,00 7,77 0<br />
M02AB01 capsaicin<br />
0367605 HANSAMEDIC 2 EMPLATRES 46944 P<br />
0 0 0,00 4,37 0<br />
M02AC Preparations with salicylic acid derivatives<br />
0274859 ALGESAL CREME 100 G P<br />
0 0 3,95 6,79 40<br />
0138888 ALGESAL MOUSSE 100 G P<br />
0 0 0,00 11,97 40<br />
0002828 ALGESAL MOUSSE 50 G P<br />
0 0 0,00 6,84 40<br />
0002909 ALGIPAN POM 140 G P<br />
0 0 5,15 8,84 40<br />
0002893 ALGIPAN POM 80 G P<br />
0 0 3,34 5,73 40<br />
0289364 DOLAL LINIMENT 50 G P<br />
0 0 0,00 6,12 40<br />
0592156 EMERXIL SOL PULV CUT 150 ML P<br />
0 0 4,59 7,85 0<br />
0072982 MOBILAT CREME 100 G P<br />
0 0 7,48 12,85 0<br />
0072979 MOBILAT CREME 50 G P<br />
0 0 4,67 8,03 0<br />
0073007 MOBILAT GEL 100 G P<br />
0 0 7,48 12,85 0<br />
0072996 MOBILAT GEL 50 G P<br />
0 0 4,67 8,03 0<br />
0088285 PERCUTALGINE GEL 80 G RR<br />
0 0 3,80 6,53 0<br />
0096547 RADOSALIL STICK 25 G P<br />
0 0 5,05 8,68 0<br />
0487696 REFLEXGEL TUBE 50 G P<br />
0 0 5,23 8,98 0<br />
0197991 REFLEXSPRAY 150 ML P<br />
0 0 5,65 9,72 0<br />
0199124 STILENE 180 ML P<br />
0 0 3,92 6,74 40<br />
M02AX10 various<br />
0586789 ALGIS SPRAY 150 ML P<br />
0 0 5,80 9,96 0<br />
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délivrance prescription<br />
0141575 KLOSTERFRAU FRANZBRANNTWEIN GEL 100 G P<br />
0 0 2,90 5,76 0<br />
0541305 KLOSTERFRAU LATSCHENKIEFER FRANZB 200 ML P<br />
0 0 3,27 5,83 0<br />
0541319 KLOSTERFRAU LATSCHENKIEFER FRANZB 400 ML P<br />
0 0 5,95 10,60 0<br />
M03AB01 suxamethonium<br />
0571948 CELOCURINE 100 MG 10 AMP 2 ML IV RR H<br />
0 0 73,50 0,00 0<br />
M03AC04 atracurium<br />
0118532 TRACRIUM 25 MG 10 AMP 2,5 ML IV RR HC<br />
0 0 22,83 0,00 0<br />
0192414 TRACRIUM 50 MG 5 AMP 5 ML IV RR HC<br />
0 0 21,74 0,00 0<br />
M03AC09 rocuronium bromide<br />
0231445 ESMERON 100 MG 10 AMP 10 ML IV RR HC<br />
0 0 69,45 0,00 0<br />
0481952 ESMERON 50 MG 10 AMP 5 ML IV RR HC<br />
0 0 43,10 0,00 0<br />
0231073 ESMERON 50 MG 12 AMP 5 ML IV RR HC<br />
0 0 74,06 0,00 0<br />
M03AC10 mivacurium chloride<br />
0220746 MIVACRON 10 MG 5 AMP 5 ML IV RR HC<br />
0 0 11,47 0,00 0<br />
0220763 MIVACRON 20 MG 5 AMP 10 ML IV RR HC<br />
0 0 18,53 0,00 0<br />
M03AC11 cisatracurium<br />
0645411 CISATRACURIUM ACTAVIS 2 MG/ML 1 FL 10 ML RR HC<br />
0 0 19,23 0,00 0<br />
0645408 CISATRACURIUM ACTAVIS 2 MG/ML 1 FL 5 ML RR HC<br />
0 0 9,61 0,00 0<br />
0645487 CISATRACURIUM HOSPIRA 2 MG/ML 5 FL 10 ML RR HC<br />
0 0 19,70 0,00 0<br />
0645456 CISATRACURIUM HOSPIRA 2 MG/ML 5 FL 5 ML RR HC<br />
0 0 9,85 0,00 0<br />
0217222 NIMBEX 10 MG 5 AMP 5 ML IV RR HC<br />
0 0 9,85 0,00 0<br />
0217236 NIMBEX 20 MG 5 AMP 10 ML IV RR HC<br />
0 0 19,70 0,00 0<br />
0172801 NORCURON 4 MG 10 AMP + S 1 ML IV RR HC<br />
0 0 18,28 0,00 0<br />
0611301 NORCURON 4 MG 10 AMP IV RR HC<br />
0 0 18,28 0,00 0<br />
M03AX01 botulinum toxin<br />
0519769 AZZALURE 10 U/0,05 ML PDR 2 FL 3 ML IM RR C<br />
0 0 230,00 246,81 0<br />
0209041 BOTOX 100 U PDR 1 FL IMSC RR C<br />
0 0 164,01 182,61 0<br />
0312493 DYSPORT 500 U PDR 1 FL SCIM RR C<br />
0 0 232,36 249,24 0<br />
0312509 DYSPORT 500 U PDR 2 FL SCIM RR C<br />
0 0 370,07 401,01 0<br />
0436084 VISTABEL 4 U/0,1 ML PDR 1 FL 50 U RR C<br />
0 0 118,11 131,56 0<br />
0461199 XEOMIN 100 U PDR 1 FL IM RR C<br />
0 0 196,19 211,99 0<br />
M03BX01 baclofen<br />
0066050 LIORESAL 10 MG 50 CPR R<br />
0 0 4,48 9,76 80<br />
0066064 LIORESAL 25 MG 50 CPR R<br />
0 0 9,26 15,72 80<br />
0236682 LIORESAL INTRATHECAL 0,05 MG 5 AMP 1 ML RR H<br />
0 0 10,23 0,00 0<br />
0236701 LIORESAL INTRATHECAL 10 MG 5 AMP 20 ML RR H<br />
0 0 370,00 0,00 0<br />
0236679 LIORESAL INTRATHECAL 10 MG 5 AMP 5 ML RR H<br />
0 0 370,00 0,00 0<br />
M03BX02 tizanidine<br />
0105436 SIRDALUD 2 MG 100 CPR R<br />
0 0 4,12 13,60 80<br />
0105422 SIRDALUD 2 MG 50 CPR R<br />
0 0 4,65 13,83 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0105467 SIRDALUD 4 MG 100 CPR R<br />
0 0 8,27 18,14 80<br />
0105453 SIRDALUD 4 MG 50 CPR R<br />
0 0 8,49 18,09 80<br />
0152629 SIRDALUD 6 MG 100 CPR R<br />
0 0 12,78 23,08 80<br />
M03BX07 tetrazepam<br />
0366205 EPSIPAM 50 MG 20 CPR RR<br />
0 0 2,87 4,94 40<br />
0366219 EPSIPAM 50 MG 60 CPR RR<br />
0 0 0,00 15,69 0<br />
0218832 MYOLASTAN 50 MG 20 CPR RR<br />
0 0 3,04 5,23 40<br />
M04AA01 allopurinol<br />
0136804 ALLOPURINOL EG 300 MG 90 CPR R<br />
0 0 4,87 10,24 80<br />
0576301 ALLOPURINOL RATIO 100 MG 100 CPR R<br />
0 0 1,22 7,53 80<br />
0576295 ALLOPURINOL RATIO 100 MG 50 CPR R<br />
0 0 0,63 6,41 80<br />
0149606 ALLOPURINOL RATIO 300 MG 100 CPR R<br />
0 0 3,46 12,01 80<br />
0149587 ALLOPURINOL RATIO 300 MG 20 CPR R<br />
0 0 0,75 3,52 80<br />
0149591 ALLOPURINOL RATIO 300 MG 50 CPR R<br />
0 0 1,79 9,79 80<br />
0219874 ALPURIC 300 MG 90 CAPS R<br />
0 0 6,54 12,21 80<br />
0131288 ZYLORIC 100 MG 100 CPR R<br />
0 0 3,28 8,26 80<br />
0131291 ZYLORIC 300 MG 30 CPR R<br />
0 0 3,03 7,94 80<br />
0139644 ZYLORIC 300 MG 90 CPR R<br />
0 0 6,96 12,85 80<br />
M04AA03 febuxostat<br />
0492729 ADENURIC 120 MG 28 CPR RR<br />
0 0 25,79 34,81 80<br />
0492732 ADENURIC 120 MG 84 CPR RR<br />
0 0 77,37 90,90 80<br />
0492701 ADENURIC 80 MG 28 CPR RR<br />
0 0 25,79 34,81 80<br />
0492715 ADENURIC 80 MG 84 CPR RR<br />
0 0 77,37 90,90 80<br />
M04AC01 colchicine<br />
0362397 COLCHICINE OPOCALCIUM 1 MG 20 CPR R<br />
0 0 2,83 4,86 80<br />
M05BA02 clodronic acid<br />
0206389 BONEFOS 300 MG 5 AMP 5 ML PERF RR H<br />
0 0 57,87 0,00 0<br />
0244538 BONEFOS 800 MG 50 CPR RR<br />
0 0 129,46 146,10 80<br />
M05BA03 pamidronic acid<br />
0236312 AREDIA 15 MG PSV 1 FL + S IV RR HC<br />
0 0 47,71 0,00 0<br />
0414011 PAMIDRIN 15 MG 1 FL 5 ML PERF RR HC<br />
0 0 21,66 0,00 0<br />
0414042 PAMIDRIN 30 MG 1 FL 10 ML PERF RR HC<br />
0 0 43,32 0,00 0<br />
0414087 PAMIDRIN 60 MG 1 FL 20 ML PERF RR HC<br />
0 0 95,15 0,00 0<br />
0414123 PAMIDRIN 90 MG 1 FL 30 ML PERF RR HC<br />
0 0 129,97 0,00 0<br />
0447432 PAMINJECT 15 MG 1 FL 5 ML PERF RR HC<br />
0 0 15,38 0,00 0<br />
0447477 PAMINJECT 30 MG 1 FL 10 ML PERF RR HC<br />
0 0 30,75 0,00 0<br />
0447513 PAMINJECT 60 MG 1 FL 20 ML PERF RR HC<br />
0 0 61,50 0,00 0<br />
0447544 PAMINJECT 90 MG 1 FL 30 ML PERF RR HC<br />
0 0 92,26 0,00 0<br />
M05BA04 alendronic acid<br />
0463839 ALENDRON HEXAL 70 MG 12 CPR RR<br />
0 0 21,48 27,01 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0463811 ALENDRON HEXAL 70 MG 4 CPR RR<br />
0 0 9,38 14,74 80<br />
0409719 ALENDRONSAEURE RATIO 70 MG 12 CPR RR<br />
0 0 15,01 26,75 80<br />
0409686 ALENDRONSAEURE RATIO 70 MG 4 CPR RR<br />
0 0 8,27 14,74 80<br />
0486797 BEENOS 70 MG 12 CPR RR<br />
0 0 18,90 27,22 80<br />
0486783 BEENOS 70 MG 4 CPR RR<br />
0 0 7,87 13,98 80<br />
0212808 FOSAMAX 10 MG 28 CPR RR<br />
0 0 10,45 17,20 80<br />
0252669 FOSAMAX 10 MG 98 CPR RR<br />
0 0 65,24 78,88 80<br />
0303481 FOSAMAX 70 MG HEBDOMADAIRE 12 CPR RR<br />
0 0 31,35 40,92 80<br />
0303463 FOSAMAX 70 MG HEBDOMADAIRE 4 CPR RR<br />
0 0 10,45 17,20 80<br />
0565632 OSTACID 70 MG 12 CPR RR<br />
0 0 14,18 23,97 80<br />
0565615 OSTACID 70 MG 4 CPR RR<br />
0 0 7,80 13,19 0<br />
M05BA06 ibandronic acid<br />
0243401 BONDRONAT 2 MG 1 AMP 2 ML PERF RR H<br />
0 0 55,89 0,00 0<br />
0355716 BONDRONAT 50 MG 84 CPR RR C<br />
0 0 357,05 387,33 80<br />
0355683 BONDRONAT 6 MG 5 FL 6 ML PERF RR H<br />
0 0 558,90 0,00 0<br />
0409414 BONVIVA 150 MG 3 CPR RR<br />
0 0 38,23 48,52 80<br />
0432247 BONVIVA 3 MG PERF 1 SRG 3 ML IV RR<br />
0 0 43,01 53,77 80<br />
0624358 IBANDRONSAEURE RATIO 150 MG 1 CPR RR<br />
0 0 18,27 29,09 0<br />
0624375 IBANDRONSAEURE RATIO 150 MG 3 CPR RR<br />
0 0 33,02 41,43 0<br />
0624215 IBANDRONSAEURE RATIO 50 MG 28 CPR RR C<br />
0 0 210,21 239,12 0<br />
0624281 IBANDRONSAEURE RATIO 50 MG 84 CPR RR C<br />
0 0 311,86 346,08 0<br />
M05BA07 risedronic acid<br />
0280761 ACTONEL 30 MG 28 CPR RR<br />
0 0 106,22 121,48 80<br />
0283083 ACTONEL 5 MG 84 CPR RR<br />
0 0 41,94 52,59 80<br />
0338621 ACTONEL HEBDO 35 MG 12 CPR RR<br />
0 0 41,94 52,59 80<br />
0609575 RISEDREENOS 35 MG 12 CPR RR<br />
0 0 10,56 17,33 80<br />
0636684 RISEDREENOS 35 MG 24 CPR RR<br />
0 0 10,77 17,49 0<br />
0609513 RISEDREENOS 5 MG 84 CPR RR<br />
0 0 10,56 17,33 80<br />
M05BA08 zoledronic acid<br />
0405608 ACLASTA 5 MG 1 FL 100 ML PERF RR C<br />
0 0 328,68 357,25 80<br />
0348675 ZOMETA 4 MG 1 FL 5 ML IV RR HC<br />
0 0 282,75 0,00 0<br />
0348692 ZOMETA 4 MG 10 FL 5 ML IV RR HC<br />
0 0 2.222,59 0,00 0<br />
M05BB02 risedronic acid and calcium, sequential<br />
0431561 ACTONEL COMBI 35/500 MG 12+72 CPR RR<br />
0 0 88,50 103,64 0<br />
M05BB03 alendronic acid and colecalciferol<br />
0471133 FOSAVANCE 70 MG/5600 U 12 CPR RR<br />
0 0 48,18 59,47 80<br />
0408921 FOSAVANCE 70 MG/70 MCG (2800 U) 12 CPR RR<br />
0 0 51,99 63,67 0<br />
M05BB04 risedronic acid, calcium and colecalciferol, sequential<br />
0480857 ACTONEL COMBI D 12 CPR + 72 SACH RR<br />
0 0 52,85 64,50 80<br />
M05BC01 dibotermin alfa<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0352888 INDUCTOS 12 MG 1 KIT P IMPLANT RR HC<br />
0 0 2.916,67 0,00 0<br />
M05BX03 strontium ranelate<br />
0388779 PROTELOS 2 G 84 SACH RR<br />
0 0 90,60 104,92 80<br />
M05BX04 denosumab<br />
0569015 PROLIA 60 MG 1 SRG 1 ML SC RR<br />
0 0 188,10 208,25 80<br />
0627587 XGEVA 120 MG 1 FL V 1,7 ML SC RR C<br />
0 0 321,23 349,35 100<br />
0627591<br />
M09AB02<br />
XGEVA 120 MG 4 FL V 1,7 ML SC RR C<br />
0 0 1.284,92 1.370,75 100<br />
0607309 XIAPEX 0,9 MG PSV 1 FL + S RR HC<br />
RM 0 0<br />
701,79 0,00 0<br />
M09AX01 hyaluronic acid<br />
0388152 HYALGAN 20 MG 1 SRG 2 ML IR RR<br />
0 0 21,14 31,69 0<br />
N01AB06 isoflurane<br />
0294865 AERRANE ISOFLURANE 1 FL 100 ML IH RR H<br />
0 0 50,72 0,00 0<br />
0294879 AERRANE ISOFLURANE 1 FL 250 ML IH RR H<br />
0 0 111,06 0,00 0<br />
0045923 FORENE 100% SOL 100 ML INH RR H<br />
0 0 42,48 0,00 0<br />
0189792 FORENE 100% SOL 250 ML INH RR H<br />
0 0 106,20 0,00 0<br />
N01AB07 <strong>des</strong>flurane<br />
0295053 SUPRANE DESFLURANE 240 ML IH RR H<br />
0 0 52,39 0,00 0<br />
N01AB08 sevoflurane<br />
0341402 SEVORANE 100% SOL 1 FL PEN 250 ML RR H<br />
0 0 114,06 0,00 0<br />
N01AF03 thiopental<br />
0419262 PENTOTHAL PDR 1 G 1 FL 20 ML IV RR H<br />
0 0 2,92 0,00 0<br />
0087923 PENTOTHAL PDR 1 G 10 FL 20 ML IV RR H<br />
0 0 17,35 0,00 0<br />
0206554 PENTOTHAL PDR 1 G 10 FL 50 ML IV RR H<br />
0 0 24,34 0,00 0<br />
N01AH01 fentanyl<br />
0044215 FENTANYL 0,1 MG 30 AMP 2 ML IV S H<br />
0 0 4,50 0,00 0<br />
0044232 FENTANYL 0,5 MG 50 AMP 10 ML IV S H<br />
0 0 29,57 0,00 0<br />
N01AH02 alfentanil<br />
0306109 RAPIFEN 1 MG 30 AMP 2 ML IMIVSC (H) S H<br />
0 0 12,59 0,00 0<br />
0096807 RAPIFEN 5 MG 50 AMP 10 ML IMIVSC S H<br />
0 0 104,83 0,00 0<br />
N01AH03 sufentanil<br />
0111030 SUFENTA 0,01 MG 5 AMP 2 ML IV (H) S H<br />
0 0 1,27 0,00 0<br />
0111061 SUFENTA 0,05 MG 5 AMP 10 ML IV (H) S H<br />
0 0 5,12 0,00 0<br />
0111092 SUFENTA FORTE 0,25 MG 5 AMP 5 ML IV (H) S H<br />
0 0 16,21 0,00 0<br />
N01AH06 remifentanil<br />
0633571 REMIFENTANIL HOSPIRA 1 MG SOL 5 FL IV S HC<br />
0 0 11,48 0,00 0<br />
0633584 REMIFENTANIL HOSPIRA 2 MG SOL 5 FL IV S HC<br />
0 0 22,89 0,00 0<br />
0633598 REMIFENTANIL HOSPIRA 5 MG SOL 5 FL IV S HC<br />
0 0 57,23 0,00 0<br />
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délivrance prescription<br />
0570954 REMIFENTANIL TEVA 1MG PDR 5FL DIL 4ML IV S HC<br />
0 0 14,35 0,00 0<br />
0570971 REMIFENTANIL TEVA 2MG PDR 5FL DIL 6ML IV S HC<br />
0 0 28,61 0,00 0<br />
0570999 REMIFENTANIL TEVA 5MG PDR 5FL DIL 12,5ML S HC<br />
0 0 71,54 0,00 0<br />
0227571 ULTIVA 1 MG PDR 5 FL IV S HC<br />
0 0 11,48 0,00 0<br />
0227585 ULTIVA 2 MG PDR 5 FL IV S HC<br />
0 0 22,89 0,00 0<br />
0227599 ULTIVA 5 MG PDR 5 FL IV S HC<br />
0 0 57,23 0,00 0<br />
N01AX03 ketamine<br />
0260304 KETALAR 500 MG 1 FL 10 ML IV S H<br />
0 0 8,73 0,00 0<br />
N01AX07 etomidate<br />
0055320 HYPNOMIDATE 20 MG 50 AMP 10 ML IV RR H<br />
0 0 68,27 0,00 0<br />
N01AX10 propofol<br />
0259043 DIPRIVAN 1 G 1 FL 50 ML IV RR HC<br />
0 0 5,31 0,00 0<br />
0219664 DIPRIVAN 1 G 1 SRG 50 ML IV RR HC<br />
0 0 9,59 0,00 0<br />
0033323 DIPRIVAN 200 MG 5 AMP 20 ML IV RR HC<br />
0 0 6,64 0,00 0<br />
0151781 DIPRIVAN 500 MG 1 FL 50 ML IV RR HC<br />
0 0 3,59 0,00 0<br />
0211375 DIPRIVAN 500 MG 1 SRG 50 ML IV RR HC<br />
0 0 6,48 0,00 0<br />
0398811 PROPOFOL FRSN MCT 1% 1 FL 50 ML IV RR HC<br />
0 0 9,05 0,00 0<br />
0404516 PROPOFOL FRSN MCT 1% 5 AMP 20 ML G RR HC<br />
0 0 18,64 0,00 0<br />
0398842 PROPOFOL FRSN MCT 2% 1 FL 50 ML IV RR HC<br />
0 0 18,64 0,00 0<br />
0404502 PROPOFOL MCT FRSN 1% 5 FL 20 ML G RR HC<br />
0 0 18,64 0,00 0<br />
N01AX13 nitrous oxide<br />
0336576 KALINOX 170 BAR GAZ 1 BTL B20 6 M3 RR HC<br />
0 0 370,00 0,00 0<br />
0336559 KALINOX 170 BAR GAZ 1 BTL B5 1,5 M3 RR HC<br />
0 0 165,00 0,00 0<br />
N01BB01 bupivacaine<br />
0286717 MARCAINE 0,5% 5 FL 20 ML + 5 BOUCHONS R P<br />
0 0 16,53 26,94 0<br />
0069567 MARCAINE HYPERBARE 0,5% 5 AMP 4 ML R H<br />
0 0 27,24 0,00 0<br />
N01BB02 lidocaine<br />
0065649 LIDOCAIN BRN 2% 10 AMP 5 ML V RR P<br />
0 0 0,00 3,79 0<br />
0478491 VERSATIS 5% 10 EMPLATRES R<br />
0 0 28,65 37,95 80<br />
0478537 VERSATIS 5% 30 EMPLATRES R<br />
0 0 85,96 100,01 80<br />
0286765 XYLOCAINE ASTRA 1% 1 FL 20ML + 1 BOUCHON RR P<br />
0 0 0,00 3,47 0<br />
0286703 XYLOCAINE ASTRA 2% 1 FL 20ML + 1 BOUCHON RR P<br />
0 0 0,00 3,63 0<br />
N01BB03 mepivacaine<br />
0286734 SCANDICAINE 1% 5 FL 20 ML + 5 BOUCHONS RR P<br />
0 0 0,00 14,33 0<br />
0286748 SCANDICAINE 2% 5 FL 20 ML + 5 BOUCHONS RR P<br />
0 0 0,00 15,27 0<br />
N01BB04 prilocaine<br />
0368423 CITANEST 1% 50 ML IM RR P<br />
0 0 4,67 0,00 0<br />
0368437 CITANEST 2% 50 ML IM RR P<br />
0 0 5,01 0,00 0<br />
N01BB09 ropivacaine<br />
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délivrance prescription<br />
0220889 NAROPIN 150 MG 5 AMP 20 ML RR HC<br />
0 0 28,83 0,00 0<br />
0229982 NAROPIN 200 MG 5 AMP 20 ML RR HC<br />
0 0 38,50 0,00 0<br />
0220858 NAROPIN 200 MG 5 PP 100 ML RR HC<br />
0 0 65,07 0,00 0<br />
0230001 NAROPIN 40 MG 5 AMP 20 ML RR HC<br />
0 0 17,08 0,00 0<br />
0220861 NAROPIN 400 MG 5 PP 200 ML RR HC<br />
0 0 102,50 0,00 0<br />
0378075 NAROPIN 50 MG 5 AMP 10 ML RR HC<br />
0 0 21,36 0,00 0<br />
N01BB10 levobupivacaine<br />
0271809 CHIROCAINE 25 MG 10 AMP 10 ML IV RR H<br />
0 0 32,85 0,00 0<br />
0271762 CHIROCAINE 50 MG 10 AMP 10 ML IV RR H<br />
0 0 36,74 0,00 0<br />
0271843 CHIROCAINE 75 MG 10 AMP 10 ML IV RR H<br />
0 0 55,11 0,00 0<br />
N01BB20 combinations<br />
0057437 INSTILLAGEL 10*11 ML RR<br />
0 0 12,79 19,18 80<br />
0057406 INSTILLAGEL 10*6 ML RR<br />
0 0 9,97 15,20 80<br />
0057423 INSTILLAGEL 11 ML RR<br />
0 0 2,13 3,56 80<br />
0057390 INSTILLAGEL 6 ML RR<br />
0 0 1,82 3,04 80<br />
N01BB51 bupivacaine, combinations<br />
0069598 MARCAINE ADREN 0,5% 5 FL 20 ML RR H<br />
0 0 16,53 0,00 0<br />
N01BB52 lidocaine, combinations<br />
0227859 EMLA 5 % 2 PATCH R<br />
0 0 0,00 5,54 80<br />
0157754 EMLA 5% CREME 5 G + 2 PANSEM R<br />
0 0 0,00 5,47 80<br />
0473933 RAPYDAN 70/70 MG 1 PATCH RR H<br />
0 0 8,25 0,00 0<br />
0473947 RAPYDAN 70/70 MG 2 PATCH RR H<br />
0 0 16,51 0,00 0<br />
0473978 RAPYDAN 70/70 MG 25 PATCH RR H<br />
0 0 165,05 0,00 0<br />
0130408 XYLOCAINE ADREN ASTRA 1% 1 FL 20 ML IMSC RR P<br />
0 0 0,00 3,63 0<br />
0598861 XYLOCAINE ADREN ASTRA 1% 1FL 20MLPNSCIRE RR P<br />
0 0 2,50 4,29 0<br />
0130425 XYLOCAINE ADREN ASTRA 2% 1 FL 20 ML IMSC RR P<br />
0 0 0,00 3,63 0<br />
0598874 XYLOCAINE ADREN ASTRA 2% 1FL 20MLPNSCIRE RR P<br />
0 0 2,50 4,29 0<br />
N01BX04 capsaicin<br />
0523261 QUTENZA 179 MG 1 PATCH + 1 SET RR H<br />
0 0 284,35 0,00 0<br />
N02AA01 morphine<br />
0575706 MORPHINE HCL 10 MG 10 AMP 1 ML STRP S<br />
0 0 4,28 7,35 80<br />
0249789 MS CONTIN 10 MG 30 CPR S<br />
0 0 4,68 10,00 80<br />
0073881 MS CONTIN 10 MG 56 CPR (UD) S<br />
0 0 0,00 22,83 0<br />
0249811 MS CONTIN 100 MG 30 CPR S<br />
0 0 31,75 41,37 80<br />
0073900 MS CONTIN 100 MG 56 CPR (UD) S<br />
0 0 98,85 111,72 0<br />
0204675 MS CONTIN 200 MG 14 CPR S<br />
0 0 28,54 39,31 80<br />
0249792 MS CONTIN 30 MG 30 CPR S<br />
6 11 10,53 17,31 80<br />
0073928 MS CONTIN 30 MG 56 CPR S<br />
6 11 17,11 25,24 80<br />
0249808 MS CONTIN 60 MG 30 CPR S<br />
6 11 20,63 29,13 80<br />
0073945 MS CONTIN 60 MG 56 CPR S<br />
6 11 33,33 43,10 80<br />
0270376 MS DIRECT 10 MG 56 CPR S<br />
0 0 10,56 18,13 80<br />
Page 154 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0243589 ORAMORPH 10 MG 30*5 ML UD S<br />
0 0 15,00 25,77 0<br />
0243494 ORAMORPH 2 MG/ML SOL OR 1 FL 100 ML S<br />
0 0 0,00 8,41 0<br />
0243544 ORAMORPH 20 MG/ML SOL OR 1 FL 20 ML S<br />
0 0 0,00 12,03 0<br />
0243592 ORAMORPH 30 MG 30*5 ML UD S<br />
0 0 15,00 25,77 0<br />
0210283 STELLORPHINE SINE CONSERV 10 MG 100 AMP S<br />
0 0 20,33 0,00 0<br />
N02AA03 hydromorphone<br />
0538263 PALLADONE INJEKT 10 MG 5 AMP 1 ML IVSC S<br />
0 0 42,97 55,05 0<br />
0538246 PALLADONE INJEKT 2 MG 5 AMP 1 ML IVSC S<br />
0 0 12,78 21,95 0<br />
0538277 PALLADONE INJEKT 20 MG 5 AMP 1 ML IVSC S<br />
0 0 90,00 105,24 0<br />
0538281 PALLADONE INJEKT 50 MG 5 AMP 1 ML IVSC S<br />
0 0 240,00 264,96 0<br />
0441098 PALLADONE IR 1,3 MG 14 CAPS S<br />
0 0 0,00 5,05 0<br />
0366222 PALLADONE IR 1,3 MG 28 CAPS S<br />
0 0 4,31 9,55 80<br />
0441103 PALLADONE IR 2,6 MG 14 CAPS S<br />
0 0 0,00 10,10 0<br />
0366271 PALLADONE IR 2,6 MG 28 CAPS S<br />
0 0 8,62 14,92 80<br />
0334893 PALLADONE SR 16 MG 30 CAPS S<br />
0 0 56,07 68,16 80<br />
0334912 PALLADONE SR 24 MG 30 CAPS S<br />
0 0 71,31 84,47 80<br />
0334845 PALLADONE SR 4 MG 30 CAPS S<br />
0 0 14,96 22,82 80<br />
0334862 PALLADONE SR 8 MG 30 CAPS S<br />
0 0 29,59 38,99 80<br />
N02AA05 oxycodone<br />
0354302 OXYCONTIN 10 MG 30 CPR S<br />
0 0 10,17 16,85 80<br />
0354395 OXYCONTIN 20 MG 30 CPR S<br />
0 0 19,47 27,85 80<br />
0354476 OXYCONTIN 40 MG 30 CPR S<br />
0 0 36,33 46,41 80<br />
0415554 OXYCONTIN 5 MG 30 CPR S<br />
0 0 6,10 11,79 80<br />
0354574 OXYCONTIN 80 MG 30 CPR S<br />
0 0 65,11 77,91 80<br />
0544596 OXYNORM 10 MG 5 AMP 1 ML IVSC S<br />
0 0 6,49 11,15 0<br />
0544601 OXYNORM 10 MG/ML 5 AMP 2 ML IVSC S<br />
0 0 12,74 21,89 0<br />
0538232 OXYNORM 50 MG PERF 5 AMP 1 ML DIL S<br />
0 0 60,11 73,42 0<br />
0495721 OXYNORM INSTANT 10 MG 28 CPR ORODISP S<br />
0 0 8,36 14,59 80<br />
0495667 OXYNORM INSTANT 20 MG 28 CPR ORODISP S<br />
0 0 16,71 24,80 80<br />
0495698 OXYNORM INSTANT 5 MG 28 CPR ORODISP S<br />
0 0 4,18 9,39 80<br />
N02AA55 oxycodone, combinations<br />
0509356 TARGINACT LP 10/5 MG 30 CPR S<br />
0 0 16,72 24,82 0<br />
0509485 TARGINACT LP 20/10 MG 30 CPR S<br />
0 0 32,07 41,72 0<br />
0533513 TARGINACT LP 40/20 MG 30 CPR S<br />
0 0 60,02 72,50 0<br />
0533382 TARGINACT LP 5/2,5 MG 30 CPR S<br />
0 0 9,19 15,63 0<br />
N02AA59 codeine, combinations excl. psycholeptics<br />
0211439 ALGISEDAL 16 CPR RR<br />
0 0 1,70 2,67 80<br />
0459741 ALGISEDAL 48 CPR RR<br />
0 0 4,01 7,15 0<br />
0277072 DAFALGAN CODEINE 30 CPR RR<br />
0 0 3,57 6,13 80<br />
0138485 DAFALGAN CODEINE 32 CPR EFF RR<br />
0 0 4,54 7,80 80<br />
0364603 DOLVIRAN N 20 CPR RR<br />
0 0 8,38 14,92 40<br />
0185759 PANADOL CODEINE 20 CPR RR<br />
0 0 0,00 4,07 80<br />
Page 155 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0299147 PARACOD MYLAN 500 MG/30 MG 30 CPR RR<br />
0 0 2,53 4,82 80<br />
0266003 TALVOSILEN FORTE 10 SUPP RR<br />
0 0 3,23 11,77 80<br />
N02AB02 pethidine<br />
0034429 DOLANTINE 100 MG 5 AMP 2 ML IMIVSC S<br />
0 0 1,26 5,91 80<br />
N02AB03 fentanyl<br />
0403813 ACTIQ 600 MCG 30 CPR A SUCER S<br />
0 0 262,80 288,26 0<br />
0403827 ACTIQ 800 MCG 3 CPR A SUCER S<br />
0 0 26,28 36,97 0<br />
0492621 DUROGESIC 100 MCG/H (16,8 MG) 10 PATCH S<br />
0 0 95,31 0,00 0<br />
0227943 DUROGESIC 100 MCG/H (16,8 MG) 5 PATCH S<br />
0 0 52,37 64,07 80<br />
0409803 DUROGESIC 12 MCG/H (2,1 MG) 10 PATCH S<br />
0 0 21,62 0,00 0<br />
0409798 DUROGESIC 12 MCG/H (2,1 MG) 5 PATCH S<br />
0 0 10,96 17,83 80<br />
0492598 DUROGESIC 25 MCG/H (4,2 MG) 10 PATCH S<br />
0 0 29,42 0,00 0<br />
0227909 DUROGESIC 25 MCG/H (4,2 MG) 5 PATCH S<br />
0 0 14,93 22,79 80<br />
0492603 DUROGESIC 50 MCG/H (8,4 MG) 10 PATCH S<br />
0 0 56,00 0,00 0<br />
0227912 DUROGESIC 50 MCG/H (8,4 MG) 5 PATCH S<br />
0 0 28,79 38,11 80<br />
0492617 DUROGESIC 75 MCG/H (12,6 MG) 10 PATCH S<br />
0 0 77,64 0,00 0<br />
0227926 DUROGESIC 75 MCG/H (12,6 MG) 5 PATCH S<br />
0 0 41,24 51,82 80<br />
0540504 INSTANYL 100 MCG/D SPRAY 10 D 1 FL 1,8ML S C<br />
RM 0 0<br />
87,60 102,69 0<br />
0540535 INSTANYL 200 MCG/D SPRAY 10 D 1 FL 1,8ML S C<br />
RM 0 0<br />
87,60 102,69 0<br />
0540471 INSTANYL 50 MCG/D SPRAY 10 D 1 FL 1,8 ML S C<br />
RM 0 0<br />
87,60 102,69 0<br />
0472337 MATRIFEN 100 (11 MG) 5 PATCH S<br />
0 0 51,36 62,97 80<br />
0477204 MATRIFEN 12 (1,38 MG) 2 PATCH S<br />
0 0 4,30 9,54 80<br />
0472113 MATRIFEN 12 (1,38 MG) 5 PATCH S<br />
0 0 10,75 17,57 80<br />
0477235 MATRIFEN 25 (2,75 MG) 2 PATCH S<br />
0 0 5,86 11,48 80<br />
0472161 MATRIFEN 25 (2,75 MG) 5 PATCH S<br />
0 0 14,64 22,43 80<br />
0472211 MATRIFEN 50 (5,5 MG) 5 PATCH S<br />
0 0 28,24 37,52 80<br />
0472273 MATRIFEN 75 (8,25 MG) 5 PATCH S<br />
0 0 40,45 50,96 80<br />
N02AC03 piritramide<br />
0033242 DIPIDOLOR 20 MG 30 AMP 2 ML IMSCIV S<br />
0 0 10,45 0,00 0<br />
0033239 DIPIDOLOR 20 MG 5 AMP 2 ML IMSCIV S<br />
0 0 1,92 6,64 80<br />
N02AD01 pentazocine<br />
0045985 FORTAL 30 MG 10 AMP 1 ML IMIVSC S<br />
0 0 3,96 9,10 80<br />
0045968 FORTAL 50 MG 100 CPR S<br />
0 0 8,91 15,28 80<br />
0045954 FORTAL 50 MG 30 CPR S<br />
0 0 3,34 8,34 80<br />
N02AE01 buprenorphine<br />
0413871 NORSPAN 10 MG 4 PATCH S<br />
0 0 58,15 71,32 0<br />
0413921 NORSPAN 20 MG 4 PATCH S<br />
0 0 110,78 127,36 0<br />
0413823 NORSPAN 5 MG 4 PATCH S<br />
0 0 30,44 41,75 0<br />
0114189 TEMGESIC 0,3 MG 5 AMP 1 ML IVIM S<br />
0 0 7,14 12,26 0<br />
0114211 TEMGESIC SL 0,2 MG 50 CPR S<br />
0 0 8,42 14,66 80<br />
0314873 TRANSTEC 35 (20 MG) 10 PATCH S<br />
0 0 48,96 60,32 0<br />
Page 156 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0314856 TRANSTEC 35 (20 MG) 5 PATCH S<br />
0 0 27,64 36,85 80<br />
0314906 TRANSTEC 52,5 (30 MG) 10 PATCH S<br />
0 0 71,51 84,68 0<br />
0314891 TRANSTEC 52,5 (30 MG) 5 PATCH S<br />
0 0 40,31 50,79 80<br />
0314941 TRANSTEC 70 (40 MG) 10 PATCH S<br />
0 0 94,85 109,42 0<br />
0314937 TRANSTEC 70 (40 MG) 5 PATCH S<br />
0 0 53,33 65,13 80<br />
N02AX Other opioids<br />
0135291 VALTRAN GTTS 10 ML RR<br />
0 0 1,71 6,39 80<br />
0135306 VALTRAN GTTS 20 ML RR<br />
0 0 3,10 8,05 80<br />
0269121 VALTRAN GTTS 60 ML RR<br />
0 0 8,19 14,38 80<br />
0284614 VALTRAN RET 100/8 MG 30 CPR RR<br />
0 0 10,23 16,93 80<br />
0284645 VALTRAN RET 150/12 MG 30 CPR RR<br />
0 0 14,12 21,78 80<br />
0284581 VALTRAN RET 50/4 MG 30 CPR RR<br />
0 0 5,79 11,39 80<br />
N02AX02 tramadol<br />
0481448 CONTRAMAL UNO 100 MG 30 CPR RR<br />
0 0 6,43 12,19 80<br />
0481529 CONTRAMAL UNO 200 MG 30 CPR RR<br />
0 0 12,18 19,37 80<br />
0481613 CONTRAMAL UNO 300 MG 30 CPR RR<br />
0 0 18,44 26,71 80<br />
0212906 DOLZAM 100 MG 10 AMP 2 ML RR<br />
0 0 5,47 10,99 80<br />
0212891 DOLZAM 100 MG 5 AMP 2 ML RR<br />
0 0 3,40 8,41 80<br />
0212856 DOLZAM 100 MG/ML GTTS 10 ML RR<br />
0 0 3,20 8,16 80<br />
0212873 DOLZAM 100 MG/ML GTTS 3*10 ML RR<br />
0 0 7,38 13,38 80<br />
0245261 DOLZAM 100 MG/ML GTTS 5*10 ML RR<br />
0 0 10,56 17,34 80<br />
0220441 DOLZAM 50 MG 30 CAPS RR<br />
0 0 4,46 9,74 80<br />
0212842 DOLZAM 50 MG 60 CAPS RR<br />
0 0 7,38 13,38 80<br />
0371317 DOLZAM RET 100 MG 56 CPR RR<br />
0 0 11,88 18,99 80<br />
0371284 DOLZAM RET 150 MG 56 CPR RR<br />
0 0 16,75 24,85 80<br />
0371253 DOLZAM RET 200 MG 56 CPR RR<br />
0 0 21,12 29,67 80<br />
0371348 DOLZAM RET 75 MG 56 CPR RR<br />
0 0 9,26 15,72 80<br />
0279712 DOLZAM UNO 150 MG 28 CPR RR<br />
0 0 9,26 15,72 80<br />
0279726 DOLZAM UNO 200 MG 28 CPR RR<br />
0 0 10,89 17,74 80<br />
0272188 DOLZAM UNO 300 MG 14 CPR RR<br />
0 0 9,26 15,72 80<br />
0272191 DOLZAM UNO 400 MG 14 CPR RR<br />
0 0 10,89 17,74 80<br />
0230949 TRADONAL 100 MG 10 AMP 2 ML IMIV RR<br />
0 0 4,23 9,33 80<br />
0230899 TRADONAL 100 MG/ML GTTS 10 ML RR<br />
0 0 2,06 6,67 80<br />
0230904 TRADONAL 100 MG/ML GTTS 30 ML RR<br />
0 0 5,56 10,99 80<br />
0230918 TRADONAL 50 MG 30 CAPS RR<br />
0 0 3,09 7,91 80<br />
0290284 TRADONAL 50 MG 30 CPR EFF RR<br />
0 0 4,66 9,86 80<br />
0230921 TRADONAL 50 MG 60 CAPS RR<br />
0 0 5,56 10,99 80<br />
0386001 TRADONAL ODIS 50 MG 100 CPR RR<br />
0 0 11,40 0,00 0<br />
0385942 TRADONAL ODIS 50 MG 30 CPR RR<br />
0 0 2,87 7,57 80<br />
0248411 TRADONAL RET 100 MG 60 CAPS RR<br />
0 0 13,31 20,65 80<br />
0248425 TRADONAL RET 150 MG 60 CAPS RR<br />
0 0 18,99 27,20 80<br />
0248442 TRADONAL RET 200 MG 60 CAPS RR<br />
0 0 23,67 32,37 80<br />
0248392 TRADONAL RET 50 MG 60 CAPS RR<br />
0 0 7,75 13,72 80<br />
Page 157 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0321721 TRAMADOL EG 100 MG 10 AMP 2 ML IMIVSC RR<br />
0 0 3,44 8,46 0<br />
0321641 TRAMADOL EG 100 MG/ML GTTS 10 ML RR<br />
0 0 1,66 6,35 0<br />
0321668 TRAMADOL EG 100 MG/ML GTTS 30 ML RR<br />
0 0 4,49 9,77 0<br />
0321671 TRAMADOL EG 100 MG/ML GTTS 50 ML RR<br />
0 0 8,17 14,36 0<br />
0371382 TRAMADOL EG 50 MG 30 CPR RR<br />
0 0 2,49 7,27 0<br />
0371396 TRAMADOL EG 50 MG 60 CPR RR<br />
0 0 4,49 9,77 0<br />
0485724 TRAMADOL RET EG 100 MG 30 CPR RR<br />
0 0 4,49 9,77 80<br />
0485741 TRAMADOL RET EG 100 MG 60 CPR RR<br />
0 0 7,84 13,94 80<br />
0485755 TRAMADOL RET EG 100 MG 90 CPR RR<br />
0 0 13,22 0,00 0<br />
0486171 TRAMADOL RET EG 150 MG 20 CPR RR<br />
0 0 4,49 9,77 80<br />
0486203 TRAMADOL RET EG 150 MG 60 CPR RR<br />
0 0 13,24 20,68 80<br />
0486217 TRAMADOL RET EG 150 MG 90 CPR RR<br />
0 0 19,86 0,00 0<br />
0485948 TRAMADOL RET EG 200 MG 20 CPR RR<br />
0 0 5,38 10,87 80<br />
0485979 TRAMADOL RET EG 200 MG 60 CPR RR<br />
0 0 15,87 23,87 80<br />
0485982 TRAMADOL RET EG 200 MG 90 CPR RR<br />
0 0 23,81 0,00 0<br />
0501148 TRAMADOL RET MYLAN 100 MG 30 CPR RR<br />
0 0 4,52 9,69 80<br />
0501151 TRAMADOL RET MYLAN 100 MG 60 CPR RR<br />
0 0 7,32 13,29 80<br />
0508507 TRAMADOL RET MYLAN 150 MG 20 CPR RR<br />
0 0 4,52 9,63 80<br />
0508511 TRAMADOL RET MYLAN 150 MG 60 CPR RR<br />
0 0 13,37 20,84 80<br />
0508524 TRAMADOL RET MYLAN 200 MG 20 CPR RR<br />
0 0 5,43 10,82 80<br />
0508538 TRAMADOL RET MYLAN 200 MG 60 CPR RR<br />
0 0 16,03 24,06 80<br />
0149542 TRAMAL 100 MG 10 AMP 2 ML IMIVSC RR<br />
0 0 3,13 12,52 80<br />
0216628 TRAMAL 100 MG 10 SUPP RR<br />
0 0 2,31 11,61 80<br />
0216631 TRAMAL 100 MG 20 SUPP RR<br />
0 0 4,48 13,99 80<br />
0197908 TRAMAL 100 MG 400 AMP 2 ML IMIVSC RR<br />
0 0 209,97 0,00 0<br />
0144367 TRAMAL 100 MG 5 AMP 2 ML IMIVSC RR<br />
0 0 1,61 10,87 80<br />
0205347 TRAMAL 100 MG 80 AMP 2 ML IMIVSC RR<br />
0 0 44,29 0,00 0<br />
0198628 TRAMAL 100 MG/ML 1 FL DOS 96 ML RR<br />
0 0 26,52 0,00 0<br />
0211697 TRAMAL 100 MG/ML GTTS 1 FL DOS 100 ML RR<br />
0 0 12,11 22,34 80<br />
0211795 TRAMAL 100 MG/ML GTTS 1 FL DOS 50 ML RR<br />
0 0 5,58 15,19 80<br />
0144336 TRAMAL 100 MG/ML GTTS 10 ML RR<br />
0 0 0,97 10,14 80<br />
0144353 TRAMAL 50 MG 10 CAPS RR<br />
0 0 0,76 9,91 80<br />
0206859 TRAMAL 50 MG 30 CAPS RR<br />
