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En bref

Cette loi est une liste de médicaments qui sont inscrits à la liste positive pour le remboursement par la sécurité sociale au Luxembourg. Elle indique le taux de prise en charge pour chaque médicament.

Ce qu'elle réglemente

Les médicaments éligibles au remboursement par la sécurité sociale.
Le taux de prise en charge (pourcentage remboursé) pour chaque médicament.
La situation des médicaments au 1er janvier 2016.
L'application de l'article 22, alinéa premier, du Code de la sécurité sociale.

Qui elle concerne

Les personnes assurées par la sécurité sociale au Luxembourg.
Les pharmacies et les professionnels de la santé qui délivrent ces médicaments.

Points clés

Les taux de prise en charge varient, étant de 40%, 80% ou 100% pour les médicaments listés.
Certains médicaments ont une "Prise en charge conditionnelle" indiquée par un chiffre (par exemple, 6 pour ALMOGRAN 12,5 MG).
La liste inclut des médicaments avec des dénominations abrégées, des dosages et des formes diverses (comprimés, capsules, crèmes, solutions, etc.).
La situation des médicaments est celle au 1er janvier 2016.

Texte de loi

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 CPR 0 100% 0214221 CAPTOHEXAL COR 12,5 MG 20 CPR 0 100% 0214234 CAPTOHEXAL COR 12,5 MG 50 CPR 0 100% 0451385 CAPTOPRIL EG 100 MG 30 CPR 0 100% 0451404 CAPTOPRIL EG 100 MG 60 CPR 0 100% 0455949 CAPTOPRIL EG 25 MG 60 CPR 0 100% 0482414 CAPTOPRIL EG 50 MG 60 CPR 0 100% 0708461 CAPTOPRIL MYLAN 100 MG 30 CPR 0 100% 0708475 CAPTOPRIL MYLAN 100 MG 60 CPR 0 100% 0384685 CARBO VEGETABILIS 12 CH DOSES LHL 0 80% 0383495 CARBO VEGETABILIS 12 CH GRAN LHL 0 80% 0384685 CARBO VEGETABILIS 15 CH DOSE LHL 0 80% 0383495 CARBO VEGETABILIS 15 CH GRAN LHL 0 80% 0384685 CARBO VEGETABILIS 30 CH DOSE LHL 0 80% 0383495 CARBO VEGETABILIS 30 CH GRAN LHL 0 80% 0383495 CARBO VEGETABILIS 4 CH GRAN LHL 0 80% 0383495 CARBO VEGETABILIS 5 CH GRAN LHL 0 80% 0384685 CARBO VEGETABILIS 7 CH DOSES LHL 0 80% 0383495 CARBO VEGETABILIS 7 CH GRAN LHL 0 80% 0384685 CARBO VEGETABILIS 9 CH DOSE LHL 0 80% 0383495 CARBO VEGETABILIS 9 CH GRAN LHL 0 80% 0382551 CARBO VEGETABILIS GRANULE 15CH BOIRON 0 80% 0382551 CARBO VEGETABILIS GRANULES 4CH BOIRON 0 80% 0382551 CARBO VEGETABILIS GRANULES 5CH BOIRON 0 80% 0382551 CARBO VEGETABILIS GRANULES 7CH BOIRON 0 80% 0382551 CARBO VEGETABILIS GRANULES 9CH BOIRON 0 80% 0018540 CARBOBEL SIMPLEX 30 CPR 0 80% 0018554 CARBOBEL SIMPLEX GRAN 70 G 0 80% 0018604 CARBOLACTANOSE 30 CAPS 0 40% 0383495 CARBONEUM SULFURATUM 7 CH GRAN LHL 0 80% 0383495 CARBONEUM SULFURATUM 9 CH GRAN LHL 0 80% 0134178 CARBOSYLANE 24 D 48 CAPS 0 80% Mémorial B – N° 23 du 25 février 2016 624 No national 0134164 Dénomination abrégée CARBOSYLANE 48 D 96 CAPS Prise en charge conditionnelle Taux de prise en charge 0 80% 0207128 CARDEGIC 160 PDR 30 SACH 0 80% 0207131 CARDEGIC 300 PDR 30 SACH 0 80% 0517456 CARDIOASPIRINE 100 MG 28 CPR 0 80% 0244667 CARDIOASPIRINE 100 MG 30 CPR 0 80% 0517487 CARDIOASPIRINE 100 MG 56 CPR 0 80% 0311791 CARDIOASPIRINE 100 MG 60 CPR 0 80% 0517506 CARDIOASPIRINE 100 MG 84 CPR 0 80% 0384332 CARDUUS MARIANUS 12 CH DOSES LHL 0 80% 0383514 CARDUUS MARIANUS 12 CH GRAN LHL 0 80% 0383514 CARDUUS MARIANUS 4 CH GRAN LHL 0 80% 0383514 CARDUUS MARIANUS 5 CH GRAN LHL 0 80% 0383514 CARDUUS MARIANUS 7 CH GRAN LHL 0 80% 0019002 CAROTABEN 100 CAPS 0 80% 0150431 CARTEOL 1% COLLY 5 ML 0 80% 0472953 CARTEOL 2% COLLY 3*5 ML 0 80% 0150445 CARTEOL 2% COLLY 5 ML 0 80% 0396249 CARVEDILOL EG 25 MG 56 CPR 0 100% 0396283 CARVEDILOL EG 25 MG 98 CPR 0 100% 0395093 CARVEDILOL EG 6,25 MG 56 CPR 0 100% 0395126 CARVEDILOL EG 6,25 MG 98 CPR 0 100% 0329751 CASODEX 150 MG 28 CPR 0 100% 0216211 CASODEX 50 MG 28 CPR 0 100% 0154525 CATAFLAM 50 MG 30 DRG 0 80% 0217883 CATAPRESSAN 150 0,15 MG 100 CPR 0 100% 0019193 CATAPRESSAN 150 0,15 MG 5 AMP IMIVSC 0 80% 0384332 CAULOPHYLLUM 12 CH DOSE LHL 0 80% 0383514 CAULOPHYLLUM 12 CH GRAN LHL 0 80% 0383514 CAULOPHYLLUM 15 CH GRAN LHL 0 80% 0383514 CAULOPHYLLUM 4 CH GRAN LHL 0 80% 0383514 CAULOPHYLLUM 5 CH GRAN LHL 0 80% 0383514 CAULOPHYLLUM 7 CH GRAN LHL 0 80% 0384332 CAULOPHYLLUM 9 CH DOSES LHL 0 80% 0383514 CAULOPHYLLUM 9 CH GRAN LHL 0 80% 0382632 CAULOPHYLLUM THALICT GRANULES 5CH BOIRON 0 80% 0382632 CAULOPHYLLUM THALICT GRANULES 9CH BOIRON 0 80% 0384685 CAUSTICUM 12 CH DOSE LHL 0 80% 0384685 CAUSTICUM 15 CH DOSE LHL 0 80% 0383495 CAUSTICUM 15 CH GRAN LHL 0 80% 0384685 CAUSTICUM 30 CH DOSE LHL 0 80% 0383495 CAUSTICUM 30 CH GRAN LHL 0 80% 0383495 CAUSTICUM 4 CH GRAN LHL 0 80% 0383495 CAUSTICUM 5 CH GRAN LHL 0 80% 0384685 CAUSTICUM 7 CH DOSE LHL 0 80% 0383495 CAUSTICUM 7 CH GRAN LHL 0 80% 0384685 CAUSTICUM 9 CH DOSE LHL 0 80% 0383495 CAUSTICUM 9 CH GRAN LHL 0 80% 0384766 CAUSTICUM GLOBULE 12CH BOIRON 0 80% 0384766 CAUSTICUM GLOBULE 15CH BOIRON 0 80% 0384766 CAUSTICUM GLOBULES 7CH BOIRON 0 80% Mémorial B – N° 23 du 25 février 2016 625 No national 0384766 Dénomination abrégée CAUSTICUM GLOBULES 9CH BOIRON Prise en charge conditionnelle Taux de prise en charge 0 80% 0382551 CAUSTICUM GRANULE 15CH BOIRON 0 80% 0382551 CAUSTICUM GRANULE 30CH BOIRON 0 80% 0382551 CAUSTICUM GRANULES 5CH BOIRON 0 80% 0382551 CAUSTICUM GRANULES 9CH BOIRON 0 80% 0220066 CEC 125 MG/5 ML GRAN 1 FL 100 ML 0 80% 0220083 CEC FORTE 250 MG/5 ML GRAN 1 FL 100 ML 0 80% 0019565 CEDOCARD 5 MG 180 CPR 0 100% 0019551 CEDOCARD 5 MG 60 CPR 0 100% 0384332 CEDRON 15 CH DOSES LHL 0 80% 0384332 CEDRON 30 CH DOSES LHL 0 80% 0383514 CEDRON 30 CH GRAN LHL 0 80% 0383514 CEDRON 5 CH GRAN LHL 0 80% 0383514 CEDRON 9 CH GRAN LHL 0 80% 0268591 CEDUR 200 MG 60 CPR 0 80% 0301018 CEFASILYMARIN 105 MG 100 CPR 0 40% 0301004 CEFASILYMARIN 105 MG 60 CPR 0 40% 0394454 CEFUROXIM MYLAN 250 MG 10 CPR 0 80% 0394485 CEFUROXIM MYLAN 250 MG 24 CPR 0 80% 0394521 CEFUROXIM MYLAN 500 MG 10 CPR 0 80% 0394552 CEFUROXIM MYLAN 500 MG 24 CPR 0 80% 0281108 CELEBREX 100 MG 60 CAPS 0 80% 0298011 CELEBREX 200 MG 10 CAPS 0 80% 0295764 CELEBREX 200 MG 100 CAPS 0 80% 0281125 CELEBREX 200 MG 30 CAPS 0 80% 0281139 CELEBREX 200 MG 60 CAPS 0 80% 0747541 CELECOXIB EG 100 MG 100 CAPS 0 80% 0747506 CELECOXIB EG 100 MG 60 CAPS 0 80% 0747683 CELECOXIB EG 200 MG 100 CAPS 0 80% 0747618 CELECOXIB EG 200 MG 30 CAPS 0 80% 0747649 CELECOXIB EG 200 MG 60 CAPS 0 80% 0676905 CELECOXIB RATIO 100 MG 100 CAPS 0 80% 0676841 CELECOXIB RATIO 100 MG 20 CAPS 0 80% 0676869 CELECOXIB RATIO 100 MG 50 CAPS 0 80% 0676953 CELECOXIB RATIO 200 MG 10 CAPS 0 80% 0677012 CELECOXIB RATIO 200 MG 100 CAPS 0 80% 0676967 CELECOXIB RATIO 200 MG 20 CAPS 0 80% 0676984 CELECOXIB RATIO 200 MG 50 CAPS 0 80% 0770423 CELECOXIB SDZ 100 MG 30 CAPS 0 80% 0770441 CELECOXIB SDZ 100 MG 60 CAPS 0 80% 0770454 CELECOXIB SDZ 100 MG 90 CAPS 0 80% 0770471 CELECOXIB SDZ 200 MG 10 CAPS 0 80% 0770499 CELECOXIB SDZ 200 MG 30 CAPS 0 80% 0770518 CELECOXIB SDZ 200 MG 60 CAPS 0 80% 0770521 CELECOXIB SDZ 200 MG 90 CAPS 0 80% 0019873 CELESTONE 0,5 MG 30 CPR (FL) 0 80% 0019890 CELESTONE 0,5 MG/ML GTTS 30 ML 0 80% 0019906 CELESTONE 5,3 MG 1 AMP 1 ML IMIV 0 80% 0019923 CELESTONE CHRONODOSE 1 FL 1 ML IM M.D. 0 80% 0384783 CELIDONIUM MAJUS GLOBULES 15 CH BOIRON 0 80% Mémorial B – N° 23 du 25 février 2016 626 No national 0384783 Dénomination abrégée CELIDONIUM MAJUS GLOBULES 30 CH BOIRON Prise en charge conditionnelle Taux de prise en charge 0 80% 0384783 CELIDONIUM MAJUS GLOBULES 7 CH BOIRON 0 80% 0384783 CELIDONIUM MAJUS GLOBULES 9 CH BOIRON 0 80% 0382632 CELIDONIUM MAJUS GRAN 5 CH BOIRON 0 80% 0264111 CELLCEPT 1 G/5 ML PDR 110 G 0 100% 0224566 CELLCEPT 250 MG 3*100 CAPS 0 100% 0224552 CELLCEPT 500 MG 3*50 CPR 0 100% 0467113 CELSENTRI 150 MG 60 CPR 0 100% 0467161 CELSENTRI 300 MG 60 CPR 0 100% 