Common use of Xxxx Clause in Contracts

Xxxx. Xxxxx Xxxxxx, Jednatel / Executive Director Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Betaserc 8 100 x 8 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Granisetron Mylan 1 mg 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 100 mg 60 x 100 mg Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2

Xxxx. Xxxxx Xxxxxx, Jednatel / Executive Director Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg NÁZEV PŘÍPRAVKU DOPLŇEK NÁZVU Agomelatine Mylan 25 mg x 28 tbl flm Agomelatine Mylan 25 mg x 84 tbl flm Amisulprid Generics 50 mg tbl nob Amisulprid Generics 50 mg tbl nob Aripiprazol Mylan 10 mg - 28 x 10 mg tbl nob Aripiprazol Mylan 10 mg - 98 x 10 mg tbl nob Aripiprazol Mylan 15 mg - 28 x 15 mg tbl nob Aripiprazol Mylan 15 mg - 98 x 15 mg tbl nob Bisoprolol Mylan 10mg por.tbl.flm.100x10 tbl flm Bisoprolol Mylan 10mgpor.tbl.flm.30x10m tbl flm Bisoprolol Mylan 2.5mg por.tbl.30x2.5mg tbl flm Bisoprolol Mylan 5mg por.tbl.100x5mg tbl flm Bisoprolol Mylan 5mg por.tbl.flm.30x5mg tbl flm Donepezil Mylan 10 mg - 56 x 10 mg tbl flm Donepezil Mylan 10mg por.tbl.28x10 tbl flm Donepezil Mylan 10mg por.tbl.84x10 tbl flm Donepezil Mylan 10mg por.tbl.dis. 28x10mg por tbl dis Donepezil Mylan 5mg por.tbl.flm 28x5 tbl flm Irbesartan Hydrochlorothiazid 28 x 150 mg / tbl nob Irbesartan Hydrochlorothiazid 28 x 300 mg / tbl nob Isoptin 100x240mg tbl pro Isoptin 30x240mg tbl pro Isoptin 50x40mg tbl flm Isoptin 50x80mg tbl flm Lipanthyl 100x215mg tbl flm Lipanthyl 30x145mg tbl flm Lipanthyl 30x215mg tbl flm Lipanthyl 30x267mg cps dur Lipanthyl 90x145mg tbl flm Lipanthyl 90x267mg cps dur Lipanthyl SUPRA 30x160mg tbl ret Lipanthyl SUPRA 90x160mg tbl ret Xxxxxxxxxx Xxxxx 30mg por.tbl.30x30mg por tbl dis Mirtazapin Mylan 45mg por.tbl.30x45mg por tbl dis Olanzapine Mylan 10mg por.tbl.28x10mg tbl flm Olanzapine Mylan 5mg por.tbl.flm.28x5mg tbl flm Olanzapine Mylan dis 28 x 10 mg por tbl dis Olanzapine Mylan dis 28 x 5 mg por tbl dis Olicard 50x40mg cps pro Olicard 50x60mg cps pro Perindopril Mylan 4mg por.tbl.nob. 30x4mg tbl nob Perindopril Mylan 4mg por.tbl.nob. 90x4mg tbl nob Perindopril Mylan 8mg por.tbl.nob. 30x8mg tbl nob Perindopril Mylan 8mg por.tbl.nob. 90x8mg tbl nob Pramipexol Mylan 0,52 mg x 30 tbl pro Pramipexol Mylan 2,1 mg x 30 tbl pro Quetiapin Mylan 200 mg - 60 x 200 mg tbl pro Quetiapin Mylan 300 mg - 60 x 300 mg tbl pro Quetiapin Mylan 400 mg - 60 x 400 mg tbl pro Rytmonorm 100x150mg tbl flm Rytmonorm 100x300mg tbl flm Rytmonorm 50x150mg tbl flm Rytmonorm 50x300mg tbl flm Sevelamer Carbonate 800 mg - 180 x 800 mg tbl flm Simvastatin Mylan 20mg por.tbl.flm.100x20 tbl flm Simvastatin Mylan 40mg por.tbl.flm.100x40 tbl flm Solifenacin Mylan 10 mg - 100 x 10 mg tbl flm Solifenacin Mylan 5 mg - 100 x 5 mg tbl flm Twicor 30 x 10mg/10mg tbl flm Twicor 90 x 10mg/10mg tbl flm Twicor 30 x 20mg/10mg tbl flm Twicor 90 x 20mg/10mg tbl flm Venlafaxin Mylan 150 mg - 90 x 150 mg cps pro Venlafaxin Mylan 150mg por.cps.30x150mg cps pro Venlafaxin Mylan 75 mg - 90 x 75 mg cps pro Venlafaxin Mylan 75mg por.cps.30x75mg cps pro Zonisamide Mylan 100 mg - 98 x 100 mg cps dur Zonisamide Mylan 25 mg - 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Betaserc 8 100 x 8 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Granisetron Mylan 1 mg 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 100 mg 60 x 100 mg Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml cps dur Zonisamide Mylan 50 mg - 56 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2cps dur 

Xxxx. Xxxxx Xxxxxx, Jednatel / Executive Director Xxx. Xxxxxx Xxxxxx, MBA člen představenstva MEDA Pharma s.r.o. Xxxxx Xxxxxx, jednatel / Executive Director Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 MIC kod Název přípravku Forma přípravku Balení přípravku MYL0366 Afonilum SR 125 mg cps pro 50 x 30 gm 125 mg MYL0367 Afonilum SR 250 mg cps pro 50 x 250 mg Agomelatine MYL0363 Akarboza Mylan 25 100 mg tbl nob 120 x 100 mg MYL0002 Alendrogen 70 mg tbl nob 12 x 70 mg MYL0004 Alfuzosin Mylan 10 mg tbl pro 90 x 10 mg MYL0515 Allergodil spr nas 1 x 10 ml/ 10 mg MYL0516 Allergodil oční kapky oph gtt sol 1 x 6 ml 0,5% MYL0619 Amisulprid Generics 200 mg tbl nob 150 x 200 mg MYL0611 Amisulprid Generics 200 mg tbl nob 30 x 200 mg MYL0617 Amisulprid Generics 50 mg tbl nob 30 x 50 mg MYL0618 Amisulprid Generics 50 mg tbl nob 90 x 50 mg MYL0623 Anagrelid Mylan 0,5 mg cps dur 100 x 0,5mg MYL0312 Aripiprazol Mylan Pharma 10 mg tbl nob 28 x 25 10mg Agomelatine MYL0508 Aripiprazol Mylan 25 Pharma 10 mg 84 tbl nob 98 x 25 10mg Anastrozol MYL0313 Aripiprazol Mylan 1 Pharma 15 mg 30 tbl nob 28 x 1 15mg MYL0509 Aripiprazol Mylan Pharma 15 mg tbl nob 98 x 15mg MYL0369 Betaserc 16 tbl nob 60 x 16 mg MYL0370 Betaserc 24 tbl nob 50 x 24 mg MYL0371 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 28 MYL0033 Bisoprolol Mylan 10 mg tbl flm 100 x 200 mcg I Breakyl 400 mikrogramů 28 10 mg MYL0034 Bisoprolol Mylan 10 mg tbl flm 30 x 400 mcg I Breakyl 800 mikrogramů 28 10 mg MYL0035 Bisoprolol Mylan 2,5 mg tbl flm 30 x 800 mcg I 2,5 mg MYL0036 Bisoprolol Mylan 5 mg tbl flm 100 x 5 mg MYL0037 Bisoprolol Mylan 5 mg tbl flm 30 x 5 mg MYL0362 Brufen 600 mg gra eff 20 x 600 mg MYL0346 Buprenorfin Mylan 35 mikrogramů/h tdr emp 5 x 20 mg MYL0347 Buprenorfin Mylan 52,5 mikrogramů/h tdr emp 5 x 30 mg MYL0348 Buprenorfin Mylan 70 mikrogramů/h tdr emp 5 x 40 mg Capecitabine MYL0570 Darunavir Mylan 150 mg tbl flm 60 x 150 600mg Capecitabine MYL0569 Darunavir Mylan 500 mg 120 x 500 mg Cynt 0,2 tbl flm 30 x 0,2 800mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg MYL0525 Dona 1500 mg por plv sol 20 sačků Exemestan MYL0045 Donepezil Mylan 25 10 mg 30 por tbl dis 28 x 25 10 mg Fentanyl MYL0046 Donepezil Mylan 100 mikrogramů/ hodinu 10 mg tbl flm 28 x 10 mg MYL0327 Donepezil Mylan 10 mg tbl flm 56 x 10 mg MYL0047 Donepezil Mylan 10 mg tbl flm 84 x 10 mg MYL0048 Donepezil Mylan 5 mg tbl flm 28 x 16,8 5 mg Fentanyl Mylan 12 mikrogramů/ hodinu MYL0336 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 1 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 ml MYL0049 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 3 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid ml MYL0050 Doxazosin Mylan 4 mg 30 tbl pro 28 x 4 mg Glimepirid MYL0051 Doxazosin Mylan 4 mg 90 tbl pro 98 x 4 mg MYL0386 Duspatalin Retard cps rdr 30 x 200 mg MYL0527 Dymistin 137 mikrogramů/50 mikrogramů nas spr sus 1 x 23 g MYL0571 Emtricitabine/Tenofovir disoproxil Mylan 200 mg/245 mg tbl flm 30 x 200mg/245mg MYL0572 Entecavir Mylan tbl flm 0,5mg x 30 MYL0052 Escitalopram Mylan 10 mg tbl flm 30 x 10 mg MYL0053 Escitalopram Mylan 10 mg tbl flm 90 x 10 mg MYL0055 Escitalopram Mylan 20 mg tbl flm 90 x 20 mg MYL0391 Fevarin 100 tbl flm 30 x 100 mg MYL0392 Fevarin 50 tbl flm 30 x 50 mg MYL0168 Galantamin Mylan 16 mg cps pro 30 x 16 mg MYL0169 Galantamin Mylan 24 mg cps pro 30 x 24 mg MYL0167 Galantamin Mylan 8 mg cps pro 30 x 8 mg MYL0062 Gliclazid Mylan 30 mg tbl ret 120 x 30 mg MYL0063 Gliclazid Mylan 30 mg tbl ret 60 x 30 mg MYL0393 Xxxxxx 0,5 mg cps dur 28 x 0,5 mg Granisetron Mylan 1 MYL0394 Xxxxxx 2 mg 10 cps dur 28 x 1 2 mg MYL0395 Xxxxxx 2 mg cps dur 98 x 2 mg MYL0396 Xxxxxx 4 mg cps dur 28 x 4 mg MYL0397 Xxxxxx 4 mg cps dur 98 x 4 mg MYL0680 Hulio inj sol 40mg 2x0,8ml pfs MYL0681 Hulio inj sol 40mg 2x0,8ml pfp MYL0464 Cholib 145 mg/20 mg tbl flm 30 MYL0465 Cholib 145 mg/40 mg tbl flm 30 MYL0072 Ibandronát Mylan 150 mg tbl flm 3 x 150 mg MYL0193 Irbesartan/Hydrochlorothiazid Mylan 150 mg /12,5mg tbl nob 28 x 150 mg/12,5 mg MYL0194 Irbesartan/Hydrochlorothiazid Mylan 300mg /12,5mg tbl nob 28 x 300 mg/12,5 mg MYL0400 Isoptin 40 mg tbl flm 50 x 40 mg MYL0401 Isoptin 80 mg tbl flm 50 x 80 mg MYL0402 Isoptin SR 240 mg tbl pro 100 x 240 mg MYL0403 Isoptin SR 240 mg tbl pro 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg MYL0404 Klacid 125 mg/5 ml por gra sus 1 x 100 ml MYL0405 Klacid 125 mg/5 ml por gra sus 1 x 60 ml MYL0406 Klacid 250 tbl flm 10 x 250 mg MYL0407 Klacid 250 tbl flm 14 x 250 mg MYL0408 Klacid 250 mg/5 ml por gra sus 1 x 100 ml MYL0409 Klacid 250 mg/5 ml por gra sus 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml MYL0410 Klacid 500 tbl flm 14 x 500 mg MYL0365 Klacid SR 7 i.v. inf plv sol 1 x 500 mg MYL0413 Klacid SR tbl ret 14 x 500 mg-d MYL0411 Klacid SR tbl ret 7 x 500 mg MYL0415 Kreon 10 000 cps etd 20 MYL0414 Kreon 10 000 cps etd 50 MYL0416 Kreon 25 000 cps etd 50 MYL0300 Lansoprazol Mylan 30 mg cps etd 28 x 30 mg MYL0301 Lansoprazol Mylan 30 mg cps etd 56 x 30 mg MYL0299 Letmylan 2,5 mg tbl flm 100 x 2,5 mg MYL0265 Letmylan 2,5 mg tbl flm 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz MYL0086 Levofloxacin Mylan 500 mg 56 tbl flm 10 x 500 mg Levelanz MYL0085 Levofloxacin Mylan 500 mg 98 mg/100 ml inf sol 10 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/mg/100 ml 10 x 1 x 300 ml MYL0418 Lipanthyl 267 M cps dur 30 x 267 mg MYL0419 Lipanthyl 267 M cps dur 90 x 267 mg Xxxxxxxxx Xx 000 MYL0420 Lipanthyl Nt 145 mg tbl flm 30 x 145 mg Xxxxxxxxx Xx 000 MYL0421 Lipanthyl Nt 145 mg tbl flm 90 x 145 mg MYL0422 Lipanthyl S 215 mg tbl flm 100 x 215 mg MYL0423 Lipanthyl S 215 mg tbl flm 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg MYL0425 Lipanthyl Supra 160 mg tbl ret 30 x 160 mg MYL0424 Lipanthyl Supra 160 mg tbl ret 90 x 160 mg MYL0091 Meloxicam Mylan 15 mg tbl nob 100 x 15 mg MYL0092 Meloxicam Mylan 15 mg tbl nob 20 x 15 mg MYL0093 Meloxicam Mylan 15 mg tbl nob 60 x 15 mg MYL0323 Memantin Mylan 10 mg tbl flm 28 x 10 mg MYL0203 Memantin Mylan 10 mg tbl flm 56 x 10 mg MYL0334 Memantin Mylan 10 mg tbl flm 84x10 mg MYL0204 Memantin Mylan 20 mg tbl flm 28 x 20 mg MYL0094 Metformin Mylan 1000 mg tbl flm 120 x 1 000 mg MYL0504 Metformin Mylan 1000 mg tbl flm 180 x 1 000 mg MYL0095 Metformin Mylan 1000 mg tbl flm 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg MYL0096 Metformin Mylan 500 mg tbl flm 120 x 500 mg MYL0505 Metformin Mylan 500 mg tbl flm 180 x 500 mg MYL0097 Metformin Mylan 500 mg tbl flm 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg MYL0098 Metformin Mylan 850 mg tbl flm 120 x 850 mg MYL0506 Metformin Mylan 850 mg tbl flm 180 x 850 mg MYL0099 Metformin Mylan 850 mg tbl flm 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg MYL0106 Mirtazapin Mylan 30 mg por tbl dis 30 x 30 mg MYL0107 Mirtazapin Mylan 45 mg por tbl dis 30 x 45 mg MYL0108 Montelukast Mylan 10 mg tbl flm 100 x 10 mg MYL0109 Montelukast Mylan 10 mg tbl flm 30 x 10 mg MYL0171 Montelukast Mylan 4 mg tbl mnd 30 x 4 mg MYL0110 Montelukast Mylan 5 mg tbl mnd 100 x 5 mg MYL0172 Montelukast Mylan 5 mg tbl mnd 30 x 5 mg MYL0495 Oxykodon Mylan 10 mg tbl pro 60 x 10 mg MYL0497 Oxykodon Mylan 20 mg tbl pro 60 x 20 mg MYL0498 Oxykodon Mylan 40 mg tbl pro 60 x 40 mg MYL0499 Oxykodon Mylan 80 mg tbl pro 60 x 80 mg MYL0205 Pioglitazon Mylan 15 mg tbl nob 28 x 15 mg MYL0177 Pioglitazon Mylan 30 mg tbl nob 28 x 30 mg Pregabalin MYL0131 Quetiapin Mylan 75 100 mg 14 tbl flm 60 x 75 100 mg Pregabalin MYL0332 Quetiapin Mylan 75 200 mg 56 tbl flm 100 x 75 200 mg Pregabalin MYL0298 Quetiapin Mylan 150 200 mg 56 tbl flm 30 x 150 200 mg MYL0258 Quetiapin Mylan 200 mg tbl pro 60 x 200 mg MYL0297 Quetiapin Mylan 25 