0 0 2,28 11,58 80<br />
0207887 TRAMAL 50 MG 50 CAPS RR<br />
0 0 3,89 13,34 80<br />
0216595 TRAMAL LONG 100 MG 10 CPR RR<br />
0 0 4,94 8,80 80<br />
0216601 TRAMAL LONG 100 MG 30 CPR RR<br />
0 0 12,65 22,53 80<br />
0216614 TRAMAL LONG 100 MG 50 CPR RR<br />
0 0 9,24 19,20 80<br />
0232506 TRAMAL LONG 150 MG 10 CPR RR<br />
0 0 7,40 13,19 80<br />
0232523 TRAMAL LONG 150 MG 30 CPR RR<br />
0 0 18,96 33,79 80<br />
0235721 TRAMAL LONG 150 MG 50 CPR RR<br />
0 0 15,09 25,60 80<br />
0232537 TRAMAL LONG 200 MG 10 CPR RR<br />
0 0 9,87 17,58 80<br />
0232541 TRAMAL LONG 200 MG 30 CPR RR<br />
0 0 25,28 45,04 80<br />
0232554 TRAMAL LONG 200 MG 50 CPR RR<br />
0 0 21,14 32,23 80<br />
0349414 TRAMIUM 100 MG 30 CAPS RR<br />
0 0 5,56 10,99 80<br />
Page 158 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0349459 TRAMIUM 150 MG 30 CAPS RR<br />
0 0 8,34 14,45 80<br />
0349509 TRAMIUM 200 MG 30 CAPS RR<br />
0 0 10,13 16,68 80<br />
0329862 ZUMALGIC GE 50 MG 2*15 CPR EFF RR<br />
0 0 0,00 7,25 0<br />
N02AX52 tramadol, combinations<br />
0337993 ZALDIAR 37,5/325 MG 20 CPR RR<br />
0 0 4,15 9,34 80<br />
0502422 ZALDIAR 37,5/325 MG 20 CPR EFF BLIST RR<br />
0 0 4,15 9,34 80<br />
0338018 ZALDIAR 37,5/325 MG 40 CPR RR<br />
0 0 8,30 14,53 80<br />
0502453 ZALDIAR 37,5/325 MG 40 CPR EFF BLIST RR<br />
0 0 8,30 14,53 80<br />
0338035 ZALDIAR 37,5/325 MG 60 CPR RR<br />
0 0 11,90 19,02 80<br />
0502471 ZALDIAR 37,5/325 MG 60 CPR EFF BLIST RR<br />
0 0 11,90 19,02 80<br />
N02BA01 acetylsalicylic acid<br />
0131419 ACENTERINE 500 MG 100 CPR P<br />
0 0 4,26 7,33 80<br />
0441294 ALKA SELTZER 30 CPR EFF P<br />
0 0 4,68 8,04 0<br />
0285481 ASPEGIC 100 30 SACH BB P<br />
0 0 2,66 4,57 80<br />
0008351 ASPEGIC 1000 20 SACH P<br />
0 0 4,38 7,53 80<br />
0285494 ASPEGIC 250 30 SACH ENF P<br />
0 0 3,11 5,34 80<br />
0008382 ASPEGIC 500 20 SACH P<br />
0 0 0,00 3,26 80<br />
0285513 ASPEGIC 500 30 SACH P<br />
0 0 3,39 5,83 80<br />
0008334 ASPEGIC 6 AMP 5 ML IMIV RR<br />
0 0 2,40 7,16 80<br />
0311899 ASPIRINE 100 MG 30 CPR P<br />
0 0 1,95 3,35 0<br />
0008480 ASPIRINE 500 MG 20 CPR P<br />
0 0 1,89 3,26 0<br />
0529511 ASPIRINE 500 MG 30 CPR P<br />
0 0 3,18 5,46 0<br />
0458808 ASPIRINE 500 MG 36 CPR EFF P<br />
0 0 4,65 7,99 0<br />
0311885 ASPIRINE 500 MG 50 CPR P<br />
0 0 3,51 6,02 0<br />
0529538 ASPIRINE 500 MG 60 CPR P<br />
0 0 5,03 8,64 0<br />
0601658 ASPIRINE INSTANT 500 MG 10 SACH P<br />
0 0 2,74 4,70 0<br />
0247981 SEDERGINE 325 MG 2*10 CPR EFF P<br />
0 0 1,46 2,51 0<br />
0318998 SEDERGINE FORTE 1 G 20 CPR EFF P<br />
0 0 3,79 6,52 80<br />
N02BA51 acetylsalicylic acid, combinations excl. psycholeptics<br />
0569161 ASPIRINE DUO 650/65 MG 30 CPR P<br />
0 0 4,06 6,98 0<br />
0008513 ASPIRINE VIT C 20 CPR EFF P<br />
0 0 4,24 7,29 0<br />
0147291 ASS + C RATIO 10 CPR EFF P<br />
0 0 1,88 3,76 40<br />
0147355 ASS + C RATIO 20 CPR EFF P<br />
0 0 3,26 6,48 40<br />
0218989 MIGPRIV PDR 20 SACH R<br />
0 0 18,63 29,10 0<br />
0218958 MIGPRIV PDR 6 SACH R<br />
0 0 6,70 11,51 40<br />
0092114 POLYPIRINE 20 CAPS LHL P<br />
0 0 0,00 4,61 40<br />
N02BB02 metamizole sodium<br />
0080239 NOVALGINE 1 G 10 AMP 2 ML IMIV R<br />
0 0 4,59 7,88 80<br />
0080208 NOVALGINE 500 MG 20 CPR R<br />
0 0 2,03 3,49 80<br />
0235847 NOVALGINE GTTS 20 ML R<br />
0 0 2,01 3,44 80<br />
N02BE01 paracetamol<br />
Page 159 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0334814 ALGOSTASE MONO 1 G 20 CPR EFF R<br />
0 0 0,00 5,34 80<br />
0362173 ALGOSTASE MONO 1 G 40 CPR EFF R<br />
0 0 5,37 9,23 80<br />
0341674 ALGOSTASE MONO 500 MG 32 CPR EFF R<br />
0 0 0,00 4,62 80<br />
0400176 ALGOSTASE MONO 500 MG 32 SACH R<br />
0 0 0,00 3,74 80<br />
0259155 BENURON 1 G 10 SUPP P<br />
0 0 2,80 4,67 80<br />
0259111 BENURON 125 MG 10 SUPP P<br />
0 0 1,10 1,90 80<br />
0262486 BENURON 200 MG/5 ML SIR 100 ML P<br />
0 0 2,57 4,28 80<br />
0259124 BENURON 250 MG 10 SUPP P<br />
0 0 1,24 2,13 80<br />
0259138 BENURON 500 MG 10 SUPP P<br />
0 0 1,51 2,53 80<br />
0259141 BENURON 500 MG 20 CPR P<br />
0 0 0,95 1,69 80<br />
0156601 CROIX BLANCHE MONO 500 MG 20 SACH P<br />
0 0 0,00 2,38 80<br />
0602351 DAFALGAN 500 MG 20 CPR P<br />
0 0 1,79 3,07 0<br />
0602364 DAFALGAN 500 MG 20 CPR EFF P<br />
0 0 2,35 4,03 0<br />
0027312 DAFALGAN 500 MG 30 CPR R<br />
0 0 2,63 4,52 80<br />
0138132 DAFALGAN 500 MG 32 CPR EFF R<br />
0 0 3,42 5,88 80<br />
0298198 DAFALGAN AD 600 MG 12 SUPP P<br />
0 0 2,03 3,49 80<br />
0298167 DAFALGAN BB 80 MG 12 SUPP P<br />
0 0 1,23 2,12 80<br />
0380073 DAFALGAN FORTE 1 G 16 CPR R<br />
0 0 2,86 4,91 80<br />
0311627 DAFALGAN FORTE 1 G 16 CPR EFF R<br />
0 0 3,57 6,14 80<br />
0380087 DAFALGAN FORTE 1 G 32 CPR R<br />
0 0 5,14 8,82 80<br />
0311631 DAFALGAN FORTE 1 G 32 CPR EFF R<br />
0 0 6,39 10,97 80<br />
0380091 DAFALGAN FORTE 1 G 50 CPR R<br />
0 0 6,97 11,98 80<br />
0525248 DAFALGAN FORTE 1 G 8 CPR P<br />
0 0 1,43 2,45 0<br />
0525251 DAFALGAN FORTE 1 G 8 CPR EFF P<br />
0 0 1,79 3,07 0<br />
0298184 DAFALGAN GD ENF 300 MG 12 SUPP P<br />
0 0 1,59 2,74 80<br />
0298171 DAFALGAN J ENF 150 MG 12 SUPP P<br />
0 0 1,43 2,46 80<br />
0277735 DAFALGAN ODIS 500 MG 16 CPR P<br />
0 0 2,29 3,95 80<br />
0298203 DAFALGAN PED 3% 90 ML P<br />
0 0 1,54 2,64 80<br />
0344113 DOLOL INSTANT 500 MG 20 CPR DISP P<br />
0 0 2,38 4,08 80<br />
0205395 DOLPRONE 500 MG 100 CPR R<br />
0 0 7,89 0,00 0<br />
0205381 DOLPRONE 500 MG 16 CPR P<br />
0 0 1,72 2,95 80<br />
0260674 ENELFA 125 MG 10 SUPP P<br />
0 0 0,69 1,43 80<br />
0260688 ENELFA 250 MG 10 SUPP P<br />
0 0 0,82 1,71 80<br />
0260691 ENELFA 500 MG 10 SUPP P<br />
0 0 0,95 1,97 80<br />
0039389 ENELFA SIR 100 ML P<br />
0 0 0,00 2,86 80<br />
0556194 LEMSIP 500 MG 10 SACH P<br />
0 0 2,93 5,03 0<br />
0167523 LEMSIP 650 MG 12 SACH P<br />
0 0 3,52 6,04 80<br />
0276934 PANADOL 1 G 100 CPR R<br />
0 0 10,24 0,00 0<br />
0276917 PANADOL 1 G 20 CPR R<br />
0 0 0,00 5,54 80<br />
0276921 PANADOL 1 G 50 CPR R<br />
0 0 0,00 11,08 80<br />
0143258 PANADOL 500 MG 20 CPR P<br />
0 0 0,00 3,40 80<br />
0085574 PANADOL 500 MG 30 CPR R<br />
0 0 0,00 4,21 80<br />
0143261 PANADOL 500 MG 60 CPR R<br />
0 0 0,00 7,16 80<br />
0547651 PANADOL RET 8H 665 MG 48 CPR R<br />
0 0 5,88 10,11 0<br />
Page 160 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0366321 PANADOL ZAPP 500 MG 16 CPR P<br />
0 0 0,00 3,84 0<br />
0460367 PARACETAMOL EG 500 MG 30 CPR R<br />
0 0 0,00 3,44 80<br />
0594262 PARACETAMOL KABI 1000 MG PERF 1*100 ML RR<br />
0 0 1,45 2,47 0<br />
0594228 PARACETAMOL KABI 500 MG PERF 1*50 ML RR<br />
0 0 1,25 2,25 0<br />
0598021 PARACETAMOL MACO 10 MG/ML 1 PP 100 ML RR H<br />
0 0 9,80 0,00 0<br />
0597958 PARACETAMOL MACO 10 MG/ML 1 PP 50 ML RR H<br />
0 0 8,60 0,00 0<br />
0598048 PARACETAMOL MACO 10 MG/ML 10 PP 100 ML RR H<br />
0 0 98,00 0,00 0<br />
0597975 PARACETAMOL MACO 10 MG/ML 10 PP 50 ML RR H<br />
0 0 86,00 0,00 0<br />
0598051 PARACETAMOL MACO 10 MG/ML 40 PP 100 ML RR H<br />
0 0 392,00 0,00 0<br />
0597989 PARACETAMOL MACO 10 MG/ML 40 PP 50 ML RR H<br />
0 0 344,00 0,00 0<br />
0598065 PARACETAMOL MACO 10 MG/ML 45 PP 100 ML RR H<br />
0 0 441,00 0,00 0<br />
0597992 PARACETAMOL MACO 10 MG/ML 45 PP 50 ML RR H<br />
0 0 387,00 0,00 0<br />
0598034 PARACETAMOL MACO 10 MG/ML 5 PP 100 ML RR H<br />
0 0 49,00 0,00 0<br />
0597961 PARACETAMOL MACO 10 MG/ML 5 PP 50 ML RR H<br />
0 0 43,00 0,00 0<br />
0598079 PARACETAMOL MACO 10 MG/ML 50 PP 100 ML RR H<br />
0 0 490,00 0,00 0<br />
0598003 PARACETAMOL MACO 10 MG/ML 50 PP 50 ML RR H<br />
0 0 430,00 0,00 0<br />
0598082 PARACETAMOL MACO 10 MG/ML 55 PP 100 ML RR H<br />
0 0 539,00 0,00 0<br />
0598017 PARACETAMOL MACO 10 MG/ML 60 PP 50 ML RR H<br />
0 0 516,00 0,00 0<br />
0170241 PARACETAMOL RATIO 1 G 10 SUPP P<br />
0 0 1,07 2,17 80<br />
0633083 PARACETAMOL RATIO 1000 MG 10 CPR P<br />
0 0 0,81 1,70 80<br />
0086005 PARACETAMOL RATIO 125 MG 10 SUPP P<br />
0 0 0,50 1,05 80<br />
0086019 PARACETAMOL RATIO 250 MG 10 SUPP P<br />
0 0 0,60 1,26 80<br />
0086036 PARACETAMOL RATIO 500 MG 10 SUPP P<br />
0 0 0,73 1,52 80<br />
0482526 PARACETAMOL RATIO 500 MG 20 CPR P<br />
0 0 0,81 1,70 80<br />
0086022 PARACETAMOL RATIO 500 MG 30 CPR R<br />
0 0 0,00 1,89 80<br />
0633178 PARACETAMOL RATIO 75 MG 10 SUPP P<br />
0 0 0,81 1,70 0<br />
0150171 PARACETAMOL RATIO LOESUNG 100 ML P<br />
0 0 1,36 2,72 80<br />
0462358 PE TAM 500 MG 20 CPR P<br />
0 0 1,13 1,94 0<br />
0625355 PERDOLAN 1000 MG 10 SACH P<br />
0 0 5,06 8,70 0<br />
0333817 PERDOLAN 500 MG 20 CPR EFF P<br />
0 0 2,55 4,38 80<br />
0290852 PERDOLAN AD 500 MG 12 SUPP 96147 P<br />
0 0 2,79 4,80 80<br />
0297514 PERDOLAN AD 500 MG 30 CPR 96157 R<br />
0 0 2,88 4,96 80<br />
0290883 PERDOLAN BB 100 MG 12 SUPP 96153 P<br />
0 0 1,95 3,35 80<br />
0311451 PERDOLAN ENF 32 MG/ML SIR 200 ML 96145 P<br />
0 0 4,21 7,24 80<br />
0290866 PERDOLAN ENF 350 MG 12 SUPP 96149 P<br />
0 0 2,69 4,62 80<br />
0297495 PERDOLAN J ENF 200 MG 12 SUPP P<br />
0 0 2,29 3,94 80<br />
0315241 PERFUSALGAN 1 G 12 FL 100 ML PERF RR<br />
0 0 21,31 29,87 0<br />
N02BE51 paracetamol, combinations excl. psycholeptics<br />
0131758 AFEBRYL 16 CPR EFF P<br />
0 0 2,01 3,45 40<br />
0364911 AFEBRYL 32 CPR EFF P<br />
0 0 3,54 6,07 40<br />
0242046 ALGOSTASE 30 CAPS R<br />
0 0 2,80 4,81 40<br />
0193196 ALGOSTASE 32 CPR EFF R<br />
0 0 3,39 5,83 40<br />
0368583 ALGOSTASE PDR 32 SACH R<br />
0 0 0,00 3,89 40<br />
Page 161 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0285642 ANTIGRIPHINE 20 CPR P<br />
0 0 0,00 3,83 0<br />
0174545 CROIX BLANCHE 20 CPR P<br />
0 0 1,47 2,53 40<br />
0152101 CROIX BLANCHE 20 SACH P<br />
0 0 1,63 2,81 40<br />
0558428 EXCEDRYN 32 CPR P<br />
0 0 4,47 7,68 0<br />
0429546 GRIPPAL + C RATIO 10 CPR EFF P<br />
0 0 1,32 2,64 40<br />
0429563 GRIPPAL + C RATIO 20 CPR EFF P<br />
0 0 2,26 4,50 40<br />
0067321 LONARID N 30 CPR R<br />
0 0 3,15 5,41 40<br />
0191837 MELABON K 20 CPR P<br />
0 0 2,40 4,28 40<br />
0399805 MIGRAENERTON 20 CAPS R<br />
0 0 14,68 25,15 0<br />
0399819 MIGRAENERTON 50 CAPS R<br />
0 0 32,59 44,76 0<br />
0334103 PANADOL PLUS 20 CPR P<br />
0 0 0,00 3,83 0<br />
0309579 PERDOLAN COMP 20 CPR P<br />
0 0 2,54 4,35 40<br />
0342394 PERDOLAN COMP 30 CPR P<br />
0 0 3,62 6,22 0<br />
0309596 PERDOLAN COMP AD 12 SUPP P<br />
0 0 3,27 5,62 40<br />
N02BG06 nefopam<br />
0000661 ACUPAN 30 MG 30 CPR R<br />
0 0 3,45 8,47 80<br />
N02CA01 dihydroergotamine<br />
0055740 IKARAN GE GTTS 50 ML R<br />
0 0 0,00 3,21 80<br />
0224082 IKARAN LP 5 MG 30 CPR R<br />
0 0 0,00 9,26 80<br />
N02CC01 sumatriptan<br />
0248537 IMITREX 10 MG SPRAY 6 FL 0,1 ML IN RR<br />
6 7 32,65 43,52 80<br />
0229271 IMITREX 20 MG SPRAY 6 FL 0,1 ML IN RR<br />
6 7 53,97 65,49 80<br />
0172215 IMITREX 6 MG 2 SRG 0,5 ML SC RR<br />
6 7 26,76 35,88 80<br />
0205351 IMITREX 6 MG 4 SRG 0,5 ML SC RR<br />
6 7 53,52 65,03 80<br />
0427197 IMITREX INSTANT 100 MG 6 CPR R<br />
6 7 53,50 65,02 80<br />
0427166 IMITREX INSTANT 50 MG 12 CPR R<br />
6 7 53,50 65,02 80<br />
0461042 SUMATRIPTAN TEVA 100 MG 12 CPR R<br />
0 0 9,74 16,31 0<br />
0461008 SUMATRIPTAN TEVA 100 MG 2 CPR R<br />
0 0 4,16 9,35 0<br />
0461039 SUMATRIPTAN TEVA 100 MG 6 CPR R<br />
0 0 6,94 12,83 0<br />
0460949 SUMATRIPTAN TEVA 50 MG 12 CPR R<br />
0 0 9,74 16,31 0<br />
0460904 SUMATRIPTAN TEVA 50 MG 2 CPR R<br />
0 0 4,16 9,35 0<br />
0460935 SUMATRIPTAN TEVA 50 MG 6 CPR R<br />
0 0 6,94 12,83 0<br />
N02CC02 naratriptan<br />
0250115 NARAMIG 2,5 MG 12 CPR R<br />
6 7 46,93 58,24 80<br />
N02CC03 zolmitriptan<br />
0279967 ZOMIG INSTANT 2,5 MG 12 CPR ORODISP RR<br />
6 7 53,55 65,06 80<br />
0279936 ZOMIG INSTANT 2,5 MG 2 CPR ORODISP RR<br />
6 7 0,00 19,20 80<br />
0279953 ZOMIG INSTANT 2,5 MG 6 CPR ORODISP RR<br />
6 7 30,14 40,95 80<br />
0338831 ZOMIG NASAL 5 MG SPRAY IN 2 FL RR<br />
0 0 17,30 27,71 0<br />
0240024 ZOMIG ORAL 2,5 MG 12 CPR RR<br />
6 7 53,55 65,06 80<br />
0240007 ZOMIG ORAL 2,5 MG 3 CPR RR<br />
6 7 16,76 27,17 80<br />
Page 162 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
N02CC04 rizatriptan<br />
0253327 MAXALT LYO 10 MG 3 CPR R<br />
6 7 16,71 27,12 80<br />
0253331 MAXALT LYO 10 MG 6 CPR R<br />
6 7 33,42 44,35 80<br />
N02CC05 almotriptan<br />
0441053 ALMOGRAN 12,5 MG 12 CPR R<br />
6 7 49,44 60,83 80<br />
0285897 ALMOGRAN 12,5 MG 3 CPR R<br />
6 7 15,85 26,24 80<br />
N02CC06 eletriptan<br />
0308621 RELERT 40 MG 6 CPR R<br />
6 7 30,12 40,92 80<br />
N02CX02 clonidine<br />
0136741 DIXARIT 0,025 MG 100 DRG R<br />
0 0 9,19 15,78 80<br />
N02CX06 oxetorone<br />
0079482 NOCERTONE 60 MG 30 CPR R<br />
0 0 3,85 8,86 80<br />
N03AA02 phenobarbital<br />
0047833 GARDENAL 100 MG 20 CPR RR<br />
0 0 0,76 1,30 80<br />
N03AA03 primidone<br />
0238981 MYSOLINE 250 MG 90 CPR R<br />
0 0 13,26 20,53 80<br />
N03AB02 phenytoin<br />
0033189 DIPHANTOINE 100 MG 100 CPR R<br />
0 0 4,82 10,17 100<br />
0033211 DIPHANTOINE 250 MG 5 AMP IV RR<br />
0 0 6,99 12,88 100<br />
0039991 EPANUTIN 100 MG 100 CAPS R<br />
0 0 6,64 11,40 100<br />
N03AB52 phenytoin, combinations<br />
0126999 VETHOINE 100 CPR RR<br />
0 0 5,97 11,62 100<br />
N03AD01 ethosuximide<br />
0254579 ZARONTIN 250 MG/5 ML SIR 200 ML R<br />
0 0 1,78 6,48 100<br />
N03AE01 clonazepam<br />
0100328 RIVOTRIL 0,5 MG 150 CPR RR<br />
0 0 6,28 10,79 100<br />
0100314 RIVOTRIL 0,5 MG 50 CPR RR<br />
0 0 2,33 4,00 100<br />
0100345 RIVOTRIL 2 MG 100 CPR RR<br />
0 0 8,55 14,68 100<br />
0100331 RIVOTRIL 2 MG 30 CPR RR<br />
0 0 3,27 5,62 100<br />
0100359 RIVOTRIL 2,5 MG/ML GTTS 10 ML RR<br />
0 0 2,29 3,94 100<br />
N03AF01 carbamazepine<br />
0236536 TEGRETAL 2% SIR 250 ML R<br />
0 0 6,29 15,98 80<br />
0237063 TEGRETAL 200 MG 200 CPR R<br />
0 0 9,91 0,00 0<br />
0236831 TEGRETAL 200 MG 50 CPR R<br />
0 0 2,47 11,80 80<br />
0236908 TEGRETAL RET 200 MG 100 CPR R<br />
0 0 7,24 17,02 80<br />
0236892 TEGRETAL RET 200 MG 50 CPR R<br />
0 0 5,48 14,74 80<br />
0236911 TEGRETAL RET 400 MG 50 CPR R<br />
0 0 6,48 16,17 80<br />
0331714 TEGRETOL 200 MG 50 CPR UD R<br />
0 0 3,53 0,00 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0331728 TEGRETOL CR 200 MG 50 CPR UD R<br />
0 0 3,76 0,00 0<br />
0331731 TEGRETOL CR 400 MG 50 CPR UD R<br />
0 0 6,17 0,00 0<br />
N03AF02 oxcarbazepine<br />
0279385 TRILEPTAL 150 MG 100 CPR R<br />
0 0 22,77 34,01 100<br />
0281223 TRILEPTAL 150 MG 200 CPR R<br />
0 0 44,34 57,61 100<br />
0281241 TRILEPTAL 300 MG 200 CPR R<br />
0 0 84,45 101,49 100<br />
0279399 TRILEPTAL 300 MG 50 CPR R<br />
0 0 22,29 33,48 100<br />
0279421 TRILEPTAL 600 MG 100 CPR R<br />
0 0 84,45 101,49 100<br />
0281268 TRILEPTAL 600 MG 200 CPR R<br />
0 0 165,52 190,21 100<br />
N03AF03 rufinamide<br />
0458534 INOVELON 200 MG 60 CPR RR DC X 0 0<br />
59,79 0,00 0<br />
0637762 INOVELON 400 MG 200 CPR RR DC X 0 0<br />
375,00 0,00 0<br />
N03AG01 valproic acid<br />
0024937 CONVULEX 300 MG 100 CAPS R<br />
0 0 6,50 12,28 100<br />
0024940 CONVULEX 500 MG 100 CAPS R<br />
0 0 11,20 18,14 100<br />
0029317 DEPAKINE 30% GTTS 60 ML R<br />
0 0 4,47 9,75 100<br />
0196069 DEPAKINE 400 MG PDR 1 FL + S 4 ML IV RR<br />
0 0 5,24 12,28 0<br />
0029320 DEPAKINE 6% SIR 300 ML R<br />
0 0 3,96 9,10 100<br />
0210611 DEPAKINE CHRONO 300 MG 50 CPR R<br />
0 0 3,72 8,80 100<br />
0210686 DEPAKINE CHRONO 500 MG 50 CPR R<br />
0 0 6,25 11,97 100<br />
0029334 DEPAKINE EC 150 MG 100 DRG R<br />
0 0 3,24 8,22 100<br />
0145297 DEPAKINE EC 300 MG 100 CPR R<br />
0 0 4,79 10,14 100<br />
0029348 DEPAKINE EC 500 MG 100 CPR R<br />
0 0 8,37 14,61 100<br />
0447995 VALPROAT RATIO CHRONO 300MG 100CPR BLIST R<br />
0 0 0,00 11,50 0<br />
0447964 VALPROAT RATIO CHRONO 300MG 50CPR BLIST R<br />
0 0 0,00 7,95 0<br />
0448121 VALPROAT RATIO CHRONO 500MG 100CPR BLIST R<br />
0 0 0,00 17,92 0<br />
0448099 VALPROAT RATIO CHRONO 500MG 50CPR BLIST R<br />
0 0 0,00 13,40 0<br />
N03AG04 vigabatrin<br />
0172778 SABRIL 500 MG 100 CPR RR<br />
0 0 46,12 57,20 100<br />
N03AG06 tiagabine<br />
0233937 GABITRIL 10 MG 100 CPR R<br />
0 0 80,18 93,70 100<br />
0233954 GABITRIL 15 MG 100 CPR R<br />
0 0 124,55 140,73 100<br />
0233891 GABITRIL 5 MG 50 CPR R<br />
0 0 29,64 38,87 100<br />
N03AX09 lamotrigine<br />
0390603 LAMBIPOL 100 MG 60 CPR DISP RR<br />
0 0 31,10 40,66 80<br />
0390651 LAMBIPOL 200 MG 60 CPR DISP RR<br />
0 0 62,19 74,81 80<br />
0390519 LAMBIPOL 25 MG 60 CPR DISP RR<br />
0 0 9,72 16,30 80<br />
0390553 LAMBIPOL 50 MG 60 CPR DISP RR<br />
0 0 15,56 23,53 80<br />
0390522 LAMBIPOL STARTER PACK 25 MG 42 CPR DISP RR<br />
0 0 6,81 12,66 80<br />
0218765 LAMICTAL 100 MG 90 CPR DISP R<br />
0 0 33,50 43,29 100<br />
0312543 LAMICTAL 2 MG 30 CPR DISP R<br />
0 0 1,90 6,60 100<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0228887 LAMICTAL 200 MG 30 CPR DISP R<br />
0 0 26,17 35,22 100<br />
0218751 LAMICTAL 25 MG 30 CPR DISP R<br />
0 0 4,09 9,27 100<br />
0511824 LAMICTAL 25 MG STARTERPACK ADD-ON 21 CPR R<br />
0 0 2,86 7,73 100<br />
0511838 LAMICTAL 25 MG STARTERPACK MONO 42 CPR R<br />
0 0 5,73 11,32 100<br />
0218748 LAMICTAL 5 MG 30 CPR DISP R<br />
0 0 1,90 6,60 100<br />
0229285 LAMICTAL 50 MG 90 CPR DISP R<br />
0 0 19,63 28,02 100<br />
0511841 LAMICTAL 50 MG STARTERPACK ADD-ON 42 CPR R<br />
0 0 9,17 15,61 100<br />
0407826 LAMOTRIGIN CT 100 MG 100 CPR RR<br />
0 0 14,69 26,18 100<br />
0407776 LAMOTRIGIN CT 100 MG 50 CPR RR<br />
0 0 8,46 15,13 100<br />
0408001 LAMOTRIGIN CT 200 MG 100 CPR RR<br />
0 0 25,65 45,71 100<br />
0407437 LAMOTRIGIN CT 25 MG 50 CPR RR<br />
0 0 5,70 10,17 100<br />
0407258 LAMOTRIGIN CT 5 MG 50 CPR RR<br />
0 0 0,00 10,50 0<br />
0407651 LAMOTRIGIN CT 50 MG 100 CPR RR<br />
0 0 9,54 17,00 100<br />
0407602 LAMOTRIGIN CT 50 MG 50 CPR RR<br />
0 0 6,64 11,83 100<br />
0424411 LAMOTRIGINE EG DISP 100 MG 90 CPR RR<br />
0 0 39,40 49,80 0<br />
0424617 LAMOTRIGINE EG DISP 25 MG 30 CPR RR<br />
0 0 4,81 10,16 0<br />
0424536 LAMOTRIGINE EG DISP 50 MG 90 CPR RR<br />
0 0 23,10 31,85 0<br />
N03AX10 felbamate<br />
0219485 TALOXA 600 MG/5 ML SIR 230 ML RR<br />
0 0 45,59 56,61 100<br />
0218992 TALOXA TABS 600 MG 100 CPR RR<br />
0 0 91,17 105,53 100<br />
N03AX11 topiramate<br />
0242497 TOPAMAX 100 MG 60 CPR 140602 R<br />
0 0 26,38 35,46 80<br />
0273221 TOPAMAX 15 MG 60 CAPS 140381 R<br />
0 0 5,69 11,26 80<br />
0273235 TOPAMAX 25 MG 60 CAPS 140379 R<br />
0 0 10,06 16,71 80<br />
0242404 TOPAMAX 25 MG 60 CPR 140600 R<br />
0 0 10,06 16,71 80<br />
0273249 TOPAMAX 50 MG 60 CAPS 140380 R<br />
0 0 16,59 24,67 80<br />
0242449 TOPAMAX 50 MG 60 CPR 140601 R<br />
0 0 16,59 24,67 80<br />
N03AX12 gabapentin<br />
0402377 GABAPENTINE EG 100 MG 90 CAPS RR<br />
0 0 6,12 11,81 0<br />
0402718 GABAPENTINE EG 300 MG 90 CAPS RR<br />
0 0 13,98 21,60 0<br />
0403049 GABAPENTINE EG 400 MG 90 CAPS RR<br />
0 0 18,79 26,97 0<br />
0234501 NEURONTIN 100 MG 90 CAPS R<br />
0 0 6,18 11,87 80<br />
0234481 NEURONTIN 300 MG 90 CAPS R<br />
0 0 14,12 21,78 80<br />
0234464 NEURONTIN 400 MG 90 CAPS R<br />
0 0 18,79 27,09 80<br />
0296128 NEURONTIN 600 MG 90 CPR R<br />
0 0 28,95 38,28 80<br />
0296159 NEURONTIN 800 MG 90 CPR RR<br />
0 0 38,25 48,54 80<br />
N03AX14 levetiracetam<br />
0525363 KEPPRA 100 MG/ML 1 FL 150 ML + SRG 1 ML RR<br />
0 0 14,91 22,77 100<br />
0525346 KEPPRA 100 MG/ML 1 FL 150 ML + SRG 3 ML RR<br />
0 0 14,91 22,77 100<br />
0341688 KEPPRA 100 MG/ML 1 FL 300 ML + SRG RR<br />
0 0 28,00 37,24 100<br />
0433955 KEPPRA 100 MG/ML PERF 10 FL 5 ML RR H<br />
0 0 62,58 0,00 0<br />
0288482 KEPPRA 1000 MG 100 CPR RR<br />
0 0 93,35 107,83 100<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0288272 KEPPRA 250 MG 100 CPR RR<br />
0 0 23,34 32,10 100<br />
0288353 KEPPRA 500 MG 100 CPR RR<br />
0 0 46,68 57,82 100<br />
0289963 KEPPRA 500 MG 20 CPR RR<br />
0 0 27,35 38,08 0<br />
0290091 KEPPRA 750 MG 100 CPR RR<br />
0 0 70,01 83,09 100<br />
0648511 LEVETIRACETAM SDZ 100 MG/ML BUV 300 ML RR<br />
0 0 33,75 43,58 0<br />
N03AX15 zonisamide<br />
0434272 ZONEGRAN 100 MG 56 CAPS RR<br />
0 0 68,12 81,94 100<br />
0434336 ZONEGRAN 100 MG 98 CAPS RR<br />
0 0 119,23 136,37 100<br />
0434305 ZONEGRAN 25 MG 28 CAPS RR<br />
0 0 12,26 21,06 100<br />
0434319 ZONEGRAN 50 MG 28 CAPS RR<br />
0 0 20,44 30,96 100<br />
N03AX16 pregabalin<br />
0379296 LYRICA 150 MG 100 CAPS UD RR<br />
0 0 106,76 0,00 0<br />
0377811 LYRICA 150 MG 14 CAPS RR<br />
0 0 20,69 31,21 0<br />
0377825 LYRICA 150 MG 56 CAPS RR<br />
0 0 68,99 82,01 80<br />
0379363 LYRICA 300 MG 100 CAPS UD RR<br />
0 0 159,78 0,00 0<br />
0377887 LYRICA 300 MG 14 CAPS RR<br />
0 0 33,18 44,09 0<br />
0377891 LYRICA 300 MG 56 CAPS RR<br />
0 0 106,10 121,36 80<br />
0379234 LYRICA 75 MG 100 CAPS UD RR<br />
0 0 72,01 0,00 0<br />
0377758 LYRICA 75 MG 14 CAPS RR<br />
0 0 0,00 18,78 0<br />
0377761 LYRICA 75 MG 56 CAPS RR<br />
0 0 38,31 48,59 80<br />
N03AX18 lacosamide<br />
0493601 VIMPAT 100 MG 56 CPR RR<br />
0 0 71,40 84,39 100<br />
0493709 VIMPAT 15 MG/ML SIR 200 ML RR<br />
0 0 38,25 48,36 100<br />
0493631 VIMPAT 150 MG 56 CPR RR<br />
0 0 107,10 122,24 100<br />
0493662 VIMPAT 200 MG 56 CPR RR<br />
0 0 142,80 160,07 100<br />
0493502<br />
N03AX21<br />
VIMPAT 50 MG 56 CPR RR<br />
0 0 35,70 45,54 100<br />
0607361 TROBALT 100 MG 84 CPR RR<br />
RM 0 0<br />
35,01 44,96 100<br />
0607388 TROBALT 200 MG 84 CPR RR<br />
RM 0 0<br />
70,02 83,10 100<br />
0607407 TROBALT 300 MG 84 CPR RR<br />
RM 0 0<br />
105,03 120,21 100<br />
0607424 TROBALT 400 MG 84 CPR RR<br />
RM 0 0<br />
140,04 157,31 100<br />
0607312 TROBALT 50 MG 21 CPR RR<br />
RM 0 0<br />
4,38 9,63 100<br />
0607441 TROBALT 50 MG 21 CPR + 100 MG 42 CPR RR<br />
RM 0 0<br />
21,88 30,50 100<br />
0607326 TROBALT 50 MG 84 CPR RR<br />
RM 0 0<br />
17,50 25,68 100<br />
N04AA01 trihexyphenidyl<br />
0007886 ARTANE 2 MG 50 CPR R<br />
0 0 1,53 6,20 100<br />
0007919 ARTANE 5 MG 50 CPR R<br />
0 0 3,10 8,05 100<br />
N04AA02 biperiden<br />
0205462 AKINETON 2 MG 60 CPR R<br />
0 0 3,14 12,52 100<br />
N04AA04 procyclidine<br />
Page 166 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0061913 KEMADRIN 5 MG 100 CPR R<br />
0 0 3,01 7,92 100<br />
N04BA02 levodopa and decarboxylase inhibitor<br />
0416176 DUODOPA 20/5 MG/ML GEL 7 SACH 100 ML RR DC X 0 0<br />
763,72 0,00 0<br />
0094461 PROLOPA 125 MG 100 CAPS R<br />
0 0 7,51 13,54 100<br />
0094489 PROLOPA 250 MG 100 CPR SEC R<br />
0 0 12,85 20,20 100<br />
0094475 PROLOPA 250 MG 30 CPR SEC R<br />
0 0 4,51 9,79 100<br />
0235962 PROLOPA DISP 125 MG 100 CPR SEC R<br />
0 0 7,51 13,54 100<br />
0166771 PROLOPA HBS 125 MG 100 CAPS R<br />
0 0 7,51 13,54 100<br />
N04BB01 amantadine<br />
0171199 PK MERZ 100 FILMTABL RR<br />
0 0 7,94 17,78 100<br />
0091215 PK MERZ INFUSIONSLSG 10*500 ML RR<br />
0 0 151,98 175,40 100<br />
0380476 PK MERZ INFUSIONSLSG 2*500 ML RR<br />
0 0 31,44 43,49 0<br />
0218359 PK MERZ INFUSIONSLSG 500 ML RR<br />
0 0 15,72 21,73 100<br />
N04BC01 bromocriptine<br />
0086439 PRAVIDEL 10 MG 100 CAPS RR<br />
0 0 188,90 219,40 100<br />
0086425 PRAVIDEL 10 MG 30 CAPS RR<br />
0 0 58,98 74,21 100<br />
0086442 PRAVIDEL 5 MG 100 CAPS RR<br />
0 0 88,45 107,14 100<br />
N04BC04 ropinirole<br />
0229108 REQUIP 1 MG 84 CPR R<br />
0 0 17,12 25,25 100<br />
0229559 REQUIP 2 MG 84 CPR R<br />
0 0 27,28 36,45 100<br />
0229111 REQUIP 5 MG 84 CPR R<br />
0 0 62,18 74,80 100<br />
0483084 REQUIP MODUTAB 2 MG 28 CPR R<br />
0 0 9,10 15,52 100<br />
0483148 REQUIP MODUTAB 4 MG 84 CPR R<br />
0 0 49,74 61,18 100<br />
0483067 REQUIP MODUTAB 8 MG 84 CPR R<br />
0 0 99,49 114,34 100<br />
N04BC05 pramipexole<br />
0248196 MIRAPEXIN 0,18 MG 30 CPR RR<br />
0 0 10,21 16,90 100<br />
0248215 MIRAPEXIN 0,7 MG 100 CPR RR<br />
0 0 80,20 93,90 100<br />
0529183 MIRAPEXIN LP 0,26 MG 30 CPR RR<br />
0 0 13,99 21,61 100<br />
0529264 MIRAPEXIN LP 1,05 MG 100 CPR RR<br />
0 0 112,04 127,64 100<br />
0529251 MIRAPEXIN LP 1,05 MG 30 CPR RR<br />
0 0 47,75 58,99 100<br />
0529295 MIRAPEXIN LP 2,10 MG 100 CPR RR<br />
0 0 214,33 236,05 100<br />
0529281 MIRAPEXIN LP 2,10 MG 30 CPR RR<br />
0 0 86,48 100,55 100<br />
0529328 MIRAPEXIN LP 3,15 MG 100 CPR RR<br />
0 0 316,63 344,49 100<br />
0564151 PRAMIPEXOL RATIO 0,18 MG 100 CPR RR<br />
0 0 16,60 28,98 80<br />
0564134 PRAMIPEXOL RATIO 0,18 MG 30 CPR RR<br />
0 0 7,27 12,70 80<br />
0564277 PRAMIPEXOL RATIO 0,7 MG 100 CPR RR<br />
0 0 42,97 75,02 80<br />
N04BC08 piribedil<br />
0170997 TRIVASTAL L.P. 50 MG 30 CPR R<br />
0 0 0,00 13,53 0<br />
N04BC09 rotigotine<br />
0493323 NEUPRO 1 MG/24 H 2,25 MG 28 PATCH RR<br />
0 0 121,37 143,73 0<br />
Page 167 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0493291 NEUPRO 1 MG/24 H 2,25 MG 7 PATCH RR<br />
0 0 30,69 42,58 0<br />
0431111 NEUPRO 2 MG/24 H 4,5 MG 28 PATCH RR<br />
0 0 147,08 172,41 0<br />
0431107 NEUPRO 2 MG/24 H 4,5 MG 7 PATCH RR<br />
0 0 36,96 49,59 0<br />
0493418 NEUPRO 3 MG/24 H 7,75 MG 28 PATCH RR<br />
0 0 173,42 201,81 0<br />
0493399 NEUPRO 3 MG/24 H 7,75 MG 7 PATCH RR<br />
0 0 43,85 57,26 0<br />
0431155 NEUPRO 4 MG/24 H 9 MG 100 PATCH RR<br />
0 0 0,00 734,72 0<br />
0431141 NEUPRO 4 MG/24 H 9 MG 28 PATCH RR<br />
0 0 199,28 230,66 0<br />
0431138 NEUPRO 4 MG/24 H 9 MG 7 PATCH RR<br />
0 0 50,39 64,55 0<br />
0431172 NEUPRO 6 MG/24 H 13,5 MG 28 PATCH RR<br />
0 0 228,05 262,74 0<br />
0431169 NEUPRO 6 MG/24 H 13,5 MG 7 PATCH RR<br />
0 0 57,62 72,63 0<br />
0431219 NEUPRO 8 MG/24 H 18 MG 28 PATCH RR<br />
0 0 252,50 290,02 0<br />
0431205 NEUPRO 8 MG/24 H 18 MG 7 PATCH RR<br />
0 0 63,89 79,62 0<br />
N04BD01 selegiline<br />
0300699 ELDEPRYL 10 MG 30 CPR R<br />
0 0 35,85 45,88 100<br />
0237709 ELDEPRYL 5 MG 100 CPR R<br />
0 0 0,00 86,47 100<br />
0237693 ELDEPRYL 5 MG 30 CPR R<br />
0 0 0,00 31,36 100<br />
0237791 ELDEPRYL 5 MG 60 CPR R<br />
0 0 35,85 45,88 100<br />
N04BD02 rasagiline<br />
0396561 AZILECT 1 MG 28 CPR RR<br />
0 0 83,56 97,46 100<br />
N04BX01 tolcapone<br />
0240878 TASMAR 100 MG 100 CPR RR C<br />
0 0 122,53 138,57 100<br />
0240851 TASMAR 100 MG 30 CPR RR C<br />
0 0 33,34 44,25 0<br />
0240901 TASMAR 200 MG 100 CPR RR C<br />
0 0 171,52 186,56 0<br />
0240881 TASMAR 200 MG 30 CPR RR C<br />
0 0 52,73 64,22 0<br />
N04BX02 entacapone<br />
0255657 COMTAN 200 MG 100 CPR (FL) RR<br />
0 0 80,56 94,28 100<br />
N05AA02 levomepromazine<br />
0080712 NOZINAN 100 MG 20 CPR R<br />
0 0 2,31 7,05 80<br />
0080743 NOZINAN 25 MG 20 CPR R<br />
0 0 0,90 5,51 80<br />
0080760 NOZINAN 4% GTTS 30 ML R<br />
0 0 1,37 6,02 80<br />
N05AD01 haloperidol<br />
0051786 HALDOL 10 MG/ML GTTS 30 ML 38114 RR<br />
0 0 10,40 17,14 80<br />
0051724 HALDOL 2 MG 25 CPR 38109 RR<br />
0 0 2,13 6,86 80<br />
0051738 HALDOL 2 MG 250 CPR RR<br />
0 0 19,23 0,00 0<br />
0051805 HALDOL 2 MG/ML GTTS 15 ML 17449 RR<br />
0 0 1,11 5,74 80<br />
0051819 HALDOL 2 MG/ML GTTS 30 ML 17454 RR<br />
0 0 2,23 6,97 80<br />
0051755 HALDOL 20 MG 100 CPR RR<br />
0 0 64,44 0,00 0<br />
0051741 HALDOL 20 MG 20 CPR 38112 RR<br />
0 0 14,30 22,00 80<br />
0051769 HALDOL 5 MG 25 CPR 17455 RR<br />
0 0 4,92 10,31 80<br />
0051772 HALDOL 5 MG 250 CPR RR<br />
0 0 44,32 0,00 0<br />
0051853 HALDOL 5 MG 5 AMP 1 ML IMIV 17448 RR<br />
0 0 2,55 7,35 80<br />
Page 168 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0051870 HALDOL DEC 100 MG 1 AMP 1 ML 30135 RR<br />
0 0 8,67 14,97 80<br />
0051898 HALDOL DEC 150 MG 1 AMP 3 ML 22952 RR<br />
0 0 12,94 20,30 80<br />
0051917 HALDOL DEC 50 MG 1 AMP 1 ML 22951 RR<br />