0020308 CERULYX GTTS 10 ML 0 80% 0182211 CETAVLEX CREME 60 G 0 80% 0321381 CETIRIZINE EG 10 MG 100 CPR 0 80% 0321346 CETIRIZINE EG 10 MG 20 CPR 0 80% 0321377 CETIRIZINE EG 10 MG 50 CPR 0 80% 0305096 CETIRIZINE MYLAN 10 MG 100 CPR 0 80% 0305051 CETIRIZINE MYLAN 10 MG 20 CPR 0 80% 0383514 CETRARIA ISLANDICA 5 CH GRAN LHL 0 80% 0384332 CETRARIA ISLANDICA 9 CH DOSES LHL 0 80% 0264978 CETROTIDE 0,25 MG PSV 1 FL + 1 SRG SC 0 80% 0264981 CETROTIDE 0,25 MG PSV 7 FL + 7 SRG SC 0 80% 0383514 CHAMOMILLA VULGARIS 12 CH GRAN LHL 0 80% 0384332 CHAMOMILLA VULGARIS 15 CH DOSE LHL 0 80% 0383514 CHAMOMILLA VULGARIS 15 CH GRAN LHL 0 80% 0384332 CHAMOMILLA VULGARIS 30 CH DOSE LHL 0 80% 0383514 CHAMOMILLA VULGARIS 30 CH GRAN LHL 0 80% 0383514 CHAMOMILLA VULGARIS 4 CH GRAN LHL 0 80% 0383514 CHAMOMILLA VULGARIS 5 CH GRAN LHL 0 80% 0384332 CHAMOMILLA VULGARIS 7 CH DOSE LHL 0 80% 0383514 CHAMOMILLA VULGARIS 7 CH GRAN LHL 0 80% 0384332 CHAMOMILLA VULGARIS 9 CH DOSE LHL 0 80% 0383514 CHAMOMILLA VULGARIS 9 CH GRAN LHL 0 80% 0384783 CHAMOMILLA VULGARIS GLOBULE 12CH BOIRON 0 80% 0384783 CHAMOMILLA VULGARIS GLOBULE 15CH BOIRON 0 80% 0384783 CHAMOMILLA VULGARIS GLOBULES 7CH BOIRON 0 80% 0384783 CHAMOMILLA VULGARIS GLOBULES 9CH BOIRON 0 80% 0382632 CHAMOMILLA VULGARIS GRANULE 12CH BOIRON 0 80% 0382632 CHAMOMILLA VULGARIS GRANULE 15CH BOIRON 0 80% 0382632 CHAMOMILLA VULGARIS GRANULES 4CH BOIRON 0 80% 0382632 CHAMOMILLA VULGARIS GRANULES 5CH BOIRON 0 80% 0382632 CHAMOMILLA VULGARIS GRANULES 7CH BOIRON 0 80% 0382632 CHAMOMILLA VULGARIS GRANULES 9CH BOIRON 0 80% 0383514 CHEIRANTHUS CHEIRI 5 CH GRAN LHL 0 80% 0383514 CHEIRANTHUS CHEIRI 7 CH GRAN LHL 0 80% 0384332 CHELIDONIUM MAJUS 15 CH DOSE LHL 0 80% 0383514 CHELIDONIUM MAJUS 15 CH GRAN LHL 0 80% 0383514 CHELIDONIUM MAJUS 30 CH GRAN LHL 0 80% 0383514 CHELIDONIUM MAJUS 4 CH GRAN LHL 0 80% 0383514 CHELIDONIUM MAJUS 5 CH GRAN LHL 0 80% 0383514 CHELIDONIUM MAJUS 7 CH GRAN LHL 0 80% 0383514 CHELIDONIUM MAJUS 9 CH GRAN LHL 0 80% Mémorial B – N° 23 du 25 février 2016 627 No national 0383514 Dénomination abrégée CHIMAPHILA 5 CH GRAN LHL Prise en charge conditionnelle Taux de prise en charge 0 80% 0383514 CHINA REGIA 5 CH GRAN LHL 0 80% 0384332 CHINA RUBRA 12 CH DOSES LHL 0 80% 0383514 CHINA RUBRA 12 CH GRAN LHL 0 80% 0384332 CHINA RUBRA 15 CH DOSES LHL 0 80% 0383514 CHINA RUBRA 15 CH GRAN LHL 0 80% 0384332 CHINA RUBRA 30 CH DOSES LHL 0 80% 0383514 CHINA RUBRA 30 CH GRAN LHL 0 80% 0383514 CHINA RUBRA 4 CH GRAN LHL 0 80% 0384332 CHINA RUBRA 5 CH DOSES LHL 0 80% 0383514 CHINA RUBRA 5 CH GRAN LHL 0 80% 0384332 CHINA RUBRA 7 CH DOSE LHL 0 80% 0383514 CHINA RUBRA 7 CH GRAN LHL 0 80% 0384332 CHINA RUBRA 9 CH DOSE LHL 0 80% 0383514 CHINA RUBRA 9 CH GRAN LHL 0 80% 0384783 CHINA RUBRA GLOBULES 15CH BOIRON 0 80% 0384783 CHINA RUBRA GLOBULES 9CH BOIRON 0 80% 0382632 CHINA RUBRA GRANULE 12CH BOIRON 0 80% 0382632 CHINA RUBRA GRANULE 15CH BOIRON 0 80% 0382632 CHINA RUBRA GRANULES 5CH BOIRON 0 80% 0382632 CHINA RUBRA GRANULES 7CH BOIRON 0 80% 0382632 CHINA RUBRA GRANULES 9CH BOIRON 0 80% 0383495 CHININUM SULFURICUM 5 CH GRAN LHL 0 80% 0383495 CHININUM SULFURICUM 9 CH GRAN LHL 0 80% 0383514 CHIONANTHUS 4 CH GRAN LHL 0 80% 0383495 CHLORALUM 4 CH GRAN LHL 0 80% 0383495 CHLORALUM 5 CH GRAN LHL 0 80% 0383495 CHLORALUM 7 CH GRAN LHL 0 80% 0020860 CHLORAMINE PURA 250 MG 60 CPR 0 80% 0767042 CHLORAMPHENICOL BEPB 0,5% COLLY 5 ML 0 80% 0767056 CHLORAMPHENICOL BEPB 1% POM OPHT 2,5 G 0 80% 0767283 CHLORAMPHENICOL BEPB 10 MG/G CREME 20 G 0 80% 0021109 CHLORAMPHENICOL BRNV 0,4% COLLY 10 ML 0 80% 0021384 CHLOROPOTASSURYL 1 G 10 AMP BUV 0 80% 0383495 CHLORUM 4 CH GRAN LHL 0 80% 0371061 CHOLESTAGEL 625 MG 180 CPR 0 80% 0383495 CHOLESTERINUM 9 CH DOSE LHL 0 80% 0384685 CHOLESTERINUM 9 CH GRAN LHL 0 80% 0383514 CHRYSANTHELLUM 5 CH GRAN LHL 0 80% 0215181 CIBACEN 10 MG 28 CPR 0 100% 0236567 CIBACEN 10 MG 42 CPR 0 100% 0236571 CIBACEN 10 MG 98 CPR 0 100% 0254811 CIBACEN 20 MG 28 CPR 0 100% 0254825 CIBACEN 20 MG 42 CPR 0 100% 0257116 CIBACEN 20 MG 98 CPR 0 100% 0215178 CIBACEN 5 MG 28 CPR 0 100% 0236181 CIBACEN 5 MG 42 CPR 0 100% 0236195 CIBACEN 5 MG 98 CPR 0 100% 0254842 CIBADREX 10/12,5 MG 28 CPR 0 100% 0254856 CIBADREX 10/12,5 MG 42 CPR 0 100% Mémorial B – N° 23 du 25 février 2016 628 No national 0254873 Dénomination abrégée CIBADREX 10/12,5 MG 98 CPR Prise en charge conditionnelle Taux de prise en charge 0 100% 0384332 CICUTA VIROSA 12 CH DOSES LHL 0 80% 0383514 CICUTA VIROSA 4 CH GRAN LHL 0 80% 0383514 CICUTA VIROSA 5 CH GRAN LHL 0 80% 0383514 CICUTA VIROSA 7 CH GRAN LHL 0 80% 0197181 CILOXAN 0,3% COLLY 5 ML 0 80% 0183561 CIMEHEXAL 200 MG 10 AMP 2 ML IV 0 80% 0178951 CIMEHEXAL 800 MG 100 CPR 0 80% 0178947 CIMEHEXAL 800 MG 50 CPR 0 80% 0301195 CIMETIDINE EG 200 MG 100 CPR 0 80% 0301178 CIMETIDINE EG 200 MG 20 CPR 0 80% 0301201 CIMETIDINE EG 400 MG 56 CPR 0 80% 0301214 CIMETIDINE EG 800 MG 28 CPR 0 80% 0383514 CIMICIFUGA 12 CH GRAN LHL 0 80% 0384332 CIMICIFUGA 15 CH DOSES LHL 0 80% 0383514 CIMICIFUGA 4 CH GRAN LHL 0 80% 0383514 CIMICIFUGA 5 CH GRAN LHL 0 80% 0383514 CIMICIFUGA 7 CH GRAN LHL 0 80% 0384332 CIMICIFUGA 9 CH DOSES LHL 0 80% 0383514 CIMICIFUGA 9 CH GRAN LHL 0 80% 0541272 CIMZIA 200 MG 2 SRG 1 ML SC 0 80% 0383514 CINA 15 CH GRAN LHL 0 80% 0383514 CINA 4 CH GRAN LHL 0 80% 0383514 CINA 5 CH GRAN LHL 0 80% 0383514 CINA 7 CH GRAN LHL 0 80% 0384332 CINA 9 CH DOSES LHL 0 80% 0383514 CINA 9 CH GRAN LHL 0 80% 0382632 CINA ARTEMISIA GRANULE 15CH BOIRON 0 80% 0382632 CINA ARTEMISIA GRANULES 4CH BOIRON 0 80% 0382632 CINA ARTEMISIA GRANULES 5CH BOIRON 0 80% 0382632 CINA ARTEMISIA GRANULES 7CH BOIRON 0 80% 0382632 CINA ARTEMISIA GRANULES 9CH BOIRON 0 80% 0383495 CINNABARIS 15 CH GRAN LHL 0 80% 0383495 CINNABARIS 30 CH GRAN LHL 0 80% 0383495 CINNABARIS 4 CH GRAN LHL 0 80% 0383495 CINNABARIS 5 CH GRAN LHL 0 80% 0383495 CINNABARIS 7 CH GRAN LHL 0 80% 0383495 CINNABARIS 9 CH GRAN LHL 0 80% 0158149 CIPRALAN 130 MG 100 CPR 0 100% 0158135 CIPRALAN 130 MG 40 CPR 0 100% 0164065 CIPRAMIL 20 MG 28 CPR 0 80% 0164129 CIPRAMIL 40 MG PERF 10 AMP 1 ML 0 80% 0316881 CIPROFLOXACIN RATIO 250 MG 10 CPR 0 80% 0316895 CIPROFLOXACIN RATIO 250 MG 20 CPR 0 80% 0316851 CIPROFLOXACIN RATIO 500 MG 10 CPR 0 80% 0316864 CIPROFLOXACIN RATIO 500 MG 20 CPR 0 80% 0316816 CIPROFLOXACIN RATIO 750 MG 10 CPR 0 80% 0316833 CIPROFLOXACIN RATIO 750 MG 20 CPR 0 80% 0358959 CIPROFLOXACINE EG 250 MG 10 CPR 0 80% 0359083 CIPROFLOXACINE EG 500 MG 20 CPR 0 80% Mémorial B – N° 23 du 25 février 2016 629 No national 0359178 Dénomination abrégée CIPROFLOXACINE EG 750 MG 20 CPR Prise en charge conditionnelle Taux de prise en charge 0 80% 0754142 CIPROFLOXACINE SDZ 250 MG 10 CPR 0 80% 0754156 CIPROFLOXACINE SDZ 250 MG 20 CPR 0 80% 0754271 CIPROFLOXACINE SDZ 500 MG 10 CPR 0 80% 0754268 CIPROFLOXACINE SDZ 500 MG 20 CPR 0 80% 0754383 CIPROFLOXACINE SDZ 750 MG 10 CPR 0 80% 0754366 CIPROFLOXACINE SDZ 750 MG 20 CPR 0 80% 0135645 CIPROXINE 250 MG 10 CPR 0 80% 0321282 CIPROXINE 5% 2 FL MICROCPS + S 0 80% 0135709 CIPROXINE 500 MG 20 CPR 0 80% 0708749 CIQORIN 10 MG 50 CAPS 0 100% 0709018 CIQORIN 100 MG 50 CAPS 0 100% 0708847 CIQORIN 25 MG 50 CAPS 0 100% 0708928 CIQORIN 50 MG 50 CAPS 0 100% 0383514 CISTUS CANADENSIS 12 CH GRAN LHL 0 80% 0383514 CISTUS CANADENSIS 9 CH GRAN LHL 0 80% 0421941 CITALOPRAM EG 20 MG 28 CPR 0 80% 0421971 CITALOPRAM EG 20 MG 56 CPR 0 80% 0421985 CITALOPRAM EG 20 MG 98 CPR 0 80% 0426799 CITALOPRAM HEXAL 20 MG 100 CPR BLIST 0 80% 0426706 CITALOPRAM HEXAL 20 MG 20 CPR BLIST 0 80% 0426768 CITALOPRAM HEXAL 20 MG 50 CPR BLIST 0 80% 0426964 CITALOPRAM HEXAL 30 MG 100 CPR BLIST 0 80% 0339094 CITALOPRAM HEXAL 30 MG 20 CPR 0 80% 0426866 CITALOPRAM HEXAL 30 MG 20 CPR BLIST 0 80% 0426933 CITALOPRAM HEXAL 