Lista Medicamentos - 01-11-2011
If you can't read please download the document
description
Esta é lista de medicamentos concedidos pelo sus de distribuição dos estados e governo federal.
Transcript of Lista Medicamentos - 01-11-2011
TABELA DESCRITIVA DO COMPONENTE ESPECIALIZADO DA ASSISTNCIA FARMACUTICA - PORTARIA 2.981 - com alteraes da 3439/2010atualizada em 01/11/11
Proced.060460001-1 060460002-0 060438001-1 060438006-2 060446001-5 060462001-2 060462002-0 060444001-4 060447005-3 060447001-0 060447002-9 060447003-7 060447004-5 060439003-3 060439001-7 060439002-5 060439004-1 060439006-8 060439007-6 060439005-0 060424004-0 060424005-8 060420001-3 060436001-0 060436002-9 060436003-7 060436004-5
Descrio
CID PERMITIDOS
QTD MAX
IDADE
Acitretina 10 mg (por capsula) Acitretina 25 mg (por capsula) Adalimumabe 40 mg injetavel (por seringa preenchida) (ARTRITE) Adalimumabe 40 mg injetavel (por seringa preenchida) (CROHN) Adefovir 10 mg (por comprimido) Alfacalcidol 0,25 mcg (por capsula) Alfacalcidol 1,0 mcg (por capsula) Alfadornase 2,5 mg (por ampola) Alfaepoetina 10.000 ui injetavel (por frascoampola) Alfaepoetina 1000 ui injetavel (por frascoampola) Alfaepoetina 2000 ui injetavel (por frascoampola) Alfaepoetina 3000 ui injetavel (por frascoampola) Alfaepoetina 4000 ui injetavel (por frascoampola) Alfainterferona 2b 10.000.000 ui injetavel (por frasco- ampola) Alfainterferona 2b 3.000.000 ui injetavel (por frasco- ampola) Alfainterferona 2b 5.000.000 ui injetavel (por frasco- ampola) Alfapeginterferona 2a 180 mcg (por seringa preenchida) Alfapeginterferona 2b 100 mcg (por frascoampola) Alfapeginterferona 2b 120 mcg (por frascoampola) Alfapeginterferona 2b 80 mcg (por frascoampola) Alfavelaglicerase 200 u injetavel (por frasco ampola) Alfavelaglicerase 400 u injetavel (por frasco ampola) Amantadina 100 mg (por comprimido) Atorvastatina 10 mg (por comprimido) Atorvastatina 20 mg (por comprimido) Atorvastatina 40 mg (por comprimido) Atorvastatina 80 mg (por comprimido)
L400, L401, L404, L408, L440, Q800, Q801, Q802, Q803, Q808, Q828 L400, L401, L404, L408, L440, Q800, Q801, Q802, Q803, Q808, Q828 M050, M051, M052, M053, M058, M060, M068, M070, M073, M080, M45 K500, K501, K508 B181 E200, E201, E208, E892, N180, N188, N250, N258 E200, E201, E208, E892, N180, N188, N250, N258 E840, E848 B171, B182, N180, N188, Z948 N180, N188, Z948 N180, N188, Z948 N180, N188, Z948 N180, N188, Z948 B180, B181, D180 B171, B180, B181, B182, D180 B171,B180, B181, D180 B171, B180, B182 B171, B180, B182 B171, B180, B182 B171, B180, B182 E752 E752 G20 E78.0, E78.1, E78.2, E78.3, E78.4, E78.5, E78.6, E78.8 E78.0, E78.1, E78.2, E78.3, E78.4, E78.5, E78.6, E78.8 E78.0, E78.1, E78.2, E78.3, E78.4, E78.5, E78.6, E78.8 E78.0, E78.1, E78.2, E78.3, E78.4, E78.5, E78.6, E78.8
217 93 2 3 31 744 186 62 22 37 37 37 56 12 56 31 5 5 5 5 48 24 124 248 124 62 31
0 0 0
110 110 110
18 110 13 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110
060453001-3
Azatioprina 50 mg (por comprimido)
D610, G700, G35, H300, H301, H302, H308, K500, K501, K508, K510, K511, K512, K513, K514, K515, K518, K754, M321, M328, M330, M331, M332, M340, M341, M348, N040, N041, N042, N043, N044, N045, N046, N047, N048, T861, Z940, Z941, Z942, Z943, Z944, Z945, Z946, Z947, Z948 J45.0, J45.1, J45.8
248
0
110
060428002-5 060428001-7 060428003-3 060428004-1 060428005-0 060439010-6 060439008-4 060439009-2 060439011-4 060427001-1 060427002-0 060403001-0 060403002-9 060428006-8 060428008-4 060428009-2 060428007-6 060403003-7 060457002-3
Beclometasona 200 mcg por inalante(por frasco de 100 doses)
