Preferentiematrix per stofnaam / per verzekeraar / per 1 juli 2015 (voor zover bekend en bijgewerkt per 30 juni 2015) 1/9

Transcription

1 Preferentiematrix per stofnaam / per verzekeraar / per 1 juli 2015 (voor zover bekend en bijgewerkt per 30 juni 2015) 1/9 STOFNAAM MG/mcg AGIS/ACHMEA CZ groep MENZIS VGZ/Univé ATC code VERZEKERAAR UZOVI Acenocoumarol 1 SZ B01AA07 Acetylsalicylzuur 30 RP RP B01AC06 Acetylsalicylzuur 80 AX MY RP B01AC06 Aciclovir SZ SZ J01AB01 Acitretine (=Neotigason) ACT D05BB02 Alendroninezuur 10 AH M05BA04 Alendroninezuur 70 AH ACT/AUR ACT/AUR AUR M05BA04 Alfuzosine 2,5 AUR G04CA01 Alfuzosine 10 AUR/RB AUR FF G04CA01 Allopurinol 100 AX/SZ SZ M04AA01 Allopurinol 300 ACT/AX ACT M04AA01 Alprazolam 0,25+0,5 MY MY N05BA12 Amiloride/HCLt 2,5/25 PCH/SZ C03EA01 Aevitae (Avéro Achmea) 8958 Amiloride/HCLt 5/50 AH AH C03EA01 Aevitae (VGZ) 8956 Amiodaron 200 MY C01BD01 Aevitae-De Goudse (Uvit) 3330 Amitriptyline 10 AX/SZ CF W06AA09 Agis 3337 Amitriptyline 25 AX CF W06AA09 Anderzorg (2011) 3333 Amlodipine 5 AH AH/FC AH AH C08CA01 Avéro Achmea 3329 Amlodipine 10 FC FC FC FC C08CA01 Azivo 7054 Amoxicill./Clav Sus. 125/31,25 SZ J01CR02 Caresco (de Goudse) 8995 Amoxicill./Clav Sus. 250/62,5 SZ SZ J01CR02 CZ 7119 Amoxicilline Caps 500 MY/SZ FC J01CA04 CZ groep 9664 Amoxicilline Disp T. 375 ACT J01CA04 Delta Lloyd 104 Amoxicilline Disp T. 750 SZ SZ J01CA04 DJI 9551 Amoxicilline Susp 250mg/5ml SZ J01CA04 FBTO 211 Amoxicilline/Clav T. 500/125 SZ AUR J01CR02 IAK (Avéro Achmea) 8971 Amoxicilline/Clav T. 875/125 SZ AUR J01CR02 IAK (VGZ) 8972 Anastrozol 1 AH AH/FC FC FC L02BG03 Interpolis Zorgverzekeringen 3313 Atenolol 25 ACT ACT L02BG03 IZA (nieuw) 699 Atenolol ACT/KW ACT C07AB03 IZA zorgverzekeraar NV 3334 Atenolol HCl 50/12,5 AX SZ C07AB03 IZZ (VGZ) 9015 Atenolol HCl 100/25 SZ SZ C07AB03 Menzis (2011) 3332 Atorvastatine 10 MY/RB FF/MY/PF PF RB C10AA05 Nedasco (Avéro Achmea) 8960 Atorvastatine 20 MY FF/MY/PF PF RB C10AA05 Nedasco (VGZ) 8965 Atorvastatine 40 RB FF/MY/PF PF RB C10AA05 Ohra Atorvastatine 80 RB C10AA05 Ohra Azathioprine 25 SZ SZ L04AX01 OZF Achmea 3314 Azathioprine 50 SZ SZ L04AX01 Turien - Avéro Achmea 3342 Azitromycine 250 FC FC J01FA10 Turien & Co 3341 Azitromycine 500 FC/SZ FC J01FA10 Turien (Avéro Achmea) 8966 Azitromycine 200mg/5ml SZ J01FA10 UMC 736 Baclofen 10 ACT ACT M03BX01 Unive 101 Baclofen 25 MY MY M03BX01 VGZ 7095 Beclometason 50ug/do neusspray SZ SZ R03BA01 Zilveren Kruis Achmea 3311 Beclometason 250ug/do aerosol AX R03BA01 Betahistine 8+16 AH AH N07CA01 Betamethason creme, lotion, zalf 1mg/gr SZ SZ D07AC01 Bicatulamide 50 SU SU AH L02BB03 Bisoprolol 1,25 MY C07AB07 Bisoprolol 2,5 AH ACT C07AB07 Bisoprolol 5 MY MY C07AB07 Bisoprolol 10 AH AH C07AB07 Bisoprolol/HCt 5/12,5+10/25 SZ C07AB07 Brimonidine 2mg/ml MY MY S01EA05 Bromazepam 3 SZ N05BA08 Budesonide ug/do poeder ME A07EA06 Budesonide 200ug/do aerosol AG/MY MY A07EA06 Budesonide 50ug/do spray FC FC FC A07EA06 Budesonide 100ug/do spray MY AX AX A07EA06 Bumetadine 1 SZ C03CA02 Bumetadine 2 RP C03CA02 Bumetadine 5 RP C03CA02 Buprenorfine 35ug+52,5ug+70ug/uur FF N02AE01 Buspiron 10 MY N05BE01