30 MG 50 CPR BLIST 0 80% 0427104 CITALOPRAM HEXAL 40 MG 100 CPR BLIST 0 80% 0339189 CITALOPRAM HEXAL 40 MG 20 CPR 0 80% 0427037 CITALOPRAM HEXAL 40 MG 20 CPR BLIST 0 80% 0427071 CITALOPRAM HEXAL 40 MG 50 CPR BLIST 0 80% 0432619 CITALOPRAM HEXAL 60 MG 100 CPR BLIST 0 80% 0338875 CITALOPRAM HEXAL 60 MG 20 CPR 0 80% 0432524 CITALOPRAM HEXAL 60 MG 20 CPR BLIST 0 80% 0432569 CITALOPRAM HEXAL 60 MG 50 CPR BLIST 0 80% 0709083 CITRA FLEET PDR 2 SACH 0 40% 0206716 CLAFORAN 1000 MG PDR 1 FL + S IMIV 0 80% 0206733 CLAFORAN 2000 MG PDR 1 FL + S IV 0 80% 0022705 CLAMOXYL 125 MG/5 ML SIR 80 ML 0 80% 0140466 CLAMOXYL 250 MG/5 ML SIR 80 ML 0 80% 0022624 CLAMOXYL 500 MG 16 CAPS 0 80% 0385049 CLAMOXYL TABS 1 G 24 CPR 0 80% 0196623 CLAMOXYL TABS 1 G 8 CPR 0 80% 0426186 CLARELUX 0,5 MG/G MOUSSE 100 G 0 80% 0378853 CLARITHROMYCIN HEXAL 250 MG 10 CPR 0 80% 0378867 CLARITHROMYCIN HEXAL 250 MG 12 CPR 0 80% 0378903 CLARITHROMYCIN HEXAL 250 MG 20 CPR 0 80% 0378979 CLARITHROMYCIN HEXAL 500 MG 14 CPR 0 80% 0379007 CLARITHROMYCIN HEXAL 500 MG 20 CPR 0 80% 0375347 CLARITHROMYCIN RATIO 250 MG 10 CPR 0 80% 0375395 CLARITHROMYCIN RATIO 250 MG 20 CPR 0 80% Mémorial B – N° 23 du 25 février 2016 630 No national 0375607 Dénomination abrégée CLARITHROMYCIN RATIO 500 MG 14 CPR Prise en charge conditionnelle Taux de prise en charge 0 80% 0375638 CLARITHROMYCIN RATIO 500 MG 20 CPR 0 80% 0400341 CLARITHROMYCINE ABBOTT UNO 500 MG 10 CPR 0 80% 0400355 CLARITHROMYCINE ABBOTT UNO 500 MG 20 CPR 0 80% 0398114 CLARITHROMYCINE EG 250 MG 10 CPR 0 80% 0398324 CLARITHROMYCINE EG 500 MG 10 CPR 0 80% 0398369 CLARITHROMYCINE EG 500 MG 21 CPR 0 80% 0409364 CLARITINE 1 MG/ML SIROP 100 ML 0 80% 0148191 CLARITINE 10 MG 21 CPR 0 80% 0022865 CLAVERSAL 250 MG 100 CPR 0 100% 0022896 CLAVERSAL 250 MG 120 SUPP 0 100% 0022882 CLAVERSAL 250 MG 30 SUPP 0 100% 0151281 CLAVERSAL 250 MG 300 CPR 0 100% 0296985 CLAVERSAL 500 MG 100 CPR 0 100% 0150771 CLAVERSAL 500 MG 15 SUPP 0 100% 0296999 CLAVERSAL 500 MG 300 CPR 0 100% 0150784 CLAVERSAL 500 MG 60 SUPP 0 100% 0210817 CLAVERSAL MOUSSE RECT 1 FL 14 D 0 100% 0340471 CLAVUCID SOLUTAB 500/125 MG 20 CPR 0 80% 0376036 CLAVUCID SOLUTAB 875/125 MG 20 CPR 0 80% 0383514 CLEMATIS ERECTA 5 CH GRAN LHL 0 80% 0383514 CLEMATIS ERECTA 7 CH GRAN LHL 0 80% 0383514 CLEMATIS ERECTA 9 CH GRAN LHL 0 80% 0190485 CLEXANE 100 MG 10 SRG 1 ML IVSC 0 80% 0316492 CLEXANE 120 MG 10 SRG 0,8 ML SCIV 0 80% 0316489 CLEXANE 150 MG 10 SRG 1 ML SCIV 0 80% 0173128 CLEXANE 20 MG 10 SRG 0,2 ML IVSCVI 0 80% 0173145 CLEXANE 40 MG 10 SRG 0,4 ML IVSCVI 0 80% 0267613 CLEXANE 60 MG 10 SRG 0,6 ML IVSC 0 80% 0190454 CLEXANE 80 MG 10 SRG 0,8 ML IVSC 0 80% 0260447 CLIMARA 50 12 PATCH 0 80% 0220729 CLIMARA 50 4 PATCH 0 80% 0186093 CLIMEN 3*21 CPR 0 80% 0308473 CLIMODIEN 2/2 3*28 CPR 0 80% 0617868 CLINDAMYCINE EG 300 MG 16 CAPS 0 80% 0617904 CLINDAMYCINE EG 300 MG 32 CAPS 0 80% 0457599 CLOBEX 500 MCG/G SHAMP 125 ML 0 80% 0023070 CLOMID 50 MG 10 CPR 0 80% 0629551 CLOPIDOGREL (HCL) SDZ 75 MG 28 CPR 0 80% 0629601 CLOPIDOGREL (HCL) SDZ 75 MG 98 CPR 0 80% 0560488 CLOPIDOGREL EG 75 MG 28 CPR 0 80% 0560524 CLOPIDOGREL EG 75 MG 84 CPR 0 80% 0789487 CLOPIDOGREL RATIO 75 MG 100*1 CPR 0 80% 0789425 CLOPIDOGREL RATIO 75 MG 28*1 CPR 0 80% 0789442 CLOPIDOGREL RATIO 75 MG 50*1 CPR 0 80% 0537316 CLOPIDOGREL RATIO GMBH 75 MG 100 CPR 0 80% 0537252 CLOPIDOGREL RATIO GMBH 75 MG 28 CPR 0 80% 0023117 CLOPIXOL 10 MG 100 CPR 0 80% 0023098 CLOPIXOL 2 MG 100 CPR 0 80% 0023151 CLOPIXOL 2% GTTS 20 ML 0 80% Mémorial B – N° 23 du 25 février 2016 631 No national Dénomination abrégée Prise en charge conditionnelle Taux de prise en charge 0023134 CLOPIXOL 25 MG 100 CPR 0 80% 0165997 CLOPIXOL ACUTARD 50 MG 1 AMP 1 ML IM 0 80% 0023179 CLOPIXOL DEPOT 200 MG 1 AMP 1 ML IM 0 80% 0023232 CLOZAN 10 MG 50 CPR 0 40% 0023246 CLOZAN 5 MG 20 CPR 0 40% 0023263 CLOZAN 5 MG 50 CPR 0 40% 0206408 CO INHIBACE 5/12,5 MG 28 CPR 0 100% 0247963 CO RENITEC 56 CPR 0 100% 0252834 CO RENITEC 98 CPR 0 100% 0258273 COAPROVEL 150/12,5 28 CPR 0 100% 0258306 COAPROVEL 300/12,5 28 CPR 0 100% 0258337 COAPROVEL 300/12,5 98 CPR 0 100% 0441491 COAPROVEL 300/25 28 CPR 0 100% 0441537 COAPROVEL 300/25 98 CPR 0 100% 0348272 COBISOPROLOL EG 10/25 MG 28 CPR 0 100% 0348319 COBISOPROLOL EG 10/25 MG 56 CPR 0 100% 0348031 COBISOPROLOL EG 5/12,5 MG 28 CPR 0 100% 0348062 COBISOPROLOL EG 5/12,5 MG 56 CPR 0 100% 0383514 COCA 30 CH GRAN LHL 0 80% 0383514 COCA 4 CH GRAN LHL 0 80% 0383514 COCA 5 CH GRAN LHL 0 80% 0383514 COCA 7 CH GRAN LHL 0 80% 0383514 COCA 9 CH GRAN LHL 0 80% 0661043 COCANDESARTAN SDZ 16/12,5 MG 28 CPR 0 100% 0661088 COCANDESARTAN SDZ 16/12,5 MG 56 CPR 0 100% 0661124 COCANDESARTAN SDZ 16/12,5 MG 98 CPR 0 100% 0660886 COCANDESARTAN SDZ 8/12,5 MG 28 CPR 0 100% 0660936 COCANDESARTAN SDZ 8/12,5 MG 56 CPR 0 100% 100% 0661253 COCANDESARTAN SDZ 8/12,5 MG 98 CPR 0 0384332 COCCULUS INDICUS 12 CH DOSES LHL 0 80% 0383514 COCCULUS INDICUS 12 CH GRAN LHL 0 80% 0384332 COCCULUS INDICUS 15 CH DOSES LHL 0 80% 0383514 COCCULUS INDICUS 15 CH GRAN LHL 0 80% 0384332 COCCULUS INDICUS 30 CH DOSES LHL 0 80% 0383514 COCCULUS INDICUS 30 CH GRAN LHL 0 80% 0383514 COCCULUS INDICUS 4 CH GRAN LHL 0 80% 0383514 COCCULUS INDICUS 5 CH GRAN LHL 0 80% 0383514 COCCULUS INDICUS 7 CH GRAN LHL 0 80% 0384332 COCCULUS INDICUS 9 CH DOSES LHL 0 80% 0383514 COCCULUS INDICUS 9 CH GRAN LHL 0 80% 0382632 COCCULUS INDICUS GRANULES 5CH BOIRON 0 80% 0382632 COCCULUS INDICUS GRANULES 7CH BOIRON 0 80% 0382632 COCCULUS INDICUS GRANULES 9CH BOIRON 0 80% 0384332 COCCUS CACTI 12 CH DOSE LHL 0 80% 0384332 COCCUS CACTI 15 CH DOSE LHL 0 80% 0383514 COCCUS CACTI 15 CH GRAN LHL 0 80% 0383514 COCCUS CACTI 4 CH GRAN LHL 0 80% 0383514 COCCUS CACTI 5 CH GRAN LHL 0 80% 0383514 COCCUS CACTI 7 CH GRAN LHL 0 80% 0384332 COCCUS CACTI 9 CH DOSE LHL 0 80% Mémorial B – N° 23 du 25 février 2016 632 No national 0383514 Dénomination abrégée COCCUS CACTI 9 CH GRAN LHL Prise en charge conditionnelle Taux de prise en charge 0 80% 0382632 COCCUS CACTI GRANULES 4CH BOIRON 0 80% 0382632 COCCUS CACTI GRANULES 5CH BOIRON 0 80% 0382632 COCCUS CACTI GRANULES 7CH BOIRON 0 80% 0382632 COCCUS CACTI GRANULES 9CH BOIRON 0 80% 0767073 CODETHYLINE BEPB 5 MG 50 CPR 0 40% 0353841 CODIOVANE 160/12,5 MG 28 CPR 0 100% 0353868 CODIOVANE 160/12,5MG 98 CPR 0 100% 0389731 CODIOVANE 160/25 MG 28 CPR 0 100% 0389759 CODIOVANE 160/25 MG 98 CPR 0 100% 100% 0253537 CODIOVANE 80/12,5 MG 56 CPR 0 0383514 COFFEA CRUDA 12 CH GRAN LHL 0 80% 0384332 COFFEA CRUDA 15 CH DOSES LHL 0 80% 0383514 COFFEA CRUDA 15 CH GRAN LHL 0 80% 0384332 COFFEA CRUDA 30 CH DOSES LHL 0 80% 0383514 COFFEA CRUDA 30 CH GRAN LHL 0 80% 0383514 COFFEA CRUDA 4 CH GRAN LHL 0 80% 0383514 COFFEA CRUDA 5 CH GRAN LHL 0 80% 0383514 COFFEA CRUDA 7 CH GRAN LHL 0 80% 0384332 COFFEA CRUDA 9 CH DOSE LHL 0 80% 0383514 COFFEA CRUDA 9 CH GRAN LHL 0 80% 0384783 COFFEA CRUDA GLOBULES 9CH BOIRON 0 80% 0382632 COFFEA CRUDA GRANULE 12CH BOIRON 0 80% 0382632 COFFEA CRUDA GRANULE 15CH BOIRON 0 80% 0382632 COFFEA CRUDA GRANULE 30CH BOIRON 0 80% 0382632 COFFEA CRUDA GRANULES 4CH BOIRON 0 80% 0382632 COFFEA CRUDA GRANULES 5CH BOIRON 0 80% 0382632 COFFEA CRUDA GRANULES 7CH BOIRON 0 80% 0382632 COFFEA CRUDA GRANULES 9CH BOIRON 0 80% 0383514 COFFEA TOSTA 12 CH GRAN LHL 0 80% 0384332 COFFEA TOSTA 15 CH DOSES LHL 0 80% 0383514 COFFEA TOSTA 5 CH GRAN LHL 0 80% 0383514 COFFEA TOSTA 7 CH GRAN LHL 0 80% 0383514 COFFEA TOSTA 9 CH GRAN LHL 0 80% 0362397 COLCHICINE OPOCALCIUM 1 MG 20 CPR 0 80% 0383514 COLCHICUM AUTUMNALE 4 CH GRAN LHL 0 80% 0383514 COLCHICUM AUTUMNALE 5 CH GRAN LHL 0 80% 0383514 COLCHICUM AUTUMNALE 9 CH GRAN LHL 0 80% 0023652 COLESTID PDR 50 SACH 5 G 0 80% 0420053 COLISINOPRIL EG 20/12,5 MG 28 CPR 0 100% 0420098 