Příloha č. 4
Seznam zvlášť účtovaných léčivých přípravků pro léčbu hemofilie
+-------+-----------------------------------------------+----------------------+
| Kód | Název | Doplněk názvu |
+-------+-----------------------------------------------+----------------------+
| | Koagulační faktor IX, II, VII a X v kombinaci | |
+-------+-----------------------------------------------+----------------------+
| 86657 | PROTHROMPLEX TOTAL TIM 4 200I.E | INJ SIC 1X200UT+SOL |
+-------+-----------------------------------------------+----------------------+
| 75634 | PROTHROMPLEX TOTAL TIM 4 600I.E | INJ SIC 1X600UT+SOL |
+-------+-----------------------------------------------+----------------------+
| | Koagulační faktor VIII | |
+-------+-----------------------------------------------+----------------------+
| 53360 | ANTIHEM.F. (LIDSKÝ), HEMOFIL M | INJ SIC 1X1000UT+SO |
+-------+-----------------------------------------------+----------------------+
| 93006 | ANTIHEM.F. (LIDSKÝ), HEMOFIL M | INJ SIC 1X250UT+SOL |
+-------+-----------------------------------------------+----------------------+
| 53359 | ANTIHEM.F. (LIDSKÝ), HEMOFIL M | INJ SIC 1X500UT+SOL |
+-------+-----------------------------------------------+----------------------+
| 87240 | FANHDI 1000 IU | INJ SIC 1X1KU+SOLV. |
+-------+-----------------------------------------------+----------------------+
| 87238 | FANHDI 250 IU | INJ SIC 1X250UT+SOL |
+-------+-----------------------------------------------+----------------------+
| 87239 | FANHDI 500 IU | INJ SIC 1X500UT+SOL |
+-------+-----------------------------------------------+----------------------+
| 60381 | HAEMOCTIN SDH 1000 | INJ SIC 1X1KU+SOLV. |
+-------+-----------------------------------------------+----------------------+
| 60379 | HAEMOCTIN SDH 250 | INJ SIC 1X250UT+SOL |
+-------+-----------------------------------------------+----------------------+
| 60380 | HAEMOCTIN SDH 500 | INJ SIC 1X500UT+SOL |
+-------+-----------------------------------------------+----------------------+
| 89029 | IMMUNATE STIM PLUS 1000 | INJ SIC 1X1KU+SOLV. |
+-------+-----------------------------------------------+----------------------+
| 89027 | IMMUNATE STIM PLUS 250 | INJ SIC 1X250UT+SOL |
+-------+-----------------------------------------------+----------------------+
| 89028 | IMMUNATE STIM PLUS 500 | INJ SIC 1X500UT+SOL |
+-------+-----------------------------------------------+----------------------+
| 58700 | OCTANATE 1000 | INJ SIC 1X1000UT+SOL |
+-------+-----------------------------------------------+----------------------+
| 58278 | OCTANATE 250 I.U. | INJ SIC 1X250UT+SOL |
+-------+-----------------------------------------------+----------------------+
| 58279 | OCTANATE 500 I.U. | INJ SIC 1X500UT+SOL |
+-------+-----------------------------------------------+----------------------+
| 10747 | REFACTO 1000 I.E. | INJ PSO LQP 1X1KU |
+-------+-----------------------------------------------+----------------------+
| 10745 | REFACTO 250 I.E. | INJ PSO LQP1X250UT |
+-------+-----------------------------------------------+----------------------+
| 10746 | REFACTO 500 I.E. | INJ PSO LQP1X500UT |
+-------+-----------------------------------------------+----------------------+
| | Faktor VIII inhibitor "bypassing" aktivity | |
+-------+-----------------------------------------------+----------------------+
| 85677 | FEIBA TIM 4 1000 J. | INJ SIC 1X1KU+SOLV. |
+-------+-----------------------------------------------+----------------------+
| 85676 | FEIBA TIM 4 500 J. | INJ SIC 1X500UT+SOL |
+-------+-----------------------------------------------+----------------------+
| | Koagulační faktor IX | |
+-------+-----------------------------------------------+----------------------+
| 75080 | IMMUNINE 1200 I.E. | INJ SIC 1.2KU+10ML |
+-------+-----------------------------------------------+----------------------+
| 75078 | IMMUNINE 200 I.E. | INJ SIC 1X200UT+5ML |
+-------+-----------------------------------------------+----------------------+
| 75079 | IMMUNINE 600 I.E. | INJ SIC 1X600UT+5ML |
+-------+-----------------------------------------------+----------------------+
| 57481 | OCTANINE F 1000 | INJ PSO LQF1X1KU |
+-------+-----------------------------------------------+----------------------+
| 57468 | OCTANINE F 250 | INJ PSO LQF1X250UT |
+-------+-----------------------------------------------+----------------------+
| 57477 | OCTANINE F 500 | INJ PSO LQF1X500UT |
+-------+-----------------------------------------------+----------------------+
| | Eptakog alfy (aktivovaný) | |
+-------+-----------------------------------------------+----------------------+
| 89826 | NOVOSEVEN 120KIU (2.4MG) | INJ SIC 1X2.4MG+SOL |
+-------+-----------------------------------------------+----------------------+
| 58496 | NOVOSEVEN 120KIU (2.4MG) | INJ SIC2.4MG+SO+STR |
+-------+-----------------------------------------------+----------------------+
| 92641 | NOVOSEVEN 240KIU (4.8MG) | INJ SIC 1X4.8MG+SOL |
+-------+-----------------------------------------------+----------------------+
| 58497 | NOVOSEVEN 240KIU (4.8MG) | INJ SIC4.8MG+SO+STR |
+-------+-----------------------------------------------+----------------------+
| 58495 | NOVOSEVEN 60KIU (1.2MG) | INJ SIC1.2MG+SO+STR |
+-------+-----------------------------------------------+----------------------+
| 89825 | NOVOSEVEN 60KIU (1.2MG) | INJ SIC 1X1.2MG+SOL |
+-------+-----------------------------------------------+----------------------+
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