2 Preferentiematrix per stofnaam / per verzekeraar / per 1 juli 2015 (voor zover bekend en bijgewerkt per 30 juni 2015) 2/9 Cabergoline 0,5 SZ SZ G02CB03 Calci/colecal kwt 500mg/800ie ME A12AX Calci/vit D3 kwt 1000mg/880ie SZ A12AX Calciumcarbonaat 500 SZ A12AA04 Candesartan 4 ACT ACT/AUR ACT FC C09CA06 Candesartan 8 ACT ACT/AUR ACT FC C09CA06 Candesartan 16 ACT ACT/AUR ACT FC C09CA06 zie 1/9 + 3/9 + 5/9 + 7/9 + 9/9 Candesartan 32 FC CF FC C09CA06 Candesartan HCt 16/12,5 ACT/CF/FC/ MY/PCH/SZ ACT/MY ACT FC C09DA06 Captopril AH C09AA01 Captopril HCl 50/25 SZ C09BA01 Carbamazepine 100 AX N03AF01 Carbamazepine 200 MY N03AF01 Unive 101 Carbamazepine Ret 200 AX N03AF01 Delta Lloyd 104 Carbamazepine Ret 400 AX N03AF01 Ohra Carbasalaat calcium 100 RP B01AC08 FBTO 211 Carvedilol 3,125 SZ SZ C07AG02 IZA (nieuw) 699 Carvedilol 6,25+25 SZ SZ C07AG02 UMC 736 Carvedilol 12,5 SZ SZ C07AG02 Zilveren Kruis Achmea 3311 Celecoxib CF SZ M01AH01 Interpolis Zorgverzekeringen 3313 Chlooramfenicol oogzalf 10mg/g RP RP S01AA01 OZF Achmea 3314 Chloortalidon 25 AH/AX AH C03BA04 Avéro Achmea 3329 Chloortalidon 50 AH C03BA04 Aevitae-De Goudse (Uvit) 3330 Cimetidine 200 AH A02BA01 Menzis (2011) 3332 Cimetidine 400 AH AH A02BA01 Anderzorg (2011) 3333 Cimetidine 800 SZ AH A02BA01 IZA zorgverzekeraar NV 3334 Ciprofloxacine Tab AH AH J01MA02 Agis 3337 Ciprofloxacine Tab 750 AH RP J01MA02 Turien & Co 3341 Citalopram Tab 10 ACT ACT N06AB04 Turien - Avéro Achmea 3342 Citalopram Tab 20 SZ ACT N06AB04 Ohra Citalopram Tab 30 SZ N06AB04 Azivo 7054 Citalopram Tab 40 ACT/MY SZ N06AB04 VGZ 7095 Claritromycine Tab 250 RB RB J01FA09 CZ 7119 Claritromycine Tab 500 AUR AUR AUR J01FA09 Aevitae (VGZ) 8956 Claritromycine Ret Tab 500 ACT/CF/MY /PCH/SZ CF J01FA09 Aevitae (Avéro Achmea) 8958 Clindamycine 150 SZ SZ J01FF01 Nedasco (Avéro Achmea) 8960 Clindamycine 300 SZ SZ J01FF01 Nedasco (VGZ) 8965 Clomipramine 25 SZ MY N06AA04 Turien (Avéro Achmea) 8966 Clomipramine 75 MY SZ N06AA04 IAK (Avéro Achmea) 8971 Clopidogrel 75 GL/MY AH/AUR AUR GL B01AC04 IAK (VGZ) 8972 Clozapine 25 ACT ACT N05AH02 Caresco (de Goudse) 8995 Clozapine 100 ACT ACT N05AH02 IZZ (VGZ) 9015 Clozapine 200 SZ N05AH02 DJI 9551 Codeïne 10 RP RP R05DA04 CZ groep 9664 Codeïne 20 RP RP R05DA04 Colchicine 0,5 SZ SZ M04AC01 Colistine pdr vernevelvlst IE CP CP CP J01XB01 Cyproteron 50 MY G03HA01 Cyproteron/Ethin. 2mg/35mcg FC/MY G03HB01 Desloratadine drank 0,5mg/ml SZ R06AX27 Desloratadine 5mg GL GL RP R06AX27 Desmopressine 0,1 MY SZ FE H01BA02 Desmopressine 0,2 FE ACT/MY/SZ FE H01BA02 Desmopressine Spray 10mcg ACT/MY ACT H01BA02 Diazepam 2 ACT/AX N05BA01 Diazepam 5 ACT/AX/CF/ MY/PCH/SZ N05BA01 Diazepam 10 AX N05BA01 zie 1/9 + 3/9 + 5/9 + 7/9 + 9/9 Diclofenac Sup 50 AX CF M01AB05 Diclofenac Sup 100 AX CF M01AB05 Diclofenac Tab 25 ACT CF M01AB05 Diclofenac Tab 50 CF M01AB05 Diclofenac Tab 75 CF M01AB05 Diclofenac Tab 100 CF M01AB05 Diclofenac/Misoprostol 50+75mg/200ug SZ M01AB55

