597 1 MEMORIAL MEMORIAL Journal Officiel du Grand-Duché de Luxembourg Amtsblatt des Großherzogtums Luxemburg RECUEIL ADMINISTRATIF ET ECONOMIQUE B –– N° 23 25 février 2016 Sommaire Médicaments inscrits à la liste positive Médicaments inscrits à la liste positive en application de l’article 22, alinéa premier, du Code de la sécurité sociale, (Situation au 1er janvier 2016) . . . . . . . . . . . . . . . . . . . . . . . . page 598 598 Médicaments inscrits à la liste positive en application de l’article 22, alinéa premier, du Code de la sécurité sociale. Situation au 1er janvier 2016 No national Dénomination abrégée Prise en charge conditionnelle Taux de prise en charge 0258953 1 ALPHA LEO 0,25 MCG 30 CAPS 0 80% 0258971 1 ALPHA LEO 1 MCG 50 CAPS BLIST 0 80% 0559876 1 ALPHA LEO 2 MCG/ML 10 AMP 0,5 ML 0 80% 0559909 1 ALPHA LEO 2 MCG/ML GTTS 1 FL 10 ML 0 80% 0311384 AACIDEXAM 5 MG 1 AMP 1 ML IMIV 0 80% 0000112 AACIFEMINE 0,5 MG 15 OV 0 80% 0000076 AACIFEMINE 2 MG 30 CPR 0 80% 0000109 AACIFEMINE CREME 15 G 0 80% 0375882 ABILIFY 10 MG 28*1 CPR 0 80% 0375932 ABILIFY 15 MG 28 CPR 0 80% 0375994 ABILIFY 30 MG 28 CPR 0 80% 0762273 ABILIFY MAINTENA 400 MG PSV 1 FL + S 2ML 0 80% 0195108 ACC 100 MG 20 CPR EFF 0 40% 0175637 ACC 200 MG 100 CPR EFF 0 40% 0195531 ACC 200 MG 20 CPR EFF 0 40% 0166915 ACC 200 MG 50 CPR EFF 0 40% 0204403 ACC 200 MG TABS 100 CPR 0 40% 0204384 ACC 200 MG TABS 20 CPR 0 40% 0204398 ACC 200 MG TABS 50 CPR 0 40% 0204417 ACC 600 MG TABS 20 CPR 0 40% 0204421 ACC 600 MG TABS 50 CPR 0 40% 0208268 ACC AKUT 600 MG 6 CPR EFF 0 40% 0166977 ACC INJEKT 300 MG 5 AMP 3 ML IMIV 0 80% 0462599 ACC KINDERSAFT 20 MG/ML 100 ML 0 40% 0468379 ACC KINDERSAFT 20 MG/ML 200 ML 0 40% 0197813 ACC LONG 600 MG 100 CPR EFF 0 40% 0166946 ACC LONG 600 MG 20 CPR EFF 0 40% 0166963 ACC LONG 600 MG 50 CPR EFF 0 40% 0228744 ACCOLATE 20 MG 56 CPR 0 80% 0163881 ACCUPRIL 20 MG 28 CPR 0 100% 0273087 ACCUPRIL 40 MG 56 CPR 0 100% 0163877 ACCUPRIL 5 MG 28 CPR 0 100% 0197201 ACCURETIC 10/12,5 28 CPR 0 100% 100% 0197214 ACCURETIC 20/12,5 28 CPR 0 0523291 ACECLOFENAC EG 100 MG 20 CPR 0 80% 0523324 ACECLOFENAC EG 100 MG 60 CPR 0 80% 0784673 ACETANDOS 200 MG GRAN 30 SACH 0 40% 0784639 ACETANDOS 600 MG 10 CPR EFF 0 40% 0784642 ACETANDOS 600 MG 30 CPR EFF 0 40% 0784656 ACETANDOS 600 MG 60 CPR EFF 0 40% 0756505 ACETYLCYSTEIN SDZ 600 MG 10 SACH 0 40% 0756522 ACETYLCYSTEIN SDZ 600 MG 30 SACH 0 40% 0756536 ACETYLCYSTEIN SDZ 600 MG 60 SACH 0 40% 0136799 ACETYLCYSTEINE EG 200 MG 30 CAPS 0 40% 0501912 ACETYLCYSTEINE EG 200 MG 30 SACH 0 40% 0240461 ACETYLCYSTEINE EG 600 MG 30 CPR EFF 0 40% 0455904 ACETYLCYSTEINE EG 600 MG 60 CPR EFF 0 40% Mémorial B – N° 23 du 25 février 2016 599 No national 0455918 Dénomination abrégée ACETYLCYSTEINE EG 600 MG 60 SACH Prise en charge conditionnelle Taux de prise en charge 0 40% 0347518 ACETYLCYSTEINE MYLAN 600 MG 30 SACH 0 40% 0301438 ACICLOVIR EG 200 MG 25 CPR 0 80% 0301469 ACICLOVIR EG 800 MG 35 CPR 0 80% 0298878 ACICLOVIR MYLAN 200 MG 25 CPR 0 80% 0298881 ACICLOVIR MYLAN 800 MG 35 CPR 0 80% 0539517 ACICLOVIR RATIO 800 MG 35 CPR 0 80% 0657328 ACICLOVIR SDZ 200 MG 25 CPR 0 80% 0657331 ACICLOVIR SDZ 800 MG 35 CPR 0 80% 0541353 ACIDINE 75 MG 20 CPR EFF (TUBE) 0 80% 0384685 ACIDUM PHOSPHORICUM 12 CH DOSES LHL 0 80% 0383495 ACIDUM PHOSPHORICUM 12 CH GRAN LHL 0 80% 0384685 ACIDUM PHOSPHORICUM 15 CH DOSE LHL 0 80% 0383495 ACIDUM PHOSPHORICUM 15 CH GRAN LHL 0 80% 0384685 ACIDUM PHOSPHORICUM 30 CH DOSE LHL 0 80% 0383495 ACIDUM PHOSPHORICUM 30 CH GRAN LHL 0 80% 0383495 ACIDUM PHOSPHORICUM 4 CH GRAN LHL 0 80% 0383495 ACIDUM PHOSPHORICUM 5 CH GRAN LHL 0 80% 0384685 ACIDUM PHOSPHORICUM 7 CH DOSE LHL 0 80% 0383495 ACIDUM PHOSPHORICUM 7 CH GRAN LHL 0 80% 0384685 ACIDUM PHOSPHORICUM 9 CH DOSE LHL 0 80% 0383495 ACIDUM PHOSPHORICUM 9 CH GRAN LHL 0 80% 0384766 ACIDUM PHOSPHORICUM GLOBULE 15CH BOIRON 0 80% 0384766 ACIDUM PHOSPHORICUM GLOBULES 9CH BOIRON 0 80% 0382551 ACIDUM PHOSPHORICUM GRANULE 12CH BOIRON 0 80% 0382551 ACIDUM PHOSPHORICUM GRANULE 15CH BOIRON 0 80% 0382551 ACIDUM PHOSPHORICUM GRANULE 30CH BOIRON 0 80% 0382551 ACIDUM PHOSPHORICUM GRANULES 4CH BOIRON 0 80% 0382551 ACIDUM PHOSPHORICUM GRANULES 5CH BOIRON 0 80% 0382551 ACIDUM PHOSPHORICUM GRANULES 7CH BOIRON 0 80% 0382551 ACIDUM PHOSPHORICUM GRANULES 9CH BOIRON 0 80% 0405608 ACLASTA 5 MG 1 FL 100 ML PERF 0 80% 0269277 ACNEPLUS CREME 30 G 0 80% 0196279 ACNERYNE 4% GEL 30 G 0 80% 0384332 ACONITUM NAPELLUS 12 CH DOSE LHL 0 80% 0383514 ACONITUM NAPELLUS 12 CH GRAN LHL 0 80% 0384332 ACONITUM NAPELLUS 15 CH DOSE LHL 0 80% 0383514 ACONITUM NAPELLUS 15 CH GRAN LHL 0 80% 0384332 ACONITUM NAPELLUS 30 CH DOSE LHL 0 80% 0383514 ACONITUM NAPELLUS 30 CH GRAN LHL 0 80% 0384332 ACONITUM NAPELLUS 4 CH DOSE LHL 0 80% 0383514 ACONITUM NAPELLUS 4 CH GRAN LHL 0 80% 0383514 ACONITUM NAPELLUS 5 CH GRAN LHL 0 80% 0384332 ACONITUM NAPELLUS 7 CH DOSE LHL 0 80% 0383514 ACONITUM NAPELLUS 7 CH GRAN LHL 0 80% 0384332 ACONITUM NAPELLUS 9 CH DOSE LHL 0 80% 0383514 ACONITUM NAPELLUS 9 CH GRAN LHL 0 80% 0384783 ACONITUM NAPELLUS GLOBULE 15CH BOIRON 0 80% 0384783 ACONITUM NAPELLUS GLOBULES 7CH BOIRON 0 80% 0384783 ACONITUM NAPELLUS GLOBULES 9CH BOIRON 0 80% Mémorial B – N° 23 du 25 février 2016 600 No national 0382632 Dénomination abrégée ACONITUM NAPELLUS GRANULE 15CH BOIRON Prise en charge conditionnelle Taux de prise en charge 0 80% 0382632 ACONITUM NAPELLUS GRANULE 30CH BOIRON 0 80% 0382632 ACONITUM NAPELLUS GRANULES 4CH BOIRON 0 80% 0382632 ACONITUM NAPELLUS GRANULES 5CH BOIRON 0 80% 0382632 ACONITUM NAPELLUS GRANULES 7CH BOIRON 0 80% 0382632 ACONITUM NAPELLUS GRANULES 9CH BOIRON 0 80% 0384332 ACTAEA RACEMOSA 12 CH DOSE LHL 0 80% 0383514 ACTAEA RACEMOSA 12 CH GRAN LHL 0 80% 0384332 ACTAEA RACEMOSA 15 CH DOSE LHL 0 80% 0384332 ACTAEA RACEMOSA 30 CH DOSE LHL 0 80% 0383514 ACTAEA RACEMOSA 30 CH GRAN LHL 0 80% 0383514 ACTAEA RACEMOSA 4 CH GRAN LHL 0 80% 0383514 ACTAEA RACEMOSA 5 CH GRAN LHL 0 80% 0384332 ACTAEA RACEMOSA 7 CH DOSE LHL 0 80% 0383514 ACTAEA RACEMOSA 7 CH GRAN LHL 0 80% 0384332 ACTAEA RACEMOSA 9 CH DOSE LHL 0 80% 0383514 ACTAEA RACEMOSA 9 CH GRAN LHL 0 80% 0384783 ACTAEA RACEMOSA GLOBULE 15CH BOIRON 0 80% 0384783 ACTAEA RACEMOSA GLOBULE 30CH BOIRON 0 80% 0384783 ACTAEA RACEMOSA GLOBULES 7CH BOIRON 0 80% 0384783 ACTAEA RACEMOSA GLOBULES 9CH BOIRON 0 80% 0382632 ACTAEA RACEMOSA GRANULE 15CH BOIRON 0 80% 0382632 ACTAEA RACEMOSA GRANULES 5CH BOIRON 0 80% 0382632 ACTAEA RACEMOSA GRANULES 7CH BOIRON 0 80% 0382632 ACTAEA RACEMOSA GRANULES 9CH BOIRON 0 80% 0383514 ACTAEA SPICATA 5 CH GRAN LHL 0 80% 0000482 ACTAPULGITE 30 SACH 0 80% 0252543 ACTIVELLE 3*28 CPR 0 80% 0536211 ACTIVELLE MINOR 0,5/0,1 MG 3*28 CPR 0 80% 0280761 ACTONEL 30 MG 28 CPR 0 80% 0283083 ACTONEL 5 MG 84 CPR 0 80% 0480857 ACTONEL COMBI D 12 CPR + 72 SACH 0 80% 0338621 ACTONEL HEBDO 35 MG 12 CPR 0 80% 0287809 ACTOS 15 MG 28 CPR 0 100% 0287826 ACTOS 15 MG 98 CPR 0 100% 0287843 ACTOS 30 MG 28 CPR 0 100% 0287861 ACTOS 30 MG 98 CPR 0 100% 0238205 ACULARE 0,5% COLLY 10 ML 0 80% 0000661 ACUPAN 30 MG 30 CPR 0 80% 0183544 ADALAT OROS 30 MG 28 CPR 0 100% 0380141 ADALAT OROS 60 MG 56 CPR 0 100% 0000787 ADALAT RET 20 MG 30 CPR 0 100% 0492729 ADENURIC 120 MG 28 CPR 0 80% 0492732 ADENURIC 120 MG 84 CPR 0 80% 0492701 ADENURIC 80 MG 28 CPR 0 80% 0492715 ADENURIC 80 MG 84 CPR 0 80% 0477798 ADVAGRAF 0,5 MG 100 CAPS 0 100% 0477767 ADVAGRAF 1 MG 100 CAPS 0 100% 0555149 ADVAGRAF 3 MG 100 CAPS 0 100% 0477803 ADVAGRAF 5 MG 100 CAPS 0 100% Mémorial B – N° 23 du 25 février 2016 601 No national 0186059 Dénomination abrégée