0 0 5,41 10,92 80<br />
N05AD03 melperone<br />
0259271 BURONIL 25 MG 50 DRG RR<br />
0 0 2,70 4,64 80<br />
N05AD05 pipamperone<br />
0033290 DIPIPERON 4% GTTS 60 ML 17425 RR<br />
0 0 3,10 8,05 80<br />
0033256 DIPIPERON 40 MG 20 CPR 17421 RR<br />
0 0 1,38 6,03 80<br />
0033273 DIPIPERON 40 MG 60 CPR 17424 RR<br />
0 0 3,34 8,34 80<br />
N05AD06 bromperidol<br />
0056362 IMPROMEN 0,2% GTTS 30 ML 22890 RR<br />
0 0 3,33 8,32 80<br />
N05AD07 benperidol<br />
0046688 FRENACTIL GTTS 15 ML 17438 RR<br />
0 0 1,16 5,80 80<br />
0056412 IMPROMEN DEC 50 MG 1 AMP 1 ML 34199 RR<br />
0 0 6,23 11,94 80<br />
0056426 IMPROMEN DECANOAS 50 MG 5 AMP 1 ML IM RR<br />
0 0 24,89 0,00 0<br />
N05AD08 droperidol<br />
0349056 DEHYDROBENZPERIDOL 2,5 MG 10 AMP 1 ML RR<br />
0 0 34,10 45,03 0<br />
0349073 DEHYDROBENZPERIDOL 5 MG 10 AMP 2 ML RR<br />
0 0 39,60 50,69 0<br />
N05AE03 sertindole<br />
0237855 SERDOLECT 12 MG 28 CPR RR C<br />
1 1 96,98 111,68 80<br />
0237869 SERDOLECT 16 MG 28 CPR RR C<br />
1 1 96,98 111,68 80<br />
0237872 SERDOLECT 20 MG 28 CPR RR C<br />
1 1 96,98 111,68 80<br />
0237841 SERDOLECT 4 MG 30 CPR RR C<br />
1 1 25,98 35,02 80<br />
N05AF01 flupentixol<br />
0045386 FLUANXOL 0,5 MG 30 DRG R<br />
0 0 1,21 2,04 80<br />
0045419 FLUANXOL 1 MG 50 DRG R<br />
0 0 2,43 7,20 80<br />
0045422 FLUANXOL 3 MG 50 DRG R<br />
0 0 4,11 9,19 80<br />
0045467 FLUANXOL DEPOT 100 MG 1 AMP 1 ML IM RR<br />
0 0 7,35 13,33 80<br />
0045484 FLUANXOL DEPOT 20 MG 1 AMP 1 ML IM RR<br />
0 0 2,24 6,99 80<br />
N05AF05 zuclopenthixol<br />
0023117 CLOPIXOL 10 MG 100 CPR RR<br />
0 0 7,03 12,92 80<br />
0023098 CLOPIXOL 2 MG 100 CPR RR<br />
0 0 1,78 6,48 80<br />
0023151 CLOPIXOL 2% GTTS 20 ML RR<br />
0 0 4,53 9,81 80<br />
0023134 CLOPIXOL 25 MG 100 CPR RR<br />
0 0 13,83 21,42 80<br />
0165997 CLOPIXOL ACUTARD 50 MG 1 AMP 1 ML IM RR<br />
0 0 0,00 11,06 80<br />
0023179 CLOPIXOL DEPOT 200 MG 1 AMP 1 ML IM RR<br />
0 0 3,22 8,18 80<br />
N05AG01 fluspirilene<br />
0056023 IMAP 12 MG 1 FL 6 ML IM 17463 RR<br />
0 0 8,98 15,37 80<br />
N05AG02 pimozide<br />
Page 169 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0083051 ORAP 1 MG 75 CPR 17495 R<br />
0 0 5,39 10,89 80<br />
0083082 ORAP FORTE 4 MG 20 CPR 17499 R<br />
0 0 5,39 10,89 80<br />
0083096 ORAP FORTE 4 MG 240 CPR R<br />
0 0 58,28 0,00 0<br />
N05AG03 penfluridol<br />
0103669 SEMAP 20 MG 12 CPR 17554 RR<br />
0 0 3,88 8,82 80<br />
N05AH02 clozapine<br />
0212727 LEPONEX 100 MG 20 CPR RR C<br />
0 0 9,15 19,09 80<br />
0212677 LEPONEX 25 MG 20 CPR RR C<br />
0 0 2,50 11,82 80<br />
0212681 LEPONEX 25 MG 50 CPR RR C<br />
0 0 6,12 15,42 80<br />
N05AH03 olanzapine<br />
0655046 FIONAPEL 10 MG 28 CPR ORODIS RR<br />
0 0 54,14 66,04 0<br />
0655077 FIONAPEL 10 MG 56 CPR ORODIS RR<br />
0 0 86,62 100,71 0<br />
0657251 FIONAPEL 10 MG 98 CPR ORODIS RR<br />
0 0 151,58 169,56 0<br />
0654696 FIONAPEL 5 MG 28 CPR ORODIS RR<br />
0 0 27,06 36,21 0<br />
0654729 FIONAPEL 5 MG 56 CPR ORODIS RR<br />
0 0 47,10 58,27 0<br />
0657247 FIONAPEL 5 MG 98 CPR ORODIS RR<br />
0 0 75,77 89,20 0<br />
0635057 OLANZAPIN RATIO 10 MG 35 CPR RR<br />
0 0 45,28 54,64 80<br />
0635061 OLANZAPIN RATIO 10 MG 70 CPR RR<br />
0 0 88,02 102,28 80<br />
0635107 OLANZAPIN RATIO 15 MG 35 CPR RR<br />
0 0 69,28 80,95 80<br />
0635111 OLANZAPIN RATIO 15 MG 70 CPR RR<br />
0 0 132,61 151,08 80<br />
0635155 OLANZAPIN RATIO 2,5 MG 35 CPR RR<br />
0 0 13,12 17,60 0<br />
0635169 OLANZAPIN RATIO 2,5 MG 70 CPR RR<br />
0 0 25,81 31,54 0<br />
0635219 OLANZAPIN RATIO 20 MG 35 CPR RR<br />
0 0 80,50 94,06 80<br />
0635222 OLANZAPIN RATIO 20 MG 70 CPR RR<br />
0 0 146,73 166,32 80<br />
0635271 OLANZAPIN RATIO 5 MG 35 CPR RR<br />
0 0 21,31 26,71 80<br />
0635284 OLANZAPIN RATIO 5 MG 70 CPR RR<br />
0 0 41,08 49,89 80<br />
0635321 OLANZAPIN RATIO 7,5 MG 35 CPR RR<br />
0 0 42,52 52,00 80<br />
0635334 OLANZAPIN RATIO 7,5 MG 70 CPR RR<br />
0 0 66,48 77,88 80<br />
0650036 OLANZAPINE SDZ 10 MG 28 CPR RR<br />
0 0 58,90 71,27 0<br />
0650358 OLANZAPINE SDZ 10 MG 28 FILMS ORODISP RR<br />
0 0 58,90 71,27 0<br />
0650084 OLANZAPINE SDZ 10 MG 56 CPR RR<br />
0 0 116,34 132,20 0<br />
0650392 OLANZAPINE SDZ 10 MG 56 FILMS ORODISP RR<br />
0 0 94,24 108,78 0<br />
0650117 OLANZAPINE SDZ 10 MG 98 CPR RR<br />
0 0 164,91 183,68 0<br />
0650425 OLANZAPINE SDZ 10 MG 98 FILMS ORODISP RR<br />
0 0 164,91 183,68 0<br />
0650506 OLANZAPINE SDZ 15 MG 28 FILMS ORODISP RR<br />
0 0 88,35 102,53 0<br />
0650554 OLANZAPINE SDZ 15 MG 56 FILMS ORODISP RR<br />
0 0 141,35 158,70 0<br />
0650585 OLANZAPINE SDZ 15 MG 98 FILMS ORODISP RR<br />
0 0 247,36 271,06 0<br />
0650652 OLANZAPINE SDZ 20 MG 28 FILMS ORODISP RR<br />
0 0 117,79 133,73 0<br />
0650702 OLANZAPINE SDZ 20 MG 56 FILMS ORODISP RR<br />
0 0 188,47 208,64 0<br />
0650747 OLANZAPINE SDZ 20 MG 98 FILMS ORODISP RR<br />
0 0 329,82 358,46 0<br />
0649729 OLANZAPINE SDZ 5 MG 28 CPR RR<br />
0 0 29,44 38,83 0<br />
0650196 OLANZAPINE SDZ 5 MG 28 FILMS ORODISP RR<br />
0 0 29,44 38,83 0<br />
Page 170 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0649777 OLANZAPINE SDZ 5 MG 56 CPR RR<br />
0 0 47,10 58,27 0<br />
0650232 OLANZAPINE SDZ 5 MG 56 FILMS ORODISP RR<br />
0 0 47,10 58,27 0<br />
0649813 OLANZAPINE SDZ 5 MG 98 CPR RR<br />
0 0 82,43 96,26 0<br />
0650277 OLANZAPINE SDZ 5 MG 98 FILMS ORODISP RR<br />
0 0 82,43 96,26 0<br />
0649925 OLANZAPINE SDZ 7,5 MG 56 CPR RR<br />
0 0 84,14 98,07 0<br />
0649956 OLANZAPINE SDZ 7,5 MG 98 CPR RR<br />
0 0 147,24 164,96 0<br />
0502243 ZYPADHERA 210 MG PDR 1 FL + S 3 ML IM RR HC<br />
RM 0 0<br />
125,07 0,00 0<br />
0502257 ZYPADHERA 300 MG PDR 1 FL + S 3 ML IM RR HC<br />
RM 0 0<br />
182,64 0,00 0<br />
0502261 ZYPADHERA 405 MG PDR 1 FL + S 3 ML IM RR HC<br />
RM 0 0<br />
250,14 0,00 0<br />
0319267 ZYPREXA 10 MG 1 FL IM RR<br />
0 0 3,50 8,42 0<br />
0319271 ZYPREXA 10 MG 10 FL IM RR<br />
0 0 4,22 9,31 0<br />
0226462 ZYPREXA 10 MG 28 CPR RR<br />
0 0 54,14 65,92 80<br />
0585439 ZYPREXA 10 MG 70 CPR RR<br />
0 0 117,79 133,62 80<br />
0585442 ZYPREXA 10 MG 98 CPR RR<br />
0 0 151,58 169,44 80<br />
0226414 ZYPREXA 5 MG 28 CPR RR<br />
0 0 27,06 36,09 80<br />
0585411 ZYPREXA 5 MG 70 CPR RR<br />
0 0 58,87 71,13 80<br />
0585425 ZYPREXA 5 MG 98 CPR RR<br />
0 0 75,77 89,09 80<br />
0226431 ZYPREXA 7,5 MG 56 CPR RR<br />
0 0 77,34 90,76 80<br />
0277251 ZYPREXA VELOTAB 10 MG 28 CPR DISP RR<br />
0 0 54,14 65,92 80<br />
0459156 ZYPREXA VELOTAB 10 MG 70 CPR DISP RR<br />
0 0 117,79 133,62 80<br />
0585408 ZYPREXA VELOTAB 10 MG 98 CPR DISP RR<br />
0 0 151,58 169,44 80<br />
0277265 ZYPREXA VELOTAB 15 MG 28 CPR DISP RR<br />
0 0 158,01 176,25 0<br />
0277279 ZYPREXA VELOTAB 20 MG 28 CPR DISP RR<br />
0 0 210,68 232,08 0<br />
0277248 ZYPREXA VELOTAB 5 MG 28 CPR DISP RR<br />
0 0 27,06 36,09 80<br />
0459139 ZYPREXA VELOTAB 5 MG 70 CPR DISP RR<br />
0 0 58,87 71,13 80<br />
0585392 ZYPREXA VELOTAB 5 MG 98 CPR DISP RR<br />
0 0 75,77 89,09 80<br />
N05AH04 quetiapine<br />
0653525 QUETIAPINE SDZ 100 MG 100 CPR RR<br />
0 0 38,15 48,42 0<br />
0653489 QUETIAPINE SDZ 100 MG 30 CPR RR<br />
0 0 14,28 21,97 0<br />
0653508 QUETIAPINE SDZ 100 MG 60 CPR RR<br />
0 0 28,62 37,93 0<br />
0653993 QUETIAPINE SDZ 200 MG 100 CPR RR<br />
0 0 76,31 89,78 0<br />
0653945 QUETIAPINE SDZ 200 MG 30 CPR RR<br />
0 0 28,60 37,91 0<br />
0653962 QUETIAPINE SDZ 200 MG 60 CPR RR<br />
0 0 57,23 69,45 0<br />
0654519 QUETIAPINE SDZ 300 MG 100 CPR RR<br />
0 0 111,60 127,19 0<br />
0654097 QUETIAPINE SDZ 300 MG 30 CPR RR<br />
0 0 41,83 52,48 0<br />
0654116 QUETIAPINE SDZ 300 MG 60 CPR RR<br />
0 0 83,70 97,62 0<br />
0272949 SEROQUEL 100 MG 100 CPR RR<br />
0 0 38,16 48,43 80<br />
0277542 SEROQUEL 100 MG 60 CPR RR<br />
0 0 28,62 37,93 80<br />
0635012 SEROQUEL 200 MG 100 CPR RR<br />
0 0 76,31 89,78 80<br />
0277556 SEROQUEL 200 MG 60 CPR RR<br />
0 0 57,23 69,45 80<br />
0274795 SEROQUEL 200 MG 60 CPR UD RR<br />
0 0 102,40 0,00 0<br />
0274747 SEROQUEL 25 MG 6 CPR RR<br />
0 0 0,00 6,17 0<br />
0274751 SEROQUEL 25 MG 60 CPR UD RR<br />
0 0 28,71 0,00 0<br />
Page 171 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0323841 SEROQUEL 300 MG 100 CPR RR<br />
0 0 114,46 130,20 80<br />
0323824 SEROQUEL 300 MG 60 CPR RR<br />
0 0 83,70 97,62 80<br />
0323886 SEROQUEL 300 MG 60 CPR UD RR<br />
0 0 149,76 0,00 0<br />
0479565 SEROQUEL XR 200 MG 100 CPR RR<br />
0 0 136,53 153,60 80<br />
0479551 SEROQUEL XR 200 MG 60 CPR RR<br />
0 0 102,40 117,42 80<br />
0479615 SEROQUEL XR 300 MG 100 CPR RR<br />
0 0 204,80 225,96 80<br />
0479601 SEROQUEL XR 300 MG 60 CPR RR<br />
0 0 149,76 167,62 80<br />
0479677 SEROQUEL XR 400 MG 100 CPR RR<br />
0 0 273,06 298,31 80<br />
0479663 SEROQUEL XR 400 MG 60 CPR RR<br />
0 0 204,79 225,95 80<br />
0479471 SEROQUEL XR 50 MG 10 CPR RR<br />
0 0 11,96 19,07 0<br />
0482686 SEROQUEL XR 50 MG 100 CPR UD RR<br />
0 0 119,60 0,00 0<br />
N05AH05 asenapine<br />
0598423 SYCREST 10 MG 100 CPR SL RR<br />
0 0 150,00 167,75 0<br />
0598406 SYCREST 10 MG 60 CPR SL RR<br />
0 0 81,31 95,07 0<br />
0598387 SYCREST 5 MG 100 CPR SL RR<br />
0 0 150,00 167,75 0<br />
0598373 SYCREST 5 MG 60 CPR SL RR<br />
0 0 81,31 95,07 0<br />
N05AL01 sulpiride<br />
0034379 DOGMATIL 100 MG 6 AMP 2 ML IM R<br />
0 0 1,99 6,70 80<br />
0034365 DOGMATIL 25 MG/5 ML SIR 200 ML R<br />
0 0 3,31 5,67 80<br />
0034351 DOGMATIL 50 MG 30 CAPS R<br />
0 0 4,91 8,41 80<br />
0034348 DOGMATIL FORTE 200 MG 12 CPR R<br />
0 0 4,69 10,01 80<br />
0180704 MERESA FORTE 200 MG 100 CPR R<br />
0 0 19,89 30,86 80<br />
0071114 MERESA FORTE 200 MG 20 CPR R<br />
0 0 4,59 14,10 80<br />
0071128 MERESA FORTE 200 MG 50 CPR R<br />
0 0 10,73 20,83 80<br />
0502789 MERESASUL 50 MG 100 CAPS R<br />
0 0 6,31 16,00 80<br />
0502792 MERESASUL 50 MG 20 CAPS R<br />
0 0 1,45 10,68 80<br />
0502808 MERESASUL 50 MG 50 CAPS R<br />
0 0 3,30 12,69 80<br />
0134603 SULPIRIDE EG 200 MG 12 CPR R<br />
0 0 2,38 7,14 80<br />
N05AL03 tiapride<br />
0116748 TIAPRIDAL 100 MG 12 AMP 2 ML IMIV RR<br />
0 0 2,66 7,38 80<br />
0116720 TIAPRIDAL 100 MG 20 CPR R<br />
0 0 4,14 9,33 80<br />
0116734 TIAPRIDAL 100 MG 60 CPR R<br />
0 0 9,92 16,54 80<br />
0233002 TIAPRIDAL GTTS 30 ML R<br />
0 0 7,76 13,85 80<br />
N05AL05 amisulpride<br />
0335985 SOLIAN 100 MG 60 CPR R<br />
0 0 26,77 35,88 80<br />
0446291 SOLIAN 100 MG/ML GTTS 60 ML R<br />
0 0 26,77 35,88 0<br />
0265846 SOLIAN 200 MG 120 CPR R<br />
0 0 94,18 108,71 80<br />
0265832 SOLIAN 200 MG 30 CPR R<br />
0 0 26,77 35,88 80<br />
0336031 SOLIAN 400 MG 60 CPR R<br />
0 0 94,18 108,71 80<br />
0265863 SOLIAN 50 MG 30 CPR R<br />
0 0 6,53 12,31 80<br />
N05AN01 lithium<br />
Page 172 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0140726 CAMCOLIT 400 MG 100 CPR RR<br />
0 0 5,03 8,64 80<br />
0069438 MANIPREX 250 MG 100 DRG RR<br />
0 0 5,35 10,83 80<br />
0093478 PRIADEL 100 CPR RR<br />
0 0 6,18 10,62 80<br />
N05AX07 prothipendyl<br />
0035331 DOMINAL 40 MG 20 DRG RR<br />
0 0 2,35 6,99 80<br />
0035359 DOMINAL FORTE 80 MG 50 CPR RR<br />
0 0 5,16 10,60 80<br />
N05AX08 risperidone<br />
0439895 RISPERDAL 1 MG 100 CPR RR<br />
0 0 25,63 34,63 80<br />
0471181 RISPERDAL 1 MG 100 CPR UD RR<br />
0 0 25,63 0,00 0<br />
0439864 RISPERDAL 1 MG 20 CPR RR<br />
0 0 5,74 11,33 80<br />
0204434 RISPERDAL 1 MG 6 CPR 72249 RR<br />
0 0 1,73 6,41 80<br />
0245616 RISPERDAL 1 MG 60 CPR 63122 RR<br />
0 0 15,38 23,34 80<br />
0238916 RISPERDAL 1 MG/ML GTTS 100 ML 87530 RR<br />
0 0 25,63 34,63 80<br />
0306322 RISPERDAL 1 MG/ML GTTS 30 ML 96471 RR<br />
0 0 8,65 14,95 80<br />
0439945 RISPERDAL 2 MG 100 CPR RR<br />
0 0 51,26 62,86 80<br />
0471151 RISPERDAL 2 MG 100 CPR UD RR<br />
0 0 51,26 0,00 0<br />
0204448 RISPERDAL 2 MG 20 CPR 82196 RR<br />
0 0 11,54 18,56 80<br />
0204451 RISPERDAL 2 MG 60 CPR 63125 RR<br />
0 0 30,76 40,29 80<br />
0440008 RISPERDAL 3 MG 100 CPR RR<br />
0 0 76,89 90,39 80<br />
0471164 RISPERDAL 3 MG 100 CPR UD RR<br />
0 0 76,89 0,00 0<br />
0204479 RISPERDAL 3 MG 20 CPR 82197 RR<br />
0 0 17,08 25,22 80<br />
0204482 RISPERDAL 3 MG 60 CPR 63128 RR<br />
0 0 46,13 57,21 80<br />
0440056 RISPERDAL 4 MG 100 CPR RR<br />
0 0 102,50 117,53 80<br />
0471178 RISPERDAL 4 MG 100 CPR UD RR<br />
0 0 102,50 0,00 0<br />
0204515 RISPERDAL 4 MG 60 CPR RR<br />
0 0 61,50 74,08 80<br />
0440137 RISPERDAL 6 MG 60 CPR RR<br />
0 0 92,27 106,68 80<br />
0360425 RISPERDAL CONSTA 25 MG PDR 1 FL + S IM RR<br />
0 0 91,83 106,23 80<br />
0360439 RISPERDAL CONSTA 37,5 MG PDR 1 FL + S IM RR<br />
0 0 123,98 140,29 80<br />
0360442 RISPERDAL CONSTA 50 MG PDR 1 FL + S IM RR<br />
0 0 146,94 164,63 80<br />
0347213 RISPERDAL INSTASOLV 1 MG 28 CPR RR<br />
0 0 9,28 15,74 80<br />
0347231 RISPERDAL INSTASOLV 2 MG 28 CPR RR<br />
0 0 18,52 26,80 80<br />
0588847 RISPERIDON RATIO 0,25 MG 20 CPR RR<br />
0 0 4,36 7,77 0<br />
0589004 RISPERIDON RATIO 0,5 MG 100 CPR RR<br />
0 0 13,33 23,76 0<br />
0588959 RISPERIDON RATIO 0,5 MG 20 CPR RR<br />
0 0 4,60 8,20 0<br />
0588976 RISPERIDON RATIO 0,5 MG 50 CPR RR<br />
0 0 8,88 15,82 0<br />
0430578 RISPERIDON RATIO 1 MG 100 CPR RR<br />
0 0 15,73 28,03 0<br />
0430502 RISPERIDON RATIO 1 MG 20 CPR RR<br />
0 0 5,04 8,98 0<br />
0430547 RISPERIDON RATIO 1 MG 50 CPR RR<br />
0 0 10,51 18,73 0<br />
0430551 RISPERIDON RATIO 1 MG 60 CPR RR<br />
0 0 10,48 20,71 0<br />
0571075 RISPERIDON RATIO 1 MG/ML SOL BUCC 100 ML RR<br />
0 0 16,69 29,75 0<br />
0571058 RISPERIDON RATIO 1 MG/ML SOL BUCC 30 ML RR<br />
0 0 7,43 13,25 0<br />
0430757 RISPERIDON RATIO 2 MG 100 CPR RR<br />
0 0 28,78 51,29 0<br />
0430676 RISPERIDON RATIO 2 MG 20 CPR RR<br />
0 0 8,38 14,94 0<br />
Page 173 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0430712 RISPERIDON RATIO 2 MG 50 CPR RR<br />
0 0 18,34 32,68 0<br />
0430726 RISPERIDON RATIO 2 MG 60 CPR RR<br />
0 0 24,42 35,88 0<br />
0430922 RISPERIDON RATIO 3 MG 100 CPR RR<br />
0 0 41,41 0,00 0<br />
0430855 RISPERIDON RATIO 3 MG 20 CPR RR<br />
0 0 11,37 20,27 0<br />
0430886 RISPERIDON RATIO 3 MG 50 CPR RR<br />
0 0 26,11 46,53 0<br />
0430905 RISPERIDON RATIO 3 MG 60 CPR RR<br />
0 0 38,38 51,08 0<br />
0589133 RISPERIDON RATIO 4 MG 100 CPR RR<br />
0 0 53,96 96,18 0<br />
0589083 RISPERIDON RATIO 4 MG 20 CPR RR<br />
0 0 16,03 28,57 0<br />
0589102 RISPERIDON RATIO 4 MG 50 CPR RR<br />
0 0 34,07 60,73 0<br />
0589245 RISPERIDON RATIO 6 MG 100 CPR RR<br />
0 0 93,41 166,48 0<br />
0589201 RISPERIDON RATIO 6 MG 20 CPR RR<br />
0 0 21,38 38,10 0<br />
0589228 RISPERIDON RATIO 6 MG 50 CPR RR<br />
0 0 47,91 85,39 0<br />
N05AX12 aripiprazole<br />
0375882 ABILIFY 10 MG 28 CPR RR<br />
0 0 103,17 118,25 80<br />
0375932 ABILIFY 15 MG 28 CPR RR<br />
0 0 103,17 118,25 80<br />
0375994 ABILIFY 30 MG 28 CPR RR<br />
0 0 120,74 136,86 80<br />
0375834 ABILIFY 5 MG 28 CPR BLIST RR<br />
0 0 103,17 119,27 0<br />
0482091 ABILIFY 7,5 MG/ML 1 FL 1,3 ML RR<br />
0 0 3,65 8,73 0<br />
N05AX13 paliperidone<br />
0462747 INVEGA 3 MG 28 CPR RR<br />
0 0 86,00 100,05 80<br />
0462778 INVEGA 3 MG 56 CPR RR<br />
0 0 172,00 191,19 80<br />
0462814 INVEGA 6 MG 28 CPR RR<br />
0 0 93,01 107,47 80<br />
0462845 INVEGA 6 MG 56 CPR RR<br />
0 0 186,00 206,03 80<br />
0462893 INVEGA 9 MG 28 CPR RR<br />
0 0 93,01 107,47 80<br />
0462926 INVEGA 9 MG 56 CPR RR<br />
0 0 186,00 206,03 80<br />
0601269 XEPLION 100 MG 1 SRG + 2 AIG RR<br />
0 0 336,03 365,04 80<br />
0601272 XEPLION 150 MG 1 SRG + 2 AIG RR<br />
0 0 489,64 527,86 80<br />
0601286 XEPLION 150/100 MG 1SRG+2AIG+1SRG+2AIG RR<br />
0 0 825,67 884,00 80<br />
0601238 XEPLION 25 MG 1 SRG + 2 AIG RR<br />
0 0 108,68 124,09 80<br />
0601241 XEPLION 50 MG 1 SRG + 2 AIG RR<br />
0 0 210,51 232,01 80<br />
0601255 XEPLION 75 MG 1 SRG + 2 AIG RR<br />
0 0 279,12 304,72 80<br />
N05BA01 diazepam<br />
0171185 DIAZEPAM EG 10 MG 100 CPR RR<br />
0 0 0,00 12,10 40<br />
0154542 DIAZEPAM EG 10 MG 25 CPR RR<br />
0 0 0,00 3,70 40<br />
0031606 DIAZEPAM RATIO 10 MG 10 CPR RR<br />
0 0 0,00 0,71 40<br />
0031623 DIAZEPAM RATIO 10 MG 20 CPR RR<br />
0 0 0,00 1,19 40<br />
0214038 DIAZEPAM RATIO 10 MG 5 AMP 2 ML IMIV RR<br />
0 0 0,00 2,47 40<br />
0031637 DIAZEPAM RATIO 10 MG 50 CPR RR<br />
0 0 0,00 2,65 40<br />
0206201 DIAZEPAM RATIO 10 MG GTTS 25 ML RR<br />
0 0 0,00 1,54 40<br />
0031640 DIAZEPAM RATIO 2 MG 10 CPR RR<br />
0 0 0,00 0,31 40<br />
0031654 DIAZEPAM RATIO 2 MG 20 CPR RR<br />
0 0 0,00 0,53 40<br />
0031668 DIAZEPAM RATIO 2 MG 50 CPR RR<br />
0 0 0,00 1,27 40<br />
Page 174 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0031671 DIAZEPAM RATIO 5 MG 10 CPR RR<br />
0 0 0,00 0,53 40<br />
0031685 DIAZEPAM RATIO 5 MG 20 CPR RR<br />
0 0 0,00 0,88 40<br />
0031699 DIAZEPAM RATIO 5 MG 50 CPR RR<br />
0 0 0,00 1,94 40<br />
0124574 VALIUM 10 MG 100 CPR RR<br />
0 0 11,81 20,29 40<br />
0246045 VALIUM 10 MG 30 CPR RR<br />
0 0 4,33 7,43 40<br />
0124669 VALIUM 10 MG 50 AMP 2 ML IMIV RR<br />
0 0 33,92 0,00 0<br />
0124655 VALIUM 10 MG 6 AMP 2 ML IMIV RR<br />
0 0 4,07 7,00 40<br />
0124624 VALIUM 5 MG 100 CPR RR<br />
0 0 7,71 13,24 40<br />
0246031 VALIUM 5 MG 30 CPR RR<br />
0 0 3,13 5,37 40<br />
N05BA04 oxazepam<br />
0084580 OXAZEPAM EG 15 MG 50 CPR RR<br />
0 0 0,00 3,76 40<br />
N05BA05 potassium clorazepate<br />
0118935 TRANXENE 10 MG 30 CAPS RR<br />
0 0 2,74 4,70 40<br />
0118983 TRANXENE 20 MG PDR 5 FL + S IMIV RR<br />
0 0 5,43 9,33 40<br />
0118966 TRANXENE 5 MG 100 CAPS RR<br />
0 0 0,00 9,54 40<br />
0118952 TRANXENE 5 MG 30 CAPS RR<br />
0 0 2,23 3,84 40<br />
0118997 TRANXENE 50 MG PDR 5 FL + S IMIV RR<br />
0 0 7,35 12,63 40<br />
0123014 UNI TRANXENE 15 MG 30 CAPS RR<br />
0 0 4,37 7,51 40<br />
N05BA06 lorazepam<br />
0187901 LAURACALM 1 MG 30 CPR RR<br />
0 0 0,00 3,32 40<br />
0187932 LAURACALM 2,5 MG 30 CPR RR<br />
0 0 0,00 5,52 40<br />
0067822 LORAZEPAM EG 1 MG 50 CPR RR<br />
0 0 0,00 3,77 40<br />
0067819 LORAZEPAM EG 2,5 MG 50 CPR RR<br />
0 0 0,00 6,79 40<br />
0304877 LORAZEPAM MYLAN 1 MG 50 CPR RR<br />
0 0 1,06 2,63 40<br />
0304894 LORAZEPAM MYLAN 2,5 MG 50 CPR RR<br />
0 0 1,71 4,67 40<br />
0067853 LORIDEM 2,5 MG 50 CPR RR<br />
0 0 3,91 6,72 40<br />
0104148 SERENASE 1 MG 20 CPR RR<br />
0 0 1,35 2,32 40<br />
0104151 SERENASE 1 MG 50 CPR RR<br />
0 0 2,87 4,93 40<br />
0104179 SERENASE 2,5 MG 50 CPR RR<br />
0 0 4,85 8,34 40<br />
0114032 TEMESTA 1 MG 20 CPR RR<br />
0 0 1,19 2,05 40<br />
0114046 TEMESTA 1 MG 50 CPR RR<br />
0 0 2,48 4,26 40<br />
0173016 TEMESTA 1 MG 500 CPR UD RR<br />
0 0 24,80 0,00 0<br />
0114063 TEMESTA 2,5 MG 20 CPR RR<br />
0 0 1,99 3,42 40<br />
0114077 TEMESTA 2,5 MG 50 CPR RR<br />
0 0 4,24 7,28 40<br />
0173047 TEMESTA 2,5 MG 500 CPR UD RR<br />
0 0 42,40 0,00 0<br />
0114080 TEMESTA 4 MG 10 AMP 1 ML IMIV RR<br />
0 0 0,00 11,90 40<br />
0114127 TEMESTA EXPIDET 1 MG 50 CPR RR<br />
0 0 0,00 6,43 40<br />
0114161 TEMESTA EXPIDET 2,5 MG 50 CPR RR<br />
0 0 0,00 10,47 40<br />
N05BA08 bromazepam<br />
0015583 BROMAZEPAM EG 12 MG 50 CPR RR<br />
0 0 0,00 9,71 40<br />
0015597 BROMAZEPAM EG 6 MG 50 CPR RR<br />
0 0 0,00 5,24 40<br />
0015633 BROMIDEM 12 MG 50 CPR RR<br />
0 0 5,20 8,94 40<br />
Page 175 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0015647 BROMIDEM 6 MG 50 CPR RR<br />
0 0 2,89 4,97 40<br />
0065330 LEXOTAN 3 MG 50 CPR RR<br />
0 0 3,41 5,86 40<br />
0065358 LEXOTAN 6 MG 20 CPR RR<br />
0 0 2,72 4,66 40<br />
0065361 LEXOTAN 6 MG 50 CPR RR<br />
0 0 5,72 9,82 40<br />
N05BA09 clobazam<br />
0046755 FRISIUM 10 MG 20 CPR RR<br />
0 0 3,05 5,25 40<br />
0046769 FRISIUM 10 MG 50 CPR RR<br />
0 0 6,38 10,96 40<br />
0046805 FRISIUM 20 MG 50 CPR RR<br />
0 0 11,00 18,90 40<br />
N05BA11 prazepam<br />
0068511 LYSANXIA 10 MG 20 CPR RR<br />
0 0 0,00 5,03 40<br />
0068525 LYSANXIA 10 MG 50 CPR RR<br />
0 0 0,00 10,02 40<br />
0068542 LYSANXIA 20 MG 50 CPR BISEC RR<br />
0 0 0,00 15,78 40<br />
0231929 LYSANXIA GTTS 15 MG/ML 20 ML RR<br />
0 0 6,69 11,50 40<br />
0540874 PRAZEPAM EG 10 MG 20 CPR RR<br />
0 0 2,34 4,02 40<br />
0540907 PRAZEPAM EG 10 MG 50 CPR RR<br />
0 0 4,67 8,02 40<br />
0540924 PRAZEPAM EG 20 MG 50 CPR RR<br />
0 0 7,35 12,62 40<br />
0540938 PRAZEPAM EG GTTS 15 MG/ML 1 FL 20 ML RR<br />
0 0 4,87 8,37 40<br />
N05BA12 alprazolam<br />
0206263 ALPRAZ 0,5 MG 14 CPR RR<br />
0 0 0,00 3,61 40<br />
0206277 ALPRAZ 0,5 MG 28 CPR RR<br />
0 0 0,00 5,42 40<br />
0488581 ALPRAZ 0,5 MG 56 CPR RR<br />
0 0 5,03 8,65 40<br />
0206281 ALPRAZ 1 MG 14 CPR RR<br />
0 0 0,00 5,06 40<br />
0206294 ALPRAZ 1 MG 28 CPR RR<br />
0 0 0,00 8,09 40<br />
0457389 ALPRAZOLAM EG 0,25 MG 20 CPR RR<br />
0 0 0,00 2,70 40<br />
0457392 ALPRAZOLAM EG 0,25 MG 50 CPR RR<br />
0 0 0,00 5,42 40<br />
0457408 ALPRAZOLAM EG 0,5 MG 20 CPR RR<br />
0 0 0,00 4,56 40<br />
0457411 ALPRAZOLAM EG 0,5 MG 50 CPR RR<br />
0 0 0,00 8,65 40<br />
0457425 ALPRAZOLAM EG 1 MG 20 CPR RR<br />
0 0 0,00 6,96 40<br />
0457439 ALPRAZOLAM EG 1 MG 50 CPR RR<br />
0 0 0,00 14,43 40<br />
0457442 ALPRAZOLAM EG 2 MG 20 CPR RR<br />
0 0 0,00 12,51 40<br />
0457456 ALPRAZOLAM EG 2 MG 50 CPR RR<br />
0 0 14,42 24,76 40<br />
0298962 ALPRAZOLAM MYLAN 0,25 MG 50 CPR RR<br />
0 0 1,71 4,71 40<br />
0298945 ALPRAZOLAM MYLAN 0,5 MG 50 CPR RR<br />
0 0 3,67 8,58 40<br />
0298901 ALPRAZOLAM MYLAN 1 MG 50 CPR RR<br />
0 0 6,33 14,82 40<br />
0130277 XANAX 0,25 MG 50 CPR RR<br />
0 0 0,00 7,38 40<br />
0279743 XANAX 0,25 MG 50 CPR UD RR<br />
0 0 4,29 0,00 0<br />
0130294 XANAX 0,5 MG 50 CPR RR<br />
0 0 0,00 12,00 40<br />
0279757 XANAX 0,5 MG 50 CPR UD RR<br />
0 0 6,99 0,00 0<br />
0244555 XANAX 0,75 MG/ML GTTS 20 ML RR<br />
0 0 0,00 8,81 40<br />
0130327 XANAX 1 MG 50 CPR RR<br />
0 0 0,00 20,72 40<br />
0154041 XANAX 2 MG 50 CPR RR<br />
0 0 21,77 32,33 40<br />
0221189 XANAX RET 0,5 MG 30 CPR RR<br />
0 0 0,00 8,62 40<br />
Page 176 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0221208 XANAX RET 1 MG 30 CPR RR<br />
0 0 0,00 14,69 40<br />
0221225 XANAX RET 2 MG 30 CPR RR<br />
0 0 14,75 25,34 40<br />
N05BA16 nordazepam<br />
0201723 CALMDAY 10 MG 30 DRG RR<br />
0 0 4,31 7,39 40<br />
0201737 CALMDAY 10 MG 300 DRG RR<br />
0 0 23,50 0,00 0<br />
0204174 CALMDAY 10 MG 60 DRG RR<br />
0 0 6,80 11,68 40<br />
0017476 CALMDAY 5 MG 30 DRG RR<br />
0 0 3,24 5,56 40<br />
0017493 CALMDAY 5 MG 60 DRG RR<br />
0 0 5,43 9,34 40<br />
0500042 NORDAZ 15 MG 30 CPR RR<br />
0 0 2,70 4,36 40<br />
N05BA18 ethyl loflazepate<br />
0127447 VICTAN 2 MG 30 CPR RR<br />
0 0 3,25 5,58 40<br />
N05BA21 clotiazepam<br />
0023232 CLOZAN 10 MG 50 CPR RR<br />
0 0 6,03 10,37 40<br />
0023246 CLOZAN 5 MG 20 CPR RR<br />
0 0 2,17 3,73 40<br />
0023263 CLOZAN 5 MG 50 CPR RR<br />
0 0 4,76 8,18 40<br />
N05BA22 cloxazolam<br />
0150591 AKTON 1 MG 50 CPR RR<br />
0 0 5,38 9,24 40<br />
0081608 AKTON 2 MG 20 CPR RR<br />
0 0 4,32 7,42 40<br />
0150588 AKTON 2 MG 50 CPR RR<br />
0 0 10,84 18,63 40<br />
N05BB01 hydroxyzine<br />
0008897 ATARAX 25 MG 50 CPR RR<br />
0 0 0,00 7,31 40<br />
N05BX03 etifoxine<br />
0272434 STRESAM 50 MG 60 CAPS RR<br />
0 0 0,00 6,54 40<br />
N05CD01 flurazepam<br />
0109418 STAURODORM NEU 20 CPR RR<br />
0 0 7,74 17,55 40<br />
N05CD02 nitrazepam<br />
0241991 MOGADON 5 MG 30 CPR RR<br />
0 0 0,00 3,61 40<br />
N05CD03 flunitrazepam<br />
0233825 FLUNITRAZEPAM EG 1 MG 10 CPR S<br />
0 0 0,00 1,29 40<br />
N05CD05 triazolam<br />
0178494 HALCION 0,125 MG 10 CPR RR<br />
0 0 1,76 3,02 40<br />
0178513 HALCION 0,250 MG 10 CPR RR<br />
0 0 2,19 3,77 40<br />
0190521 HALCION 0,250 MG 250 CPR UD (H) RR<br />
0 0 30,44 0,00 0<br />
N05CD06 lormetazepam<br />
0067660 LORAMET 1 MG 30 CPR RR<br />
0 0 3,34 5,73 40<br />
0172876 LORAMET 1 MG 500 CPR UD RR<br />
0 0 55,67 0,00 0<br />
0067674 LORAMET 2 MG 30 CPR RR<br />
0 0 5,24 9,00 40<br />
0172893 LORAMET 2 MG 500 CPR UD RR<br />
0 0 87,33 0,00 0<br />
Page 177 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0210401 LORANKA 2 MG 28 CPR RR<br />
0 0 4,58 7,87 40<br />
0304913 LORMETAZEPAM DOC 2 MG 30 CPR RR<br />
0 0 2,21 7,08 40<br />
0152016 LORMETAZEPAM EG 1 MG 30 CPR RR<br />
0 0 0,00 5,25 40<br />
0152033 LORMETAZEPAM EG 2 MG 30 CPR RR<br />
0 0 0,00 8,51 40<br />
0307932 NOCTACALM 1 MG 30 DRG RR<br />
0 0 0,00 5,78 0<br />
0307946 NOCTACALM 2 MG 30 DRG RR<br />
0 0 0,00 8,96 0<br />
0189839 NOCTAMID 1 MG 30 CPR RR<br />
0 0 0,00 7,66 40<br />
0189842 NOCTAMID 2 MG 30 CPR RR<br />
0 0 7,00 12,02 40<br />
0152051 STILAZE 2 MG 30 CPR RR<br />
0 0 5,74 9,86 40<br />
N05CD08 midazolam<br />
0035636 DORMICUM 15 MG 2 AMP 3 ML IMIV RR D<br />
0 0 1,62 0,00 0<br />
0409395 DORMICUM 5 MG 1 AMP 5 ML IMIV RR D<br />
0 0 0,40 0,00 0<br />
0240153 DORMICUM 50 MG 5 AMP 10 ML PERF RR D<br />
0 0 12,72 0,00 0<br />
N05CD09 brotizolam<br />
0064932 LENDORMIN 0,25 MG 30 CPR RR<br />
0 0 7,53 12,93 40<br />
0231641 LENDORMIN 0,25 MG 50 CPR UD RR<br />
0 0 11,42 0,00 0<br />
N05CD11 loprazolam<br />
0199513 DORMONOCT 1 MG 30 CPR RR<br />
0 0 6,13 10,53 40<br />
0199527 DORMONOCT 2 MG 30 CPR RR<br />
0 0 10,31 17,71 40<br />
N05CF01 zopiclone<br />
0056197 IMOVANE 7,5 MG 30 CPR RR<br />
0 0 8,05 13,85 40<br />
0177385 IMOVANE 7,5 MG 30 CPR UD RR<br />
0 0 8,06 0,00 0<br />
0269912 ZOPICLONE EG 7,5 MG 30 CPR RR<br />
0 0 0,00 9,01 40<br />
N05CF02 zolpidem<br />
0149217 STILNOCT 10 MG 30 CPR RR<br />
0 0 7,40 12,72 40<br />
0323502 STILNOCT 10 MG 30 CPR UD RR<br />
0 0 7,40 12,72 0<br />
0326003 ZOLPIDEM EG 10 MG 30 CPR BLIST RR<br />
0 0 0,00 9,62 40<br />
0517313 ZOLPIDEM EG 10 MG 30 CPR EFF RR<br />
0 0 5,92 10,17 0<br />
N05CF03 zaleplon<br />
0262939 SONATA 10 MG 14 CAPS RR<br />
0 0 0,00 8,11 40<br />
0262908 SONATA 5 MG 14 CAPS RR<br />
0 0 0,00 5,08 40<br />
N05CH01 melatonin<br />
0463985 CIRCADIN 2 MG 21 CPR RET RR<br />
0 0 9,81 16,86 0<br />
N05CM09 valerian<br />
0243673 RELAXINE 500 MG 15 CPR P<br />
0 0 0,00 6,99 40<br />
0243687 RELAXINE 500 MG 30 CPR P<br />
0 0 6,66 11,44 40<br />
0228338 VALERIAL 500 MG 30 CPR P<br />
0 0 0,00 11,32 40<br />
N05CM18 dexmedetomidine<br />
0635415 DEXDOR 100 MCG/ML 25 AMP V 2 ML IV RR HC<br />
0 0 405,00 0,00 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0635432 DEXDOR 100 MCG/ML 4 FL V 10 ML IV RR HC<br />
0 0 324,00 0,00 0<br />
0635429 DEXDOR 100 MCG/ML 4 FL V 4 ML IV RR HC<br />
0 0 129,60 0,00 0<br />
0635401 DEXDOR 100 MCG/ML 5 AMP V 2 ML IV RR HC<br />
0 0 81,00 0,00 0<br />
N06AA02 imipramine<br />
0288949 TOFRANIL 25 MG 100 DRG 10366 RR<br />
0 0 4,24 13,72 80<br />
0288921 TOFRANIL 25 MG 20 DRG 10364 RR<br />
0 0 0,77 9,92 80<br />
0288935 TOFRANIL 25 MG 50 DRG 10165 RR<br />
0 0 2,01 11,28 80<br />
N06AA04 clomipramine<br />
0236262 ANAFRANIL 10 MG 100 DRG 10351 RR<br />
0 0 1,92 11,18 80<br />
0236245 ANAFRANIL 10 MG 20 DRG 10349 RR<br />
0 0 0,36 9,48 80<br />
0236259 ANAFRANIL 10 MG 50 DRG 10350 RR<br />
0 0 0,93 10,10 80<br />
0236519 ANAFRANIL 25 MG 100 DRG 10355 RR<br />
0 0 4,24 13,72 80<br />
0236486 ANAFRANIL 25 MG 20 DRG 10353 RR<br />
0 0 0,77 9,92 80<br />
0236505 ANAFRANIL 25 MG 50 DRG 10354 RR<br />
0 0 2,01 11,28 80<br />
0236293 ANAFRANIL RET 75 MG 20 CPR 10604 RR<br />
0 0 7,94 17,78 80<br />
0236309 ANAFRANIL RET 75 MG 50 CPR 10602 RR<br />
0 0 13,65 24,02 80<br />
N06AA09 amitriptyline<br />
0097351 REDOMEX 10 MG 100 CPR RR<br />
0 0 1,47 6,14 80<br />
0097379 REDOMEX 25 MG 100 CPR RR<br />
0 0 2,78 7,65 80<br />
0097396 REDOMEX DIFFUCAPS 25 MG 40 CAPS RR<br />
0 0 2,14 6,87 80<br />
0097415 REDOMEX DIFFUCAPS 50 MG 40 CAPS RR<br />
0 0 3,49 8,52 80<br />