mg tbl flm 30 x 25 mg MYL0134 Quetiapin Mylan 300 mg tbl flm 60 x 300 mg MYL0259 Quetiapin Mylan 300 mg tbl pro 60 x 300 mg MYL0260 Quetiapin Mylan 400 mg tbl pro 60 x 400 mg MYL0616 Reparil - Dragées 20 mg 40 tbl ent 100 x 20 mg MYL0543 Reparil - Dragées 20 mg 100 tbl ent 40 x 20 mg MYL0545 Reparil - Gel N 100 g gel 100 g I MYL0544 Reparil - Gel N 40 g gel 40 g I MYL0255 Rismyl 35 mg tbl flm 12 x 35 mg MYL0429 Rytmonorm 150 mg tbl flm 100 x 150 mg MYL0428 Rytmonorm 150 mg tbl flm 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg MYL0431 Rytmonorm 300 mg tbl flm 100 x 300 mg MYL0430 Rytmonorm 300 mg tbl flm 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg MYL0493 Sevelamer Carbonate Mylan 800 mg tbl flm 180 x 800 mg Tamsulosin HCI MYL0144 Simvastatin Mylan 0,4 20 mg tbl flm 100 x 0,4 20 mg MYL0146 Simvastatin Mylan 40 mg tbl flm 100 x 40 mg MYL0548 Solcoseryl 2,125 mg/10 mg/ 1g orální pasta orm pst 1 x 5 g MYL0547 Solcoseryl 8,3 mg/g oční gel oph gel 1 x 5 g MYL0147 Sumatriptan Mylan 100 mg tbl flm 2 x 100 mg MYL0148 Sumatriptan Mylan 50 mg tbl flm 6 x 50 mg MYL0435 Tarka 180/2 mg tbl. tbl ret 28 MYL0436 Tarka 180/2 mg tbl. tbl ret 98 MYL0437 Tarka 240/4 mg tbl. tbl ret 28 MYL0438 Tarka 240/4 mg tbl. tbl ret 98 MYL0356 Tenofovir disoproxil Mylan tbl flm 30 x 245mg MYL0151 Topiramat Mylan 100 mg tbl flm 60 x 100 mg MYL0152 Topiramat Mylan 25 mg tbl flm 60 x 25 mg MYL0153 Topiramat Mylan 50 mg tbl flm 60 x 50 mg Uralyt U 280 g 1 MYL0441 Transmetil 500 mg tbl ent 10 x 280 g 500 mg MYL0554 Uraplex 20 mg tbl obd 20 x 20 mg MYL0555 Uraplex 20 mg tbl obd 50 x 20 mg MYL0364 Uroxal 5 mg tbl nob 60 x 5 mg MYL0225 Valaciclovir Mylan 500 mg tbl flm 42 x 500 mg MYL0590 Valganciclovir Mylan 450 mg tbl flm 60 x 450 mg MYL0157 Vancomycin Mylan 1000 mg inf plv sol 1 x 1000 mg MYL0158 Vancomycin Mylan 500 mg inf plv sol 1 x 500 mg MYL0159 Venlafaxin Mylan 150 mg cps pro 30 x 150 mg MYL0307 Venlafaxin Mylan 150 mg cps pro 90 x 150 mg MYL0160 Venlafaxin Mylan 75 mg cps pro 30 x 75 mg MYL0306 Venlafaxin Mylan 75 mg cps pro 90 x 75 mg MYL0183 Ziprasidon Mylan 40 mg cps dur 30 x 40 mg MYL0184 Ziprasidon Mylan 60 mg cps dur 30 x 60 mg MYL0185 Ziprasidon Mylan 80 mg cps dur 30 x 80 mg MYL0186 Zoledronic acid Mylan 4 mg/5 ml inf cnc sol 1 x 4mg/5ml MYL0186 Zoledronic acid Mylan 4 mg/5 ml inf cnc sol 1 x 4mg/5ml MYL0161 Zolpidem Mylan 10 mg tbl flm 20 x 10 mg MYL0187 Zolpidem Mylan 10 mg tbl flm 50 x 10 mg MYL0483 Zonisamide Mylan 100 mg cps dur 98 x 100 mg MYL0507 Zonisamide Mylan 25 mg cps dur 28 x 25 mg MYL0482 Zonisamide Mylan 50 mg cps dur 56 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.22

Xxxx. Xxxxx Xxxxxx, Jednatel Zmocněnec na základě plné moci / Executive Director Authorised under a power of attorney Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx Skupina výrobků č.1 /Group of Products Xx. 0 xxx xxxxxxxxx Xxxxxx xxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm xxxxxxxx xxxxxx 000000 Afonilum SR 125 mg cps pro 50 x 125 mg 50 x 125 mg 185728 Afonilum SR 250 mg cps pro 50 x 250 mg 50 x 250 mg Agomelatine 124065 Akarboza Mylan 25 100 mg 28 tbl nob 120 x 25 100 mg Agomelatine 120 x 100 mg 136168 Alfuzosin Mylan 25 10 mg 84 tbl pro 90 x 25 10 mg Anastrozol Mylan 1 90 x 10 mg 197908 Amisulprid Generics 200 mg tbl nob 150 x 200 mg 150 x 200 mg 197898 Amisulprid Generics 200 mg tbl nob 30 x 200 mg 30 x 1 200 mg 197882 Amisulprid Generics 50 mg tbl nob 30 x 50 mg 30 x 50 mg 197885 Amisulprid Generics 50 mg tbl nob 90 x 50 mg 90 x 50 mg 176178 Amlodipin Mylan 10 mg tbl nob 100 x 10 mg 100 x 10 mg 176174 Amlodipin Mylan 10 mg tbl nob 30 x 10 mg 30 x 10 mg 176163 Amlodipin Mylan 5 mg tbl nob 100 x 5 mg 100 x 5 mg 176159 Amlodipin Mylan 5 mg tbl nob 30 x 5 mg 30 x 5 mg 208332 Amoxicillin/Clavulanic Acid Mylan 500 mg/125 mg tbl flm 21 x 500mg/125mg 21 x 500mg/125mg 208351 Amoxicillin/Clavulanic Acid Mylan 875 mg/125 mg tbl flm 14 x 875mg/125mg 14 x 875mg/125mg 147274 Atorvastatin Mylan 10 mg tbl flm 100 x 10 mg 100 x 10 mg 191224 Atorvastatin Mylan 10 mg tbl flm 30 x 10 mg 30 x 10 mg 147295 Atorvastatin Mylan 20 mg tbl flm 100 x 20 mg 100 x 20 mg 191229 Atorvastatin Mylan 20 mg tbl flm 30 x 20 mg 30 x 20 mg 147316 Atorvastatin Mylan 40 mg tbl flm 100 x 40 mg 100 x 40 mg 191234 Atorvastatin Mylan 40 mg tbl flm 30 x 40 mg 30 x 40 mg 153973 Azitromycin Mylan 500 mg tbl flm 3 x 500 mg 3 x 500 mg 215566 Betaserc 16 tbl nob 60 x 16 mg 60 x 16 mg 215708 Betaserc 24 tbl nob 50 x 24 mg 50 x 24 mg 215559 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 100 x 8 mg 158716 Bisoprolol Mylan 10 mg tbl flm 100 x 10 mg 100 x 10 mg 158711 Bisoprolol Mylan 10 mg tbl flm 30 x 10 mg 30 x 10 mg 158673 Bisoprolol Mylan 2,5 mg tbl flm 30 x 2,5 mg 30 x 2,5 mg 158697 Bisoprolol Mylan 5 mg tbl flm 100 x 5 mg 100 x 5 mg 158692 Bisoprolol Mylan 5 mg tbl flm 30 x 5 mg 30 x 5 mg 177606 Calcium/ Vitamin D3 Meda 500 mg /800 IU tbl.mnd. 30 30 149388 Clopidogrel Mylan 75 mg tbl flm 30 x 75 mg 30 x 75 mg 149392 Clopidogrel Mylan 75 mg tbl flm 90 x 75 mg 90 x 75 mg 179954 Desloratadin Mylan 5 mg tbl flm 30 x 5 mg 30 x 5 mg 179955 Desloratadin Mylan 5 mg tbl flm 50 x 5 mg 50 x 5 mg 179957 Desloratadin Mylan 5 mg tbl flm 90 x 5 mg 90 x 5 mg 148748 Donepezil Mylan 10 mg por tbl dis 28 x 200 mcg I Breakyl 400 mikrogramů 10 mg 28 x 400 mcg I Breakyl 800 mikrogramů 10 mg 142136 Donepezil Mylan 10 mg tbl flm 28 x 800 mcg I 10 mg 28 x 10 mg 142138 Donepezil Mylan 10 mg tbl flm 56 x 10 mg 56 x 10 mg 142140 Donepezil Mylan 10 mg tbl flm 84 x 10 mg 84 x 10 mg 142150 Donepezil Mylan 5 mg tbl flm 28 x 5 mg 28 x 5 mg 146366 Doxazosin Mylan 4 mg tbl pro 28 x 4 mg 28 x 4 mg 146374 Doxazosin Mylan 4 mg tbl pro 98 x 4 mg 98 x 4 mg 215713 Duphalac por sol 1 x 200 ml 1 x 200 ml 215715 Duphalac por sol 1 x 500 ml 1 x 500 ml 138974 Escitalopram Mylan 10 mg tbl flm 30 x 10 mg 30 x 10 mg 138979 Escitalopram Mylan 10 mg tbl flm 90 x 10 mg 90 x 10 mg 139015 Escitalopram Mylan 20 mg tbl flm 90 x 20 mg 90 x 20 mg 219251 Emtricitabine/Tenofovir disoproxil Mylan 200 mg/245 mg 30 x 200mg/245mg 197376 Ezetimib Mylan 10 mg tbl nob 98 x10 mg 98 x10 mg 197372 Ezetimib Mylan 10 mg tbl nob 30 x10 mg 30 x10 mg 169688 Finasterid Mylan 5 mg tbl flm 100 x 5 mg 100 x 5 mg 154049 Glimepirid Mylan 2 mg tbl nob 30 x 2 mg 30 x 2 mg 154051 Glimepirid Mylan 2 mg tbl nob 90 x 2 mg 90 x 2 mg 154056 Glimepirid Mylan 3 mg tbl nob 30 x 3 mg 30 x 3 mg 154059 Glimepirid Mylan 3 mg tbl nob 90 x 3 mg 90 x 3 mg 154063 Glimepirid Mylan 4 mg tbl nob 30 x 4 mg 30 x 4 mg 154066 Glimepirid Mylan 4 mg tbl nob 90 x 4 mg 90 x 4 mg 215913 Xxxxxx 0,5 mg cps dur 28 x 0,5 mg 28 x 0,5 mg 215914 Xxxxxx 2 mg cps dur 28 x 2 mg 28 x 2 mg 215917 Xxxxxx 2 mg cps dur 98 x 2 mg 98 x 2 mg 215920 Xxxxxx 4 mg cps dur 28 x 4 mg 28 x 4 mg 215922 Xxxxxx 4 mg cps dur 98 x 4 mg 98 x 4 mg 179761 Irbesartan/Hydrochlorothiazid Mylan 150 mg /12,5mg tbl nob 28 x 150 mg/12,5 mg 28 x 150 mg/12,5 mg 179771 Irbesartan/Hydrochlorothiazid Mylan 300mg /12,5mg tbl nob 28 x 300 mg/12,5 mg 28 x 300 mg/12,5 mg 215966 Isoptin 40 mg tbl flm 50 x 40 mg 50 x 40 mg 215970 Isoptin 80 mg tbl flm 50 x 80 mg 50 x 80 mg 215965 Isoptin SR 240 mg tbl pro 100 x 240 mg 100 x 240 mg 215964 Isoptin SR 240 mg tbl pro 30 x 240 mg 30 x 240 mg 216192 Klacid 125 mg/5 ml por gra sus 1 x 100 ml 1 x 100 ml 216191 Klacid 125 mg/5 ml por gra sus 1 x 60 ml 1 x 60 ml 216195 Klacid 250 mg/5 ml por gra sus 1 x 100 ml 1 x 100 ml 216194 Klacid 250 mg/5 ml por gra sus 1 x 60 ml 1 x 60 ml 216197 Klacid 250 tbl flm 10 x 250 mg 10 x 250 mg 216196 Klacid 250 tbl flm 14 x 250 mg 14 x 250 mg 216199 Klacid 500 tbl flm 14 x 500 mg 14 x 500 mg 216189 Klacid SR tbl ret 14 x 500 mg-d 14 x 500 mg-d 216185 Klacid SR tbl ret 7 x 500 mg 7 x 500 mg 151383 Lamotrigin Mylan 100 mg tbl nob 100 x 100 mg 100 x 100 mg 151382 Lamotrigin Mylan 100 mg tbl nob 30 x 100 mg 30 x 100 mg 156537 Lansoprazol Mylan 30 mg cps etd 28 x 30 mg 28 x 30 mg 156539 Lansoprazol Mylan 30 mg cps etd 56 x 30 mg 56 x 30 mg 159982 Leflugen 20 mg tbl flm 30 x 20 mg 30 x 20 mg 207098 Lipanthyl 267 M cps dur 30 x 267 mg 30 x 267 mg 207100 Lipanthyl 267 M cps dur 90 x 267 mg 90 x 267 mg 214919 Xxxxxxxxx Xx 000 mg tbl flm 30 x 145 mg 30 x 145 mg 214922 Xxxxxxxxx Xx 000 mg tbl flm 90 x 145 mg 90 x 145 mg 207094 Lipanthyl S 215 mg tbl flm 100 x 215 mg 100 x 215 mg 225967 Lipanthyl S 215 mg tbl flm 100 x 215 mg 100 x 215 mg 207092 Lipanthyl S 215 mg tbl flm 30 x 215 mg 30 x 215 mg 207095 Lipanthyl Supra 160 mg tbl ret 30 x 160 mg 30 x 160 mg 207097 Lipanthyl Supra 160 mg tbl ret 90 x 160 mg 90 x 160 mg 150983 Meloxicam Mylan 15 mg tbl nob 100 x 15 mg 100 x 15 mg 194025 Memantin Mylan 10 mg tbl flm 28 x 10 mg 28 x 10 mg 194030 Memantin Mylan 10 mg tbl flm 56 x 10 mg 56 x 10 mg 194034 Memantin Mylan 10 mg tbl flm 84x10 mg 84x10 mg 194043 Memantin Mylan 20 mg tbl flm 28 x 20 mg 28 x 20 mg 136398 Mestinon tbl obd 150 x 60 mg 150 x 60 mg 169552 Metformin Mylan 1000 mg tbl flm 120 x 1 000 mg 120 x 1 000 mg 169553 Metformin Mylan 1000 mg tbl flm 180 x 1 000 mg 180 x 1 000 mg 169548 Metformin Mylan 1000 mg tbl flm 60 x 1 000 mg 60 x 1 000 mg 169516 Metformin Mylan 500 mg tbl flm 120 x 500 mg 120 x 500 mg 169517 Metformin Mylan 500 mg tbl flm 180 x 500 mg 180 x 500 mg 169512 Metformin Mylan 500 mg tbl flm 60 x 500 mg 60 x 500 mg 169534 Metformin Mylan 850 mg tbl flm 120 x 850 mg 120 x 850 mg 169535 Metformin Mylan 850 mg tbl flm 180 x 850 mg 180 x 850 mg 169530 Metformin Mylan 850 mg tbl flm 60 x 850 mg 60 x 850 mg 146071 Mirtazapin Mylan 30 mg por tbl dis 30 x 30 mg 30 x 30 mg 146079 Mirtazapin Mylan 45 mg por tbl dis 30 x 45 mg 30 x 45 mg 148529 Montelukast Mylan 10 mg tbl flm 100 x 10 mg 100 x 10 mg 148523 Montelukast Mylan 10 mg tbl flm 30 x 10 mg 30 x 10 mg 165127 Montelukast Mylan 4 mg tbl mnd 30 x 4 mg 30 x 4 mg 165149 Montelukast Mylan 5 mg tbl mnd 100 x 5 mg 100 x 5 mg 165145 Montelukast Mylan 5 mg tbl mnd 30 x 5 mg 30 x 5 mg 201236 Olanzapin Mylan 10 mg por tbl dis 28 x 10 mg 28 x 10 mg 500764 Olanzapin Mylan 10 mg tbl flm 28 x 10 mg 28 x 10 mg 201204 Olanzapin Mylan 5 mg por tbl dis 28 x 5 mg 28 x 5 mg 500752 Olanzapin Mylan 5 mg tbl flm 28 x 5 mg 28 x 5 mg 215180 Olicard 40 mg Retard cps pro 50 x 40 mg 50 x 40 mg 215184 Olicard 60 mg Retard cps pro 50 x 60 mg 50 x 60 mg 158341 Omeprazol Mylan 20 mg cps etd 100 x 20 mg 100 x 20 mg 158337 Omeprazol Mylan 20 mg cps etd 30 x 20 mg 30 x 20 mg 160379 Pantomyl 40 mg tbl ent 100 x 40 mg 100 x 40 mg 160373 Pantomyl 40 mg tbl ent 30 x 40 mg 30 x 40 mg 177322 Perindopril Mylan 4 mg tbl nob 30 x 4 mg 30 x 4 mg 177326 Perindopril Mylan 4 mg tbl nob 90 x 4 mg 90 x 4 mg 177332 Perindopril Mylan 8 mg tbl nob 30 x 8 mg 30 x 8 mg 177336 Perindopril Mylan 8 mg tbl nob 90 x 8 mg 90 x 8 mg 177371 Pioglitazon Mylan 15 mg tbl nob 28 x 15 mg 28 x 15 mg 177380 Pioglitazon Mylan 30 mg tbl nob 28 x 30 mg 28 x 30 mg 153045 Pramipexol Mylan 0,18 mg tbl nob 100 x 0,18 mg 100 x 0,18 mg 153056 Pramipexol Mylan 0,7 mg tbl nob 100 x 0,7 mg 100 x 0,7 mg 210716 Pregabalin Mylan 150 mg cps dur 56 x 150 mg 56 x 150 mg 210703 Pregabalin Mylan 75 mg cps dur 14 x 75 mg 14 x 75 mg 210704 Pregabalin Mylan 75 mg cps dur 56 x 75 mg 56 x 75 mg 146010 Quetiapin Mylan 100 mg tbl flm 60 x 100 mg 60 x 100 mg 146042 Quetiapin Mylan 200 mg tbl flm 100 x 200 mg 100 x 200 