COLISINOPRIL EG 20/12,5 MG 56 CPR 0 100% 0602821 COLITOFALK 1 G 30 SUPP 0 100% 0541966 COLITOFALK 1,5 G 90 SACH 0 100% 0023974 COLITOFALK 250 MG 100 CPR 0 100% 0024002 COLITOFALK 250 MG 120 SUPP 0 100% 0023991 COLITOFALK 250 MG 30 SUPP 0 100% 0647495 COLITOFALK 3 G 60 SACH 0 100% 0168101 COLITOFALK 500 MG 100 CPR 0 100% 0168081 COLITOFALK 500 MG 120 SUPP 0 100% 0168064 COLITOFALK 500 MG 30 SUPP 0 100% Mémorial B – N° 23 du 25 février 2016 633 No national 0189517 Dénomination abrégée COLITOFALK 500 MG 300 DRG Prise en charge conditionnelle Taux de prise en charge 0 100% 0176925 COLITOFALK SUSP 2 G 7 LAV 60 G 0 100% 0136852 COLITOFALK SUSP 4 G 7 LAV 60 G 0 100% 0383514 COLLINSONIA 5 CH GRAN LHL 0 80% 0383514 COLLINSONIA 7 CH GRAN LHL 0 80% 0383514 COLLINSONIA 9 CH GRAN LHL 0 80% 0299892 COLLYRE BLEU LAITER COLLY 10 ML 0 80% 0674847 COLOBREATHE 1662500 U 56 C APS+INH TURBO 0 80% 0383514 COLOCYNTHIS 12 CH GRAN LHL 0 80% 0384332 COLOCYNTHIS 15 CH DOSES LHL 0 80% 0383514 COLOCYNTHIS 15 CH GRAN LHL 0 80% 0384332 COLOCYNTHIS 30 CH DOSES LHL 0 80% 0383514 COLOCYNTHIS 30 CH GRAN LHL 0 80% 0383514 COLOCYNTHIS 4 CH GRAN LHL 0 80% 0383514 COLOCYNTHIS 5 CH GRAN LHL 0 80% 0383514 COLOCYNTHIS 7 CH GRAN LHL 0 80% 0383514 COLOCYNTHIS 9 CH GRAN LHL 0 80% 0382632 COLOCYNTHIS GRANULE 15CH BOIRON 0 80% 0382632 COLOCYNTHIS GRANULE 30CH BOIRON 0 80% 0382632 COLOCYNTHIS GRANULES 4CH BOIRON 0 80 % 0382632 COLOCYNTHIS GRANULES 5CH BOIRON 0 80 % 0382632 COLOCYNTHIS GRANULES 7CH BOIRON 0 80 % 0382632 COLOCYNTHIS GRANULES 9CH BOIRON 0 80 % 0344273 COLOFORT 4 SACH 0 40 % 0436862 COMBIGAN 0,2/0,5% COLLY 3*5 ML 0 80 % 0306806 COMBIVENT 60 FL UD INH 0 100 % 0250701 COMBIVENT SOL 20 FL UD INH 0 100 % 0252753 COMBIVIR 150 MG 60 CPR BLIST 0 100 % 0569081 COMBODART 0,5/0,4 MG 30 CAPS (FL) 0 80 % 0569094 COMBODART 0,5/0,4 MG 90 CAPS (FL) 0 80 % 0255657 COMTAN 200 MG 100 CPR (FL) 0 100 % 0024579 CONCOR 10 MG 100 CPR 0 100 % 0024551 CONCOR 10 MG 30 CPR 0 100 % 0194968 CONCOR 10 PLUS 30 CPR 0 100 % 0024601 CONCOR 5 MG 100 CPR 0 100 % 0024582 CONCOR 5 MG 30 CPR 0 100 % 0194937 CONCOR 5 PLUS 30 CPR 0 100 % 0273588 CONCOR COR 2,5 MG 100 CPR 0 100 % 0273561 CONCOR COR 2,5 MG 30 CPR 0 100 % 0383514 CONDURANGO 5 CH GRAN LHL 0 80 % 0383514 CONIUM MACULATUM 12 CH GRAN LHL 0 80 % 0384332 CONIUM MACULATUM 15 CH DOSES LHL 0 80% 0383514 CONIUM MACULATUM 15 CH GRAN LHL 0 80% 0384332 CONIUM MACULATUM 30 CH DOSES LHL 0 80% 0383514 CONIUM MACULATUM 30 CH GRAN LHL 0 80% 0383514 CONIUM MACULATUM 4 CH GRAN LHL 0 80% 0383514 CONIUM MACULATUM 5 CH GRAN LHL 0 80% 0383514 CONIUM MACULATUM 7 CH GRAN LHL 0 80% 0384332 CONIUM MACULATUM 9 CH DOSES LHL 0 80% 0383514 CONIUM MACULATUM 9 CH GRAN LHL 0 80% Mémorial B – N° 23 du 25 février 2016 634 No national 0382632 Dénomination abrégée CONIUM MACULATUM GRANULE 15CH BOIRON Prise en charge conditionnelle Taux de prise en charge 0 80% 0382632 CONIUM MACULATUM GRANULE 30CH BOIRON 0 80% 0382632 CONIUM MACULATUM GRANULES 4CH BOIRON 0 80% 0382632 CONIUM MACULATUM GRANULES 5CH BOIRON 0 80% 0382632 CONIUM MACULATUM GRANULES 7CH BOIRON 0 80% 0382632 CONIUM MACULATUM GRANULES 9CH BOIRON 0 80% 0481448 CONTRAMAL UNO 100 MG 30 CPR 0 80% 0481529 CONTRAMAL UNO 200 MG 30 CPR 0 80% 0481613 CONTRAMAL UNO 300 MG 30 CPR 0 80% 0024937 CONVULEX 300 MG 100 CAPS 0 100% 0024940 CONVULEX 500 MG 100 CAPS 0 100% 0370291 COPAXONE 20 MG/ML 28 SRG PRERPL SC 0 100% 0336612 COPEGUS 200 MG 168 CPR 0 100% 0445925 COPEGUS 400 MG 56 CPR 0 100% 0419763 COQUINAPRIL 20/12,5 MG 28 CPR 0 100% 0419813 COQUINAPRIL 20/12,5 MG 56 CPR 0 100% 0419827 COQUINAPRIL 20/12,5 MG 98 CPR 0 100% 0382632 CORALLIUM RUBRUM GRANULE 15CH BOIRON 0 80% 0382632 CORALLIUM RUBRUM GRANULES 5CH BOIRON 0 80% 0382632 CORALLIUM RUBRUM GRANULES 7CH BOIRON 0 80% 0382632 CORALLIUM RUBRUM GRANULES 9CH BOIRON 0 80% 0024999 CORDARONE 200 MG 20 CPR 0 100% 0025013 CORDARONE 200 MG 60 CPR 0 100% 0187561 CORNEREGEL 10 G 0 80% 0207727 CORSODYL SOL 200 ML 0 40% 0384685 CORTISONE 12 CH DOSES LHL 0 80% 0384685 CORTISONE 15 CH DOSES LHL 0 80% 0384685 CORTISONE 30 CH DOSES LHL 0 80% 0384685 CORTISONE 9 CH DOSES LHL 0 80% 0335291 CORUNO 16 MG 28 CPR 0 80% 0355649 CORUNO 16 MG 42 CPR 0 80% 0156452 CORVATON 2 MG 100 CPR 0 80% 0025822 CORVATON 2 MG 50 CPR 0 80% 0025853 CORVATON 4 MG 120 CPR 0 80% 0025836 CORVATON 4 MG 60 CPR 0 80% 0288773 COSE ANAL POM 20 G 0 80% 0779334 COSENTYX 150 MG/ML 2 SRG PRER 6 100% 100% 0779351 COSENTYX 150 MG/ML 2 STYLOS PRER 6 0274801 COSOPT COLLY 1 OCUMETER PLUS 5 ML 0 80% 0297593 COSOPT COLLY 3 OCUMETER PLUS 5 ML 0 80% 0457621 COSOPT UD COLLY 20MG/ML 5MG/ML 60*0,2 ML 0 80% 0025996 COTRIM FORTE RATIO 10 CPR 0 80% 0026007 COTRIM FORTE RATIO 20 CPR 0 80% 0690739 COVALSARTAN EG 160/12,5 MG 28 CPR 0 100% 0690787 COVALSARTAN EG 160/12,5 MG 98 CPR 0 100% 0690837 COVALSARTAN EG 160/25 MG 28 CPR 0 100% 0690871 COVALSARTAN EG 160/25 MG 98 CPR 0 100% 0690658 COVALSARTAN EG 80/12,5 MG 28 CPR 0 100% 0690692 COVALSARTAN EG 80/12,5 MG 98 CPR 0 100% 0646789 COVALSARTAN SDZ 160/12,5 MG 28 CPR 0 100% Mémorial B – N° 23 du 25 février 2016 635 No national 0646825 Dénomination abrégée COVALSARTAN SDZ 160/12,5 MG 56 CPR Prise en charge conditionnelle Taux de prise en charge 0 100% 0646873 COVALSARTAN SDZ 160/12,5 MG 98 CPR 0 100% 0646968 COVALSARTAN SDZ 160/25 MG 28 CPR 0 100% 0647013 COVALSARTAN SDZ 160/25 MG 56 CPR 0 100% 0647058 COVALSARTAN SDZ 160/25 MG 98 CPR 0 100% 0646601 COVALSARTAN SDZ 80/12,5 MG 28 CPR 0 100% 0646646 COVALSARTAN SDZ 80/12,5 MG 56 CPR 0 100% 0646694 COVALSARTAN SDZ 80/12,5 MG 98 CPR 0 100% 0500252 COVERAM 10/10 MG 60 CPR 0 100% 0500266 COVERAM 10/10 MG 90 CPR 0 100% 0500722 COVERAM 10/5 MG 60 CPR 0 100% 0500736 COVERAM 10/5 MG 90 CPR 0 100% 0500381 COVERAM 5/10 MG 30 CPR 0 100% 0500428 COVERAM 5/10 MG 90 CPR 0 100% 0500543 COVERAM 5/5 MG 30 CPR 0 100% 0500588 COVERAM 5/5 MG 90 CPR 0 100% 0406278 COVERSYL 10 MG 60 CPR 0 100% 0406281 COVERSYL 10 MG 90 CPR 0 100% 0406121 COVERSYL 5 MG 30 CPR 0 100% 0406152 COVERSYL 5 MG 90 CPR 0 100% 0544261 COVERSYL PLUS 10/2,5 MG 60 CPR (FL) 0 100% 0544274 COVERSYL PLUS 10/2,5 MG 90 CPR (FL) 0 100% 0471987 COVERSYL PLUS 2,5/0,625 MG 30 CPR 0 100% 0472029 COVERSYL PLUS 2,5/0,625 MG 90 CPR 0 100% 0471875 COVERSYL PLUS 5/1,25 MG 30 CPR 0 100% 0471911 COVERSYL PLUS 5/1,25 MG 90 CPR 0 100% 0329683 COZAAR 100 MG 28 CPR 0 100% 0329702 COZAAR 100 MG 98 CPR 0 100% 0209171 COZAAR 50 MG 28 CPR 0 100% 0209184 COZAAR 50 MG 56 CPR 0 100% 0249646 COZAAR 50 MG 98 CPR 0 100% 0698107 COZAAR 50 PI-PL 50 MG 98 CPR 0 100% 0539954 COZAAR PLUS 100/12,5 MG 98 CPR 0 100% 0244345 COZAAR PLUS 50/12,5 MG 28 CPR 0 100% 0244359 COZAAR PLUS 50/12,5 MG 56 CPR 0 100% 0249632 COZAAR PLUS 50/12,5 MG 98 CPR 0 100% 0315545 COZAAR PLUS FORTE 100/25 MG 28 CPR 0 100% 100% 0315562 COZAAR PLUS FORTE 100/25 MG 98 CPR 0 0383612 CRATAEGUS OXYACANTHA D 1 MG 125 ML LHL 0 80% 0384945 CRATAEGUS OXYACANTHA D 1 MG 60 ML 0 80% LHL 0383514 CRATAEGUS OXYCANTHA 5 CH GRAN LHL 0 80% 0685014 CREON 10000 150 MG 100 CAPS (FL) 0 80% 0685045 CREON 25000 300 MG 100 CAPS (FL) 0 80% 0685076 CREON 40000 400 MG 100 CAPS 0 80% 0346636 CRESTOR 10 MG 28 CPR 0 80% 0346717 CRESTOR 10 MG 98 CPR 0 80% 0346796 CRESTOR 20 MG 28 CPR 0 80% 0346877 CRESTOR 20 MG 98 CPR 0 80% 0346975 CRESTOR 40 MG 28 CPR 0 80% 0347048 CRESTOR 40 MG 98 CPR 0 80% Mémorial B – N° 23 du 25 février 2016 636 No national 0226526 Dénomination abrégée CRIXIVAN 200 MG 360 CAPS Prise en charge conditionnelle Taux de prise en charge 0 100% 100% 0226557 CRIXIVAN 400 MG 180 CAPS 0 0383514 CROCUS SATIVUS 5 CH GRAN LHL 0 80% 0174545 CROIX BLANCHE 20 CPR 0 40% 0152101 CROIX BLANCHE 20 SACH 0 40% 0156601 CROIX BLANCHE MONO 500 MG 20 SACH 0 80% 0364571 CROMABAK 20 MG/ML COLLY 10 ML 0 