ADVANTAN 0,1% CREME 15 G Prise en charge conditionnelle Taux de prise en charge 0 80% 0186031 ADVANTAN 0,1% POM 15 G 0 80% 0186045 ADVANTAN 0,1% POM GRASSE 15 G 0 80% 0455496 AERIUS 0,5 MG/ML SOL BUV 150 ML 0 80% 0292003 AERIUS 5 MG 100 CPR 0 80% 0291989 AERIUS 5 MG 30 CPR 0 80% 0291992 AERIUS 5 MG 50 CPR 0 80% 0383514 AESCULUS HIPPOCASTANUM 12 CH GRAN LHL 0 80% 0383514 AESCULUS HIPPOCASTANUM 4 CH GRAN LHL 0 80% 0383514 AESCULUS HIPPOCASTANUM 5 CH GRAN LHL 0 80% 0383514 AESCULUS HIPPOCASTANUM 7 CH GRAN LHL 0 80% 0383514 AESCULUS HIPPOCASTANUM 9 CH GRAN LHL 0 80% 0382632 AESCULUS HIPPOCASTANUM GRAN 5CH BOIRON 0 80% 0382632 AESCULUS HIPPOCASTANUM GRAN 7CH BOIRON 0 80% 0383514 AETHUSA CYNAPIUM 15 CH GRAN LHL 0 80 % 0383514 AETHUSA CYNAPIUM 30 CH GRAN LHL 0 80% 0383514 AETHUSA CYNAPIUM 5 CH GRAN LHL 0 80% 0383514 AETHUSA CYNAPIUM 7 CH GRAN LHL 0 80% 0383514 AETHUSA CYNAPIUM 9 CH GRAN LHL 0 80% 0131758 AFEBRYL 16 CPR EFF 0 40% 0364911 AFEBRYL 32 CPR EFF 0 40% 0656527 AFFUSINE 20 MG/G CREME 15 G 0 80% 0656531 AFFUSINE 20 MG/G CREME 30 G 0 80% 0383514 AGARICUS MUSCARIUS 15 CH GRAN LHL 0 80% 0383514 AGARICUS MUSCARIUS 4 CH GRAN LHL 0 80% 0383514 AGARICUS MUSCARIUS 5 CH GRAN LHL 0 80% 0383514 AGARICUS MUSCARIUS 7 CH GRAN LHL 0 80% 0384332 AGARICUS MUSCARIUS 9 CH DOSE LHL 0 80% 0383514 AGARICUS MUSCARIUS 9 CH GRAN LHL 0 80% 0382632 AGARICUS MUSCARIUS GRANULE 5CH BOIRON 0 80% 0382632 AGARICUS MUSCARIUS GRANULE 7CH BOIRON 0 80% 0289008 AGGRENOX 60 CAPS 0 80% 0175976 AGIOCUR GRAN 250 G 0 40% 0281934 AGIOLAX GRAN 100 G 0 40% 0158152 AGIOLAX GRAN 250 G 0 40% 0383514 AGNUS CASTUS 12 CH GRAN LHL 0 80% 0383514 AGNUS CASTUS 4 CH GRAN LHL 0 80% 0383514 AGNUS CASTUS 5 CH GRAN LHL 0 80% 0383514 AGNUS CASTUS 7 CH GRAN LHL 0 80% 0383514 AGNUS CASTUS 9 CH GRAN LHL 0 80% 0383514 AGRAPHIS MUTANS 5 CH GRAN LHL 0 80% 0210641 AIROMIR 100 MCG AER 200 D 0 100% 0228471 AIRTAL 100 MG 20 CPR 0 80% 0228484 AIRTAL 100 MG 60 CPR 0 80% 0205462 AKINETON 2 MG 60 CPR 0 100% 0001977 AKNEMYCIN 2% SOL 25 ML 0 80% 0146473 AKNEMYCIN 2000 POM 2% 25 G 0 80% 0001980 AKNEROXID 100 MG/G GEL 50 G 0 80% 0001994 AKNEROXID 50 MG/G GEL 50 G 0 80% 0150591 AKTON 1 MG 50 CPR 0 40% Mémorial B – N° 23 du 25 février 2016 602 No national Dénomination abrégée Prise en charge conditionnelle Taux de prise en charge 0081608 AKTON 2 MG 20 CPR 0 40% 0150588 AKTON 2 MG 50 CPR 0 40% 0002201 ALBICORT 10 MG 1 FL 5 ML IM 0 80% 0223782 ALCON EYE GEL 10 G 0 40% 0002537 ALDACTAZINE 28 CPR 0 80% 0002540 ALDACTAZINE 98 CPR 0 80% 0002554 ALDACTONE 100 MG 30 CPR 0 80% 0002568 ALDACTONE 100 MG 50 CPR 0 80% 0002599 ALDACTONE 25 MG 50 CPR 0 80% 0229593 ALDACTONE 50 MG 30 CPR 0 80% 0256749 ALDARA 5% CREME 12 SACH 250 MG 0 80% 0722491 ALENDRONAAT+CA/VIT D SDZ 70 MG 12+72 CPR 0 80% 0722488 ALENDRONAAT+CA/VIT D SDZ 70 MG 4+24 CPR 0 80% 0734346 ALENDRONATE EG 10 MG 28 CPR 0 80% 0734394 ALENDRONATE EG 10 MG 98 CPR 0 80% 0734458 ALENDRONATE EG 70 MG 12 CPR 0 80% 0734431 ALENDRONATE EG 70 MG 4 CPR 0 80% 0754982 ALENDRONATE SDZ 70 MG 12 CPR 0 80% 0755007 ALENDRONATE SDZ 70 MG 4 CPR 0 80% 0409719 ALENDRONSAEURE RATIO 70 MG 12 CPR 0 80% 0409686 ALENDRONSAEURE RATIO 70 MG 4 CPR 0 80% 0383514 ALETRIS FARINOSA 4 CH GRAN LHL 0 80% 0383514 ALETRIS FARINOSA 5 CH GRAN LHL 0 80% 0211439 ALGISEDAL 16 CPR 0 80% 0524871 ALGOCOD 500/30 MG 32 CPR EFF 0 80% 0242046 ALGOSTASE 30 CAPS 0 40% 0193196 ALGOSTASE 32 CPR EFF 0 40% 0334814 ALGOSTASE MONO 1 G 20 CPR EFF 0 80% 0362173 ALGOSTASE MONO 1 G 40 CPR EFF 0 80% 0667033 ALGOSTASE MONO 1 G 60 CPR EFF 0 80% 0657443 ALGOSTASE MONO 1 G 90 CPR 0 80% 0731005 ALGOSTASE MONO 1 G 90 CPR (FL) 0 80% 0341674 ALGOSTASE MONO 500 MG 32 CPR EFF 0 80% 0400176 ALGOSTASE MONO 500 MG 32 SACH 0 80% 0368583 ALGOSTASE PDR 32 SACH 0 40% 0756648 ALGOTRA 37,5/325 MG 100 CPR 0 80% 0756621 ALGOTRA 37,5/325 MG 30 CPR 0 80% 100% 0003050 ALKERAN 2 MG 25 CPR 0 0686008 ALLEGRATAB 120 MG 20 CPR 0 80% 0257553 ALLERGODIL COLLY 6 ML 0 80% 0188716 ALLERGODIL SPRAY 10 ML 0 80% 0213206 ALLERGOVIT 1 FL B (ENTRETIEN) 1*3 ML 0 80% 0213191 ALLERGOVIT ST A+B / 2*3 ML 0 80% 0384332 ALLIUM CEPA 15 CH DOSE LHL 0 80% 0383514 ALLIUM CEPA 15 CH GRAN LHL 0 80% 0383514 ALLIUM CEPA 30 CH GRAN LHL 0 80% 0383514 ALLIUM CEPA 4 CH GRAN LHL 0 80% 0383514 ALLIUM CEPA 5 CH GRAN LHL 0 80% 0383514 ALLIUM CEPA 7 CH GRAN LHL 0 80% 0384332 ALLIUM CEPA 9 CH DOSE LHL 0 80% Mémorial B – N° 23 du 25 février 2016 603 No national 0383514 Dénomination abrégée ALLIUM CEPA 9 CH GRAN LHL Prise en charge conditionnelle Taux de prise en charge 0 80% 0383612 ALLIUM CEPA D1 MG 125 ML LHL 0 80% 0384945 ALLIUM CEPA D1 MG 60 ML LHL 0 80% 0384783 ALLIUM CEPA GLOBULE 15CH BOIRON 0 80% 0384783 ALLIUM CEPA GLOBULE 30CH BOIRON 0 80% 0384783 ALLIUM CEPA GLOBULES 9CH BOIRON 0 80% 0382632 ALLIUM CEPA GRANULES 4CH BOIRON 0 80% 0382632 ALLIUM CEPA GRANULES 5CH BOIRON 0 80% 0382632 ALLIUM CEPA GRANULES 7CH BOIRON 0 80% 0382632 ALLIUM CEPA GRANULES 9CH BOIRON 0 80% 0383514 ALLIUM SATIVUM 5 CH GRAN LHL 0 80% 0383514 ALLIUM SATIVUM 9 CH GRAN LHL 0 80% 0136804 ALLOPURINOL EG 300 MG 90 CPR 0 80% 0576301 ALLOPURINOL RATIO 100 MG 100 CPR 0 80% 0576295 ALLOPURINOL RATIO 100 MG 50 CPR 0 80% 0149606 ALLOPURINOL RATIO 300 MG 100 CPR 0 80% 0149587 ALLOPURINOL RATIO 300 MG 20 CPR 0 80% 0149591 ALLOPURINOL RATIO 300 MG 50 CPR 0 80% 0441053 ALMOGRAN 12,5 MG 12 CPR 6 80% 0285897 ALMOGRAN 12,5 MG 3 CPR 6 80% 0722412 ALMOTRIPTAN SDZ 12,5 MG 12 CPR 0 80% 0722457 ALMOTRIPTAN SDZ 12,5 MG 24 CPR 0 80% 0722362 ALMOTRIPTAN SDZ 12,5 MG 6 CPR 0 80% 0383514 ALOE 4 CH GRAN LHL 0 80% 0383514 ALOE 5 CH GRAN LHL 0 80% 0383514 ALOE 7 CH GRAN LHL 0 80% 0383514 ALOE 9 CH GRAN LHL 0 80% 0170689 ALOMIDE 1 MG/ML COLLY 5 ML 0 80% 100% 0756679 ALPHA RIX TETRA 1 SRG PRER 0,5 ML+1 AIG 6 0250471 ALPHAGAN 0,2% COLLY 5 ML 0 80% 0206263 ALPRAZ 0,5 MG 14 CPR 0 40% 0206277 ALPRAZ 0,5 MG 28 CPR 0 40% 0488581 ALPRAZ 0,5 MG 56 CPR 0 40% 0206281 ALPRAZ 1 MG 14 CPR 0 40% 0206294 ALPRAZ 1 MG 28 CPR 0 40% 0457389 ALPRAZOLAM EG 0,25 MG 20 CPR 0 40% 0457392 ALPRAZOLAM EG 0,25 MG 50 CPR 0 40% 0699426 ALPRAZOLAM EG 0,25 MG 60 CPR 0 40% 0457408 ALPRAZOLAM EG 0,5 MG 20 CPR 0 40% 0457411 ALPRAZOLAM EG 0,5 MG 50 CPR 0 40% 0699461 ALPRAZOLAM EG 0,5 MG 60 CPR 0 40% 0457425 ALPRAZOLAM EG 1 MG 20 CPR 0 40% 0457439 ALPRAZOLAM EG 1 MG 50 CPR 0 40% 0699491 ALPRAZOLAM EG 1 MG 60 CPR 0 40% 0457442 ALPRAZOLAM EG 2 MG 20 CPR 0 40% 0457456 ALPRAZOLAM EG 2 MG 50 CPR 0 40% 0699524 ALPRAZOLAM EG 2 MG 60 CPR 0 40% 0298962 ALPRAZOLAM MYLAN 0,25 MG 50 CPR 0 40% 0298945 ALPRAZOLAM MYLAN 0,5 MG 50 CPR 0 40% 0298901 ALPRAZOLAM MYLAN 1 MG 50 CPR 0 40% Mémorial B – N° 23 du 25 février 2016 604 No national 0576314 Dénomination abrégée ALTRIABAK 0,25 MG/ML COLLY 5 ML Prise en charge conditionnelle Taux de prise en charge 0 80% 0384685 ALUMEN 9 CH DOSES LHL 0 80% 0383495 ALUMINA 12 CH GRAN LHL 0 80% 0383495 ALUMINA 15 CH GRAN LHL 0 80% 0383495 ALUMINA 4 CH GRAN LHL 0 80% 0383495 ALUMINA 5 CH GRAN LHL 0 80% 0383495 ALUMINA 7 CH GRAN LHL 0 80% 0384685 ALUMINA 9 CH DOSES LHL 0 80% 0383495 ALUMINA 9 CH GRAN LHL 0 80% 0382551 ALUMINA GRANULES 5CH BOIRON 0 80% 0244636 AMARYLLE 2 MG 30 CPR 0 100% 0244653 AMARYLLE 2 MG 90 CPR 0 100% 0351233 AMARYLLE 3 MG 30 CPR 0 100% 0351328 AMARYLLE 4 MG 30 CPR 0 100% 0004030 AMBROHEXAL 3 MG/ML SIR 100 ML 0 40% 0004044 AMBROHEXAL 3 MG/ML SIR 250 ML 0 40% 0175699 AMBROHEXAL 30 MG 20 CPR 0 40% 0003985 AMBROHEXAL 30 MG 50 CPR 0 40% 0004027 AMBROHEXAL 7,5 MG/ML GTTS 100 ML 0 40% 0004013 AMBROHEXAL 7,5 MG/ML GTTS 50 ML 0 40% 0184538 AMBROHEXAL RET 75 MG 10 CAPS 0 40% 