mg 146030 Quetiapin Mylan 200 mg tbl flm 30 x 200 mg 30 x 200 mg 204363 Quetiapin Mylan 200 mg tbl pro 60 x 200 mg 60 x 200 mg 136322 Quetiapin Mylan 25 mg tbl flm 30 x 25 mg 30 x 25 mg 204373 Quetiapin Mylan 300 mg tbl pro 60 x 300 mg 60 x 300 mg 147785 Quetiapin Mylan 300 mg tbl flm 60 x 300 mg 60 x 300 mg 204383 Quetiapin Mylan 400 mg tbl pro 60 x 400 mg 60 x 400 mg 162723 Ropinirol Mylan 2 mg tbl flm 84 x 2 mg 84 x 2 mg 162728 Ropinirol Mylan 5 mg tbl flm 84 x 5 mg 84 x 5 mg 215906 Rytmonorm 150 mg tbl flm 100 x 150 mg 100 x 150 mg 215904 Rytmonorm 150 mg tbl flm 50 x 150 mg 50 x 150 mg 215909 Rytmonorm 300 mg tbl flm 100 x 300 mg 100 x 300 mg 215907 Rytmonorm 300 mg tbl flm 50 x 300 mg 50 x 300 mg 157898 Sildenafil Mylan 100 mg tbl flm 4 x 100 mg 4 x 100 mg 157899 Sildenafil Mylan 100 mg tbl flm 8 x 100 mg 8 x 100 mg 157892 Sildenafil Mylan 50 mg tbl flm 4 x 50 mg 4 x 50 mg 144127 Simvastatin Mylan 20 mg tbl flm 100 x 20 mg 100 x 20 mg 144166 Simvastatin Mylan 40 mg tbl flm 100 x 40 mg 100 x 40 mg 211946 Solifenacin Mylan 10 mg tbl flm 100 x 10 mg 100 x 10 mg 211928 Solifenacin Mylan 5 mg tbl flm 100 x 5 mg 100 x 5 mg 146269 Sumatriptan Mylan 100 mg tbl flm 2 x 100 mg 2 x 100 mg 146283 Sumatriptan Mylan 50 mg tbl flm 6 x 50 mg 6 x 50 mg 151239 Tamsulosin HCI Mylan 0,4 mg cps rdr 100 x 0,4 mg 100 x 0,4 mg 142333 Topiramat Mylan 100 mg tbl flm 60 x 100 mg 60 x 100 mg 142313 Topiramat Mylan 25 mg tbl flm 60 x 25 mg 60 x 25 mg 142323 Topiramat Mylan 50 mg tbl flm 60 x 50 mg 60 x 50 mg 207076 Uroxal 5 mg tbl nob 60 x 5 mg 60 x 5 mg 115562 Venlafaxin Mylan 150 mg cps pro 30 x 150 mg 30 x 150 mg 142080 Venlafaxin Mylan 150 mg cps pro 90 x 150 mg 90 x 150 mg 115551 Venlafaxin Mylan 75 mg cps pro 30 x 75 mg 30 x 75 mg 142083 Venlafaxin Mylan 75 mg cps pro 90 x 75 mg 90 x 75 mg 146893 Zolpidem Mylan 10 mg tbl flm 20 x 10 mg 20 x 10 mg 146899 Zolpidem Mylan 10 mg tbl flm 50 x 10 mg 50 x 10 mg Skupina výrobků č.2 /Group of Products Xx. 0 xxx xxxxxxxxx xxxxx xxxxxxxxx xxxxxxxx xxxxxx 000000 Anagrelid Mylan 0,5mg 100 x 0,5 mg 179604 Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg 179576 Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg 179583 Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg 179590 Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg 179597 Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg 144277 Granisetron Mylan 1 mg 10 x 1 mg 145695 Letmylan 2,5 mg 100 x 2,5 mg 139555 Oxykodon Mylan 10 mg 30 x 10 mg 139570 Oxykodon Mylan 20 mg 30 x 20 mg 139565 Oxykodon Mylan 10 mg 60 x 10 mg 139580 Oxykodon Mylan 20 mg 60 x 20 mg 139610 Oxykodon Mylan 40 mg 60 x 40 mg 139655 Oxykodon Mylan 80 mg 80 x 40 mg Skupina výrobků č.3 /Group of Products Xx. 0 xxx xxxxxxxxx xxxxx xxxxxxxxx xxxxxxxx xxxxxx 000000 Ciclosporin Mylan 50x 100mg 50x 100mg 162018 Ciclosporin Mylan 50x25mg 50x 25mg 162024 Ciclosporin Mylan50x 50mg 50x 50mg 183132 Ribavirin Mylan 200 mg 168 x 200 mg 219169 Tenofovir disoproxil Mylan 30 x 245mg 124231 Valaciclovir Mylan 500 mg 42 x 500 mg Skupina výrobků č.4 /Group of Products Xx. 0 xxx xxxxxxxxx xxxxx xxxxxxxxx xxxxxxxx xxxxxx 000000 Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg 212307 Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg 212314 Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 213894 Hulio 40mg 60 x 150 2x0,8ml pfs 238197 Hulio 40mg Capecitabine Mylan 500 mg 120 x 500 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Granisetron Mylan 1 mg 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 100 mg 60 x 100 mg Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 x 50 mg 2x0,8ml pfp Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2Calculation

Xxxx. Xxxxx Xxxxxx, Jednatel / Executive Director jednatel Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 SUKL kód Název přípravku Forma -přípravku Balení přípravku 232841 Afonilum SR 125 mg cps pro 50 x 30 gm 125 mg 232845 Afonilum SR 250 mg cps pro 50 x 250 mg Agomelatine 235130 Alendrogen 70 mg tbl nob 12 x 70 mg 221768 Alendronic Acid/Vitamin D3 Mylan 25 70 mg/2800 IU tbl nob 12 x 70 mg/2800 IU 221770 Alendronic Acid/Vitamin D3 Mylan 70 mg/5600 IU tbl nob 12 x 70 mg/5600 IU 235142 Alfuzosin Mylan 10 mg 28 tbl pro 90 x 25 10 mg Agomelatine 222784 Anagrelid Mylan 25 0,5 mg 84 cps dur 100 x 25 0,5mg 234231 Anastrozol Mylan 1 mg tbl flm 30 x 1 mg 229646 Betaserc 16 tbl nob 60 x 16 mg 229648 Betaserc 24 tbl nob 50 x 24 mg 229644 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 212339 Betaxolol Mylan 20 mg tbl flm 28 x 200 mcg I Breakyl 400 mikrogramů 28 20 mg 233553 Betaxolol Mylan 20 mg tbl flm 98 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I 20 mg 235234 Buprenorfin Mylan 35 mikrogramů/h tdr emp 5 x 20 mg 212307 Buprenorfin Mylan 52,5 mikrogramů/h tdr emp 5 x 30 mg 235248 Buprenorfin Mylan 70 mikrogramů/h tdr emp 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg 230590 Cynt 0,2 tbl flm 30 x 0,2 mg 230591 Cynt 0,2 tbl flm 98 x 0,2 mg 230594 Cynt 0,3 tbl flm 30 x 0,3 mg 230595 Cynt 0,3 tbl flm 98 x 0,3 mg 230598 Cynt 0,4 tbl flm 30 x 0,4 mg 230599 Cynt 0,4 tbl flm 98 x 0,4 mg Dona 1500 233619 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 1 x 5 ml 233620 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 3 x 5 ml 235185 Doxazosin Mylan 4 mg tbl pro 28 x 4 mg 235193 Doxazosin Mylan 4 mg tbl pro 98 x 4 mg 234823 Escitalopram Mylan 10 mg tbl flm 30 x 10 mg 234828 Escitalopram Mylan 10 mg tbl flm 90 x 10 mg 234849 Escitalopram Mylan 20 sačků mg tbl flm 90 x 20 mg 234441 Exemestan Mylan 25 mg tbl flm 30 x 25 mg Fentanyl 234454 Gliclazid Mylan 100 mikrogramů/ hodinu 5 30 mg tbl ret 120 x 16,8 30 mg Fentanyl 234451 Gliclazid Mylan 12 mikrogramů/ hodinu 5 30 mg tbl ret 60 x 2,1 30 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg 234726 Xxxxxx 0,5 mg cps dur 28 x 0,5 mg Granisetron 234727 Xxxxxx 2 mg cps dur 28 x 2 mg 234730 Xxxxxx 2 mg cps dur 98 x 2 mg 215920 Xxxxxx 4 mg cps dur 28 x 4 mg 234735 Xxxxxx 4 mg cps dur 98 x 4 mg 238197 Hulio inj sol 40mg 2x0,8ml pfp 238194 Hulio inj sol 40mg 2x0,8ml pfs 238198 Hulio 40 mg inj sol 40 mg 6x0,8ml pfp 238195 Hulio 40 mg inj sol 40 mg 6x0,8ml pfs 231055 Ibandronát Mylan 1 150 mg 10 tbl flm 3 x 1 150 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 233480 Isoptin 40 mg tbl flm 50 x 40 mg 233484 Isoptin 80 mg tbl flm 50 x 80 mg 233479 Isoptin SR 240 mg tbl pro 100 x 240 mg 233478 Isoptin SR 240 mg tbl pro 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml 235806 Klacid 250 tbl flm 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml 235808 Klacid 500 tbl flm 14 x 500 mg 235801 Klacid SR 7 x 500 mg Klacid SR tbl ret 14 x 500 mg-d 216185 Klacid SR tbl ret 7 x 500 mg 230609 Kreon 10 000 cps etd 50 230614 Kreon 25 000 cps etd 50 151383 Lamotrigin Mylan 100 mg tbl nob 100 x 100 mg 151382 Lamotrigin Mylan 100 mg tbl nob 30 x 100 mg 233649 Leflugen 20 mg tbl flm 30 x 20 mg 145695 Letmylan 2,5 mg tbl flm 100 x 2,5 mg 234500 Letmylan 2,5 mg tbl flm 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml 225971 Lipanthyl 267 M cps dur 30 x 267 mg 225973 Lipanthyl 267 M cps dur 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg 225967 Lipanthyl S 215 mg tbl flm 100 x 215 mg 225965 Lipanthyl S 215 mg tbl flm 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg 225968 Lipanthyl Supra 160 mg tbl ret 30 x 160 mg 225970 Lipanthyl Supra 160 mg tbl ret 90 x 160 mg Metformin 150983 Meloxicam Mylan 1000 15 mg 60 tbl nob 100 x 1 000 15 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg 235822 Mirtazapin Mylan 30 mg por tbl dis 30 x 30 mg 235831 Mirtazapin Mylan 45 mg por tbl dis 30 x 45 mg 139555 Oxykodon Mylan 10 mg tbl pro 30 x 10mg 235851 Oxykodon Mylan 10 mg tbl pro 60 x 10 10mg 139570 Oxykodon Mylan 20 mg tbl pro 30 x 20mg 235866 Oxykodon Mylan 20 mg tbl pro 60 x 20 20mg 235881 Oxykodon Mylan 40 mg tbl pro 60 x 40 40mg 139655 Oxykodon Mylan 80 mg tbl pro 60 x 80 80mg 233298 Pioglitazon Mylan 15 mg tbl nob 28 x 15 mg 233307 Pioglitazon Mylan 30 mg tbl nob 28 x 30 mg Pregabalin Mylan 75 187318 Rismyl 35 mg 14 tbl flm 12 x 75 35 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 235815 Rytmonorm 150 mg 56 tbl flm 100 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg 235813 Rytmonorm 150 mg tbl flm 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg 235818 Rytmonorm 300 mg tbl flm 100 x 300 mg 235816 Rytmonorm 300 mg tbl flm 50 x 300 mg Rytmonorm 300 233667 Serkep inh sus pss 25mcg/125mcg/dáv x 120dáv 233668 Serkep inh sus pss 25mcg/250mcg/dáv x 120dáv 230647 Solifenacin Mylan 10 mg tbl flm 100 x 300 10 mg Sevelamer Carbonate 230629 Solifenacin Mylan 800 5 mg 180 tbl flm 100 x 800 5 mg 233348 Tamsulosin HCI Mylan 0,4 mg cps rdr 100 x 0,4 mg 228747 Taris 0,5 mg/0,4 mg cps dur 90 x 0,5 mg/0,4 mg 234218 Tarka 180/2 mg tbl. tbl ret 28 234220 Tarka 180/2 mg tbl. tbl ret 98 234223 Tarka 240/4 mg tbl. tbl ret 28 234221 Tarka 240/4 mg tbl. tbl ret 98 Topiramat Mylan 100 233487 Twicor 10 mg/10 mg 60 tbl flm 30 x 100 10mg/10mg Topiramat Mylan 25 135113 Twicor 10 mg/10 mg 60 tbl flm 90 x 25 10mg/10mg Topiramat Mylan 50 mg 60 x 50 mg 115527 Uralyt U 280 g gra 1 x 280 g Valaciclovir Mylan 500 46890 Uraplex 20 mg 42 x 500 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 tbl obd 20 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 208354 Uraplex 20 mg 60 tbl obd 50 x 20 mg Oxykodon Mylan 40 225974 Uroxal 5 mg tbl nob 60 x 40 5 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat 209286 Zonisamide Mylan 100 mg 60 cps dur 98 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2mg

Xxxx. Xxxxx Xxxxxx, Jednatel jednatel / Executive Director ____________________________ Krajská zdravotní, a.s. XXXx. Xxxx Xxxx, MBA/ General Director Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 MIC kód/ MIC Code Název přípravku/ Name of the Product Forma Přípravku/ Form of the Product Balení přípravku/ Package of the Product MYL0513 Acnatac 10 mg/g + 0,25 mg/g Gel gel 1 x 30 gm Afonilum SR 250 mg 50 MYL0514 Aldara 5% krém crm 12 x 250 mg Agomelatine MYL0014 Amlodipin Mylan 25 10 mg 28 tbl nob 100 x 25 10 mg Agomelatine MYL0015 Amlodipin Mylan 25 10 mg 84 tbl nob 30 x 25 10 mg MYL0016 Amlodipin Mylan 5 mg tbl nob 100 x 5 mg MYL0017 Amlodipin Mylan 5 mg tbl nob 30 x 5 mg MYL0018 Anastrozol Mylan 1 mg tbl flm 30 x 1 mg MYL0911 Arixtra inj sol 10 x 0,5 ml MYL0023 Atorvastatin Mylan 10 mg tbl flm 100 x 10 mg MYL0024 Atorvastatin Mylan 10 mg tbl flm 30 x 10 mg MYL0026 Atorvastatin Mylan 20 mg tbl flm 100 x 20 mg MYL0025 Atorvastatin Mylan 20 mg tbl flm 30 x 20 mg MYL0021 Atorvastatin Mylan 40 mg tbl flm 100 x 40 mg MYL0022 Atorvastatin Mylan 40 mg tbl flm 30 x 40 mg MYL0028 Azitromycin Mylan 500 mg tbl flm 3 x 500 mg MYL0369 Betaserc 16 tbl nob 60 x 16 mg MYL0823 Betaserc 24 tbl nob 100 x 24 mg MYL0370 Betaserc 24 tbl nob 50 x 24 mg MYL0371 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I MYL0346 Buprenorfin Mylan 35 mikrogramů/h tdr emp 5 x 20 mg MYL0347 Buprenorfin Mylan 52,5 mikrogramů/h tdr emp 5 x 30 mg MYL0348 Buprenorfin Mylan 70 mikrogramů/h tdr emp 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine MYL0523 Calcium/ Vitamin D3 Mylan 500 mg 120 x /800 IU tbl mnd 30 MYL0821 Calcium/ Vitamin D3 Mylan 500 mg /800 IU tbl mnd 90 MYL0040 Ciclosporin Mylan 100 mg cps mol 