80% 0170791 CROMOHEXAL 1% 20 MG 50 AMP 2 ML 0 80% 0170403 CROMOHEXAL 2% COLLY 10 ML 0 80% 0187235 CROMOHEXAL KOMB 2% SPRAY 15 ML + COLLY 0 80% 0267708 CROMOHEXAL SANFT NASENSPRAY 15 ML 0 80% 0267711 CROMOHEXAL SANFT NASENSPRAY 30 ML 0 80% 0176553 CROMOHEXAL UD COLLY 20*0,5 ML 0 80% 0195528 CROMOHEXAL UD COLLY 50*0,5 ML 0 80% 0383514 CROTON TIGLIUM 4 CH GRAN LHL 0 80% 0383514 CROTON TIGLIUM 5 CH GRAN LHL 0 80% 0383514 CROTON TIGLIUM 7 CH GRAN LHL 0 80% 0383514 CROTON TIGLIUM 9 CH GRAN LHL 0 80% 0383514 CUBEBA 5 CH GRAN LHL 0 80% 0383514 CUPRESSUS SEMPERVIRENS 5 CH GRAN 0 80% 0383495 CUPRUM ARSENICOSUM 5 CH GRAN LHL LHL 0 80% 0383495 CUPRUM ARSENICOSUM 7 CH GRAN LHL 0 80% 0384346 CUPRUM METALLICUM 12 CH DOSES LHL 0 80% 0383661 CUPRUM METALLICUM 12 CH GRAN LHL 0 80% 0384346 CUPRUM METALLICUM 15 CH DOSE LHL 0 80% 0383661 CUPRUM METALLICUM 15 CH GRAN LHL 0 80% 0384346 CUPRUM METALLICUM 30 CH DOSES LHL 0 80% 0383661 CUPRUM METALLICUM 30 CH GRAN LHL 0 80% 0383661 CUPRUM METALLICUM 4 CH GRAN LHL 0 80% 0383661 CUPRUM METALLICUM 5 CH GRAN LHL 0 80% 0383661 CUPRUM METALLICUM 7 CH GRAN LHL 0 80% 0384346 CUPRUM METALLICUM 9 CH DOSES LHL 0 80% 0383661 CUPRUM METALLICUM 9 CH GRAN LHL 0 80% 0382551 CUPRUM METALLICUM GRANULE 15CH BOIRON 0 80% 0382551 CUPRUM METALLICUM GRANULE 30CH BOIRON 0 80% 0382551 CUPRUM METALLICUM GRANULES 4CH BOIRON 0 80% 0382551 CUPRUM METALLICUM GRANULES 5CH BOIRON 0 80% 0382551 CUPRUM METALLICUM GRANULES 7CH BOIRON 0 80% 0382551 CUPRUM METALLICUM GRANULES 9CH BOIRON 0 80% 0472984 CURACNE 40 MG 30 CAPS 0 80% 0427927 CURACNE GE 10 MG 30 CAPS MOLLES 0 80% 0427975 CURACNE GE 20 MG 30 CAPS MOLLES 0 80% 0427863 CURACNE GE 5 MG 30 CAPS MOLLES 0 80% 0428017 CURATODERM EMULSION 4 MCG/G 20 ML 0 80% 0428034 CURATODERM EMULSION 4 MCG/G 50 ML 0 80% 0192767 CUTIVATE 0,005% POM 30 G 0 80% 0192736 CUTIVATE 0,05% CREME 30 G 0 80% 0382632 CYCLAMEN EUROPAEUM GRANULES 5CH BOIRON 0 80% 0382632 CYCLAMEN EUROPAEUM GRANULES 7CH BOIRON 0 80% 0382632 CYCLAMEN EUROPAEUM GRANULES 9CH BOIRON 0 80% Mémorial B – N° 23 du 25 février 2016 637 No national 0383514 Dénomination abrégée CYCLAMEN EUROPEUM 4 CH GRAN LHL Prise en charge conditionnelle Taux de prise en charge 0 80% 0383514 CYCLAMEN EUROPEUM 5 CH GRAN LHL 0 80% 0383514 CYCLAMEN EUROPEUM 7 CH GRAN LHL 0 80% 0383514 CYCLAMEN EUROPEUM 9 CH GRAN LHL 0 80% 0384332 CYCLANEM EUROPEUM 15 CH DOSES LHL 0 80% 0384332 CYCLANEM EUROPEUM 30CH DOSES LHL 0 80% 0384332 CYCLANEM EUROPEUM 7 CH DOSES LHL 0 80% 0384332 CYCLANEM EUROPEUM 9 CH DOSES LHL 0 80% 0026864 CYCLOCUR 3*21 DRG 0 80% 0394583 CYMBALTA 30 MG 28 CAPS 0 80% 0394602 CYMBALTA 60 MG 28 CAPS 0 80% 0754934 CYMBALTA 60 MG 98 CAPS 0 80% 0383514 CYPRIPEDIUM 5 CH GRAN LHL 0 80% 0383514 CYPRIPEDIUM 7 CH GRAN LHL 0 80% 0027164 CYTEAL SOL ANTISEPTIQUE 250 ML 0 80% 0027178 CYTEAL SOL ANTISEPTIQUE 500 ML 0 80% 0027262 CYTOTEC 200 MCG 112 CPR 0 80% 0720841 D CURE 25000 U/ML 12 AMP BUV 0 80% 0233341 D CURE 25000 U/ML 4 AMP BUV 0 80% 0176729 D CURE GTTS 10 ML 0 80% 0252798 D VITAL 500/440 GRAN EFF 30 SACH 0 80% 0252803 D VITAL FORTE 1000/880 GRAN EFF 30 SACH 0 80% 0462666 D VITAL FORTE 1000/880 GRAN EFF 90 SACH 0 80% 0027312 DAFALGAN 500 MG 30 CPR 0 80% 0138132 DAFALGAN 500 MG 32 CPR EFF 0 80% 0298198 DAFALGAN AD 600 MG 12 SUPP 0 80% 0298167 DAFALGAN BB 80 MG 12 SUPP 0 80% 0277072 DAFALGAN CODEINE 30 CPR 0 80% 0138485 DAFALGAN CODEINE 32 CPR EFF 0 80% 0380073 DAFALGAN FORTE 1 G 16 CPR 0 80% 0311627 DAFALGAN FORTE 1 G 16 CPR EFF 0 80% 0380087 DAFALGAN FORTE 1 G 32 CPR 0 80% 0311631 DAFALGAN FORTE 1 G 32 CPR EFF 0 80% 0380091 DAFALGAN FORTE 1 G 50 CPR 0 80% 0298184 DAFALGAN GD ENF 300 MG 12 SUPP 0 80% 0298171 DAFALGAN J ENF 150 MG 12 SUPP 0 80% 0277735 DAFALGAN ODIS 500 MG 16 CPR 0 80% 0298203 DAFALGAN PED 3% 90 ML 0 80% 0240122 DAKAR 15 MG 56 CAPS 0 80% 0204837 DAKAR 30 MG 28 CAPS 0 80% 0181276 DAKIN COOPER STABILISE 250 ML 0 80% 0027584 DAKTACORT CREME 15 G 17396 0 80% 0027598 DAKTACORT CREME 30 G 27332 0 80% 0027620 DAKTARIN CREME 30 G 17398 0 80% 0027634 DAKTARIN GEL ORAL 40 G 17392 0 80% 0027651 DAKTARIN PDR 20 G 17397 0 80% 0347911 DAKTARIN SPRAY 2%/D 1 FL 8 G 0 80% 0027679 DAKTARIN TEINTURE 30 ML 17395 0 80% 0177631 DAKTOZIN 0,25% PATE 90 G 52490 0 80% 0027763 DALACIN C 150 MG 16 CAPS 0 80% Mémorial B – N° 23 du 25 février 2016 638 No national 0027780 Dénomination abrégée DALACIN C 300 MG 16 CAPS Prise en charge conditionnelle Taux de prise en charge 0 80% 0027794 DALACIN C SIR 80 ML 0 80% 0239748 DALACIN TOPICAL 1% LOTIO 30 ML 0 80% 0203289 DALACIN VAG 2% CREME 40 G 0 80% 0027892 DAONIL 5 MG 100 CPR 0 100% 0027889 DAONIL 5 MG 30 CPR 0 100% 0381281 DAPHNE 2 MG 3*21 CPR 0 80% 0409137 DAPHNE 2 MG 6*21 CPR 0 80% 0027939 DARAPRIM 25 MG 30 CPR 0 80% 0028208 DEANXIT 30 CPR 0 80% 0285205 DECAPEPTYL 0,1 MG PSV 7 FL + S SC 0 80% 0299956 DECAPEPTYL SR 11,25 MG 1 SRG + S 2 ML 0 100% 0591517 DECAPEPTYL SR 22,5 MG 1 FL + S 0 100% 0299942 DECAPEPTYL SR 3,75 MG 1 SRG + S 2 ML 0 100% 0028600 DECODERM COMP CREME 20 G 0 80% 0028614 DECODERM COMP CREME 50 G 0 80% 0028631 DECODERM COMP SALBE 20 G 0 80% 0028645 DECODERM COMP SALBE 50 G 0 80% 0028547 DECODERM CREME 20 G 0 80% 0028550 DECODERM CREME 50 G 0 80% 0028564 DECODERM SALBE 20 G 0 80% 0192137 DECODERM TRI CREME 50 G 0 80% 0195464 DEHYDROSANOL TRI 30 DRG 0 80% 0028855 DEHYDROSANOL TRI 50 DRG 0 80% 0028984 DELPHI 0,1% CREME 30 G 0 80% 0029317 DEPAKINE 30% GTTS 60 ML 0 100% 0029320 DEPAKINE 6% SIR 300 ML 0 100% 0210611 DEPAKINE CHRONO 300 MG 50 CPR 0 100% 0210686 DEPAKINE CHRONO 500 MG 50 CPR 0 100% 0029334 DEPAKINE EC 150 MG 100 DRG 0 100% 0145297 DEPAKINE EC 300 MG 100 CPR 0 100% 0029348 DEPAKINE EC 500 MG 100 CPR 0 100% 0393099 DEPO ELIGARD 22,5 MG PSV 1 SRG + S SC 0 100% 0470461 DEPO ELIGARD 45 MG PSV 1 SRG + S SC 0 100% 0393118 DEPO ELIGARD 7,5 MG PSV 1 SRG + S SC 0 100% 0029611 DEPO MEDROL 200 MG 1 AMP 5 ML IMTO 0 80% 0029589 DEPO MEDROL 40 MG 1 AMP 1 ML IMTO 0 80% 0029639 DEPO MEDROL 40 MG 1 SRG 1 ML IMTO 0 80% 0029592 DEPO MEDROL 40 MG 3 AMP 1 ML IMTO 0 80% 0029625 DEPO MEDROL 40 MG 3 SRG 1 ML IMTO 0 80% 0029608 DEPO MEDROL 80 MG 1 AMP 2 ML IMTO 0 80% 0029642 DEPO MEDROL 80 MG 1 SRG 2 ML IMTO 0 80% 0029673 DEPO MEDROL LIDO 40 MG 1 FL 1 ML IMTO 0 80% 0029690 DEPO MEDROL LIDO 40 MG 3 FL 1 ML IMTO 0 80% 0029687 DEPO MEDROL LIDO 80 MG 1 FL 2 ML 0 80% 0029866 DEPO PROVERA 500 MG 1 AMP 3,3 ML IM 0 100% 0268401 DEPONIT NT 10 100 PATCH 0 80% 0268395 DEPONIT NT 10 30 PATCH 0 80% 0268378 DEPONIT NT 5 100 PATCH 0 80% 0268364 DEPONIT NT 5 30 PATCH 0 80% Mémorial B – N° 23 du 25 février 2016 639 No national Dénomination abrégée Prise en charge conditionnelle Taux de prise en charge 0030108 DEQUONAL SOL 200 ML 0 40% 0269215 DERMAZOL 1% PDR 30 G 0 80% 0256167 DERMAZOL 1% SOL 30 G 0 80% 0256136 DERMAZOL GE 1% CREME 30 G 0 80% 0256153 DERMAZOL GE 1% EMULSION 30 G 0 80% 0226168 DERMESTRIL 100 8 PATCH 0 80% 0350321 DERMESTRIL 25 26 PATCH 0 80% 0350334 DERMESTRIL 50 26 PATCH 0 80% 0269071 DERMESTRIL SEPTEM 25 12 PATCH 0 80% 0269098 DERMESTRIL SEPTEM 50 12 PATCH 0 80% 0030299 DERMOVATE 0,05% 1 TUBE ALU 30 G 0 80% 0030268 DERMOVATE 0,05% CREME 1 TUBE ALU 30 G 0 80% 0030271 DERMOVATE 0,05% FL HDPE 30 ML 0 80% 0030545 DESFERAL 500 MG PDR 10 FL+S 0 100% 0681094 DESLORATADIN SDZ 0,5MG/ML SOL BUV 150 ML 0 80% 0680794 DESLORATADIN SDZ 5 MG 10 CPR 0 80% 0680889 DESLORATADIN SDZ 5 MG 100 CPR 0 80% 0680858 DESLORATADIN SDZ 5 MG 30 CPR 0 80% 0680861 DESLORATADIN SDZ 5 MG 50 CPR 0 80% 0723132 DESLORATADINE EG 0,5 MG/ML SOL BUV 150ML 0 80% 0723051 DESLORATADINE EG 5 MG 100 CPR 0 80% 0723017 DESLORATADINE EG 5 MG 30 CPR 0 80% 0723021 DESLORATADINE EG 5 MG 50 CPR 0 80% 0459559 DESMOPRESSING FERRING 0,2 MG 100 CPR 0 80% 0459531 DESMOPRESSING FERRING 