2 124 1 62 1 14 14 5 16 93 31 868 438 186 2 1 93 310 31
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110
Beclometasona 200 mg (por capsula inalante) J45.0, J45.1, J45.8 Beclometasona 250 mcg spray (por frasco de 200 doses) J45.0, J45.1, J45.8
Beclometasona 400 mcg (por capsula inalante) J45.0, J45.1, J45.8 Beclometasona 400 mcg por inalante(por frasco de 100 doses) Betainterferona 1a 12.000.000 ui (44 mcg ) injetavel (por seringa preenchida) Betainterferona 1a 6.000.000 (22 mcg ) injetavel (por seringa preenchida) Betainterferona 1a 6.000.000 ui (30 mcg ) injetavel ( por frasco- ampola ou seringa preenchida) Betainterferona 1a 9.600.000 ui (300 mcg ) injetavel (por frasco- ampola) Bezafibrato 200 mg (por drgea ou comprimido) Bezafibrato 400 mg (por comprimido de desintegrao lenta) Bromocriptina - 2,5 mg (por comprimido ou capsula de liberaco retardada) Bromocriptina - 5 mg (por comprimido ou capsula de liberaco retardada) Budesonida 200 mcg (por capsula inalante) Budesonida 200 mcg por inalante ou aerossol bucal (por frasco c/ 100 doses) Budesonida 200 mcg por inalante ou aerossol bucal (por frasco c/ 200 doses) Budesonida 400 mcg (por capsula inalante) Cabergolina 0,5 mg (por comprimido) Calcitonina 100 ui injetavel (por ampola) J45.0, J45.1, J45.8 G35 G35 G35 G35 E780, E781, E782, E783, E784, E785, E786, E788 E780, E781, E782, E783, E784, E785, E786, E788 E22.0, E22.1, G20 E22.0, E22.1, G20 J45.0, J45.1, J45.8 J45.0, J45.1, J45.8 J45.0, J45.1, J45.8 J45.0, J45.1, J45.8 E22.0, E22.1, M800, M801, M802, M803, M804, M805, M808, M810, M811, M812, M813, M814, M815, M816, M818, M820, M821, M828, M880, M888 M800, M801, M802, M803, M804, M805, M808, M810, M811, M812, M813, M814, M815, M816, M818, M820, M821, M828, M880, M888 M800, M801, M802, M803, M804, M805, M808, M810, M811, M812, M813, M814, M815, M816, M818, M820, M821, M828, M880, M888 E200, E201, E208, E550, E559, E643, E833, E892, M805, M815, M830, M831, M832, M833, M838, N180, N188, N250, N258 N180, N188, N250, N258 D60.0, M34.0, M34.1, M34.8
060457003-1
Calcitonina 200 spray nasal (por ampola)
2
0
110
060457001-5
Calcitonina 50 ui injetavel (por ampola)
31
0
110
060462003-9 060462004-7 060409001-3
Calcitriol
0,25 mcg (por capsula)
372 30 186
0 0 0
110 110 110
Calcitriol 1,0 mcg injetavel (por ampola) Ciclofosfamida 50 mg (por dragea)
060434001-0
Ciclosporina 10 mg (por capsula)
D600, D610, D611, D612, D613, D618, G700, H300, H301, H302, H308, K500, K501, K508, K510, K511, K512, K513, K514, K515, K518, L400, L401, L404, L408, M050, M051, M052, M053, M058, M060, M068, M070, M073, M080, M321, M328, M330, M331, M332, N040, N041, N042, N043, N044, N045, N046, N047, N048, T861, Z940, Z941, Z942, Z943, Z944, Z945, Z946, Z947, Z948 D600, D610, D611, D612, D613, D618, G700, H300, H301, H302, H308, K500, K501, K508, K510, K511, K512, K513, K514, K515, K518, L400, L401, L404, L408, M050, M051, M052, M053, M058, M060, M068, M070, M073, M080, M321, M328, M330, M331, M332, N040, N041, N042, N043, N044, N045, N046, N047, N048, T861, Z940, Z941, Z942, Z943, Z944, Z945, Z946, Z947, Z948 D600, D610, D611, D612, D613, D618, G700, H300, H301, H302, H308, K500, K501, K508, K510, K511, K512, K513, K514, K515, K518, L400, L401, L404, L408, M050, M051, M052, M053, M058, M060, M068, M070, M073, M080, M321, M328, M330, M331, M332, N040, N041, N042, N043, N044, N045, N046, N047, N048, T861, Z940, Z941, Z942, Z943, Z944, Z945, Z946, Z947, Z948 