50 x 100 mg MYL0041 Ciclosporin Mylan 25 mg cps mol 50 x 25 mg MYL0042 Ciclosporin Mylan 50 mg cps mol 50 x 50 mg MYL0043 Clopidogrel Mylan 75 mg tbl flm 30 x 75 mg MYL0044 Clopidogrel Mylan 75 mg tbl flm 90 x 75 mg MYL0377 Cynt 0,2 tbl flm 30 x 0,2 mg MYL0378 Cynt 0,2 tbl flm 98 x 0,2 mg MYL0379 Cynt 0,3 tbl flm 30 x 0,3 mg MYL0380 Cynt 0,3 tbl flm 98 x 0,3 mg MYL0381 Cynt 0,4 tbl flm 30 x 0,4 mg MYL0382 Cynt 0,4 tbl flm 98 x 0,4 mg MYL0164 Desloratadin Mylan 5 mg tbl flm 30 x 5 mg MYL0165 Desloratadin Mylan 5 mg tbl flm 50 x 5 mg MYL0166 Desloratadin Mylan 5 mg tbl flm 90 x 5 mg MYL0819 Dona 1500 mg por plv sol 30 sačků MYL0820 Dona 1500 mg por plv sol 90 sačků MYL0526 Dona 400 mg inj sol 6 x 2 mla + 6 x 1 mlb MYL0045 Donepezil Mylan 10 mg por tbl dis 28 x 10 mg MYL0046 Donepezil Mylan 10 mg tbl flm 28 x 10 mg MYL0327 Donepezil Mylan 10 mg tbl flm 56 x 10 mg MYL0047 Donepezil Mylan 10 mg tbl flm 84 x 10 mg MYL0048 Donepezil Mylan 5 mg tbl flm 28 x 5 mg MYL0336 Dorzogen Combi 20 sačků Exemestan mg/ml + 5 mg/ml oph gtt sol 1 x 5 ml MYL0049 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 3 x 5 ml MYL0527 Dymistin 137 mikrogramů/50 mikrogramů nas spr sus 1 x 23 g MYL0528 Elidel 10 mg/g krém crm 1 x 15 g (tuba Al) MYL0831 Elidel 10 mg/g krém crm 1 x 30 g (tuba Al) MYL0571 Emtricitabine/Tenofovir disoproxil Mylan 25 200 mg/245 mg tbl flm 30 x 25 200 mg/245 mg MYL0572 Entecavir Mylan 0,5 mg tbl flm 30 x 0,5 mg MYL0573 Entecavir Mylan 1 mg tbl flm 30 x 1 mg MYL0052 Escitalopram Mylan 10 mg tbl flm 30 x 10 mg MYL0053 Escitalopram Mylan 10 mg tbl flm 90 x 10 mg MYL0055 Escitalopram Mylan 20 mg tbl flm 90 x 20 mg MYL0188 Fentanyl Mylan 100 mikrogramů/ hodinu tdr emp 5 x 16,8 mg MYL0189 Fentanyl Mylan 12 mikrogramů/ hodinu tdr emp 5 x 2,1 mg MYL0190 Fentanyl Mylan 25 mikrogramů/ hodinu tdr emp 5 x 4,2 mg MYL0191 Fentanyl Mylan 50 mikrogramů/ hodinu tdr emp 5 x 8,4 mg MYL0192 Fentanyl Mylan 75 mikrogramů/ hodinu tdr emp 5 x 12,6 mg MYL0917 Fraxiparine inj sol isp 10 x 0,3 ml MYL0918 Fraxiparine inj sol isp 10 x 0,4 ml MYL0919 Fraxiparine inj sol isp 10 x 0,6 ml MYL0920 Fraxiparine inj sol isp 10 x 0,8 ml MYL0921 Fraxiparine inj sol isp 10 x 1 ml MYL0915 Fraxiparine Forte inj sol isp 10 x 0,6 ml MYL0912 Fraxiparine Forte inj sol isp 10 x 0,8 ml MYL0916 Fraxiparine Forte inj sol isp 10 x 1 ml MYL0062 Gliclazid Mylan 30 mg tbl ret 120 x 30 mg MYL0063 Gliclazid Mylan 30 mg tbl ret 60 x 30 mg MYL0064 Glimepirid Mylan 2 mg tbl nob 30 x 2 mg MYL0065 Glimepirid Mylan 2 mg tbl nob 90 x 2 mg MYL0066 Glimepirid Mylan 3 mg tbl nob 30 x 3 mg MYL0067 Glimepirid Mylan 3 mg tbl nob 90 x 3 mg MYL0068 Glimepirid Mylan 4 mg tbl nob 30 x 4 mg MYL0069 Glimepirid Mylan 4 mg tbl nob 90 x 4 mg MYL0393 Xxxxxx 0,5 mg cps dur 28 x 0,5 mg MYL0394 Xxxxxx 2 mg cps dur 28 x 2 mg MYL0395 Xxxxxx 2 mg cps dur 98 x 2 mg MYL0396 Xxxxxx 4 mg cps dur 28 x 4 mg MYL0397 Xxxxxx 4 mg cps dur 98 x 4 mg MYL0070 Granisetron Mylan 1 mg tbl flm 10 x 1 mg MYL0464 Cholib 145 mg/20 mg tbl flm 30 MYL0883 Cholib 145 mg/20 mg tbl flm 90 MYL0465 Cholib 145 mg/40 mg tbl flm 30 MYL0884 Cholib 145 mg/40 mg tbl flm 90 MYL0072 Ibandronát Mylan 150 mg tbl flm 3 x 150 mg MYL0400 Isoptin 40 mg tbl flm 50 x 40 mg MYL0401 Isoptin 80 mg tbl flm 50 x 80 mg MYL0402 Isoptin SR 240 mg tbl pro 100 x 240 mg MYL0403 Isoptin SR 240 mg tbl pro 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg MYL0404 Klacid 125 mg/5 ml por gra sus 1 x 100 ml MYL0405 Klacid 125 mg/5 ml por gra sus 1 x 60 ml MYL0406 Klacid 250 mg tbl flm 10 x 250 mg MYL0407 Klacid 250 mg tbl flm 14 x 250 mg MYL0408 Klacid 250 mg/5 ml por gra sus 1 x 100 ml MYL0409 Klacid 250 mg/5 ml por gra sus 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml MYL0410 Klacid 500 mg tbl flm 14 x 500 mg MYL0413 Klacid SR 500 mg tbl ret 14 x 500 mg MYL0411 Klacid SR 500 mg tbl ret 7 x 500 mg Klacid SR 14 x 500 mg-d MYL0415 Kreon 25 10 000 cps etd 20 MYL0414 Kreon 10 000 cps etd 50 MYL0299 Letmylan 2,5 mg tbl flm 100 x 2,5 mg MYL0265 Letmylan 2,5 mg tbl flm 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml MYL0418 Lipanthyl 267 M cps dur 30 x 267 mg MYL0419 Lipanthyl 267 M cps dur 90 x 267 mg Xxxxxxxxx Xx 000 MYL0420 Lipanthyl Nt 145 mg tbl flm 30 x 145 mg Xxxxxxxxx Xx 000 MYL0421 Lipanthyl Nt 145 mg tbl flm 90 x 145 mg MYL0422 Lipanthyl S 215 mg tbl flm 100 x 215 mg MYL0423 Lipanthyl S 215 mg tbl flm 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg MYL0425 Lipanthyl Supra 160 mg tbl ret 30 x 160 mg MYL0424 Lipanthyl Supra 160 mg tbl ret 90 x 160 mg MYL0943 Lyrica cps dur 112 x 150 mg (2x56) MYL0950 Lyrica cps dur 112 x 75 mg (2x56) MYL0944 Lyrica cps dur 14 x 150 mg MYL0945 Lyrica cps dur 56 x 150 mg MYL0947 Lyrica cps dur 56 x 225 mg MYL0948 Lyrica cps dur 56 x 300 mg MYL0949 Lyrica cps dur 56 x 50 mg MYL0952 Lyrica cps dur 56 x 75 mg MYL0323 Memantin Mylan 10 mg tbl flm 28 x 10 mg MYL0203 Memantin Mylan 10 mg tbl flm 56 x 10 mg MYL0334 Memantin Mylan 10 mg tbl flm 84 x 10 mg MYL0204 Memantin Mylan 20 mg tbl flm 28 x 20 mg MYL0540 Mestinon 60 mg tbl obd 150 x 60 mg MYL0094 Metformin Mylan 1000 mg tbl flm 120 x 1 000 mg MYL0095 Metformin Mylan 1000 mg tbl flm 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg MYL0096 Metformin Mylan 500 mg tbl flm 120 x 500 mg MYL0097 Metformin Mylan 500 mg tbl flm 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg MYL0098 Metformin Mylan 850 mg tbl flm 120 x 850 mg MYL0099 Metformin Mylan 850 mg tbl flm 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Oxykodon MYL0108 Montelukast Mylan 10 mg tbl flm 100 x 10 mg MYL0109 Montelukast Mylan 10 mg tbl flm 30 x 10 mg MYL0171 Montelukast Mylan 4 mg tbl mnd 30 x 4 mg MYL0110 Montelukast Mylan 5 mg tbl mnd 100 x 5 mg MYL0172 Montelukast Mylan 5 mg tbl mnd 30 x 5 mg MYL0954 Neurontin cps dur 100 x 100 mg MYL0955 Neurontin cps dur 100 x 300 mg MYL0956 Neurontin cps dur 50 x 300 mg MYL0957 Neurontin cps dur 50 x 400 mg MYL0958 Neurontin tbl flm 50 x 600 mg MYL0959 Neurontin tbl flm 50 x 800 mg MYL0684 Oxykodon/Naloxon Mylan tbl pro 60 x 10 mg Oxykodon / 5 mg MYL0682 Oxykodon/Naloxon Mylan 20 mg tbl pro 60 x 20 mg Oxykodon / 10 mg MYL0683 Oxykodon/Naloxon Mylan 40 mg tbl pro 60 x 40 mg Oxykodon / 20 mg MYL0736 Perindopril/Amlodipin Mylan 80 4 mg/10 mg 60 tbl nob 90 x 80 4mg/10mg MYL0739 Perindopril/Amlodipin Mylan 4 mg/5 mg tbl nob 90 x 4mg/5mg MYL0827 Perindopril/Amlodipin Mylan 8 mg/10 mg tbl nob 90 x 8mg/10mg MYL0743 Perindopril/Amlodipin Mylan 8 mg/5 mg tbl nob 90 x 8mg/5mg MYL0205 Pioglitazon Mylan 15 mg tbl nob 28 x 15 mg MYL0177 Pioglitazon Mylan 30 mg tbl nob 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg MYL0545 Reparil - Gel N 100 g gel 100 g MYL0544 Reparil - Gel N 40 g gel 40 g MYL0616 Reparil Dragées 20 mg tbl ent 100 x 20 mg MYL0543 Reparil Dragées 20 mg tbl ent 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg MYL0429 Rytmonorm 150 mg tbl flm 100 x 150 mg MYL0428 Rytmonorm 150 mg tbl flm 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg MYL0431 Rytmonorm 300 mg tbl flm 100 x 300 mg MYL0430 Rytmonorm 300 mg tbl flm 50 x 300 mg Rytmonorm 300 MYL0650 Semglee 100 jednotek/ml inj sol pep 5 x 3 ml MYL0688 Serkep 25 mikrogramů/125 mikrogramů/dávka inh sus pss 25mcg/125mcg/dáv x 120dáv MYL0689 Serkep 25 mikrogramů/250 mikrogramů/dávka inh sus pss 25mcg/250mcg/dáv x 120dáv MYL0694 Sertralin Mylan 100 mg tbl flm 30 x 100 mg MYL0692 Sertralin Mylan 50 mg tbl flm 30 x 300 50 mg MYL0693 Sertralin Mylan 50 mg tbl flm 90 x 50 mg MYL0493 Sevelamer Carbonate Mylan 800 mg tbl flm 180 x 800 mg Tamsulosin HCI MYL0144 Simvastatin Mylan 0,4 20 mg tbl flm 100 x 0,4 20 mg MYL0146 Simvastatin Mylan 40 mg tbl flm 100 x 40 mg MYL0792 Sitagliptin Mylan tbl flm 28 x 100 mg MYL1009 Sitagliptin Mylan tbl flm 98 x 100 mg MYL0785 Sitagliptin/Metformin hydrochloride Mylan 50 mg/1000 mg tbl flm 56 x 50 mg/1000 mg MYL0787 Sitagliptin/Metformin hydrochloride Mylan 50 mg/850 mg tbl flm 56 x 50 mg/850 mg MYL0965 Sortis tbl flm 100 x 10 mg MYL0967 Sortis tbl flm 100 x 20 mg MYL0969 Sortis tbl flm 100 x 40 mg MYL0966 Sortis tbl flm 30 x 10 mg MYL0968 Sortis tbl flm 30 x 20 mg MYL0970 Sortis tbl flm 30 x 40 mg MYL0971 Sortis tbl flm 30 x 80 mg MYL0147 Sumatriptan Mylan 100 mg tbl flm 2 x 100 mg MYL0148 Sumatriptan Mylan 50 mg tbl flm 6 x 50 mg MYL0720 Taris 0,5 mg/0,4 mg cps dur 90 x 0,5 mg/0,4 mg MYL0435 Tarka 180/2 180 mg/2 mg tbl. tbl ret 28 MYL0436 Tarka 180/2 180 mg/2 mg tbl. tbl ret 98 MYL0437 Tarka 240/4 240 mg/4 mg tbl. tbl ret 28 MYL0438 Tarka 240/4 240 mg/4 mg tbl. tbl ret 98 MYL0356 Tenofovir disoproxil Mylan 245 mg tbl flm 30 x 245 mg MYL0151 Topiramat Mylan 100 mg tbl flm 60 x 100 mg MYL0152 Topiramat Mylan 25 mg tbl flm 60 x 25 mg MYL0153 Topiramat Mylan 50 mg tbl flm 60 x 50 mg Uralyt U 280 g 1 MYL0246 Tramadol Mylan 100 mg tbl pro 30 x 280 g 100 mg MYL0247 Tramadol Mylan 150 mg tbl pro 30 x 150 mg MYL0248 Tramadol Mylan 200 mg tbl pro 30 x 200 mg MYL0335 Tramylpa 37,5 mg/ 325 mg tbl flm 20 x 37,5 mg/ 325 mg MYL0155 Tramylpa 37,5 mg/ 325 mg tbl flm 30 x 37,5 mg/ 325 mg MYL0798 Tutecvi 50 mg tbl nob 56 x 50 mg MYL0644 Twicor 10 mg/10 mg tbl flm 30 x 10 mg/10 mg MYL0643 Twicor 10 mg/10 mg tbl flm 90 x 10 mg/10 mg MYL0657 Twicor 20 mg/10 mg tbl flm 30 x 20 mg/10 mg MYL0658 Twicor 20 mg/10 mg tbl flm 90 x 20 mg/10 mg MYL0225 Valaciclovir Mylan 500 mg tbl flm 42 x 500 mg MYL0590 Valganciclovir Mylan 450 mg tbl flm 60 x 450 mg MYL0159 Venlafaxin Mylan 150 mg cps pro 30 x 150 mg MYL0307 Venlafaxin Mylan 150 mg cps pro 90 x 150 mg MYL0160 Venlafaxin Mylan 75 mg cps pro 30 x 75 mg MYL0306 Venlafaxin Mylan 75 mg cps pro 90 x 75 mg Zoledronic acid MYL0475 Vorikonazol Mylan 4 mg/5 ml 200 mg tbl flm 14 x 200 mg MYL0980 Xalacom oph gtt sol 1 x 4mg/5ml Zonisamide Mylan 50 2.5 ml MYL0981 Xalacom oph gtt sol 3 x 2.5 ml MYL0982 Xalatan oph gtt sol 1 x 2.5 ml MYL0983 Xalatan oph gtt sol 3 x 2.5 ml MYL0984 Xanax tbl nob 30 x 0.25 mg 56 MYL0985 Xanax tbl nob 30 x 50 0.5 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg MYL0986 Xanax tbl nob 30 x 1 mg Breakyl 200 mikrogramů 28 MYL0987 Xanax tbl nob 50 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 2 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg MYL0988 Xanax SR tbl pro 30 x 25 0.5 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 MYL0989 Xanax SR tbl pro 30 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo MYL0990 Xanax SR tbl pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg MYL0996 Zoloft tbl flm 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 MYL0995 Zoloft tbl flm 28 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 MYL0997 Zoloft tbl flm 28 x 50 mg Bonusové pásmo pro skupinu č.2MYL0892 Zolpidem Mylan 10 mg tbl flm 100 x 10 mg MYL0161 Zolpidem Mylan 10 mg tbl flm 20 x 10 mg MYL0187 Zolpidem Mylan 10 mg tbl flm 50 x 10 mg