0,2 MG 15 CPR 0 80% 0244474 DETRUSITOL 2 MG 56 CPR 0 80% 0303706 DETRUSITOL RET 4 MG 28 CAPS 0 80% 0279807 DEXAGENTA POS COLLY 5 ML 0 80% 0030934 DEXAMYTREX COLLY 5 ML 555 0 80% 0030948 DEXAMYTREX POM OPHT 3 G 556 0 80% 0569841 DIAMICRON 60 MG 30 CPR 0 100% 0569886 DIAMICRON 60 MG 90 CPR 0 100% 0138101 DIAMOX 250 MG 25 CPR 0 80% 0031458 DIAMOX 500 MG PDR 1 FL IV 0 80% 0139997 DIANE 35 3*21 DRG 0 80% 0154542 DIAZEPAM EG 10 MG 25 CPR 0 40% 0031606 DIAZEPAM RATIO 10 MG 10 CPR 0 40% 0031623 DIAZEPAM RATIO 10 MG 20 CPR 0 40% 0214038 DIAZEPAM RATIO 10 MG 5 AMP 2 ML IMIV 0 40% 0031637 DIAZEPAM RATIO 10 MG 50 CPR 0 40% 0206201 DIAZEPAM RATIO 10 MG GTTS 25 ML 0 40% 0031640 DIAZEPAM RATIO 2 MG 10 CPR 0 40% 0031654 DIAZEPAM RATIO 2 MG 20 CPR 0 40% 0031668 DIAZEPAM RATIO 2 MG 50 CPR 0 40% 0031671 DIAZEPAM RATIO 5 MG 10 CPR 0 40% 0031685 DIAZEPAM RATIO 5 MG 20 CPR 0 40% 0031699 DIAZEPAM RATIO 5 MG 50 CPR 0 40% 0031783 DIBERTIL 10 MG 30 CAPS 0 80% 0031802 DIBERTIL 5 MG 30 CAPS 0 80% 0031895 DICLAC 100 MG 10 SUPP 0 80% Mémorial B – N° 23 du 25 février 2016 640 No national Dénomination abrégée Prise en charge conditionnelle Taux de prise en charge 0031928 DICLAC 25 MG 100 CPR 0 80% 0162365 DICLAC 25 MG 20 CPR 0 80% 0031914 DICLAC 25 MG 50 CPR 0 80% 0031959 DICLAC 50 MG 10 SUPP 0 80% 0031945 DICLAC 50 MG 100 CPR 0 80% 0162379 DICLAC 50 MG 20 CPR 0 80% 0208335 DICLAC 50 MG 30 SUPP 0 80% 0031931 DICLAC 50 MG 50 CPR 0 80% 0155519 DICLAC RET 100 MG 100 CPR 0 80% 0155486 DICLAC RET 100 MG 20 CPR 0 80% 0155505 DICLAC RET 100 MG 50 CPR 0 80% 0458694 DICLOABAK 0,1% COLLY 10 ML 0 80% 0451886 DICLOFENAC EG 100 MG 12 SUPP 0 80% 0451872 DICLOFENAC EG 100 MG 30 CPR 0 80% 0182662 DICLOFENAC EG 25 MG 100 CPR 0 80% 0182659 DICLOFENAC EG 25 MG 30 CPR 0 80% 0182676 DICLOFENAC EG 50 MG 50 CPR 0 80% 0451841 DICLOFENAC EG 75 MG 6 AMP 3 ML IVIM 0 80% 0451869 DICLOFENAC EG RET 75 MG 60 CPR 0 80% 0032021 DICLOFENAC RATIO 100 MG 10 SUPP 0 80% 0032035 DICLOFENAC RATIO 100 MG 50 SUPP 0 80% 0032066 DICLOFENAC RATIO 25 MG 100 CPR PELLIC 0 80% 0032049 DICLOFENAC RATIO 25 MG 20 CPR PELLIC 0 80% 0032052 DICLOFENAC RATIO 25 MG 50 CPR PELLIC 0 80% 0032147 DICLOFENAC RATIO 50 MG 10 SUPP 0 80% 0032133 DICLOFENAC RATIO 50 MG 100 CPR PELLIC 0 80% 0032102 DICLOFENAC RATIO 50 MG 20 CPR PELLIC 0 80% 0032116 DICLOFENAC RATIO 50 MG 50 CPR PELLIC 0 80% 0032150 DICLOFENAC RATIO 50 MG 50 SUPP 0 80% 0173405 DICLOFENAC RATIO SF 75 MG 1 AMP 2 ML IM 0 80% 0267269 DICLOFENAC RATIO SF 75 MG 10 AMP 2 ML 0 80% 0173422 DICLOFENAC RATIO SF 75 MG 30 AMP 2 ML IM 0 80% 0304796 DICLOFENAC RET MYLAN 100 MG 30 CPR 0 80% 0304782 DICLOFENAC RET MYLAN 75 MG 60 CPR 0 80% 0032228 DICLOFENAC RET RATIO 100 MG 100 CAPS RET 0 80% 0032200 DICLOFENAC RET RATIO 100 MG 20 CAPS RET 0 80% 0032214 DICLOFENAC RET RATIO 100 MG 50 CAPS RET 0 80% 0032357 DICYNONE 250 MG 20 CPR 0 80% 0032360 DICYNONE 50 CPR 0 80% 0032374 DICYNONE 6 AMP 2 ML IMIV 0 80% 0252025 DIFFERIN 0,1% CREME 30 G 0 80% 0380459 DIFFERIN 0,1% CREME 60 G 0 80% 0380462 DIFFERIN 0,1% GEL 60 G 0 80% 0244717 DIFLUCAN 10 MG/ML PDR SIR 1 FL 60 ML 0 80% 0163068 DIFLUCAN 150 MG 1 CAPS 0 80% 0178222 DIFLUCAN 200 MG 10 CAPS 0 80% 0178236 DIFLUCAN 200 MG 20 CAPS 0 80% 0244703 DIFLUCAN 40 MG/ML PDR SIR 1 FL 35 ML 0 80% 0165918 DIFLUCAN 50 MG 10 CAPS 0 80% 0383514 DIGITALIS PURPUREA 15 CH GRAN LHL 0 80% Mémorial B – N° 23 du 25 février 2016 641 No national 0383514 Dénomination abrégée DIGITALIS PURPUREA 30 CH GRAN LHL Prise en charge conditionnelle Taux de prise en charge 0 80% 0383514 DIGITALIS PURPUREA 4 CH GRAN LHL 0 80% 0383514 DIGITALIS PURPUREA 5 CH GRAN LHL 0 80% 0383514 DIGITALIS PURPUREA 7 CH GRAN LHL 0 80% 0383514 DIGITALIS PURPUREA 9 CH GRAN LHL 0 80% 0191501 DILTAHEXAL RET 90 MG 100 CPR 0 100% 0191496 DILTAHEXAL RET 90 MG 50 CPR 0 100% 0723423 DILTIAZEM RET 300 MG 100 CAPS 0 100% 0723339 DILTIAZEM RET 300 MG 30 CAPS 0 100% 0723289 DILTIAZEM RET EG 200 MG 100 CAPS 0 100% 0723213 DILTIAZEM RET EG 200 MG 30 CAPS 0 100% 0723454 DILTIAZEM SDZ 200 MG 28 CAPS 0 100% 0723549 DILTIAZEM SDZ 200 MG 98 CAPS 0 100% 0723597 DILTIAZEM SDZ 300 MG 28 CAPS 0 100% 0723695 DILTIAZEM SDZ 300 MG 98 CAPS 0 100% 0171669 DIMITONE 25 MG 56 CPR 0 100% 0383514 DIOSCOREA VILLOSA 5 CH GRAN LHL 0 80% 0383514 DIOSCOREA VILLOSA 7 CH GRAN LHL 0 80% 0310972 DIOVANE 160 MG 28 CPR 0 100% 0311001 DIOVANE 160 MG 98 CPR 0 100% 0310938 DIOVANE 80 MG 28 CPR 0 100% 0311255 DIOVANE 80 MG 56 CPR 0 100% 0033189 DIPHANTOINE 100 MG 100 CPR 0 100% 0033211 DIPHANTOINE 250 MG 5 AMP IV 0 100% 0033239 DIPIDOLOR 20 MG 5 AMP 2 ML IMSCIV 0 80% 0033290 DIPIPERON 4% GTTS 60 ML 17425 0 80% 0033256 DIPIPERON 40 MG 20 CPR 17421 0 80% 0033273 DIPIPERON 40 MG 60 CPR 17424 0 80% 0033337 DIPROLENE 0,05% CREME 30 G 0 80% 0033371 DIPROPHOS DS 2MG+5MG 1 SRG 1 ML IMIAID 0 80% 0033385 DIPROPHOS DS 4MG+10MG 1 SRG 2 ML IMIAID 0 80% 0033399 DIPROSALIC LOTION 30 ML 0 80% 0033404 DIPROSALIC ONG 30 G 0 80% 0033418 DIPROSONE 0,05% CREME 30 G 0 80% 0033421 DIPROSONE 0,05% LOTION 30 ML 0 80% 0033435 DIPROSONE 0,05% ONG 30 G 0 80% 0134648 DIPYRIDAMOLE EG 75 MG 100 DRG 0 80% 0164003 DISPACROMIL COLLY 10 ML 0 80% 0163992 DISPACROMIL SINE COLLY 20*0,5 ML 0 80% 0164017 DISPATENOL COLLY 10 ML 0 40% 0233226 DISPATENOL COLLY 3*10 ML 0 40% 0213996 DISPATIM SINE 0,25% COLLY 120*0,4 ML UD 0 80% 0214011 DISPATIM SINE 0,5% COLLY 120*0,4 ML UD 0 80% 0134522 DITROPAN 5 MG 100 CPR 0 80% 0134519 DITROPAN 5 MG 30 CPR 0 80% 0134505 DITROPAN 5 MG/5 ML SIR 473 ML 0 80% 0136741 DIXARIT 0,025 MG 100 DRG 0 80% 0298816 DOCCAPTOPRI 25 MG 60 CPR 0 100% 0298847 DOCCAPTOPRI 50 MG 60 CPR 0 100% 0034379 DOGMATIL 100 MG 6 AMP 2 ML IM 0 80% Mémorial B – N° 23 du 25 février 2016 642 No national Dénomination abrégée Prise en charge conditionnelle Taux de prise en charge 0034348 DOGMATIL 200 MG 12 CPR 0 80% 0034365 DOGMATIL 25 MG/5 ML SIR 200 ML 0 80% 0034351 DOGMATIL 50 MG 30 CAPS 0 80% 0034530 DOLCIDIUM 100 MG 12 SUPP 0 80% 0034544 DOLCIDIUM GE 50 MG 12 SUPP 0 80% 0189193 DOLCISPRAY 25 ML 0 40% 0768134 DOLCISPRAY 40 MG/ML 1 FL 50 ML 0 40% 0174741 DOLGIT 600 MG 100 DRG 0 80% 0174738 DOLGIT 600 MG 50 DRG 0 80% 0170627 DOLGIT 800 MG 20 CPR 0 80% 0170631 DOLGIT 800 MG 50 CPR 0 80% 0700057 DOLGIT SCHMERZCREME 5% 100 G 0 40% 0700043 DOLGIT SCHMERZCREME 5% 50 G 0 40% 0700012 DOLGIT SCHMERZGEL 5% 100 G 0 40% 0700026 DOLGIT SCHMERZGEL 5% 50 G 0 40% 0383514 DOLICHOS PRURIENS 4 CH GRAN LHL 0 80% 0383514 DOLICHOS PRURIENS 5 CH GRAN LHL 0 80% 0383514 DOLICHOS PRURIENS 7 CH GRAN LHL 0 80% 0383514 DOLICHOS PRURIENS 9 CH GRAN LHL 0 80% 0382632 DOLICHOS PRURIENS GRAN 5 CH BOIRON 0 80% 0382632 DOLICHOS PRURIENS GRAN 9 CH BOIRON 0 80% 0344113 DOLOL INSTANT 500 MG 20 CPR ORODISP 0 80% 0205381 DOLPRONE 500 MG 16 CPR 0 80% 0364603 DOLVIRAN N 20 CPR 0 40% 0212906 DOLZAM 100 MG 10 AMP 2 ML 0 80% 0212891 DOLZAM 100 MG 5 AMP 2 ML 0 80% 0212856 DOLZAM 100 MG/ML GTTS 10 ML 0 80% 0212873 DOLZAM 100 MG/ML GTTS 3*10 ML 0 80% 0245261 DOLZAM 100 MG/ML GTTS 5*10 ML 0 80% 0220441 DOLZAM 50 MG 30 CAPS 0 80% 0212842 DOLZAM 50 MG 60 CAPS 0 80% 0371317 DOLZAM RET 100 MG 56 CPR 0 80% 0371284 DOLZAM RET 150 MG 56 CPR 0 80% 0371253 DOLZAM RET 200 MG 56 CPR 0 80% 0371348 DOLZAM RET 75 MG 56 CPR 0 80% 0279712 DOLZAM UNO 150 MG 28 CPR 0 80% 0279726 DOLZAM UNO 200 MG 28 CPR 0 80% 0272188 DOLZAM UNO 300 MG 14 CPR 0 80% 0272191 DOLZAM UNO 400 MG 14 CPR 0 80% 0035359 DOMINAL FORTE 80 MG 50 CPR 0 80% 0457747 DOMPERIDONE EG 10 MG 30 CPR 0 80% 0560931 DOMPERIDONE EG 10 MG 30 CPR ORODISP 0 80% 0734928 DONEPEZIL EG 10 MG 28 CPR 1 80% 0735004 DONEPEZIL EG 10 MG 98 CPR 1 80% 0734721 DONEPEZIL EG 5 MG 28 CPR 1 80% 0734802 DONEPEZIL EG 5 MG 98 CPR 1 80% 0587626 DONEPEZIL HCL RATIO 10 MG 28 CPR 1 80% 0587657 DONEPEZIL