D600, D610, D611, D612, D613, D618, G700, H300, H301, H302, H308, K500, K501, K508, K510, K511, K512, K513, K514, K515, K518, L400, L401, L404, L408, M050, M051, M052, M053, M058, M060, M068, M070, M073, M080, M321, M328, M330, M331, M332, N040, N041, N042, N043, N044, N045, N046, N047, N048, T861, Z940, Z941, Z942, Z943, Z944, Z945, Z946, Z947, Z948 D600, D610, D611, D612, D613, D618, G700, H300, H301, H302, H308, K500, K501, K508, K510, K511, K512, K513, K514, K515, K518, L400, L401, L404, L408, M050, M051, M052, M053, M058, M060, M068, M070, M073, M080, M321, M328, M330, M331, M332, N040, N041, N042, N043, N044, N045, N046, N047, N048, T861, Z940, Z941, Z942, Z943, Z944, Z945, Z946, Z947, Z948 E780, E781, E782, E783, E784, E785, E786, E788 E228, E250, E280, E282, L680 G400, G401, G402, G403, G404, G405, G406, G407, G408 G400, G401, G402, G403, G404, G405, G406, G407, G408 M050, M051, M052, M053, M058, M060, M068, M080 F20.0, F20.1,F20.2, F20.3, F20.4, F20.5, F20.6, F20.8 F20.0, F20.1,F20.2, F20.3, F20.4, F20.5, F20.6, F20.8 R52.2, R52.1 R52.2, R52.1 R52.2, R52.1 R52.2, R52.1
496
0
110
060434004-4
Ciclosporina 100 mg (por capsula)
372
0
110
060434005-2
Ciclosporina 100 mg/ml soluo oral (por frasco de 50 ml )
8
0
110
060434002-8
Ciclosporina 25 mg (por capsula)
496
0
110
060434003-6
Ciclosporina 50 mg (por capsula)
744
0
110
060427003-8 060412001-0 060418001-2 060418002-0 060408001-8 060423008-7 060423007-9 060405001-1 060405003-8 060405002-0 060405004-6
Ciprofibrato 100 mg (por comprimido) Ciproterona 50 mg (por comprimido) Clobazam 10 mg (por comprimido) Clobazam 20 mg (por comprimido) Cloroquina 150 mg por comprimido Clozapina 100 mg (por comprimido) Clozapina 25 mg (por comprimido) Codeina 3 mg/ml Soluo oral (por frasco de 120 ml) Codeina 30 mg (por comprimido) Codeina 30 mg/ml (por ampola de 2 ml) Codeina 60 mg (por comprimido)
31 21 124 62 186 248 992 6 744 186 372
0 0 0 0 0 0 0 0 0 0 0
110 110 110 110 110 110 110 110 110 110 110
060406002-5
Complemento Alimentar para Fenilcetonricos Frmula de Aminocidos E70.0 Isenta de Fenilalanina (para pacientes maiores de 1 ano de idade) lata por grama Complemento Alimentar para pacientes Fenilcetonricos Frmula de Aminocidos E70.0 Isenta de Fenilalanina (para pacientes menores de 1 ano de idade) lata por grama Danazol 100 mg ( por cpsula) Danazol 200 mg ( por cpsula) Danazol 50 mg ( por cpsula) Deferasirox 125 mg/ por comprimido Deferasirox 250 mg/ por comprimido Deferasirox 500 mg/ por comprimido Deferiprona 500 mg / por comprimido Desferroxamina 500 mg injetavel (por frasco ampola) Desmopressina 0,1 mg/ml aplicaao nasal (por frasco de 2,5 ml) Donepezila - 10 mg por comprimido Donepezila - 5 mg (por comprimido) Entacapona 200 mg (por comprimido) Entecavir 0,5 mg (por comprimido) Etanercepte 25 mg injetavel (por frasco ampola) Etanercepte 50 mg injetavel (por frasco ampola) Etofibrato 500 mg (por capsula) Etossuximida 50 mg/ml (frasco de 120ml) D84.1, N80.0, N80.1, N80.2, N80.3, N80.4, N80.5, N80.8 D84.1, N80.0, N80.1, N80.2, N80.3, N80.4, N80.5, N80.8 D841, N800, N801, N802, N803, N804, N805, N808 T454 T454 T454 T454 N250, T454 E23.2 G300, G301, G308 G300, G301, G308 G20 B181 M050, M051, M052, M053, M058, M060, M068, M070, M073, M080, M45 M050, M051, M052, M053, M058, M060, M068, M070, M073, M080, M45 E780, E781, E782, E783, E784, E785, E786, E788 G400, G401, G402, G403, G404, G405, G406, G407, G408 T86.1, Z94.0 T86.1, Z94.0 T86.1, Z94.0 E780, E781, E782, E783, E784, E785, E786, E788
3617
1
110
060406001-7
1550
0
1
060414002-9 060414003-7 060414001-0 060402001-5 060402002-3 060402003-1 060402004-0 060402005-8 060410001-9 060413002-3 060413001-5 060449001-1 060446002-3 060438002-0 060438003-8 060427004-6 060422001-4 060432001-9 060432002-7 060432003-5 060427005-4 060427006-2 060404001-6