Xxxx. Xxxxx Xxxxxx, Jednatel jednatel / Executive Director Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mgMIC kód/ MIC Code Název přípravku/ Name of the Product Forma přípravku/ Form of the Product Balení přípravku/ Package of the Product MYL0002 Alendrogen 70 mg tbl nob 12 x 70 mg MYL0661 Alendronic Acid/g + 0,25 mgVitamin D3 Mylan 70 mg/2800 IU tbl nob 12 x 70 mg/2800 IU MYL0662 Alendronic Acid/g Gel 1 Vitamin D3 Mylan 70 mg/5600 IU tbl nob 12 x 30 gm Afonilum SR 250 70 mg/5600 IU MYL0023 Atorvastatin Mylan 10 mg 50 tbl flm 100 x 250 10 mg Agomelatine MYL0026 Atorvastatin Mylan 25 20 mg 28 tbl flm 100 x 25 20 mg Agomelatine MYL0025 Atorvastatin Mylan 25 20 mg 84 x 25 mg Anastrozol Mylan 1 mg tbl flm 30 x 1 20 mg MYL0021 Atorvastatin Mylan 40 mg tbl flm 100 x 40 mg MYL0022 Atorvastatin Mylan 40 mg tbl flm 30 x 40 mg MYL0028 Azitromycin Mylan 500 mg tbl flm 3 x 500 mg MYL0369 Betaserc 16 tbl nob 60 x 16 mg MYL0823 Betaserc 24 tbl nob 100 x 24 mg MYL0370 Betaserc 24 tbl nob 50 x 24 mg MYL0371 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 28 MYL0033 Bisoprolol Mylan 10 mg tbl flm 100 x 200 mcg I Breakyl 400 mikrogramů 28 10 mg MYL0036 Bisoprolol Mylan 5 mg tbl flm 100 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I 5 mg MYL0346 Buprenorfin Mylan 35 mikrogramů/h tdr emp 5 x 20 mg MYL0347 Buprenorfin Mylan 52,5 mikrogramů/h tdr emp 5 x 30 mg MYL0348 Buprenorfin Mylan 70 mikrogramů/h tdr emp 5 x 40 mg Capecitabine MYL0043 Clopidogrel Mylan 150 75 mg 60 tbl flm 30 x 150 75 mg Capecitabine MYL0044 Clopidogrel Mylan 500 75 mg 120 tbl flm 90 x 500 75 mg MYL0377 Cynt 0,2 tbl flm 30 x 0,2 mg MYL0378 Cynt 0,2 tbl flm 98 x 0,2 mg MYL0379 Cynt 0,3 tbl flm 30 x 0,3 mg MYL0380 Cynt 0,3 tbl flm 98 x 0,3 mg MYL0381 Cynt 0,4 tbl flm 30 x 0,4 mg MYL0382 Cynt 0,4 tbl flm 98 x 0,4 mg Dona 1500 MYL0164 Desloratadin Mylan 5 mg 20 sačků Exemestan Mylan 25 mg tbl flm 30 x 25 5 mg MYL0165 Desloratadin Mylan 5 mg tbl flm 50 x 5 mg MYL0166 Desloratadin Mylan 5 mg tbl flm 90 x 5 mg MYL0046 Donepezil Mylan 10 mg tbl flm 28 x 10 mg MYL0045 Donepezil Mylan 10 mg por tbl dis 28 x 10 mg MYL0327 Donepezil Mylan 10 mg tbl flm 56 x 10 mg MYL0047 Donepezil Mylan 10 mg tbl flm 84 x 10 mg MYL0048 Donepezil Mylan 5 mg tbl flm 28 x 5 mg MYL0336 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 1 x 5 ml MYL0049 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 3 x 5 ml MYL0386 Duspatalin Retard 200 mg cps rdr 30 x 200 mg MYL0052 Escitalopram Mylan 10 mg tbl flm 30 x 10 mg MYL0053 Escitalopram Mylan 10 mg tbl flm 90 x 10 mg MYL0055 Escitalopram Mylan 20 mg tbl flm 90 x 20 mg MYL0690 Ezetimib Mylan 10 mg tbl nob 30 x 10 mg MYL0691 Ezetimib Mylan 10 mg tbl nob 98 x 10 mg MYL0188 Fentanyl Mylan 100 mikrogramů/ hodinu tdr emp 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg MYL0192 Fentanyl Mylan 75 mikrogramů/ hodinu tdr emp 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg MYL0070 Granisetron Mylan 1 mg tbl flm 10 x 1 mg Cholib 145 mg/20 MYL0681 Hulio 40 mg 30 Cholib 145 mg/40 inj sol 40 mg 30 2x0,8ml pfp MYL0680 Hulio 40 mg inj sol 40 mg 2x0,8ml pfs MYL0400 Isoptin 40 mg tbl flm 50 x 40 mg MYL0401 Isoptin 80 mg tbl flm 50 x 80 mg MYL0402 Isoptin SR 240 mg tbl pro 100 x 240 mg MYL0403 Isoptin SR 240 mg tbl pro 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg MYL0404 Klacid 125 mg/5 ml por gra sus 1 x 100 ml MYL0405 Klacid 125 mg/5 ml por gra sus 1 x 60 ml MYL0406 Klacid 250 mg tbl flm 10 x 250 mg MYL0407 Klacid 250 mg tbl flm 14 x 250 mg MYL0408 Klacid 250 mg/5 ml por gra sus 1 x 100 ml MYL0409 Klacid 250 mg/5 ml por gra sus 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml MYL0410 Klacid 500 mg tbl flm 14 x 500 mg MYL0413 Klacid SR 500 mg tbl ret 14 x 500 mg MYL0411 Klacid SR 500 mg tbl ret 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 MYL0265 Letmylan 2,5 mg tbl flm 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg MYL0443 Levelanz 1000 mg tbl flm 56 x 1000 mg MYL0445 Levelanz 250 mg tbl flm 56 x 250 mg MYL0447 Levelanz 500 mg tbl flm 56 x 500 mg MYL0449 Levelanz 500 mg tbl flm 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml MYL0418 Lipanthyl 267 M cps dur 30 x 267 mg MYL0419 Lipanthyl 267 M cps dur 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x MYL0421 Lipanthyl Nt 145 mg Xxxxxxxxx Xx 000 mg tbl flm 90 x 145 mg MYL0422 Lipanthyl S 215 mg tbl flm 100 x 215 mg MYL0423 Lipanthyl S 215 mg tbl flm 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg MYL0424 Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg tbl ret 90 x 160 mg MYL0323 Memantin Mylan 10 mg tbl flm 28 x 10 mg MYL0203 Memantin Mylan 10 mg tbl flm 56 x 10 mg MYL0334 Memantin Mylan 10 mg tbl flm 84 x 10 mg MYL0204 Memantin Mylan 20 mg tbl flm 28 x 20 mg MYL0540 Mestinon 60 mg tbl obd 150 x 60 mg MYL0094 Metformin Mylan 1000 mg tbl flm 120 x 1 000 mg MYL0095 Metformin Mylan 1000 mg tbl flm 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg MYL0096 Metformin Mylan 500 mg tbl flm 120 x 500 mg MYL0097 Metformin Mylan 500 mg tbl flm 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg MYL0098 Metformin Mylan 850 mg tbl flm 120 x 850 mg MYL0099 Metformin Mylan 850 mg tbl flm 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Oxykodon MYL0822 Olanzapin Mylan 10 mg 60 tbl flm 56 x 10 mg MYL0497 Oxykodon Mylan 20 mg tbl pro 60 x 20 mg MYL0498 Oxykodon Mylan 40 mg tbl pro 60 x 40 mg MYL0499 Oxykodon Mylan 80 mg tbl pro 60 x 80 mg MYL0205 Pioglitazon Mylan 15 mg tbl nob 28 x 15 mg MYL0177 Pioglitazon Mylan 30 mg tbl nob 28 x 30 mg Pregabalin MYL0136 Ropinirol Mylan 75 2 mg 14 tbl flm 84 x 75 2 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan MYL0429 Rytmonorm 150 mg 56 tbl flm 100 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg MYL0428 Rytmonorm 150 mg tbl flm 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg MYL0431 Rytmonorm 300 mg tbl flm 100 x 300 mg MYL0430 Rytmonorm 300 mg tbl flm 50 x 300 mg Rytmonorm 300 MYL0694 Sertralin Mylan 100 mg tbl flm 30 x 100 mg MYL0692 Sertralin Mylan 50 mg tbl flm 30 x 50 mg MYL0693 Sertralin Mylan 50 mg tbl flm 90 x 50 mg MYL0353 Solifenacin Mylan 10 mg tbl flm 100 x 300 10 mg Sevelamer Carbonate MYL0352 Solifenacin Mylan 800 5 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg tbl flm 100 x 0,4 5 mg Tarka 180/2 MYL0147 Sumatriptan Mylan 100 mg tbl. 28 Tarka 180/2 tbl flm 2 x 100 mg tbl. 98 Tarka 240/4 MYL0148 Sumatriptan Mylan 50 mg tbl. 28 Tarka 240/4 tbl flm 6 x 50 mg tbl. 98 MYL0720 Taris 0,5 mg/0,4 mg cps dur 90 x 0,5 mg/0,4 mg MYL0356 Tenofovir disoproxil Mylan 245 mg tbl flm 30 x 245 mg MYL0151 Topiramat Mylan 100 mg tbl flm 60 x 100 mg MYL0152 Topiramat Mylan 25 mg tbl flm 60 x 25 mg MYL0153 Topiramat Mylan 50 mg tbl flm 60 x 50 mg MYL0246 Tramadol Mylan 100 mg tbl pro 30 x 100 mg MYL0247 Tramadol Mylan 150 mg tbl pro 30 x 150 mg MYL0248 Tramadol Mylan 200 mg tbl pro 30 x 200 mg MYL0553 Uralyt U 280 g gra 1 x 280 g Valaciclovir Mylan 500 MYL0555 Uraplex 20 mg 42 tbl obd 50 x 500 20 mg MYL0364 Uroxal 5 mg tbl nob 60 x 5 mg MYL0159 Venlafaxin Mylan 150 mg cps pro 30 x 150 mg MYL0307 Venlafaxin Mylan 150 mg cps pro 90 x 150 mg MYL0160 Venlafaxin Mylan 75 mg cps pro 30 x 75 mg MYL0306 Venlafaxin Mylan 75 mg cps pro 90 x 75 mg Zoledronic acid MYL0475 Vorikonazol Mylan 4 mg/5 ml 1 x 4mg/5ml Zonisamide Mylan 50 200 mg 56 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 tbl flm 14 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2

Xxxx. Xxxxx Xxxxxx, Jednatel / Executive Director Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg MIC Produkt / Product forma balení MYL0659 Agomelatine Mylan 25 mg tbl flm 28 x 25 mg MYL0660 Agomelatine Mylan 25 mg tbl flm 84 x 25 mg Anastrozol MYL0663 Atomoxetin Mylan 1 10 mg 30 cps dur 28 x 1 10mg MYL0664 Atomoxetin Mylan 18 mg cps dur 28 x 18mg MYL0665 Atomoxetin Mylan 25 mg cps dur 28 x 25mg MYL0666 Atomoxetin Mylan 40 mg cps dur 28 x 40mg MYL0667 Atomoxetin Mylan 60 mg cps dur 28 x 60mg MYL0668 Atomoxetin Mylan 80 mg cps dur 28 x 80mg MYL0369 Betaserc 16 tbl nob 60 x 16 mg MYL0370 Betaserc 24 tbl nob 50 x 24 mg MYL0823 Betaserc 24 tbl nod 100 x 24 mg MYL0371 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I MYL0346 Buprenorfin Mylan 35 mikrogramů/h tdr emp 5 x 20 mg MYL0347 Buprenorfin Mylan 52,5 mikrogramů/h tdr emp 5 x 30 mg MYL0348 Buprenorfin Mylan 70 mikrogramů/h tdr emp 5 x 40 mg Capecitabine Mylan 150 MYL0523 Calcium/ Vitamin D3 Meda 500 mg 60 x 150 mg Capecitabine /800 IU tbl.mnd. 30 MYL0821 Calcium/ Vitamin D3 Mylan 500 mg 120 x 500 mg /800 IU tbl mnd 90 MYL0377 Cynt 0,2 tbl flm 30 x 0,2 mg MYL0378 Cynt 0,2 tbl flm 98 x 0,2 mg MYL0379 Cynt 0,3 tbl flm 30 x 0,3 mg MYL0380 Cynt 0,3 tbl flm 98 x 0,3 mg MYL0382 Cynt 0,4 tbl flm 98 x 0,4 mg MYL0381 Cynt 0,4 tbl flm 30 x 0,4 mg Cynt 0,4 98 MYL0164 Desloratadin Mylan 5 mg tbl flm 30 x 0,4 5 mg MYL0165 Desloratadin Mylan 5 mg tbl flm 50 x 5 mg MYL0166 Desloratadin Mylan 5 mg tbl flm 90 x 5 mg MYL0525 Dona 1500 mg por plv sol 20 sačků Exemestan Mylan 25 MYL0820 Dona 1500 mg por plv sol 90 sačků MYL0526 Dona 400 mg inj sol 6 x 2 mla + 6 x 1 mlb MYL0386 Duspatalin Retard cps rdr 30 x 25 200 mg Fentanyl MYL0572 Entecavir Mylan 100 mikrogramů/ hodinu 5 tbl flm 0,5mg x 16,8 30 MYL0573 Entecavir Mylan tbl flm 1mg Fentanyl x 30 MYL0072 Ibandronát Mylan 12 mikrogramů/ hodinu 5 150 mg tbl flm 3 x 2,1 150 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Granisetron Mylan 1 mg 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg MYL0402 Isoptin SR 240 mg tbl pro 100 x 240 mg MYL0403 Isoptin SR 240 mg tbl pro 30 x 240 mg Isoptin SR 240 MYL0414 Kreon 10 000 cps etd 50 MYL0300 Lansoprazol Mylan 30 mg 100 cps etd 28 x 240 30 mg Klacid 125 mg/5 ml 1 MYL0301 Lansoprazol Mylan 30 mg cps etd 56 x 100 ml Klacid 250 10 x 250 30 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg MYL0443 Levelanz 1000 mg tbl flm 56 x 1000 mg MYL0443 Levelanz 1000 mg tbl flm 56 x 1000 mg MYL0445 Levelanz 250 mg tbl flm 56 x 250 mg MYL0445 Levelanz 250 mg tbl flm 56 x 250 mg MYL0447 Levelanz 500 mg tbl flm 56 x 250 mg MYL0449 Levelanz 500 mg tbl flm 56 x 500 mg MYL0447 Levelanz 500 mg tbl flm 56 x 500 mg MYL0449 Levelanz 500 mg tbl flm 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml MYL0418 Lipanthyl 267 M cps dur 30 x 267 mg MYL0419 Lipanthyl 267 M cps dur 90 x 267 mg Xxxxxxxxx Xx 000 MYL0420 Lipanthyl Nt 145 mg tbl flm 30 x 145 mg Xxxxxxxxx Xx 000 MYL0421 Lipanthyl Nt 145 mg tbl flm 90 x 145 mg MYL0422 Lipanthyl S 215 mg tbl flm 100 x 215 mg MYL0423 Lipanthyl S 215 mg tbl flm 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg MYL0425 Lipanthyl Supra 160 mg tbl ret 90 x 160 mg MYL0424 Lipanthyl Supra 160 mg tbl ret 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg MYL0495 Oxykodon Mylan 10 mg tbl pro 60 x 10 mg MYL0497 Oxykodon Mylan 20 mg tbl pro 60 x 20 mg MYL0498 Oxykodon Mylan 40 mg tbl pro 60 x 40 mg MYL0499 Oxykodon Mylan 80 mg tbl pro 60 x 80 mg Pioglitazon MYL0684 Oxykodon/Naloxon Mylan 15 tbl pro 60 x 10 mg 28 / 5 mg MYL0682 Oxykodon/Naloxon Mylan tbl pro 60 x 15 20 mg Pioglitazon / 10 mg MYL0683 Oxykodon/Naloxon Mylan 30 tbl pro 60 x 40 mg 28 x 30 / 20 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan MYL0429 Rytmonorm 150 mg 56 tbl flm 100 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg MYL0428 Rytmonorm 150 mg tbl flm 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg MYL0430 Rytmonorm 300 mg tbl flm 50 x 300 mg MYL0431 Rytmonorm 300 mg tbl flm 100 x 300 mg Sevelamer Carbonate MYL0694 Sertralin Mylan 800 100 mg 180 tbl flm 30 x 800 100mg Tamsulosin HCI MYL0692 Sertralin Mylan 0,4 50 mg 100 tbl flm 30 x 0,4 50mg Tarka 180/2 MYL0693 Sertralin Mylan 50 mg tbl. 28 Tarka 180/2 tbl flm 90 x 50mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 MYL0151 Topiramat Mylan 100 mg tbl flm 60 x 100 mg MYL0152 Topiramat Mylan 25 mg tbl flm 60 x 25 mg MYL0153 Topiramat Mylan 50 mg tbl flm 60 x 50 mg Uralyt U 280 g 1 MYL0643 Twicor 10 mg/10 mg tbl flm 90 x 280 g Valaciclovir Mylan 500 10mg/10mg 42 x 500 MYL0644 Twicor 10 mg/10 mg Venlafaxin Mylan 150 mg tbl flm 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 10mg/10mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2