0004092 AMBROHEXAL RET 75 MG 100 CAPS 0 40% 0175704 AMBROHEXAL RET 75 MG 20 CAPS 0 40% 0004089 AMBROHEXAL RET 75 MG 50 CAPS 0 40% 0208951 AMBROHEXAL S 60 MG 20 CPR EFF 0 40% 0135967 AMBROXOL RATIO 15 MG 10 AMP 2 ML IMIVSC 0 80% 0267014 AMBROXOL RATIO HL 30 MG 100 CPR 0 40% 0266986 AMBROXOL RATIO HL 30 MG 20 CPR 0 40% 0267001 AMBROXOL RATIO HL 30 MG 50 CPR 0 40% 0266972 AMBROXOL RATIO HL RET 75 MG 100 CAPS 0 40% 0266955 AMBROXOL RATIO HL RET 75 MG 20 CAPS 0 40% 0266969 AMBROXOL RATIO HL RET 75 MG 50 CAPS 0 40% 0264754 AMBROXOL RATIO HUSTENSAFT 100 ML 0 40% 0264768 AMBROXOL RATIO HUSTENSAFT 250 ML 0 40% 0264785 AMBROXOL RATIO HUSTENTROPFEN 100 ML 0 40% 0264771 AMBROXOL RATIO HUSTENTROPFEN 50 ML 0 40% 0004299 AMICLA CREME 30 G 0 80% 0004321 AMILORETIK 100 CPR 0 80% 0225594 AMILORETIK 30 CPR 0 80% 0004318 AMILORETIK 50 CPR 0 80% 0153559 AMIODARONE EG 200 MG 60 CPR 0 100% 0756794 AMISULPRIDE EG 100 MG 150 CPR 0 80% 0756781 AMISULPRIDE EG 100 MG 60 CPR 0 80% 0756831 AMISULPRIDE EG 200 MG 150 CPR 0 80% 0756813 AMISULPRIDE EG 200 MG 30 CPR 0 80% 0756861 AMISULPRIDE EG 400 MG 150 CPR 0 80% 0756858 AMISULPRIDE EG 400 MG 60 CPR 0 80% 0756701 AMISULPRIDE EG 50 MG 30 CPR 0 80% 0756715 AMISULPRIDE EG 50 MG 60 CPR 0 80% 0445309 AMLODIPIN HEXAL 10 MG 100 CPR BLIST 0 100% Mémorial B – N° 23 du 25 février 2016 605 No national 0445245 Dénomination abrégée AMLODIPIN HEXAL 10 MG 20 CPR BLIST Prise en charge conditionnelle Taux de prise en charge 0 100% 0445276 AMLODIPIN HEXAL 10 MG 50 CPR BLIST 0 100% 0445696 AMLODIPIN HEXAL 5 MG 100 CPR BLIST 0 100% 0445648 AMLODIPIN HEXAL 5 MG 20 CPR BLIST 0 100% 0445679 AMLODIPIN HEXAL 5 MG 50 CPR BLIST 0 100% 0445505 AMLODIPIN HEXAL 7,5 MG 100 CPR BLIST 0 100% 0445441 AMLODIPIN HEXAL 7,5 MG 20 CPR BLIST 0 100% 0445472 AMLODIPIN HEXAL 7,5 MG 50 CPR BLIST 0 100% 0491508 AMLODIPIN N RATIO 10 MG 100 CPR 0 100% 0491427 AMLODIPIN N RATIO 10 MG 20 CPR 0 100% 0491458 AMLODIPIN N RATIO 10 MG 50 CPR 0 100% 0491329 AMLODIPIN N RATIO 5 MG 100 CPR 0 100% 0491248 AMLODIPIN N RATIO 5 MG 20 CPR 0 100% 0491279 AMLODIPIN N RATIO 5 MG 50 CPR 0 100% 0657748 AMLODIPINE BESILAAT SDZ 10 MG 100 CPR 0 100% 0657703 AMLODIPINE BESILAAT SDZ 10 MG 30 CPR 0 100% 0657541 AMLODIPINE BESILAAT SDZ 5 MG 100 CPR 0 100% 0657507 AMLODIPINE BESILAAT SDZ 5 MG 30 CPR 0 100% 0657538 AMLODIPINE BESILAAT SDZ 5 MG 60 CPR 0 100% 0466732 AMLODIPINE BESILATE EG 10 MG 100 CPR 0 100% 0466679 AMLODIPINE BESILATE EG 10 MG 30 CPR 0 100% 0466536 AMLODIPINE BESILATE EG 5 MG 28 CPR 0 100% 0466571 AMLODIPINE BESILATE EG 5 MG 56 CPR 0 100% 0466598 AMLODIPINE BESILATE EG 5 MG 98 CPR 0 100% 0590019 AMLOR 10 MG 100 CAPS 0 100% 0158314 AMLOR 10 MG 30 CAPS 0 100% 0158301 AMLOR 5 MG 28 CAPS 0 100% 0589991 AMLOR 5 MG 56 CAPS 0 100% 100% 0622188 AMLOR 5 MG 98 CAPS 0 0383495 AMMONIUM BROMATUM 4 CH GRAN LHL 0 80% 0383495 AMMONIUM BROMATUM 5 CH GRAN LHL 0 80% 0384685 AMMONIUM CARBONICUM 30 CH DOSES LHL 0 80% 0383495 AMMONIUM CARBONICUM 4 CH GRAN LHL 0 80% 0383495 AMMONIUM CARBONICUM 5 CH GRAN LHL 0 80% 0383495 AMMONIUM CARBONICUM 7 CH GRAN LHL 0 80% 0384685 AMMONIUM CARBONICUM 9 CH DOSE LHL 0 80% 0383495 AMMONIUM CARBONICUM 9 CH GRAN LHL 0 80% 0382551 AMMONIUM CARBONICUM GRANULE 4CH BOIRON 0 80% 0382551 AMMONIUM CARBONICUM GRANULE 5CH BOIRON 0 80% 0382551 AMMONIUM CARBONICUM GRANULE 7CH BOIRON 0 80% 0382551 AMMONIUM CARBONICUM GRANULE 9CH BOIRON 0 80% 0384685 AMMONIUM CRUDUM 9 CH DOSE LHL 0 80% 0383495 AMMONIUM MURIATICUM 4 CH GRAN LHL 0 80% 0383495 AMMONIUM MURIATICUM 5 CH GRAN LHL 0 80% 0383495 AMMONIUM MURIATICUM 7 CH GRAN LHL 0 80% 0501845 AMOCLANE EG 875/125 MG 20 SACH 0 80% 0149573 AMOXICILLIN 250 TS RATIO GRAN 100G=200ML 0 80% 0005105 AMOXICILLIN 250 TS RATIO GRAN 50G=100ML 0 80% 0267255 AMOXICILLIN RATIO 1 G 14 CPR 0 80% 0005086 AMOXICILLIN RATIO 1 G 20 CPR 0 80% Mémorial B – N° 23 du 25 février 2016 606 No national 0218216 Dénomination abrégée AMOXICILLIN RATIO 1 G 30 CPR Prise en charge conditionnelle Taux de prise en charge 0 80% 0005122 AMOXICILLIN RATIO 500 MG 20 CPR PELLIC 0 80% 0005153 AMOXICILLIN RATIO 750 MG 20 CPR PELLIC 0 80% 0249985 AMOXICILLIN RATIO 750 MG 30 CPR PELLIC 0 80% 0679695 AMOXICILLINE EG 1 G 24 CPR EFF 0 80% 0237936 AMOXICILLINE EG 1 G 8 CPR 0 80% 0458629 AMOXICILLINE EG 1 G 8 CPR EFF 0 80% 0475701 AMOXICILLINE EG 250 MG/5 ML PDR 100 ML 0 80% 0146134 AMOXICILLINE EG 500 MG 16 CAPS 0 80% 0459304 AMOXICILLINE EG 500 MG 30 CAPS 0 80% 0757242 AMOXICILLINE SDZ 1000 MG 20 CPR DISP 0 80% 0757256 AMOXICILLINE SDZ 1000 MG 24 CPR DISP 0 80% 0757192 AMOXICILLINE SDZ 1000 MG 8 CPR DISP 0 80% 0756991 AMOXICILLINE SDZ 250MG/5ML PDR 100 ML 0 80% 0756892 AMOXICILLINE SDZ 500 MG 16 CAPS 0 80% 0757127 AMOXICILLINE SDZ 500 MG 16 CPR DISP 0 80% 0757158 AMOXICILLINE SDZ 500 MG 30 CPR DISP 0 80% 0757077 AMOXICILLINE SDZ 500MG/5ML PDR 100 ML 0 80% 0657975 AMOXICLAV SDZ 125MG+31,25MG/5ML 100 ML 0 80% 0666991 AMOXICLAV SDZ 125MG+31,25MG/5ML 60 ML 0 80% 0658021 AMOXICLAV SDZ 250MG+62,5MG/5ML 100 ML 0 80% 0658048 AMOXICLAV SDZ 250MG+62,5MG/5ML 60 ML 0 80% 0657881 AMOXICLAV SDZ 500/125 MG 16 CPR 0 80% 0657927 AMOXICLAV SDZ 500/125 MG 30 CPR 0 80% 0757337 AMOXICLAV SDZ 875 MG 10 CPR 0 80% 0757385 AMOXICLAV SDZ 875 MG 20 CPR 0 80% 0139823 AMOXIHEXAL 250 MG/5 ML SIR 100 ML 0 80% 0197682 AMOXIHEXAL 250 MG/5 ML SIR 2*100 ML 0 80% 0005203 AMOXIHEXAL 500 MG 10 CPR PELLIC 0 80% 0162351 AMOXIHEXAL 500 MG 20 CPR PELLIC 0 80% 0224731 AMUKIN 1 G 2 FL 4 ML IMIV 0 80% 0005573 AMUKIN 100 MG 2 FL 2 ML IMIV 0 80% 0005590 AMUKIN 500 MG 2 FL 2 ML IMIV 0 80% 0383495 AMYLUM NITROSUM 5 CH GRAN LHL 0 80% 0383514 ANACARDIUM ORIENTALE 12 CH GRAN LHL 0 80% 0384332 ANACARDIUM ORIENTALE 15 CH DOSES LHL 0 80% 0383514 ANACARDIUM ORIENTALE 15 CH GRAN LHL 0 80% 0383514 ANACARDIUM ORIENTALE 30 CH GRAN LHL 0 80% 0383514 ANACARDIUM ORIENTALE 4 CH GRAN LHL 0 80% 0383514 ANACARDIUM ORIENTALE 5 CH GRAN LHL 0 80% 0384332 ANACARDIUM ORIENTALE 7 CH DOSES LHL 0 80% 0383514 ANACARDIUM ORIENTALE 7 CH GRAN LHL 0 80% 0384332 ANACARDIUM ORIENTALE 9 CH DOSES LHL 0 80% 0383514 ANACARDIUM ORIENTALE 9 CH GRAN LHL 0 80% 0382632 ANACARDIUM ORIENTALE GRAN 7 CH BOIRON 0 80% 0382632 ANACARDIUM ORIENTALE GRAN 9 CH BOIRON 0 80% 0236262 ANAFRANIL 10 MG 100 DRG 10351 0 80% 0236245 ANAFRANIL 10 MG 20 DRG 10349 0 80% 0236259 ANAFRANIL 10 MG 50 DRG 10350 0 80% 0236519 ANAFRANIL 25 MG 100 DRG 10355 0 80% Mémorial B – N° 23 du 25 février 2016 607 No national 0236486 Dénomination abrégée ANAFRANIL 25 MG 20 DRG 10353 Prise en charge conditionnelle Taux de prise en charge 0 80% 0236505 ANAFRANIL 25 MG 50 DRG 10354 0 80% 0236293 ANAFRANIL RET 75 MG 20 CPR 10604 0 80% 0236309 ANAFRANIL RET 75 MG 50 CPR 10602 0 80% 0383514 ANAGALIS ARVENSIS 4 CH GRAN LHL 0 80% 0383514 ANAGALIS ARVENSIS 5 CH GRAN LHL 0 80% 0495801 ANASTROZOL RATIO 1 MG 100 CPR 0 100% 0495765 ANASTROZOL RATIO 1 MG 30 CPR 0 100% 0652206 ANASTROZOL SDZ 1 MG 28 CPR 0 100% 0652285 ANASTROZOL SDZ 1 MG 98 CPR 0 100% 0565713 ANASTROZOLE EG 1 MG 28 CPR 0 100% 0565758 ANASTROZOLE EG 1 MG 98 CPR 0 100% 0006049 ANDROCUR 10 MG 45 CPR 0 80% 0006035 ANDROCUR 50 MG 50 CPR 0 80% 0753419 ANORO 55/22 MCG PDR 1 INH 30 D 0 100% 0753422 ANORO 55/22 MCG PDR 3 INH 30 D 0 100% 0006312 ANTABUSE 400 MG 50 CPR 0 80% 0006388 ANTEBOR SOLUTION 200 ML 0 80% 0383495 ANTIMONIUM CRUDUM 12 CH GRAN LHL 0 80% 0384685 ANTIMONIUM CRUDUM 15 CH DOSES LHL 0 80% 0383495 ANTIMONIUM CRUDUM 15 CH GRAN LHL 0 80% 0384685 ANTIMONIUM CRUDUM 30 CH DOSES LHL 0 80% 0383495 ANTIMONIUM CRUDUM 30 CH GRAN LHL 0 80% 0383495 ANTIMONIUM CRUDUM 4 CH GRAN LHL 0 80% 0383495 