248 124 496 744 372 186 465 310 5 31 62 310 62 9 5 31 8 186 124 93 31 31 2
0 0 0 0 0 0 0 0 0 40 40 0 13 0 0 0 0 0 0 0 0 0 0
110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110
Everolimo 0,5 mg (por comprimido) Everolimo 0,75 mg (por comprimido) Everolimo 1,0 mg (por comprimido) Fenofibrato 200 mg (por capsula) Fenofibrato 250 mg (por capsula de liberao E780, E781, E782, E783, E784, E785, E786, E788 retardada) Fenoterol 100 mcg aerossol (por frasco de 200 J45.0, J45.1, J45.8 doses)
060425001-0
Filgrastim 300 mcg injetavel (por frasco)
B171, B182, B200, B201, B202, B203, B204, B205, B206, B207, B208, B209, B220, B221, B222, B227, B230, B231, B232, B238, B24, D460, D461, D467,D610, D611, D612, D613, D618, D70, Z948 E250,E271,E274 E78.0, E78.1, E78.2, E78.3, E78.4, E78.5, E78.6, E78.8 E78.0, E78.1, E78.2, E78.3, E78.4, E78.5, E78.6, E78.8 J45.0, J45.1, J45.8 J45.0, J45.1, J45.8 J45.0, J45.1, J45.8 J45.0, J45.1, J45.8 J45.0, J45.1, J45.8
64
0
110
060442001-3 060436005-3 060436006-1 060404002-4 060404004-0 060404005-9 060404003-2 060404007-5
Fludrocortisona 0,1 mg (por comprimido) Fluvastatina 20 mg (por capsula) Fluvastatina 40 mg (por capsula) Formoterol 12 mcg ( por capsula inalante ) Formoterol 12 mcg + Budesonida 400 mcg (por capsula inalante) Formoterol 12 mcg + Budesonida 400 mcg por inalante(por frasco de 60 doses) Formoterol 12 mcg por inalante( por frasco de 60 doses ) Formoterol 6 mcg + Budesonida 200 mcg (por capsula inalante)
124 124 62 62 62 1 1 124
0 0 0 0 0 0 0 0
110 110 110 110 110 110 110 110
060404006-7 060450001-7 060450002-5 060413004-0 060413005-8 060413003-1 060427007-0 060427008-9 060452001-8 060411002-2 060411001-4 060408002-6 060417001-7 060417002-5 060417003-3 060417004-1 060417005-0 060448001-6 060433001-4 060424001-5 060424003-1 060430001-8 060430002-6 060430003-4
060431001-3
Formoterol 6 mcg + Budesonida 200 mcg por J45.0, J45.1, J45.8 inalante(por frasco de 60 doses) G400, G401, G402, G403, G404, G405, G406, G407, Gabapentina 300 mg (por capsula) G408 G400, G401, G402, G403, G404, G405, G406, G407, Gabapentina 400 mg (por capsula) G408 Galantamina 16 mg (por capsula de liberao G300, G301, G308 controlada) Galantamina 24 mg (por capsula de liberao G300, G301, G308 controlada) Galantamina 8 mg (por capsula de liberao G300, G301, G308 controlada) Genifibrozila 600 mg (por comprimido) E780, E781, E782, E783, E784, E785, E786, E788 Genifibrozila 900 mg (por comprimido) E780, E781, E782, E783, E784, E785, E786, E788 Glatiramer 20 mg injetavel (por frasco-ampola G35 ou seringa preenchida) Gosserrelina 10,80 mg injetavel (por seringa D250, D251, D252, E228, N800, N801, N802, N803, preenchida) N804, N805, N808 Gosserrelina 3,60 mg injetavel (por seringa D250, D251, D252, E228, N800, N801, N802, N803, preenchida) N804, N805, N808 M050, M051, M052, M053, M058, M060, M068, Hidroxicloroquina 400 mg (por comprimido) M080, M330, M331 Hidrxido de Alumnio 230 mg (por E83.3, N18.0 comprimido) Hidrxido de Alumnio 300 mg (por E83.3, N18.0 comprimido) Hidrxido de Alumnio 61,5 mg/ml (suspenso E83.3, N18.0 por frasco de 100 ml) Hidrxido de Alumnio 61,5 mg/ml (suspenso E83.3, N18.0 por frasco de 150 ml) Hidrxido de Alumnio 61,5 mg/ml (suspenso E83.3, N18.0 por frasco de 240 ml) Hidroxiureia 500 mg (por capsula) D561, D568, D570, D571, D572 Iloprosta 10 mcg/ml soluo para nebulizao I27.0, I27.2 (ampola 2 ml) Imiglucerase 200 ui injetavel (por frasco de E75.2 ampola) Imiglucerase 400 ui injetavel (por frasco de E75.2 ampola) Imonoglobulina anti-hepatite b 100 ui injetavel