3 Preferentiematrix per stofnaam / per verzekeraar / per 1 juli 2015 (voor zover bekend en bijgewerkt per 30 juni 2015) 3/9 Diltiazem 60 SZ C08DB01 Diltiazem 120 AX RP C08DB01 Diltiazem 180 MY C08DB01 Diltiazem 200 CF CF MY C08DB01 Diltiazem 240 MY C08DB01 Diltiazem 300 CF/MY CF MY C08DB01 Dorzolamide oogdr 20mg/ml SZ ACT S01EC03 Doxazosine 4 SZ SZ C02CA04 Doxazosine 8 MY MY C02CA04 Doxycycline 100 RP RP J01AA02 Efavirenz 600mg MY MY J05AG03 Enalapril HCt 20/12,5mg RP RP C09BA02 Enalapril HCt 20/6mg SZ C09BA02 Aevitae (Avéro Achmea) 8958 Enalapril Tab 5 SZ RP C09AA02 Aevitae (VGZ) 8956 Enalapril Tab 10 RP SZ C09AA02 Aevitae-De Goudse (Uvit) 3330 Enalapril Tab 20 SZ SZ C09AA02 Agis 3337 Enalapril Tab 40 SZ SZ C09AA02 Anderzorg (2011) 3333 Epoetine 0,6+0,75+0,8+1,0 HOS N04BX02 Avéro Achmea 3329 Entacapon 200 MY MY N04BX02 Azivo 7054 Eprosartan 400 MY C09CA02 Caresco (de Goudse) 8995 Eprosartan 600 MY C09CA02 CZ 7119 Escitalopram 10 MY/SZ ACT ACT N06AB10 CZ groep 9664 Escitalopram 15 AUR AUR RP N06AB10 Delta Lloyd 104 Escitalopram 20 AUR/SZ AUR RP N06AB10 DJI 9551 Escitalopram druppels 20mg/ml FC FC N06AB10 FBTO 211 Esomeprazol 20 SZ SZ PR SZ A02BC05 IAK (Avéro Achmea) 8971 Esomeprazol 40 SZ SZ PR SZ A02BC05 IAK (VGZ) 8972 Estradiol 2 SZ G03CA03 Interpolis Zorgverzekeringen 3313 Estradiol 50ug/24u SZ SZ G03CA03 IZA (nieuw) 699 Ethinylestradiol/Desog 20/150ug FF G03AA09 IZA zorgverzekeraar NV 3334 Ethinylestradiol/Desog 30/150ug MY FF G03AA09 IZZ (VGZ) 9015 Ethinylestradiol/Drospir 20UG/3mg CF CF G03AA12 Menzis (2011) 3332 Ethinylestradiol/Drospir 30UG/3mg MY CF/SZ MY G03AA12 Nedasco (Avéro Achmea) 8960 Ethinylestradiol/Levon 20/100Ug SZ FC/SZ FC FC G03AA07 Nedasco (VGZ) 8965 Ethinylestradiol/Levon 30/150Ug FF FF/MY MY FF G03AA07 Ohra Exemestaan 25mg AH AH AH L02BG06 Ohra Famciclovir 125 SZ ACT J05AB09 OZF Achmea 3314 Famciclovir 500 SZ ACT J05AB09 Turien - Avéro Achmea 3342 Famotidine 20 SZ A02BA03 Turien & Co 3341 Famotidine 40 ACT/SZ A02BA03 Turien (Avéro Achmea) 8966 Felodipine 5 ACT SZ C08CA02 UMC 736 Felodipine 10 ACT ACT C08CA02 Unive 101 Fenprocoumon 3mg SZ B01AA04 VGZ 7095 Fentanyl pleister 12 mcg/u CF SZ N02AB03 Zilveren Kruis Achmea 3311 Fentanyl pleister mcg/u CF SZ N02AB03 Fentanyl tabletten ug GR N02AB03 Fentanyl tabletten ug ME N02AB03 Ferrofumaraat 200 ACT/AX/CF/ MY/PCH/SZ B03AA02 Fexofenadine 120 RP RP R06AX26 Fexofenadine 180 MY R06AX26 Finasteride 5 AH AUR G04CB01 Flecainide Tablet 50 ACT/SZ C01BC04 Flecainide Tablet 100 ACT C01BC04 Flecainide Tablet SZ C01BC04 Flucloxacilline 250 ACT J01CF05 Flucloxacilline 500 MY MY J01CF05 Fluconazol 50 SZ J02AC01 Fluconazol 150 SZ J02AC01 Fluconazol 200 ACT J02AC01 Fluconazol Infvlst 2mg/ml FK J02AC01 Fluoxetine 20 ACT ACT N06AB03 Fluticason neusspr. 50mcg FC FC/MY FC FC R01AD08 Fluvastatine Caps SZ SZ C10AA04 Fluvastatine Caps 80 ACT/AH AH C10AA04