N06AA10 nortriptyline<br />
0080094 NORTRILEN 25 MG 50 CPR RR<br />
0 0 2,10 6,83 80<br />
N06AA12 doxepin<br />
0105145 SINEQUAN 25 MG 100 CAPS RR<br />
0 0 5,97 11,62 80<br />
0105162 SINEQUAN 50 MG 100 CAPS RR<br />
0 0 10,45 17,20 80<br />
N06AA16 dosulepin<br />
0095035 PROTHIADEN 25 MG 100 CAPS RR<br />
0 0 4,31 9,55 80<br />
0177341 PROTHIADEN 25 MG 30 CAPS RR<br />
0 0 1,60 6,29 80<br />
0095021 PROTHIADEN 75 MG 28 DRG RR<br />
0 0 3,67 8,75 80<br />
N06AB03 fluoxetine<br />
0293532 DOCFLUOXETINE 20 MG 28 CAPS RR<br />
0 0 3,80 8,74 80<br />
0293546 DOCFLUOXETINE 20 MG 60 CAPS RR<br />
0 0 10,33 16,94 80<br />
0647921 FLUOXETIN RATIO 20 MG 100 CAPS RR<br />
0 0 12,69 22,97 0<br />
0647884 FLUOXETIN RATIO 20 MG 100 CPR RR<br />
0 0 12,69 22,97 0<br />
0647903 FLUOXETIN RATIO 20 MG 20 CAPS RR<br />
0 0 2,08 11,37 0<br />
0647836 FLUOXETIN RATIO 20 MG 20 CPR RR<br />
0 0 2,08 11,37 0<br />
0647917 FLUOXETIN RATIO 20 MG 50 CAPS RR<br />
0 0 5,82 15,45 0<br />
0647871 FLUOXETIN RATIO 20 MG 50 CPR RR<br />
0 0 5,82 15,45 0<br />
0647934 FLUOXETIN RATIO 20MG/5ML SOL BUV 70 ML RR<br />
0 0 14,18 24,61 0<br />
Page 179 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0323273 FLUOXONE DIVULE 20 MG 100 CPR RR<br />
0 0 27,38 36,38 80<br />
0323256 FLUOXONE DIVULE 20 MG 30 CPR RR<br />
0 0 11,32 18,10 80<br />
0281481 FONTEX 20 MG 28 PULV RR<br />
0 0 15,04 22,82 80<br />
0203373 PROZAC 20 MG 28 CAPS RR<br />
0 0 15,04 22,82 80<br />
0519501 PROZAC DISP 20 MG 28 CPR SEC RR<br />
0 0 15,04 22,82 80<br />
N06AB04 citalopram<br />
0164065 CIPRAMIL 20 MG 28 CPR RR<br />
0 0 10,37 17,11 80<br />
0164129 CIPRAMIL 40 MG PERF 10 AMP 1 ML RR<br />
0 0 58,01 69,66 80<br />
0421941 CITALOPRAM EG 20 MG 28 CPR RR<br />
0 0 9,12 15,43 80<br />
0421971 CITALOPRAM EG 20 MG 56 CPR RR<br />
0 0 14,78 22,60 80<br />
0426799 CITALOPRAM HEXAL 20 MG 100 CPR BLIST RR<br />
0 0 14,03 24,44 80<br />
0426706 CITALOPRAM HEXAL 20 MG 20 CPR BLIST RR<br />
0 0 2,74 12,09 80<br />
0426768 CITALOPRAM HEXAL 20 MG 50 CPR BLIST RR<br />
0 0 7,03 16,78 80<br />
0426964 CITALOPRAM HEXAL 30 MG 100 CPR BLIST RR<br />
0 0 24,64 36,05 80<br />
0339094 CITALOPRAM HEXAL 30 MG 20 CPR RR<br />
0 0 7,91 14,10 80<br />
0426866 CITALOPRAM HEXAL 30 MG 20 CPR BLIST RR<br />
0 0 4,92 14,46 80<br />
0426933 CITALOPRAM HEXAL 30 MG 50 CPR BLIST RR<br />
0 0 12,58 22,42 80<br />
0427104 CITALOPRAM HEXAL 40 MG 100 CPR BLIST RR<br />
0 0 33,74 46,01 80<br />
0339189 CITALOPRAM HEXAL 40 MG 20 CPR RR<br />
0 0 9,09 16,21 80<br />
0427037 CITALOPRAM HEXAL 40 MG 20 CPR BLIST RR<br />
0 0 6,89 16,63 80<br />
0427071 CITALOPRAM HEXAL 40 MG 50 CPR BLIST RR<br />
0 0 17,07 27,77 80<br />
0432619 CITALOPRAM HEXAL 60 MG 100 CPR BLIST RR<br />
0 0 37,63 67,07 80<br />
0338875 CITALOPRAM HEXAL 60 MG 20 CPR RR<br />
0 0 11,57 20,63 80<br />
0432524 CITALOPRAM HEXAL 60 MG 20 CPR BLIST RR<br />
0 0 11,57 20,63 80<br />
0432569 CITALOPRAM HEXAL 60 MG 50 CPR BLIST RR<br />
0 0 21,48 38,29 80<br />
0367829 CITALOPRAM VON CT 20 MG 100 CPR RR<br />
0 0 0,00 39,14 80<br />
0367765 CITALOPRAM VON CT 20 MG 20 CPR RR<br />
0 0 6,28 11,19 80<br />
0367796 CITALOPRAM VON CT 20 MG 50 CPR RR<br />
0 0 0,00 23,18 80<br />
0367961 CITALOPRAM VON CT 40 MG 100 CPR RR<br />
0 0 0,00 65,18 80<br />
0367894 CITALOPRAM VON CT 40 MG 20 CPR RR<br />
0 0 0,00 17,76 80<br />
0367931 CITALOPRAM VON CT 40 MG 50 CPR RR<br />
0 0 0,00 38,65 80<br />
N06AB05 paroxetine<br />
0354221 PAROXETINE EG 20 MG 28 CPR PELLIC RR<br />
0 0 10,21 16,90 80<br />
0354235 PAROXETINE EG 20 MG 56 CPR PELLIC RR<br />
0 0 12,31 19,52 80<br />
0563753 PAROXETINE EG 30 MG 28 CPR RR<br />
0 0 12,50 19,76 0<br />
0563771 PAROXETINE EG 30 MG 56 CPR RR<br />
0 0 23,54 32,32 80<br />
0563865 PAROXETINE EG 40 MG 28 CPR RR<br />
0 0 16,76 24,86 80<br />
0563915 PAROXETINE EG 40 MG 98 CPR RR<br />
0 0 53,74 65,60 80<br />
0352244 PAROXETINE RATIO 20 MG 28 CPR RR<br />
0 0 0,00 14,77 80<br />
0352275 PAROXETINE RATIO 20 MG 56 CPR RR<br />
0 0 16,80 24,72 80<br />
0187137 SEROXAT 20 MG 28 CPR RR<br />
0 0 11,13 18,04 80<br />
0330474 SEROXAT 20 MG 56 CPR RR<br />
0 0 17,82 26,03 80<br />
0319401 SEROXAT 20 MG/10 ML SUSP 150 ML RR<br />
0 0 5,97 11,62 80<br />
Page 180 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0309632 SEROXAT 30 MG 28 CPR RR<br />
0 0 13,36 20,82 80<br />
N06AB06 sertraline<br />
0405382 DOCSERTRALI 100 MG 100 CPR RR<br />
0 0 65,27 0,00 0<br />
0405317 DOCSERTRALI 50 MG 100 CPR RR<br />
0 0 37,04 0,00 0<br />
0405351 DOCSERTRALINE 100 MG 30 CPR RR<br />
0 0 10,41 17,03 80<br />
0405284 DOCSERTRALINE 50 MG 30 CPR RR<br />
0 0 8,44 14,53 80<br />
0342251 SERLAIN 100 MG 30 CPR RR<br />
0 0 10,41 17,15 80<br />
0307722 SERLAIN 20 MG/ML GTTS 60 ML RR<br />
0 0 8,19 14,38 80<br />
0244183 SERLAIN 50 MG 30 CPR SEC RR<br />
0 0 8,89 15,26 80<br />
0268543 SERLAIN 50 MG 6*5 CPR UD RR<br />
0 0 8,89 0,00 0<br />
0270409 SERLAIN 50 MG 60 CPR RR<br />
0 0 23,62 34,23 0<br />
0392818 SERTRALIN HEXAL 100 MG 100 CPR BLIST RR<br />
0 0 27,91 49,74 80<br />
0392741 SERTRALIN HEXAL 100 MG 20 CPR RR<br />
0 0 5,39 9,60 80<br />
0392771 SERTRALIN HEXAL 100 MG 50 CPR BLIST RR<br />
0 0 13,13 23,40 80<br />
0393006 SERTRALIN HEXAL 50 MG 100 CPR BLIST RR<br />
0 0 16,83 30,00 80<br />
0392933 SERTRALIN HEXAL 50 MG 20 CPR RR<br />
0 0 4,99 8,90 80<br />
0392964 SERTRALIN HEXAL 50 MG 50 CPR BLIST RR<br />
0 0 8,70 15,50 80<br />
0408644 SERTRALIN RATIO 100 MG 20 CPR RR<br />
0 0 4,38 11,10 80<br />
0408675 SERTRALIN RATIO 100 MG 50 CPR RR<br />
0 0 14,87 23,47 80<br />
0408434 SERTRALIN RATIO 50 MG 20 CPR RR<br />
0 0 4,62 8,13 80<br />
0408465 SERTRALIN RATIO 50 MG 50 CPR RR<br />
0 0 11,79 21,99 80<br />
0415442 SERTRALINE EG 100 MG 30 CPR RR<br />
0 0 10,41 17,15 80<br />
0415487 SERTRALINE EG 100 MG 60 CPR RR<br />
0 0 20,82 29,34 80<br />
0415331 SERTRALINE EG 50 MG 30 CPR RR<br />
0 0 8,45 14,71 80<br />
0415361 SERTRALINE EG 50 MG 60 CPR RR<br />
0 0 11,29 18,24 80<br />
N06AB08 fluvoxamine<br />
0228579 FLOXYFRAL 100 MG 30 CPR SEC RR<br />
0 0 11,49 18,37 80<br />
0395631 FLUVOXAMINE EG 100 MG 30 CPR RR<br />
0 0 7,77 13,75 80<br />
N06AB10 escitalopram<br />
0327661 SIPRALEXA 10 MG 28 CPR RR<br />
0 0 16,41 24,48 80<br />
0327675 SIPRALEXA 10 MG 56 CPR RR<br />
0 0 26,25 35,32 80<br />
0455692 SIPRALEXA 10 MG 98 CPR UD RR<br />
0 0 45,94 0,00 0<br />
0327997 SIPRALEXA 20 MG 28 CPR BLIST CLAIR RR<br />
0 0 26,25 35,32 80<br />
0328008 SIPRALEXA 20 MG 56 CPR RR<br />
0 0 53,57 65,23 80<br />
0455739 SIPRALEXA 20 MG 98 CPR UD RR<br />
0 0 91,88 0,00 0<br />
0666165 SIPRALEXA ODIS 10 MG 30 CPR RR<br />
0 0 17,58 25,76 0<br />
0666179 SIPRALEXA ODIS 10 MG 60 CPR RR<br />
0 0 28,12 37,39 0<br />
N06AF03 phenelzine<br />
0075600 NARDELZINE 15 MG 100 DRG RR<br />
0 0 21,96 32,52 80<br />
N06AG02 moclobemide<br />
0170448 AURORIX 150 MG 100 CPR RR<br />
0 0 24,32 33,08 80<br />
Page 181 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0181813 AURORIX 150 MG 100 CPR UD RR<br />
0 0 24,32 0,00 0<br />
N06AX03 mianserin<br />
0065070 LERIVON 10 MG 90 CPR RR<br />
0 0 4,93 10,32 80<br />
0487066 LERIVON 30 MG 30 CPR RR<br />
0 0 3,18 8,13 80<br />
0192073 LERIVON 30 MG 50 CPR RR<br />
0 0 7,52 13,43 80<br />
0162981 LERIVON 60 MG 30 CPR RR<br />
0 0 8,88 15,25 80<br />
N06AX05 trazodone<br />
0603294 TRAZODONE MYLAN 100 MG 30 CPR RR<br />
0 0 2,59 7,40 80<br />
0603313 TRAZODONE MYLAN 100 MG 90 CPR RR<br />
0 0 6,26 11,98 80<br />
0119428 TRAZOLAN 100 MG 30 CPR RR<br />
0 0 3,27 8,25 80<br />
0119445 TRAZOLAN 100 MG 90 CPR RR<br />
0 0 7,88 14,00 80<br />
N06AX11 mirtazapine<br />
0389065 MIRTAZAPIN RATIO 15 MG 10 CPR RR<br />
0 0 0,00 5,10 80<br />
0387477 MIRTAZAPIN RATIO 15 MG 100 CPR RR<br />
0 0 32,13 0,00 0<br />
0387401 MIRTAZAPIN RATIO 15 MG 50 CPR RR<br />
0 0 8,55 15,23 80<br />
0387673 MIRTAZAPIN RATIO 30 MG 100 CPR RR<br />
0 0 53,57 0,00 0<br />
0387561 MIRTAZAPIN RATIO 30 MG 20 CPR RR<br />
0 0 7,36 13,11 80<br />
0387608 MIRTAZAPIN RATIO 30 MG 50 CPR RR<br />
0 0 13,18 23,49 80<br />
0387897 MIRTAZAPIN RATIO 45 MG 100 CPR RR<br />
0 0 81,05 0,00 0<br />
0387785 MIRTAZAPIN RATIO 45 MG 20 CPR RR<br />
0 0 9,12 16,26 80<br />
0387821 MIRTAZAPIN RATIO 45 MG 50 CPR RR<br />
0 0 18,17 32,39 80<br />
0398954 MIRTAZAPINE EG 15 MG 30 CPR RR<br />
0 0 7,34 13,32 80<br />
0398985 MIRTAZAPINE EG 15 MG 60 CPR RR<br />
0 0 14,00 21,63 80<br />
0399142 MIRTAZAPINE EG 30 MG 30 CPR RR<br />
0 0 13,74 21,30 80<br />
0656611 MIRTAZAPINE EG 30 MG 60 CPR RR<br />
0 0 21,89 30,51 0<br />
0399402 MIRTAZAPINE EG 45 MG 100 CPR RR<br />
0 0 32,74 42,46 80<br />
0399366 MIRTAZAPINE EG 45 MG 50 CPR RR<br />
0 0 20,76 29,26 80<br />
0485254 MIRTAZAPINE RATIO 15 MG 48 CPR ORODISP RR<br />
0 0 8,35 14,88 80<br />
0485223 MIRTAZAPINE RATIO 15 MG 6 CPR ORODISP RR<br />
0 0 0,00 3,12 80<br />
0485299 MIRTAZAPINE RATIO 30 MG 18 CPR ORODISP RR<br />
0 0 7,13 12,71 80<br />
0485318 MIRTAZAPINE RATIO 30 MG 48 CPR ORODISP RR<br />
0 0 12,78 22,77 80<br />
0485352 MIRTAZAPINE RATIO 45 MG 18 CPR ORODISP RR<br />
0 0 8,58 15,30 80<br />
0485383 MIRTAZAPINE RATIO 45 MG 48 CPR ORODISP RR<br />
0 0 17,51 31,21 80<br />
0290236 REMERGON 15 MG/ML GTTS 1 FL 66 ML RR<br />
0 0 15,30 23,07 80<br />
0329991 REMERGON SOLTAB 15 MG 5*6 CPR RR<br />
0 0 9,51 16,02 80<br />
0330041 REMERGON SOLTAB 30 MG 5*6 CPR RR<br />
0 0 15,23 23,16 80<br />
0330085 REMERGON SOLTAB 45 MG 5*6 CPR RR<br />
0 0 18,29 26,55 80<br />
N06AX12 bupropion<br />
0463887 WELLBUTRIN XR 150 MG 30 CPR RR<br />
0 0 23,82 32,64 80<br />
0463891 WELLBUTRIN XR 150 MG 90 CPR RR<br />
0 0 57,19 69,39 80<br />
0463923 WELLBUTRIN XR 300 MG 30 CPR RR<br />
0 0 42,89 53,64 80<br />
0463937 WELLBUTRIN XR 300 MG 90 CPR RR<br />
0 0 102,93 117,98 80<br />
Page 182 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0281707 ZYBAN 150 MG 100 CPR RR<br />
0 0 80,51 94,23 0<br />
0280825 ZYBAN 150 MG 30 CPR RR<br />
0 0 30,19 41,00 0<br />
N06AX14 tianeptine<br />
0139319 STABLON 12,5 MG 30 CPR ENR RR<br />
0 0 0,00 11,38 80<br />
N06AX16 venlafaxine<br />
0342221 EFEXOR EXEL 150 MG 100 CAPS UD RR<br />
0 0 75,13 0,00 0<br />
0258127 EFEXOR EXEL 150 MG 28 CAPS RR<br />
0 0 23,79 32,61 80<br />
0482249 EFEXOR EXEL 150 MG 56 CAPS RR<br />
0 0 42,07 52,56 80<br />
0482252 EFEXOR EXEL 150 MG 98 CAPS RR<br />
0 0 73,63 86,75 0<br />
0409476 EFEXOR EXEL 37,5 MG 7 CAPS RR<br />
0 0 3,86 6,64 80<br />
0258077 EFEXOR EXEL 75 MG 28 CAPS RR<br />
0 0 13,30 20,76 80<br />
0482431 EFEXOR EXEL 75 MG 56 CAPS RR<br />
0 0 23,52 32,12 80<br />
0482445 EFEXOR EXEL 75 MG 98 CAPS RR<br />
0 0 41,16 51,56 0<br />
0528558 VENLAFAXINE EG 150 MG 28 CAPS RR<br />
0 0 12,13 19,29 80<br />
0529426 VENLAFAXINE EG 150 MG 56 CAPS RR<br />
0 0 26,31 35,38 80<br />
0528589 VENLAFAXINE EG 150 MG 98 CAPS RR<br />
0 0 43,64 54,46 0<br />
0529362 VENLAFAXINE EG 37,5 MG 14 CAPS RR<br />
0 0 3,33 8,32 80<br />
0528379 VENLAFAXINE EG 37,5 MG 28 CAPS RR<br />
0 0 6,65 12,47 80<br />
0528463 VENLAFAXINE EG 75 MG 28 CAPS RR<br />
0 0 5,19 10,64 80<br />
0529409 VENLAFAXINE EG 75 MG 56 CAPS RR<br />
0 0 19,23 27,59 0<br />
0528494 VENLAFAXINE EG 75 MG 98 CAPS RR<br />
0 0 25,75 34,77 0<br />
N06AX17 milnacipran<br />
0306451 IXEL 25 MG 56 CAPS BLIST RR<br />
0 0 0,00 16,73 80<br />
0261475 IXEL 50 MG 56 CAPS BLIST RR<br />
0 0 0,00 29,65 80<br />
N06AX18 reboxetine<br />
0242256 EDRONAX 4 MG 60 CPR RR<br />
0 0 21,09 29,63 0<br />
N06AX21 duloxetine<br />
0458842 CYMBALTA 30 MG 7 CAPS RR<br />
0 0 5,00 8,59 0<br />
0394602 CYMBALTA 60 MG 28 CAPS RR<br />
0 0 31,97 41,50 80<br />
0380185 YENTREVE 20 MG 56 CAPS R<br />
1 5 44,80 56,06 80<br />
0380204 YENTREVE 40 MG 56 CAPS R<br />
1 5 44,80 56,06 80<br />
N06AX22 agomelatine<br />
0519853 VALDOXAN 25 MG 28 CPR RR<br />
RM 0 0<br />
36,40 47,40 0<br />
0519871 VALDOXAN 25 MG 56 CPR RR<br />
RM 0 0<br />
73,87 86,93 0<br />
0519884 VALDOXAN 25 MG 84 CPR RR<br />
RM 0 0<br />
109,20 125,69 0<br />
N06BA04 methylphenidate<br />
0331861 CONCERTA 18 MG 30 CPR S C<br />
0 0 43,52 54,74 0<br />
0499702 CONCERTA 27 MG 30 CPR S C<br />
0 0 49,52 60,92 0<br />
0331911 CONCERTA 36 MG 30 CPR S C<br />
0 0 55,50 67,08 0<br />
0331969 CONCERTA 54 MG 30 CPR S C<br />
0 0 68,10 80,05 0<br />
Page 183 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0450018 MEDIKINET 10 MG 100 CPR S C<br />
0 0 30,28 42,13 0<br />
0449986 MEDIKINET 10 MG 20 CPR S C<br />
0 0 3,88 6,92 0<br />
0450004 MEDIKINET 10 MG 50 CPR S C<br />
0 0 12,55 21,74 0<br />
0450021 MEDIKINET 20 MG 50 CPR S C<br />
0 0 19,44 34,60 0<br />
0449969 MEDIKINET 5 MG 20 CPR S C<br />
0 0 1,77 3,46 0<br />
0449972 MEDIKINET 5 MG 50 CPR S C<br />
0 0 5,69 10,87 0<br />
0450035 MEDIKINET RET 10 MG 50 CAPS S C<br />
1 1 16,76 27,20 80<br />
0450049 MEDIKINET RET 20 MG 50 CAPS S C<br />
1 1 37,39 50,07 80<br />
0450052 MEDIKINET RET 30 MG 50 CAPS S C<br />
1 1 59,83 75,15 80<br />
0450066 MEDIKINET RET 40 MG 50 CAPS S C<br />
1 1 83,20 101,28 80<br />
0553399 RILATINE MR 20 MG 30 CAPS S C<br />
1 1 20,01 28,44 80<br />
0553418 RILATINE MR 30 MG 30 CAPS S C<br />
1 1 25,50 34,49 80<br />
0571092 RILATINE MR 40 MG 30 CAPS S C<br />
1 1 45,72 56,64 80<br />
0236889 RITALIN 10 MG 20 CPR S C<br />
1 1 3,88 13,33 80<br />
0651744 RITALIN 10 MG 30 CPR S C<br />
0 0 6,55 16,25 0<br />
N06BA07 modafinil<br />
0264741 PROVIGIL 100 MG 90 CPR RR<br />
1 5 113,42 129,10 80<br />
N06BA09 atomoxetine<br />
0431995 STRATTERA 10 MG 28 CAPS RR C<br />
0 0 78,40 90,66 0<br />
0431978 STRATTERA 10 MG 7 CAPS RR C<br />
0 0 19,60 30,09 0<br />
0432041 STRATTERA 18 MG 28 CAPS RR C<br />
0 0 78,40 90,66 0<br />
0432023 STRATTERA 18 MG 7 CAPS RR C<br />
0 0 19,60 30,09 0<br />
0432085 STRATTERA 25 MG 28 CAPS RR C<br />
0 0 78,40 90,66 0<br />
0432068 STRATTERA 25 MG 7 CAPS RR C<br />
0 0 19,60 30,09 0<br />
0432121 STRATTERA 40 MG 28 CAPS RR C<br />
0 0 78,40 90,66 0<br />
0432104 STRATTERA 40 MG 7 CAPS RR C<br />
0 0 19,60 30,09 0<br />
0432166 STRATTERA 60 MG 28 CAPS RR C<br />
0 0 78,40 90,66 0<br />
0518369 STRATTERA 80 MG 28 CAPS RR C<br />
0 0 104,44 117,48 0<br />
N06BC01 caffeine<br />
0444492 PERCOFFEDRINOL N 50 MG 20 CPR P<br />
0 0 2,06 4,07 0<br />
0444508 PERCOFFEDRINOL N 50 MG 50 CPR P<br />
0 0 4,47 8,57 0<br />
N06BX03 piracetam<br />
0143549 BRAINTOP 800 MG 60 CPR R<br />
0 0 8,34 14,33 0<br />
0299164 DOCPIRACE 1200 MG 112 CPR R<br />
0 0 13,18 23,49 0<br />
0149377 NOOTROPIL 12 G 1 FL 60 ML PERF RR<br />
0 0 6,06 10,41 0<br />
0429644 NOOTROPIL 1200 MG 100 CPR R<br />
0 0 24,27 34,90 0<br />
0427426 NOOTROPIL 1200 MG 60 CPR R<br />
0 0 15,38 25,75 0<br />
0468513 NOOTROPIL 20% SOL 150 ML R<br />
0 0 8,49 14,59 0<br />
0427461 NOOTROPIL 2400 MG 30 SACH R<br />
0 0 15,38 25,75 0<br />
0162639 NOOTROPIL 3 G 12 AMP 15 ML IMIV RR H<br />
0 0 16,56 0,00 0<br />
0079711 NOOTROPIL 800 MG 90 CPR R<br />
0 0 17,34 27,77 0<br />
0176388 PIRACEBRAL 1200 MG 100 CPR R<br />
0 0 0,00 23,30 0<br />
Page 184 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0201951 PIRACEBRAL 1200 MG 30 CPR R<br />
0 0 0,00 8,11 0<br />
0201964 PIRACEBRAL 1200 MG 60 CPR R<br />
0 0 0,00 13,42 0<br />
0176391 PIRACEBRAL 333 MG/ML SOL 100 ML R<br />
0 0 0,00 8,85 0<br />
0176357 PIRACEBRAL 800 MG 100 CPR R<br />
0 0 0,00 15,74 0<br />
0201933 PIRACEBRAL 800 MG 30 CPR R<br />
0 0 0,00 5,40 0<br />
0201947 PIRACEBRAL 800 MG 60 CPR R<br />
0 0 0,00 10,63 0<br />
0451256 PIRACETAM EG 1200 MG 112 CPR R<br />
0 0 13,25 23,55 0<br />
0451287 PIRACETAM EG 1200 MG 112 SACH R<br />
0 0 14,11 24,44 0<br />
0451242 PIRACETAM EG 1200 MG 56 CPR R<br />
0 0 7,29 17,13 0<br />
0451273 PIRACETAM EG 1200 MG 56 SACH R<br />
0 0 8,35 18,22 0<br />
0451291 PIRACETAM EG 2400 MG 28 SACH R<br />
0 0 8,07 18,22 0<br />
0178334 PIRACETAM EG 800 MG 60 CPR R<br />
0 0 2,84 12,84 0<br />
0149265 PIRACETAM RATIO 1 G 10 AMP 5 ML IV RR<br />
0 0 0,00 10,98 0<br />
0221967 PIRACETAM RATIO 1200 MG 100 DRG R<br />
0 0 9,24 16,47 0<br />
0245129 PIRACETAM RATIO 1200 MG 30 CPR R<br />
0 0 6,16 10,98 0<br />
0221953 PIRACETAM RATIO 1200 MG 60 DRG R<br />
0 0 7,50 13,37 0<br />
0091022 PIRACETAM RATIO 400 MG 100 CAPS R<br />
0 0 7,82 13,94 0<br />
0091005 PIRACETAM RATIO 400 MG 30 CAPS R<br />
0 0 5,68 10,13 0<br />
0091019 PIRACETAM RATIO 400 MG 50 CAPS R<br />
0 0 5,77 10,29 0<br />
0091067 PIRACETAM RATIO 800 MG 100 CPR R<br />
0 0 8,11 14,45 0<br />
0091036 PIRACETAM RATIO 800 MG 30 CPR R<br />
0 0 5,78 10,30 0<br />
0246336 PIRACETAM RATIO 800 MG 60 CPR R<br />
0 0 6,79 12,11 0<br />
0554852 PIRACETAM RATIO LIQ 416,25MG/1,25ML 75ML R<br />
0 0 0,00 12,03 0<br />
0554849 PIRACETAM RATIO LIQ 416,25MG/1,25ML150ML R<br />
0 0 0,00 15,61 0<br />
N06BX04 deanol<br />
0028287 DEBRUMYL 20 AMP BUV 5 ML R<br />
0 0 0,00 12,34 0<br />
N06CA Antidepressants in combination with psycholeptics<br />
0028208 DEANXIT 30 DRG R<br />
0 0 3,45 5,92 80<br />
N06DA02 donepezil<br />
0238897 ARICEPT 10 MG 28 CPR R C<br />
1 1 44,38 55,28 80<br />
0238902 ARICEPT 10 MG 56 CPR R C<br />
1 1 82,54 96,36 80<br />
0459871 ARICEPT 10 MG 56 CPR ORODISP R C<br />
1 1 82,54 96,36 80<br />
0478246 ARICEPT 10 MG 98 CPR R C<br />
1 1 124,25 140,59 80<br />
0435638 ARICEPT 5 MG 28 CPR R C<br />
1 1 38,16 48,43 80<br />
0459769 ARICEPT 5 MG 28 CPR ORODISP R C<br />
0 0 79,40 91,69 0<br />
0435672 ARICEPT 5 MG 98 CPR R C<br />
1 1 106,85 122,13 80<br />
0587626 DONEPEZIL HCL RATIO 10 MG 28 CPR R C<br />
1 1 23,67 34,99 80<br />
0587657 DONEPEZIL HCL RATIO 10 MG 56 CPR R C<br />
1 1 48,22 61,85 80<br />
0587674 DONEPEZIL HCL RATIO 10 MG 98 CPR R C<br />
1 1 85,45 102,60 80<br />
0587528 DONEPEZIL HCL RATIO 5 MG 28 CPR R C<br />
1 1 20,48 31,50 80<br />
0587545 DONEPEZIL HCL RATIO 5 MG 56 CPR R C<br />
1 1 42,22 55,29 80<br />
0587562 DONEPEZIL HCL RATIO 5 MG 98 CPR R C<br />
1 1 74,75 90,87 80<br />
Page 185 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0591789 DONEPEZIL RATIO 10 MG 28 CPR ORODISP R C<br />
1 1 23,67 34,99 80<br />
0591839 DONEPEZIL RATIO 10 MG 98 CPR ORODISP R C<br />
1 1 85,45 102,60 80<br />
0591663 DONEPEZIL RATIO 5 MG 28 CPR ORODISP R C<br />
1 1 20,48 31,50 80<br />
0591727 DONEPEZIL RATIO 5 MG 98 CPR ORODISP R C<br />
1 1 74,75 90,87 80<br />
0653296 DONEPEZIL SDZ 10 MG 28 CPR ORODIS R C<br />
0 0 35,95 46,00 0<br />
0653637 DONEPEZIL SDZ 10 MG 28 CPR PELLIC R C<br />
0 0 44,38 55,28 0<br />
0654326 DONEPEZIL SDZ 10 MG 28 FILMS (SACH) R C<br />
0 0 35,95 46,00 0<br />
0653332 DONEPEZIL SDZ 10 MG 56 CPR ORODIS R C<br />
0 0 82,54 96,36 0<br />
0653668 DONEPEZIL SDZ 10 MG 56 CPR PELLIC R C<br />
0 0 82,54 96,36 0<br />
0654374 DONEPEZIL SDZ 10 MG 56 FILMS (SACH) R C<br />
0 0 82,54 96,36 0<br />
0653427 DONEPEZIL SDZ 10 MG 98 CPR ORODIS R C<br />
0 0 117,00 132,90 0<br />
0653704 DONEPEZIL SDZ 10 MG 98 CPR PELLIC R C<br />
0 0 124,25 140,59 0<br />
0654407 DONEPEZIL SDZ 10 MG 98 FILMS (SACH) R C<br />
0 0 117,00 132,90 0<br />
0652786 DONEPEZIL SDZ 5 MG 28 CPR ORODIS R C<br />
0 0 30,91 40,45 0<br />
0653783 DONEPEZIL SDZ 5 MG 28 CPR PELLIC R C<br />
0 0 38,16 48,43 0<br />
0654178 DONEPEZIL SDZ 5 MG 28 FILMS (SACH) R C<br />
0 0 30,91 40,45 0<br />
0652822 DONEPEZIL SDZ 5 MG 56 CPR ORODIS R C<br />
0 0 61,06 73,62 0<br />
0653816 DONEPEZIL SDZ 5 MG 56 CPR PELLIC R C<br />
0 0 61,05 73,61 0<br />
0654214 DONEPEZIL SDZ 5 MG 56 FILMS (SACH) R C<br />
0 0 61,06 73,62 0<br />
0652871 DONEPEZIL SDZ 5 MG 98 CPR ORODIS R C<br />
0 0 106,86 122,15 0<br />
0653864 DONEPEZIL SDZ 5 MG 98 CPR PELLIC R C<br />
0 0 106,86 122,15 0<br />
0654245 DONEPEZIL SDZ 5 MG 98 FILMS (SACH) R C<br />
0 0 106,86 122,15 0<br />
N06DA03 rivastigmine<br />
0249941 EXELON 1,5 MG 112 CAPS RR C<br />
1 1 169,29 194,34 80<br />
0249937 EXELON 1,5 MG 56 CAPS RR C<br />
1 1 84,59 101,65 80<br />
0250163 EXELON 3 MG 112 CAPS RR C<br />
1 1 169,29 194,34 80<br />
0250146 EXELON 3 MG 56 CAPS RR C<br />
1 1 84,59 101,65 80<br />
0250194 EXELON 4,5 MG 112 CAPS RR C<br />
1 1 169,29 194,34 80<br />
0250181 EXELON 4,5 MG 56 CAPS RR C<br />
1 1 84,59 101,65 80<br />
0468267 EXELON 4,6 MG 30 PATCH RR C<br />
1 1 87,90 105,28 80<br />
0468271 EXELON 4,6 MG 60 PATCH RR C<br />
1 1 175,80 201,46 80<br />
0250231 EXELON 6 MG 112 CAPS RR C<br />
1 1 169,29 194,34 80<br />
0250227 EXELON 6 MG 56 CAPS RR C<br />
1 1 84,59 101,65 80<br />
0468303 EXELON 9,5 MG 30 PATCH RR C<br />
1 1 87,90 105,28 80<br />
0468321 EXELON 9,5 MG 90 PATCH RR C<br />
1 1 263,70 297,66 80<br />
N06DA04 galantamine<br />
0661589 GALANTAMINE MYLAN 16 MG 28 CAPS RR<br />
0 0 36,60 46,71 0<br />
0661611 GALANTAMINE MYLAN 16 MG 84 CAPS RR<br />
0 0 106,65 121,93 0<br />
0661691 GALANTAMINE RET MYLAN 24 MG 28 CAPS R<br />
0 0 40,69 51,22 0<br />
0661737 GALANTAMINE RET MYLAN 24 MG 84 CAPS R<br />
0 0 115,39 131,19 0<br />
0661477 GALANTAMINE RET MYLAN 8 MG 28 CAPS RR<br />
0 0 25,43 34,41 0<br />
0292793 REMINYL 4 MG 56 CPR 96472 RR C<br />
1 1 25,43 34,41 80<br />
0286135 REMINYL 4 MG/ML SOL 100 ML 96131 RR C<br />
1 1 32,23 41,90 80<br />
Page 186 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0394701 REMINYL RET 16 MG 28 CAPS RR C<br />
1 1 36,60 46,71 80<br />
0394728 REMINYL RET 16 MG 84 CAPS RR C<br />
1 1 106,65 121,93 80<br />
0394745 REMINYL RET 24 MG 28 CAPS RR C<br />
1 1 40,69 51,22 80<br />
0394762 REMINYL RET 24 MG 84 CAPS RR C<br />
1 1 115,40 131,20 80<br />
0394681 REMINYL RET 8 MG 28 CAPS RR C<br />
1 1 25,43 34,41 80<br />
N06DX01 memantine<br />
0320299 AXURA 10 MG 100 CPR RR C<br />
0 0 128,80 163,80 0<br />
0611315 AXURA 10 MG 42 CPR RR C<br />
1 1 57,60 72,11 80<br />
0320285 AXURA 10 MG 50 CPR RR C<br />
1 1 67,94 84,93 80<br />
0611329 AXURA 10 MG 98 CPR RR C<br />
0 0 137,10 159,11 0<br />
0487469 AXURA 20 MG 42 CPR RR C<br />
1 1 122,53 143,17 80<br />
0320318 AXURA 5 MG/HUB 1 FL 50 G RR C<br />
1 1 70,00 85,70 80<br />
0487519 AXURA STARTERPACK 4*7 CPR RR C<br />
1 1 46,45 59,91 80<br />
0361985 EBIXA 10 MG 56 CPR RR C<br />
0 0 70,61 83,74 0<br />
0362031 EBIXA 500 MG SOL 50 G RR C<br />
0 0 63,04 75,71 0<br />
N06DX02 ginkgo biloba<br />
0150574 TANAKAN 4 % GTTS 90 ML P<br />
0 0 0,00 18,47 0<br />
0176052 TANAKAN 40 MG 90 CPR P<br />
0 0 0,00 18,47 0<br />
N07AA01 neostigmine<br />
0249694 PROSTIGMINE 0,5 MG 5 AMP 1 ML IMIVSC RR<br />
0 0 4,81 8,26 0<br />
0249713 PROSTIGMINE 12,5 MG 5 AMP 5 ML IMIVSC RR<br />
0 0 21,90 32,46 0<br />
N07AA02 pyridostigmine<br />
0071419 MESTINON 10 MG 50 CPR R<br />
0 0 2,74 7,59 80<br />
0071453 MESTINON 60 MG 150 DRG R<br />
0 0 26,52 35,60 80<br />
N07AA51 neostigmine, combinations<br />
0184961 ROBINUL NEOSTIGMINE 10 AMP 1 ML IV RR<br />
0 0 28,56 39,32 80<br />
N07AB01 carbachol<br />
0505049 NIQUITIN MINI MINT 1,5 MG 20 CPR SUCER P<br />
0 0 0,00 8,21 0<br />
0505052 NIQUITIN MINI MINT 1,5 MG 60 CPR SUCER P<br />
0 0 0,00 20,84 0<br />
0505066 NIQUITIN MINI MINT 4 MG 20 CPR SUCER P<br />
0 0 0,00 8,21 0<br />
0505083 NIQUITIN MINI MINT 4 MG 60 CPR SUCER P<br />
0 0 0,00 20,84 0<br />
N07AB02 bethanechol<br />
0408093 MYOCHOLINE GLENWOOD 10 MG 50 CPR R<br />
0 0 9,48 16,29 80<br />
N07BA01 nicotine<br />
0418167 NICOPASS S SUCRE REGL MENTHE 1,5MG 1PAST P<br />
0 0 0,00 4,68 0<br />
0418184 NICOPASS S SUCRE REGL MENTHE 1,5MG 3PAST P<br />
0 0 0,00 12,00 0<br />
0418234 NICOPASS S SUCRE REGL MENTHE 1,5MG 8PAST P<br />
0 0 0,00 27,28 0<br />
0379993 NICOPATCH 14 MG 21 PATCH P<br />
0 0 0,00 89,85 0<br />
0380008 NICOPATCH 14 MG 28 PATCH P<br />
0 0 0,00 68,00 0<br />
0379962 NICOPATCH 14 MG 7 PATCH P<br />
0 0 0,00 21,00 0<br />
Page 187 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0380039 NICOPATCH 21 MG 21 PATCH P<br />
0 0 0,00 89,85 0<br />
0380042 NICOPATCH 21 MG 28 PATCH P<br />
0 0 0,00 68,00 0<br />
0380011 NICOPATCH 21 MG 7 PATCH P<br />
0 0 0,00 21,00 0<br />
0379945 NICOPATCH 7 MG 21 PATCH P<br />
0 0 0,00 89,85 0<br />
0379959 NICOPATCH 7 MG 28 PATCH P<br />
0 0 0,00 68,00 0<br />
0379928 NICOPATCH 7 MG 7 PATCH P<br />
0 0 0,00 21,00 0<br />
0191076 NICORETTE 10 MG 14 PATCH P<br />
0 0 27,64 38,38 0<br />
0191126 NICORETTE 15 MG 14 PATCH P<br />
0 0 27,64 38,38 0<br />
0078437 NICORETTE 2 MG 105 GOMMES P<br />
0 0 12,53 21,52 0<br />
0230658 NICORETTE 2 MG 30 GOMMES P<br />
0 0 4,19 7,19 0<br />
0191272 NICORETTE 4 MG 105 GOMMES P<br />
0 0 16,53 26,94 0<br />
0191031 NICORETTE 5 MG 14 PATCH P<br />
0 0 27,64 38,38 0<br />
0449227 NICORETTE FRESHMINT 2 MG 105 GOMMES P<br />
0 0 12,53 21,52 0<br />
0449177 NICORETTE FRESHMINT 2 MG 30 GOMMES P<br />
0 0 4,19 7,19 0<br />
0449325 NICORETTE FRESHMINT 4 MG 105 GOMMES P<br />
0 0 16,53 26,94 0<br />
0525072 NICORETTE FRUIT 2 MG 105 GOMMES P<br />
0 0 12,53 21,52 0<br />
0525055 NICORETTE FRUIT 4 MG 105 GOMMES P<br />
0 0 16,70 27,11 0<br />
0234318 NICORETTE INHALER 10 MG 42 CRT P<br />
0 0 20,10 30,61 0<br />
0635575 NICORETTE INHALER 10 MG 6 CRT P<br />
0 0 5,60 9,62 0<br />
0482509 NICORETTE MICROTAB 2 MG 100 CPR SL P<br />
0 0 14,11 24,24 0<br />
0267501 NICORETTE MICROTAB 2 MG 105 CPR SL P<br />
0 0 13,01 22,35 0<br />
0486847 NICORETTE MICROTAB LEMON 2 MG 100 CPR P<br />
0 0 14,11 24,24 0<br />
0556793 NICOTINELL 14 MG/24 H 21 PATCH P<br />
0 0 43,43 54,64 0<br />
0556874 NICOTINELL 21 MG/24 H 21 PATCH P<br />
0 0 48,17 59,53 0<br />
0556857 NICOTINELL 21 MG/24 H 7 PATCH P<br />
0 0 14,05 24,14 0<br />
0556826 NICOTINELL 7 MG/24 H 21 PATCH P<br />
0 0 37,58 48,61 0<br />
0556809 NICOTINELL 7 MG/24 H 7 PATCH P<br />
0 0 0,00 18,73 0<br />
0390781 NICOTINELL CLASSIC 2 MG 96 GOMMES P<br />
0 0 10,81 18,57 0<br />
0390892 NICOTINELL CLASSIC 4 MG 96 GOMMES P<br />
0 0 13,85 23,80 0<br />
0364621 NICOTINELL COOL MINT 2 MG 12 GOMMES P<br />
0 0 1,79 3,08 0<br />
0364729 NICOTINELL COOL MINT 2 MG 96 GOMMES P<br />
0 0 11,26 19,21 0<br />
0363431 NICOTINELL COOL MINT 4 MG 96 GOMMES P<br />
0 0 14,33 24,62 0<br />
0363203 NICOTINELL FRUIT 2 MG 12 GOMMES P<br />
0 0 1,79 3,08 0<br />
0363265 NICOTINELL FRUIT 2 MG 96 GOMMES P<br />
0 0 11,18 19,21 0<br />
0363346 NICOTINELL FRUIT 4 MG 96 GOMMES P<br />
0 0 14,33 24,62 0<br />
0261641 NIQUITIN 14 MG 14 PATCH P<br />
0 0 0,00 38,52 0<br />
0261654 NIQUITIN 14 MG 28 PATCH P<br />
0 0 0,00 61,64 0<br />
0261637 NIQUITIN 14 MG 7 PATCH P<br />
0 0 0,00 24,06 0<br />
0446368 NIQUITIN 2 MG 72 CPR SUCER P<br />
0 0 0,00 24,24 0<br />
0261671 NIQUITIN 21 MG 14 PATCH P<br />
0 0 0,00 38,52 0<br />
0261685 NIQUITIN 21 MG 28 PATCH P<br />
0 0 0,00 61,64 0<br />
0261668 NIQUITIN 21 MG 7 PATCH P<br />
0 0 0,00 24,06 0<br />
0446385 NIQUITIN 4 MG 72 CPR SUCER P<br />
0 0 0,00 24,24 0<br />
0261606 NIQUITIN 7 MG 14 PATCH P<br />
0 0 0,00 38,52 0<br />
Page 188 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0261623 NIQUITIN 7 MG 28 PATCH P<br />
0 0 0,00 61,64 0<br />
0261591 NIQUITIN 7 MG 7 PATCH P<br />
0 0 0,00 24,06 0<br />
0349364 NIQUITIN CLEAR 14 MG 14 PATCH P<br />
0 0 27,78 38,51 0<br />
0444011 NIQUITIN CLEAR 14 MG 21 PATCH P<br />
0 0 39,00 50,08 0<br />
0349351 NIQUITIN CLEAR 14 MG 7 PATCH P<br />
0 0 0,00 24,05 0<br />
0350111 NIQUITIN CLEAR 21 MG 14 PATCH P<br />
0 0 27,78 38,51 0<br />
0444024 NIQUITIN CLEAR 21 MG 21 PATCH P<br />
0 0 39,00 50,08 0<br />
0349381 NIQUITIN CLEAR 21 MG 7 PATCH P<br />
0 0 0,00 24,05 0<br />
0349316 NIQUITIN CLEAR 7 MG 7 PATCH P<br />
0 0 0,00 24,05 0<br />
0446161 NIQUITIN MINT 2 MG 72 CPR SUCER BLIST P<br />
0 0 0,00 24,24 0<br />
0446131 NIQUITIN MINT 4 MG 72 CPR SUCER BLIST P<br />
0 0 0,00 24,24 0<br />
N07BA03 varenicline<br />
0444167 CHAMPIX 0,5 MG 11 CPR ETUI + 1 MG 14 CPR RR V<br />
0 0 37,50 48,54 0<br />