B16.0, B16.2, B18.0, B18.1 (por frasco) Imonoglobulina anti-hepatite b 500 ui injetavel B16.0, B16.2, B18.0, B18.1 (por frasco) Imonoglobulina anti-hepatite b 600 ui injetavel B16.0, B16.2, B18.0, B18.1 (por frasco) B200, B201, B202, B203, B204, B205, B206, B207, B208, B209, B220, B221, B222, B227, B230, B231, B232, B238, B24, D590, D591, D600, D693, D800, Imunoglobulina humana 0,5 g injetavel (por D801, D803, D805, D806, D807, D808, D810, D811, frasco) D812, D813, D814, D815, D816, D817, D818, D820, D821, D830, D832, D838, G610, G700, M330, M331, M332 B200, B201, B202, B203, B204, B205, B206, B207, B208, B209, B220, B221, B222, B227, B230, B231, B232, B238, B24, D590, D591, D600, D693, D800, D801, D803, D805, D806, D807, D808, D810, D811, D812, D813, D814, D815, D816, D817, D818, D820, D821, D830, D832, D838, G610, G700, M330, M331, M332
2 372 279 31 31 93 62 31 31 1 2 93 1456 1116 54 36 23 217 62 48 24 8 1 1
0 3 3
110 110 110
40 110 40 110 40 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110
600
0
110
060431002-1
Imunoglobulina humana 1,0 g injetavel (por frasco)
300
0
110
060431003-0
Imunoglobulina humana 2,5 g injetavel (por frasco)
B200, B201, B202, B203, B204, B205, B206, B207, B208, B209, B220, B221, B222, B227, B230, B231, B232, B238, B24, D590, D591, D600, D693, D800, D801, D803, D805, D806, D807, D808, D810, D811, D812, D813, D814, D815, D816, D817, D818, D820, D821, D830, D832, D838, G610, G700, M330, M331, M332 B20.0, B20.1, B20.2, B20.3, B20.4, B20.5, B20.6, B20.7, B20.8, B20.9, B22.0, B22.1, B22.2, B22.7, B23.0, B23.1, B23.2, B23.8, B24, D59.0, D59.1, D60.0, D69.3, D80.0, D80.1, D80.3, D80.5, D80.6, D80.7, D80.8, D81.0, D81.1, D81.2, D81.3, D81.4, D81.5, D81.6, D81.7, D81.8, D82.0, D82.1, D83.0, D83.2, D83.8, G61.0, G70.0, M33.0, M33.1, M33.2 B20.0, B20.1, B20.2, B20.3, B20.4, B20.5, B20.6, B20.7, B20.8, B20.9, B22.0, B22.1, B22.2, B22.7, B23.0, B23.1, B23.2, B23.8, B24, D59.0, D59.1, D60.0, D69.3, D80.0, D80.1, D80.3, D80.5, D80.6, D80.7, D80.8, D81.0, D81.1, D81.2, D81.3, D81.4, D81.5, D81.6, D81.7, D81.8, D82.0, D82.1, D83.0, D83.2, D83.8, G61.0, G70.0, M33.0, M33.1, M33.2 B200, B201, B202, B203, B204, B205, B206, B207, B208, B209, B220, B221, B222, B227, B230, B231, B232, B238, B24, D590, D591, D600, D693, D800, D801, D803, D805, D806, D807, D808, D810, D811, D812, D813, D814, D815, D816, D817, D818, D820, D821, D830, D832, D838, G610, G700, M330, M331, M332 M070, M073, M45, K500, K501, K508 M050, M051, M052, M053, M058, M060, M068, M080 L700, L701, L708 L700, L701, L708 B160, B162, B180, B181
120
0
110
060431004-8
Imunoglobulina humana 3,0 g injetavel (por frasco)
100
0
110
060431005-6
Imunoglobulina humana 5,0 g injetavel (por frasco)
60
0
110
060431006-4
Imunoglobulina humana 6,0 g injetavel (por frasco)
50
0
110
060438005-4 060438004-6 060459001-6 060459002-4 060446003-1 060446004-0 060450005-0 060450003-3 060450004-1 060432004-3 060411004-9 060411003-0 060436007-0 060436008-8 060436009-6 060401007-9 060401006-0
B160, B162, B180, B181 G400, G401, G402, G403, G404, G405, G406, G407, Lamotrigina 100 mg (por comprimido) G408 G400, G401, G402, G403, G404, G405, G406, G407, Lamotrigina 25 mg (por comprimido) G408 G400, G401, G402, G403, G404, G405, G406, G407, Lamotrigina 50 mg (por comprimido) G408 M05.0, M05.1, M05.2, M05.3, M05.8, M06.0, Leflunomida 20 mg (por comprimido) M06.8, M07.0, M07.3, M08.0 Leuprorrelina 11,25 mg injetavel (por frasco D250, D251, D252, E228, N800, N801, N802, N803, ampola) N804, N805, N808 Leuprorrelina 3,75 mg injetavel (por frasco D250, D251, D252, E228, N800, N801, N802, N803, ampola) N804, N805, N808 Lovastatina 10 mg (por comprimido) E78.0, E78.1, E78.2, E78.3, E78.4, E78.5, E78.6, E78.8 Lovastatina 20 mg (por comprimido) E78.0, E78.1, E78.2, E78.3, E78.4, E78.5, E78.6, E78.8 Lovastatina 40 mg (por comprimido) E78.0, E78.1, E78.2, E78.3, E78.4, E78.5, E78.6, E78.8 Mesalazina - 1 G + diluente 100 ml (enema) - K500, K501, K508, K510, K511, K512, K513, K514, por dose K515, K518 K500, K501, K508, K510, K511, K512, K513, K514, Mesalazina - 1000 mg por supositorio K515, K518