ANTIMONIUM CRUDUM 5 CH GRAN LHL 0 80% 0384685 ANTIMONIUM CRUDUM 7 CH DOSES LHL 0 80% 0383495 ANTIMONIUM CRUDUM 7 CH GRAN LHL 0 80% 0384685 ANTIMONIUM CRUDUM 9 CH DOSES LHL 0 80% 0383495 ANTIMONIUM CRUDUM 9 CH GRAN LHL 0 80% 0382551 ANTIMONIUM CRUDUM GRANULES 4CH BOIRON 0 80% 0382551 ANTIMONIUM CRUDUM GRANULES 5CH BOIRON 0 80% 0382551 ANTIMONIUM CRUDUM GRANULES 7CH BOIRON 0 80% 0382551 ANTIMONIUM MURIAT GRANULES 5CH BOIRON 0 80% 0384685 ANTIMONIUM TARTARICUM 12 CH DOSES LHL 0 80% 0384685 ANTIMONIUM TARTARICUM 15 CH DOSES LHL 0 80% 0383495 ANTIMONIUM TARTARICUM 15 CH GRAN LHL 0 80% 0383495 ANTIMONIUM TARTARICUM 30 CH GRAN LHL 0 80% 0383495 ANTIMONIUM TARTARICUM 4 CH GRAN LHL 0 80% 0383495 ANTIMONIUM TARTARICUM 5 CH GRAN LHL 0 80% 0383495 ANTIMONIUM TARTARICUM 7 CH GRAN LHL 0 80% 0384685 ANTIMONIUM TARTARICUM 9 CH DOSES 0383495 ANTIMONIUM TARTARICUM 9 CH GRAN LHL LHL 0 80% 0 80% 0382551 ANTIMONIUM TARTARICUM GRANUL 15CH BOIRON 0 80% 0382551 ANTIMONIUM TARTARICUM GRANULE 5CH BOIRON 0 80% 0382551 ANTIMONIUM TARTARICUM GRANULE 7CH BOIRON 0 80% 0382551 ANTIMONIUM TARTARICUM GRANULE 9CH BOIRON 0 80% 0388801 APIDRA 100 U/ML 1 FL 10 ML SC 0 100% 0388881 APIDRA 100 U/ML 5 CRT 3 ML SC 0 100% 0470928 APIDRA 100 U/ML 5 STYLOS SOLOSTAR 3ML SC 0 100% 0745854 APLEEK 60 MCG/24H + 13 MCG/24H 9 PATCH 6 80% Mémorial B – N° 23 du 25 février 2016 608 No national 0363851 Dénomination abrégée APOCARD RET 100 MG 60 CAPS Prise en charge conditionnelle Taux de prise en charge 0 100% 0363914 APOCARD RET 150 MG 60 CAPS 0 100% 0363881 APOCARD RET 200 MG 60 CAPS 0 100% 0007158 APRANAX 275 MG 30 CPR 0 80% 0169433 APRANAX 550 MG 30 CPR 0 80% 0240959 APROVEL 150 MG 28 CPR 0 100% 0240993 APROVEL 300 MG 28 CPR 0 100% 0241018 APROVEL 300 MG 98 CPR 0 100% 0416842 APTIVUS 250 MG 120 CAPS 0 100% 0007340 AQUA AD INJ BRN 10 AMP 20 ML P 0 80% 0007337 AQUA AD INJ BRN 10 MINI PL 10 ML 0 80% 0007256 AQUA AD INJ BRN 100 ML V 0 80% 0383514 ARALIA RACEMOSA 5 CH GRAN LHL 0 80% 0383514 ARALIA RACEMOSA 7 CH GRAN LHL 0 80% 0302564 ARANESP 10 MCG 4 SRG 0,4 ML SCIV 1 100% 0530394 ARANESP 100 MCG 4 SRG SECURISEES SC 1 100% 0302757 ARANESP 150 MCG 1 STYLO 0,3 ML (SURCLIC) 1 100% 0530444 ARANESP 150 MCG 4 SRG SECURISEES SC 1 100% 0530265 ARANESP 20 MCG 4 SRG SECURISEES SC 1 100% 0530282 ARANESP 30 MCG 4 SRG SECURISEES SC 1 100% 0530458 ARANESP 300 MCG 1 SRG SECURISEE SC 1 100% 0302774 ARANESP 300 MCG 1 STYLO 0,6 ML (SURCLIC) 1 100% 0530301 ARANESP 40 MCG 4 SRG SECURISEES SC 1 100% 0530329 ARANESP 50 MCG 4 SRG SECURISEES SC 1 100% 0530475 ARANESP 500 MCG 1 SRG SECURISEE SC 1 100% 0368441 ARANESP 500 MCG 1 STYLO 1 ML (SURCLIC) 1 100% 0530346 ARANESP 60 MCG 4 SRG SECURISEES SC 1 100% 0530377 ARANESP 80 MCG 4 SRG SECURISEES SC 1 100% 0270832 ARAVA 10 MG 100 CPR 0 100% 0270829 ARAVA 10 MG 30 CPR 0 100% 0285382 ARAVA 100 MG 3 CPR 0 100% 0270881 ARAVA 20 MG 100 CPR 0 100% 0270877 ARAVA 20 MG 30 CPR 0 100% 0332837 ARCOXIA 120 MG 14 CPR 0 80% 0332854 ARCOXIA 120 MG 28 CPR 0 80% 0476367 ARCOXIA 30 MG 28 CPR 0 80% 0332532 ARCOXIA 60 MG 28 CPR 0 80% 0332692 ARCOXIA 90 MG 28 CPR 0 80% 0383661 ARGENTUM METALLICUM 30 CH GRAN LHL 0 80% 0383661 ARGENTUM METALLICUM 4 CH GRAN LHL 0 80% 0383661 ARGENTUM METALLICUM 5 CH GRAN LHL 0 80% 0383661 ARGENTUM METALLICUM 7 CH GRAN LHL 0 80% 0383661 ARGENTUM METALLICUM 9 CH GRAN LHL 0 80% 0384685 ARGENTUM NITRICUM 12 CH DOSES LHL 0 80% 0383495 ARGENTUM NITRICUM 12 CH GRAN LHL 0 80% 0384685 ARGENTUM NITRICUM 15 CH DOSE LHL 0 80% 0383495 ARGENTUM NITRICUM 15 CH GRAN LHL 0 80% 0384685 ARGENTUM NITRICUM 30 CH DOSE LHL 0 80% 0383495 ARGENTUM NITRICUM 30 CH GRAN LHL 0 80% 0383495 ARGENTUM NITRICUM 4 CH GRAN LHL 0 80% Mémorial B – N° 23 du 25 février 2016 609 No national 0383495 Dénomination abrégée ARGENTUM NITRICUM 5 CH GRAN LHL Prise en charge conditionnelle Taux de prise en charge 0 80% 0384685 ARGENTUM NITRICUM 7 CH DOSE LHL 0 80% 0383495 ARGENTUM NITRICUM 7 CH GRAN LHL 0 80% 0384685 ARGENTUM NITRICUM 9 CH DOSE LHL 0 80% 0383495 ARGENTUM NITRICUM 9 CH GRAN LHL 0 80% 0384766 ARGENTUM NITRICUM GLOBULE 12CH BOIRON 0 80% 0384766 ARGENTUM NITRICUM GLOBULE 15CH BOIRON 0 80% 0384766 ARGENTUM NITRICUM GLOBULES 7CH BOIRON 0 80% 0384766 ARGENTUM NITRICUM GLOBULES 9CH BOIRON 0 80% 0382551 ARGENTUM NITRICUM GRANULE 12CH BOIRON 0 80% 0382551 ARGENTUM NITRICUM GRANULE 15CH BOIRON 0 80% 0382551 ARGENTUM NITRICUM GRANULES 5CH BOIRON 0 80% 0382551 ARGENTUM NITRICUM GRANULES 7CH BOIRON 0 80% 0382551 ARGENTUM NITRICUM GRANULES 9CH BOIRON 0 80% 0238897 ARICEPT 10 MG 28 CPR 1 80% 0238902 ARICEPT 10 MG 56 CPR 1 80% 0478246 ARICEPT 10 MG 98 CPR 1 80% 0698351 ARICEPT 10 PI-UK 10 MG 56 CPR 1 80% 0698415 ARICEPT 10 PI-UK 10 MG 98 CPR 1 80% 0435638 ARICEPT 5 MG 28 CPR 1 80% 0435672 ARICEPT 5 MG 98 CPR 1 80% 0698222 ARICEPT 5 PI-UK 5 MG 28 CPR 1 80% 0698271 ARICEPT 5 PI-UK 5 MG 98 CPR 1 80% 0215151 ARIMIDEX 1 MG 28 CPR 0 100% 0330927 ARIMIDEX 1 MG 84 CPR 0 100% 0789764 ARIPIPRAZOL SDZ 10 MG 28*1 CPR UD 0 80% 0789781 ARIPIPRAZOL SDZ 10 MG 56*1 CPR UD 0 80% 0789795 ARIPIPRAZOL SDZ 10 MG 98*1 CPR UD 0 80% 0789912 ARIPIPRAZOL SDZ 15 MG 28*1 CPR UD 0 80% 0789943 ARIPIPRAZOL SDZ 15 MG 56*1 CPR UD 0 80% 0789957 ARIPIPRAZOL SDZ 15 MG 98*1 CPR UD 0 80% 0790121 ARIPIPRAZOL SDZ 30 MG 28*1 CPR UD 0 80% 0790149 ARIPIPRAZOL SDZ 30 MG 56*1 CPR UD 0 80% 0790152 ARIPIPRAZOL SDZ 30 MG 98*1 CPR UD 0 80% 0383514 ARISTOLOCHIA 7 CH GRAN LHL 0 80% 0384332 ARNICA MONTANA 12 CH DOSE LHL 0 80% 0383514 ARNICA MONTANA 12 CH GRAN LHL 0 80% 0384332 ARNICA MONTANA 15 CH DOSE LHL 0 80% 0383514 ARNICA MONTANA 15 CH GRAN LHL 0 80% 0384332 ARNICA MONTANA 30 CH DOSE LHL 0 80% 0383514 ARNICA MONTANA 30 CH GRAN LHL 0 80% 0383514 ARNICA MONTANA 4 CH GRAN LHL 0 80% 0384332 ARNICA MONTANA 5 CH DOSE LHL 0 80% 0383514 ARNICA MONTANA 5 CH GRAN LHL 0 80% 0384332 ARNICA MONTANA 7 CH DOSE LHL 0 80% 0383514 ARNICA MONTANA 7 CH GRAN LHL 0 80% 0384332 ARNICA MONTANA 9 CH DOSE LHL 0 80% 0383514 ARNICA MONTANA 9 CH GRAN LHL 0 80% 0384783 ARNICA MONTANA GLOBULE 12CH BOIRON 0 80% 0384783 ARNICA MONTANA GLOBULE 15CH BOIRON 0 80% Mémorial B – N° 23 du 25 février 2016 610 No national 0384783 Dénomination abrégée ARNICA MONTANA GLOBULES 7CH BOIRON Prise en charge conditionnelle Taux de prise en charge 0 80% 0384783 ARNICA MONTANA GLOBULES 9CH BOIRON 0 80% 0382632 ARNICA MONTANA GRANULE 12CH BOIRON 0 80% 0382632 ARNICA MONTANA GRANULE 15CH BOIRON 0 80% 0382632 ARNICA MONTANA GRANULE 30CH BOIRON 0 80% 0382632 ARNICA MONTANA GRANULES 4CH BOIRON 0 80% 0382632 ARNICA MONTANA GRANULES 5CH BOIRON 0 80% 0382632 ARNICA MONTANA GRANULES 7CH BOIRON 0 80% 0382632 ARNICA MONTANA GRANULES 9CH BOIRON 0 80% 0271485 AROMASIN 25 MG 30 CPR 0 100% 0384685 ARSENICUM ALBUM 12 CH DOSE LHL 0 80% 0383495 ARSENICUM ALBUM 12 CH GRAN LHL 0 80% 0384685 ARSENICUM ALBUM 15 CH DOSE LHL 0 80% 0383495 ARSENICUM ALBUM 15 CH GRAN LHL 0 80% 0384685 ARSENICUM ALBUM 30 CH DOSE LHL 0 80% 0383495 ARSENICUM ALBUM 30 CH GRAN LHL 0 80% 0383495 ARSENICUM ALBUM 4 CH GRAN LHL 0 80% 0383495 ARSENICUM ALBUM 5 CH GRAN LHL 0 80% 0384685 ARSENICUM ALBUM 7 CH DOSE LHL 0 80% 0383495 ARSENICUM ALBUM 7 CH GRAN LHL 0 80% 0384685 ARSENICUM ALBUM 9 CH DOSE LHL 0 80% 0383495 ARSENICUM ALBUM 9 CH GRAN LHL 0 80% 0384766 ARSENICUM ALBUM GLOBULE 12CH BOIRON 0 80% 0384766 ARSENICUM ALBUM GLOBULE 15CH BOIRON 0 80% 0384766 ARSENICUM ALBUM GLOBULE 30CH BOIRON 0 80% 0384766 ARSENICUM ALBUM GLOBULES 7CH BOIRON 0 80% 0384766 ARSENICUM ALBUM GLOBULES 9CH BOIRON 0 80% 0382551 ARSENICUM ALBUM GRANULE 12CH BOIRON 0 80% 0382551 ARSENICUM ALBUM GRANULE 15CH