HCL RATIO 10 MG 56 CPR 1 80% 0587674 DONEPEZIL HCL RATIO 10 MG 98 CPR 1 80% 0587528 DONEPEZIL HCL RATIO 5 MG 28 CPR 1 80% Mémorial B – N° 23 du 25 février 2016 643 No national 0587545 Dénomination abrégée DONEPEZIL HCL RATIO 5 MG 56 CPR Prise en charge conditionnelle Taux de prise en charge 1 80% 0587562 DONEPEZIL HCL RATIO 5 MG 98 CPR 1 80% 0591789 DONEPEZIL RATIO 10 MG 28 CPR ORODISP 1 80% 0591839 DONEPEZIL RATIO 10 MG 98 CPR ORODISP 1 80% 0591663 DONEPEZIL RATIO 5 MG 28 CPR ORODISP 1 80% 0591727 DONEPEZIL RATIO 5 MG 98 CPR ORODISP 1 80% 0653296 DONEPEZIL SDZ 10 MG 28 CPR ORODIS 1 80% 0653637 DONEPEZIL SDZ 10 MG 28 CPR PELLIC 1 80% 0654326 DONEPEZIL SDZ 10 MG 28 FILMS (SACH) 1 80% 0653332 DONEPEZIL SDZ 10 MG 56 CPR ORODIS 1 80% 0653668 DONEPEZIL SDZ 10 MG 56 CPR PELLIC 1 80% 0654374 DONEPEZIL SDZ 10 MG 56 FILMS (SACH) 1 80% 0653427 DONEPEZIL SDZ 10 MG 98 CPR ORODIS 1 80% 0653704 DONEPEZIL SDZ 10 MG 98 CPR PELLIC 1 80% 0654407 DONEPEZIL SDZ 10 MG 98 FILMS (SACH) 1 80% 0652786 DONEPEZIL SDZ 5 MG 28 CPR ORODIS 1 80% 0653783 DONEPEZIL SDZ 5 MG 28 CPR PELLIC 1 80% 0654178 DONEPEZIL SDZ 5 MG 28 FILMS (SACH) 1 80% 0652822 DONEPEZIL SDZ 5 MG 56 CPR ORODIS 1 80% 0653816 DONEPEZIL SDZ 5 MG 56 CPR PELLIC 1 80% 0654214 DONEPEZIL SDZ 5 MG 56 FILMS (SACH) 1 80% 0652871 DONEPEZIL SDZ 5 MG 98 CPR ORODIS 1 80% 0653864 DONEPEZIL SDZ 5 MG 98 CPR PELLIC 1 80% 0654245 DONEPEZIL SDZ 5 MG 98 FILMS (SACH) 1 80% 0199513 DORMONOCT 1 MG 30 CPR 0 40% 0199527 DORMONOCT 2 MG 30 CPR 0 40% 0638191 DORZOLAMIDE/TIMOLOL EG 20+5MG/ML 3*5 ML 0 80% 0638188 DORZOLAMIDE/TIMOLOL EG 20+5MG/ML 5 ML 0 80% 0191319 DOSTINEX 0,5 MG 2 CPR 0 80% 0501121 DOVOBET 50 MCG/G+0,5 MG/G GEL 2*60 G 0 80% 0501103 DOVOBET 50 MCG/G+0,5 MG/G GEL 30 G 0 80% 0501117 DOVOBET 50 MCG/G+0,5 MG/G GEL 60 G 0 80% 0313392 DOVOBET POM 120 G 0 80% 0313361 DOVOBET POM 30 G 0 80% 0313375 DOVOBET POM 60 G 0 80% 0169805 DOXY M RATIO 100 MG 10 CPR 0 80% 0169819 DOXY M RATIO 100 MG 20 CPR 0 80% 0169822 DOXY M RATIO 200 MG 10 CPR 0 80% 0245101 DOXY M RATIO 200 MG 20 CPR 0 80% 0185843 DOXYCYCLIN RATIO SF 2 AMP 5 ML IV 0 80% 0185857 DOXYCYCLIN RATIO SF 5 AMP 5 ML IV 0 80% 0238091 DOXYCYCLINE EG 100 MG 10 CPR 0 80% 0238088 DOXYCYCLINE EG 200 MG 10 CPR 0 80% 0170384 DOXYHEXAL TABS 100 MG 10 CPR 0 80% 0170398 DOXYHEXAL TABS 100 MG 20 CPR 0 80% 0170367 DOXYHEXAL TABS 200 MG 10 CPR 0 80% 0170371 DOXYHEXAL TABS 200 MG 20 CPR 0 80% 0036034 DOXYLETS 100 MG 10 CAPS 0 80% 0036048 DOXYLETS 200 MG 10 CAPS 0 80% 0384332 DROSERA ROTUNDIFOLIA 12 CH DOSES 0 80% LHL Mémorial B – N° 23 du 25 février 2016 644 No national 0383514 Dénomination abrégée DROSERA ROTUNDIFOLIA 12 CH GRAN LHL Prise en charge conditionnelle Taux de prise en charge 0 80% 0384332 DROSERA ROTUNDIFOLIA 15 CH DOSE LHL 0 80% 0383514 DROSERA ROTUNDIFOLIA 15 CH GRAN LHL 0 80% 0384332 DROSERA ROTUNDIFOLIA 30 CH DOSES 0 80% LHL 0383514 DROSERA ROTUNDIFOLIA 30 CH GRAN LHL 0 80% 0383514 DROSERA ROTUNDIFOLIA 4 CH GRAN LHL 0 80% 0383514 DROSERA ROTUNDIFOLIA 5 CH GRAN LHL 0 80% 0383514 DROSERA ROTUNDIFOLIA 7 CH GRAN LHL 0 80% 0384332 DROSERA ROTUNDIFOLIA 9 CH DOSE LHL 0 80% 0383514 DROSERA ROTUNDIFOLIA 9 CH GRAN LHL 0 80% 0384783 DROSERA ROTUNDIFOLIA GLOBULE 15CH BOIRON 0 80% 0384783 DROSERA ROTUNDIFOLIA GLOBULES 9CH BOIRON 0 80% 0382632 DROSERA ROTUNDIFOLIA GRANULE 15CH BOIRON 0 80% 0382632 DROSERA ROTUNDIFOLIA GRANULE 30CH BOIRON 0 80% 0382632 DROSERA ROTUNDIFOLIA GRANULES 5CH BOIRON 0 80% 0382632 DROSERA ROTUNDIFOLIA GRANULES 7CH BOIRON 0 80% 0382632 DROSERA ROTUNDIFOLIA GRANULES 9CH BOIRON 0 80% 0781685 DUALKOPT 20+5 MG/ML COLLY 10 ML 0 80% 0384332 DULCAMARA 12 CH DOSE LHL 0 80% 0383514 DULCAMARA 12 CH GRAN LHL 0 80% 0384332 DULCAMARA 15 CH DOSE LHL 0 80% 0383514 DULCAMARA 15 CH GRAN LHL 0 80% 0384332 DULCAMARA 30 CH DOSES LHL 0 80% 0383514 DULCAMARA 30 CH GRAN LHL 0 80% 0383514 DULCAMARA 4 CH GRAN LHL 0 80% 0383514 DULCAMARA 5 CH GRAN LHL 0 80% 0384332 DULCAMARA 7 CH DOSES LHL 0 80% 0383514 DULCAMARA 7 CH GRAN LHL 0 80% 0384332 DULCAMARA 9 CH DOSE LHL 0 80% 0383514 DULCAMARA 9 CH GRAN LHL 0 80% 0384783 DULCAMARA GLOBULES 7CH BOIRON 0 80% 0384783 DULCAMARA GLOBULES 9CH BOIRON 0 80% 0382632 DULCAMARA GRANULE 15CH BOIRON 0 80% 0382632 DULCAMARA GRANULES 4CH BOIRON 0 80% 0382632 DULCAMARA GRANULES 5CH BOIRON 0 80% 0382632 DULCAMARA GRANULES 7CH BOIRON 0 80% 0382632 DULCAMARA GRANULES 9CH BOIRON 0 80% 0245664 DULCOLAX BISACODYL 10 MG 10 SUPP 0 40% 0245647 DULCOLAX BISACODYL 5 MG 40 DRG 0 40% 0178785 DUOFILM SOL 15 ML 0 80% 0434997 DUOTRAV 40 MCG/ML 5 MG/ML COLLY 3*2,5 ML 0 80% 0305499 DUOVENT HFA 200 D 10 ML INH 0 100% 0213187 DUOVENT SOL INH 20 AMP MD 4 ML 0 100% 0203888 DUPHALAC DRY PDR 20 SACH 10 G 0 40% 0398064 DUPHALAC FRUIT 10 G 20 SACH 15 ML 0 40% 0156127 DUPHALAC SIR 20 SACH 15 ML 0 40% 0037059 DUPHALAC SIR 300 ML 0 40% 0037062 DUPHALAC SIR 500 ML 0 40% 0171624 DUPHASTON 10 MG 42 CPR 0 80% 0037286 DURACEF 500 MG 16 CAPS 0 80% Mémorial B – N° 23 du 25 février 2016 645 No national 0217608 Dénomination abrégée DURACEF 500 MG/5 ML PDR SIR 80 ML Prise en charge conditionnelle Taux de prise en charge 0 80% 0037322 DURACEF HD 250 MG/5 ML SIR 80 ML 0 80% 0492621 DUROGESIC 100 MCG/H (16,8 MG) 10 PATCH 0 80% 0227943 DUROGESIC 100 MCG/H (16,8 MG) 5 PATCH 0 80% 0409803 DUROGESIC 12 MCG/H (2,1 MG) 10 PATCH 0 80% 0409798 DUROGESIC 12 MCG/H (2,1 MG) 5 PATCH 0 80% 0492598 DUROGESIC 25 MCG/H (4,2 MG) 10 PATCH 0 80% 0227909 DUROGESIC 25 MCG/H (4,2 MG) 5 PATCH 0 80% 0492603 DUROGESIC 50 MCG/H (8,4 MG) 10 PATCH 0 80% 0227912 DUROGESIC 50 MCG/H (8,4 MG) 5 PATCH 0 80% 0492617 DUROGESIC 75 MCG/H (12,6 MG) 10 PATCH 0 80% 0227926 DUROGESIC 75 MCG/H (12,6 MG) 5 PATCH 0 80% 0195481 DUSPATALIN 135 MG 120 DRG 0 80% 0037434 DUSPATALIN 135 MG 40 DRG 0 80% 0037787 DYTENZIDE 112 CPR 0 80% 0037773 DYTENZIDE 28 CPR 0 80% 0383514 ECHINACEA ANGUSTIFOLIUM 4 CH GRAN LHL 0 80% 0383514 ECHINACEA ANGUSTIFOLIUM 5 CH GRAN LHL 0 80% 0383514 ECHINACEA ANGUSTIFOLIUM 7 CH GRAN LHL 0 80% 0384332 ECHINACEA ANGUSTIFOLIUM 9 CH DOSE LHL 0 80% 0383514 ECHINACEA ANGUSTIFOLIUM 9 CH GRAN LHL 0 80% 0384332 ECHINACEA AUGUSTIFOLIA 12 CH DOSES LHL 0 80% 0384332 ECHINACEA AUGUSTIFOLIA 7 CH DOSES LHL 0 80% 0038042 ECLARAN 10 GEL 45 G 0 80% 0038056 ECLARAN 5 GEL 45 G 0 80% 0182547 EDUCTYL 12 SUPP AD 0 40% 0182533 EDUCTYL 12 SUPP ENF 0 40% 0634998 EDURANT 25 MG 30 CPR (FL) 0 100% 100% 0758057 EFAVIRENZ SDZ 600 MG 60 CPR 0 0258127 EFEXOR EXEL 150 MG 28 CAPS 0 80% 0482249 EFEXOR EXEL 150 MG 56 CAPS 0 80% 0482252 EFEXOR EXEL 150 MG 98 CAPS 0 80% 0409476 EFEXOR EXEL 37,5 MG 7 CAPS 0 80% 0258077 EFEXOR EXEL 75 MG 28 CAPS 0 80% 0482431 EFEXOR EXEL 75 MG 56 CAPS 0 80% 0482445 EFEXOR EXEL 75 MG 98 CAPS 0 80% 0038199 EFFORTIL 0,75% GTTS 50 ML 0 80% 0038185 EFFORTIL 5 MG 50 CPR 0 80% 0516977 EFIENT 10 MG 28 CPR 1 80% 0517005 EFIENT 10 MG 84 CPR 1 80% 0516641 EFIENT 5 MG 28 CPR 1 80% 0516672 EFIENT 5 MG 84 CPR 1 80% 0038266 EFUDIX ONG 20 G 0 80% 0383514 ELAIS 5 CH GRAN LHL 0 80% 0300699 ELDEPRYL 10 MG 30 CPR 0 100% 0237791 ELDEPRYL 5 MG 60 CPR 0 100% 0383514 ELEUTHEROCOCCUS 5 CH GRAN LHL 0 80% 0334439 ELIDEL 1% CREME 15 G 0 80% 0334442 ELIDEL 1% CREME 30 G 0 80% 0679552 ELIQUIS 2,5 MG 168 CPR 0 80% Mémorial B – N° 23 du 25 février 2016 646 No national Dénomination abrégée Prise en charge conditionnelle Taux de prise en charge 0612391 ELIQUIS 2,5 MG 20 CPR 0 80% 0612407 ELIQUIS 2,5 MG 60 CPR 0 80% 0679535 ELIQUIS 5 MG 168 CPR 0 80% 0679504 ELIQUIS 5 MG 56 CPR 0 80% 0182872 ELOCOM 0,1% CREME 20 G 0 80% 0182905 ELOCOM 0,1% LOT 20 ML 0 80% 0182886 ELOCOM 0,1% ONG 20 G 0 80% 0555815 ELONVA 100 MCG 1 SRG 0,5 ML + 1 AIG SC 0 80% 0558767 ELONVA 150 MCG 1 SRG 0,5 ML + 1 AIG SC 0 80% 0038736 ELOTRANS 10 SACH 3660851 0 80% 100% 0213531 