Infliximabe 10 mg/ml injetavel (por frascoampola com 10 ml) (CROHN) Infliximabe 10 mg/ml injetavel (por frascoampola) (ARTRITE) Isotretinoina 10 mg (por capsula) Isotretinoina 20 mg (por capsula) Lamivudina 10 mg/ml soluo oral (frasco de 240 ml) Lamivudina 150mg (por comprimido)
3 2 620 310 4 62 155 620 310 31 1 2 248 124 62 124 124
0 0 0 0 0 0 2 2 2 0 0 0 0 0 0 0 0
110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110
060401004-4 060401008-7 060401001-0 060401002-8 060401005-2 060401003-6 060441002-6 060441003-4 060441001-8 060428010-6
K500, K501, K508, K510, K511, K512, K513, K514, K515, K518 Mesalazina - 3 G + diluente 100 ml (enema) - K500, K501, K508, K510, K511, K512, K513, K514, por dose K515, K518 K500, K501, K508, K510, K511, K512, K513, K514, Mesalazina - 400 mg por comprimido K515, K518 K500, K501, K508, K510, K511, K512, K513, K514, Mesalazina - 500 mg por comprimido K515, K518 K500, K501, K508, K510, K511, K512, K513, K514, Mesalazina - 500 mg por supositorio K515, K518 K500, K501, K508, K510, K511, K512, K513, K514, Mesalazina - 800 mg por comprimido K515, K518 Metadona 10 mg (por comprimido) R521, R522 Metadona 10 mg/ml injetavel (por ampola de 1 R521, R522 ml) Metadona 5 mg (por comprimido) R521, R522 Metilprednisolona 500 mg injetavel (por T861, Z940, Z941, Z942, Z943, Z944, Z945, Z946, ampola) Z947, Z948 Mesalazina - 250 mg por supositorio Metotrexato 2,5 mg (por comprimido) L400, L401, L404, L408, M050, M051, M052, M053, M058, M060, M068, M070, M073, M080, M330, M331, M332, M340,M341, M348, M45 K500, K501, K508, M050, M051, M052, M053, M058, M060, M068, M070, M073, M080, M330, M331, M332 K500, K501, K508 T86.1, Z94.0, Z94.1, Z94.4 T86.1, Z94.0, Z94.1, Z94.4 T86.1, Z94.0, Z94.1, Z94.4 E752
496 31 310 248 248 155 620 620 1240 14
0 0 0 0 0 0 0 0 0 0
110 110 110 110 110 110 110 110 110 110
060453002-1
50
0
110
060453003-0 060453004-8 060432005-1 060432006-0 060432007-8 060463001-8
Metotrexato 25 mg/ml injetavel (por ampola de 2 ml) Metotrexato 25 mg/ml injetavel (por ampola de 20 ml) Micofenolato de mofetila 500 mg (por comprimido) Micofenolato de sodio 180 mg (por comprimido) Micofenolato de sodio 360 mg (por comprimido) Miglustate 100 mg (por capsula)
5 15 186 248 124 93
0 0 0 0 0
110 110 110 110 110
18 110
060425002-9
B200, B201, B202, B203, B204, B205, B206, B207, B208, B209, B220, B221, B222, B227, B230, B231, Molgramostim 300 mcg injetavel (por frasco) B232, B238, B24, D460, D461, D467, D610, D611, D612, D613, D618, D70, Z948 Morfina 10 mg/ml (por ampola de 1 ml) Morfina 10 mg/ml soluo oral(por frasco de 60 ml) Morfina 10mg (por comprimido) Morfina 30 mg (por comprimido) Morfina de Liberao Controlada 100 mg (por capsula) Morfina de Liberao Controlada 30 mg (por capsula) Morfina de Liberao Controlada 60 mg (por capsula) Natalizumabe 300 mg (por frasco-ampola) Octreotida 0,1 mg/ml injetavel (por ampola) Octreotida 0,5 mg/ml injetavel (por ampola) Octreotida Lar 10 mg injetavel (por frasco ampola) Octreotida Lar 20 mg injetavel (por frasco ampola) Octreotida Lar 30 mg injetavel (por frasco ampola) Olanzapina 10 mg (por comprimido) Olanzapina 5 mg (por comprimido) R52.2, R52.1 R52.2, R52.1 R52.2, R52.1 R52.2, R52.1 R52.2, R52.1 R52.2, R52.1 R52.2, R52.1 G35 E22.0 E22.0 E22.0 E22.0 E22.0 F20.0, F20.1,F20.2, F20.3, F20.4, F20.5, F20.6, F20.8 F20.0, F20.1,F20.2, F20.3, F20.4, F20.5, F20.6, F20.8