0524786 CHAMPIX 1 MG 140 CPR RR V<br />
0 0 172,20 191,41 0<br />
0444119 CHAMPIX 1 MG 28 CPR RR V<br />
0 0 42,00 53,17 0<br />
0444105 CHAMPIX 1 MG 56 CPR RR V<br />
0 0 74,34 86,48 0<br />
0444122 CHAMPIX 1 MG 56 CPR BLIST RR V<br />
0 0 74,34 86,48 0<br />
N07BB01 disulfiram<br />
0006312 ANTABUSE 400 MG 50 CPR RR<br />
0 0 3,86 6,63 80<br />
N07BB03 acamprosate<br />
0328719 CAMPRAL 333 MG 168 CPR RR<br />
0 0 35,55 45,55 80<br />
0215438 CAMPRAL 333 MG 84 CPR RR<br />
0 0 18,73 27,02 80<br />
N07BB04 naltrexone<br />
0281965 NALOREX 50 MG 28 CPR RR C<br />
0 0 56,77 69,69 80<br />
N07BC01 buprenorphine<br />
0251211 SUBUTEX 2 MG 7 CPR S C<br />
6 11 5,08 10,50 100<br />
0251224 SUBUTEX 8 MG 7 CPR S C<br />
6 11 15,49 23,47 100<br />
N07BC02 methadone<br />
0436439 MEPHENON 10 MG 6 AMP 1 ML IMIV S C<br />
0 0 2,31 3,97 0<br />
0436361 MEPHENON 5 MG 30 CPR S C<br />
6 11 3,05 5,24 80<br />
0277153 METHADDICT 5 MG 100 CPR S C<br />
6 11 0,00 11,16 100<br />
0277122 METHADDICT 5 MG 20 CPR S C<br />
6 11 0,00 2,23 100<br />
0277136 METHADDICT 5 MG 50 CPR S C<br />
6 11 0,00 5,58 100<br />
N07BC51 buprenorphine, combinations<br />
0445973 SUBOXONE 2/0,5 MG 28 CPR S C<br />
6 11 22,41 31,07 100<br />
0445956 SUBOXONE 2/0,5 MG 7 CPR S C<br />
6 11 5,60 11,16 100<br />
0445991 SUBOXONE 8/2 MG 28 CPR S C<br />
6 11 71,94 85,14 100<br />
0445987 SUBOXONE 8/2 MG 7 CPR S C<br />
6 11 17,98 26,21 100<br />
N07CA01 betahistine<br />
0136818 BETAHISTINE EG 6 MG 100 CPR R<br />
0 0 3,37 8,38 80<br />
Page 189 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0162947 BETASERC 16 MG 42 CPR SEC R<br />
0 0 6,04 11,59 80<br />
0176781 BETASERC 16 MG 84 CPR SEC R<br />
0 0 9,18 15,50 80<br />
0012807 BETASERC 8 MG 100 CPR R<br />
0 0 6,42 12,06 80<br />
0278424 LECTIL 16 MG 45 CPR R<br />
0 0 5,42 8,38 80<br />
0499568 LECTIL 24 MG 60 CPR R<br />
0 0 9,10 14,08 80<br />
0251529 LECTIL 8 MG 30 CPR R<br />
0 0 1,91 2,78 80<br />
0251515 LECTIL 8 MG 90 CPR R<br />
0 0 4,87 7,53 80<br />
N07CA02 cinnarizine<br />
0136849 CINNARIZINE EG 75 MG 100 CAPS R<br />
0 0 7,64 13,13 0<br />
0110680 STUGERON 25 MG 200 CPR 17572 R<br />
0 0 8,09 13,90 0<br />
0110694 STUGERON 75 MG/ML GTTS 100 ML 17578 R<br />
0 0 10,92 18,75 0<br />
N07CA03 flunarizine<br />
0104568 SIBELIUM 10 MG 28 CPR 38101 R<br />
0 0 11,26 19,35 80<br />
N07CA52 cinnarizine, combinations<br />
0118451 TOURISTIL 12 CPR 32232 R<br />
0 0 4,29 7,38 0<br />
N07XX Other nervous system drugs<br />
0634984 VYNDAQEL 20 MG 30 CAPS RR DC X RM 0 0<br />
12.246,60 0,00 0<br />
N07XX02 riluzole<br />
0223913 RILUTEK 50 MG 56 CPR RR C<br />
0 0 229,20 251,82 100<br />
N07XX04 sodium oxybate<br />
0420795<br />
N07XX07<br />
XYREM 500 MG/ML SOL 180 ML S DC<br />
RM 0 0<br />
349,00 0,00 0<br />
0623896 FAMPYRA 10 MG 2*14 CPR (FL) RR C<br />
0 0 205,25 237,30 0<br />
0623901 FAMPYRA 10 MG 4*14 CPR (FL) RR C<br />
0 0 410,50 465,65 0<br />
P01AB07 secnidazole<br />
0434031 SECNOL 2 G 1 SACH RR<br />
0 0 4,83 8,60 0<br />
P01AX06 atovaquone<br />
0231249 WELLVONE 750 MG/5 ML SIR 240 ML RR<br />
0 0 323,28 342,89 0<br />
P01BA01 chloroquine<br />
0079238 NIVAQUIN 100 MG 100 CPR R<br />
6 8 2,64 4,53 80<br />
0079224 NIVAQUIN 100 MG 20 CPR R<br />
6 8 0,63 5,22 80<br />
P01BA02 hydroxychloroquine<br />
0091344 PLAQUENIL 200 MG 100 DRG R<br />
6 8 7,97 14,11 80<br />
P01BB51 proguanil, combinations<br />
0235511 MALARONE 12 CPR RR<br />
6 8 32,02 42,89 80<br />
0340521 MALARONE JR 62,5/25 MG 12 CPR RR<br />
6 8 10,45 17,96 80<br />
P01BC02 mefloquine<br />
Page 190 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0186658 LARIAM 250 MG 8 CPR R<br />
6 8 22,70 33,29 80<br />
P01BD01 pyrimethamine<br />
0027939 DARAPRIM 25 MG 30 CPR R<br />
6 8 0,00 4,33 80<br />
P01CX01 pentamidine isethionate<br />
0146229 PENTACARINAT 300 MG 5 FL RR<br />
0 0 89,13 103,36 80<br />
P02CA01 mebendazole<br />
0304931 DOCMEBENDA 100 MG 10 CPR P<br />
0 0 0,00 4,43 80<br />
0126663 VERMOX 100 MG 6 CPR 17604 P<br />
0 0 2,97 5,10 80<br />
0126694 VERMOX SIR 30 ML 17606 P<br />
0 0 3,38 5,80 80<br />
P02DA01 niclosamide<br />
0130750 YOMESAN 500 MG 4 CPR P<br />
0 0 3,56 6,12 80<br />
P03AC04 permethrin<br />
0436134 INFECTOSCAB 5% CREME 30 G RR<br />
0 0 12,63 26,20 0<br />
0185888 NIX CREME RINSE 1% LOT 59 ML P<br />
0 0 0,00 9,27 0<br />
0190728 ZALVOR 5% CREME 30 G RR<br />
0 0 0,00 13,11 80<br />
P03AC54 permethrin, combinations<br />
0263094 PARAPLUS SPRAY 125 ML P<br />
0 0 6,19 10,64 0<br />
P03AX03 malathion<br />
0093805 PRIODERM 0,5% LOTION 100 ML P<br />
0 0 0,00 6,95 0<br />
0223815 RADIKAL 0,5% LOT CAPILL ANTIPOUX 100 ML P<br />
0 0 4,36 7,48 0<br />
R01 NASAL PREPARATIONS<br />
0000627 ACTISOUFRE 30 AMP BUV 10 ML P<br />
0 0 0,00 5,18 0<br />
R01AA Sympathomimetics, plain<br />
0043753 FARIAL DOSIERSPRAY 10 ML P<br />
0 0 0,00 3,40 0<br />
0192091 FARIAL NASENSPRAY 10 ML P<br />
0 0 0,00 2,35 0<br />
R01AA05 oxymetazoline<br />
0075774 NASIVIN DOSIERSPRAY 0,05% ERW 10 ML P<br />
0 0 2,88 5,14 0<br />
0075743 NASIVIN NASENTROPFEN 0,05% ERW 10 ML P<br />
0 0 2,06 3,68 0<br />
0260321 NASIVIN O.KONS 0,01% BB DOSIERTROPFER P<br />
0 0 2,40 4,28 0<br />
0355491 NASIVIN O.KONS 0,025% KLEINK DOSIERSPRAY P<br />
0 0 2,40 4,28 0<br />
0538121 NASIVIN O.KONS 0,05% ERW DOSIERSPRAY P<br />
0 0 0,00 5,14 0<br />
0075760 NASIVIN SPRAY 0,05% ERW 10 ML P<br />
0 0 0,00 4,38 0<br />
0127402 VICKS SINEX SPRAY NASAL 15 ML P<br />
0 0 2,82 4,85 0<br />
R01AA07 xylometazoline<br />
0010542 BALKIS SPRAY NASAL 10 ML P<br />
0 0 1,68 3,37 0<br />
0268431 NASA RHINATHIOL 0,05% SPRAY NAS ENF 10ML P<br />
0 0 2,74 4,71 0<br />
0314338 NASA RHINATHIOL 0,1% SPRAY NAS AD 10 ML P<br />
0 0 3,54 6,07 0<br />
0297691 NASASINUTAB 0,1% SPRAY 10 ML P<br />
0 0 3,37 5,78 0<br />
Page 191 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0132576 NASENGEL RATIO 10 G P<br />
0 0 1,38 2,77 0<br />
0426009 NASENSPRAY E HEXAL 0,1% 10 ML P<br />
0 0 0,00 2,15 0<br />
0429577 NASENSPRAY RATIO ERW 0,1% 10ML KONSFREI P<br />
0 0 1,53 3,07 0<br />
0429581 NASENSPRAY RATIO KIN 0,05% 10ML KONSFREI P<br />
0 0 1,00 2,08 0<br />
0132562 NASENTROPFEN RATIO KINDER 0,05% 10 ML P<br />
0 0 1,00 2,08 0<br />
0319513 OTRIVINE ANTIRHIN 0,05% GTTS ENF 10 ML P<br />
0 0 2,80 4,81 0<br />
0319527 OTRIVINE ANTIRHIN 0,1% GTTS AD 10 ML P<br />
0 0 3,04 5,22 0<br />
0319531 OTRIVINE ANTIRHIN 0,1% MICRODOS 10 ML P<br />
0 0 3,74 6,42 0<br />
0319544 OTRIVINE ANTIRHIN MENTH 0,1% MICROD 10ML P<br />
0 0 3,74 6,42 0<br />
0497871 OTRIVINE ANTIRHIN SINE CONS 0,05% SPRAY P<br />
0 0 3,74 6,42 0<br />
R01AA08 naphazoline<br />
0125151 VASOCEDINE NAPHA GTTS 15 ML IN P<br />
0 0 3,11 5,34 0<br />
0125148 VASOCEDINE NAPHA MICRODOSEUR 15 ML IN P<br />
0 0 3,73 6,41 0<br />
R01AA09 tramazoline<br />
0099387 RHINOSPRAY CPT GTTS 15 ML P<br />
0 0 3,39 5,82 0<br />
0311421 RHINOSPRAY EUCALYPTUS SPRAY 10 ML P<br />
0 0 3,70 6,35 0<br />
0099390 RHINOSPRAY MICRODOSEUR 15 ML P<br />
0 0 4,29 7,38 0<br />
R01AB01 phenylephrine<br />
0189713 VIBROCIL GEL TUBE 12 G P<br />
0 0 3,38 5,81 0<br />
0127299 VIBROCIL GTTS NAS 15 ML P<br />
0 0 2,97 5,10 0<br />
0189891 VIBROCIL SPRAY 15 ML P<br />
0 0 3,75 6,44 0<br />
R01AB02 naphazoline<br />
0141415 SOFRALINE GTTS 15 ML P<br />
0 0 2,35 4,03 0<br />
0181831 SOFRALINE SPRAY MICRODOSEUR 15 ML P<br />
0 0 2,98 5,12 0<br />
R01AB05 ephedrine<br />
0039330 ENDRINE DOUX GTTS NAS 30 ML P<br />
0 0 2,19 3,76 0<br />
0039327 ENDRINE FORT GTTS NAS 30 ML P<br />
0 0 2,19 3,76 0<br />
R01AB06 xylometazoline<br />
0522974 OTRIVINE DUO SPRAY 1 FL MD 10 ML P<br />
0 0 4,36 7,48 0<br />
R01AC01 cromoglicic acid<br />
0187235 CROMOHEXAL KOMB 2% SPRAY 15 ML + COLLY P<br />
0 0 4,90 9,39 40<br />
0267708 CROMOHEXAL SANFT NASENSPRAY 15 ML P<br />
0 0 3,01 5,97 40<br />
0267711 CROMOHEXAL SANFT NASENSPRAY 30 ML P<br />
0 0 5,85 11,21 40<br />
0215729 LOMUSOL 2% GTTS 13,5 ML IN P<br />
0 0 3,34 8,22 40<br />
0216291 LOMUSOL FORTE 4% SPRAY 15 ML IN P<br />
0 0 3,71 8,79 40<br />
R01AC02 levocabastine<br />
0173985 LIVOSTIN 0,05% SPRAY 1 FL 10 ML 52017 R<br />
0 0 7,03 12,09 40<br />
R01AC03 azelastine<br />
0188716 ALLERGODIL SPRAY 10 ML P<br />
0 0 6,70 11,51 40<br />
Page 192 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
R01AC51 cromoglicic acid, combinations<br />
0151568 VIVIDRIN SPRAY 15 ML 241 P<br />
0 0 3,85 6,86 40<br />
R01AD04 flunisolide<br />
0112637 SYNTHARIS NEB NAS 24 ML RR<br />
0 0 5,37 9,23 40<br />
R01AD05 bu<strong>des</strong>onide<br />
0298539 RHINOCORT AQUA 64 MCG/D 120 D RR<br />
0 0 6,06 11,73 40<br />
R01AD08 fluticasone<br />
0251791 FLIXONASE AQUA 50 MCG/D SPRAY 150 D RR<br />
0 0 8,39 14,63 40<br />
R01AD09 mometasone<br />
0253439 NASONEX 50 MCG/D SPRAY 18 G RR<br />
0 0 9,67 16,11 40<br />
R01AD12 fluticasone furoate<br />
0475759 AVAMYS 27,5 MCG SPRAY 120 D RR<br />
0 0 8,29 14,50 40<br />
R01AD52 prednisolone, combinations<br />
0181844 SOFRASOLONE GTTS NASALES 10 ML RR<br />
0 0 3,07 5,28 0<br />
0105811 SOFRASOLONE SPRAY MICRODOSEUR 10 ML RR<br />
0 0 3,82 6,56 0<br />
R01AD53 dexamethasone, combinations<br />
0231638 DEXARHINOSPRAY MICRODOS 10 ML RR<br />
0 0 6,48 11,13 0<br />
R01AX03 ipratropium bromide<br />
0226106 ATRONASE 0,3 MG/ML MICRODOS 1 FL 15 ML P<br />
0 0 7,69 13,21 40<br />
R01AX08 framycetin<br />
0105761 SOFRAMYCINE SIMPLE GTTS NAS 15 ML P<br />
0 0 2,56 4,40 40<br />
0105789 SOFRAMYCINE SPRAY MICRODOSEUR 15 ML P<br />
0 0 2,83 4,86 40<br />
R01AX10 various<br />
0337315 PHYSIOLOGICA 0,9% SOL IRR 10*5 ML P<br />
0 0 0,00 3,01 40<br />
0255318 PHYSIOLOGICA 0,9% SOL IRR 16*5 ML P<br />
0 0 0,00 4,69 40<br />
0337542 PHYSIOLOGICA 0,9% SOL IRR 30*100 ML P<br />
0 0 0,00 2,06 0<br />
0337511 PHYSIOLOGICA 0,9% SOL IRR 30*45 ML P<br />
0 0 1,24 1,85 0<br />
0337332 PHYSIOLOGICA 0,9% SOL IRR 30*5 ML P<br />
0 0 0,00 7,25 40<br />
0255321 PHYSIOLOGICA 0,9% SOL IRR 32*5 ML P<br />
0 0 0,00 7,95 40<br />
0209122 PHYSIORHINE 0.9% SOL IN 18 UD 5 ML P<br />
0 0 0,00 4,85 40<br />
R01AX30 combinations<br />
0416873 ACTISOUFRE VAPO 100 ML P<br />
0 0 0,00 8,16 0<br />
R01BA02 pseudoephedrine<br />
0277685 RINOMAR 60 MG 24 CPR 90816 R<br />
0 0 2,94 5,05 0<br />
0300851 VASOCEDINE PSEUDOEPHEDRINE 60 MG 30 CPR R<br />
0 0 3,37 5,78 0<br />
0300847 VASOCEDINE PSEUDOEPHEDRINE 60 MG 6 CPR R<br />
0 0 1,16 1,99 0<br />
Page 193 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
R01BA52 pseudoephedrine, combinations<br />
0469328 AERINAZE 2,5/120 MG 14 CPR R<br />
0 0 4,50 7,72 0<br />
0320349 CIRRUS 120/5 MG 14 CPR R<br />
0 0 0,00 7,72 0<br />
0229884 CLARINASE 120/5 MG 14 REPETABS R<br />
0 0 3,95 6,79 0<br />
0231154 CLARINASE 240/10 MG ONCE DAILY 7 CPR R<br />
0 0 4,33 7,44 0<br />
0385469 REACTINE PSEUDOEPHEDRINE 120/5 MG 14 CPR R<br />
0 0 4,24 7,29 0<br />
0349011 SINUTAB 500/30 MG 15 CPR P<br />
0 0 3,23 5,56 0<br />
0349039 SINUTAB FORTE 500/60 MG 20 CPR R<br />
0 0 4,79 8,24 0<br />
R01BA53 phenylephrine, combinations<br />
0259849 RHINATHIOL ANTIRHINITIS 20 CPR P<br />
0 0 0,00 3,03 0<br />
0311806 RHINATHIOL ANTIRHINITIS 40 CPR P<br />
0 0 3,62 6,22 0<br />
0259852 RHINATHIOL ANTIRHINITIS SIR 200 ML P<br />
0 0 4,10 7,04 0<br />
R02A THROAT PREPARATIONS<br />
0453881 MAXILASE 3000 30 CPR P<br />
0 0 3,12 5,48 0<br />
R02AA Antiseptics<br />
0241651 HEXASPRAY COLLU 30 G P<br />
0 0 2,83 5,04 0<br />
R02AA02 dequalinium<br />
0309941 ORORHINATHIOL 30 PAST P<br />
0 0 3,79 6,51 0<br />
R02AA03 dichlorobenzyl alcohol<br />
0391967 STREPSILS LIDOCAINE 36 PAST P<br />
0 0 4,85 8,33 0<br />
0247025 STREPSILS LIDOCAINE SPRAY 20 ML P<br />
0 0 4,12 7,09 0<br />
R02AA05 chlorhexidine<br />
0375249 ANGIOCINE 1,5/5 MG 24 CPR P<br />
0 0 2,53 4,34 0<br />
0179006 GOLASEPTINE 5 MG 20 PAST P<br />
0 0 2,69 4,62 0<br />
0651731 MEDICA LEMON GORGE 36 CPR SUCER P<br />
0 0 3,51 5,85 0<br />
0651694 MEDICA LEMON GORGE 40 CPR SUCER P<br />
0 0 0,00 5,09 0<br />
0614835 MEDICA LEMON GORGE SPRAY 30 ML P<br />
0 0 4,47 7,68 0<br />
0544663 MEDICA MENTHOL GORGE 36 CPR SUCER P<br />
0 0 3,51 6,02 0<br />
0544681 MEDICA MENTHOL GORGE SPRAY 30 ML P<br />
0 0 4,47 7,68 0<br />
0183271 MEFREN 24 PAST P<br />
0 0 2,58 4,44 0<br />
R02AA15 povidone-iodine<br />
0174612 IODEX BUCCAL 1% COLLU 200 ML P<br />
0 0 0,00 4,66 40<br />
0058966 ISOBETADINE BUCCAL 1% SOL 200 ML P<br />
0 0 3,09 5,31 40<br />
R02AA18 hexamidine<br />
0053536 HEXOMEDINE COLLU AER 30 G P<br />
0 0 3,74 6,42 0<br />
R02AA20 various<br />
0030108 DEQUONAL SOL 200 ML P<br />
0 0 4,24 6,36 40<br />
0030111 DEQUONAL SPRAY 50 ML P<br />
0 0 4,57 6,86 0<br />
0035622 DORITHRICIN 20 CPR P<br />
0 0 3,35 5,96 0<br />
Page 194 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0386483 HEXALYSE 30 CPR P<br />
0 0 0,00 1,97 0<br />
0243481 NEOGOLASEPTINE SPRAY 30 G P<br />
0 0 3,90 6,70 0<br />
0319107 OROFAR LIDOCAINE MENTHE PERLES 24 CAPS P<br />
0 0 4,09 7,03 0<br />
0488533 OROFAR LIDOCAINE MENTHE PERLES 36 CAPS P<br />
0 0 5,54 9,51 0<br />
0217446 OROFAR LIDOCAINE PERLES 24 CAPS P<br />
0 0 3,93 6,75 0<br />
0334652 OROFAR LIDOCAINE PERLES 36 CAPS P<br />
0 0 5,31 9,12 0<br />
0319111 OROFAR MENTHE PERLES 24 CAPS P<br />
0 0 3,60 6,18 0<br />
0488547 OROFAR MENTHE PERLES 36 CAPS P<br />
0 0 5,16 8,87 0<br />
0149704 OROFAR PERLES 24 CAPS P<br />
0 0 3,51 6,03 0<br />
0334649 OROFAR PERLES 36 CAPS P<br />
0 0 4,97 8,54 0<br />
0149671 OROFAR SPRAY 30 ML P<br />
0 0 4,85 8,35 0<br />
0280176 PATE SUISSE NOUVELLE 50 G P<br />
0 0 3,53 6,68 0<br />
0525458 STREPSILS COOL MINT 20 PAST P<br />
0 0 4,24 7,29 0<br />
0508461 STREPSILS COOL MINT 36 PAST P<br />
0 0 4,24 7,29 0<br />
0525427 STREPSILS MIEL CITRON 20 PAST P<br />
0 0 3,93 6,76 0<br />
0487942 STREPSILS MIEL CITRON 36 PAST P<br />
0 0 4,05 6,96 0<br />
0487911 STREPSILS SS SUCRE CITRON 36 PAST P<br />
0 0 4,21 7,24 0<br />
0487956 STREPSILS SS SUCRE FRAISE 36 PAST P<br />
0 0 4,21 7,24 0<br />
0487939 STREPSILS VIT C ORANGE 36 PAST P<br />
0 0 4,05 6,96 0<br />
R02AB02 tyrothricin<br />
0248361 LEMOCIN 24 PAST P<br />
0 0 2,61 4,48 0<br />
0260254 LEMOCIN 50 PAST P<br />
0 0 3,99 6,85 0<br />
0248294 TYROTHRICINE LIDOC RPR CITRON 48 PAST P<br />
0 0 3,79 6,51 0<br />
0253926 TYROTHRICINE LIDOC RPR MENTHE 48 PAST P<br />
0 0 0,00 5,33 0<br />
R02AB03 fusafungine<br />
0229769 LOCABIOTAL 1% 1 FL DOS 5 ML IN + BU P<br />
0 0 0,00 6,20 0<br />
R02AD Anesthetics, local<br />
0517537 MUCOANGIN CASSIS 20 MG 30 PAST P<br />
0 0 4,53 7,67 0<br />
0517541 MUCOANGIN CASSIS 20 MG 48 PAST P<br />
0 0 4,53 7,78 0<br />
0330538 MUCOANGIN MENTHE 20 MG 20 PAST P<br />
0 0 3,55 6,10 0<br />
0330555 MUCOANGIN MENTHE 20 MG 30 PAST P<br />
0 0 4,53 7,78 0<br />
R02AX01 flurbiprofen<br />
0557773 STREPFEN 8,75 MG 24 PAST P<br />
0 0 4,67 8,03 0<br />
R03AC02 salbutamol<br />
0210641 AIROMIR 100 MCG AER 200 D R<br />
0 0 2,72 7,44 100<br />
0288661 AIROMIR AUTOHALER 100 MCG/D 200 D R<br />
0 0 0,00 14,68 0<br />
0409141 NOVOLIZER SALBUT 100 MCG 1 CRT 200D RECH R<br />
0 0 3,02 5,19 100<br />
0405687 NOVOLIZER SALBUT 100 MCG 1 INH+CRT 200 D R<br />
0 0 6,73 11,56 100<br />
0126307 VENTOLIN 0,5% SOL INH NEB 10 ML R<br />
0 0 1,72 6,40 100<br />
0265511 VENTOLIN 100 MCG/D 200 D SPRAY SS CFC R<br />
0 0 1,77 6,47 100<br />
0220827 VENTOLIN DISKUS 200 MCG 60 BLIST R<br />
0 0 0,00 9,59 100<br />
Page 195 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0263662 VENTOLIN NEBULES 1 MG/ML 20 AMP 2,5 ML R<br />
0 0 0,00 9,51 100<br />
R03AC03 terbutaline<br />
0161791 BRICANYL TURBOHALER 0,5 MG/D PDR IH 200D R<br />
0 0 0,00 14,69 100<br />
R03AC12 salmeterol<br />
0214024 SEREVENT DISKUS 50 MCG 1 DISQ 60 BL RR<br />
0 0 19,16 27,50 100<br />
0458615 SEREVENT EVOHALER 25 MCG/D SUSP 120 D IH RR<br />
0 0 19,16 27,50 100<br />
R03AC13 formoterol<br />
0376071 FORADIL P 9,8 MCG 180 CAPS RR<br />
0 0 95,10 114,58 0<br />
0449485 NOVOLIZER FORMOTEROL 12 MCG 1 CRT 60 D RR<br />
0 0 18,79 27,09 100<br />
0232621 OXIS TURBOHALER 4,5 MCG/D 60 D IH RR<br />
0 0 14,43 24,76 100<br />
0232635 OXIS TURBOHALER 9 MCG/D 60 D IH RR<br />
0 0 15,82 23,83 100<br />
R03AC18 indacaterol<br />
0558834 ONBREZ BREEZHALER 150 MCG 30 CAPS + INH RR<br />
RM 0 0<br />
28,80 38,12 100<br />
0558865 ONBREZ BREEZHALER 300 MCG 30 CAPS + INH RR<br />
RM 0 0<br />
28,80 38,12 100<br />
R03AK03 fenoterol and other drugs for obstructive airway diseases<br />
0305499 DUOVENT HFA 200 D 10 ML INH R<br />
0 0 5,68 11,25 100<br />
0213187 DUOVENT SOL INH 20 FL UD R<br />
0 0 7,29 13,25 100<br />
R03AK04 salbutamol and other drugs for obstructive airway diseases<br />
0306806 COMBIVENT 60 FL UD INH R<br />
0 0 14,84 23,76 100<br />
0250701 COMBIVENT SOL 20 FL UD INH R<br />
0 0 6,02 12,07 100<br />
R03AK06 salmeterol and other drugs for obstructive airway diseases<br />
0296291 SERETIDE 25/125 AER 120 D RR<br />
0 0 37,33 47,52 100<br />
0296307 SERETIDE 25/250 AER 120 D RR<br />
0 0 50,57 62,10 100<br />
0296288 SERETIDE 25/50 AER 120 D RR<br />
0 0 28,22 37,48 100<br />
0261041 SERETIDE 50/100 DISKUS 60 D RR<br />
0 0 28,22 37,48 100<br />
0261072 SERETIDE 50/250 DISKUS 60 D RR<br />
0 0 37,33 47,52 100<br />
0261119 SERETIDE 50/500 DISKUS 60 D RR<br />
0 0 50,57 62,10 100<br />
R03AK07 formoterol and other drugs for obstructive airway diseases<br />
0472967 INUVAIR 100/6 MCG SOL INH 120 D RR<br />
0 0 36,01 45,89 100<br />
0339404 SYMBICORT FORTE TURBO 320/9 MCG 1*60 D RR<br />
0 0 38,00 48,25 100<br />
0294672 SYMBICORT TURBOHALER 1*120 D RR<br />
0 0 38,00 48,25 100<br />
0294624 SYMBICORT TURBOHALER 1*60 D RR<br />
0 0 23,75 34,37 100<br />
R03BA01 beclometasone<br />
0286931 QVAR AUTOHALER 100 MCG/D 200D IH RR<br />
0 0 18,14 26,27 100<br />
0286927 QVAR AUTOHALER 50 MCG/D 200 D IH RR<br />
0 0 11,08 17,87 100<br />
R03BA02 bu<strong>des</strong>onide<br />
0398016 NOVOLIZER BUDESONIDE 200MCG/D INH+2*200D RR<br />
0 0 26,79 35,90 100<br />
0398002 NOVOLIZER BUDESONIDE 200MCG/D INH+200 D RR<br />
0 0 13,73 21,29 100<br />
0162706 PULMICORT SUSP 0,5 MG/ML 20 UD 2 ML RR<br />
0 0 33,84 43,67 100<br />
Page 196 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0416243 PULMICORT TURBOHALER 200 MCG PDR 100 D RR<br />
0 0 9,56 16,09 100<br />
R03BA05 fluticasone<br />
0257035 FLIXOTIDE 250 MCG/D AER SS CFC 120 D RR<br />
0 0 26,84 35,95 100<br />
0275632 FLIXOTIDE 50 MCG/D AER SS CFC 120 D RR<br />
0 0 6,71 12,54 100<br />
0216811 FLIXOTIDE DISKUS 100 MCG 60 D RR<br />
0 0 6,71 12,54 100<br />
0216824 FLIXOTIDE DISKUS 250 MCG 60 D RR<br />
0 0 14,92 22,78 100<br />
0216838 FLIXOTIDE DISKUS 500 MCG 60 D RR<br />
0 0 26,84 35,95 100<br />
0270068 FLIXOTIDE NEBULES 0,5 MG 10 AMP 2 ML INH RR<br />
0 0 8,39 14,42 100<br />
0270054 FLIXOTIDE NEBULES 2 MG 10 AMP 2 ML INH RR<br />
0 0 14,16 21,82 100<br />
R03BB01 ipratropium bromide<br />
0214556 ATROVENT 0,25 MG 20 FL 2 ML UD IH R<br />
0 0 4,43 9,72 100<br />
0306787 ATROVENT 0,25 MG 60 FL 2 ML UD IH R<br />
0 0 10,53 18,06 100<br />
0214573 ATROVENT 0,5 MG 20 FL 2 ML UD IH R<br />
0 0 6,60 12,84 100<br />
0345222 ATROVENT HFA 20 MCG/D AER 10 ML R<br />
0 0 4,70 10,11 100<br />
R03BB04 tiotropium bromide<br />
0316041 SPIRIVA 18 MCG 30 CAPS + HANDIHALER R<br />
0 0 38,48 48,78 100<br />
0495586 SPIRIVA RESPIMAT 2,5 MCG/D 2 CRT + 2 INH R<br />
0 0 38,48 50,29 0<br />
R03BC01 cromoglicic acid<br />
0170791 CROMOHEXAL 1% 20 MG 50 AMP 2 ML R<br />
0 0 10,94 18,96 80<br />
0256315 LOMUDAL INHAL CFC-FREE 5MG/D AER 12 ML R<br />
0 0 6,31 12,04 80<br />
0067254 LOMUDAL SOL NEB 20 MG 48 AMP 2 ML V IH R<br />
0 0 7,38 13,38 80<br />
R03CC02 salbutamol<br />
0126288 VENTOLIN 2 MG 100 CPR R<br />
0 0 2,02 6,73 100<br />
0126310 VENTOLIN 2 MG/5 ML SIR 150 ML R<br />
0 0 0,96 5,59 100<br />
0126291 VENTOLIN 4 MG 50 CPR R<br />
0 0 1,97 6,69 100<br />
0126341 VENTOLIN 5 MG 1 AMP 5 ML PERF RR H<br />
0 0 3,77 0,00 0<br />
0126338 VENTOLIN 500 MCG 3 AMP 1 ML IMSC R<br />
0 0 1,55 6,22 100<br />
R03DA04 theophylline<br />
0115754 THEOLAIR LA 250 MG 100 CPR R<br />
0 0 4,13 9,32 100<br />
0115771 THEOLAIR LA 350 MG 100 CPR R<br />
0 0 5,40 10,91 100<br />
0115964 THEOSTAT 300 MG 30 CPR LP R<br />
0 0 0,00 3,31 100<br />
0160617 XANTHIUM 200 MG 60 CAPS R<br />
0 0 2,71 7,38 100<br />
0182551 XANTHIUM 300 MG 60 CAPS R<br />
0 0 3,68 8,58 100<br />
0160603 XANTHIUM 400 MG 60 CAPS R<br />
0 0 4,35 9,42 100<br />
R03DA05 aminophylline<br />
0222396 EUPHYLLIN 200 MG 50 AMP 10 ML IV RR<br />
0 0 7,40 0,00 0<br />
R03DC01 zafirlukast<br />
0228744 ACCOLATE 20 MG 56 CPR R<br />
0 0 14,38 22,11 80<br />
0251823 RESMA 20 MG 56 CPR R<br />
0 0 14,38 22,11 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
R03DC03 montelukast<br />
0503268 MONTELUKAST RATIO JR 5 MG 28 CPR R<br />
0 0 18,44 29,40 0<br />
0503299 MONTELUKAST RATIO JR 5 MG 56 CPR R<br />
0 0 29,50 41,37 0<br />
0503321 MONTELUKAST RATIO JR 5 MG 98 CPR R<br />
0 0 51,63 65,58 0<br />
0503397 MONTELUKAST RATIO MINI 4 MG 28 CPR R<br />
0 0 18,44 29,40 0<br />
0503433 MONTELUKAST RATIO MINI 4 MG 56 CPR R<br />
0 0 29,50 41,37 0<br />
0503464 MONTELUKAST RATIO MINI 4 MG 98 CPR R<br />
0 0 51,63 65,58 0<br />
0648721 MONTELUKAST SDZ 10 MG 28 CPR R<br />
0 0 17,82 26,03 0<br />
0648802 MONTELUKAST SDZ 10 MG 98 CPR R<br />
0 0 53,00 64,77 0<br />
0648901 MONTELUKAST SDZ 4 MG 28 CPR CROQ R<br />
0 0 17,82 26,03 0<br />
0648993 MONTELUKAST SDZ 4 MG 98 CPR CROQ R<br />
0 0 53,00 64,77 0<br />
0649097 MONTELUKAST SDZ 5 MG 28 CPR CROQ R<br />
0 0 17,82 26,03 0<br />
0649181 MONTELUKAST SDZ 5 MG 98 CPR CROQ R<br />
0 0 53,00 64,77 0<br />
0503528 MONTELUKAST TEVA 10 MG 28 CPR R<br />
0 0 18,44 29,40 0<br />
0503559 MONTELUKAST TEVA 10 MG 56 CPR R<br />
0 0 29,50 41,37 0<br />
0503593 MONTELUKAST TEVA 10 MG 98 CPR R<br />
0 0 51,63 65,58 0<br />
0368911 RHINOSINGULAIR 10 MG 28 CPR R<br />
0 0 30,68 41,50 0<br />
0246904 SINGULAIR 10 MG 28 CPR R<br />
0 0 30,68 41,50 80<br />
0246918 SINGULAIR 10 MG 56 CPR R<br />
0 0 67,95 79,88 80<br />
0433292 SINGULAIR 4 MG 28 CPR CROQ R<br />
0 0 30,68 41,50 80<br />
0512706 SINGULAIR 4 MG 28 SACH R<br />
0 0 30,68 41,50 80<br />
0246935 SINGULAIR 5 MG 28 CPR CROQ R<br />
0 0 30,68 41,50 80<br />
R03DX05 omalizumab<br />
0558803 XOLAIR 150 MG 1 SRG PREREMPLIE SC RR DC<br />
0 0 356,63 0,00 0<br />
0558771 XOLAIR 75 MG 1 SRG PREREMPLIE 0,5 ML SC RR DC<br />
0 0 181,88 0,00 0<br />
R03DX07 roflumilast<br />
0596481 DAXAS 500 MCG 30 CPR RR<br />
0 0 42,90 53,54 0<br />
R05 COUGH AND COLD PREPARATIONS<br />
0511113 TOULARYNX THYM SIR 180 ML P<br />
0 0 4,41 7,38 0<br />
R05CA03 guaifenesin<br />
0652349 BRONCHOSEDAL MUCUS MENTHOL SIR 150 ML P<br />
0 0 4,08 7,01 0<br />
0413403 VICKS EXPECT MIEL 200MG/15ML SIR 180 ML P<br />
0 0 4,20 7,21 0<br />
R05CA10 combinations<br />
0118191 TOPLEXIL SIR 150 ML P<br />
0 0 0,00 5,10 0<br />
R05CB01 acetylcysteine<br />
0148383 ACC 100 MG 100 SACH P<br />
0 0 0,00 10,51 40<br />
0195108 ACC 100 MG 20 CPR EFF P<br />
0 0 1,30 2,61 40<br />
0197763 ACC 100 MG 20 SACH P<br />
0 0 0,00 2,60 40<br />
0195111 ACC 100 MG 50 CPR EFF P<br />
0 0 0,00 5,82 40<br />
0197777 ACC 100 MG 50 SACH P<br />
0 0 0,00 5,82 40<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0204353 ACC 100 MG TABS 20 CPR P<br />
0 0 1,30 2,61 40<br />
0175637 ACC 200 MG 100 CPR EFF P<br />
0 0 4,21 13,69 40<br />
0148402 ACC 200 MG 100 SACH P<br />
0 0 0,00 13,26 40<br />
0195531 ACC 200 MG 20 CPR EFF P<br />
0 0 0,36 3,76 40<br />
0197781 ACC 200 MG 20 SACH P<br />
0 0 0,00 3,76 40<br />
0166915 ACC 200 MG 50 CPR EFF P<br />
0 0 2,20 11,49 40<br />
0197794 ACC 200 MG 50 SACH P<br />
0 0 0,00 7,58 40<br />
0204403 ACC 200 MG TABS 100 CPR P<br />
0 0 4,21 13,69 40<br />
0204384 ACC 200 MG TABS 20 CPR P<br />
0 0 0,36 3,76 40<br />
0204398 ACC 200 MG TABS 50 CPR P<br />
0 0 2,20 11,49 40<br />
0204417 ACC 600 MG TABS 20 CPR P<br />
0 0 1,81 11,07 40<br />
0204421 ACC 600 MG TABS 50 CPR P<br />
0 0 4,21 13,69 40<br />
0229755 ACC AKUT 600 MG 10 CPR EFF P<br />
0 0 2,68 5,32 0<br />
0208268 ACC AKUT 600 MG 6 CPR EFF P<br />
0 0 0,00 2,65 40<br />
0175654 ACC INJEKT 300 MG 100 AMP 3 ML IMIVIH RR<br />
0 0 34,20 0,00 0<br />
0166977 ACC INJEKT 300 MG 5 AMP 3 ML IMIV RR<br />
0 0 0,00 1,70 80<br />
0175641 ACC INJEKT 300 MG 50 AMP 3 ML IMIVIH RR<br />
0 0 15,80 0,00 0<br />
0462599 ACC KINDERSAFT GRAN 20 MG/ML 100 ML P<br />
0 0 1,92 3,82 40<br />
0468379 ACC KINDERSAFT GRAN 20 MG/ML 200 ML P<br />
0 0 3,46 6,73 40<br />
0175668 ACC LONG 600 MG 10 CPR EFF P<br />
0 0 0,51 5,31 40<br />
0197813 ACC LONG 600 MG 100 CPR EFF P<br />
0 0 8,05 17,89 40<br />
0166946 ACC LONG 600 MG 20 CPR EFF P<br />
0 0 1,81 11,07 40<br />
0166963 ACC LONG 600 MG 50 CPR EFF P<br />
0 0 4,21 13,69 40<br />
0136799 ACETYLCYSTEINE EG 200 MG 30 CAPS P<br />
0 0 0,00 5,85 40<br />
0240458 ACETYLCYSTEINE EG 600 MG 10 CPR EFF P<br />
0 0 0,00 6,29 0<br />
0240475 ACETYLCYSTEINE EG 600 MG 10 SACH P<br />
0 0 0,00 5,85 0<br />
0240461 ACETYLCYSTEINE EG 600 MG 30 CPR EFF P<br />
0 0 2,78 7,65 40<br />
0240489 ACETYLCYSTEINE EG 600 MG 30 SACH P<br />
0 0 2,78 7,65 0<br />
0455904 ACETYLCYSTEINE EG 600 MG 60 CPR EFF P<br />
0 0 5,09 10,51 40<br />
0455918 ACETYLCYSTEINE EG 600 MG 60 SACH P<br />
0 0 5,09 10,51 40<br />
0347518 ACETYLCYSTEINE MYLAN 600 MG 30 SACH P<br />
0 0 4,63 9,94 40<br />
0173839 EXOMUC 200 MG 30 SACH P<br />
0 0 2,44 4,35 40<br />
0068637 LYSOMUCIL 200 MG 30 CAPS P<br />
0 0 4,57 7,85 40<br />
0068623 LYSOMUCIL 200 MG 30 CPR EFF P<br />
0 0 3,37 5,78 40<br />
0068654 LYSOMUCIL 300 MG 20 AMP 3 ML IMIVIH RR<br />
0 0 3,56 8,61 80<br />
0378013 LYSOMUCIL 4% SOL BUV 150 ML P<br />
0 0 5,08 8,74 40<br />
0277591 LYSOMUCIL 600 MG 14 CPR EFF P<br />
0 0 4,51 7,75 40<br />
0265586 LYSOMUCIL 600 MG 14 SACH P<br />
0 0 4,51 7,75 40<br />
0187686 LYSOMUCIL 600 MG 30 CPR EFF P<br />
0 0 5,11 10,54 40<br />
0265605 LYSOMUCIL 600 MG 30 SACH P<br />
0 0 5,11 10,54 40<br />
0277606 LYSOMUCIL 600 MG 60 CPR EFF P<br />
0 0 9,38 15,76 0<br />
0277573 LYSOMUCIL 600 MG 60 SACH P<br />
0 0 9,38 15,76 0<br />
0235993 LYSOMUCIL GRAN 200 MG 30 SACH P<br />
0 0 4,24 7,29 40<br />
0666215 LYSOMUCIL JR 2% SIR 100 ML P<br />
0 0 3,11 5,34 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0305227 LYSOMUCIL JR 2% SIR 150 ML P<br />
0 0 3,68 6,32 40<br />
0305231 LYSOMUCIL JR 2% SIR 200 ML P<br />
0 0 4,98 8,55 0<br />
0296162 LYSOX 2% SIR 180 ML P<br />
0 0 4,02 6,90 40<br />
0187008 LYSOX 200 MG 30 SACH P<br />
0 0 4,07 7,00 40<br />
0188019 LYSOX 200 MG/15 G SOL 30 FL P<br />
0 0 0,00 7,85 40<br />
0222155 LYSOX 400 MG 14 SACH P<br />
0 0 0,00 7,75 0<br />
0222169 LYSOX 400 MG 30 SACH P<br />
0 0 3,81 8,92 40<br />
0251001 LYSOX 600 MG 30 SACH P<br />
0 0 5,32 10,81 40<br />
0230613 LYSOX JR 100 MG 30 SACH P<br />
0 0 2,82 4,84 40<br />
0193568 NAC RATIO 200 MG 20 BRAUSETABL P<br />
0 0 0,97 3,88 40<br />
0193523 NAC RATIO 200 MG 20 SACH 2 G P<br />
0 0 1,76 3,88 40<br />
0190888 NAC RATIO 200 MG 20 TRINKTABL P<br />
0 0 0,97 3,88 40<br />
0206571 NAC RATIO 200 MG 30 SACH P<br />
0 0 0,00 6,35 40<br />
0193571 NAC RATIO 200 MG 50 BRAUSETABL P<br />
0 0 2,20 7,81 40<br />
0193537 NAC RATIO 200 MG 50 SACH P<br />
0 0 4,09 7,81 40<br />
0190891 NAC RATIO 200 MG 50 TRINKTABL P<br />
0 0 2,20 7,81 40<br />
0193585 NAC RATIO 600 MG 10 BRAUSETABL P<br />
0 0 0,97 4,03 40<br />
0193599 NAC RATIO 600 MG 20 BRAUSETABL P<br />
0 0 1,81 7,33 40<br />
0190911 NAC RATIO 600 MG 20 TRINKTABL P<br />
0 0 1,81 7,33 40<br />
0193604 NAC RATIO 600 MG 50 BRAUSETABL P<br />
0 0 4,21 13,21 40<br />
0190924 NAC RATIO 600 MG 50 TRINKTABL P<br />