BOIRON 0 80% 0382551 ARSENICUM ALBUM GRANULE 30CH BOIRON 0 80% 0382551 ARSENICUM ALBUM GRANULES 4CH BOIRON 0 80% 0382551 ARSENICUM ALBUM GRANULES 5CH BOIRON 0 80% 0382551 ARSENICUM ALBUM GRANULES 7CH BOIRON 0 80% 0382551 ARSENICUM ALBUM GRANULES 9CH BOIRON 0 80% 0384685 ARSENICUM IODATUM 15 CH DOSE LHL 0 80% 0383495 ARSENICUM IODATUM 15 CH GRAN LHL 0 80% 0383495 ARSENICUM IODATUM 30 CH GRAN LHL 0 80% 0383495 ARSENICUM IODATUM 4 CH GRAN LHL 0 80% 0383495 ARSENICUM IODATUM 5 CH GRAN LHL 0 80% 0383495 ARSENICUM IODATUM 7 CH GRAN LHL 0 80% 0384685 ARSENICUM IODATUM 9 CH DOSE LHL 0 80% 0383495 ARSENICUM IODATUM 9 CH GRAN LHL 0 80% 0384766 ARSENICUM IODATUM GLOBULE 15CH BOIRON 0 80% 0384766 ARSENICUM IODATUM GLOBULE 30CH BOIRON 0 80% 0384766 ARSENICUM ALBUM GLOBULES 7CH BOIRON 0 80% 0384766 ARSENICUM IODATUM GLOBULES 9CH BOIRON 0 80 % 0007886 ARTANE 2 MG 50 CPR 0 100% 0007919 ARTANE 5 MG 50 CPR 0 100% 0182341 ARTELAC COLLY 1 FL 10 ML 450 0225451 ARTELAC EDO COLLY 120 * 0,6 ML 40% 0 Mémorial B – N° 23 du 25 février 2016 40% 611 No national 0225434 Dénomination abrégée ARTELAC EDO COLLY 30 * 0,6 ML Prise en charge conditionnelle Taux de prise en charge 0 40% 0225448 ARTELAC EDO COLLY 60 * 0,6 ML 0 40% 0376554 ARTEOPTIC LA 2% COLLY 3 ML 0 80% 0399786 ARTEOPTIC LA 2% COLLY 3*3 ML 0 80% 0241861 ARTHROTEC 75 30 CPR 0 80% 0383514 ARUM TRIPHYLLUM 30 CH GRAN LHL 0 80% 0383514 ARUM TRIPHYLLUM 4 CH GRAN LHL 0 80% 0383514 ARUM TRIPHYLLUM 5 CH GRAN LHL 0 80% 0383514 ARUM TRIPHYLLUM 7 CH GRAN LHL 0 80% 0383514 ARUM TRIPHYLLUM 9 CH GRAN LHL 0 80% 0382551 ARUM TRIPHYLLUM GRAN 5 CH BOIRON 0 80% 0383514 ARUNDO DONAX 4 CH GRAN LHL 0 80% 0383514 ARUNDO DONAX 5 CH GRAN LHL 0 80% 0383514 ARUNDO DONAX 9 CH GRAN LHL 0 80% 0746266 ASA EG 100 MG 168 CPR 0 80% 0746221 ASA EG 100 MG 84 CPR 0 80% 0383514 ASA FOETIDA 15 CH GRAN LHL 0 80% 0383514 ASA FOETIDA 30 CH GRAN LHL 0 80% 0383514 ASA FOETIDA 4 CH GRAN LHL 0 80% 0383514 ASA FOETIDA 5 CH GRAN LHL 0 80% 0383514 ASA FOETIDA 7 CH GRAN LHL 0 80% 0383514 ASA FOETIDA 9 CH GRAN LHL 0 80% 0382632 ASA FOETIDA GRAN 5 CH BOIRON 0 80% 0382632 ASA FOETIDA GRAN 7 CH BOIRON 0 80% 0382632 ASA FOETIDA GRAN 9 CH BOIRON 0 80% 0169271 ASAFLOW 160 MG 56 CPR 0 80% 0251952 ASAFLOW 80 MG 56 CPR 0 80% 0383514 ASARUM EUROPAEUM 4 CH GRAN LHL 0 80% 0383514 ASARUM EUROPAEUM 5 CH GRAN LHL 0 80% 0285481 ASPEGIC 100 30 SACH BB 0 80% 0008351 ASPEGIC 1000 20 SACH 0 80% 0285494 ASPEGIC 250 30 SACH ENF 0 80% 0285513 ASPEGIC 500 30 SACH 0 80% 0008334 ASPEGIC 6 AMP 5 ML IMIV 0 80% 0147291 ASS + C RATIO 10 CPR EFF 0 40% 0147355 ASS + C RATIO 20 CPR EFF 0 40% 0195772 ASTONIN H 50 CPR 0 80% 0137412 ASTREXINE PDR 30 G 0 80% 0245096 ATACAND 16 MG 28 CPR 0 100% 0272112 ATACAND 16 MG 56 CPR 0 100% 0319432 ATACAND 16 MG 98 CPR 0 100% 0382209 ATACAND 32 MG 98 CPR 0 100% 0245082 ATACAND 8 MG 28 CPR 0 100% 0272093 ATACAND 8 MG 56 CPR 0 100% 0342525 ATACAND 8 MG 98 CPR 0 100% 0278621 ATACAND PLUS 16/12,5 28 CPR 0 100% 0278634 ATACAND PLUS 16/12,5 56 CPR 0 100% 0278648 ATACAND PLUS 16/12,5 98 CPR 0 100% 0008897 ATARAX 25 MG 50 CPR 0 40% 0155617 ATEHEXAL 100 MG 100 CPR 0 100% Mémorial B – N° 23 du 25 février 2016 612 No national Dénomination abrégée Prise en charge conditionnelle Taux de prise en charge 0208304 ATEHEXAL 100 MG 30 CPR 0 100% 0155603 ATEHEXAL 100 MG 50 CPR 0 100% 0237967 ATENOLOL EG 100 MG 28 CPR 0 100% 0237971 ATENOLOL EG 100 MG 56 CPR 0 100% 0237998 ATENOLOL EG 25 MG 28 CPR 0 100% 0238009 ATENOLOL EG 25 MG 56 CPR 0 100% 0238026 ATENOLOL EG 50 MG 28 CPR 0 100% 0238043 ATENOLOL EG 50 MG 56 CPR 0 100% 0238061 ATENOLOL/CHLORTALIDONE EG 28 CPR 0 100% 0238074 ATENOLOL/CHLORTALIDONE EG 56 CPR 0 100% 0659371 ATORASAT 80 MG 98 CPR 0 80% 0644932 ATORSTATINE EG 10 MG 100 CPR 0 80% 0644865 ATORSTATINE EG 10 MG 28 CPR 0 80% 0645067 ATORSTATINE EG 20 MG 100 CPR 0 80% 0644981 ATORSTATINE EG 20 MG 28 CPR 0 80% 0645165 ATORSTATINE EG 40 MG 100 CPR 0 80% 0645263 ATORSTATINE EG 80 MG 100 CPR 0 80% 0590456 ATORVASTATIN RATIO GMBH 10 MG 100 CPR 0 80% 0590389 ATORVASTATIN RATIO GMBH 10 MG 30 CPR 0 80% 0590392 ATORVASTATIN RATIO GMBH 10 MG 50 CPR 0 80% 0590618 ATORVASTATIN RATIO GMBH 20 MG 100 CPR 0 80% 0590541 ATORVASTATIN RATIO GMBH 20 MG 30 CPR 0 80% 0590554 ATORVASTATIN RATIO GMBH 20 MG 50 CPR 0 80% 0590778 ATORVASTATIN RATIO GMBH 40 MG 100 CPR 0 80% 0590697 ATORVASTATIN RATIO GMBH 40 MG 30 CPR 0 80% 0590702 ATORVASTATIN RATIO GMBH 40 MG 50 CPR 0 80% 0590943 ATORVASTATIN RATIO GMBH 80 MG 100 CPR 0 80% 0590859 ATORVASTATIN RATIO GMBH 80 MG 30 CPR 0 80% 0590862 ATORVASTATIN RATIO GMBH 80 MG 50 CPR 0 80% 0658096 ATORVASTATIN SDZ 10 MG 28 CPR 0 80% 0673349 ATORVASTATIN SDZ 10 MG 98 CPR 0 80% 0658194 ATORVASTATIN SDZ 20 MG 28 CPR 0 80% 0673366 ATORVASTATIN SDZ 20 MG 98 CPR 0 80% 0673416 ATORVASTATIN SDZ 40 MG 98 CPR 0 80% 0658521 ATORVASTATINE SDZ 10 MG 28 CPR 0 80% 0658678 ATORVASTATINE SDZ 10 MG 98 CPR 0 80% 0658759 ATORVASTATINE SDZ 20 MG 28 CPR 0 80% 0658907 ATORVASTATINE SDZ 20 MG 98 CPR 0 80% 0659143 ATORVASTATINE SDZ 40 MG 98 CPR 0 80% 0722717 ATOVAQUON/PROG RATIO 250/100MG 12CPR(PVC) 6 80% 0722586 ATOVAQUON/PROG RATIO 62,5/25MG 12CPR(PVC) 6 80% 0476353 ATRIPLA 30 CPR 0 100% 0226106 ATRONASE 0,3 MG/ML MICRODOS 1 FL 15 ML 0 80% 0009152 ATROPINSULFAT BRN 1 MG 10 AMP 1 ML V 0 80% 0214556 ATROVENT 0,25 MG 20 FL 2 ML UD IH 0 100% 0306787 ATROVENT 0,25 MG 60 FL 2 ML UD IH 0 100% 0214573 ATROVENT 0,5 MG 20 FL 2 ML UD IH 0 100% 0345222 ATROVENT HFA 20 MCG/D AER 10 ML 0 100% 0708086 AUBAGIO 14 MG 28 CPR (ETUI) 6 100% 0009300 AUGMENTIN 125/31,25 MG/5 ML SIR 80 ML 0 80% Mémorial B – N° 23 du 25 février 2016 613 No national 0009314 Dénomination abrégée AUGMENTIN 250/62,5 MG/5 ML SIR 80 ML Prise en charge conditionnelle Taux de prise en charge 0 80% 0009328 AUGMENTIN 500/125 MG 16 CPR (PLAQU.) 0 80% 0187834 AUGMENTIN 500/125 MG 16 SACH 0 80% 0697788 AUGMENTIN 875 PI-ES 875/125MG 20 CPR 0 80% 0265569 AUGMENTIN 875/125 MG 10 CPR (PLAQU.) 0 80% 0311773 AUGMENTIN 875/125 MG 20 CPR (PLAQU.) 0 80% 0340033 AUGMENTIN RET 1 G/62,5 MG 28 CPR 0 80% 0340047 AUGMENTIN RET 1 G/62,5 MG 40 CPR 0 80% 0009491 AUREOMYCINE 1% POM OPHT 5 G 0 80% 0170448 AURORIX 150 MG 100 CPR 0 80% 0384346 AURUM METALLICUM 12 CH DOSE LHL 0 80% 0383661 AURUM METALLICUM 12 CH GRAN LHL 0 80% 0384346 AURUM METALLICUM 15 CH DOSE LHL 0 80% 0383661 AURUM METALLICUM 15 CH GRAN LHL 0 80% 0384346 AURUM METALLICUM 30 CH DOSE LHL 0 80% 0383661 AURUM METALLICUM 30 CH GRAN LHL 0 80% 0383661 AURUM METALLICUM 4 CH GRAN LHL 0 80% 0383661 AURUM METALLICUM 5 CH GRAN LHL 0 80% 0384346 AURUM METALLICUM 7 CH DOSE LHL 0 80% 0383661 AURUM METALLICUM 7 CH GRAN LHL 0 80% 0384346 AURUM METALLICUM 9 CH DOSE LHL 0 80% 0383661 AURUM METALLICUM 9 CH GRAN LHL 0 80% 0383657 AURUM METALLICUM D 5 CPR LHL 0 80% 0383657 AURUM METALLICUM D 6 CPR LHL 0 80% 0384766 AURUM METALLICUM GLOBULES 15 CH BOIRON 0 80% 0384766 AURUM METALLICUM GLOBULES 7CH BOIRON 0 80% 0384766 AURUM METALLICUM GLOBULES 9 CH BOIRON 0 80% 0382551 AURUM METALLICUM GRAN 30 CH BOIRON 0 80% 0382551 AURUM METALLICUM GRAN 5 CH BOIRON 0 80% 0382551 AURUM METALLICUM GRAN 7 CH BOIRON 0 80% 0382551 AURUM METALLICUM GRAN 9 CH BOIRON 0 80% 0475759 AVAMYS 27,5 MCG SPRAY 120 D 0 80% 0281075 AVELOX 400 MG 10 CPR 0 80% 0292924 AVELOX 400 MG 5 CPR 0 80% 0383514 AVENA SATIVA 5 CH GRAN LHL 0 80% 0383514 AVENA SATIVA 7 CH GRAN LHL 0 80% 0343438 AVODART 0,5 MG 30 CAPS 0 80% 0233629 AVONEX 30 MCG (6MIO) PDR 4 FL UD 3 ML IM 0 100% 0624134 AVONEX 30 MCG 4 PEN 0,5ML+4AIG+4CAPUC 0 100% 0355375 AVONEX 30 MCG 4 SRG PRER 0,5 ML + 4 AIG 