64
0
110
060405005-4 060405006-2 060405007-0 060405008-9 060405011-9 060405009-7 060405010-0 060432011-6 060429004-7 060429005-5 060429001-2 060429002-0 060429003-9 060423002-8 060423001-0
1860 62 1860 1240 62 217 124 1 465 93 8 4 2 31 93
0 0 0 0 0 0 0
110 110 110 110 110 110 110
18 110 0 110 0 110 0 0 0 0 0 110 110 110 110 110
060416001-1
Pamidronato 30 mg injetvel (por frascoampola)
060416002-0
Pamidronato 60 mg injetvel (por frascoampola) Pamidronato 90 mg injetvel ( por frascoampola) Pancreatina 10.000 ui (por capsula) Pancreatina 25.000 ui (por capsula) Pancrelipase 12.000 ui (por capsula) Pancrelipase 18.000 ui (por capsula) Pancrelipase 20.00 ui (por capsula) Pancrelipase 4500 ui (por capsula) Penicilamina 250 mg (por capsula) Piridostigmina 60 mg ( por comprimido) Pramipexol 0,125 mg (por comprimido) Pramipexol 0,25 mg (por comprimido) Pramipexol 1 mg (por comprimido) Pravastatina 10 mg (por comprimido) Pravastatina 20 mg (por comprimido) Pravastatina 40 mg (por comprimido) Primidona 100 mg (por comprimido) Primidona 250 mg (por comprimido) Quetiapina 100 mg (por comprimido) Quetiapina 200 mg (por comprimido) Quetiapina 25 mg (por comprimido) Quetiapina 300 mg (por comprimido) Raloxifeno 60 mg (por comprimido) Ribavirina 250 mg (por capsula) Riluzol 50 mg (por comprimido) Risedronato 35 mg ( por comprimido)
M80.0, M80.1, M80.2, M80.3, M80.4, M80.5, M80.8, M81.0, M81.1, M81.2, M81.3, M81.4, M81.5, M81.6, M81.8, M82.0, M82.1, M82.8, M88.0, M88.8 M80.0, M80.1, M80.2, M80.3, M80.4, M80.5, M80.8, M81.0, M81.1, M81.2, M81.3, M81.4, M81.5, M81.6, M81.8, M82.0, M82.1, M82.8, M88.0, M88.8 M88.0, M88.8 E841, E848, K860, K861, K903 E841, E848, K860, K861, K903 E841, E848, K860, K861, K903 E841, E848, K860, K861, K903 E841, E848, K860, K861, K903 E841, E848, K860, K861, K903 E830, M340, M341, M348 G700 G20 G20 G20 E78.0, E78.1, E78.2, E78.3, E78.4, E78.5, E78.6, E78.8 E78.0, E78.1, E78.2, E78.3, E78.4, E78.5, E78.6, E78.8 E78.0, E78.1, E78.2, E78.3, E78.4, E78.5, E78.6, E78.8 G400, G401, G402, G403, G404, G405, G406, G407, G408 G400, G401, G402, G403, G404, G405, G406, G407, G408 F20.0, F20.1,F20.2, F20.3, F20.4, F20.5, F20.6, F20.8 F20.0, F20.1,F20.2, F20.3, F20.4, F20.5, F20.6, F20.8 F20.0, F20.1,F20.2, F20.3, F20.4, F20.5, F20.6, F20.8 F20.0, F20.1,F20.2, F20.3, F20.4, F20.5, F20.6, F20.8 M800, M801, M802, M803, M804, M805, M808, M810, M811, M812, M813, M814, M815, M816, M818, M820, M821, M828 B171, B182 G12.2 M80.0, M80.1, M80.2, M80.3, M80.4, M80.5, M80.8, M81.0, M81.1, M81.2, M81.3, M81.4, M81.5, M81.6, M81.8, M82.0, M82.1, M82.8, M88.0, M88.8 M80.0, M80.1, M80.2, M80.3, M80.4, M80.5, M80.8, M81.0, M81.1, M81.2, M81.3, M81.4, M81.5, M81.6, M81.8, M82.0, M82.1, M82.8, M88.0, M88.8 F200, F201, F202, F203, F204, F205, F206, F208 F200, F201, F202, F203, F204, F205, F206, F208 F200, F201, F202, F203, F204, F205, F206, F208 G300, G301, G308 G300, G301, G308 G300, G301, G308 G300, G301, G308 G300, G301, G308
3
0
110
1
0
110
060416003-8 060458001-0 060458002-9 060458004-5 060458005-3 060458006-1 060458003-7 060456001-0 060413011-2 060403004-5 060403005-3 060403006-1 060436010-0 060436011-8 060436012-6 060415001-6 060415002-4 060423004-4 060423005-2 060423003-6 060423006-0 060443001-9 060445001-0 060454001-9 060416005-4