4 Preferentiematrix per stofnaam / per verzekeraar / per 1 juli 2015 (voor zover bekend en bijgewerkt per 30 juni 2015) 4/9 Fluvoxamine 50 ACT N06AB08 Fluvoxamine 100 MY ACT N06AB08 Foliumzuur 5 AX B03BB01 Formoterol aerosol 12mcg/do CH R03AC13 Formoterol Drup./Pdr. 6+12mcg/do ME R03AC13 Fosinopril ACT ACT C09AA09 Fosinopril HCt 20/12,5 ACT C09BA09 zie 1/9 + 3/9 + 5/9 + 7/9 + 9/9 Fucidinezuur creme 20mg/g WP WP D06AX01 Furosemide 20 CF C03CA01 Furosemide 40 AX/SZ CF C03CA01 Furosemide 500 SA C03CA01 Gabapentine AUR AUR N03AX12 Gabapentine 400 RP AUR N03AX12 Unive 101 Galantamine 8 CF ACT N06DA04 Delta Lloyd 104 Galantamine 16 MY CF ACT N06DA04 Ohra Galantamine 24 MY CF CF N06DA04 FBTO 211 Gemfibrozil 600 AX/SZ C10AB04 IZA (nieuw) 699 Gemfibrozil 900 ACT C10AB04 UMC 736 Glibenclamide 5 AX/CF/MY/ PCH/SZ A10BB01 Zilveren Kruis Achmea 3311 Gliclazide MY A10BB09 Interpolis Zorgverzekeringen 3313 Glimepiride AH AH A10BB12 OZF Achmea 3314 Glimepiride 3 AH SZ A10BB12 Avéro Achmea 3329 Glimepiride 6 SZ SZ A10BB12 Aevitae-De Goudse (Uvit) 3330 Granisetron 1+2 ACT ACT A04AA02 Menzis (2011) 3332 Hydrochloorthiazide 12,5 SZ MY MY MY C03AA03 Anderzorg (2011) 3333 Hydrochloorthiazide 25 AX/SZ CF MY C03AA03 IZA zorgverzekeraar NV 3334 Hydrochloorthiazide 50 AX C03AA03 Agis 3337 Hydrocortison/Miconazol creme 10/20mg/g PCH RP D07XA01 Turien & Co 3341 Hydroxocobalamine 500ug/ml inj. CF B03BA03 Turien - Avéro Achmea 3342 Ibandroninezuur 150mg MY CF MY M05BA06 Ohra Ibuprofen Tabl 600 ACT ACT M01AE01 Azivo 7054 Indapamide 2,5 SZ C03BA11 VGZ 7095 Indometacine 25 ACT M01AB01 CZ 7119 Irbesartan 75 ACT FC ACT C09CA04 Aevitae (VGZ) 8956 Irbesartan 150 FC/PR ACT PR ULL C09CA05 Aevitae (Avéro Achmea) 8958 Irbesartan 300 ACT/FC AH FC ACT C09CA04 Nedasco (Avéro Achmea) 8960 Irbesartan HCt 150/12,5 ACT/SZ SZ FC C09CA04 Nedasco (VGZ) 8965 Irbesartan HCt 300/12,5 ACT SZ FC C09CA04 Turien (Avéro Achmea) 8966 Irbesartan HCt 300/25 SZ SZ FC C09CA04 IAK (Avéro Achmea) 8971 Isosorbidedinitraat 20 AX C01DA08 IAK (VGZ) 8972 Isosorbidemononitraat 10 ACT ACT C01DA14 Caresco (de Goudse) 8995 Isosorbidemononitraat AH C01DA14 IZZ (VGZ) 9015 Isosorbidemononitraat 60 SZ MY C01DA14 DJI 9551 Isotretinoine ACT ACT D10BA01 CZ groep 9664 Itraconazol 100 MY/SZ J02AC02 (Kal.)Losartan HCt 100/12,5mg AUR/MY AUR AUR C09DA01 (Kal.)Losartan HCt 100/25mg FC FC FC FC C09DA01 (Kal.)Losartan HCt 50/12,5mg FC FC/MY FC FC C09DA01 (Kalium)Losartan 25 AH AH C09CA01 (Kalium)Losartan 50 AH AH AH FC C09CA01 (Kalium)Losartan 100 AH/FC AH/FC/MY AH FC C09CA01 Ketoconazol Sham. 20mg/g ACT ACT D01AC08 Ketotifen stroop 0,2mg/ml AX R06AX17 Labetalol MY C07AG01 Labetalol 200 AX MY C07AG01 Lactulose 6 FC A06AD11 Lactulose 12 FC A06AD11 zie 1/9 + 3/9 + 5/9 + 7/9 + 9/9 Lactulose 670mg/ml 300ml FC FK A06AD11 Lactulose 670mg/ml 500ml FC MY FK A06AD11 Lactulose 670mg/ml 1000ml FK FC MY FK A06AD11 Lamivudine 100 SZ J05AF05 Lamivudine 150 AUR J05AF05 Lamivudine 300 AUR AUR J05AF05 Lamotrigine 5 CF N03AX09

5 Preferentiematrix per stofnaam / per verzekeraar / per 1 juli 2015 (voor zover bekend en bijgewerkt per 30 juni 2015) 5/9 Lamotrigine ACT MY N03AX09 Lamotrigine 50 ACT/SZ MY N03AX09 Lansoprazol 30 CF A02BC03 Latanoprost oogdruppels 50mcg/ml SZ ACT/MY PF SZ S01EE01 Leflunomide RP CF L04AA13 Lercanidipine ACT ACT C08CA13 Letrozol 2,5 AH AH/FC FC AH L02BG04 Levetiracetam AH AUR AH N03AX14 Levetiracetam 1000 AUR AUR AH N03AX14 Levetiracetam 100mg/ml ACT/AUR AUR ACT N03AX14 Levocetirizine 5 FC/GL SZ FC FC R06AE09 Levodopa/Carbidopa 100/10mg MY N04BA02 