0 100% 0611315 AXURA 10 MG 42 CPR (ALU) 1 80% 0320285 AXURA 10 MG 50 CPR (ALU) 1 80% 0487469 AXURA 20 MG 42 CPR (ALU) 1 80% 0492343 AXURA 20 MG 98 CPR (ALU) 1 80% 0320318 AXURA 5 MG/HUB 1 FL 50 G 1 80% 0487519 AXURA STARTERPACK 4*7 CPR (ALU) 1 80% 0502288 AZARGA 10 MG/ML 5 MG/ML COLLY 3*5 ML 0 80% 0680147 AZATHIOPRIN SDZ 100 MG 100 CPR (FL) 0 100% 0780921 AZATHIOPRINE SDZ 50 MG 100 CPR (PP-ALU) 0 100% 0780965 AZATHIOPRINE SDZ 50 MG 100 CPR (PVC) 0 100% Mémorial B – N° 23 du 25 février 2016 614 No national 0780898 Dénomination abrégée AZATHIOPRINE SDZ 50 MG 30 CPR (PP-ALU) Prise en charge conditionnelle Taux de prise en charge 0 100% 100% 0780934 AZATHIOPRINE SDZ 50 MG 30 CPR (PVC) 0 0676774 AZELASTIN COMOD 0,5 MG/ML COLLY 10 ML 0 80% 0396561 AZILECT 1 MG 28 CPR 0 100% 0420571 AZITHROMYCIN RATIO 250 MG 6 CPR 0 80% 0420604 AZITHROMYCIN RATIO 500 MG 3 CPR 0 80% 0483246 AZITHROMYCINE EG 250 MG 6 CPR 0 80% 0483327 AZITHROMYCINE EG 500 MG 3 CPR 0 80% 0278343 AZOPT 1% COLLY 5 ML 0 80% 0477073 AZYTER 0,015% COLLY 6 UD 0 80% 0010346 BACTRIM FORTE 10 CPR 0 80% 0485139 BACTROBAN 2% POM 15 G 0 80% 0443786 BALSOCLASE ANTITUSSIVUM SS SUCRE SIR 200 0 40% 0383514 BAPTISIA 15 CH GRAN LHL 0 80% 0383514 BAPTISIA 4 CH GRAN LHL 0 80% 0383514 BAPTISIA 5 CH GRAN LHL 0 80% 0437162 BARACLUDE 0,5 MG 30 CPR 0 100% 0437193 BARACLUDE 1 MG 30 CPR 0 100% 0384685 BARYTA CARBONICA 12 CH DOSES LHL 0 80% 0383495 BARYTA CARBONICA 12 CH GRAN LHL 0 80% 0384685 BARYTA CARBONICA 15 CH DOSE LHL 0 80% 0383495 BARYTA CARBONICA 15 CH GRAN LHL 0 80% 0384685 BARYTA CARBONICA 30 CH DOSE LHL 0 80% 0383495 BARYTA CARBONICA 30 CH GRAN LHL 0 80% 0383495 BARYTA CARBONICA 4 CH GRAN LHL 0 80% 0383495 BARYTA CARBONICA 5 CH GRAN LHL 0 80% 0384685 BARYTA CARBONICA 7 CH DOSE LHL 0 80% 0383495 BARYTA CARBONICA 7 CH GRAN LHL 0 80% 0384685 BARYTA CARBONICA 9 CH DOSE LHL 0 80% 0383495 BARYTA CARBONICA 9 CH GRAN LHL 0 80% 0384766 BARYTA CARBONICA GLOBULES 12 CH BOIRON 0 80% 0384766 BARYTA CARBONICA GLOBULES 15 CH BOIRON 0 80% 0384766 BARYTA CARBONICA GLOBULES 7 CH BOIRON 0 80% 0384766 BARYTA CARBONICA GLOBULES 9 CH BOIRON 0 80% 0382551 BARYTA CARBONICA GRAN 15 CH BOIRON 0 80% 0382551 BARYTA CARBONICA GRAN 7 CH BOIRON 0 80% 0382551 BARYTA CARBONICA GRAN 9 CH BOIRON 0 80% 0383495 BARYTA IODATA 4 CH GRAN LHL 0 80% 0383495 BARYTA IODATA 9 CH GRAN LHL 0 80% 0383495 BARYTA MURIATICA 5 CH GRAN LHL 0 80% 0278228 BAUME PULMONAIRE SIR AD 250 ML 0 40% 0011116 BAYPRESS 20 MG 14 CPR 0 100% 0011133 BAYPRESS MITIS 10 MG 28 CPR 0 100% 0486797 BEENOS 70 MG 12 CPR 0 80% 0486783 BEENOS 70 MG 4 CPR 0 80% 0269281 BEFACT FORTE B1 B2 B6 B12 100 DRG 0 80% 0226561 BEFACT FORTE B1 B2 B6 B12 30 DRG 0 80% 0383514 BELLADONNA 12 CH GRAN LHL 0 80% 0384332 BELLADONNA 15 CH DOSES LHL 0 80% 0383514 BELLADONNA 15 CH GRAN LHL 0 80% Mémorial B – N° 23 du 25 février 2016 615 No national 0384332 Dénomination abrégée BELLADONNA 30 CH DOSES LHL Prise en charge conditionnelle Taux de prise en charge 0 80% 0383514 BELLADONNA 30 CH GRAN LHL 0 80% 0383514 BELLADONNA 4 CH GRAN LHL 0 80% 0383514 BELLADONNA 5 CH GRAN LHL 0 80% 0383514 BELLADONNA 7 CH GRAN LHL 0 80% 0384332 BELLADONNA 9 CH DOSE LHL 0 80% 0383514 BELLADONNA 9 CH GRAN LHL 0 80% 0384783 BELLADONNA GLOBULES 9 CH BOIRON 0 80% 0382632 BELLADONNA GRAN 15 CH BOIRON 0 80% 0382632 BELLADONNA GRAN 4 CH BOIRON 0 80% 0382632 BELLADONNA GRAN 5 CH BOIRON 0 80% 0382632 BELLADONNA GRAN 7 CH BOIRON 0 80% 0382632 BELLADONNA GRAN 9 CH BOIRON 0 80% 0383514 BELLIS PERENNIS 5 CH GRAN LHL 0 80% 0384332 BELLIS PERENNIS 7 CH DOSES LHL 0 80% 0384332 BELLIS PERENNIS 9 CH DOSES LHL 0 80% 0383514 BELLIS PERENNIS 9 CH GRAN LHL 0 80% 0592755 BELLOZAL 20 MG 30 CPR 0 80% 0592772 BELLOZAL 20 MG 50 CPR 0 80% 0359701 BELSAR 10 MG 28 CPR 0 100% 0359763 BELSAR 20 MG 28 CPR 0 100% 0359781 BELSAR 20 MG 98 CPR 0 100% 0359827 BELSAR 40 MG 28 CPR 0 100% 0359844 BELSAR 40 MG 98 CPR 0 100% 0422528 BELSAR PLUS 20/12,5 MG 28 CPR 0 100% 0422545 BELSAR PLUS 20/12,5 MG 98 CPR 0 100% 0422478 BELSAR PLUS 20/25 MG 28 CPR 0 100% 0422495 BELSAR PLUS 20/25 MG 98 CPR 0 100% 0569581 BELSAR PLUS 40/12,5 MG 28 CPR 0 100% 0569601 BELSAR PLUS 40/12,5 MG 98 CPR 0 100% 0569631 BELSAR PLUS 40/25 MG 28 CPR 0 100% 0569659 BELSAR PLUS 40/25 MG 98 CPR 0 100% 0779656 BEMFOLA 150 U/0,25 ML 1 STYLO PRER 0 80% 0779691 BEMFOLA 225 U/0,375 ML 1 STYLO PRER 0 80% 0779737 BEMFOLA 300 U/0,5 ML 1 STYLO PRER 0 80% 0779768 BEMFOLA 450 U/0,75 ML 1 STYLO PRER 0 80% 0779625 BEMFOLA 75 U/0,125 ML 1 STYLO PRER 0 80% 0011987 BENERVA 300 MG 20 CPR 0 80% 0259155 BENURON 1 G 10 SUPP 0 80% 0259111 BENURON 125 MG 10 SUPP 0 80% 0262486 BENURON 200 MG/5 ML SIR 100 ML 0 80% 0259124 BENURON 250 MG 10 SUPP 0 80% 0259141 BENURON 500 MG 20 CPR 0 80% 0183107 BENZAC 10% GEL 40 G 0 80% 0183111 BENZAC 5% GEL 40 G 0 80% 0523579 BENZADERMINE GEL 1 POT + S 0 80% 0383495 BENZOICUM ACIDUM 4 CH GRAN LHL 0 80% 0383495 BENZOICUM ACIDUM 5 CH GRAN LHL 0 80% 0193361 BERBERIL N COLLY 10 ML 0 80% 0277007 BERBERIL N EDO COLLY 10*0,5 ML 0 80% Mémorial B – N° 23 du 25 février 2016 616 No national 0277011 Dénomination abrégée BERBERIL N EDO COLLY 20*0,5 ML Prise en charge conditionnelle Taux de prise en charge 0 80% 0383514 BERBERIS VULGARIS 12 CH GRAN LHL 0 80% 0383514 BERBERIS VULGARIS 15 CH GRAN LHL 0 80% 0383514 BERBERIS VULGARIS 4 CH GRAN LHL 0 80% 0383514 BERBERIS VULGARIS 5 CH GRAN LHL 0 80% 0384332 BERBERIS VULGARIS 7 CH DOSES LHL 0 80% 0383514 BERBERIS VULGARIS 7 CH GRAN LHL 0 80% 0384332 BERBERIS VULGARIS 9 CH DOSE LHL 0 80% 0383514 BERBERIS VULGARIS 9 CH GRAN LHL 0 80% 0383612 BERBERIS VULGARIS D 1 MG 125 ML LHL 0 80% 0384945 BERBERIS VULGARIS D 1 MG 60 ML LHL 0 80% 0382632 BERBERIS VULGARIS GRAN 4 CH BOIRON 0 80% 0382632 BERBERIS VULGARIS GRAN 5 CH BOIRON 0 80% 0274957 BETAFERON 8 MIO U PDR 15 FL + 15 SRG SC 0 100% 0217138 BETAFERON 8 MIO U PDR 15 FL + S 2 ML SC 0 100% 0441456 BETAFERON 8 MIO U PDR 15FL+15SRG+15ADAPT 0 100% 0142586 BETAGAN 0,5% COLLY 5 ML 0 80% 0136818 BETAHISTINE EG 6 MG 100 CPR 0 80% 0012760 BETAMINE 500 MG 50 DRG 0 80% 0162947 BETASERC 16 MG 42 CPR SEC 0 80% 0176781 BETASERC 16 MG 84 CPR SEC 0 80% 0012807 BETASERC 8 MG 100 CPR 0 80% 0689173 BETMIGA 25 MG 30 CPR 0 80% 0689191 BETMIGA 25 MG 90 CPR 0 80% 0689254 BETMIGA 50 MG 30 CPR 0 80% 0689271 BETMIGA 50 MG 90 CPR 0 80% 0012886 BETNELAN V 0,1% CREME 30 G 0 80% 0012919 BETNELAN V 0,1% LOTION 30 ML 0 80% 0012936 BETNELAN V 0,1% ONG 30 G 0 80% 0013088 BETOPTIC 0,5% COLLY 5 ML 0 80% 0193666 BETOPTIC SUSP 0,25% COLLY 5 ML 0 80% 0383612 BETULA VERRUCOSA D 1 MG 125 ML LHL 0 80% 0384945 BETULA VERRUCOSA D 1 MG 60 ML LHL 0 80% 0389373 BEZAFIBRAT HEXAL RET 400 MG 100 CPR 0 80% 0389356 BEZAFIBRAT HEXAL RET 400 MG 30 CPR 0 80% 0461333 BICALUTAMID RATIO 50 MG 30 CPR 0 100% 0461364 BICALUTAMID RATIO 50 MG 90 CPR 0 100% 0628942 BICALUTAMIDE EG 150 MG 100 CPR 0 100% 0519965 BICALUTAMIDE EG 50 MG 100 CPR 0 100% 0519948 BICALUTAMIDE EG 50 MG 28 CPR 0 100% 0466151 BICALUTAMIDE TEVA 50 MG 56 CPR 0 100% 0205509 BICLAR 125 BEBE SIR 60 ML 0 80% 0225465 BICLAR 125 JR SIR 120 ML 0 80% 0171154 BICLAR 250 MG 10 CPR 0 80% 0221323 BICLAR 500 MG PDR 1 FL IV 0 80% 0221337 BICLAR FORTE 500 MG 10 CPR 0 80% 0289395 BICLAR KIDS 250 MG/5 ML GRAN SIROP 80 ML 0 80% 0409509 BICLAR UNO 500 MG 10 CPR 0 80% 0409512 BICLAR UNO 500 MG 20 CPR 0 80% 0013317 BIFITERAL 500 ML 0 40% Mémorial B – N° 23 du 25 février 2016 617 No national Dénomination abrégée Prise en charge conditionnelle Taux de prise en charge 0228341 BIOFENAC 100 MG 20 CPR 0 80% 0228355 BIOFENAC 100 MG 60 CPR 0 80% 