0 0 4,21 13,21 40<br />
0197147 PECTOMUCIL 200 MG GRAN 30 SACH P<br />
0 0 3,17 5,44 40<br />
R05CB02 bromhexine<br />
0014328 BISOLVON 0,2% SOL INH 100 ML P<br />
0 0 3,96 6,80 80<br />
0162687 BISOLVON 0,2% SOL OR 100 ML P<br />
0 0 3,96 6,80 40<br />
0014295 BISOLVON 8 MG 50 CPR P<br />
0 0 3,96 8,73 40<br />
0014314 BISOLVON 8 MG/5ML SIR 250 ML P<br />
0 0 5,01 8,61 40<br />
0197178 BROMEX 5 MG/ML SIROP 180 ML P<br />
0 0 4,64 7,97 40<br />
0136821 BROMHEXINE EG 8 MG 50 CPR P<br />
0 0 2,66 6,02 40<br />
0314095 BRONCHIMEREPRINE 8 MG 50 CPR SEC P<br />
0 0 0,00 4,53 0<br />
R05CB03 carbocisteine<br />
0525718 BALSOCLASE MUCOLYT SS SUCRE 5% 150 ML P<br />
0 0 3,05 5,25 0<br />
0314274 MUCORHINATHIOL AD 5% SIR 250 ML P<br />
0 0 4,41 7,58 0<br />
0334831 MUCORHINATHIOL AD SS SUCRE 5% SIR 250 ML P<br />
0 0 4,61 7,92 0<br />
0314257 MUCORHINATHIOL ENF 2% SIR 200 ML P<br />
0 0 3,93 6,75 0<br />
0314261 MUCORHINATHIOL ENF SS SUCRE 2% SIR 200ML P<br />
0 0 4,10 7,04 0<br />
0105565 SIROXYL 5 % SIR 250 ML P<br />
0 0 0,00 7,24 40<br />
0340842 SIROXYL ENF 100 MG/5 ML SIR 125 ML P<br />
0 0 2,37 4,07 0<br />
0340856 SIROXYL ENF 100 MG/5 ML SIR 250 ML P<br />
0 0 0,00 7,24 0<br />
0143082 SIROXYL GRAN 14 SACH P<br />
0 0 0,00 7,91 40<br />
0346295 SIROXYL SS SUCRE 750 MG/15 ML 300 ML P<br />
0 0 0,00 9,71 0<br />
0207226 SOLUDRILL EXP 750 MG 20 CPR P<br />
0 0 0,00 5,48 0<br />
0207243 SOLUDRILL EXP AD 5% 150 ML P<br />
0 0 0,00 5,03 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0252771 SOLUDRILL EXP AD 5% 200 ML P<br />
0 0 0,00 5,65 0<br />
0225143 SOLUDRILL EXP AD SANS SUCRE 5% 150ML P<br />
0 0 0,00 5,78 0<br />
0225157 SOLUDRILL EXP AD SANS SUCRE 5% 250ML P<br />
0 0 0,00 7,24 0<br />
0209816 SOLUDRILL EXP ENF 2% 125 ML P<br />
0 0 0,00 4,02 0<br />
0252784 SOLUDRILL EXP SS SUCRE AD 5% 200 ML P<br />
0 0 0,00 5,65 0<br />
R05CB06 ambroxol<br />
0004030 AMBROHEXAL 15 MG/5 ML SIR ENF 100 ML P<br />
0 0 1,04 2,15 40<br />
0004044 AMBROHEXAL 15 MG/5 ML SIR ENF 250 ML P<br />
0 0 2,14 4,28 40<br />
0003999 AMBROHEXAL 30 MG 100 CPR P<br />
0 0 0,00 9,56 40<br />
0175699 AMBROHEXAL 30 MG 20 CPR P<br />
0 0 1,53 3,07 40<br />
0003985 AMBROHEXAL 30 MG 50 CPR P<br />
0 0 2,74 5,44 40<br />
0004027 AMBROHEXAL 7,5 MG/ML GTTS 100 ML P<br />
0 0 2,23 3,98 40<br />
0004013 AMBROHEXAL 7,5 MG/ML GTTS 50 ML P<br />
0 0 1,33 2,37 40<br />
0184538 AMBROHEXAL RET 75 MG 10 CAPS P<br />
0 0 1,71 3,42 40<br />
0004092 AMBROHEXAL RET 75 MG 100 CAPS P<br />
0 0 0,00 22,67 40<br />
0175704 AMBROHEXAL RET 75 MG 20 CAPS P<br />
0 0 2,90 5,76 40<br />
0004089 AMBROHEXAL RET 75 MG 50 CAPS P<br />
0 0 5,97 11,43 40<br />
0208951 AMBROHEXAL S 60 MG 20 CPR EFF P<br />
0 0 0,00 5,43 40<br />
0135967 AMBROXOL RATIO 15 MG 10 AMP 2 ML IMIVSC RR<br />
0 0 4,24 13,72 80<br />
0135971 AMBROXOL RATIO 15 MG 50 AMP 2 ML IMIVSC RR<br />
0 0 15,17 0,00 0<br />
0267014 AMBROXOL RATIO HL 30 MG 100 CPR P<br />
0 0 5,38 10,32 40<br />
0266986 AMBROXOL RATIO HL 30 MG 20 CPR P<br />
0 0 1,53 3,07 40<br />
0267001 AMBROXOL RATIO HL 30 MG 50 CPR P<br />
0 0 3,08 6,13 40<br />
0266972 AMBROXOL RATIO HL RET 75 MG 100 CAPS P<br />
0 0 13,46 22,81 40<br />
0266955 AMBROXOL RATIO HL RET 75 MG 20 CAPS P<br />
0 0 3,14 6,24 40<br />
0266969 AMBROXOL RATIO HL RET 75 MG 50 CAPS P<br />
0 0 7,20 13,04 40<br />
0264754 AMBROXOL RATIO HUSTENSAFT 100 ML P<br />
0 0 1,04 2,15 40<br />
0264768 AMBROXOL RATIO HUSTENSAFT 250 ML P<br />
0 0 2,14 4,28 40<br />
0264785 AMBROXOL RATIO HUSTENTROPFEN 100 ML P<br />
0 0 2,01 4,01 40<br />
0264771 AMBROXOL RATIO HUSTENTROPFEN 50 ML P<br />
0 0 1,19 2,39 40<br />
0161905 MUXOL 30 MG 30 CPR P<br />
0 0 0,00 4,83 40<br />
0152596 MUXOL SOL BUV 180 ML P<br />
0 0 2,48 4,42 40<br />
0144001 SURBRONC 30 MG/5 ML SIR 250 ML P<br />
0 0 7,92 13,60 40<br />
0144371 SURBRONC 60 MG 20 CPR SEC P<br />
0 0 6,16 10,58 40<br />
0162978 SURBRONC 60 MG 20 SACH P<br />
0 0 5,03 8,65 40<br />
0223183 SURBRONC 60 MG 50 CPR UD P<br />
0 0 14,00 0,00 0<br />
R05CB10 combinations<br />
0139367 FLUIMUCIL ANTIBIOTIC 1 FL+S INTO RR<br />
0 0 2,80 4,81 40<br />
0045596 FLUIMUCIL ANTIBIOTIC 3 FL+S INTO RR<br />
0 0 5,63 9,67 40<br />
R05CB13 dornase alfa (<strong>des</strong>oxyribonuclease)<br />
0203082 PULMOZYME 1 MG 30 AMP 2,5 ML INH RR<br />
0 0 614,54 660,22 80<br />
R05CB15 erdosteine<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0249503 MUCODOX 300 MG 14 CAPS P<br />
0 0 5,20 8,94 40<br />
0249517 MUCODOX 300 MG 56 CAPS P<br />
0 0 9,01 17,00 40<br />
R05DA01 ethylmorphine<br />
0288563 CODETHYLINE ERFA 5 MG 50 CPR R<br />
0 0 3,09 5,32 40<br />
R05DA04 codeine<br />
0015664 BROMOPHAR SIR 180 ML R<br />
0 0 4,59 7,88 0<br />
0227103 BRONCHOSEDAL CODEIN SIR 200 ML 87957 R<br />
0 0 4,08 7,01 0<br />
0219163 GLOTTYL SIR 300 ML R<br />
0 0 4,04 6,95 40<br />
0076530 NEOCODION 20 CPR R<br />
0 0 1,41 2,51 40<br />
0076589 NEOCODION AD SIR 180 ML RR<br />
0 0 1,54 2,67 40<br />
0076592 NEOCODION ENF SIR 125 ML RR<br />
0 0 1,06 1,88 40<br />
0517053 TOULARYNX CODEINE SIR 180 ML R<br />
0 0 4,41 7,58 0<br />
0511144 TOUXSAN CODEINE S SUCRE SIR 200 ML R<br />
0 0 3,68 6,32 0<br />
R05DA07 noscapine<br />
0306448 NOSCA MEREPRINE 15 MG 24 CPR P<br />
0 0 0,00 5,44 40<br />
0662992 NOSCAFLEX 15 MG 20 CPR P<br />
0 0 3,62 6,21 0<br />
R05DA08 pholcodine<br />
0525851 CLARIX SIR 250 ML P<br />
0 0 4,30 7,66 0<br />
0525847 CLARIX SS SUCRE SIR 250 ML P<br />
0 0 4,30 7,66 0<br />
R05DA09 dextromethorphan<br />
0306093 ACTIFED NEW SIR 180 ML P<br />
0 0 4,29 7,37 0<br />
0219888 BRONCHOSEDAL DEXTROMETHORPHAN SIR 180 ML P<br />
0 0 4,08 7,01 0<br />
0262536 DEXIR 7,5 MG/5 ML SIR ENF 125 ML P<br />
0 0 2,73 4,68 40<br />
0317052 HUMEX ANTITUSSIV 13,3MG/10ML SIR 200 ML P<br />
0 0 0,00 5,01 40<br />
0311126 NORTUSSINE MONO 10 MG/5 ML SIR 125 ML P<br />
0 0 3,60 6,19 0<br />
0252655 SOLUDRILL TOUX SECHES AD SIR 125 ML P<br />
0 0 0,00 4,73 0<br />
0207209 SOLUDRILL TOUX SECHES AD SIR 150 ML P<br />
0 0 0,00 4,93 0<br />
0252641 SOLUDRILL TOUX SECHES ENF SIR. 125 ML P<br />
0 0 0,00 3,97 0<br />
0627976 TOUXIUM ANTITUSSIVUM 30 MG 18 CAPS P<br />
0 0 3,63 6,24 0<br />
0213285 TOUXIUM ANTITUSSIVUM 30 MG 20 CAPS P<br />
0 0 3,96 6,80 40<br />
0511127 TOUXSAN DEXTROMET ENF 1 MG/ML SIR 120 ML P<br />
0 0 3,00 5,15 0<br />
0511131 TOUXSAN DEXTROMET S SUCRE SIR 120 ML P<br />
0 0 3,11 5,34 0<br />
0197164 TUSSIPECT 1,5 MG/ML 180 ML P<br />
0 0 3,84 6,69 40<br />
0450584 TUSSO RHINATHIOL 10 MG 36 PAST P<br />
0 0 4,72 8,11 0<br />
0314291 TUSSO RHINATHIOL AD 0,133% SIR 200 ML P<br />
0 0 3,93 6,75 0<br />
0314307 TUSSO RHINATHIOL ENF 0,1% SIR 125 ML P<br />
0 0 3,05 5,25 0<br />
R05DA20 combinations<br />
0150963 NORTUSSINE SIR 125 ML R<br />
0 0 3,60 6,19 0<br />
R05DB05 pentoxyverine<br />
0443786 BALSOCLASE ANTITUSSIVUM SS SUCRE SIR 200 P<br />
0 0 3,93 6,75 40<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
R05DB13 butamirate<br />
0651677 SINECOD 7,5 MG/5 ML SIR 200 ML P<br />
0 0 4,52 7,76 0<br />
0467225 SINECOD AD 7,5 MG/5 ML SIR 125 ML P<br />
0 0 3,96 6,80 40<br />
R05DB21 cloperastine<br />
0345639 LYSOTOSSIL 0,354 G/ML SIR 200 ML R<br />
0 0 3,68 6,32 40<br />
0419505 LYSOTOSSIL 10 MG 30 DRG R<br />
0 0 2,72 4,66 40<br />
R05DB27 levodropropizine<br />
0427331 LEVOTUSS 0,6% SIR 200 ML R<br />
0 0 4,67 8,03 0<br />
R05FA02 opium derivatives and expectorants<br />
0278228 BAUME PULMONAIRE SIR AD 250 ML P<br />
0 0 3,67 6,31 40<br />
0042076 EUCALYPTINE PHOLCODINE 10 SUPP AD P<br />
0 0 3,36 5,78 0<br />
0042093 EUCALYPTINE PHOLCODINE 10 SUPP ENF P<br />
0 0 2,66 4,58 0<br />
0056460 INALPIN SIR 180 ML R<br />
0 0 4,47 7,68 40<br />
0089914 PHOLCO MEREPRINE SIR 200 ML P<br />
0 0 0,00 7,09 0<br />
0245048 TROPHIRES SIR AD 200 ML P<br />
0 0 0,00 4,69 40<br />
0121099 TROPHIRES SIR ENF 125 ML P<br />
0 0 0,00 2,48 40<br />
R05FB02 cough suppressants and expectorants<br />
0090235 PHYTOTUX SIR 250 ML P<br />
0 0 3,82 7,16 40<br />
R05X OTHER COLD COMBINATION PREPARATIONS<br />
0241844 AEROSOL SPITZNER 30 ML P<br />
0 0 0,00 10,27 0<br />
0174884 BRONCHICUM GTTS 30 ML P<br />
0 0 3,01 5,97 0<br />
0017817 CALYPTOL 10 AMP 5 ML INH P<br />
0 0 2,50 4,46 0<br />
0340985 EMSER NASENSPRAY 15 ML P<br />
0 0 2,31 4,64 0<br />
0260711 EMSER NASENTROPFEN 15 ML P<br />
0 0 3,11 5,94 0<br />
0429711 EMSER SALZ 2,95 G 100 BTL P<br />
0 0 18,25 30,06 0<br />
0230269 EMSER SALZ 2,95 G 20 BTL P<br />
0 0 3,64 6,75 0<br />
0429708 EMSER SALZ 2,95 G 50 BTL P<br />
0 0 9,12 15,91 0<br />
0487991 EUFLUX POM 50 G P<br />
0 0 0,00 7,41 0<br />
0076558 NEOCODION BB SIR 125 ML P<br />
0 0 0,00 1,78 0<br />
0400369 PINIMENTHOL ERKAELTUNGSBALSAM MILD 20 G P<br />
0 0 0,00 3,66 0<br />
0400372 PINIMENTHOL ERKAELTUNGSBALSAM MILD 40 G P<br />
0 0 0,00 5,21 0<br />
0635589 PINIMENTHOL ERKAELTUNGSBALSAM MILD 50 G P<br />
0 0 3,17 6,49 0<br />
0179992 PINIMENTHOL ERKAELTUNGSSALBE 20 G TB P<br />
0 0 0,00 3,66 0<br />
0180007 PINIMENTHOL ERKAELTUNGSSALBE 40 G TB P<br />
0 0 0,00 5,21 0<br />
0651663 PINIMENTHOL ERKAELTUNGSSALBE 50 G P<br />
0 0 3,59 6,90 0<br />
0180011 PINIMENTHOL ERKAELTUNGSSALBE N 100 G TB P<br />
0 0 0,00 10,37 0<br />
0249677 PROSPAN HUSTENTROPFEN 20 ML P<br />
0 0 2,28 4,54 0<br />
0249681 PROSPAN HUSTENTROPFEN 50 ML P<br />
0 0 4,81 9,22 0<br />
0181634 PULMEX BABY POM 20 G P<br />
0 0 2,27 3,90 0<br />
0487231 PULMEX POM 40 G P<br />
0 0 3,08 5,30 0<br />
0105341 SINUPRET 100 DRG P<br />
0 0 9,89 17,57 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0105338 SINUPRET 50 DRG P<br />
0 0 5,08 9,74 0<br />
0571108 SINUPRET SAFT 100 ML P<br />
0 0 4,38 8,40 0<br />
0105355 SINUPRET TROPFEN 100 ML P<br />
0 0 5,08 9,74 0<br />
0303012 TUMAROL N BALSAM 50 G P<br />
0 0 2,68 5,32 0<br />
0268561 VICKS VAPORUB POM 100 G P<br />
0 0 4,80 8,25 0<br />
R06AA02 diphenhydramine<br />
0446645 EMESAN 50 MG 10 CPR R<br />
0 0 1,00 2,08 40<br />
0438867 EMESAN 50 MG 20 CPR R<br />
0 0 1,64 3,29 40<br />
0438871 EMESAN 50 MG 50 CPR R<br />
0 0 3,84 7,36 40<br />
R06AB02 dexchlorpheniramine<br />
0091862 POLARAMINE 2 MG/5 ML SIR 100 ML P<br />
0 0 0,93 5,55 80<br />
0091909 POLARAMINE REPETABS 6 MG 20 CPR P<br />
0 0 1,45 5,95 80<br />
R06AB03 dimetindene<br />
0044148 FENISTIL 1 MG 20 DRG P<br />
0 0 2,83 5,63 80<br />
0268252 FENISTIL 24 STD 4 MG 20 CAPS P<br />
0 0 6,53 12,23 80<br />
0268266 FENISTIL 24 STD 4 MG 50 CAPS P<br />
0 0 15,63 26,47 80<br />
0044179 FENISTIL GTTS 20 ML R<br />
0 0 2,88 5,73 80<br />
R06AB54 chlorphenamine, combinations<br />
0099275 RHINOFEBRYL 20 CAPS P<br />
0 0 3,26 5,60 40<br />
R06AD01 alimemazine<br />
0116085 THERALENE 10 MG 50 CPR R<br />
0 0 1,36 2,34 80<br />
0116104 THERALENE 4% GTTS 30 ML R<br />
0 0 1,78 3,07 80<br />
R06AD02 promethazine<br />
0089704 PHENERGAN 50 MG 5 AMP 2 ML R<br />
0 0 0,91 5,52 80<br />
R06AE05 meclozine<br />
0143003 AGYRAX 50 CPR R<br />
0 0 4,02 6,91 0<br />
0092517 POSTAFENE 25 MG 25 CPR R<br />
0 0 2,23 3,84 0<br />
R06AE07 cetirizine<br />
0321346 CETIRIZINE EG 10 MG 20 CPR P<br />
0 0 2,67 7,50 80<br />
0321377 CETIRIZINE EG 10 MG 50 CPR P<br />
0 0 7,81 13,91 80<br />
0321315 CETIRIZINE EG 10 MG 7 CPR P<br />
0 0 0,00 4,02 0<br />
0339578 CETIRIZINE HEXAL 10 MG 100 CPR R<br />
0 0 14,71 24,93 0<br />
0339547 CETIRIZINE HEXAL 10 MG 20 CPR P<br />
0 0 2,88 5,73 80<br />
0339564 CETIRIZINE HEXAL 10 MG 50 CPR R<br />
0 0 7,30 13,16 80<br />
0339516 CETIRIZINE HEXAL 10 MG 7 CPR P<br />
0 0 1,29 2,59 80<br />
0325314 CETIRIZINE RATIO 10 MG 20 CPR P<br />
0 0 2,67 6,64 80<br />
0472516 HYPERPOLL 10 MG 10 CPR P<br />
0 0 3,37 5,78 0<br />
0472547 HYPERPOLL 10 MG 20 CPR P<br />
0 0 5,39 9,25 0<br />
0472581 HYPERPOLL 10 MG 50 CPR P<br />
0 0 8,29 14,39 0<br />
0330301 REACTINE 10 MG 21 CPR PL P<br />
0 0 0,00 10,59 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0177094 ZYRTEC 1 MG/ML SIR 200 ML P<br />
0 0 4,99 10,28 80<br />
0138566 ZYRTEC 10 MG 20 CPR P<br />
0 0 4,99 10,28 80<br />
0171395 ZYRTEC 10 MG 40 CPR P<br />
0 0 8,45 14,59 0<br />
0167666 ZYRTEC 10 MG/ML GTTS 20 ML P<br />
0 0 4,99 10,28 80<br />
R06AE09 levocetirizine<br />
0543358 LEVOCETIRIZINE EG 5 MG 10 CPR R<br />
0 0 2,81 4,84 0<br />
0543506 LEVOCETIRIZINE EG 5 MG 100 CPR R<br />
0 0 13,55 21,07 80<br />
0543389 LEVOCETIRIZINE EG 5 MG 20 CPR R<br />
0 0 3,25 8,23 80<br />
0543439 LEVOCETIRIZINE EG 5 MG 40 CPR R<br />
0 0 5,96 11,60 80<br />
0543473 LEVOCETIRIZINE EG 5 MG 60 CPR R<br />
0 0 8,74 14,95 80<br />
0465122 XYZALL 0,5 MG/ML GTTS 200 ML R<br />
0 0 6,73 11,56 80<br />
0307817 XYZALL 5 MG 20 CPR R<br />
0 0 4,07 9,25 80<br />
0307851 XYZALL 5 MG 40 CPR R<br />
0 0 6,84 12,70 80<br />
0429211 XYZALL 5 MG/ML GTTS 20 ML R<br />
0 0 6,73 11,56 80<br />
R06AX13 loratadine<br />
0409364 CLARITINE 1 MG/ML SIR 100 ML P<br />
0 0 4,56 7,83 80<br />
0148191 CLARITINE 10 MG 21 CPR P<br />
0 0 5,07 10,49 80<br />
0365001 CLARITINE 10 MG 7 CPR P<br />
0 0 3,11 5,34 0<br />
0374126 LORANO AKUT 10 MG 14 CPR P<br />
0 0 2,49 4,98 80<br />
0374112 LORANO AKUT 10 MG 7 CPR P<br />
0 0 1,29 2,59 80<br />
0370998 RUPTON 10 MG 10 CPR P<br />
0 0 2,35 4,03 80<br />
0371026 RUPTON 10 MG 100 CPR P<br />
0 0 13,57 20,92 80<br />
R06AX17 ketotifen<br />
0130800 ZADITEN SIR 200 ML R<br />
0 0 0,00 17,20 80<br />
R06AX22 ebastine<br />
0223054 ESTIVAN 10 MG 20 CPR R<br />
0 0 5,29 10,65 80<br />
0353191 ESTIVAN 10 MG 40 CPR R<br />
0 0 8,80 15,14 0<br />
0348918 ESTIVAN 20 MG 20 CPR R<br />
0 0 8,80 15,14 80<br />
0509308 ESTIVAN 5 MG/5 ML SOL 120 ML R<br />
0 0 4,21 7,23 0<br />
0397331 ESTIVAN LYO 20 MG 20 LYOPH ORAUX R<br />
0 0 10,20 17,53 0<br />
0397344 ESTIVAN LYO 20 MG 30 LYOPH ORAUX R<br />
0 0 10,36 17,09 0<br />
R06AX25 mizolastine<br />
0246238 MIZOLLEN 20 CPR R<br />
0 0 4,75 10,10 80<br />
R06AX26 fexofenadine<br />
0244301 TELFAST 120 MG 20 CPR P<br />
0 0 5,29 10,77 80<br />
0244328 TELFAST 180 MG 20 CPR R<br />
0 0 8,36 14,35 80<br />
R06AX27 <strong>des</strong>loratadine<br />
0455496 AERIUS 0,5 MG/ML SOL BUV 150 ML R<br />
0 0 4,19 9,40 80<br />
0455211 AERIUS 2,5 MG 12 CPR ORODISP R<br />
0 0 3,49 6,00 0<br />
0455255 AERIUS 2,5 MG 30 CPR ORODISP R<br />
0 0 7,85 13,49 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0292003 AERIUS 5 MG 100 CPR R<br />
0 0 16,28 24,33 80<br />
0455353 AERIUS 5 MG 12 CPR ORODISP R<br />
0 0 4,93 8,47 0<br />
0291961 AERIUS 5 MG 20 CPR R<br />
0 0 0,00 13,66 0<br />
0291989 AERIUS 5 MG 30 CPR R<br />
0 0 8,14 14,31 80<br />
0455398 AERIUS 5 MG 30 CPR ORODISP R<br />
0 0 11,22 19,28 0<br />
0291992 AERIUS 5 MG 50 CPR R<br />
0 0 12,45 19,70 80<br />
R06AX28 rupatadine<br />
0477591 RUPATALL 10 MG 100 CPR R<br />
0 0 25,21 34,16 0<br />
0477574 RUPATALL 10 MG 30 CPR R<br />
0 0 9,45 15,96 80<br />
0477588<br />
R06AX29<br />
RUPATALL 10 MG 50 CPR R<br />
0 0 14,18 21,85 0<br />
0592755 BELLOZAL 20 MG 30 CPR R<br />
0 0 5,52 11,05 80<br />
0592772 BELLOZAL 20 MG 50 CPR R<br />
0 0 8,76 15,09 80<br />
R07AX Other respiratory system products<br />
0511399 VASOKINOX GAZ INHAL 1 BT 20 L RR HC<br />
0 0 2.500,00 0,00 0<br />
0511385 VASOKINOX GAZ INHAL 1 BT 5 L RR HC<br />
0 0 1.400,00 0,00 0<br />
S01AA01 chloramphenicol<br />
0021109 CHLORAMPHENICOL BRNV 0,4% COLLY 10 ML RR<br />
0 0 1,05 5,56 80<br />
0254517 CHLORAMPHENICOL ERFA 0,5% COLLY 5 ML RR<br />
0 0 0,47 5,04 80<br />
0254521 CHLORAMPHENICOL ERFA 1% POM OPH 2,5 G RR<br />
0 0 1,07 5,69 80<br />
S01AA02 chlortetracycline<br />
0009491 AUREOMYCINE LEDERLE 1% POM OPHT 5 G RR<br />
0 0 0,99 5,44 80<br />
S01AA11 gentamicin<br />
0048844 GENTAMYTREX COLLY + POM OPHT 743 RR<br />
0 0 0,00 5,60 80<br />
0048858 GENTAMYTREX COLLY 5 ML 741 RR<br />
0 0 0,00 3,79 80<br />
0048830 GENTAMYTREX POM OPHT 3 G 742 RR<br />
0 0 0,00 2,69 80<br />
S01AA12 tobramycin<br />
0398792 TOBRAVISC 0,3% COLLY 5 ML RR<br />
0 0 3,38 8,39 80<br />
0117518 TOBREX COLLY 5 ML RR<br />
0 0 3,38 8,39 80<br />
0117521 TOBREX ONG OPHT 3,5 G RR<br />
0 0 2,56 7,36 80<br />
S01AA26 azithromycin<br />
0477073 AZYTER 0,015% COLLY 6 UD RR<br />
0 0 0,00 6,97 80<br />
S01AA30 combinations of different antibiotics<br />
0114967 TERRAMYCINE POM OPHT 3,5 G RR<br />
0 0 3,32 5,69 80<br />
S01AD02 trifluridine<br />
0204725 TRIFLUMANN COLLY 5 ML R<br />
0 0 11,01 19,61 80<br />
S01AD03 aciclovir<br />
0131257 ZOVIRAX 3% ONG OPHT 4,5 G R<br />
0 0 6,40 12,16 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
S01AD09 ganciclovir<br />
0435821 VIRGAN 0,15% GEL 5 G RR<br />
0 0 8,28 14,49 80<br />
S01AX07 sodium borate<br />
0002523 ALCASOL COLLY 9 ML P<br />
0 0 3,54 6,07 80<br />
S01AX08 hexamidine<br />
0444198 DESOMEDINE 0,1% COLLY 10 ML P<br />
0 0 3,91 6,71 0<br />
0082443 OPHTAMEDINE SOL 10 ML P<br />
0 0 0,00 5,57 80<br />
S01AX13 ciprofloxacin<br />
0197181 CILOXAN 0,3% COLLY 5 ML RR<br />
0 0 2,24 6,99 80<br />
S01AX18 povidone-iodine<br />
0393653 ISOBETADINE OCULAIRE 5% 20 FL UD 20 ML R H<br />
0 0 26,38 0,00 0<br />
S01AX22 moxifloxacin<br />
0571884 KANAVIG 5 MG/ML COLLY 5 ML RR<br />
0 0 9,10 15,62 0<br />
S01BA01 dexamethasone<br />
0069956 MAXIDEX COLLY 5 ML RR<br />
0 0 3,04 7,96 80<br />
0512348 MONOFREE DEXAMETH 0,1% COLLY 20*0,4 ML RR<br />
0 0 5,48 11,00 0<br />
0611024 OZURDEX 700 MCG 1 SACH + 1 SYST APPL RR HC<br />
RM 0 0<br />
950,00 0,00 0<br />
0108536 SPERSADEX 0,1% DISP COLLY RR<br />
0 0 0,00 10,28 80<br />
S01BA04 prednisolone<br />
0092923 PRED FORTE COLLY 5 ML RR<br />
0 0 2,64 7,47 80<br />
0122535 ULTRACORTENOL POM OPHT 5 G RR<br />
0 0 6,25 11,12 80<br />
S01BA07 fluorometholone<br />
0408076 FLUACORT 0,1% COLLY 5 ML RR<br />
0 0 1,92 6,52 80<br />
0045551 FLUCON 1 MG/ML COLLY 5 ML RR<br />
0 0 3,57 8,63 80<br />
0045792 FML LIQUIFILM 0,1% COLLY 5 ML RR<br />
0 0 1,94 6,66 80<br />
S01BA13 rimexolone<br />
0247882 VEXOLON 1% COLLY 1 FL CPT-GTTS 5 ML RR<br />
0 0 3,62 8,69 80<br />
S01BC01 indometacin<br />
0286815 INDOCOLLYRE 0,1% SOL 5 ML R<br />
0 0 3,26 8,18 80<br />
S01BC03 diclofenac<br />
0458694 DICLOABAK 0,1% COLLY 10 ML P<br />
0 0 4,33 9,57 80<br />
0187091 VOLTAREN OPHTA SINE COLLY 20*0,3 ML R<br />
0 0 13,93 24,01 80<br />
S01BC05 ketorolac<br />
0238205 ACULARE 0,5% COLLY 10 ML R<br />
0 0 3,07 8,01 80<br />
S01BC09 pranoprofen<br />
0170918 PRANOX 0,1% COLLY 1 FL 5 ML R<br />
0 0 2,70 7,54 80<br />
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délivrance prescription<br />
S01BC10 nepafenac<br />
0474569 NEVANAC 0,1% COLLY 5 ML RR<br />
0 0 8,50 14,59 0<br />
S01CA01 dexamethasone and antiinfectives<br />
0279807 DEXAGENTA POS 5 MG COLLY 5 ML RR<br />
0 0 2,12 6,10 80<br />
0243639 DEXAGRANE COLLY 5 ML RR<br />
0 0 0,00 2,50 80<br />
0030934 DEXAMYTREX COLLY 5 ML 555 RR<br />
0 0 0,00 7,44 80<br />
0030948 DEXAMYTREX POM OPHT 3 G 556 RR<br />
0 0 0,00 5,72 80<br />
0070019 MAXITROL COLLY 5 ML RR<br />
0 0 3,08 8,02 80<br />
0070022 MAXITROL POM OPHT 3,5 G RR<br />
0 0 2,29 7,04 80<br />
0156872 TOBRADEX POM OPH 3,5 G RR<br />
0 0 2,48 7,26 80<br />
0156869 TOBRADEX SUSP 5 ML RR<br />
0 0 3,47 8,50 80<br />
S01CA02 prednisolone and antiinfectives<br />
0092940 PREDMYCINE P LIQUIFILM 5 ML RR<br />
0 0 2,13 6,86 80<br />
S01CA03 hydrocortisone and antiinfectives<br />
0114726 TERRACORTRIL POM OPHT 3,5 G RR<br />
0 0 1,54 6,21 80<br />
0114743 TERRACORTRIL SUSP OPHT 5 ML RR<br />
0 0 2,01 6,72 80<br />
S01EA02 dipivefrine<br />
0156659 PROPINE 0,1% COLLY 5 ML R<br />
0 0 0,00 7,25 80<br />
S01EA03 apraclonidine<br />
0204899 IOPIDINE 0,5% COLLY 5 ML R<br />
0 0 0,00 13,08 80<br />
S01EA05 brimonidine<br />
0250471 ALPHAGAN 0,2% COLLY 5 ML R<br />
0 0 0,00 18,31 80<br />
S01EB01 pilocarpine<br />
0059929 ISOPTO CARPINE 1% COLLY 15 ML R<br />
0 0 0,79 5,39 80<br />
0059932 ISOPTO CARPINE 2% COLLY 15 ML R<br />
0 0 1,08 5,71 80<br />
0108438 SPERSACARPIN 0,5% COLLY 10 ML R<br />
0 0 0,00 2,38 80<br />
S01EB02 carbachol<br />
0270006 MIOSTAT 0,01% COLLY 12*1,5 ML R H<br />
0 0 123,82 0,00 0<br />
S01EB09 acetylcholine<br />
0213643 MIOCHOL E COLLY 20 MG 1 FL R<br />
0 0 24,17 35,47 80<br />
S01EB51 pilocarpine, combinations<br />
0157111 NORMOGLAUCON COLLY 10 ML 582 R<br />
0 0 10,86 19,35 80<br />
S01EC01 acetazolamide<br />
0138101 DIAMOX 250 MG 25 CPR R<br />
0 0 3,15 8,09 80<br />
0031458 DIAMOX 500 MG PDR 1 FL IV RR<br />
0 0 3,04 7,96 80<br />
S01EC03 dorzolamide<br />
0273932 TRUSOPT 2% COLLY 1 OCUMETER PLUS 5 ML R<br />
0 0 8,52 14,79 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
S01EC04 brinzolamide<br />
0278343 AZOPT 1% COLLY 5 ML R<br />
0 0 8,52 14,79 80<br />
S01ED01 timolol<br />
0213996 DISPATIM SINE 0,25% COLLY 120*0,4 ML UD R<br />
0 0 0,00 28,28 80<br />
0214011 DISPATIM SINE 0,5% COLLY 120*0,4 ML UD R<br />
0 0 0,00 28,42 80<br />
0500154 GELTIM 0,1% GEL OPHTAL 90*0,4 ML UD R<br />
0 0 13,39 20,87 80<br />
0289561 TIMABAK 0,25% COLLY 5 ML R<br />
0 0 3,86 8,98 80<br />
0289574 TIMABAK 0,5% COLLY 5 ML R<br />
0 0 4,14 9,33 80<br />
0195501 TIMOHEXAL 0,25% COLLY 3*5 ML R<br />
0 0 2,47 11,80 80<br />
0167196 TIMOHEXAL 0,25% COLLY 5 ML R<br />
0 0 0,96 10,14 80<br />
0195514 TIMOHEXAL 0,5% COLLY 3*5 ML R<br />
0 0 4,56 14,07 80<br />
0167182 TIMOHEXAL 0,5% COLLY 5 ML R<br />
0 0 1,60 10,84 80<br />
0241908 TIMOLOL FALCON 0,25% COLLY 5 ML R<br />
0 0 0,98 5,61 80<br />
0241889 TIMOLOL FALCON 0,5% COLLY 5 ML R<br />
0 0 1,05 5,67 80<br />
0322746 TIMOPOS 0,25% COLLY 10 ML R<br />
0 0 2,41 7,18 80<br />
0322763 TIMOPOS 0,5% COLLY 10 ML R<br />
0 0 4,82 10,17 80<br />
0311465 TIMOPTOL 0,25% COLLY 1 FL OCUM PLUS 5 ML R<br />
0 0 1,23 5,87 80<br />
0311479 TIMOPTOL 0,5% COLLY 1 FL OCUM PLUS 5 ML R<br />
0 0 1,31 5,97 80<br />
0338505 TIMOPTOLGEL 0,5% 1 FL OCUM PLUS 2,5 ML R<br />
0 0 2,88 7,75 80<br />
S01ED02 betaxolol<br />
0013088 BETOPTIC 0,5% COLLY 5 ML R<br />
0 0 2,43 7,20 80<br />
0193666 BETOPTIC SUSP 0,25% COLLY 5 ML R<br />
0 0 3,09 8,03 80<br />
S01ED03 levobunolol<br />
0158023 BETAGAN 0,25% COLLY 5 ML R<br />
0 0 3,37 8,38 80<br />
0142586 BETAGAN 0,5% COLLY 5 ML R<br />
0 0 3,37 8,38 80<br />
S01ED04 metipranolol<br />
0012712 BETAMANN 0,1% COLLY 5 ML R<br />
0 0 0,00 5,79 80<br />
0012726 BETAMANN 0,3% COLLY 5 ML R<br />
0 0 0,00 5,85 80<br />
0218183 BETAMANN 0,3% EDO SINE COLLY 60*0,5 ML R<br />
0 0 11,51 20,36 80<br />
0012743 BETAMANN 0,6% COLLY 5 ML R<br />
0 0 0,00 5,89 80<br />
S01ED05 carteolol<br />
0376541 ARTEOPTIC LA 1% COLLY 3 ML R<br />
0 0 5,34 10,48 80<br />
0376554 ARTEOPTIC LA 2% COLLY 3 ML R<br />
0 0 5,34 10,48 80<br />
0399786 ARTEOPTIC LA 2% COLLY 3*3 ML R<br />
0 0 12,56 19,34 80<br />
0150431 CARTEOL 1% COLLY 5 ML R<br />
0 0 4,84 10,20 80<br />
0472953 CARTEOL 2% COLLY 3*5 ML R<br />
0 0 12,48 19,73 80<br />
0150445 CARTEOL 2% COLLY 5 ML R<br />
0 0 5,21 10,66 80<br />
S01ED51 timolol, combinations<br />
0502288 AZARGA 10 MG/ML 5 MG/ML COLLY 3*5 ML R<br />
0 0 39,67 50,10 80<br />
0436862 COMBIGAN 0,2/0,5% COLLY 3*5 ML R<br />
0 0 32,43 41,94 80<br />
Page 209 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0431057 COMBIGAN 0,2/0,5% COLLY 5 ML R<br />
0 0 32,43 42,11 0<br />
0274801 COSOPT COLLY 1 OCUMETER PLUS 5 ML R<br />
0 0 16,71 27,12 80<br />
0297593 COSOPT COLLY 3 OCUMETER PLUS 5 ML R<br />
0 0 39,67 50,10 80<br />
0457621 COSOPT UD COLLY 20MG/ML 5MG/ML 60*0,2 ML R<br />
0 0 17,35 25,52 80<br />
0434997 DUOTRAV 40 MCG/ML 5 MG/ML COLLY 3*2,5 ML R<br />
0 0 55,00 66,98 80<br />
0436067 GANFORT 0,03/0,5% COLLY 3*3 ML R<br />
0 0 47,48 59,84 80<br />
0303379 XALACOM COLLY 2,5 ML R<br />
0 0 24,16 34,80 80<br />
0303382 XALACOM COLLY 3*2,5 ML R<br />
0 0 59,12 71,52 80<br />
S01EE01 latanoprost<br />
0556034 LATANOPROST RATIO 50MCG/ML COLLY 2,5ML R<br />
0 0 8,97 13,28 80<br />
0556048 LATANOPROST RATIO 50MCG/ML COLLY 3*2,5ML R<br />
0 0 14,17 20,12 80<br />
0556051 LATANOPROST RATIO 50MCG/ML COLLY 6*2,5ML R<br />
0 0 31,30 39,36 80<br />
0632122 LATANOTEARS 50 MCG/ML COLLY 1*2,5 ML R<br />
0 0 13,03 23,32 0<br />
0632136 LATANOTEARS 50 MCG/ML COLLY 3*2,5 ML R<br />
0 0 14,96 22,82 0<br />
0240783 XALATAN 0,005% COLLY 2,5 ML R<br />
0 0 8,19 14,38 80<br />
0251868 XALATAN 0,005% COLLY 3*2,5 ML R<br />
0 0 19,68 28,08 80<br />
S01EE03 bimatoprost<br />
0562465 LUMIGAN 0,1 MG/ML COLLY 3*3 ML RR<br />
0 0 40,15 50,63 80<br />
0565498 LUMIGAN 0,3 MG/ML COLLY 3 ML RR<br />
0 0 17,50 27,93 80<br />
0565484 LUMIGAN 0,3 MG/ML COLLY 3*3 ML RR<br />
0 0 40,15 50,63 80<br />
S01EE04 travoprost<br />
0314677 TRAVATAN 40 MCG/ML COLLY 3 FL 2,5 ML R<br />
0 0 40,15 50,63 80<br />
S01EE05 tafluprost<br />
0621231 SAFLUTAN 15 MCG/ML COLLY 30*0,3 ML UD RR<br />
0 0 19,02 27,24 80<br />
0621244 SAFLUTAN 15 MCG/ML COLLY 90*0,3 ML UD RR<br />
0 0 53,25 65,06 80<br />
S01FA04 cyclopentolate<br />
0535986 MINIMS CYCLOPENTOLATE HCL 0,5% COLLY A20 R<br />
0 0 0,00 16,79 80<br />
0183091 ZYKLOLAT EDO SINE COLLY 20 X 0,5 ML R<br />
0 0 0,00 9,27 80<br />
S01FA06 tropicamide<br />
0266809 MONOFREE TROPICAMIDE 0,5% COLLY 20*0,4ML R<br />
0 0 6,85 11,77 0<br />
0121281 TROPICOL 0,5% COLLY 10 ML R<br />
0 0 0,00 4,90 80<br />
S01FB01 phenylephrine<br />
0219292 PHENYLEPHRINE CHLORH CHVN 10% 20 MIN R<br />
0 0 0,00 16,79 80<br />
S01GA02 tetryzoline<br />
0193361 BERBERIL N COLLY 10 ML P<br />
0 0 2,26 4,04 80<br />
0277007 BERBERIL N EDO COLLY 10*0,5 ML P<br />
0 0 2,97 5,29 80<br />
0277011 BERBERIL N EDO COLLY 20*0,5 ML P<br />
0 0 4,78 8,52 80<br />
S01GA51 naphazoline, combinations<br />
0299892 COLLYRE BLEU LAITER COLLY 10 ML P<br />
0 0 3,04 5,42 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0072433 MINHAVEZ COLLY P<br />
0 0 2,85 4,90 80<br />
S01GX01 cromoglicic acid<br />
0364571 CROMABAK 20 MG/ML COLLY 10 ML P<br />
0 0 0,00 9,87 80<br />
0170403 CROMOHEXAL 2% COLLY 10 ML P<br />
0 0 2,15 4,28 80<br />
0176553 CROMOHEXAL UD COLLY 20*0,5 ML P<br />
0 0 2,56 5,11 80<br />
0195528 CROMOHEXAL UD COLLY 50*0,5 ML P<br />
0 0 5,85 11,21 80<br />
0285172 CROMOPHTA POS 20 MG/ML COLLY 10 ML P<br />
0 0 5,65 9,70 0<br />
0164003 DISPACROMIL COLLY 10 ML P<br />
0 0 0,00 4,00 80<br />
0163992 DISPACROMIL SINE COLLY 20*0,5 ML P<br />
0 0 0,00 4,00 80<br />
0082619 OPTICROM 2% COLLY 10 ML P<br />
0 0 6,15 10,56 80<br />
0151571 VIVIDRIN COLLY 10 ML 240 P<br />
0 0 3,02 5,38 80<br />
S01GX02 levocabastine<br />
0173971 LIVOSTIN 0,05% COLLY 1 FL 4 ML 52349 R<br />
0 0 7,29 12,53 80<br />
S01GX05 lodoxamide<br />
0170689 ALOMIDE 1 MG/ML COLLY 5 ML R<br />
0 0 0,00 5,68 80<br />
S01GX06 emedastine<br />
0263855 EMADINE 0,5 MG/ML COLLY 5 ML R<br />
0 0 7,51 13,42 80<br />
S01GX07 azelastine<br />
0257553 ALLERGODIL COLLY 6 ML R<br />
0 0 7,30 12,53 80<br />
0645281 AZELASTIN POS 0,5 MG/ML COLLY 10 ML R<br />
0 0 9,45 15,95 0<br />
S01GX08 ketotifen<br />
0576314 ALTRIABAK 0,25 MG/ML COLLY 5 ML R<br />
0 0 7,85 13,49 80<br />
0303544 ZADITEN OPHTA COLLY 5 ML R<br />
0 0 7,57 13,47 80<br />
0298721 ZADITEN OPHTA SINE 0,025% COLLY 20FL UD R<br />
0 0 9,37 16,67 80<br />
0298749 ZADITEN OPHTA SINE 0,025% COLLY 50FL UD R<br />
0 0 22,37 33,53 80<br />
S01GX09 olopatadine<br />
0341871 OPATANOL 0,1% COLLY 1 FL 5 ML R<br />
0 0 0,00 13,41 80<br />
S01GX10 epinastine<br />
0370113 RELESTAT 0,5 MG/ML COLLY 5 ML RR<br />
0 0 0,00 10,50 0<br />
S01HA02 oxybuprocaine<br />
0278259 MONOFREE OXYBUPROCAINE 0,4% COLLY 20*0,4 RR<br />
0 0 6,85 11,77 80<br />
0033788 NOVESINE 0,4% DISPERSA COLLY 10 ML RR<br />
0 0 0,00 4,29 80<br />
0219275 OXYBUPROCAINE HCL CHVN 0,4% COLLY 20 MIN RR<br />
0 0 0,00 16,79 80<br />
0084725 UNICAINE 0,4 % COLLY 10 ML R<br />
0 0 3,31 5,68 80<br />
S01HA03 tetracaine<br />
