Die rot hinterlegten Packungen (Originale und Generika) werden mit 20% Selbstbehalt belegt.
Die gelb hinterlegten Originale behalten während max. 24 Monaten den regulären Selbstbehalt von 10%.
14.01.13. |
Niederosmolare nicht-ionische Monomere |
V08AB02 |
Iohexol |
Präparat |
Form / Dosierung |
Packung |
O / G |
SB 20% |
Befreit |
Fabr.-Preis |
Publ.-Preis |
Unit-Preis (FAP) |
Firma |
Accupaque |
Inj Lös 300 mg |
Plast Fl 50 ml |
G |
N |
N |
32 |
53.1 |
32 |
GE Healthcare AG |
Accupaque |
Inj Lös 300 mg |
Plast Fl 100 ml |
G |
N |
N |
61.15 |
86.6 |
61.15 |
GE Healthcare AG |
Accupaque |
Inj Lös 300 mg |
Plast Fl 200 ml |
G |
N |
N |
120.6 |
154.85 |
120.6 |
GE Healthcare AG |
Accupaque |
Inj Lös 300 mg |
Plast Fl 500 ml |
G |
N |
N |
301.5 |
362.5 |
301.5 |
GE Healthcare AG |
Accupaque |
Inj Lös 350 mg |
Plast Fl 50 ml |
G |
N |
N |
33.97 |
55.35 |
33.97 |
GE Healthcare AG |
Accupaque |
Inj Lös 350 mg |
Plast Fl 100 ml |
G |
N |
N |
66.88 |
93.2 |
66.88 |
GE Healthcare AG |
Accupaque |
Inj Lös 350 mg |
Plast Fl 200 ml |
G |
N |
N |
129.28 |
164.8 |
129.28 |
GE Healthcare AG |
Accupaque |
Inj Lös 350 mg |
Plast Fl 500 ml |
G |
N |
N |
323.2 |
387.45 |
323.2 |
GE Healthcare AG |
|
|
14.01.21. |
Wasserlösliche Iodpräparate |
V08AA01 |
Amidotrizoesäure |
Präparat |
Form / Dosierung |
Packung |
O / G |
SB 20% |
Befreit |
Fabr.-Preis |
Publ.-Preis |
Unit-Preis (FAP) |
Firma |
Gastrografin |
Lös |
10 Fl 100 ml |
O |
N |
N |
171.3 |
213.05 |
0.17 |
Bayer (Schweiz) AG |
Gastrografin |
Lös |
Fl 100 ml |
O |
N |
N |
17.13 |
36.05 |
0.17 |
Bayer (Schweiz) AG |
|
|
14.02. |
Präparate für die magnetische Resonanztomographie |
V08CA02 |
Gadotersäure |
Präparat |
Form / Dosierung |
Packung |
O / G |
SB 20% |
Befreit |
Fabr.-Preis |
Publ.-Preis |
Unit-Preis (FAP) |
Firma |
Clariscan |
Inj Lös 2.793 g/10ml |
Fertspr 10 ml |
G |
N |
N |
33.46 |
54.8 |
33.46 |
GE Healthcare AG |
Clariscan |
Inj Lös 2.793 g/10ml |
Durchstf 10 ml |
G |
N |
N |
33.46 |
54.8 |
33.46 |
GE Healthcare AG |
Dotagraf |
Inj Lös 2.793 g/10ml |
Amp 10 ml |
G |
N |
N |
33.46 |
54.8 |
33.46 |
Berlis AG |
Clariscan |
Inj Lös 4.189 g/15ml |
Fertspr 15 ml |
G |
N |
N |
45.47 |
68.6 |
45.47 |
GE Healthcare AG |
Clariscan |
Inj Lös 4.189 g/15ml |
Durchstf 15 ml |
G |
N |
N |
45.47 |
68.6 |
45.47 |
GE Healthcare AG |
Dotagraf |
Inj Lös 4.189 g/15ml |
Amp 15 ml |
G |
N |
N |
45.47 |
68.6 |
45.47 |
Berlis AG |
Dotarem |
Inj Lös 2.793 g/10 ml |
Plastik-Fertspr 10 ml |
O |
N |
N |
47.8 |
71.25 |
47.8 |
Guerbet AG |
Dotarem |
Inj Lös 2.793 g/10ml |
Durchstf 10 ml |
O |
N |
N |
47.8 |
71.25 |
47.8 |
Guerbet AG |
Clariscan |
Inj Lös 5.586 g/20ml |
Fertspr 20 ml |
G |
N |
N |
57.46 |
82.35 |
57.46 |
GE Healthcare AG |
Clariscan |
Inj Lös 5.586 g/20ml |
Durchstf 20 ml |
G |
N |
N |
57.46 |
82.35 |
57.46 |
GE Healthcare AG |
Dotagraf |
Inj Lös 5.586 g/20ml |
Amp 20 ml |
G |
N |
N |
57.46 |
82.35 |
57.46 |
Berlis AG |
Dotarem |
Inj Lös 4.189 g/15 ml |
Plastik-Fertspr 15 ml |
O |
N |
N |
64.96 |
90.95 |
64.96 |
Guerbet AG |
Dotarem |
Inj Lös 4.189 g/15ml |
Durchstf 15 ml |
O |
N |
N |
64.96 |
90.95 |
64.96 |
Guerbet AG |
Dotarem |
Inj Lös 5.586 g/20 ml |
Plastik-Fertspr 20 ml |
O |
N |
N |
82.09 |
110.65 |
82.09 |
Guerbet AG |
Dotarem |
Inj Lös 5.586 g/20ml |
Durchstf 20 ml |
O |
N |
N |
82.09 |
110.65 |
82.09 |
Guerbet AG |
Clariscan |
Inj Lös 13.965 g/50ml |
PP Fl 50 ml |
G |
N |
N |
133.86 |
170.05 |
133.86 |
GE Healthcare AG |
Dotagraf |
Inj Lös 16.76 g/60ml |
Amp 60 ml |
G |
N |
N |
160.63 |
200.8 |
160.63 |
Berlis AG |
Dotarem |
Inj Lös 16.76 g/60ml |
Durchstf 60 ml |
O |
N |
N |
246.27 |
299.1 |
246.27 |
Guerbet AG |
Clariscan |
Inj Lös 27.93 g/100ml |
PP Fl 100 ml |
G |
N |
N |
267.71 |
323.75 |
267.71 |
GE Healthcare AG |
Dotagraf |
Inj Lös 27.93 g/100ml |
Amp 100 ml |
G |
N |
N |
267.71 |
323.75 |
267.71 |
Berlis AG |
|