0013799 BIOMAGNESIN 100 CPR 0 80% 0140693 BIROFENID 150 MG 30 CPR 0 80% 0451418 BISOLAX 5 MG 40 CPR 0 40% 0014328 BISOLVON 0,2% SOL INH 100 ML 0 80% 0162687 BISOLVON 0,2% SOL OR 100 ML 0 40% 0014295 BISOLVON 8 MG 50 CPR 0 40% 0014314 BISOLVON 8 MG/5 ML SIR 200 ML 0 40% 0778645 BISOPROLOL EG 10 MG 100 CPR 0 100% 0778614 BISOPROLOL EG 10 MG 30 CPR 0 100% 0778631 BISOPROLOL EG 10 MG 60 CPR 0 100% 0757628 BISOPROLOL EG 2,5 MG 100 CPR 0 100% 0757578 BISOPROLOL EG 2,5 MG 30 CPR 0 100% 0757601 BISOPROLOL EG 2,5 MG 60 CPR 0 100% 0778578 BISOPROLOL EG 5 MG 100 CPR 0 100% 0778547 BISOPROLOL EG 5 MG 30 CPR 0 100% 0778564 BISOPROLOL EG 5 MG 60 CPR 0 100% 0659949 BISOPROLOL SDZ 10 MG 28 CPR 0 100% 0659983 BISOPROLOL SDZ 10 MG 56 CPR 0 100% 0660015 BISOPROLOL SDZ 10 MG 98 CPR 0 100% 0659644 BISOPROLOL SDZ 2,5 MG 100 CPR 0 100% 0659563 BISOPROLOL SDZ 2,5 MG 30 CPR 0 100% 0659613 BISOPROLOL SDZ 2,5 MG 60 CPR 0 100% 0659791 BISOPROLOL SDZ 5 MG 28 CPR 0 100% 0659837 BISOPROLOL SDZ 5 MG 56 CPR 0 100% 0659868 BISOPROLOL SDZ 5 MG 98 CPR 0 100% 0366804 BLANEL 48 CPR EFF 0 80% 0366818 BLANEL 96 CPR EFF 0 80% 0355716 BONDRONAT 50 MG 84 CPR 0 80% 0244538 BONEFOS 800 MG 50 CPR 0 80% 0703711 BONENDRO 70+1000MG/880U 12 CPR+12*6 SACH 0 80% 0744745 BONENDRO 70+500 MG/880U 12CPR+12*6 SACH 0 80% 0409414 BONVIVA 150 MG 3 CPR 0 80% 0432247 BONVIVA 3 MG PERF 1 SRG 3 ML IV 0 80% 0384685 BORAX 12 CH DOSES LHL 0 80% 0383495 BORAX 15 CH GRAN LHL 0 80% 0383495 BORAX 30 CH GRAN LHL 0 80% 0383495 BORAX 4 CH GRAN LHL 0 80% 0383495 BORAX 5 CH GRAN LHL 0 80% 0383495 BORAX 7 CH GRAN LHL 0 80% 0383495 BORAX 9 CH GRAN LHL 0 80% 0382551 BORAX GRAN 4 CH BOIRON 0 80% 0382551 BORAX GRAN 5 CH BOIRON 0 80% 0383514 BOVISTA 7 CH GRAN LHL 0 80% 0383514 BOVISTA GIGANTEA 5 CH GRAN LHL 0 80% 0382632 BOVISTA GIGANTEA GRAN 5 CH BOIRON 0 80% 0382632 BOVISTA GIGANTEA GRAN 9 CH BOIRON 0 80% 0014944 BRAUNODERM 1/100 G SOL 1000 ML 0 80% 0014992 BRAUNOL 7,5/100 G 1 FL HDPE 1000 ML 0 80% Mémorial B – N° 23 du 25 février 2016 618 No national 0014989 Dénomination abrégée BRAUNOL 7,5/100 G 1 FL HDPE 250 ML Prise en charge conditionnelle Taux de prise en charge 0 80% 0186594 BRAUNOL 7,5/100 G 1 FL HDPE 30 ML 0 80% 0015065 BRAUNOVIDON 10% 10*20 CM 10 COMPR IMPREG 0 80% 0015048 BRAUNOVIDON 10% 7,5*10 CM 10 COMPR IMPRE 0 80% 0015115 BRAUNOVIDON POM 100 G 0 80% 0015101 BRAUNOVIDON POM 20 G 0 80% 0667243 BRETARIS GENUAIR 322 MCG/D 60 D IH 0 100% 0177662 BREXINE 20 MG 30 CPR 0 80% 0267627 BREXINE DRYFIZ 20 MG 30 CPR EFF 0 80% 0591307 BRILIQUE 90 MG 168 CPR 1 80% 0591291 BRILIQUE 90 MG 56 CPR 1 80% 0015583 BROMAZEPAM EG 12 MG 50 CPR 0 40% 0689092 BROMAZEPAM EG 12 MG 60 CPR 0 40% 0015597 BROMAZEPAM EG 6 MG 50 CPR 0 40% 0689089 BROMAZEPAM EG 6 MG 60 CPR 0 40% 0136821 BROMHEXINE EG 8 MG 50 CPR 0 40% 0383495 BROMUM 15 CH GRAN LHL 0 80% 0383495 BROMUM 4 CH GRAN LHL 0 80% 0383495 BROMUM 5 CH GRAN LHL 0 80% 0383495 BROMUM 7 CH GRAN LHL 0 80% 0383495 BROMUM 9 CH GRAN LHL 0 80% 0016109 BRUFEN 400 MG 100 CPR 0 80% 0571917 BRUFEN 600 MG GRAN 40 SACH 0 80% 0016126 BRUFEN FORTE 600 MG 30 CPR 0 80% 0512057 BRUFEN FORTE 600 MG 60 CPR 0 80% 0180718 BRUFEN RET 800 MG 28 CPR 0 80% 0201978 BRUFEN RET 800 MG 60 CPR 0 80% 0383514 BRYONIA ALBA 4 CH GRAN (CF:DIOICA) LHL 0 80% 0383514 BRYONIA ALBA 5 CH GRAN (CF:DIOICA) LHL 0 80% 0383514 BRYONIA ALBA 7 CH GRAN (CF:DIOICA) LHL 0 80% 0384332 BRYONIA DIOICA (ALBA) 12 CH DOSE 0 80% LHL 0384332 BRYONIA DIOICA (ALBA) 15 CH DOSE LHL 0 80% 0383514 BRYONIA DIOICA (ALBA) 15 CH GRAN LHL 0 80% 0384332 BRYONIA DIOICA (ALBA) 30 CH DOSE LHL 0 80% 0383514 BRYONIA DIOICA (ALBA) 3O CH GRAN LHL 0 80% 0383514 BRYONIA DIOICA (ALBA) 4 CH GRAN LHL 0 80% 0383514 BRYONIA DIOICA (ALBA) 5 CH GRAN LHL 0 80% 0384332 BRYONIA DIOICA (ALBA) 7 CH DOSE LHL 0 80% 0383514 BRYONIA DIOICA (ALBA) 7 CH GRAN LHL 0 80% 0384332 BRYONIA DIOICA (ALBA) 9 CH DOSE LHL 0 80% 0383514 BRYONIA DIOICA (ALBA) 9 CH GRAN LHL 0 80% 0384783 BRYONIA GLOBULE 12CH BOIRON 0 80% 0384783 BRYONIA GLOBULE 15CH BOIRON 0 80% 0384783 BRYONIA GLOBULE 30CH BOIRON 0 80% 0384783 BRYONIA GLOBULES 9CH BOIRON 0 80% 0382632 BRYONIA GRAN 12 CH BOIRON 0 80% 0382632 BRYONIA GRAN 15 CH BOIRON 0 80% 0382632 BRYONIA GRAN 30 CH BOIRON 0 80% 0382632 BRYONIA GRAN 4CH BOIRON 0 80% 0382632 BRYONIA GRAN 5 CH BOIRON 0 80% Mémorial B – N° 23 du 25 février 2016 619 No national 0382632 Dénomination abrégée BRYONIA GRAN 7 CH BOIRON Prise en charge conditionnelle Taux de prise en charge 0 80% 0382632 BRYONIA GRAN 9 CH BOIRON 0 80% 0384332 BRYOPHYLLUM 9 CH DOSES LHL 0 80% 0286278 BUDENOFALK 3 MG 100 CAPS 0 80% 0757645 BUFOMIX EASYHALER 160/4,5 MCG INH 120 D 0 100% 0757676 BUFOMIX EASYHALER 320/9 MCG INH 60 D 0 100% 0248568 BURINEX 1 MG 30 CPR 0 80% 0160571 BURINEX 2 MG 5 AMP 4 ML IMIV 0 80% 0160553 BURINEX 5 MG 20 CPR 0 80% 0016451 BUSCOPAN 10 MG 50 DRG 0 80% 0016482 BUSCOPAN 10 MG 6 SUPP 0 80% 0722829 BUSCOPAN 20 MG 30 CPR 0 80% 0016465 BUSCOPAN 20 MG 6 AMP 1 ML IMIVSC 0 80% 0768277 BYDUREON 2 MG PSV 4 STYLOS PRER UD 0 100% 0617014 BYDUREON 2 MG PSV 4*1 KIT UD 0 100% 0454163 BYETTA 10 MCG 1 STYLO 2,4 ML SC 0 100% 0454132 BYETTA 5 MCG 1 STYLO 1,2 ML SC 0 100% 0219048 CACIT VIT D3 1 G/880 U GRAN 30 SACH 0 80% 0219021 CACIT VIT D3 500 MG/440 U GRAN 30 SACH 0 80% 0383514 CACTUS GRANDIFLORUM 4 CH GRAN LHL 0 80% 0383514 CACTUS GRANDIFLORUM 7 CH GRAN LHL 0 80% 0383514 CACTUS GRANDIFLORUS 5 CH GRAN LHL 0 80% 0383514 CACTUS GRANDIFLORUS 9 CH GRAN LHL 0 80% 0384332 CALADIUM SEGUINUM 15 CH DOSES LHL 0 80% 0383514 CALADIUM SEGUINUM 5 CH GRAN LHL 0 80% 0383514 CALADIUM SEGUINUM 9 CH GRAN LHL 0 80% 0382632 CALADIUM SEGUINUM GRAN 15 CH BOIRON 0 80% 0382632 CALADIUM SEGUINUM GRAN 7 CH BOIRON 0 80% 0382632 CALADIUM SEGUINUM GRAN 9 CH BOIRON 0 80% 0384332 CALADIUM SEGUINUN 9 CH DOSES LHL 0 80% 0016921 CALADRYL CREME 42 G 0 40% 0016935 CALADRYL LOT 100 ML 0 40% 0258341 CALAMINE GEL 50 ML 0 80% 0384685 CALCAREA ACETICA 9 CH DOSES LHL 0 80% 0384685 CALCAREA CARBONICA 12 CH DOSE LHL 0 80% 0383495 CALCAREA CARBONICA 12 CH GRAN LHL 0 80% 0384685 CALCAREA CARBONICA 15 CH DOSE LHL 0 80% 0383495 CALCAREA CARBONICA 15 CH GRAN LHL 0 80% 0384685 CALCAREA CARBONICA 30 CH DOSE LHL 0 80% 0383495 CALCAREA CARBONICA 30 CH GRAN LHL 0 80% 0383495 CALCAREA CARBONICA 4 CH GRAN LHL 0 80% 0383495 CALCAREA CARBONICA 5 CH GRAN LHL 0 80% 0384685 CALCAREA CARBONICA 7 CH DOSE LHL 0 80% 0383495 CALCAREA CARBONICA 7 CH GRAN LHL 0 80% 0384685 CALCAREA CARBONICA 9 CH DOSE LHL 0 80% 0383495 CALCAREA CARBONICA 9 CH GRAN LHL 0 80% 0384931 CALCAREA CARBONICA D 12 CPR LHL 0 80% 0384931 CALCAREA CARBONICA D 6 CPR LHL 0 80% 0384931 CALCAREA CARBONICA D 8 CPR LHL 0 80% 0384766 CALCAREA CARBONICA GLOBULE 12CH BOIRON 0 80% Mémorial B – N° 23 du 25 février 2016 620 No national 0384766 Dénomination abrégée CALCAREA CARBONICA GLOBULE 15CH BOIRON Prise en charge conditionnelle Taux de prise en charge 0 80% 0384766 CALCAREA CARBONICA GLOBULE 30CH BOIRON 0 80% 0384766 CALCAREA CARBONICA GLOBULES 7CH BOIRON 0 80% 0384766 CALCAREA CARBONICA GLOBULES 9CH BOIRON 0 80% 0382551 CALCAREA CARBONICA GRANULE 12CH BOIRON 0 80% 0382551 CALCAREA CARBONICA GRANULE 15CH BOIRON 0 80% 0382551 CALCAREA CARBONICA GRANULE 30CH BOIRON 0 80% 0382551 CALCAREA CARBONICA GRANULES 5CH BOIRON 0 80% 0382551 CALCAREA CARBONICA GRANULES 7CH BOIRON 0 80% 0382551 CALCAREA CARBONICA GRANULES 9CH BOIRON 0 80% 0383495 CALCAREA FLUORICA 12 CH GRAN LHL 0 80% 0384685 CALCAREA FLUORICA 15 CH DOSE LHL 0 80% 0383495 CALCAREA FLUORICA 15 CH GRAN LHL 0 80% 0384685 CALCAREA FLUORICA 30 CH DOSE LHL 0 80% 0383495 