Levodopa/Carbidopa 100/25mg MY/RP MY/RP N04BA02 Aevitae (Avéro Achmea) 8958 Levodopa/Carbidopa 200/50mg RP AH N04BA02 Aevitae (VGZ) 8956 Levodopa/Carbidopa 250/25mg MY N04BA02 Aevitae-De Goudse (Uvit) 3330 Levofloxacine 250 AUR J01MA12 Agis 3337 Levofloxacine 500 AUR J01MA12 Anderzorg (2011) 3333 Lisinopril 5+10 AH AH C09AA03 Avéro Achmea 3329 Lisinopril 20 AH AH AH C09AA03 Azivo 7054 Lisinopril HCl 20/12,5 AX CF C09BA03 Caresco (de Goudse) 8995 Lorazepam 1 AX N05BA06 CZ 7119 Lorazepam 2,5 AX N05BA06 CZ groep 9664 Lormetazepam 1 MY N05CD06 Delta Lloyd 104 Lormetazepam 2 AX N05CD06 DJI 9551 Macrogol 13,1g MY SZ CF RP A06AD65 FBTO 211 Meloxicam 7,5+15 ACT/PR M01AC06 IAK (Avéro Achmea) 8971 Memantine 10 CF SZ N06DX01 IAK (VGZ) 8972 Memantine 20 ACT CF SZ N06DX01 Interpolis Zorgverzekeringen 3313 Mesalazine sup 250 SZ A07EC02 IZA (nieuw) 699 Mesalazine sup 500 SZ ACT A07EC02 IZA zorgverzekeraar NV 3334 Metformine 500 ACT SZ A10BA02 IZZ (VGZ) 9015 Metformine 850 ACT ACT A10BA02 Menzis (2011) 3332 Metformine 1000 RP RP A10BA02 Nedasco (Avéro Achmea) 8960 Methadon 5 SZ SZ N07BC02 Nedasco (VGZ) 8965 Methylfenidaat 5 MY MY N06BA04 Ohra Methylfenidaat 10 MY MY/SZ MY N06BA04 Ohra Methylfenidaat MY N06BA04 OZF Achmea 3314 Metoclopramide 10 AH AH A03FA01 Turien - Avéro Achmea 3342 Metoprolol SUC HCt 100/12,5mg PF SZ C07BB02 Turien & Co 3341 Metoprolol SUC Ret (23,75+)25 SZ SZ C07AB02 Turien (Avéro Achmea) 8966 Metoprolol SUC Ret (47,5)+50 SZ MY/SZ SZ C07AB02 UMC 736 Metoprolol SUC Ret (95+)100 SZ SZ SZ C07AB02 Unive 101 Metoprolol SUC Ret (190+)200 CF CF C07AB02 VGZ 7095 Metoprolol TAR 50 AH ACT C07AB02 Zilveren Kruis Achmea 3311 Metoprolol TAR 100 AH AH C07AB02 Metronidazol 250 ACT ACT D06BX01 Metronidazol 500 ACT ACT D06BX01 Metronidazol creme 10mg/g ACT D06BX01 Metronidazol gel 7,5mg/g SZ D06BX01 Midazolam Injvlst 5mg/ml AH/FK N05CD08 Minocycline 50 SZ ACT P01AB01 Minocycline 100 SZ ACT N05CD08 Mirtazapine 15 SZ SZ J01AA08 Mirtazapine 30 AUR AUR J01AA08 Mirtazapine 45 ACT SZ N06AX11 Moclobemide 150 SZ N06AX11 Modafinil 100 AUR PR AUR N06BA07 Mometason zalf 1mg/g MY D07AC13 Mometason neusspray 50ug/do FF FF R01AD09 Montelukast 4 AUR AH R03DC03 Montelukast 5 FC AUR AH R03DC03 Montelukast 10 RP MY MY MY R03DC03 Moxifloxacine 400 ACT J01MA14 Moxonidine 0,2 SZ N02AA01

6 Preferentiematrix per stofnaam / per verzekeraar / per 1 juli 2015 (voor zover bekend en bijgewerkt per 30 juni 2015) 6/9 Nabumeton 500 ACT L04AA06 Naltrexon 50 AH AH L04AA06 Naproxen 250 AH AH M01AX01 Naproxen 500 AH AH N07BB04 Naratriptan 2,5 ACT/CF/MY ACT N02CC02 Nebivolol Tab 2,5 GL M01AE02 Nebivolol Tab 5 ACT ACT M01AE02 zie 1/9 + 3/9 + 5/9 + 7/9 + 9/9 Nevirapine 200 SZ AUR MY J05AG01 Nifedipine Retard 20 AX CF C08CA05 Nifedipine Retard 30 RP FF/SZ FF C08CA05 Nifedipine Retard 60 SZ SZ C08CA05 Nitrazepam 5 ACT/AX C08CA05 Nitrofurantoïne AX AX C08CA05 Unive 101 Nitroglycerine spray 0,4mg/do SZ C01DA02 Delta Lloyd 104 Nitroglycerine pleister mg/24uur ME C01DA02 Ohra Norfloxacine 400 SZ GO4A9 FBTO 211 Octreotide Inj.vlst 0,05 FK FK JO1MA06 IZA (nieuw) 699 Octreotide Inj.vlst 0,1 FK/SU FK FK JO1MA06 UMC 