0219311 TETRACAINE CHLORH CHVN 1% COLLY 20 MIN RR<br />
0 0 0,00 16,79 80<br />
S01JA01 fluorescein<br />
0598857 FLUORESCEINE 10% FAURE 10 AMP 5 ML IV RR HC<br />
0 0 17,03 0,00 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0220343 FLUORESCEINE SOD CHVN 2% COLLY 20 MIN R<br />
0 0 0,00 16,53 80<br />
S01LA01 verteporfin<br />
0286041 VISUDYNE 15 MG PDR 1 FL PERF RR HC<br />
0 0 1.057,50 0,00 0<br />
S01LA03 pegaptanib<br />
0439668 MACUGEN 0,3 MG 1 SRG RR HC<br />
RM 0 0<br />
544,00 0,00 0<br />
S01LA04 ranibizumab<br />
0450729 LUCENTIS 10 MG/ML 1 FL 0,23 ML+AIG+SRG RR HC<br />
RM 0 0<br />
935,00 0,00 0<br />
S01XA12 dexpanthenol<br />
0187561 CORNEREGEL 10 G P<br />
0 0 2,51 4,47 80<br />
S01XA20 artificial tears and other indifferent preparations<br />
0223782 ALCON EYE GEL 10 G P<br />
0 0 0,00 6,50 40<br />
0182341 ARTELAC COLLY 1 FL 10 ML 450 P<br />
0 0 2,34 4,18 40<br />
0225451 ARTELAC EDO COLLY 120 * 0,6 ML P<br />
0 0 18,90 31,83 40<br />
0225434 ARTELAC EDO COLLY 30 * 0,6 ML P<br />
0 0 6,49 11,57 40<br />
0225448 ARTELAC EDO COLLY 60 * 0,6 ML P<br />
0 0 11,66 19,70 40<br />
0164017 DISPATENOL COLLY 10 ML P<br />
0 0 0,00 4,45 40<br />
0233226 DISPATENOL COLLY 3*10 ML P<br />
0 0 0,00 6,40 40<br />
0223636 DURATEARS 3,5 G POM OPHT P<br />
0 0 3,17 5,45 0<br />
0160746 ISOPTO TEARS COLLY 15 ML P<br />
0 0 0,00 4,09 40<br />
0066596 LIQUIFILM TEARS 15 ML P<br />
0 0 0,00 4,95 40<br />
0410111 OCUGEL 0,25% 20*0,4 G MND P<br />
0 0 5,24 9,01 0<br />
0294168 OCUGEL 0,25% GEL 10 G P<br />
0 0 4,53 7,77 40<br />
0444279 OCULOTECT FLUID PVD COLLY 10 ML P<br />
0 0 1,63 3,49 0<br />
0444282 OCULOTECT FLUID PVD COLLY 3*10 ML P<br />
0 0 3,15 6,22 0<br />
0419469 PVP AUGENTROPFEN DR MANN 10 ML P<br />
0 0 0,00 2,95 40<br />
0224681 SICCAGENT 2 % COLLY 10 ML P<br />
0 0 0,00 4,82 40<br />
0166851 TEARS NATURAL 15 ML P<br />
0 0 3,22 5,54 40<br />
0222186 THILO TEARS GEL OPHT 10 G P<br />
0 0 0,00 6,50 40<br />
0279273 VIDISIC EDO GEL 120*0,6 ML P<br />
0 0 18,90 31,83 40<br />
0279242 VIDISIC EDO GEL 30*0,6 ML P<br />
0 0 6,49 11,57 40<br />
0279256 VIDISIC EDO GEL 60*0,6 ML P<br />
0 0 11,66 19,70 40<br />
0140273 VIDISIC GEL 10 G 431 P<br />
0 0 2,34 4,18 40<br />
0140287 VIDISIC GEL 3*10 G 432 P<br />
0 0 4,78 8,52 40<br />
S02AA Antiinfectives<br />
0144448 OTOFA GTTS 200000 U 1 FL 10 ML RR<br />
0 0 2,25 3,51 80<br />
S02AA30 antiinfectives, combinations<br />
0076432 NEOBACITRACINE INSTILLATION RR<br />
0 0 1,96 6,68 80<br />
S02CA06 dexamethasone and antiinfectives<br />
0092050 POLYDEXA GTTS AURICUL 10 ML RR<br />
0 0 1,37 2,44 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
S02CA07 fludrocortisone and antiinfectives<br />
0131906 PANOTILE GTTS OTIQUES 10 ML RR<br />
0 0 3,36 5,78 0<br />
S02DA Analgesics and anesthetics<br />
0511631 OTOCALMINE 2% GTTS 18 ML P<br />
0 0 3,11 5,34 0<br />
S02DA01 lidocaine<br />
0084112 OTIPAX 16 G P<br />
0 0 0,00 2,63 80<br />
S02DC Indifferent preparations<br />
0020308 CERULYX GTTS 10 ML P<br />
0 0 4,01 6,88 80<br />
S03AA30 antiinfectives, combinations<br />
0512558 CIELLA 0,1% COLLY 20*5 ML UD P<br />
0 0 3,04 7,84 0<br />
S03CA01 dexamethasone and antiinfectives<br />
0380123<br />
SPACES<br />
AURICULARUM PDR 1 FL RR<br />
0 0 4,95 8,17 0<br />
0437775 ACOMPLIA 20 MG 84 CPR RR<br />
0 0 203,39 226,21 0<br />
0536126 CHONDROCELECT SUSP 1 FL 1 ML RR HC<br />
RM 0 0<br />
19.837,00 0,00 0<br />
0363993 HARTMANN + GLC 5% VIAFLO 10*1 L PERF RR<br />
0 0 2,97 7,71 0<br />
0363976 HARTMANN + GLC 5% VIAFLO 20*500 ML PERF RR<br />
0 0 2,45 7,05 0<br />
0303009 KORODIN GTTS 10 ML P<br />
0 0 2,19 4,37 0<br />
0311501 KORODIN GTTS 40 ML P<br />
0 0 5,81 11,12 0<br />
0355652 MAXILASE 20000 U SIR 200 ML P<br />
0 0 0,00 4,80 0<br />
0299908 MEGAMYLASE 200 U/ML SIR 125 ML P<br />
0 0 2,42 4,31 0<br />
0299911 MEGAMYLASE 200 U/ML SIR 250 ML P<br />
0 0 3,81 6,79 0<br />
0299925 MEGAMYLASE 3000 U 24 CPR P<br />
0 0 3,30 5,88 0<br />
0297688 MICTASOL 50 CPR P<br />
0 0 0,00 5,15 0<br />
V01AA02 grass pollen<br />
0640271 PURETHAL GRAESER 500 MCG/ML 1 FL 6 ML RR<br />
0 0 292,00 318,12 0<br />
0570891 PURETHAL GRAESER+GETREIDE 500MCG/ML 1FL RR<br />
0 0 292,00 318,12 0<br />
V01AA05 tree pollen<br />
0640284 PURETHAL BAEUME 500 MCG/ML 1 FL 6 ML RR<br />
0 0 292,00 318,12 0<br />
0640317 PURETHAL BIRKE 500 MCG/ML 1 FL 6 ML RR<br />
0 0 292,00 318,12 0<br />
V01AA20 various<br />
0213206 ALLERGOVIT 1 FL B (ENTRETIEN) 1*3 ML RR<br />
0 0 224,47 244,82 80<br />
0213191 ALLERGOVIT ST A+B / 2*3 ML RR<br />
0 0 245,10 266,70 80<br />
0305518 ALUSTAL 1 COFFRET CURE SC RR<br />
0 0 0,00 79,10 0<br />
0305521 ALUSTAL 1 FL DIL SEP 5 ML SC RR<br />
0 0 0,00 51,90 0<br />
0305535 ALUSTAL 1 FL EXTR CONC 5 ML RR<br />
0 0 0,00 51,90 0<br />
0536062 NOVO-HELISEN DEPOT EB ST 0-3 4*4,5 ML RR<br />
0 0 127,61 139,13 80<br />
0536059 NOVO-HELISEN DEPOT EB ST 1-3 3*4,5 ML RR<br />
0 0 120,92 132,03 80<br />
0536031 NOVO-HELISEN DEPOT FL ENTRETIEN 1*4,5 ML RR<br />
0 0 90,57 99,84 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0536045 NOVO-HELISEN DEPOT FL ENTRETIEN 2*4,5 ML RR<br />
0 0 164,19 177,61 80<br />
0080547 NOVO-HELISEN ORAL EB ST 1-3 3*30 ML RR<br />
0 0 0,00 115,78 0<br />
0640298 PURETHAL GRAESER+BAEUME 500MCG/ML 1FL 6 RR<br />
0 0 292,00 318,12 0<br />
0640303 PURETHAL GRAESER+BIRKE 500MCG/ML 1FL 6ML RR<br />
0 0 292,00 318,12 0<br />
0291572 STALORAL 0,1-1-10-100 IR 1 CURE 4 FL R<br />
0 0 57,11 68,72 0<br />
0311594 STALORAL 0,1-1-10-100-300 IR 1 CURE 5 FL R<br />
0 0 68,62 80,57 0<br />
0380896 STALORAL 100-100-100-100 IR 4 FL ENTRET R<br />
0 0 0,00 141,38 0<br />
0380879 STALORAL 10-100-100 IR 1 CURE 3 FL R<br />
0 0 0,00 102,81 0<br />
0380882 STALORAL 10-300-300 IR 1 CURE 3 FL R<br />
0 0 0,00 235,66 0<br />
0291586 STALORAL 300 IR 1 FL ENTRETIEN 10 ML R<br />
0 0 0,00 102,69 0<br />
0380901 STALORAL 300-300-300 IR 3 FL ENTRETIEN R<br />
0 0 0,00 282,81 0<br />
V03AB Antidotes<br />
0147101 LEGALON SIL 350 MG PDR 4 FL+S 5 ML IV RR<br />
0 0 557,74 619,43 80<br />
V03AB14 protamine<br />
0246028 PROTAMINE 1000 ROCHE 5000 U 5 AMP 5 ML RR<br />
0 0 0,00 9,87 80<br />
0536112 PROTAMINE SULF LEO 1400 U/ML 1 FL 5 ML RR<br />
0 0 4,01 6,89 80<br />
0538215 PROTAMINE SULF LEO 1400 U/ML 5 AMP 5 ML RR<br />
0 0 35,00 45,96 0<br />
V03AB25 flumazenil<br />
0138651 ANEXATE 0,5 MG 1 AMP 5 ML IV RR H<br />
0 0 13,94 0,00 0<br />
V03AB33 hydroxocobalamin<br />
0502521 CYANOKIT 2,5 G PDR 2FL+SET+2DISP+1CATH RR H<br />
0 0 600,00 0,00 0<br />
0602851 CYANOKIT 5 G PDR 1 FL + SET PERF RR H<br />
0 0 600,00 0,00 0<br />
V03AB35 sugammadex<br />
0496616 BRIDION 200 MG 10 FL 2 ML IV RR HC<br />
0 0 780,00 0,00 0<br />
0496633 BRIDION 500 MG 10 FL 5 ML IV RR HC<br />
0 0 1.950,00 0,00 0<br />
V03AC01 deferoxamine<br />
0030545 DESFERAL 500 MG PDR 10 FL+S RR<br />
0 0 24,18 33,03 100<br />
V03AC02 deferiprone<br />
0269487 FERRIPROX 500 MG 100 CPR RR C<br />
0 0 219,05 240,88 100<br />
V03AC03 deferasirox<br />
0441991 EXJADE 125 MG 84 CPR RR C<br />
X RM 1 5<br />
614,01 681,00 100<br />
0442016 EXJADE 250 MG 84 CPR RR C<br />
X RM 1 5<br />
1.229,70 1.353,78 100<br />
0442047 EXJADE 500 MG 84 CPR RR C<br />
X RM 1 5<br />
2.464,99 2.664,29 100<br />
V03AE01 polystyrene sulfonate<br />
0061622 KAYEXALATE CALCIUM PDR 300 G R<br />
0 0 13,81 21,39 100<br />
0061636 KAYEXALATE SODIUM PDR 450 G R<br />
0 0 16,59 24,67 100<br />
0483036 RESICAL PDR 1 FL 500 G R<br />
0 0 24,35 34,99 0<br />
0107170 SORBISTERIT CA PDRE 500G 3400711 R<br />
0 0 24,87 36,21 100<br />
V03AE02 sevelamer<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0319379 RENAGEL 800 MG 180 CPR RR<br />
0 0 166,60 185,47 100<br />
0519593 RENVELA 2,4 G PDR 60 SACH RR<br />
RM 0 0<br />
158,09 176,45 100<br />
0519545 RENVELA 800 MG 180 CPR (FL) RR<br />
RM 0 0<br />
158,09 176,45 100<br />
V03AE03 lanthanum carbonate<br />
0403522 FOSRENOL 500 MG 90 CPR A CROQ RR C<br />
0 0 165,98 184,82 100<br />
0403603 FOSRENOL 750 MG 90 CPR A CROQ RR C<br />
0 0 207,46 228,78 100<br />
V03AF01 mesna<br />
0123613 UROMITEXAN 400 MG 15 AMP 4 ML IV RR H<br />
0 0 27,61 0,00 0<br />
V03AF02 dexrazoxane<br />
0445201 CARDIOXANE 500 MG PDR 1 FL 36 ML IV RR HC<br />
0 0 216,98 0,00 0<br />
0439654 SAVENE 20 MG/ML PDR 10 FL 500 MG + S IV RR HC X 0 0<br />
9.559,88 0,00 0<br />
V03AF03 calcium folinate<br />
0425385 FOLINATE EG 200 MG 5 FL 20 ML IV RR H<br />
0 0 128,76 0,00 0<br />
0425404 FOLINATE EG 500 MG 5 FL 50 ML IV RR H<br />
0 0 321,91 0,00 0<br />
0492813 LEUCOVORIN CA HSP 100 MG 1 FL 10 ML IMIV RR H<br />
0 0 18,04 0,00 0<br />
0438898 RESCUVOLIN 15 MG 10 CPR RR<br />
0 0 21,20 29,74 100<br />
0438903 RESCUVOLIN 15 MG 50 CPR RR<br />
0 0 84,78 98,75 100<br />
0415121 VORINA 100 MG 1 FL 4 ML IMIV RR H<br />
0 0 12,88 0,00 0<br />
0415148 VORINA 350 MG 1 FL 14 ML IMIV RR H<br />
0 0 45,07 0,00 0<br />
0415098 VORINA 50 MG 1 FL 2 ML IMIV RR H<br />
0 0 8,85 0,00 0<br />
0415182 VORINA 500 MG 1 FL 20 ML IMIV RR H<br />
0 0 64,38 0,00 0<br />
V03AF04 calcium levofolinate<br />
0221693 ELVORINE 175 MG 1 FL 17,5 ML IMIV RR H<br />
0 0 98,66 0,00 0<br />
0221628 ELVORINE 25 MG 1 FL 2,5 ML IMIV RR H<br />
0 0 3,88 0,00 0<br />
0221645 ELVORINE 50 MG 1 FL 5 ML IMIV RR H<br />
0 0 7,76 0,00 0<br />
0213531 ELVORINE 7,5 MG 10 CPR RR<br />
0 0 12,80 20,12 100<br />
V03AF05 amifostine<br />
0436425 ETHYOL 500 MG PDR 3 FL 10 ML IV RR HC<br />
0 0 439,90 0,00 0<br />
V03AF07 rasburicase<br />
0305664 FASTURTEC 1,5 MG PSV 3 FL + S PERF RR HC<br />
0 0 180,02 0,00 0<br />
0342492 FASTURTEC 7,5 MG PDR 1 FL + S 5 ML PERF RR HC<br />
0 0 300,03 0,00 0<br />
V03AF08 palifermin<br />
0429725 KEPIVANCE 6,25 MG PDR 6 FL IV RR HC<br />
0 0 4.800,00 0,00 0<br />
V03AN Medical gases<br />
0297285 PROTOXYDE D'AZOTE MED BTG BT 3,75 KG R HC<br />
0 0 16,04 0,00 0<br />
0297304 PROTOXYDE D'AZOTE MED BTG BT 30 KG R HC<br />
0 0 128,28 0,00 0<br />
0297318 PROTOXYDE D'AZOTE MED BTG BT 37,5 KG R HC<br />
0 0 160,36 0,00 0<br />
0297299 PROTOXYDE D'AZOTE MED BTG BT 7,5 KG R HC<br />
0 0 32,07 0,00 0<br />
V03AN01 oxygen<br />
Page 215 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0301083 OXYGENE LIQ MED VIVISOL 1 REC CRYOGEN R<br />
0 0 4,94 6,56 0<br />
0296503 OXYGENE MED GAZ BTG BT 0,213 M3 R<br />
0 0 0,94 1,27 0<br />
0296517 OXYGENE MED GAZ BTG BT 0,425 M3 R<br />
0 0 1,89 2,56 0<br />
0296521 OXYGENE MED GAZ BTG BT 1,125 M3 R<br />
0 0 4,99 6,74 0<br />
0296565 OXYGENE MED GAZ BTG BT 10,61 M3 R<br />
0 0 47,08 59,40 0<br />
0296534 OXYGENE MED GAZ BTG BT 2,12 M3 R<br />
0 0 9,41 12,72 0<br />
0296548 OXYGENE MED GAZ BTG BT 4,33 M3 R<br />
0 0 19,21 25,99 0<br />
0296551 OXYGENE MED GAZ BTG BT 6,37 M3 R<br />
0 0 28,27 37,36 0<br />
0298332 OXYGENE MED GAZ HOEK LOOS 1 BT 150 10L R<br />
0 0 0,00 9,90 0<br />
0298315 OXYGENE MED GAZ HOEK LOOS 1 BT 150 2,8L R<br />
0 0 0,00 2,77 0<br />
0298346 OXYGENE MED GAZ HOEK LOOS 1 BT 150 20 L R<br />
0 0 0,00 19,80 0<br />
0298329 OXYGENE MED GAZ HOEK LOOS 1 BT 150 4 L R<br />
0 0 0,00 3,95 0<br />
0298363 OXYGENE MED GAZ HOEK LOOS 1 BT 150 40 L R<br />
0 0 29,28 40,08 0<br />
0298377 OXYGENE MED GAZ HOEK LOOS 1 BT 200 1 L R<br />
0 0 0,00 1,32 0<br />
0298461 OXYGENE MED GAZ HOEK LOOS 1 BT 200 10 L R<br />
0 0 0,00 13,20 0<br />
0298381 OXYGENE MED GAZ HOEK LOOS 1 BT 200 2 L R<br />
0 0 0,00 2,65 0<br />
0298394 OXYGENE MED GAZ HOEK LOOS 1 BT 200 2,5L R<br />
0 0 0,00 3,30 0<br />
0298413 OXYGENE MED GAZ HOEK LOOS 1 BT 200 2,8L R<br />
0 0 0,00 3,66 0<br />
0298475 OXYGENE MED GAZ HOEK LOOS 1 BT 200 20 L R<br />
0 0 16,01 26,40 0<br />
0298427 OXYGENE MED GAZ HOEK LOOS 1 BT 200 3 L R<br />
0 0 0,00 3,95 0<br />
0298489 OXYGENE MED GAZ HOEK LOOS 1 BT 200 30 L R<br />
0 0 29,28 40,08 0<br />
0298431 OXYGENE MED GAZ HOEK LOOS 1 BT 200 4 L R<br />
0 0 0,00 5,28 0<br />
0298444 OXYGENE MED GAZ HOEK LOOS 1 BT 200 5 L R<br />
0 0 0,00 6,60 0<br />
0298508 OXYGENE MED GAZ HOEK LOOS 1 BT 200 50 L R<br />
0 0 48,81 60,17 0<br />
0298458 OXYGENE MED GAZ HOEK LOOS 1 BT 200 6,6L R<br />
0 0 0,00 8,70 0<br />
0298301 OXYGENE MED GAZ HOEK LOOS 1 BT 250 2,2L R<br />
0 0 0,00 2,17 0<br />
0338536 OXYGENE MED GAZ MESSER 1 CITERNE R<br />
0 0 4,94 6,38 0<br />
0296582 OXYGENE MED GAZ MESSER BT 0,4 M3 R<br />
0 0 1,77 2,41 0<br />
0296596 OXYGENE MED GAZ MESSER BT 1 M3 R<br />
0 0 4,44 6,00 0<br />
0296629 OXYGENE MED GAZ MESSER BT 10,6 M3 R<br />
0 0 47,04 58,34 0<br />
0296601 OXYGENE MED GAZ MESSER BT 2,2 M3 R<br />
0 0 9,76 13,20 0<br />
0296615 OXYGENE MED GAZ MESSER BT 4,3 M3 R<br />
0 0 19,08 25,80 0<br />
0296422 OXYGENE MED GAZ VIVISOL BT 0,2 R<br />
0 0 0,94 1,27 0<br />
0296436 OXYGENE MED GAZ VIVISOL BT 0,4 R<br />
0 0 1,89 2,56 0<br />
0296453 OXYGENE MED GAZ VIVISOL BT 1,1 R<br />
0 0 4,99 6,74 0<br />
0296498 OXYGENE MED GAZ VIVISOL BT 10 R<br />
0 0 47,08 59,40 0<br />
0296467 OXYGENE MED GAZ VIVISOL BT 2,1 R<br />
0 0 9,41 12,72 0<br />
0296471 OXYGENE MED GAZ VIVISOL BT 4,3 R<br />
0 0 19,21 25,99 0<br />
0296484 OXYGENE MED GAZ VIVISOL BT 6,3 R<br />
0 0 28,27 37,36 0<br />
0296579 OXYGENE MED LIQ GAZ 1 CITERNE R H<br />
0 0 0,65 0,00 0<br />
0243155 OXYGENE MEDICAL BT 100 L R<br />
0 0 0,00 5,60 80<br />
0243205 OXYGENE MEDICAL BT 1000 L R<br />
0 0 0,00 5,60 80<br />
0243236 OXYGENE MEDICAL BT 10500 L R<br />
0 0 0,00 55,26 80<br />
0243169 OXYGENE MEDICAL BT 200 L R<br />
0 0 0,00 5,60 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0243219 OXYGENE MEDICAL BT 2100 L R<br />
0 0 0,00 11,80 80<br />
0243172 OXYGENE MEDICAL BT 300 L R<br />
0 0 0,00 5,60 80<br />
0243186 OXYGENE MEDICAL BT 400 L R<br />
0 0 0,00 5,60 80<br />
0243222 OXYGENE MEDICAL BT 4200 L R<br />
0 0 0,00 23,60 80<br />
0243141 OXYGENE MEDICAL BT 74 L R<br />
0 0 0,00 5,60 80<br />
V03AN05 medical air<br />
0611427 AIR SYNTH MED SOL 21,75% 1 CYL 1 L RR HC<br />
0 0 5,60 0,00 0<br />
0611461 AIR SYNTH MED SOL 21,75% 1 CYL 10 L RR HC<br />
0 0 15,46 0,00 0<br />
0611431 AIR SYNTH MED SOL 21,75% 1 CYL 2 L RR HC<br />
0 0 6,63 0,00 0<br />
0611475 AIR SYNTH MED SOL 21,75% 1 CYL 20 L RR HC<br />
0 0 26,53 0,00 0<br />
0611444 AIR SYNTH MED SOL 21,75% 1 CYL 3 L RR HC<br />
0 0 7,81 0,00 0<br />
0611489 AIR SYNTH MED SOL 21,75% 1 CYL 30 L RR HC<br />
0 0 37,51 0,00 0<br />
0611492 AIR SYNTH MED SOL 21,75% 1 CYL 40 L RR HC<br />
0 0 49,05 0,00 0<br />
0611458 AIR SYNTH MED SOL 21,75% 1 CYL 5 L RR HC<br />
0 0 9,98 0,00 0<br />
0611508 AIR SYNTH MED SOL 21,75% 1 CYL 50 L RR HC<br />
0 0 60,59 0,00 0<br />
0611525 AIR SYNTH MED SOL 21,75% 12 CYL 40 L RR HC<br />
0 0 588,60 0,00 0<br />
0611556 AIR SYNTH MED SOL 21,75% 12 CYL 50 L RR HC<br />
0 0 727,08 0,00 0<br />
0611539 AIR SYNTH MED SOL 21,75% 16 CYL 40 L RR HC<br />
0 0 784,80 0,00 0<br />
0611573 AIR SYNTH MED SOL 21,75% 16 CYL 50 L RR HC<br />
0 0 969,44 0,00 0<br />
0611511 AIR SYNTH MED SOL 21,75% 8 CYL 40 L RR HC<br />
0 0 392,40 0,00 0<br />
0611542 AIR SYNTH MED SOL 21,75% 8 CYL 50 L RR HC<br />
0 0 484,72 0,00 0<br />
V04 DIAGNOSTIC AGENTS<br />
0206022 OCTREOSCAN 111 10 MCG 1 FL A + 1 FL B IV RR HC<br />
0 0 707,06 0,00 0<br />
V04CF01 tuberculin<br />
0568987 TUBERCULIN PPD SSI 10U/0,1 ML 1 FL 1,5ML R<br />
0 0 24,84 35,50 0<br />
0423721 TUBERCULIN PPD SSI 10U/0,1 ML 10FL 1,5ML R<br />
0 0 224,33 240,97 0<br />
0568973 TUBERCULIN PPD SSI 2 U/0,1 ML 1 FL 1,5ML R<br />
0 0 10,60 18,21 0<br />
0423735 TUBERCULIN PPD SSI 2 U/0,1 ML 10FL 1,5ML R<br />
0 0 81,13 93,48 0<br />
V04CJ01 thyrotropin<br />
0278571 THYROGEN 0,9 MG PDR 2 FL IM RR DC<br />
0 0 1.101,47 0,00 0<br />
V04CX Other diagnostic agents<br />
0137975 BLEU PATENTE 5 AMP 2 ML SC R H<br />
0 0 23,95 0,00 0<br />
0330877 HELICOBACTER TEST INFAI 45 MG 1 KIT RR P<br />
0 0 15,55 24,06 0<br />
0240914 HELICOBACTER TEST INFAI 75MG 1KIT (SACS) RR P<br />
0 0 23,21 34,46 0<br />
0502551 HELICOBACTER TEST INFAI 75MG 1KIT (TUBES RR P<br />
0 0 23,21 34,46 0<br />
0414994 HEXVIX 85 MG PDR 1 FL + S PP R P<br />
0 0 405,00 0,00 0<br />
V07AB Solvents and diluting agents, incl. irrigating solutions<br />
0282752 AMPUWA 1000 ML PLASTIPUR PS 1088811 RR<br />
0 0 2,30 3,89 0<br />
0280338 AMPUWA 20 AMP 10 ML P B314063 RR<br />
0 0 4,62 8,75 0<br />
0280355 AMPUWA 20 AMP 20 ML P B314391 RR<br />
0 0 5,04 9,65 0<br />
0007340 AQUA AD INJ BRN 10 AMP 20 ML P RR<br />
0 0 0,00 7,46 80<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0007337 AQUA AD INJ BRN 10 MINI PL 10 ML RR<br />
0 0 0,00 7,06 80<br />
0007256 AQUA AD INJ BRN 100 ML V RR<br />
0 0 0,00 1,39 80<br />
0334165 EAU POUR INJ VIAFLO 1000 ML PP RR<br />
0 0 1,92 6,46 0<br />
0334151 EAU POUR INJ VIAFLO 500 ML PP RR<br />
0 0 1,54 6,03 0<br />
V08AA01 diatrizoic acid<br />
0171137 GASTROGRAFIN SOL OR 5 FL 100 ML R H<br />
0 0 20,66 0,00 0<br />
0144174 UROGRAFINE 30% 10 FL 250 ML PERF RR H<br />
0 0 68,33 0,00 0<br />
0123434 UROGRAFINE 76% 1 FL 100 ML PERF RR HC<br />
0 0 6,60 0,00 0<br />
V08AA05 ioxitalamic acid<br />
0142717 TELEBRIX 12 SODIUM 1 FL INJ 250 ML RR H<br />
0 0 7,54 0,00 0<br />
0113830 TELEBRIX 30 MEGLUMINE 1 FL 100 ML RR H<br />
0 0 7,97 0,00 0<br />
0113844 TELEBRIX 30 MEGLUMINE 1 FL 140 ML RR H<br />
0 0 10,25 0,00 0<br />
0113827 TELEBRIX 30 MEGLUMINE 1 FL 30 ML RR H<br />
0 0 2,81 0,00 0<br />
0113861 TELEBRIX 35 1 FL 100 ML RR H<br />
0 0 7,81 0,00 0<br />
0113875 TELEBRIX 35 1 FL 200 ML RR H<br />
0 0 14,14 0,00 0<br />
0113858 TELEBRIX 35 1 FL 50 ML RR H<br />
0 0 4,57 0,00 0<br />
0152694 TELEBRIX GASTRO 300 MG/ML 1 FL 100 ML R H<br />
0 0 6,64 0,00 0<br />
0152681 TELEBRIX GASTRO 300 MG/ML 1 FL 50 ML R H<br />
0 0 3,91 0,00 0<br />
0209931 TELEBRIX HYSTERO 5 G 1 FL 20 ML IV RR H<br />
0 0 1,78 0,00 0<br />
V08AB02 iohexol<br />
0081768 OMNIPAQUE 180 MG/ML 1 FL 15 ML IV RR HC<br />
0 0 4,07 0,00 0<br />
0081785 OMNIPAQUE 240 MG/ML 1 FL 10 ML IV RR HC<br />
0 0 2,99 0,00 0<br />
0081804 OMNIPAQUE 240 MG/ML 1 FL 20 ML IV RR HC<br />
0 0 4,97 0,00 0<br />
0081852 OMNIPAQUE 240 MG/ML 1 FL 200 ML IV RR HC<br />
0 0 49,66 0,00 0<br />
0081835 OMNIPAQUE 240 MG/ML 1 FL 50 ML IV RR HC<br />
0 0 12,34 0,00 0<br />
0456073 OMNIPAQUE 240 MG/ML 1 FL PP 10 ML IV RR HC<br />
0 0 3,45 0,00 0<br />
0456087 OMNIPAQUE 240 MG/ML 1 FL PP 15 ML IV RR HC<br />
0 0 4,58 0,00 0<br />
0456042 OMNIPAQUE 240 MG/ML 1 FL PP 20 ML IV RR HC<br />
0 0 5,71 0,00 0<br />
0081883 OMNIPAQUE 300 MG/ML 1 FL 10 ML IV RR HC<br />
0 0 3,67 0,00 0<br />
0081964 OMNIPAQUE 300 MG/ML 1 FL 100 ML IV RR HC<br />
0 0 29,82 0,00 0<br />
0478067 OMNIPAQUE 300 MG/ML 1 FL 150 ML IV RR HC<br />
0 0 44,38 0,00 0<br />
0081902 OMNIPAQUE 300 MG/ML 1 FL 20 ML IV RR HC<br />
0 0 6,06 0,00 0<br />
0081947 OMNIPAQUE 300 MG/ML 1 FL 50 ML IV RR HC<br />
0 0 15,12 0,00 0<br />
0478084 OMNIPAQUE 300 MG/ML 1 FL 500 ML IV RR HC<br />
0 0 142,77 0,00 0<br />
0180394 OMNIPAQUE 300 MG/ML 1 FL PLAST 50 ML IV RR HC<br />
0 0 15,41 0,00 0<br />
0456106 OMNIPAQUE 300 MG/ML 1 FL PP 10 ML IV RR HC<br />
0 0 4,22 0,00 0<br />
0456123 OMNIPAQUE 300 MG/ML 1 FL PP 20 ML IV RR HC<br />
0 0 6,97 0,00 0<br />
0081978 OMNIPAQUE 300 MG/ML 10 FL 100 ML IV RR HC<br />
0 0 41,20 0,00 0<br />
0082040 OMNIPAQUE 350 MG/ML 1 FL 100 ML RR HC<br />
0 0 33,43 0,00 0<br />
0478103 OMNIPAQUE 350 MG/ML 1 FL 150 ML IV RR HC<br />
0 0 46,91 0,00 0<br />
0081981 OMNIPAQUE 350 MG/ML 1 FL 20 ML IV RR HC<br />
0 0 7,45 0,00 0<br />
0082068 OMNIPAQUE 350 MG/ML 1 FL 200 ML IV RR HC<br />
0 0 63,51 0,00 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0082023 OMNIPAQUE 350 MG/ML 1 FL 50 ML IV RR HC<br />
0 0 17,28 0,00 0<br />
0478121 OMNIPAQUE 350 MG/ML 1 FL 500 ML IV RR HC<br />
0 0 142,90 0,00 0<br />
0180427 OMNIPAQUE 350 MG/ML 1 FL PLAST 50 ML RR HC<br />
0 0 17,36 0,00 0<br />
0456091 OMNIPAQUE 350 MG/ML 1 FL PP 20 ML IV RR HC<br />
0 0 8,05 0,00 0<br />
V08AB03 ioxaglic acid<br />
0053455 HEXABRIX 200 1 FL 100 ML IA RR H<br />
0 0 20,56 0,00 0<br />
0053441 HEXABRIX 200 1 FL 50 ML IA RR H<br />
0 0 9,78 0,00 0<br />
0140971 HEXABRIX 320 1 FL 10 ML RR H<br />
0 0 3,87 0,00 0<br />
0053505 HEXABRIX 320 1 FL 100 ML RR H<br />
0 0 31,60 0,00 0<br />
0053472 HEXABRIX 320 1 FL 20 ML RR H<br />
0 0 6,45 0,00 0<br />
0140984 HEXABRIX 320 1 FL 200 ML RR H<br />
0 0 56,90 0,00 0<br />
0053486 HEXABRIX 320 1 FL 50 ML RR H<br />
0 0 16,04 0,00 0<br />
V08AB04 iopamidol<br />
0374241 SCANLUX 300 MG/ML 100 ML IAIV RR HC<br />
0 0 39,61 0,00 0<br />
0374255 SCANLUX 300 MG/ML 200 ML IAIV RR HC<br />
0 0 76,31 0,00 0<br />
0374224 SCANLUX 300 MG/ML 50 ML IAIV RR HC<br />
0 0 21,80 0,00 0<br />
0374238 SCANLUX 300 MG/ML 75 ML IAIV RR HC<br />
0 0 30,52 0,00 0<br />
0374191 SCANLUX 370 MG/ML 100 ML IAIV RR HC<br />
0 0 45,71 0,00 0<br />
0374207 SCANLUX 370 MG/ML 200 ML IAIV RR HC<br />
0 0 87,21 0,00 0<br />
0374174 SCANLUX 370 MG/ML 50 ML IAIV RR HC<br />
0 0 25,14 0,00 0<br />
0374188 SCANLUX 370 MG/ML 75 ML IAIV RR HC<br />
0 0 37,72 0,00 0<br />
V08AB05 iopromide<br />
0192316 ULTRAVIST 240 1 FL 200 ML IVIA RR H<br />
0 0 47,58 0,00 0<br />
0132111 ULTRAVIST 240 1 FL 50 ML IVIA RR H<br />
0 0 11,69 0,00 0<br />
0132031 ULTRAVIST 300 1 AMP 20 ML IVIA RR HC<br />
0 0 6,35 0,00 0<br />
0132304 ULTRAVIST 300 1 AMP INJ 10 ML RR HC<br />
0 0 3,82 0,00 0<br />
0132075 ULTRAVIST 300 1 FL 100 ML IVIA RR HC<br />
0 0 30,18 0,00 0<br />
0192333 ULTRAVIST 300 1 FL 150 ML IVIA RR HC<br />
0 0 43,78 0,00 0<br />
0192347 ULTRAVIST 300 1 FL 200 ML IVIA RR HC<br />
0 0 58,37 0,00 0<br />
0132058 ULTRAVIST 300 1 FL 50 ML IVIA RR HC<br />
0 0 14,71 0,00 0<br />
0223071 ULTRAVIST 300 1 FL 500 ML IVIA RR HC<br />
0 0 145,92 0,00 0<br />
0132044 ULTRAVIST 300 10 AMP 20 ML IVIA RR HC<br />
0 0 6,64 0,00 0<br />
0132061 ULTRAVIST 300 10 FL 50 ML IVIA RR HC<br />
0 0 15,37 0,00 0<br />
0132268 ULTRAVIST 370 1 FL 100 ML IVIA RR H<br />
0 0 35,72 0,00 0<br />
0341481 ULTRAVIST 370 1 FL 150 ML IVIA RR H<br />
0 0 53,77 0,00 0<br />
0132285 ULTRAVIST 370 1 FL 200 ML IVIA RR H<br />
0 0 68,93 0,00 0<br />
0132139 ULTRAVIST 370 1 FL 50 ML IVIA RR H<br />
0 0 17,99 0,00 0<br />
0371074 ULTRAVIST 370 1 FL 500 ML IVIA RR H<br />
0 0 172,35 0,00 0<br />
V08AB07 ioversol<br />
0268056 OPTIJECT 300 1 SRG 50 ML IVIA RR H<br />
0 0 15,32 0,00 0<br />
0267935 OPTIJECT 300 1 SRG PERF EL 125 ML RR H<br />
0 0 39,29 0,00 0<br />
0268008 OPTIJECT 300 1 SRG PERF EL 50 ML RR H<br />
0 0 15,70 0,00 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0268199 OPTIJECT 350 1 SRG 50 ML IVIA RR H<br />
0 0 17,52 0,00 0<br />
0268171 OPTIJECT 350 1 SRG PERF EL 100 ML RR H<br />
0 0 35,96 0,00 0<br />
0268137 OPTIJECT 350 1 SRG PERF EL 125 ML RR H<br />
0 0 45,86 0,00 0<br />
0268123 OPTIJECT 350 1 SRG PERF EL 50 ML RR H<br />
0 0 18,31 0,00 0<br />
V08AB08 iopentol<br />
0163636 OPTIRAY 300 MG 1 FL 100 ML RR H<br />
0 0 30,83 0,00 0<br />
0163653 OPTIRAY 300 MG 1 FL 200 ML RR H<br />
0 0 61,68 0,00 0<br />
0163619 OPTIRAY 300 MG 1 FL 50 ML RR H<br />
0 0 16,12 0,00 0<br />
0163698 OPTIRAY 350 MG 1 FL 100 ML RR H<br />
0 0 36,68 0,00 0<br />
0163703 OPTIRAY 350 MG 1 FL 200 ML RR H<br />
0 0 71,95 0,00 0<br />
0163671 OPTIRAY 350 MG 1 FL 50 ML RR H<br />
0 0 17,87 0,00 0<br />
V08AB09 iodixanol<br />
0205817 VISIPAQUE 270 1 FL 100 ML IAIV RR HC<br />
0 0 35,06 0,00 0<br />
0269828 VISIPAQUE 270 1 FL 200 ML IAIV RR HC<br />
0 0 70,90 0,00 0<br />
0205798 VISIPAQUE 270 1 FL 50 ML IAIV RR HC<br />
0 0 17,18 0,00 0<br />
0269831 VISIPAQUE 270 1 FL 500 ML IAIV RR HC<br />
0 0 171,02 0,00 0<br />
0416629 VISIPAQUE 270 1*150 ML PPR IAIV RR HC<br />
0 0 52,26 0,00 0<br />
0416663 VISIPAQUE 270 1*500 ML PPR IAIV RR HC<br />
0 0 156,77 0,00 0<br />
0205851 VISIPAQUE 320 1 FL 100 ML IAIV RR HC<br />
0 0 41,04 0,00 0<br />
0205879 VISIPAQUE 320 1 FL 200 ML IAIV RR HC<br />
0 0 79,68 0,00 0<br />
0205834 VISIPAQUE 320 1 FL 50 ML IAIV RR HC<br />
0 0 20,26 0,00 0<br />
0269859 VISIPAQUE 320 1 FL 500 ML IAIV RR HC<br />
0 0 194,30 0,00 0<br />
0416713 VISIPAQUE 320 1*150 ML PPR IAIV RR HC<br />
0 0 60,35 0,00 0<br />
0416744 VISIPAQUE 320 1*500 ML PPR IAIV RR HC<br />
0 0 179,27 0,00 0<br />
V08AB10 iomeprol<br />
0200032 IOMERON 250 MG/ML 1 FL 200 ML IAIVIP RR HC<br />
0 0 52,05 0,00 0<br />
0200127 IOMERON 300 MG/ML 1 FL 100 ML IAIVIP RR HC<br />
0 0 31,43 0,00 0<br />
0200144 IOMERON 300 MG/ML 1 FL 200 ML IAIVIP RR HC<br />
0 0 61,20 0,00 0<br />
0200094 IOMERON 300 MG/ML 1 FL 50 ML IAIVIP RR HC<br />
0 0 15,32 0,00 0<br />
0391886 IOMERON 300 MG/ML 1 FL 500 ML IAIVIP RR HC<br />
0 0 174,50 0,00 0<br />
0200208 IOMERON 350 MG/ML 1 FL 100 ML IAIVIP RR HC<br />
0 0 35,40 0,00 0<br />
0391905 IOMERON 350 MG/ML 1 FL 150 ML IAIVIP RR HC<br />
0 0 51,91 0,00 0<br />
0200225 IOMERON 350 MG/ML 1 FL 200 ML IAIVIP RR HC<br />
0 0 68,40 0,00 0<br />
0200189 IOMERON 350 MG/ML 1 FL 50 ML IAIVIP RR HC<br />
0 0 17,70 0,00 0<br />
0391919 IOMERON 350 MG/ML 1 FL 500 ML IAIVIP RR HC<br />
0 0 196,50 0,00 0<br />
0200287 IOMERON 400 MG/ML 1 FL 100 ML IAIVIP RR HC<br />
0 0 40,45 0,00 0<br />
0200306 IOMERON 400 MG/ML 1 FL 200 ML IAIVIP RR HC<br />
0 0 78,20 0,00 0<br />
0200256 IOMERON 400 MG/ML 1 FL 50 ML IAIVIP RR HC<br />
0 0 20,22 0,00 0<br />
V08AB11 iobitridol<br />
0224101 XENETIX 250 MG/ML 1 FL 100 ML RR H<br />
0 0 26,20 0,00 0<br />
0224115 XENETIX 250 MG/ML 1 FL 200 ML RR H<br />
0 0 65,53 0,00 0<br />
0224163 XENETIX 300 MG/ML 1 FL 100 ML RR H<br />
0 0 31,76 0,00 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0362383 XENETIX 300 MG/ML 1 FL 150 ML RR H<br />
0 0 44,68 0,00 0<br />
0224132 XENETIX 300 MG/ML 1 FL 20 ML RR H<br />
0 0 6,73 0,00 0<br />
0224177 XENETIX 300 MG/ML 1 FL 200 ML RR H<br />
0 0 45,46 0,00 0<br />
0224146 XENETIX 300 MG/ML 1 FL 50 ML RR H<br />
0 0 15,47 0,00 0<br />
0224181 XENETIX 300 MG/ML 1 FL 500 ML RR H<br />
0 0 123,58 0,00 0<br />
0432426 XENETIX 300 MG/ML 1 PP 200 ML RR H<br />
0 0 46,11 0,00 0<br />
0224227 XENETIX 350 MG/ML 1 FL 100 ML RR H<br />
0 0 34,01 0,00 0<br />
0224231 XENETIX 350 MG/ML 1 FL 150 ML RR H<br />
0 0 52,23 0,00 0<br />
0224244 XENETIX 350 MG/ML 1 FL 200 ML RR H<br />
0 0 53,81 0,00 0<br />
0224213 XENETIX 350 MG/ML 1 FL 50 ML RR H<br />
0 0 17,87 0,00 0<br />
0440185 XENETIX 350 MG/ML 1 FL 500 ML RR H<br />
0 0 144,44 0,00 0<br />
0432457 XENETIX 350 MG/ML 1 PP 100 ML RR H<br />
0 0 34,01 0,00 0<br />
0432461 XENETIX 350 MG/ML 1 PP 150 ML RR H<br />
0 0 52,23 0,00 0<br />
0432474 XENETIX 350 MG/ML 1 PP 200 ML RR H<br />
0 0 53,81 0,00 0<br />
0432488 XENETIX 350 MG/ML 1 PP 500 ML RR H<br />
0 0 144,44 0,00 0<br />
V08AD01 ethyl esters of iodised fatty acids<br />
0338441 LIPIODOL ULTRA FLUIDE 1 AMP 10 ML R H<br />
0 0 11,42 0,00 0<br />
V08BA01 barium sulfate with suspending agents<br />
0286461 MCROPAQUE COLON PDR 400 G R H<br />
0 0 4,40 0,00 0<br />
0072142 MICROPAQUE HD ORAL PDR 416 G R H<br />
0 0 3,49 0,00 0<br />
0154024 MICROPAQUE SCANNER SUSP 150 ML RR HC<br />
0 0 3,76 0,00 0<br />
0286457 MICROPAQUE SUSP 2 L R H<br />
0 0 16,60 0,00 0<br />
V08BA02 barium sulfate without suspending agents<br />
0229416 MICROTRAST PATE ORALE 800 G R H<br />
0 0 15,00 0,00 0<br />
V08CA01 gadopentetic acid<br />
0486492 MAGNEGITA 78,63 MG/ML 1 FL 100 ML IV RR HC<br />
0 0 180,98 0,00 0<br />
0486431 MAGNEGITA 78,63 MG/ML 1 FL 15 ML IV RR HC<br />
0 0 33,35 0,00 0<br />
0486458 MAGNEGITA 78,63 MG/ML 1 FL 20 ML IV RR HC<br />
0 0 40,25 0,00 0<br />
0486475 MAGNEGITA 78,63 MG/ML 1 FL 30 ML IV RR HC<br />
0 0 54,36 0,00 0<br />
0486381 MAGNEGITA 78,63 MG/ML 1 FL 5 ML IV RR HC<br />
0 0 23,34 0,00 0<br />
0172408 MAGNEVIST 4,69 G 1 FL 10 ML IV RR H<br />
0 0 23,06 0,00 0<br />