Xxxx. Xxxxx Xxxxxx, Jednatel jednatel / Executive Director ____________________________ Ústřední vojenská nemocnice - Vojenská fakultní nemocnice Praha xxxx. XXXx. Xxxxxxxx Xxxxxxx, Ph.X., ředitel / Director Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg MIC kód*/ MIC Code Název přípravku/ Name of the Product Forma přípravku/ Form of the Product Balení přípravku/ Package of the Product MYL0659 Agomelatine Mylan 25 mg tbl flm 28 x 25 mg Agomelatine MYL0514 Aldara 5% krém crm 12 x 250 mg MYL0002 Alendrogen 70 mg tbl nob 12 x 70 mg MYL0004 Alfuzosin Mylan 10 mg tbl pro 90 x 10 mg MYL0014 Amlodipin Mylan 10 mg tbl nob 100 x 10 mg MYL0016 Amlodipin Mylan 5 mg tbl nob 100 x 5 mg MYL0663 Atomoxetin Mylan 10 mg cps dur 28 x 10 mg MYL0882 Atomoxetin Mylan 100 mg cps dur 28 x 100 mg MYL0664 Atomoxetin Mylan 18 mg cps dur 28 x 18 mg MYL0665 Atomoxetin Mylan 25 mg 84 cps dur 28 x 25 mg Anastrozol MYL0666 Atomoxetin Mylan 1 40 mg cps dur 28 x 40 mg MYL0667 Atomoxetin Mylan 60 mg cps dur 28 x 60 mg MYL0668 Atomoxetin Mylan 80 mg cps dur 28 x 80 mg MYL0023 Atorvastatin Mylan 10 mg tbl flm 100 x 10 mg MYL0024 Atorvastatin Mylan 10 mg tbl flm 30 x 1 10 mg MYL0026 Atorvastatin Mylan 20 mg tbl flm 100 x 20 mg MYL0025 Atorvastatin Mylan 20 mg tbl flm 30 x 20 mg MYL0021 Atorvastatin Mylan 40 mg tbl flm 100 x 40 mg MYL0022 Atorvastatin Mylan 40 mg tbl flm 30 x 40 mg MYL0517 Aurorix 150 mg tbl flm 30 x 150 mg MYL0518 Aurorix 300 mg tbl flm 30 x 300 mg MYL0369 Betaserc 16 tbl nob 60 x 16 mg MYL0823 Betaserc 24 tbl nob 100 x 24 mg MYL0370 Betaserc 24 tbl nob 50 x 24 mg MYL0371 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 28 MYL0598 Betaxolol Mylan 20 mg tbl flm 98 x 200 mcg I Breakyl 400 mikrogramů 28 20 mg MYL0033 Bisoprolol Mylan 10 mg tbl flm 100 x 400 mcg I Breakyl 800 mikrogramů 28 10 mg MYL0034 Bisoprolol Mylan 10 mg tbl flm 30 x 800 mcg I 10 mg MYL0035 Bisoprolol Mylan 2,5 mg tbl flm 30 x 2,5 mg MYL0036 Bisoprolol Mylan 5 mg tbl flm 100 x 5 mg MYL0346 Buprenorfin Mylan 35 mikrogramů/h tdr emp 5 x 20 mg MYL0347 Buprenorfin Mylan 52,5 mikrogramů/h tdr emp 5 x 30 mg MYL0348 Buprenorfin Mylan 70 mikrogramů/h tdr emp 5 x 40 mg Capecitabine Mylan 150 MYL0923 Caduet tbl flm 30 x 10 mg/10 mg 60 MYL0924 Caduet tbl flm 90 x 150 10 mg/10 mg Capecitabine MYL0925 Caduet tbl flm 30 x 5 mg/10 mg MYL0926 Caduet tbl flm 90 x 5 mg/10 mg MYL0523 Calcium/ Vitamin D3 Mylan 500 mg 120 x /800 IU tbl mnd 30 MYL0821 Calcium/ Vitamin D3 Mylan 500 mg Cynt 0,2 /800 IU tbl mnd 90 MYL0043 Clopidogrel Mylan 75 mg tbl flm 30 x 0,2 75 mg Cynt 0,2 MYL0044 Clopidogrel Mylan 75 mg tbl flm 90 x 75 mg MYL0164 Desloratadin Mylan 5 mg tbl flm 30 x 5 mg MYL0165 Desloratadin Mylan 5 mg tbl flm 50 x 5 mg MYL0166 Desloratadin Mylan 5 mg tbl flm 90 x 5 mg MYL0046 Donepezil Mylan 10 mg tbl flm 28 x 10 mg MYL0327 Donepezil Mylan 10 mg tbl flm 56 x 10 mg MYL0047 Donepezil Mylan 10 mg tbl flm 84 x 10 mg MYL0048 Donepezil Mylan 5 mg tbl flm 28 x 5 mg MYL0336 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 1 x 5 ml MYL0049 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 3 x 5 ml MYL0385 Duphaston 10 mg tbl flm 20 x 10 mg MYL0386 Duspatalin Retard 200 mg cps rdr 30 x 200 mg MYL0527 Dymistin 137 mikrogramů/50 mikrogramů nas spr sus 1 x 23 g MYL0528 Elidel 10 mg/g krém crm 1 x 15 g (tuba Al) MYL0572 Entecavir Mylan 0,5 mg tbl flm 30 x 0,5 mg MYL0573 Entecavir Mylan 1 mg tbl flm 30 x 1 mg MYL0052 Escitalopram Mylan 10 mg tbl flm 30 x 10 mg MYL0053 Escitalopram Mylan 10 mg tbl flm 90 x 10 mg MYL0055 Escitalopram Mylan 20 mg tbl flm 90 x 20 mg MYL0690 Ezetimib Mylan 10 mg tbl nob 30 x 10 mg MYL0691 Ezetimib Mylan 10 mg tbl nob 98 x 0,2 10 mg Cynt 0,3 30 MYL0388 Femoston 1/10 tbl flm 1 x 0,3 28 MYL0389 Femoston 2/10 tbl flm 1 x 28 MYL0390 Femoston Conti tbl flm 28 MYL0387 Femoston Mini 0,5 mg/2,5 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Exemestan Mylan 25 mg 30 x 25 mg tbl flm 28 MYL0188 Fentanyl Mylan 100 mikrogramů/ hodinu tdr emp 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg MYL0191 Fentanyl Mylan 50 mikrogramů/ hodinu tdr emp 5 x 8,4 mg MYL0192 Fentanyl Mylan 75 mikrogramů/ hodinu tdr emp 5 x 12,6 mg MYL0391 Fevarin 100 mg tbl flm 30 x 100 mg MYL0392 Fevarin 50 mg tbl flm 30 x 50 mg MYL0057 Finasterid Mylan 5 mg tbl flm 100 x 5 mg MYL0062 Gliclazid Mylan 30 mg tbl ret 120 x 30 mg MYL0063 Gliclazid Mylan 30 mg tbl ret 60 x 30 mg MYL0064 Glimepirid Mylan 2 mg tbl nob 30 x 2 mg MYL0065 Glimepirid Mylan 2 mg tbl nob 90 x 2 mg MYL0066 Glimepirid Mylan 3 mg tbl nob 30 x 3 mg MYL0067 Glimepirid Mylan 3 mg tbl nob 90 x 3 mg MYL0068 Glimepirid Mylan 4 mg tbl nob 30 x 4 mg MYL0069 Glimepirid Mylan 4 mg tbl nob 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg MYL0070 Granisetron Mylan 1 mg tbl flm 10 x 1 mg MYL0464 Cholib 145 mg/20 mg tbl flm 30 MYL0465 Cholib 145 mg/40 mg tbl flm 30 MYL0072 Ibandronát Mylan 150 mg tbl flm 3 x 150 mg MYL0400 Isoptin 40 mg tbl flm 50 x 40 mg MYL0401 Isoptin 80 mg tbl flm 50 x 80 mg Isoptin SR 240 MYL0512 Leponex 100 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 tbl nob 50 x 100 ml Klacid 250 10 mg MYL0511 Leponex 25 mg tbl nob 50 x 250 25 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 MYL0299 Letmylan 2,5 mg tbl flm 100 x 2,5 mg MYL0265 Letmylan 2,5 mg tbl flm 30 x 2,5 mg Letmylan 2,5 MYL0943 Lyrica cps dur 112 x 150 mg 100 x 2,5 mg Levelanz 1000 mg (2x56) MYL0945 Lyrica cps dur 56 x 1000 150 mg Levelanz 250 mg MYL0947 Lyrica cps dur 56 x 250 225 mg Levelanz 500 mg MYL0948 Lyrica cps dur 56 x 500 300 mg Levelanz 500 MYL0952 Lyrica cps dur 56 x 75 mg 98 MYL0323 Memantin Mylan 10 mg tbl flm 28 x 500 10 mg Levodopa/Carbidopa/Entacapone MYL0203 Memantin Mylan 100x50/12,5/20010 mg Levodopa/Carbidopa/Entacapone tbl flm 56 x 10 mg MYL0334 Memantin Mylan 100x100/25/20010 mg Levodopa/Carbidopa/Entacapone tbl flm 84x10 mg MYL0204 Memantin Mylan 100x150/37,5/20020 mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200tbl flm 28 x 20 mg Linezolid Mylan 2 mg/ml 10 MYL0540 Mestinon 60 mg tbl obd 150 x 1 x 300 ml Lipanthyl 267 M 30 x 267 60 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg MYL0094 Metformin Mylan 1000 mg tbl flm 120 x 1 000 mg MYL0095 Metformin Mylan 1000 mg tbl flm 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg MYL0096 Metformin Mylan 500 mg tbl flm 120 x 500 mg MYL0097 Metformin Mylan 500 mg tbl flm 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg MYL0098 Metformin Mylan 850 mg tbl flm 120 x 850 mg MYL0099 Metformin Mylan 850 mg tbl flm 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg MYL0106 Mirtazapin Mylan 30 mg por tbl dis 30 x 30 mg MYL0107 Mirtazapin Mylan 45 mg por tbl dis 30 x 45 mg Oxykodon MYL0112 Moxonidin Mylan 0,2 mg tbl flm 98 x 0,2 mg MYL0113 Moxonidin Mylan 0,3 mg tbl flm 28 x 0,3 mg MYL0114 Moxonidin Mylan 0,3 mg tbl flm 98 x 0,3 mg MYL0115 Moxonidin Mylan 0,4 mg tbl flm 28 x 0,4 mg MYL0116 Moxonidin Mylan 0,4 mg tbl flm 98 x 0,4 mg MYL0955 Neurontin cps dur 100 x 300 mg MYL0956 Neurontin cps dur 50 x 300 mg MYL0957 Neurontin cps dur 50 x 400 mg MYL0958 Neurontin tbl flm 50 x 600 mg MYL0959 Neurontin tbl flm 50 x 800 mg MYL0117 Olanzapin Mylan 10 mg tbl flm 28 x 10 mg MYL0822 Olanzapin Mylan 10 mg tbl flm 56 x 10 mg MYL0118 Olanzapin Mylan 5 mg tbl flm 28 x 5 mg MYL0885 Olanzapin Mylan 5 mg tbl flm 56 x 5 mg MYL0251 Olanzapin Mylan 10 mg por tbl dis 28 x 1 x 10 mg MYL0881 Olanzapin Mylan 10 mg por tbl dis 56 x 1 x 10 mg MYL0252 Olanzapin Mylan 5 mg por tbl dis 28 x 1 x 5 mg MYL0880 Olanzapin Mylan 5 mg por tbl dis 56 x 1 x 5 mg MYL0684 Oxykodon/Naloxon Mylan tbl pro 60 x 10 mg Oxykodon / 5 mg MYL0682 Oxykodon/Naloxon Mylan 20 mg tbl pro 60 x 20 mg Oxykodon / 10 mg MYL0683 Oxykodon/Naloxon Mylan 40 mg tbl pro 60 x 40 mg Oxykodon Mylan 80 / 20 mg 60 MYL0263 Pantomyl 40 mg tbl ent 100 x 80 40 mg MYL0287 Pantomyl 40 mg tbl ent 30 x 40 mg MYL0205 Pioglitazon Mylan 15 mg tbl nob 28 x 15 mg MYL0177 Pioglitazon Mylan 30 mg tbl nob 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg MYL0616 Reparil - Dragées 20 mg tbl ent 100 x 20 mg MYL0543 Reparil Dragées 20 mg tbl ent 40 x 20 mg Reparil - Dragées MYL0138 Rosuvastatin Mylan 10 mg tbl flm 30 x 10 mg MYL0139 Rosuvastatin Mylan 10 mg tbl flm 90 x 10 mg MYL0140 Rosuvastatin Mylan 20 mg 100 tbl flm 30 x 20 mg MYL0141 Rosuvastatin Mylan 20 mg tbl flm 90 x 20 mg MYL0429 Rytmonorm 150 mg tbl flm 100 x 150 mg MYL0428 Rytmonorm 150 mg tbl flm 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg MYL0431 Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg tbl flm 100 x 300 mg MYL0688 Serkep 25 mikrogramů/125 mikrogramů/dávka inh sus pss 25mcg/125mcg/dáv x 120dáv MYL0493 Sevelamer Carbonate Mylan 800 mg tbl flm 180 x 800 mg Tamsulosin HCI MYL0792 Sitagliptin Mylan 0,4 tbl flm 28 x 100 mg MYL1009 Sitagliptin Mylan tbl flm 98 x 100 mg MYL0785 Sitagliptin/Metformin hydrochloride Mylan 50 mg/1000 mg tbl flm 56 x 50 mg/1000 mg MYL0787 Sitagliptin/Metformin hydrochloride Mylan 50 mg/850 mg tbl flm 56 x 50 mg/850 mg MYL0965 Sortis tbl flm 100 x 0,4 10 mg Tarka 180/2 MYL0967 Sortis tbl flm 100 x 20 mg tbl. 28 Tarka 180/2 MYL0968 Sortis tbl flm 30 x 20 mg tbl. 98 Tarka 240/4 MYL0969 Sortis tbl flm 100 x 40 mg tbl. 28 Tarka 240/4 MYL0970 Sortis tbl flm 30 x 40 mg tbl. 98 MYL0720 Taris 0,5 mg/0,4 mg cps dur 90 x 0,5 mg/0,4 mg MYL0356 Tenofovir disoproxil Mylan 245 mg tbl flm 30 x 245 mg MYL0151 Topiramat Mylan 100 mg tbl flm 60 x 100 mg MYL0152 Topiramat Mylan 25 mg tbl flm 60 x 25 mg MYL0153 Topiramat Mylan 50 mg tbl flm 60 x 50 mg MYL0246 Tramadol Mylan 100 mg tbl pro 30 x 100 mg MYL0247 Tramadol Mylan 150 mg tbl pro 30 x 150 mg MYL0248 Tramadol Mylan 200 mg tbl pro 30 x 200 mg MYL0798 Tutecvi 50 mg tbl nob 56 x 50 mg MYL0799 Tutecvi Combi 50 mg/1000 mg tbl flm 60 x 50 mg/1000 mg MYL0800 Tutecvi Combi 50 mg/850 mg tbl flm 60 x 50 mg/850 mg MYL0553 Uralyt U 280 g gra 1 x 280 g MYL0364 Uroxal 5 mg tbl nob 60 x 5 mg MYL0225 Valaciclovir Mylan 500 mg tbl flm 42 x 500 mg MYL0159 Venlafaxin Mylan 150 mg cps pro 30 x 150 mg MYL0307 Venlafaxin Mylan 150 mg cps pro 90 x 150 mg MYL0160 Venlafaxin Mylan 75 mg cps pro 30 x 75 mg MYL0306 Venlafaxin Mylan 75 mg cps pro 90 x 75 mg Zoledronic acid MYL0475 Vorikonazol Mylan 4 mg/5 200 mg tbl flm 14 x 200 mg MYL0981 Xalacom oph gtt sol 3 x 2.5 ml MYL0982 Xalatan oph gtt sol 1 x 4mg/5ml Zonisamide Mylan 50 2.5 ml MYL0983 Xalatan oph gtt sol 3 x 2.5 ml MYL0995 Zoloft tbl flm 28 x 100 mg 56 MYL0996 Zoloft tbl flm 100 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg MYL0997 Zoloft tbl flm 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo * MIC kód je interní identifikační kód, unikátní pro skupinu č.2každou variantu přípravku Dodavatele. MIC kód je nezávislý na SÚKL kódu/ The MIC code is an internal identification code, unique for each variant of the Supplier's product. The MIC code is independent of the SIDC code.