CALCAREA FLUORICA 30 CH GRAN LHL 0 80% 0383495 CALCAREA FLUORICA 4 CH GRAN LHL 0 80% 0383495 CALCAREA FLUORICA 5 CH GRAN LHL 0 80% 0384685 CALCAREA FLUORICA 7 CH DOSE LHL 0 80% 0383495 CALCAREA FLUORICA 7 CH GRAN LHL 0 80% 0384685 CALCAREA FLUORICA 9 CH DOSE LHL 0 80% 0383495 CALCAREA FLUORICA 9 CH GRAN LHL 0 80% 0384931 CALCAREA FLUORICA D 12 CPR LHL 0 80% 0384931 CALCAREA FLUORICA D 6 CPR LHL 0 80% 0384766 CALCAREA FLUORICA GLOBULE 12CH BOIRON 0 80% 0384766 CALCAREA FLUORICA GLOBULE 15CH BOIRON 0 80% 0384766 CALCAREA FLUORICA GLOBULE 30CH BOIRON 0 80% 0384766 CALCAREA FLUORICA GLOBULES 7CH BOIRON 0 80% 0384766 CALCAREA FLUORICA GLOBULES 9CH BOIRON 0 80% 0382551 CALCAREA FLUORICA GRANULE 15CH BOIRON 0 80% 0382551 CALCAREA FLUORICA GRANULES 5CH BOIRON 0 80% 0382551 CALCAREA FLUORICA GRANULES 7CH BOIRON 0 80% 0384685 CALCAREA HYPOPHOS 12 CH DOSES LHL 0 80% 0384685 CALCAREA HYPOPHOS 9 CH DOSES LHL 0 80% 0383495 CALCAREA PHOSPHORICA 12 CH GRAN LHL 0 80% 0384685 CALCAREA PHOSPHORICA 15 CH DOSE LHL 0 80% 0383495 CALCAREA PHOSPHORICA 15 CH GRAN LHL 0 80% 0384685 CALCAREA PHOSPHORICA 30 CH DOSE LHL 0 80% 0383495 CALCAREA PHOSPHORICA 30 CH GRAN LHL 0 80% 0383495 CALCAREA PHOSPHORICA 4 CH GRAN LHL 0 80% 0383495 CALCAREA PHOSPHORICA 5 CH GRAN LHL 0 80% 0384685 CALCAREA PHOSPHORICA 7 CH DOSE LHL 0 80% 0383495 CALCAREA PHOSPHORICA 7 CH GRAN LHL 0 80% 0384685 CALCAREA PHOSPHORICA 9 CH DOSE LHL 0 80% 0383495 CALCAREA PHOSPHORICA 9 CH GRAN LHL 0 80% 0384931 CALCAREA PHOSPHORICA D 12 CPR LHL 0 80% 0384931 CALCAREA PHOSPHORICA D 6 CPR LHL 0 80% 0384766 CALCAREA PHOSPHORICA GLOBULE 15CH BOIRON 0 80% 0384766 CALCAREA PHOSPHORICA GLOBULE 30CH BOIRON 0 80% 0384766 CALCAREA PHOSPHORICA GLOBULES 9CH BOIRON 0 80% 0382551 CALCAREA PHOSPHORICA GRAN 12 CH BOIRON 0 80% Mémorial B – N° 23 du 25 février 2016 621 No national 0382551 Dénomination abrégée CALCAREA PHOSPHORICA GRAN 15 CH BOIRON Prise en charge conditionnelle Taux de prise en charge 0 80% 0382551 CALCAREA PHOSPHORICA GRAN 4 CH BOIRON 0 80% 0382551 CALCAREA PHOSPHORICA GRAN 5 CH BOIRON 0 80% 0382551 CALCAREA PHOSPHORICA GRAN 7 CH BOIRON 0 80% 0382551 CALCAREA PHOSPHORICA GRAN 9 CH BOIRON 0 80% 0384685 CALCAREA PHOSPORICA 12 CH DOSE LHL 0 80% 0383495 CALCAREA PICRATA 4 CH GRAN LHL 0 80% 0383495 CALCAREA PICRATA 5 CH GRAN LHL 0 80% 0384685 CALCAREA SULFURICA 15 CH DOSES LHL 0 80% 0383495 CALCAREA SULFURICA 15 CH GRAN LHL 0 80% 0383495 CALCAREA SULFURICA 30 CH GRAN LHL 0 80% 0383495 CALCAREA SULFURICA 4 CH GRAN LHL 0 80% 0383495 CALCAREA SULFURICA 5 CH GRAN LHL 0 80% 0383495 CALCAREA SULFURICA 7 CH GRAN LHL 0 80% 0383495 CALCAREA SULFURICA 9 CH GRAN LHL 0 80% 0384931 CALCAREA SULFURICA D 12 CPR LHL 0 80% 0384931 CALCAREA SULFURICA D 6 CPR LHL 0 80% 0647691 CALCI BONE D3 1000/880 ORANGE 3*30 CPR 0 80% 0647643 CALCI BONE D3 1000/880 ORANGE 30 CPR 0 80% 0211473 CALCICHEW 500 MG 100 CPR (FL) 0 80% 0380106 CALCIFORTE VIT D3 500 MG 400 U 60 CPR 0 80% 0525671 CALCIGEN D FORTE 1000MG 880U 20 CPR EFF 0 80% 0525685 CALCIGEN D FORTE 1000MG 880U 40 CPR EFF 0 80% 0017400 CALCIUM SDZ FORT 1000 MG 20 CPR EFF 0 80% 0428907 CALCIUMACETAT NEFRO 500 MG 100 CPR 0 100% 0428911 CALCIUMACETAT NEFRO 500 MG 200 CPR 0 100% 0428938 CALCIUMACETAT NEFRO 700 MG 100 CPR 0 100% 0428941 CALCIUMACETAT NEFRO 700 MG 200 CPR 0 100% 0063546 CALCORT 30 MG 10 CPR 0 80% 0156063 CALCORT 30 MG 20 CPR 0 80% 0063563 CALCORT 6 MG 20 CPR 0 80% 0154749 CALCORT 6 MG 60 CPR 0 80% 0383514 CALENDULA 30 CH GRAN LHL 0 80% 0383514 CALENDULA 4 CH GRAN LHL 0 80% 0383514 CALENDULA 5 CH GRAN LHL 0 80% 0383514 CALENDULA 7 CH GRAN LHL 0 80% 0201723 CALMDAY 10 MG 30 DRG 0 40% 0204174 CALMDAY 10 MG 60 DRG 0 40% 0017476 CALMDAY 5 MG 30 DRG 0 40% 0017493 CALMDAY 5 MG 60 DRG 0 40% 0241696 CALPEROS 500 MG 60 CPR 0 80% 0241648 CALPEROS D3 60 CPR A SUCER 0 80% 0140726 CAMCOLIT 400 MG 100 CPR 0 80% 0383495 CAMPHORA 15 CH GRAN LHL 0 80% 0383495 CAMPHORA 4 CH GRAN LHL 0 80% 0383495 CAMPHORA 5 CH GRAN LHL 0 80% 0384685 CAMPHORA 7 CH DOSES LHL 0 80% 0383495 CAMPHORA 7 CH GRAN LHL 0 80% 0383495 CAMPHORA 9 CH GRAN LHL 0 80% 0328719 CAMPRAL 333 MG 168 CPR 0 80% Mémorial B – N° 23 du 25 février 2016 622 No national Dénomination abrégée Prise en charge conditionnelle Taux de prise en charge 0215438 CAMPRAL 333 MG 84 CPR 0 80% 0629158 CANDESARTAN COMP RATIO 16/12,5 MG 28 CPR 0 100% 0629175 CANDESARTAN COMP RATIO 16/12,5 MG 56 CPR 0 100% 0629208 CANDESARTAN COMP RATIO 16/12,5 MG 98 CPR 0 100% 0660239 CANDESARTAN COMP RATIO 32/12,5 28 CPR 0 100% 0660256 CANDESARTAN COMP RATIO 32/12,5 56 CPR 0 100% 0660291 CANDESARTAN COMP RATIO 32/12,5 98 CPR 0 100% 0660371 CANDESARTAN COMP RATIO 32/25 28 CPR 0 100% 0660399 CANDESARTAN COMP RATIO 32/25 56 CPR 0 100% 0660421 CANDESARTAN COMP RATIO 32/25 98 CPR 0 100% 0629063 CANDESARTAN COMP RATIO 8/12,5 MG 28 CPR 0 100% 0629081 CANDESARTAN COMP RATIO 8/12,5 MG 56 CPR 0 100% 0629127 CANDESARTAN COMP RATIO 8/12,5 MG 98 CPR 0 100% 0637258 CANDESARTAN EG 16 MG 28 CPR 0 100% 0637308 CANDESARTAN EG 16 MG 98 CPR 0 100% 0637499 CANDESARTAN EG 32 MG 98 CPR 0 100% 0637065 CANDESARTAN EG 8 MG 28 CPR 0 100% 0637115 CANDESARTAN EG 8 MG 98 CPR 0 100% 0636881 CANDESARTAN PLUS HCT EG 16/12,5MG 28 CPR 0 100% 0636944 CANDESARTAN PLUS HCT EG 16/12,5MG 98 CPR 0 100% 0602591 CANDESARTAN RATIO 16 MG 28 CPR 0 100% 0602611 CANDESARTAN RATIO 16 MG 56 CPR 0 100% 0602641 CANDESARTAN RATIO 16 MG 98 CPR 0 100% 0602672 CANDESARTAN RATIO 32 MG 28 CPR 0 100% 0602705 CANDESARTAN RATIO 32 MG 56 CPR 0 100% 0602736 CANDESARTAN RATIO 32 MG 98 CPR 0 100% 0602414 CANDESARTAN RATIO 4 MG 28 CPR 0 100% 0602431 CANDESARTAN RATIO 4 MG 56 CPR 0 100% 0602462 CANDESARTAN RATIO 4 MG 98 CPR 0 100% 0602509 CANDESARTAN RATIO 8 MG 28 CPR 0 100% 0602526 CANDESARTAN RATIO 8 MG 56 CPR 0 100% 0602561 CANDESARTAN RATIO 8 MG 98 CPR 0 100% 0384332 CANDIDA ALBICANS 12 CH DOSES LHL 0 80% 0384332 CANDIDA ALBICANS 15 CH DOSES LHL 0 80% 0383514 CANDIDA ALBICANS 30 CH GRAN LHL 0 80% 0384332 CANDIDA ALBICANS 7 CH DOSES LHL 0 80% 0384332 CANDIDA ALBICANS 9 CH DOSE LHL 0 80% 0383514 CANDIDA ALBICANS 9 CH GRAN LHL 0 80% 0017915 CANDIO HERMAL CREME 20 G 0 80% 0017977 CANDIO HERMAL SUSP BUV 24 ML 0 80% 0434161 CANDIZOLE 150 MG 1 CAPS 0 80% 0434143 CANDIZOLE 200 MG 10 CAPS 0 80% 0434157 CANDIZOLE 200 MG 20 CAPS 0 80% 0434188 CANDIZOLE 50 MG 10 CAPS 0 80% 0385147 CANESTENE DERM BIFONAZOLE 1% CREME 15 G 0 80% 0051223 CANESTENE GYN CLOTRIMAZ 2% CR 20G +3APPL 0 80% 0051187 CANESTENE GYN CLOTRIMAZOLE 100 MG 6 CPR 0 80% 0018358 CANTABILINE 90 CAPS 0 40% 0667891 CAPECITABINE TEVA 150 MG 60 CPR 0 100% 0667906 CAPECITABINE TEVA 500 MG 120 CPR 0 100% Mémorial B – N° 23 du 25 février 2016 623 No national Dénomination abrégée Prise en charge conditionnelle Taux de prise en charge 0230577 CAPOTEN 25 MG 60 CPR 0 100% 100% 0230581 CAPOTEN 50 MG 60 CPR 0 0384332 CAPSICUM ANNUUM 12 CH DOSES LHL 0 80% 0384332 CAPSICUM ANNUUM 15 CH DOSES LHL 0 80% 0383514 CAPSICUM ANNUUM 15 CH GRAN LHL 0 80% 0384332 CAPSICUM ANNUUM 30 CH DOSES LHL 0 80% 0383514 CAPSICUM ANNUUM 30 CH GRAN LHL 0 80% 0383514 CAPSICUM ANNUUM 4 CH GRAN LHL 0 80% 0383514 CAPSICUM ANNUUM 5 CH GRAN LHL 0 80% 0383514 CAPSICUM ANNUUM 7 CH GRAN LHL 0 80% 0383514 CAPSICUM ANNUUM 9 CH GRAN LHL 0 80% 0382632 CAPSICUM ANNUUM GRANULES 7CH BOIRON 0 80% 0214184 CAPTOHEXAL 25 MG 100 CPR 0 100% 0214167 CAPTOHEXAL 25 MG 20 CPR 0 100% 0214171 CAPTOHEXAL 25 MG 50 CPR 0 100% 0214217 CAPTOHEXAL 50 MG 100 CPR 0 100% 0214198 CAPTOHEXAL 50 MG 20 CPR 0 100% 0214203 CAPTOHEXAL 50 MG 50 CPR 0 100% 0214248 CAPTOHEXAL COR 12,5 MG 100 …