0237726 MAGNEVIST 4,69 G 1 FL 100 ML IV RR H<br />
0 0 164,07 0,00 0<br />
0237712 MAGNEVIST 4,69 G 1 FL 30 ML IV RR H<br />
0 0 49,91 0,00 0<br />
0237743 MAGNEVIST 4,69 G 1 SRG 10 ML IV RR H<br />
0 0 23,06 0,00 0<br />
0237757 MAGNEVIST 4,69 G 1 SRG 15 ML IV RR H<br />
0 0 30,63 0,00 0<br />
0237761 MAGNEVIST 4,69 G 1 SRG 20 ML IV RR H<br />
0 0 36,97 0,00 0<br />
0172392 MAGNEVIST 7,04 G 1 FL 15 ML IV RR H<br />
0 0 32,95 0,00 0<br />
0149248 MAGNEVIST 9,38 G 1 FL 20 ML IV RR H<br />
0 0 36,97 0,00 0<br />
V08CA02 gadoteric acid<br />
0345382 ARTIREM 1 SRG 20 ML IR RR H<br />
0 0 41,40 0,00 0<br />
0152453 DOTAREM 1 FL 10 ML IV RR H<br />
0 0 30,49 0,00 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0152467 DOTAREM 1 FL 15 ML IV RR H<br />
0 0 43,74 0,00 0<br />
0152471 DOTAREM 1 FL 20 ML IV RR H<br />
0 0 52,89 0,00 0<br />
0305681 DOTAREM 1 FL 60 ML IV RR H<br />
0 0 139,39 0,00 0<br />
0210821 DOTAREM 1 SRG 15 ML IV RR H<br />
0 0 43,77 0,00 0<br />
0210834 DOTAREM 1 SRG 20 ML IV RR H<br />
0 0 52,89 0,00 0<br />
V08CA03 gadodiamide<br />
0196301 OMNISCAN 1 FL 10 ML IV RR HC<br />
RM 0 0<br />
31,32 0,00 0<br />
0196329 OMNISCAN 1 FL 15 ML IV RR HC<br />
RM 0 0<br />
35,10 0,00 0<br />
0196346 OMNISCAN 1 FL 20 ML IV RR HC<br />
RM 0 0<br />
69,41 0,00 0<br />
0301357 OMNISCAN 287 MG/ML 1 FL P 20 ML IV RR HC<br />
RM 0 0<br />
42,38 0,00 0<br />
0269764 OMNISCAN 287 MG/ML 1 SRG 10 ML RR HC<br />
RM 0 0<br />
31,32 0,00 0<br />
0269778 OMNISCAN 287 MG/ML 1 SRG 15 ML RR HC<br />
RM 0 0<br />
35,08 0,00 0<br />
0269781 OMNISCAN 287 MG/ML 1 SRG 20 ML RR HC<br />
RM 0 0<br />
42,36 0,00 0<br />
V08CA04 gadoteridol<br />
0347759 PROHANCE 279,3 MG/ML 1 FL 10 ML IV RR HC<br />
0 0 31,58 0,00 0<br />
0347762 PROHANCE 279,3 MG/ML 1 FL 15 ML IV RR HC<br />
0 0 59,49 0,00 0<br />
0347776 PROHANCE 279,3 MG/ML 1 FL 20 ML IV RR HC<br />
0 0 54,47 0,00 0<br />
0347745 PROHANCE 279,3 MG/ML 1 FL 5 ML IV RR HC<br />
0 0 22,44 0,00 0<br />
V08CA06 gadoversetamide<br />
0469121 OPTIMARK 330,9 MG/ML 1 FL 10 ML IV RR HC<br />
0 0 35,43 0,00 0<br />
0469149 OPTIMARK 330,9 MG/ML 1 FL 15 ML IV RR HC<br />
0 0 50,71 0,00 0<br />
0469166 OPTIMARK 330,9 MG/ML 1 FL 20 ML IV RR HC<br />
0 0 61,27 0,00 0<br />
0469197 OPTIMARK 330,9 MG/ML 1 SRG 10 ML IV RR HC<br />
0 0 35,43 0,00 0<br />
0469216 OPTIMARK 330,9 MG/ML 1 SRG 15 ML IV RR HC<br />
0 0 50,71 0,00 0<br />
0469247 OPTIMARK 330,9 MG/ML 1 SRG 20 ML IV RR HC<br />
0 0 61,27 0,00 0<br />
0469264 OPTIMARK 330,9 MG/ML 1 SRG 30 ML IV RR HC<br />
0 0 77,65 0,00 0<br />
V08CA08 gadobenic acid<br />
0254727 MULTIHANCE 0,5 M 1 FL V 10 ML IV RR HC<br />
0 0 44,88 0,00 0<br />
0254731 MULTIHANCE 0,5 M 1 FL V 15 ML IV RR HC<br />
0 0 64,14 0,00 0<br />
0254744 MULTIHANCE 0,5 M 1 FL V 20 ML IV RR HC<br />
0 0 77,37 0,00 0<br />
V08CA09 gadobutrol<br />
0380929 GADOVIST PFS-1 1 SRG 10 ML IV RR H<br />
0 0 64,71 0,00 0<br />
0293658 GADOVIST PFS-1 1 SRG 15 ML IV RR H<br />
0 0 92,50 0,00 0<br />
0380932 GADOVIST PFS-1 1 SRG 20 ML IV RR H<br />
0 0 111,64 0,00 0<br />
0380915 GADOVIST PFS-1 1 SRG 7,5 ML IV RR H<br />
0 0 50,95 0,00 0<br />
V08CB03 iron oxide, nanoparticles<br />
0203048 ENDOREM 1 AMP 8 ML IV RR H<br />
0 0 129,97 0,00 0<br />
V08DA Ultrasound contrast media<br />
0253196 ECHOGEN 2% 1 KIT + 1 FL 5 ML IV RR HC<br />
0 0 117,25 0,00 0<br />
V08DA05 sulfur hexafluoride<br />
Page 222 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0299391 SONOVUE 8 MCG/ML PDR 1FL+1DISP MI+1SRG RR HC<br />
0 0 65,00 0,00 0<br />
V09CA Technetium (99mTc) compounds<br />
0435199 PRIMOVIST 181,43 MG/ML 1 SRG 10 ML IV RR HC<br />
0 0 157,29 0,00 0<br />
V09GA01 technetium (99mTc) sestamibi<br />
0511483 STAMICIS TROUSSE PREP RADIO 1 MG 5 FL MD RR HC<br />
0 0 550,00 0,00 0<br />
V09HA03 technetium (99mTc) antigranulocyte antibody<br />
0557448 SCINTIMUN TROUSSE P RADIO 1MG 1 FL MTD+S RR HC<br />
0 0 559,80 0,00 0<br />
0557451 SCINTIMUN TROUSSE P RADIO 1MG 2 FL MTD+S RR HC<br />
0 0 559,80 0,00 0<br />
V09IX05 fluorodopa (18F)<br />
0618381 DOPACIS 90 MBQ/ML 1 FL MTD RR HC<br />
0 0 694,70 0,00 0<br />
V10AA Yttrium (90Y) compounds<br />
0346572 YTRACIS 1 FL 2 ML V RR HC<br />
0 0 2.290,03 0,00 0<br />
V10XX02 ibritumomab tiuxetan (90Y)<br />
0362593<br />
YY<br />
ZEVALIN 1,6 MG/ML 1 SET RR HC<br />
0 0 8.419,31 0,00 0<br />
0328512 AGNOLYT GTTS 50 ML P<br />
0 0 5,82 10,37 0<br />
0565663 AGNUCASTON 30 CPR P<br />
0 0 3,91 7,49 0<br />
0621728 ANGIPAX 40 CPR ORODISP P<br />
0 0 4,17 7,83 0<br />
0555703 ANGIPAX 60 CPR ORODISP P<br />
0 0 3,99 7,55 0<br />
0459921 ARKOGELULES AUBELINE 350 MG 150 CAPS P<br />
0 0 13,65 23,93 0<br />
0007757 ARNICAN CREME 35 G P<br />
0 0 2,53 4,34 0<br />
0247736 AUBELINE 350 MG 45 CAPS P<br />
0 0 0,00 8,41 0<br />
0303107 BALDRIPARAN N STARK BERUHIGUNG 100 DRG P<br />
0 0 0,00 21,49 40<br />
0305745 BALDRIPARAN N STARK BERUHIGUNG 40 DRG P<br />
0 0 0,00 9,79 0<br />
0447429 BEKUNIS SENNA 30 DRG P<br />
0 0 0,00 4,10 0<br />
0496194 BICIRKAN 30 CPR P<br />
0 0 4,87 7,53 0<br />
0013592 BIOCARDE 30 ML P<br />
0 0 2,80 5,25 0<br />
0559988 BOMBASTUS ABFUEHRTEE 20 SACH P<br />
0 0 1,44 2,55 0<br />
0559991 BOMBASTUS ARNIKABLUETEN TEE 50 G P<br />
0 0 6,73 11,90 0<br />
0560037 BOMBASTUS BAERENTRAUBENBLAETTER TEE 100G P<br />
0 0 2,21 3,91 0<br />
0560041 BOMBASTUS BAERENTRAUBENBLAETTER TEE 20SA P<br />
0 0 1,44 2,55 0<br />
0560006 BOMBASTUS BALDRIANWURZEL TEE 20 SACH P<br />
0 0 2,02 3,57 0<br />
0560023 BOMBASTUS BALDRIANWURZEL TEE 200 G P<br />
0 0 2,98 5,26 0<br />
0548323 BOMBASTUS BERUHIGUNGSTEE 20 SACH P<br />
0 0 1,94 3,43 0<br />
0555152 BOMBASTUS BERUHIGUNGSTEE 75 G P<br />
0 0 2,76 4,89 0<br />
0549902 BOMBASTUS BIRKENBLAETTER TEE 20 SACH P<br />
0 0 1,58 2,80 0<br />
0555247 BOMBASTUS BIRKENBLAETTER TEE 50 G P<br />
0 0 1,28 2,26 0<br />
0548337 BOMBASTUS BLASENNIEREN TEE 20 SACH P<br />
0 0 1,94 3,43 0<br />
0555166 BOMBASTUS BLASENNIEREN TEE 75 G P<br />
0 0 1,82 3,22 0<br />
0560054 BOMBASTUS BOHNENSCHALEN TEE 50 G P<br />
0 0 1,72 3,05 0<br />
Page 223 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0548404 BOMBASTUS BRENNESSEL TEE 110 G P<br />
0 0 2,37 4,20 0<br />
0548399 BOMBASTUS BRENNESSEL TEE 20 SACH P<br />
0 0 1,44 2,55 0<br />
0555251 BOMBASTUS BRENNESSEL TEE 60 G P<br />
0 0 1,68 2,97 0<br />
0560068 BOMBASTUS BROMBEERBLAETTER TEE 50 G P<br />
0 0 1,48 2,61 0<br />
0560071 BOMBASTUS EIBISCHWURZEL TEE 100 G P<br />
0 0 1,91 3,38 0<br />
0560085 BOMBASTUS EICHENRINDE TEE 75 G P<br />
0 0 2,02 3,57 0<br />
0560099 BOMBASTUS ENZIANWURZEL TEE 75 G P<br />
0 0 4,17 7,37 0<br />
0548341 BOMBASTUS ERKAELTUNGSTEE 20 SACH P<br />
0 0 1,94 3,43 0<br />
0555183 BOMBASTUS ERKAELTUNGSTEE 75 G P<br />
0 0 2,56 4,53 0<br />
0555264 BOMBASTUS FENCHEL TEE 125 G P<br />
0 0 2,21 3,91 0<br />
0548418 BOMBASTUS FENCHEL TEE 20 SACH P<br />
0 0 1,58 2,80 0<br />
0548421 BOMBASTUS FLOHSAMEN TEE 300 G P<br />
0 0 5,03 8,90 0<br />
0560118 BOMBASTUS FRAUENMANTELKRAUT TEE 20 SACH P<br />
0 0 1,44 2,55 0<br />
0560104 BOMBASTUS FRAUENMANTELKRAUT TEE 50 G P<br />
0 0 1,87 3,30 0<br />
0548354 BOMBASTUS GALLENTEE 20 SACH P<br />
0 0 1,94 3,43 0<br />
0555197 BOMBASTUS GALLENTEE 75 G P<br />
0 0 2,37 4,20 0<br />
0560121 BOMBASTUS GOLDRUTENKRAUT TEE 100 G P<br />
0 0 1,72 3,05 0<br />
0560135 BOMBASTUS HEIDELBEEREN TEE 100 G P<br />
0 0 6,53 11,55 0<br />
0560149 BOMBASTUS HERZ-KREISLAUF-TEE 20 SACH P<br />
0 0 1,42 2,51 0<br />
0560152 BOMBASTUS HIRTENTAESCHELKRAUT TEE 20SACH P<br />
0 0 1,58 2,80 0<br />
0560166 BOMBASTUS HIRTENTAESCHELKRAUT TEE 75 G P<br />
0 0 1,87 3,30 0<br />
0560183 BOMBASTUS HOLUNDERBLUETEN TEE 100 G P<br />
0 0 3,52 6,22 0<br />
0560197 BOMBASTUS HOPFENZAPFEN TEE 50 G P<br />
0 0 3,13 5,53 0<br />
0555216 BOMBASTUS HUSTEN-BRONCHIALTEE 100 G P<br />
0 0 2,76 4,89 0<br />
0548368 BOMBASTUS HUSTEN-BRONCHIALTEE 20 SACH P<br />
0 0 1,94 3,43 0<br />
0555202 BOMBASTUS HUSTEN-BRONCHIALTEE 50 G P<br />
0 0 1,82 3,22 0<br />
0560202 BOMBASTUS JOHANNISKRAUT TEE 100 G P<br />
0 0 1,98 3,51 0<br />
0560216 BOMBASTUS JOHANNISKRAUT TEE 20 SACH P<br />
0 0 1,44 2,55 0<br />
0548452 BOMBASTUS KAMILLENBLUETEN TEE 110 G P<br />
0 0 3,26 5,76 0<br />
0555278 BOMBASTUS KAMILLENBLUETEN TEE 20 SACH P<br />
0 0 1,58 2,80 0<br />
0548435 BOMBASTUS KAMILLENBLUETEN TEE 50 G P<br />
0 0 2,14 3,78 0<br />
0548449 BOMBASTUS KAMILLENBLUETEN TEE 75 G P<br />
0 0 2,37 4,20 0<br />
0560233 BOMBASTUS KUEMMEL TEE 125 G P<br />
0 0 2,19 3,86 0<br />
0560247 BOMBASTUS LAVENDELBLUETEN TEE 50 G P<br />
0 0 4,12 7,29 0<br />
0548564 BOMBASTUS LEINSAMEN TEE 350 G P<br />
0 0 2,08 3,68 0<br />
0548483 BOMBASTUS LINDENBLUETEN TEE 100 G P<br />
0 0 3,82 6,75 0<br />
0555281 BOMBASTUS LINDENBLUETEN TEE 20 SACH P<br />
0 0 1,58 2,80 0<br />
0548466 BOMBASTUS LINDENBLUETEN TEE 75 G P<br />
0 0 3,13 5,53 0<br />
0560251 BOMBASTUS LOEWENZAHN TEE 150 G P<br />
0 0 2,76 4,89 0<br />
0560264 BOMBASTUS LOEWENZAHN TEE 20 SACH P<br />
0 0 1,44 2,55 0<br />
0548385 BOMBASTUS MAGEN-DARMTEE 20 SACH P<br />
0 0 1,94 3,43 0<br />
0555233 BOMBASTUS MAGEN-DARMTEE 75 G P<br />
0 0 2,47 4,36 0<br />
0548371 BOMBASTUS MAGENTEE 20 SACH P<br />
0 0 1,94 3,43 0<br />
0560278 BOMBASTUS MALVENBLAETTER TEE 50 G P<br />
0 0 2,33 4,11 0<br />
Page 224 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0560281 BOMBASTUS MARIENDISTELFRUECHTE TEE 275 G P<br />
0 0 2,76 4,89 0<br />
0548497 BOMBASTUS MELISSENBLAETTER TEE 20 SACH P<br />
0 0 1,57 2,78 0<br />
0555295 BOMBASTUS MELISSENBLAETTER TEE 50 G P<br />
0 0 2,17 3,84 0<br />
0548516 BOMBASTUS PFEFFERMINZBLAETTER TEE 125 G P<br />
0 0 2,87 5,07 0<br />
0555301 BOMBASTUS PFEFFERMINZBLAETTER TEE 20SACH P<br />
0 0 1,58 2,80 0<br />
0548502 BOMBASTUS PFEFFERMINZBLAETTER TEE 50 G P<br />
0 0 2,22 3,93 0<br />
0560295 BOMBASTUS RINGELBLUMENBLUETEN TEE 50 G P<br />
0 0 2,62 4,64 0<br />
0560301 BOMBASTUS ROSMARINBLAETTER TEE 125 G P<br />
0 0 1,83 3,24 0<br />
0548533 BOMBASTUS SALBEIBLAETTER TEE 20 SACH P<br />
0 0 1,58 2,80 0<br />
0560328 BOMBASTUS SCHACHTELHALMKRAUT TEE 20 SACH P<br />
0 0 1,44 2,55 0<br />
0560314 BOMBASTUS SCHACHTELHALMKRAUT TEE 75 G P<br />
0 0 1,77 3,13 0<br />
0560359 BOMBASTUS SCHAFGARBENKRAUT TEE 100 G P<br />
0 0 1,91 3,38 0<br />
0560331 BOMBASTUS SCHAFGARBENKRAUT TEE 20 SACH P<br />
0 0 1,44 2,55 0<br />
0560345 BOMBASTUS SCHAFGARBENKRAUT TEE 50 G P<br />
0 0 1,50 2,65 0<br />
0548547 BOMBASTUS SENNESBLAETTER TEE 20 SACH P<br />
0 0 1,44 2,55 0<br />
0555314 BOMBASTUS SENNESBLAETTER TEE 30 G P<br />
0 0 1,61 2,84 0<br />
0560362 BOMBASTUS SPITZWEGERICHBLAETTER TEE 20SA P<br />
0 0 1,42 2,51 0<br />
0560376 BOMBASTUS SPITZWEGERICHBLAETTER TEE 65 G P<br />
0 0 1,72 3,05 0<br />
0560393 BOMBASTUS STIEFMUETTERCHENKRAUT TEE 50 G P<br />
0 0 1,77 3,13 0<br />
0560409 BOMBASTUS SUESSHOLZWURZEL TEE 125 G P<br />
0 0 2,62 4,64 0<br />
0560412 BOMBASTUS TAUSENDGUELDENKRAUT 75 G P<br />
0 0 2,22 3,93 0<br />
0548551 BOMBASTUS THYMIAN TEE 20 SACH P<br />
0 0 1,58 2,80 0<br />
0555328 BOMBASTUS THYMIAN TEE 80 G P<br />
0 0 1,97 3,49 0<br />
0560443 BOMBASTUS WEISSDORNBLAETTER TEE 20 SACH P<br />
0 0 1,44 2,55 0<br />
0560426 BOMBASTUS WEISSDORNBLAETTER TEE 90 G P<br />
0 0 1,68 2,94 0<br />
0560457 BOMBASTUS WERMUTKRAUT TEE 20 SACH P<br />
0 0 1,44 2,55 0<br />
0560461 BOMBASTUS WERMUTKRAUT TEE 60 G P<br />
0 0 1,52 2,69 0<br />
0353482 BRONCHICUM ELIXIR S 130 G P<br />
0 0 2,61 5,19 0<br />
0015762 BRONCHICUM ELIXIR S 325 G P<br />
0 0 6,00 11,49 0<br />
0328561 CARMINATIVUM HETTERICH 100 ML P<br />
0 0 6,75 12,04 0<br />
0328543 CARMINATIVUM HETTERICH 20 ML P<br />
0 0 0,00 3,30 0<br />
0328557 CARMINATIVUM HETTERICH 50 ML P<br />
0 0 1,92 3,43 0<br />
0018926 CARMOL NR 1 20 ML P<br />
0 0 0,00 2,63 0<br />
0018943 CARMOL NR 2 40 ML P<br />
0 0 0,00 4,46 0<br />
0018957 CARMOL NR 3 80 ML P<br />
0 0 0,00 7,24 0<br />
0018960 CARMOL NR 4 160 ML P<br />
0 0 0,00 12,62 0<br />
0018974 CARMOL NR 5 200 ML P<br />
0 0 0,00 17,67 0<br />
0018991 CAROMINTHE 90 ML P<br />
0 0 4,57 8,57 0<br />
0298282 CEFACYNAR 400 MG 100 CAPS P<br />
0 0 10,38 18,49 0<br />
0298279 CEFACYNAR 400 MG 50 CAPS P<br />
0 0 6,55 10,13 0<br />
0431303 CEFAKLIMAN MONO 2,675 MG 100 CAPS P<br />
0 0 6,67 12,39 0<br />
0431298 CEFAKLIMAN MONO 2,675 MG 50 CAPS P<br />
0 0 3,66 6,09 0<br />
0431271 CEFAN 100 CPR P<br />
0 0 0,00 18,60 0<br />
0431253 CEFAN 20 CPR P<br />
0 0 0,00 6,13 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0431267 CEFAN 50 CPR P<br />
0 0 0,00 10,61 0<br />
0300945 CEFANORM 100 CAPS P<br />
0 0 8,14 14,65 0<br />
0300928 CEFANORM 30 CAPS P<br />
0 0 3,11 6,17 0<br />
0300931 CEFANORM 60 CAPS P<br />
0 0 5,54 10,61 0<br />
0501801 CEFASEPT GTTS 100 ML P<br />
0 0 11,58 19,70 0<br />
0501795 CEFASEPT GTTS 50 ML P<br />
0 0 7,28 12,86 0<br />
0501764 CEFASEPT S 10 AMP 1 ML IMSCIV RR<br />
0 0 11,10 17,17 0<br />
0300959 CEFATEC 480 MG 20 CPR P<br />
0 0 0,00 8,82 0<br />
0300962 CEFATEC 480 MG 40 CPR EFF P<br />
0 0 7,65 13,50 0<br />
0300976 CEFATEC 480 MG 80 CPR EFF P<br />
0 0 13,56 23,93 0<br />
0368289 CEFATEC FT 480 MG 100 CPR P<br />
0 0 13,42 22,72 0<br />
0368261 CEFATEC FT 480 MG 20 CPR P<br />
0 0 0,00 8,82 0<br />
0368275 CEFATEC FT 480 MG 50 CPR P<br />
0 0 0,00 13,50 0<br />
0368308 CEFAVORA GTTS 100 ML P<br />
0 0 8,37 14,77 0<br />
0368311 CEFAVORA GTTS 200 ML P<br />
0 0 0,00 22,90 0<br />
0368292 CEFAVORA GTTS 50 ML P<br />
0 0 5,74 10,12 0<br />
0257925 CHINA OEL BIODIAET 1 FL 25 ML P<br />
0 0 4,12 5,97 0<br />
0471066 CLIMAXOL 60 ML P<br />
0 0 6,05 11,34 0<br />
0289073 COVICUX 200 MG 100 DRG P<br />
0 0 0,00 5,32 0<br />
0289087 COVICUX 200 MG 200 DRG P<br />
0 0 0,00 9,47 0<br />
0514231 CYNACTIL 28 CAPS P<br />
0 0 4,41 7,58 0<br />
0514244 CYNACTIL 56 CAPS P<br />
0 0 7,07 12,15 0<br />
0314405 CYNAROL 50 DRG P<br />
0 0 0,00 7,37 0<br />
0569709 CYSTINOL AKUT 70 MG 60 CPR P<br />
0 0 5,85 11,21 0<br />
0414946 CYSTINOL N SOL 100 ML P<br />
0 0 4,51 8,63 0<br />
0030092 DEPURATUM LEHNING 60 CAPS P<br />
0 0 4,17 7,83 0<br />
0031363 DIACURE LHL 60 CAPS P<br />
0 0 4,17 7,83 0<br />
0321007 DOLOFYTOL 200 MG 100 CAPS P<br />
0 0 0,00 12,05 0<br />
0320996 DOLOFYTOL 200 MG 50 CAPS P<br />
0 0 0,00 8,26 0<br />
0206604 ECHINACIN LIQUIDUM MADAUS 100 ML P<br />
0 0 9,23 16,45 0<br />
0206599 ECHINACIN LIQUIDUM MADAUS 50 ML P<br />
0 0 5,55 9,89 0<br />
0320965 ECHINACIN MADAUS 100 MG 100 CPR P<br />
0 0 0,00 15,57 0<br />
0320951 ECHINACIN MADAUS 100 MG 50 CPR P<br />
0 0 0,00 9,70 0<br />
0416775 ECHINACIN MADAUS POM 40 G P<br />
0 0 4,18 7,44 0<br />
0309419 ELUSANES ARTICHAUT 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0142961 ELUSANES AUBEPINE 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0335632 ELUSANES BARDANE 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0309422 ELUSANES BOLDO 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0335629 ELUSANES BUSSEROLE 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0335534 ELUSANES ESCHSCHOLTZIA 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0335548 ELUSANES FRAGON 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0309453 ELUSANES FRENE 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0309471 ELUSANES FUMETERRE 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0231932 ELUSANES HARPAGOPHYTON 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
Page 226 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0246577 ELUSANES HARPAGOPHYTON 200 MG 60 CAPS P<br />
0 0 7,19 13,12 0<br />
0335565 ELUSANES MARONNIER D'INDE 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0385892 ELUSANES MILLEPERTUIS 30 CAPS R<br />
0 0 5,01 9,14 0<br />
0309521 ELUSANES ORTHOSIPHON 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0246644 ELUSANES ORTHOSIPHON 200 MG 60 CAPS P<br />
0 0 0,00 10,91 0<br />
0335579 ELUSANES ORTIE 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0142894 ELUSANES PASSIFLORE 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0246594 ELUSANES PASSIFLORE 200 MG 60 CAPS P<br />
0 0 0,00 10,91 0<br />
0309534 ELUSANES PRELE DES CHAMPS 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0309548 ELUSANES REINE DES PRES 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0335601 ELUSANES VALERIANE 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0393149 ELUSANES VALERIANE 200 MG 60 CAPS P<br />
0 0 7,56 13,80 0<br />
0309551 ELUSANES VIGNE ROUGE 200 MG 30 CAPS P<br />
0 0 0,00 6,09 0<br />
0246675 ELUSANES VIGNE ROUGE 200 MG 60 CAPS P<br />
0 0 0,00 10,91 0<br />
0041325 ESBERITOX 100 CPR P<br />
0 0 5,85 11,21 0<br />
0380851 ESBERITOX 60 CPR P<br />
0 0 3,95 7,57 0<br />
0409607 EUPHON 50 PAST P<br />
0 0 3,22 5,52 0<br />
0409624 EUPHON SIR 200 ML P<br />
0 0 0,00 6,27 0<br />
0350401 FEMICUR N 4 MG 60 CAPS P<br />
0 0 8,17 14,70 0<br />
0206862 GASTRICHOLAN L GTTS 30 ML P<br />
0 0 2,34 4,67 0<br />
0205607 GASTRICHOLAN L GTTS 50 ML P<br />
0 0 3,41 6,66 0<br />
0433311 GYNOSOYA 175 MG 120 CAPS P<br />
0 0 0,00 22,83 0<br />
0188151 H+S BAERENTRAUBENBLAETTER 20 SACH NR12 P<br />
0 0 1,85 2,86 0<br />
0188263 H+S BERUHIGUNGSTEE II 20 SACH P<br />
0 0 0,00 2,77 0<br />
0322781 H+S BIO KINDER"ATME GUT" 20 SACH NR55 P<br />
0 0 1,93 3,26 0<br />
0322813 H+S BIO KINDER"WAERME DICH" 20SACH NR56 P<br />
0 0 1,93 3,26 0<br />
0322794 H+S BIO KINDER"WOHLIGER BAUCH"20SA NR57 P<br />
0 0 1,93 3,26 0<br />
0188277 H+S BLASENNIERENTEE II 20 SACH NR 2 P<br />
0 0 2,20 3,40 0<br />
0434791 H+S BRENNESSELBLAETTER 20 SACH 5 G NR15 P<br />
0 0 1,67 2,58 0<br />
0457473 H+S DURCHFALLTEE 20 SACH NR16 P<br />
0 0 0,00 3,25 0<br />
0457487 H+S DURCHSPUELUNGSTEE 20 SACH NR13 P<br />
0 0 2,20 3,40 0<br />
0188281 H+S ERKAELTUNGSTEE V 20 SACH NR 4 P<br />
0 0 2,20 3,40 0<br />
0188179 H+S FENCHEL 20 SACH NR17 P<br />
0 0 1,58 2,73 0<br />
0188182 H+S FRAUENMANTEL 20 SACH NR19 P<br />
0 0 1,58 2,73 0<br />
0501084 H+S GALLE + LEBERTEE 20 SACH NR 5 P<br />
0 0 2,20 3,40 0<br />
0322715 H+S HERZKREISLAUFTEE 20 SACH NR 7 P<br />
0 0 2,20 3,40 0<br />
0443661 H+S HUSTEN+BRONCHIALTEE N 20SACH 2G NR 8 P<br />
0 0 2,20 3,40 0<br />
0188327 H+S HUSTENBRONCHIALTEE II 20 SACH P<br />
0 0 0,00 2,77 0<br />
0185177 H+S JOHANNISKRAUT 20 SACH NR20 P<br />
0 0 1,67 2,58 0<br />
0188196 H+S KAMILLENBLUETEN 20 SACH NR21 P<br />
0 0 1,58 2,73 0<br />
0457491 H+S KREISLAUFTEE 20 SACH NR31 P<br />
0 0 2,20 3,40 0<br />
0188201 H+S LINDENBLUETEN 20 SACH NR22 P<br />
0 0 1,58 2,73 0<br />
0188313 H+S MAGENDARMTEE IX 20 SACH NR10 P<br />
0 0 2,20 3,40 0<br />
0188294 H+S MAGENTEE V 20 SACH NR 9 P<br />
0 0 2,20 3,40 0<br />
Page 227 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0188215 H+S MELISSENBLAETTER 20 SACH NR23 P<br />
0 0 1,67 2,58 0<br />
0322827 H+S NERVEN + SCHLAFTEE N 20 SACH NR11 P<br />
0 0 2,20 3,40 0<br />
0185146 H+S PFEFFERMINZTEE 20 SACH NR25 P<br />
0 0 1,58 2,73 0<br />
0322777 H+S RHEUMATEE 20 SACH NR 6 P<br />
0 0 2,20 3,40 0<br />
0188246 H+S SALBEIBLAETTER 20 SACH NR26 P<br />
0 0 1,58 2,73 0<br />
0188165 H+S SCHACHTELHALMKRAUT 20 SACH NR27 P<br />
0 0 1,67 2,58 0<br />
0188229 H+S SCHAFGARBENKRAUT 20 SACH NR28 P<br />
0 0 1,67 2,58 0<br />
0185132 H+S SPITZWEGERICHKRAUT 20 SACH 5 G NR30 P<br />
0 0 1,67 2,58 0<br />
0322831 H+S THYMIAN 20 SACH NR54 P<br />
0 0 1,58 2,73 0<br />
0185115 H+S WEISSDORNBLAETTER+BLUET 20 SACH NR32 P<br />
0 0 1,67 2,58 0<br />
0185101 H+S WERMUTKRAUT 20 SACH 5 G NR33 P<br />
0 0 1,67 2,58 0<br />
0329666 HEBUCOL ARTICHAUT 200 MG 60 CPR P<br />
0 0 4,73 8,11 0<br />
0380798 HERBESAN TIS 20 SACH P<br />
0 0 2,71 4,66 0<br />
0380784 HERBESAN TIS 80 G P<br />
0 0 2,34 4,01 0<br />
0250695 HEUSCHNUPFENMITTEL DHU 100 CPR P<br />
0 0 8,34 12,90 0<br />
0233209 ILON ABSZESS POM 25 G P<br />
0 0 4,38 8,34 0<br />
0447141 IMUPRET 50 DRG P<br />
0 0 4,74 9,09 0<br />
0447138 IMUPRET SOL 50 ML P<br />
0 0 4,74 9,09 0<br />
0334666 INHALO RHINATHIOL SOL 20 ML P<br />
0 0 2,69 4,62 0<br />
0229724 JOUVENCE ABBE SOURY 180 CPR P<br />
0 0 0,00 15,22 0<br />
0229711 JOUVENCE ABBE SOURY 42 CPR P<br />
0 0 0,00 4,61 0<br />
0242029 JOUVENCE ABBE SOURY GEL 100 G P<br />
0 0 0,00 7,10 0<br />
0228825 JOUVENCE ABBE SOURY LIQ 210 ML P<br />
0 0 0,00 7,98 0<br />
0303172 KAMILLIN ROBUGEN KONZENTRAT 100 ML P<br />
0 0 0,00 7,50 0<br />
0423928 KAMILLOSAN 2% CREME 40 G P<br />
0 0 3,68 6,32 0<br />
0061278 KAMILLOSAN LIQ 100 ML P<br />
0 0 4,56 7,83 0<br />
0061281 KAMILLOSAN LIQ 250 ML P<br />
0 0 9,11 15,65 0<br />
0189681 KLOSTERFRAU AKTIV 144 CAPS P<br />
0 0 0,00 9,95 0<br />
0231719 KLOSTERFRAU AKTIV 54 CAPS P<br />
0 0 0,00 4,49 0<br />
0062552 KLOSTERFRAU MELISSENGEIST 155 ML P<br />
0 0 5,78 10,30 0<br />
0062566 KLOSTERFRAU MELISSENGEIST 235 ML P<br />
0 0 8,25 14,70 0<br />
0062535 KLOSTERFRAU MELISSENGEIST 47 ML P<br />
0 0 1,96 3,49 0<br />
0062583 KLOSTERFRAU MELISSENGEIST 475 ML P<br />
0 0 15,83 28,22 0<br />
0062549 KLOSTERFRAU MELISSENGEIST 95 ML P<br />
0 0 3,58 6,38 0<br />
0062597 KLOSTERFRAU MELISSENGEIST 950 ML P<br />
0 0 31,04 55,32 0<br />
0215536 KNEIPP ARNICA SALBE S 100 G P<br />
0 0 0,00 6,32 0<br />
0215519 KNEIPP BLASEN + NIEREN-TEE 10 SACH P<br />
0 0 0,00 1,12 0<br />
0540583 KYTTA SALBE F 35% POM 100 G P<br />
0 0 6,26 11,16 0<br />
0540597 KYTTA SALBE F 35% POM 150 G P<br />
0 0 7,71 13,74 0<br />
0540566 KYTTA SALBE F 35% POM 50 G P<br />
0 0 3,37 6,00 0<br />
0432197 KYTTA SEDATIVUM 100 DRG P<br />
0 0 0,00 17,20 0<br />
0431061 KYTTA SEDATIVUM 40 DRG P<br />
0 0 0,00 8,13 0<br />
0422965 KYTTA SEDATIVUM TAG 425 MG 30 DRG P<br />
0 0 0,00 11,15 0<br />
0422979 KYTTA SEDATIVUM TAG 425 MG 60 DRG P<br />
0 0 0,00 19,78 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0306613 MELROSUM HUSTENSIRUP 100 ML P<br />
0 0 2,83 5,63 0<br />
0306627 MELROSUM HUSTENSIRUP 250 ML P<br />
0 0 6,94 12,72 0<br />
0473009 MILPERINOL 300 MG 60 CAPS R<br />
0 0 8,15 14,00 0<br />
0281349 MYRTINE INHALANTE SOL 60 ML P<br />
0 0 3,40 6,38 0<br />
0392172 NATURACTIVE VOXYL 15 MG 24 PAST P<br />
0 0 3,23 5,44 0<br />
0081396 ODDIBIL 40 CPR P<br />
0 0 2,73 6,41 0<br />
0403942 OSCILLOCOCCINUM 6 DOSES 1 G BOIRON P<br />
0 0 4,98 8,88 0<br />
0365225 PANKREAPLEX MONO 30 CAPS P<br />
0 0 5,41 10,36 0<br />
0089010 PERSKINDOL LIN 1 L P<br />
0 0 14,81 0,00 0<br />
0089007 PERSKINDOL LIN 250 ML P<br />
0 0 0,00 7,93 0<br />
0089024 PERSKINDOL SPRAY 150 G P<br />
0 0 0,00 9,22 0<br />
0210042 PHYTOMELIS 1 FL 30 ML P<br />
0 0 4,17 7,83 0<br />
0090591 PINIMENTHOL ERKAELTUNGSBAD 190 ML P<br />
0 0 0,00 9,88 0<br />
0090607 PINIMENTHOL ERKAELTUNGSBAD 500 ML P<br />
0 0 0,00 18,40 0<br />
0133833 REMIFEMIN 100 CPR P<br />
0 0 7,14 12,97 0<br />
0209377 REMIFEMIN 60 CPR P<br />
0 0 4,51 8,63 0<br />
0279547 ROTER GINSENG GINTEC 100 CAPS P<br />
0 0 0,00 52,06 0<br />
0279533 ROTER GINSENG GINTEC 30 CAPS P<br />
0 0 0,00 18,53 0<br />
0279516 ROTER IMPERIAL GINSENG GINTEC 30 SACH P<br />
0 0 0,00 76,77 0<br />
0101261 ROWACHOL 10 ML P<br />
0 0 3,63 6,06 0<br />
0101258 ROWACHOL 100 CAPS P<br />
0 0 6,22 10,07 0<br />
0101275 ROWACHOL 20 ML P<br />
0 0 7,05 11,40 0<br />
0101230 ROWACHOL 30 CAPS P<br />
0 0 2,45 4,09 0<br />
0101244 ROWACHOL 50 CAPS P<br />
0 0 3,81 6,35 0<br />
0101356 ROWATINEX 10 ML P<br />
0 0 3,63 6,06 0<br />
0101342 ROWATINEX 100 CAPS P<br />
0 0 6,22 10,07 0<br />
0101373 ROWATINEX 20 ML P<br />
0 0 7,05 11,40 0<br />
0101325 ROWATINEX 30 CAPS P<br />
0 0 2,45 4,09 0<br />
0101339 ROWATINEX 50 CAPS P<br />
0 0 3,81 6,35 0<br />
0512088 SEDANXIO 200 MG 100 CAPS P<br />
0 0 8,88 15,26 0<br />
0320982 SEDANXIO 200 MG 50 CAPS P<br />
0 0 5,55 9,53 0<br />
0103297 SEDINAL GTTS 30 ML P<br />
0 0 3,92 6,73 0<br />
0103302 SEDINAL GTTS 100 ML P<br />
0 0 9,50 16,32 0<br />
0616518 SEDISTRESS 200 MG 42 CPR P<br />
0 0 7,64 13,12 0<br />
0616521 SEDISTRESS 200 MG 98 CPR P<br />
0 0 14,09 24,20 0<br />
0210011 SEDOPAL 40 CAPS P<br />
0 0 5,48 10,28 0<br />
0544101 SIDROGA APPETIT ANREGUNGSTEE 20 SACH P<br />
0 0 2,24 3,99 0<br />
0179362 SIDROGA BAERENTRAUBENBLAETTER 20 SACH P<br />
0 0 0,00 2,99 0<br />
0417271 SIDROGA BERUHIGUNGSTEE 20 SACH P<br />
0 0 0,00 3,99 0<br />
0275811 SIDROGA BIO KINDER ERKAELTUNGSTEE 20SACH P<br />
0 0 0,00 3,99 0<br />
0275808 SIDROGA BIO KINDER HUSTENTEE 20 SACH P<br />
0 0 0,00 3,99 0<br />
0306949 SIDROGA BLASEN-NIERENTEE 20 SACH P<br />
0 0 0,00 3,99 0<br />
0179393 SIDROGA BRENNESSELBLAETTER 20 SACH P<br />
0 0 0,00 2,99 0<br />
0544114 SIDROGA DURCHFALLTEE 20 SACH P<br />
0 0 2,24 3,99 0<br />
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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x<br />
délivrance prescription<br />
0311837 SIDROGA ERKAELTUNGSTEE N 20 SACH P<br />
0 0 0,00 3,99 0<br />
0179409 SIDROGA FENCHEL 20 SACH P<br />
0 0 0,00 2,99 0<br />
0544128 SIDROGA FENCHEL-ANIS-KUEMMEL 20 SACH P<br />
0 0 1,68 2,99 0<br />
0417254 SIDROGA FETTVERDAUUNGSTEE 20 SACH P<br />
0 0 0,00 3,99 0<br />
0544131 SIDROGA FRAUENMANTELKRAUT 20 SACH P<br />
0 0 1,68 2,99 0<br />
0417268 SIDROGA HALS-UND RACHENTEE 20 SACH P<br />
0 0 0,00 3,99 0<br />
0311823 SIDROGA HUSTEN+BRONCHIALTEE N 20 SACH P<br />
0 0 0,00 3,99 0<br />
0179443 SIDROGA JOHANNISKRAUT 20 SACH P<br />
0 0 0,00 2,99 0<br />
0179345 SIDROGA KAMILLENBLUETEN 20 SACH P<br />
0 0 0,00 2,99 0<br />
0544145 SIDROGA LAVENDEL 20 SACH P<br />
0 0 1,68 2,99 0<br />
0306935 SIDROGA LEBER-GALLENTEE N 20 SACH P<br />
0 0 0,00 3,99 0<br />
0179457 SIDROGA LINDENBLUETEN 20 SACH P<br />
0 0 2,02 2,99 0<br />
0179461 SIDROGA LOEWENZAHN 20 SACH P<br />
0 0 0,00 2,99 0<br />
0306966 SIDROGA MAGEN-DARM ANREGUNGSTEE P<br />
0 0 0,00 3,99 0<br />
0544159 SIDROGA MAGEN-DARM BERUHIGUNGSTEE N 20SA P<br />
0 0 2,24 3,99 0<br />
0417285 SIDROGA MAGENHEILTEE 20 SACH P<br />
0 0 0,00 3,99 0<br />
0179488 SIDROGA MELISSENBLAETTER 20 SACH P<br />
0 0 0,00 2,99 0<br />
0544162 SIDROGA MENSTRUATIONSTEE 20 SACH P<br />
0 0 2,24 3,99 0<br />
0179359 SIDROGA PFEFFERMINZBLAETTER 20 SACH P<br />
0 0 0,00 2,99 0<br />
0541211 SIDROGA PROSTATATEE 20 SACH P<br />
0 0 2,24 3,99 0<br />
0544176 SIDROGA REIZHUSTENTEE 20 SACH P<br />
0 0 2,24 3,99 0<br />
0541224 SIDROGA RHEUMATEE 20 SACH P<br />
0 0 2,24 3,99 0<br />
0179491 SIDROGA SALBEIBLAETTER 20 SACH P<br />
0 0 0,00 2,99 0<br />
0179555 SIDROGA SCHACHTELHALMKRAUT 20 SACH P<br />
0 0 0,00 2,99 0<br />
0179507 SIDROGA SCHAFGARBENKRAUT 20 SACH P<br />
0 0 0,00 2,99 0<br />
0306952 SIDROGA SCHLAF UND NERVENTEE N 20 SACH P<br />
0 0 0,00 3,99 0<br />
0179511 SIDROGA SENNESBLAETTER 20 SACH P<br />
0 0 0,00 2,99 0<br />
0179524 SIDROGA SPITZWEGERICH 20 SACH P<br />
0 0 0,00 2,99 0<br />
0184166 SIDROGA THYMIAN 20 SACH P<br />
0 0 0,00 2,99 0<br />
0179569 SIDROGA WEISSDORN HERZKREISLAUF 20 SACH P<br />
0 0 0,00 2,99 0<br />
0106464 SOLUDOR 90 ML P<br />
0 0 4,57 8,57 0<br />
0292857 SONGHA 30 DRG P<br />
0 0 5,60 8,41 0<br />
0210106 TISANE PROVENCALE 3 20 SACH P<br />
0 0 0,00 3,57 0<br />
0210123 TISANE PROVENCALE 5 20 SACH P<br />
0 0 0,00 3,57 0<br />
0117941 TONIQUE VEGETAL LEHNING 250 ML P<br />
0 0 4,80 8,99 0<br />
0573603 TRAUMATIL 5% CREME 30 G P<br />
0 0 4,47 6,80 0<br />
0447415 TWARDY WACHOLDERBEEROEL 20 MG 60 CAPS P<br />
0 0 0,00 5,98 0<br />
0514258 UROCYSTIL 40 CPR P<br />
0 0 6,99 12,00 0<br />
0278472 VAGOSTABYL 40 CPR P<br />
0 0 2,32 4,14 0<br />
0461171 VEINOFYTOL 50 MG 40 CAPS P<br />
0 0 6,19 10,63 0<br />
0431866 VOLLMERS PRAEPAR GRUENER HAFERTEE 75 G P<br />
0 0 0,00 4,56 0<br />
0621468 ZIBRINE FORTE 425 MG 60 CAPS R<br />
0 0 11,09 19,05 0<br />
Page 230 of 230