736 Octreotide Inj.vlst 0,5 FK/SU FK FK JO1MA06 Zilveren Kruis Achmea 3311 Octreotide Inj.vlst 0,2 HOS/SZ H01CB02 Interpolis Zorgverzekeringen 3313 Ofloxacine 400 SZ D01MA01 OZF Achmea 3314 Ofloxacine oogdr 3mg/ml SZ S01AE01 Avéro Achmea 3329 Olanzapine 2,5 AH AH AH AH N05AH03 Aevitae-De Goudse (Uvit) 3330 Olanzapine 5 AH AH AH AH/GL N05AH03 Menzis (2011) 3332 Olanzapine 10 FC AH AH AH/GL N05AH03 Anderzorg (2011) 3333 Olanzapine 15 AH AH AH AH/GL N05AH03 IZA zorgverzekeraar NV 3334 Olanzapine 20 AH AH GL AH/GL N05AH03 Agis 3337 Olanzapine smelt GL N05AH03 Turien & Co 3341 Omeprazol 10 ACT ACT A02BC01 Turien - Avéro Achmea 3342 Omeprazol 20 SZ ACT ACT FF A02BC01 Ohra Omeprazol 40 SZ ACT ACT FF A02BC01 Azivo 7054 Ondansetron 4 AUR/CF AUR A04AA01 VGZ 7095 Ondansetron 8 AUR AUR AUR A04AA01 CZ 7119 Oxazepam 10 AH/AX AH N05BA04 Aevitae (VGZ) 8956 Oxazepam 50 AH/AX N05BA04 Aevitae (Avéro Achmea) 8958 Oxcarbazepine 300 FC N03AF02 Nedasco (Avéro Achmea) 8960 Oxcarbazepine 600 MY N03AF02 Nedasco (VGZ) 8965 Oxybutynine 2,5 AH PR G04BD04 Turien (Avéro Achmea) 8966 Oxybutynine 5 AH PR G04BD04 IAK (Avéro Achmea) 8971 Oxycodon 5 ACT ACT MY ACT N02AA05 IAK (VGZ) 8972 Oxycodon 10 SZ ACT MY ACT N02AA05 Caresco (de Goudse) 8995 Oxycodon 20 SZ ACT N02AA05 IZZ (VGZ) 9015 Oxycodon 40 SZ N02AA05 DJI 9551 Oxycodon MGA 5 ACT MY MY N02AA05 CZ groep 9664 Oxycodon MGA 10 ACT/SZ MY MY N02AA05 Oxycodon MGA ACT N02AA05 Oxycodon MGA 20 SZ ACT ACT N02AA05 Oxycodon MGA 40 ACT ACT N02AA05 Oxycodon MGA 80 SZ N02AA05 Pantoprazol 20 ACT/SZ ACT ACT FC A02BC02 Pantoprazol 40 ACT/SZ ACT ACT FC A02BC02 Paracetamol 1000 MY SZ SZ N02BE01 Paroxetine Tab 10 SZ SZ N06AB05 Paroxetine Tab 20 AUR AUR N06AB05 Paroxetine Tab 30 ACT/AUR AUR N06AB05 Pergolide 1 MY N04BC02 Perindopril 2 GL GL FC C09AA04 zie 1/9 + 3/9 + 5/9 + 7/9 + 9/9 Perindopril 4 FC/GL GL GL FC C09AA04 Perindopril 8 GL GL GL GL C09AA04 Perindopril/Amlodipine 5+10/5mg&5+10/10mg PCH C09BB04 Perindopril/Indapamide 2/0,625 MY C09AA04 Perindopril/Indapamide 4/1,25 MY ACT/CF/MY/SZ GL GL C09BA04 Pioglitazon 30 ACT ACT/AH/CF ACT A10BG03 Pioglitazon 45 ACT AH ACT A10BG03

7 Preferentiematrix per stofnaam / per verzekeraar / per 1 juli 2015 (voor zover bekend en bijgewerkt per 30 juni 2015) 7/9 Piroxicam 20 SZ M01AC01 Pramipexol 0,125 AH AUR GL N04BC05 Pramipexol 0,25 AH AH N04BC05 Pramipexol 0,375 FC N04BC05 Pramipexol 0,5 AH AH N04BC05 Pramipexol 1 AH GL AH N04BC05 Pramipexol 1,5 FC N04BC05 Pramipexol 2,25+3 FC N04BC05 Pravastatine 10 AH AH C10AA03 Pravastatine 20 AH RP C10AA03 Pravastatine 40 AH RP C10AA03 Prednisolon 5 AX/RP RP H02AB06 Prednisolon 20 SZ MY H02AB06 Aevitae (Avéro Achmea) 8958 Prednisolon 30 SZ MY H02AB06 Aevitae (VGZ) 8956 Prednison 5 AX H02AB07 Aevitae-De Goudse (Uvit) 3330 Propranolol 10 SZ AH C07AA05 Agis 3337 Propranolol 40 AH AH C07AA05 Anderzorg (2011) 3333 Propranolol 80 RP AH C07AA05 Avéro Achmea 3329 Propranolol Ret. 80 RP C07AA05 Azivo 7054 Propranolol Ret. 160 AX C07AA05 Caresco (de Goudse) 8995 Psylliumzaad SZ A06AC01 CZ 7119 Quetiapine 25 AH AH AH N05AH04 CZ groep 9664 Quetiapine 100 AH AUR FC N05AH04 Delta Lloyd 104 