ELVORINE 7,5 MG 10 CPR 0 0263855 EMADINE 0,5 MG/ML COLLY 5 ML 0 80% 0446645 EMESAN 50 MG 10 CPR 0 40% 0438867 EMESAN 50 MG 20 CPR 0 40% 0438871 EMESAN 50 MG 50 CPR 0 40% 0451435 EMESAN K 20 MG 10 SUPP 0 40% 0451421 EMESAN K 20 MG 5 SUPP 0 40% 0227859 EMLA 5 % 2 PATCH 0 80% 0157754 EMLA 5% CREME 5 G + 2 PANSEM 0 80% 0742321 EMSELEX 15 MG 98 CPR (PVC/PVDC) 0 80% 0742236 EMSELEX 7,5 MG 98 CPR (PVC/PVDC) 0 80% 0355988 EMTRIVA 200 MG 30 CAPS 0 100% 0419214 ENALAPRIL EG 20 MG 28 CPR 0 100% 0419231 ENALAPRIL EG 20 MG 56 CPR 0 100% 0419245 ENALAPRIL EG 20 MG 98 CPR 0 100% 0419151 ENALAPRIL EG 5 MG 28 CPR 0 100% 0443951 ENBREL 25 MG PDR 4 SRG PREREMPL 0,5 ML 0 100% 0462263 ENBREL 25 MG PDR 4FL+4SRG+20AIG+4ADAPT+T 0 100% 0524903 ENBREL 50 MG PDR 4 MYCLIC 1 ML + 8 TAMP 0 100% 0443996 ENBREL 50 MG PDR 4 SRG PREREMPL 1 ML 0 100% 0399769 ENDOFALK 6 SACH 0 40% 0039246 ENDOXAN 50 MG 50 DRG 0 100% 0260674 ENELFA DR HENK 125 MG 10 SUPP 0 80% 0260688 ENELFA DR HENK 250 MG 10 SUPP 0 80% 0260691 ENELFA DR HENK 500 MG 10 SUPP 0 80% 0428812 ENTEROL 250 MG 10 CAPS 0 40% 0635981 ENTEROL 250 MG 10 CAPS BLIST 0 40% 0428861 ENTEROL 250 MG 10 SACH 0 40% 0428826 ENTEROL 250 MG 20 CAPS 0 40% 0635995 ENTEROL 250 MG 20 CAPS BLIST 0 40% 0428874 ENTEROL 250 MG 20 SACH 0 40% 0428843 ENTEROL 250 MG 50 CAPS 0 40% 0227991 ENTOCORT 3 MG 100 CAPS 0 80% 0190213 ENTOCORT ENEMA LAVT 7 CPR + 7 FL P 0 80% 0039991 EPANUTIN 100 MG 100 CAPS 0 100% 0382632 EPATORIUM PERFOLIATUM GRAN 15 CH BOIRON 0 80% 0382632 EPATORIUM PERFOLIATUM GRAN 5 CH BOIRON 0 80% 0382632 EPATORIUM PERFOLIATUM GRAN 7 CH BOIRON 0 80% 0382632 EPATORIUM PERFOLIATUM GRAN 9 CH BOIRON 0 80% 0755766 EPERZAN 30MG/0,5ML PSV I/P 4STYLOS+4AIG 0 100% Mémorial B – N° 23 du 25 février 2016 647 No national 0755783 Dénomination abrégée EPERZAN 50MG/0,5ML PSV I/P 4STYLOS+4AIG Prise en charge conditionnelle Taux de prise en charge 0 100% 0383514 EPHEDRA VULGARIS 4 CH GRAN LHL 0 80% 0224292 EPIVIR 10 MG/ML GTTS 240 ML 0 100% 0224308 EPIVIR 150 MG 60 CPR 0 100% 0309372 EPIVIR 300 MG 30 CPR 0 100% 0226333 EPREX 1000 U 6 SRG 0,5 ML SC 1 100% 0226378 EPREX 10000 U 6 SRG 1 ML SC 1 100% 0226347 EPREX 2000 U 6 SRG 0,5 ML SC 1 100% 0449391 EPREX 20000 U 1 SRG 0,5 ML SCIV 1 100% 0226351 EPREX 3000 U 6 SRG 0,3 ML SC 1 100% 0226364 EPREX 4000 U 6 SRG 0,4 ML SC 1 100% 0449356 EPREX 40000 U 1 SRG 1 ML SCIV 1 100% 0293434 EPREX 5000 U 6 SRG 0,5 ML 1 100% 0293448 EPREX 6000 U 6 SRG 0,6 ML 1 100% 0293465 EPREX 8000 U 6 SRG 0,8 ML 1 100% 0435011 EPTAVIT 1000 MG 880 U 30 CPR EFF 0 80% 0450831 EPTAVIT 1000 MG 880 U 90 CPR EFF 0 80% 0383514 EQUISETUM ARVENSE 5 CH GRAN LHL 0 80% 0383514 EQUISETUM HIEMALE 5 CH GRAN LHL 0 80% 0383514 EQUISETUM HIEMALE 7 CH GRAN LHL 0 80% 0382632 EQUISETUM HIEMALE GRANULES 5CH BOIRON 0 80% 0382632 EQUISETUM HIEMALE GRANULES 7CH BOIRON 0 80% 0040832 ERY 125 MG 24 SACH 0 80% 0040846 ERY 250 MG 24 SACH 0 80% 0040863 ERY 500 MG 20 CPR SEC 0 80% 0040913 ERYFLUID LOTION 100 ML 0 80% 0183236 ERYHEXAL 1000 MG 12 SACH 0 80% 0183253 ERYHEXAL 1000 MG 20 SACH 0 80% 0140001 ERYHEXAL 200 MG/5 ML GRAN P SIR 100 ML 0 80% 0187221 ERYHEXAL 200 MG/5 ML GRAN P SIR 2*100 ML 0 80% 0383514 ERYSIMUM 5 CH GRAN LHL 0 80% 0383514 ERYSIMUM 7 CH GRAN LHL 0 80% 0384332 ERYSIMUM 9 CH DOSES LHL 0 80% 0041020 ERYTHROCINE 1 G PDR 1 FL + S 20 ML IV 0 80% 0252963 ERYTHROCINE 250 MG/5 ML SIR 80 ML 0 80% 0169447 ERYTHROFORTE 1000 MG 10 SACH 0 80% 0041101 ERYTHROFORTE 500 MG 16 CPR 0 80% 0041115 ERYTHROFORTE 500 MG 16 SACH 0 80% 0167974 ERYTHROMYCIN RATIO 1000 DB 12 SACH 0 80% 0167988 ERYTHROMYCIN RATIO 1000 DB 20 SACH 0 80% 0259107 ERYTHROMYCINE BAILLEUL 4% SOL 100 ML 0 80% 0168016 ERYTHROMYCINE RATIO 250 DB 20 SACH 0 80% 0771269 ESCIDIVULE 10 MG 100 CPR 3167327 0 80% 0771241 ESCIDIVULE 10 MG 30 CPR 0 80% 0771255 ESCIDIVULE 10 MG 60 CPR 0 80% 0771305 ESCIDIVULE 20 MG 100 CPR 0 80% 0771272 ESCIDIVULE 20 MG 30 CPR 0 80% 0771286 ESCIDIVULE 20 MG 60 CPR 0 80% 0749383 ESCITALOPRAM EG 10 MG 28 CPR 0 80% 0749416 ESCITALOPRAM EG 10 MG 56 CPR 0 80% Mémorial B – N° 23 du 25 février 2016 648 No national 0749447 Dénomination abrégée ESCITALOPRAM EG 10 MG 98 CPR Prise en charge conditionnelle Taux de prise en charge 0 80% 0749495 ESCITALOPRAM EG 20 MG 28 CPR 0 80% 0749545 ESCITALOPRAM EG 20 MG 98 CPR 0 80% 0668383 ESCITALOPRAM RATIO 10 MG 100 CPR 0 80% 0668285 ESCITALOPRAM RATIO 10 MG 20 CPR 0 80% 0668321 ESCITALOPRAM RATIO 10 MG 50 CPR 0 80% 0668576 ESCITALOPRAM RATIO 15 MG 100 CPR 0 80% 0668481 ESCITALOPRAM RATIO 15 MG 20 CPR 0 80% 0668528 ESCITALOPRAM RATIO 15 MG 50 CPR 0 80% 0668772 ESCITALOPRAM RATIO 20 MG 100 CPR 0 80% 0668688 ESCITALOPRAM RATIO 20 MG 20 CPR 0 80% 0668724 ESCITALOPRAM RATIO 20 MG 50 CPR 0 80% 0668187 ESCITALOPRAM RATIO 5 MG 100 CPR 0 80% 0668089 ESCITALOPRAM RATIO 5 MG 20 CPR 0 80% 0668125 ESCITALOPRAM RATIO 5 MG 50 CPR 0 80% 0710327 ESCITALOPRAM SDZ 10 MG 28 CPR 0 80% 0758589 ESCITALOPRAM SDZ 10 MG 30 CPR ORODIS 0 80% 0758625 ESCITALOPRAM SDZ 10 MG 60 CPR ORODIS 0 80% 0758639 ESCITALOPRAM SDZ 10 MG 90 CPR ORODIS 0 80% 0710408 ESCITALOPRAM SDZ 10 MG 98 CPR 0 80% 0710845 ESCITALOPRAM SDZ 20 MG 28 CPR 0 80% 0710876 ESCITALOPRAM SDZ 20 MG 56 CPR 0 80% 0758978 ESCITALOPRAM SDZ 20 MG 90 CPR ORODIS 0 80% 0710943 ESCITALOPRAM SDZ 20 MG 98 CPR 0 80% 0710067 ESCITALOPRAM SDZ 5 MG 28 CPR 0 80% 0758415 ESCITALOPRAM SDZ 5 MG 30 CPR ORODIS 0 80% 0710098 ESCITALOPRAM SDZ 5 MG 56 CPR 0 80% 0710148 ESCITALOPRAM SDZ 5 MG 98 CPR 0 80% 100% 0679678 ESMYA 5 MG 84 CPR 0 0572721 ESOMEPRAZOL RATIO 20 MG 15 CAPS 0 80% 0630274 ESOMEPRAZOL RATIO 20 MG 15 CPR 0 80% 0572749 ESOMEPRAZOL RATIO 20 MG 30 CAPS 0 80% 0630291 ESOMEPRAZOL RATIO 20 MG 30 CPR 0 80% 0572783 ESOMEPRAZOL RATIO 20 MG 60 CAPS 0 80% 0630324 ESOMEPRAZOL RATIO 20 MG 60 CPR 0 80% 0572797 ESOMEPRAZOL RATIO 20 MG 90 CAPS 0 80% 0630338 ESOMEPRAZOL RATIO 20 MG 90 CPR 0 80% 0572881 ESOMEPRAZOL RATIO 40 MG 15 CAPS 0 80% 0630422 ESOMEPRAZOL RATIO 40 MG 15 CPR 0 80% 0572901 ESOMEPRAZOL RATIO 40 MG 30 CAPS 0 80% 0630453 ESOMEPRAZOL RATIO 40 MG 30 CPR 0 80% 0572931 ESOMEPRAZOL RATIO 40 MG 60 CAPS 0 80% 0630484 ESOMEPRAZOL RATIO 40 MG 60 CPR 0 80% 0572945 ESOMEPRAZOL RATIO 40 MG 90 CAPS 0 80% 0630498 ESOMEPRAZOL RATIO 40 MG 90 CPR 0 80% 0700074 ESOMEPRAZOL SDZ 20 MG 14 CPR 0 80% 0700088 ESOMEPRAZOL SDZ 20 MG 28 CPR 0 80% 0700091 ESOMEPRAZOL SDZ 20 MG 56 CPR 0 80% 0700107 ESOMEPRAZOL SDZ 20 MG 98 CPR 0 80% 0700138 ESOMEPRAZOL SDZ 40 MG 28 CPR 0 80% Mémorial B – N° 23 du 25 février 2016 649 No national Dénomination abrégée Prise en charge conditionnelle Taux de prise en charge 0223054 ESTIVAN 10 MG 20 CPR 0 80% 0348918 ESTIVAN 20 MG 20 CPR 0 80% 0041681 ESTRACYT 140 MG 100 CAPS (FL) 0 100% 0041728 ESTRADURINE 80 MG PDR 1 FL + S 2 ML IM 0 100% 0256928 ESTRAMON 100 8 MG 6 PATCH 0 80% 0256864 ESTRAMON 25 2 MG 6 PATCH 0 80% 0256895 ESTRAMON 50 4 MG 6 PATCH 0 80% 0262505 ESTREVA 0,1 % GEL 50 G 0 80% 0238575 ESTROFEM 1 MG 3*28 CPR 0 80% 0176438 ESTROFEM 2 MG 3*28 CPR 0 80% 0383495 ETHYLICUM 5 CH GRAN LHL 0 80% 0474961 EUCREAS 50/1000 MG 180 CPR BLIST 0 100% 0474944 EUCREAS 50/1000 MG 60 CPR BLIST 0 100% 0474863 EUCREAS 50/850 MG 180 CPR BLIST 0 100% 0474832 EUCREAS 50/850 MG 60 CPR BLIST 0 100% 0383514 EUGENIA JAMBOSA 4 CH GRAN LHL 0 80% 0383514 EUGENIA JAMBOSA 5 CH GRAN LHL 0 80% 0384332 EUGENIA JAMBOSA 7 CH DOSE LHL 0 80% 0383514 EUGENIA JAMBOSA 7 CH GRAN LHL 0 80% 100% 0042370 EUGLUCON 5 100 CPR 0 0268588 EULITOP 400 MG 30 CPR 0 80% 0042515 EUMOVATE CREME 30 G 0 80% 0042529 EUMOVATE ONG 30 G 0 80% 0383514 EUPATORIUM PERFOLIATUM 15 CH GRAN LHL 0 80% 0384332 EUPATORIUM PERFOLIATUM 30 CH DOSES LHL 0 80% 0383514 EUPA

Explication IA à partir du texte officiel de la loi. Indicatif, ne remplace pas un conseil juridique.