Xxxx. Xxxxx Xxxxxx, Jednatel / Executive Director Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 Acnatac 10 mg/g + 0,25 mg/g Gel gel 1 x 30 gm Afonilum SR 250 mg x 50 Aldara 5% Cream crm 12 x 250 mg Agomelatine Alfuzosin Mylan 25 10 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Betaserc 8 100 x 8 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg 90 Cynt 0,2 30 x 0,2 mg Cynt 0,2 tbl flm 98 x 0,2 mg Cynt 0,3 tbl flm 30 x 0,3 mg Cynt 0,3 tbl flm 98 x 0,3 mg Cynt 0,4 tbl flm 30 x 0,4 mg Cynt 0,4 tbl flm 98 x 0,4 mg Dona 1500 Dorzogen Combi 20 mg/ml + 5 mg/ml x 1 Dorzogen Combi 20 mg/ml + 5 mg/ml x 3 Escitalopram Mylan 10 mg 20 sačků Exemestan Mylan 25 mg tbl flm 30 x 25 10 mg Fentanyl Escitalopram Mylan 100 mikrogramů/ hodinu 5 x 16,8 10 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg tbl flm 90 x 2 10 mg Glimepirid Escitalopram Mylan 3 20 mg 30 x 3 mg Glimepirid Mylan 3 mg tbl flm 90 x 3 20 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Granisetron Mylan 1 mg 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg tbl flm 50 x 40 mg Isoptin 80 mg tbl flm 50 x 80 mg Isoptin SR 240 mg 30 tbl pro 100 x 240 mg Isoptin SR 240 mg 100 tbl pro 30 x 240 mg Klacid 125 mg/5 ml por gra sus 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 125 mg/5 ml por gra sus 1 x 60 ml Klacid 250 mg/5 ml por gra sus 1 x 100 ml Klacid 250 mg/5 ml por gra sus 1 x 60 ml Klacid 250 tbl flm 10 x 250 mg Klacid 250 tbl flm 14 x 250 mg Klacid 500 tbl flm 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR tbl ret 14 x 500 mg-d Klacid SR tbl ret 7 x 500 mg Kreon 25 000 cps etd 50 Letmylan 2,5 Legalon 140 mg cps dur 30 x 2,5 140 mg Letmylan 2,5 Legalon 140 mg cps dur 30 x 140 mg Leponex 100 mg tbl nob 50 x 2,5 100 mg Leponex 25 mg tbl nob 50 x 25 mg Levelanz 1000 mg tbl flm 56 x 1000 mg Levelanz 250 mg tbl flm 56 x 250 mg Levelanz 500 mg tbl flm 56 x 500 mg Levelanz 500 mg tbl flm 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan Pantomyl 40 mg 60 tbl ent 100 x 40 mg Oxykodon Pantomyl 40 mg tbl ent 30 x 40 mg Quetiapin Mylan 80 100 mg tbl flm 60 x 80 100 mg Pioglitazon Quetiapin Mylan 15 200 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg tbl flm 100 x 20 200 mg Quetiapin Mylan 200 mg tbl flm 30 x 200 mg Quetiapin Mylan 200 mg tbl pro 60 x 200 mg Quetiapin Mylan 25 mg tbl flm 30 x 25 mg Quetiapin Mylan 300 mg tbl pro 60 x 300 mg Quetiapin Mylan 300 mg tbl flm 60 x 300 mg Quetiapin Mylan 400 mg tbl pro 60 x 400 mg Rytmonorm 150 mg 50 x 150 mg 100 Rytmonorm 150 mg x 50 Solifenacin Mylan 10 mg x 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 100 mg 60 x 100 Transmetil 500 mg Topiramat Mylan 25 mg 60 tbl ent 10 x 25 mg Topiramat Mylan 50 mg 60 x 50 500 mg Uralyt U 280 g gra 1 x 280 g Valaciclovir Mylan 500 Uroxal 5 mg 42 tbl nob 60 x 500 5 mg Venlafaxin Mylan 150 mg cps pro 30 x 150 mg Venlafaxin Mylan 150 mg cps pro 90 x 150 mg Venlafaxin Mylan 75 mg cps pro 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2

Xxxx. Xxxxx Xxxxxx, Jednatel / Executive Director Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Název přípravku Anastrozol Mylan 1 1mg - 30 x 1 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Betaserc 8 100 x 8 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h mcg - 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 52.5 mcg - 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h mcg - 5 x 40 mg Capecitabine Entecavir Mylan 150 - 0,5mg 60 x 150 30 Entecavir Mylan - 1mg Capecitabine Mylan 500 mg 120 x 500 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Granisetron Mylan 1 mg 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Letmylan 2,5 mg 30 x 2,5 100x2,5mg Letmylan 2,5 mg 100 x 2,5 30x2,5mg Levelanz 1000 mg 56 x 1000 56x1000mg Levelanz 250 mg 56 x 250 56x250mg Levelanz 500 mg 56 x 500 56x500mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 98x500mg Tamsulosin HCI Mylan 0,4 mg - 100 x 0,4 mg Tarka 180/2 Tenofovir disoproxil Mylan - 30 x 245mg Zolpidem Mylan 20 x 10mg Zolpidem Mylan 50 x 10mg Duphalac HDP 1x500ml Ibandronat Mylan 3 x 150 mg Klacid 10x250mg Klacid 125mg 1x100ml Klacid 125mg 1x60ml Klacid 14x250mg Klacid 14x500mg Klacid 250mg 1x100ml Klacid 250mg 1x60ml Klacid SR 14x500mg Klacid SR 7x500mg Pantomyl 40 mg 100 x 40 mg Simvastatin Mylan 20 mg - 100 x 20 mg Simvastatin Mylan 40 mg - 100 x 40 mg Betaserc 100x8mg Betaserc 50x24mg Betaserc 60x16mg Bisoprolol Mylan 100 x 10 mg Bisoprolol Mylan 30 x 10 mg Bisoprolol Mylan 100 x 5 mg Bisoprolol Mylan 30 x 2.5mg Bisoprolol Mylan 30 x 5 mg Cynt 30x0,3mg Cynt 30x0,4mg Cynt 98x0,3mg Cynt 98x0,4mg Dorzogen Combi 1 x 5 ml Dorzogen Combi 3 x 5 ml Duspatalin retard 30x200mg Xxxxxx 28x0,5mg Cholib 145mg/20mg tbl. 28 Tarka 180/2 30 Cholib 145mg/40mg tbl. 98 Tarka 240/4 30 Isoptin SR 100x240 mg tbl. 28 Tarka 240/4 Kreon 10000/20 Lipanthyl 100x215mg tbl. 98 Topiramat Lipanthyl 30x145mg Lipanthyl 30x215mg Lipanthyl 90x145mg Quetiapin Mylan 100 mg - 60 x 100 mg Topiramat Quetiapin Mylan 25 mg 60 - 30 x 25 mg Topiramat Rytmonorm 50x150mg Rytmonorm 100x150mg Rytmonorm 50x300mg Rytmonorm 100x300mg Sumatriptan Mylan 50 2 x 100 mg 60 Sumatriptan Mylan 6 x 50 mg Uralyt U 280 g 1 Tarka 28x180mg/2mg Tarka 98x180mg/2mg Tarka 98x240mg/4mg Venlafaxin Mylan 150mg x 280 g Valaciclovir 30 Venlafaxin Mylan 150mg x 90 Venlafaxin Mylan 75mg x 30 Venlafaxin Mylan 75mg x 90 Capecitabine Mylan 500 mg 42 - 120 x 500 mg Venlafaxin Mylan 150 mg Tanatril 30 x 150 10 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg Tanatril 30 x 75 20 mg Venlafaxin Mylan 75 Tanatril 30 x 5 mg 90 Tasmar 100 mg 100 x 75 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 x 50 100 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX kalendářní pololetí / calendar half-year Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 1mg - 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h mcg - 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 52.5 mcg - 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h mcg - 5 x 40 mg Capecitabine Entecavir Mylan 150 - 0,5mg 60 x 150 30 Entecavir Mylan - 1mg Capecitabine x 30 Letmylan 100x2,5mg Letmylan 30x2,5mg Levelanz 56x1000mg Levelanz 56x250mg Levelanz 56x500mg Levelanz 98x500mg Tamsulosin HCI Mylan 500 0,4 mg 120 - 100 x 500 0,4 mg Exemestan Tenofovir disoproxil Mylan 25 mg - 30 x 25 245mg Fentanyl Zolpidem Mylan 12 mikrogramů/ hodinu 5 20 x 2,1 10mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Zolpidem Mylan 50 mikrogramů/ hodinu 5 x 8,4 10mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products XxNo. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Duphalac HDP 1x500ml Ibandronat Mylan 3 x 150 mg 30 x 3 Klacid 10x250mg Glimepirid Mylan 3 Klacid 125mg 90 x 3 1x100ml Klacid 125mg Glimepirid Mylan 4 1x60ml Klacid 14x250mg 30 x 4 Klacid 14x500mg Glimepirid Mylan 4 Klacid 250mg 90 x 4 1x100ml Klacid 250mg Xxxxxx 0,5 1x60ml Klacid SR 14x500mg 28 x 0,5 Klacid SR 7x500mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin Pantomyl 40 mg 50 100 x 40 mg Isoptin 80 Simvastatin Mylan 20 mg 50 - 100 x 80 20 mg Simvastatin Mylan 40 mg - 100 x 40 mg Skupina výrobků č.3 /Group of Products No. 3 Betaserc 100x8mg Betaserc 50x24mg Betaserc 60x16mg Bisoprolol Mylan 100 x 10 mg Bisoprolol Mylan 30 x 10 mg Bisoprolol Mylan 100 x 5 mg Bisoprolol Mylan 30 x 2.5mg Bisoprolol Mylan 30 x 5 mg Cynt 30x0,3mg Cynt 30x0,4mg Cynt 98x0,3mg Cynt 98x0,4mg Dorzogen Combi 1 x 5 ml Dorzogen Combi 3 x 5 ml Duspatalin retard 30x200mg Xxxxxx 28x0,5mg Cholib 145mg/20mg tbl. 30 Cholib 145mg/40mg tbl. 30 Isoptin SR 240 100x240 mg Kreon 10000/20 Lipanthyl 100x215mg Lipanthyl 30x145mg Lipanthyl 30x215mg Lipanthyl 90x145mg Quetiapin Mylan 100 mg - 60 x 100 mg Quetiapin Mylan 25 mg - 30 x 240 25 mg Isoptin SR 240 Rytmonorm 50x150mg 100 x 240 Rytmonorm 100x150mg Klacid 125 mg/5 ml 1 Rytmonorm 50x300mg Rytmonorm 100x300mg Sumatriptan Mylan 2 x 100 ml Klacid 250 mg/5 ml 1 mg Sumatriptan Mylan 6 x 60 ml Klacid 250 mg/5 ml 1 50 mg Tarka 28x180mg/2mg Tarka 98x180mg/2mg Tarka 98x240mg/4mg Venlafaxin Mylan 150mg x 100 ml Klacid 250 10 30 Venlafaxin Mylan 150mg x 250 90 Venlafaxin Mylan 75mg Klacid 250 14 x 250 30 Venlafaxin Mylan 75mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Skupina výrobků č.4 /Group of Products No. 4 Capecitabine Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg - 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 Tasmar 100 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg Tanatril 30 x 75 10 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg Tanatril 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.220 mg

Xxxx. Xxxxx Xxxxxx, Jednatel / Executive Director Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 Alendrogen 70 mg Anastrozol Mylan 1 1mg - 30 x 1 mg Betaserc 16 100 x 8mg Betaserc 50 x 24mg Betaserc 60 x 16 16mg Betaserc 24 50 x 24 mg Betaserc 8 100 x 8 24mg Breakyl 200 mikrogramů 28 Bisoprolol Mylan 100 x 200 mcg I Breakyl 400 mikrogramů 28 10 mg Bisoprolol Mylan 30 x 400 mcg I Breakyl 800 mikrogramů 28 10 mg Bisoprolol Mylan 100 x 800 mcg I 5 mg Bisoprolol Mylan 30 x 2.5mg Bisoprolol Mylan 30 x 5 mg Buprenorfin Mylan 35 mikrogramů/h mcg - 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 52.5 mcg - 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h mcg - 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg - 120 x 500 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 30 x 0,3mg Cynt 30 x 0,4mg Cynt 98 x 0,2 0,3mg Cynt 0,3 98 x 0,4mg Dorzogen Combi 1 x 5 ml Dorzogen Combi 3 x 5 ml Duphalac HDP 1x500ml Duspatalin retard 30 x 0,3 200mg Cynt 0,3 98 Entecavir Mylan - 0,5mg x 0,3 30 Entecavir Mylan - 1mg Cynt 0,4 x 30 Xxxxxx 28 x 0,4 0,5mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Ibandronat Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Granisetron Mylan 1 mg 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 150 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 100x240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 10x250mg Klacid 250 14 x 250 125mg 1x100ml Klacid 125mg 1x60ml Klacid 14x250mg Klacid 250 mg/5 ml 1 x 60 ml 14x500mg Klacid 250 mg/5 ml 1 x 100 ml 250mg 1x100ml Klacid 500 14 x 500 250mg 1x60ml Klacid SR 14x500mg Klacid SR 7 x 500 7x500mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 10000/20 Letmylan 2,5 mg 30 x 2,5 100x2,5mg Letmylan 2,5 mg 100 x 2,5 30x2,5mg Levelanz 1000 mg 56 x 1000 56x1000mg Levelanz 250 mg 56 x 250 56x250mg Levelanz 500 mg 56 x 500 56x500mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 98x500mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 100x215mg Lipanthyl S 215 mg 30 x 215 30x145mg Lipanthyl S 215 mg 100 x 215 30x215mg Lipanthyl Supra 160 90x145mg 30 x 160 Rytmonorm 50x150mg Lipanthyl Supra 160 Rytmonorm 100x150mg 90 x 160 Rytmonorm 50x300mg Metformin Mylan 1000 Rytmonorm 