Quetiapine 200 AH AUR AH N05AH04 DJI 9551 Quetiapine 300 AH AUR FC N05AH04 FBTO 211 Quetiapine mga AH AH N05AH04 IAK (Avéro Achmea) 8971 Quinapril 5+10 MY C09AA06 IAK (VGZ) 8972 Quinapril 20 MY/PCH CF C09AA06 Interpolis Zorgverzekeringen 3313 Quinapril 40 MY MY C09AA06 IZA (nieuw) 699 Quinapril/diuretica 20/12,5 ACT CF C09AA06 IZA zorgverzekeraar NV 3334 Rabeprazol 10 AUR/FC ACT ACT ACT A02BC04 IZZ (VGZ) 9015 Rabeprazol 20 FC SZ SZ FC A02BC04 Menzis (2011) 3332 Ramipril 1,25 ACT C09AA05 Nedasco (Avéro Achmea) 8960 Ramipril 2,5 ACT SZ C09AA05 Nedasco (VGZ) 8965 Ramipril 5+10 ACT ACT C09AA05 Ohra Ramipril / diuretica 5/25 ACT C09BA05 Ohra Ranitidine Tab AH AH A02BA02 OZF Achmea 3314 Ribavirine 200 MY MY MY J05AB04 Turien - Avéro Achmea 3342 Ribavirine 400 MY J05AB04 Turien & Co 3341 Riluzol 50 GL GL GL SU N07XX02 Turien (Avéro Achmea) 8966 Risedronaatnatrium 5 FC M05BA07 UMC 736 Risedronaatnatrium 30 AUR M05BA07 Unive 101 Risedronaatnatrium 35 SZ AUR/FC AUR SZ M05BA07 VGZ 7095 Risedronaatnatrium 75 SZ SZ M05BA07 Zilveren Kruis Achmea 3311 Risedr.natrium+Calcium 35/500 AUR AUR AUR M05BB02 Risperidon Drank 1mg/ml MY SZ N05AX08 Risperidon Tabl 0,5 ACT AH N05AX08 Risperidon Tabl 1+2 AH AH N05AX08 Risperidon Tabl 3 AH AH N05AX08 Risperidon Tabl 4 AH AH N05AX08 Risperidon Tabl 6 AH N05AX08 Rivastigmine 1,5 MY N06DA03 Rivastigmine 3 SZ MY N06DA03 Rivastigmine 4,5 SZ MY N06DA03 Rivastigmine 6 SZ SZ N06DA03 Rivastigmine Pleister 4.6+9,5 SZ MY FF N06DA03 Rizatriptan 5 SZ GL N02CC04 Rizatriptan 10 AUR/GL AUR GL GL/MY N02CC04 Ropinirol 0,25 GL GL N04BC04 Ropinirol 0,5 MY MY N04BC04 Ropinirol 1 MY MY N04BC04 Ropinirol 2 MY MY N04BC04 Ropinirol 5 MY MY N04BC04 Ropinirol Retard ACT CF ACT N04BC04

8 Preferentiematrix per stofnaam / per verzekeraar / per 1 juli 2015 (voor zover bekend en bijgewerkt per 30 juni 2015) 8/9 Salbutamol inh.vlst 5mg/ml SZ R03AC02 Salbutamol aërosol 100mcg SZ SZ R03AC02 Salbutamol poeder 100ug ME R03AC02 Selegiline 5 SZ N04BD01 Sertraline Tab 50 FF FF N06AB06 Sertraline Tab 100 AUR/MY AUR N06AB06 Simvastatine 10 AH AH C10AA01 zie 1/9 + 3/9 + 5/9 + 7/9 + 9/9 Simvastatine 20 FC/FF AH AH SZ C10AA01 Simvastatine 40 SZ AH AH SZ C10AA01 Simvastatine 80 AH C10AA01 Sotalol 80 SZ C07AA07 Sotalol 160 MY C07AA07 Spironolacton AH AH C03DA01 Unive 101 Sucralfaat 1 AX/PCH/SZ AX A02BX02 Delta Lloyd 104 Sucralfaat drank 1g SZ A02BX02 Ohra Sulfamethoxazol/Trimeth. 80/400mg ACT ACT J01EE01 FBTO 211 Sulfamethoxazol/Trimeth. 160/800mg ACT ACT J01EE01 IZA (nieuw) 699 Sulfasalazine 500 CF/MY A07EC01 UMC 736 Sumatriptan 50 ACT/AUR AUR AUR N02CC01 Zilveren Kruis Achmea 3311 Sumatriptan 100 ACT/AUR AH AH AUR N02CC01 Interpolis Zorgverzekeringen 3313 Sumatriptan INJ 12mg/0,5ml SU GSK SU SU N02CC01 OZF Achmea 3314 Tamoxifen 10 MY L02BA01 Avéro Achmea 3329 Tamoxifen 20 SZ SZ L02BA01 Aevitae-De Goudse (Uvit) 3330 Tamoxifen 40 SZ SZ L02BA01 Menzis (2011) 3332 Tamsulosine 0,4 ACT/AUR ACT/CF/FF CF FF G04CA02 Anderzorg (2011) 3333 Telmisartan 20 FC/SZ ACT SZ C09CA07 IZA zorgverzekeraar NV 3334 Telmisartan 40 SZ ACT GL C09CA07 Agis 3337 Telmisartan 80 SZ GL GL C09CA07 Turien & Co 