1 3100 1240 2583 1722 1550 3100 186 372 1116 558 124 124 62 31 233 93 248 124 992 62 31 217 62 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110
060416004-6 060451001-2 060451002-0 060451003-9 060413006-6 060413009-0 060413010-4 060413007-4 060413008-2
Risedronato 5 mg (por comprimido) Risperidona 1 mg (por comprimido) Risperidona 2 mg (por comprimido) Risperidona 3 mg (por comprimido) Rivastigmina 1,5 mg (por cpsula) Rivastigmina 4,5 mg (por cpsula) Rivastigmina 6 mg (por cpsula) Rivastigmina 2,0 mg/ml- soluo oral (por frasco com 120 ml) Rivastigmina 3 mg (por cpsula)
186 186 93 62 248 62 62 2 124
0 0 0 0 40 40 40
110 110 110 110 110 110 110
40 110 40 110
060426001-6 060404008-3 060404009-1 060437002-4 060437001-6 060440001-2 060435001-5 060432008-6 060432010-8 060432009-4 060461002-5 060461001-7
Sacarato de hidroxido ferrico 100 mg injetavel D50.0, D50.8, N18.0, N18.8 (por frasco de5 ml) Salbutamol 100 mcg Aerossol(por frasco de J45.0, J45.1, J45.8 200 doses) Salmeterol 50 mcg po inalante ou aerossol J45.0, J45.1, J45.8 bucal (por frasco de 60 doses) Selegilina 10 mg (por dragea ou comprimido) G20 Selegilina 5 mg (por comprimido) Sevelamer 800 mg (por comprimido) Sildenafila 20 mg (por comprimido) Sirolimo 1 mg (por dragea) Sirolimo 1 mg/ml soluo oral(por frasco de 60 ml) Sirolimo 2 mg (por dragea) Somatropina 12 ui injetavel (por frascoampola) G20 E833, N180 I27.0, I27.2 T86.1, Z94.0 T86.1, Z94.0 T86.1, Z94.0 E230, Q960, Q961, Q962, Q963, Q964, Q968
13 2 2 31 62 279 93 65 2 32 31 93
0 0 0 0 0 18 0 0 0 0 0 0
110 110 110 110 110 110 110 110 110 110 110 110
Somatropina 4 ui injetavel (por frasco-ampola) E230, Q960, Q961, Q962, Q963, Q964, Q968 K500, K501, K508, K510, K511, K512, K513, K514, K515, K518, K522, M023, M050, M051, M052, M053, M058, M060, M068, M070, M073, M074, M075, M076, M080, M45, M460, M461, M468, M488 T86.1, Z940, Z94.4 T86.1, Z940, Z94.4 B181 G20 G400, G401, G402, G403, G404, G405, G406, G407, G408 G400, G401, G402, G403, G404, G405, G406, G407, G408 G400, G401, G402, G403, G404, G405, G406, G407, G408 G041, G240, G241, G242, G243, G244, G245, G248, G518, G800, G801,G802, G811, G821, G824, I690, I691, I692, I693, I694, I698, T905, T908 G041,G240, G241, G242, G243, G244, G245, G248,G518,G800, G801,G802, G811, G821, G824, I690, I691, I692, I693, I694, I698, T905, T908 G20 D250, D251, D252, E228, N800, N801, N802, N803, N804, N805, N808 D250, D251, D252, E228, N800, N801, N802, N803, N804, N805, N808 G400, G401, G402, G403, G404, G405, G406, G407, G408 F20.0, F20.1,F20.2, F20.3, F20.4, F20.5, F20.6, F20.8 F20.0, F20.1,F20.2, F20.3, F20.4, F20.5, F20.6, F20.8
060401009-5
Sulfassalazina - 500 mg por comprimido
372
0
110
060434006-0 060434007-9 060446005-8 060449002-0 060450008-4 060450006-8 060450007-6
Tacrolimo 1 mg (por capsula) Tacrolimo 5 mg (por capsula) Tenofovir 300 mg (por comprimido) Tolcapona 100 mg (por comprimido) Topiramato 100 mg (por comprimido) Topiramato 25 mg (por comprimido) Topiramato 50 mg (por comprimido) Toxina Botulinica tipo a 100 ui injetavel (por frasco-ampola)
930 186 31 186 124 496 248
0 0 13 0 0 0 0
110 110 110 110 110 110 110
060455001-4
8
0
110
060455002-2 060407001-2 060411006-5 060411005-7 060419001-8 060421001-9 060421002-7
Toxina Botulinica tipo a 500 ui injetavel (por frasco-ampola) Triexifenidil 5 mg (por comprimido) Triptorrelina 11,25 mg injetavel (por frasco de ampola) Triptorrelina 3,75 mg injetavel (por frasco de ampola) Vigabatrina 500 mg (por comprimido) Ziprasidona 40 mg (por capsula) Ziprasidona 80 mg (por capsula)
5 93 1 2 186 124 62
0 0 0 0 0 0 0
110 110 110 110 110 110 110