3341 Telmisartan Hct 40/12,5+80/12,5mg ACT SZ SZ C09DA07 Turien - Avéro Achmea 3342 Telmisartan Hct 80/25mg FC/SZ SZ SZ C09DA07 Ohra Temazepam 10 ACT/AX/CF/ EP/MY N0CD07 Azivo 7054 Temazepam 20 ACT/AX/CF/ EP/MY N0CD07 VGZ 7095 Temozolomide SU SU L01AX03 CZ 7119 Terazosine 5 SZ G04CA03 Aevitae (VGZ) 8956 Terbinafine 250 FF FC D01BA02 Aevitae (Avéro Achmea) 8958 Timolol 2,5+5mg/ml ACT/FC FC S01ED01 Nedasco (Avéro Achmea) 8960 Timolol / Dorzolamide 20/5mg/ml FC CF ACT ACT S01ED01 Nedasco (VGZ) 8965 Timolol / Latanoprost 5mg/50ug/ml MY SZ S01ED01 Turien (Avéro Achmea) 8966 Tolbutamide 500 CF A10BB03 IAK (Avéro Achmea) 8971 Tolterodine 1 AH G04BD07 IAK (VGZ) 8972 Tolterodine 2 AH G04BD07 Caresco (de Goudse) 8995 Tolterodine 4 ACT SZ ACT G04BD07 IZZ (VGZ) 9015 Topiramaat 25 AH AH N03AX11 DJI 9551 Topiramaat 50 AH AH N03AX11 CZ groep 9664 Topiramaat 100 AH GL N03AX11 Topiramaat 200 ACT ACT N03AX11 Tramadol 50 ACT ACT N02AX02 Tramadol RET SZ SZ N02AX02 Tramadol Drupp 100mg/ml CF N02AX02 Tramadol/Paracetamol 37,5/325 MY MY GR N02AX52 Triamcinolon creme / zalf 1mg/gr AX AX D07AB09 Triamtereen 50 AX/PCH C03DB02 Triamtereen/HCLt 50/25 SZ AH C03EA01 Trimethoprim 100 RP J01EA01 Trimethoprim 300 MY J01EA01 Ursodeoxycholzuur FPB A05AA02 Valaciclovir 250 SZ J05AB11 zie 1/9 + 3/9 + 5/9 + 7/9 + 9/9 Valaciclovir 500 ACT/AUR AUR FF J05AB11 Valsartan 40 RP CF MY C09CA03 Valsartan 80 ACT CF CF ACT C09CA03 Valsartan 160 ACT CF CF ACT C09CA03 Valsartan 320 ACT/AUR ACT/MY ACT C09CA03 Valsartan/Amlodipine alle sterktes NO C09DX01 Valsartan/Amlodipine/HCT alle sterktes NO C09DX01

9 Preferentiematrix per stofnaam / per verzekeraar / per 1 juli 2015 (voor zover bekend en bijgewerkt per 30 juni 2015) 9/9 Valsartan/HCT 80/12,5 ACT ACT ACT ACT C09DA03 Valsartan/HCT 160/12,5 ACT CF ACT C09DA03 Valsartan/HCT 160/25 ACT ACT ACT C09DA03 Valsartan/HCT 320/12,5 ACT ACT/FC ACT ACT C09DA03 Valsartan/HCT 320/25 ACT ACT ACT ACT C09DA03 Venlafaxine RET 37,5 FM ACT/FC/MY FC FC N06AX16 Venlafaxine RET 75 FC FC/MY FC FC N06AX16 Venlafaxine RET 150 BF/FM MY/FC BF FC/FF N06AX16 Venlafaxine RET 225 FC FC N06AX16 Verapamil 40 AX/SZ SZ C08DA01 Verapamil SZ SZ C08DA01 Zidovudine/Lamivudine 150/300 SZ MY J05AR01 Zofenopril 30 MY C09AA15 Aevitae (Avéro Achmea) 8958 Zoledroninezuur 0,04+0,05+0,8mg/ml SU M05BA08 Aevitae (VGZ) 8956 Zolmitriptan 2,5 mg GL GL GL MY N02CC03 Aevitae-De Goudse (Uvit) 3330 Zolpidem 10 RP RP N05CF02 Agis 3337 Zopiclon 7,5 RP RP N05CF01 Anderzorg (2011) 3333 Avéro Achmea 3329 Azivo 7054 Caresco (de Goudse) 8995 CZ 7119 CZ groep 9664 Delta Lloyd 104 DJI 9551 FBTO 211 IAK (Avéro Achmea) 8971 IAK (VGZ) 8972 Interpolis Zorgverzekeringen 3313 IZA (nieuw) 699 IZA zorgverzekeraar NV 3334 IZZ (VGZ) 9015 Menzis (2011) 3332 Nedasco (Avéro Achmea) 8960 Nedasco (VGZ) 8965 Ohra Ohra OZF Achmea 3314 Turien - Avéro Achmea 3342 Turien & Co 3341 Turien (Avéro Achmea) 8966 UMC 736 Unive 101 VGZ 7095 Zilveren Kruis Achmea 3311 (Aan dit overzicht kunnen geen rechten worden ontleend) Dit overzicht is met de grootst mogelijke aandacht en zorgvuldigheid samengesteld op basis van de gegevens zoals bij ons bekend.