100x300mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Simvastatin Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 Simvastatin Mylan 40 mg - 100 x 40 mg Sumatriptan Mylan 2 x 100 mg Sumatriptan Mylan 6 x 50 mg Tanatril 30 x 150 10 mg Rytmonorm 150 Tanatril 30 x 20 mg Tanatril 30 x 5 mg Tasmar 100 mg 100 x 150 100 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 Taris 0,5 mg/0,4 mg Tarka 180/2 28x180mg/2mg tbl. 28 Tarka 180/2 98x180mg/2mg tbl. 98 Tarka 240/4 98x240mg/4mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Tenofovir disoproxil Mylan 100 mg 60 - 30 x 100 mg Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 245mg Venlafaxin Mylan 150 150mg x 30 x 150 mg Venlafaxin Mylan 150 150mg x 90 x 150 mg Venlafaxin Mylan 75 75mg x 30 x 75 mg Venlafaxin Mylan 75 75mg x 90 Zolpidem Mylan 20 x 75 10mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Zonisamide Zolpidem Mylan 50 mg 56 x 50 10mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX kalendářní čtvrtletí / calendar quarter Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 Alendrogen 70 mg 28 12 x 25 70 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h mcg - 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 52.5 mcg - 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h mcg - 5 x 40 mg Capecitabine Entecavir Mylan 150 - 0,5mg 60 x 150 30 Entecavir Mylan - 1mg Capecitabine x 30 Letmylan 100x2,5mg Letmylan 30x2,5mg Levelanz 56x1000mg Levelanz 56x250mg Levelanz 56x500mg Levelanz 98x500mg Tenofovir disoproxil Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg - 30 x 25 245mg Fentanyl Zolpidem Mylan 12 mikrogramů/ hodinu 5 20 x 2,1 10mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Zolpidem Mylan 50 mikrogramů/ hodinu 5 x 8,4 10mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products XxNo. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 2 Duphalac HDP 1x500ml Ibandronat Mylan 3 x 150 mg Klacid 10x250mg Klacid 125mg 1x100ml Klacid 125mg 1x60ml Klacid 14x250mg Klacid 14x500mg Klacid 250mg 1x100ml Klacid 250mg 1x60ml Klacid SR 14x500mg Klacid SR 7x500mg Taris 0,5 mg/0,4 mg Bonusové pásmo – Skupina č. 2 Skupina výrobků č.3 /Group of Products No. 3 Anastrozol Mylan 1mg - 30 x 1 mg Betaserc 100 x 30 gm Afonilum SR 250 8mg Betaserc 50 x 250 24mg Betaserc 8 60x16mg Betaserc 100x24mg Bisoprolol Mylan 100 x 8 10 mg Betaserc 16 60 Bisoprolol Mylan 30 x 16 10 mg Betaserc 24 50 Bisoprolol Mylan 100 x 24 5 mg Bisoprolol Mylan 30 x 2.5mg Bisoprolol Mylan 30 x 5 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 30x0,3mg Cynt 0,3 30 x 0,3 30x0,4mg Cynt 0,3 98 x 0,3 98x0,3mg Cynt 0,4 30 98x0,4mg Dorzogen Combi 1 x 0,4 mg Cynt 0,4 98 5 ml Dorzogen Combi 3 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 5 ml Duspatalin retard 30x200mg Xxxxxx 0,5 28x0,5mg 28 Isoptin SR 100x240 mg Kreon 10000/20 Lipanthyl 100x215mg Lipanthyl 30x145mg Lipanthyl 30x215mg Lipanthyl 90x145mg Rytmonorm 50x150mg Rytmonorm 100x150mg Rytmonorm 50x300mg Rytmonorm 100x300mg Simvastatin Mylan 20 mg - 100 x 0,5 20 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin Simvastatin Mylan 40 mg 50 - 100 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 Sumatriptan Mylan 2 x 100 ml Klacid 250 mg/5 ml 1 mg Sumatriptan Mylan 6 x 60 ml Klacid 250 mg/5 ml 1 50 mg Tarka 28x180mg/2mg Tarka 98x180mg/2mg Tarka 98x240mg/4mg Venlafaxin Mylan 150mg x 100 ml Klacid 250 10 30 Venlafaxin Mylan 150mg x 250 90 Venlafaxin Mylan 75mg Klacid 250 14 x 250 30 Venlafaxin Mylan 75mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Bonusové pásmo – Skupina č. 3 Skupina výrobků č.4 /Group of Products No. 4 Capecitabine Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg - 120 x 500 mg Metformin Mylan 500 Tasmar 100 mg 180 100 x 500 100 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg Tanatril 30 x 10 mg Tanatril 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg Tanatril 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.25 mg

Xxxx. Xxxxx Xxxxxx, Jednatel jednatel / Executive Director Příloha č. 1 – seznam Výrobků Annex 1 – –Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel MIC kód/ MIC Code Název přípravku/ Name of the Product Forma přípravku/ Form of the Product Balení přípravku/ Package of the Product MYL0070 Granisetron Mylan 1 mg tbl flm 10 x 30 gm 1 mg MYL0367 Afonilum SR 250 mg cps pro 50 x 250 mg Agomelatine MYL0002 Alendrogen 70 mg tbl nob 12 x 70 mg MYL0004 Alfuzosin Mylan 25 10 mg 28 tbl pro 90 x 25 10 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg MYL0369 Betaserc 16 tbl nob 60 x 16 mg MYL0370 Betaserc 24 tbl nob 50 x 24 mg MYL0823 Betaserc 24 tbl nob 100 x 24 mg MYL0371 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 28 MYL0925 Caduet tbl flm 30 x 200 mcg I Breakyl 400 mikrogramů 28 5 mg/10 mg MYL0924 Caduet tbl flm 90 x 400 mcg I Breakyl 800 mikrogramů 28 10 mg/10 mg MYL0926 Caduet tbl flm 90 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg/10 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg MYL0377 Cynt 0,2 tbl flm 30 x 0,2 mg MYL0378 Cynt 0,2 tbl flm 98 x 0,2 mg MYL0379 Cynt 0,3 tbl flm 30 x 0,3 mg MYL0380 Cynt 0,3 tbl flm 98 x 0,3 mg MYL0381 Cynt 0,4 tbl flm 30 x 0,4 mg MYL0382 Cynt 0,4 tbl flm 98 x 0,4 mg MYL0164 Desloratadin Mylan 5 mg tbl flm 30 x 5 mg MYL0165 Desloratadin Mylan 5 mg tbl flm 50 x 5 mg MYL0166 Desloratadin Mylan 5 mg tbl flm 90 x 5 mg MYL0820 Dona 1500 mg por plv sol 90 sačků MYL0819 Dona 1500 mg por plv sol 30 sačků MYL0049 Dorzogen Combi 20 sačků Exemestan mg/ml + 5 mg/ml oph gtt sol 3 x 5 ml MYL0385 Duphaston 10 mg tbl flm 20 x 10 mg MYL0052 Escitalopram Mylan 25 10 mg tbl flm 30 x 25 10 mg Fentanyl MYL0053 Escitalopram Mylan 100 mikrogramů/ hodinu 5 10 mg tbl flm 90 x 16,8 10 mg Fentanyl MYL0055 Escitalopram Mylan 12 mikrogramů/ hodinu 5 20 mg tbl flm 90 x 2,1 20 mg Fentanyl MYL0062 Gliclazid Mylan 25 mikrogramů/ hodinu 5 30 mg tbl ret 120 x 4,2 30 mg Fentanyl MYL0063 Gliclazid Mylan 50 mikrogramů/ hodinu 5 30 mg tbl ret 60 x 8,4 30 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg MYL0064 Glimepirid Mylan 2 mg tbl nob 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg MYL0066 Glimepirid Mylan 3 mg tbl nob 30 x 3 mg MYL0067 Glimepirid Mylan 3 mg tbl nob 90 x 3 mg MYL0068 Glimepirid Mylan 4 mg tbl nob 30 x 4 mg MYL0069 Glimepirid Mylan 4 mg tbl nob 90 x 4 mg MYL0393 Xxxxxx 0,5 mg cps dur 28 x 0,5 mg Granisetron MYL0072 Ibandronát Mylan 1 150 mg 10 tbl flm 3 x 1 150 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 MYL0400 Isoptin 40 mg tbl flm 50 x 40 mg MYL0401 Isoptin 80 mg tbl flm 50 x 80 mg MYL0403 Isoptin SR 240 mg tbl pro 30 x 240 mg MYL0402 Isoptin SR 240 mg tbl pro 100 x 240 mg MYL0404 Klacid 125 mg/5 ml por gra sus 1 x 100 ml MIC kód/ MIC Code Název přípravku/ Name of the Product Forma přípravku/ Form of the Product Balení přípravku/ Package of the Product MYL0405 Klacid 125 mg/5 ml por gra sus 1 x 60 ml MYL0406 Klacid 250 mg tbl flm 10 x 250 mg MYL0407 Klacid 250 mg tbl flm 14 x 250 mg MYL0408 Klacid 250 mg/5 ml por gra sus 1 x 100 ml MYL0409 Klacid 250 mg/5 ml por gra sus 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml MYL0410 Klacid 500 mg tbl flm 14 x 500 mg MYL0411 Klacid SR 500 mg tbl ret 7 x 500 mg MYL0413 Klacid SR 500 mg tbl ret 14 x 500 mg-d mg MYL0416 Kreon 25 000 cps etd 50 Letmylan 2,5 MYL0512 Leponex 100 mg 30 tbl nob 50 x 2,5 100 mg Letmylan 2,5 MYL0511 Leponex 25 mg 100 tbl nob 50 x 2,5 25 mg MYL0443 Levelanz 1000 mg tbl flm 56 x 1000 mg MYL0445 Levelanz 250 mg tbl flm 56 x 250 mg MYL0447 Levelanz 500 mg tbl flm 56 x 500 mg MYL0449 Levelanz 500 mg tbl flm 98 x 500 mg Levodopa/Carbidopa/Entacapone MYL0086 Levofloxacin Mylan 100x50/12,5/200500 mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml tbl flm 10 x 1 x 300 ml 500 mg MYL0420 Lipanthyl 267 M 30 x 267 Nt 145 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg tbl flm 30 x 145 mg Xxxxxxxxx Xx 000 MYL0421 Lipanthyl Nt 145 mg tbl flm 90 x 145 mg MYL0422 Lipanthyl S 215 mg tbl flm 100 x 215 mg MYL0423 Lipanthyl S 215 mg tbl flm 30 x 215 mg Lipanthyl S 215 MYL0943 Lyrica cps dur 112 x 150 mg 100 (2x56) MYL0944 Lyrica cps dur 14 x 215 150 mg Lipanthyl Supra 160 MYL0945 Lyrica cps dur 56 x 150 mg 30 MYL0947 Lyrica cps dur 56 x 160 225 mg Lipanthyl Supra 160 MYL0948 Lyrica cps dur 56 x 300 mg 90 MYL0952 Lyrica cps dur 56 x 160 75 mg MYL0946 Lyrica 20 mg/ml por sol 1 x 473 ml MYL0094 Metformin Mylan 1000 mg tbl flm 120 x 1 000 mg MYL0095 Metformin Mylan 1000 mg tbl flm 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg MYL0096 Metformin Mylan 500 mg tbl flm 120 x 500 mg MYL0097 Metformin Mylan 500 mg tbl flm 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg MYL0098 Metformin Mylan 850 mg tbl flm 120 x 850 mg MYL0099 Metformin Mylan 850 mg tbl flm 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg MYL0106 Mirtazapin Mylan 30 mg por tbl dis 30 x 30 mg MYL0107 Mirtazapin Mylan 45 mg por tbl dis 30 x 45 mg MYL0108 Montelukast Mylan 10 mg tbl flm 100 x 10 mg MYL0109 Montelukast Mylan 10 mg tbl flm 30 x 10 mg MYL0171 Montelukast Mylan 4 mg tbl mnd 30 x 4 mg MYL0110 Montelukast Mylan 5 mg tbl mnd 100 x 5 mg MYL0172 Montelukast Mylan 5 mg tbl mnd 30 x 5 mg MYL0111 Moxonidin Mylan 0,2 mg tbl flm 28 x 0,2 mg MYL0112 Moxonidin Mylan 0,2 mg tbl flm 98 x 0,2 mg MYL0113 Moxonidin Mylan 0,3 mg tbl flm 28 x 0,3 mg MIC kód/ MIC Code Název přípravku/ Name of the Product Forma přípravku/ Form of the Product Balení přípravku/ Package of the Product MYL0114 Moxonidin Mylan 0,3 mg tbl flm 98 x 0,3 mg MYL0115 Moxonidin Mylan 0,4 mg tbl flm 28 x 0,4 mg MYL0116 Moxonidin Mylan 0,4 mg tbl flm 98 x 0,4 mg MYL0955 Neurontin cps dur 100 x 300 mg MYL0956 Neurontin cps dur 50 x 300 mg MYL0957 Neurontin cps dur 50 x 400 mg MYL0958 Neurontin tbl flm 50 x 600 mg MYL0959 Neurontin tbl flm 50 x 800 mg MYL0117 Olanzapin Mylan 10 mg tbl flm 28 x 10 mg MYL0822 Olanzapin Mylan 10 mg tbl flm 56 x 10 mg MYL0118 Olanzapin Mylan 5 mg tbl flm 28 x 5 mg MYL0495 Oxykodon Mylan 10 mg tbl pro 60 x 10 mg MYL0497 Oxykodon Mylan 20 mg tbl pro 60 x 20 mg MYL0498 Oxykodon Mylan 40 mg tbl pro 60 x 40 mg MYL0499 Oxykodon Mylan 80 mg tbl pro 60 x 80 mg MYL0684 Oxykodon/Naloxon Mylan tbl pro 60 x 10 mg / 5 mg MYL0682 Oxykodon/Naloxon Mylan tbl pro 60 x 20 mg / 10 mg MYL0683 Oxykodon/Naloxon Mylan tbl pro 60 x 40 mg / 20 mg MYL0205 Pioglitazon Mylan 15 mg tbl nob 28 x 15 mg MYL0177 Pioglitazon Mylan 30 mg tbl nob 28 x 30 mg Pregabalin MYL0136 Ropinirol Mylan 75 2 mg 14 tbl flm 84 x 75 2 mg Pregabalin MYL0137 Ropinirol Mylan 75 5 mg 56 tbl flm 84 x 75 5 mg Pregabalin Mylan MYL0428 Rytmonorm 150 mg 56 tbl flm 50 x 150 mg Reparil - Dragées 20 MYL0429 Rytmonorm 150 mg 40 tbl flm 100 x 20 150 mg Reparil - Dragées 20 MYL0430 Rytmonorm 300 mg tbl flm 50 x 300 mg MYL0431 Rytmonorm 300 mg tbl flm 100 x 300 mg MYL0650 Semglee 100 jednotek/ml inj sol pep 5 x 3 ml MYL0688 Serkep 25 mikrogramů/125 mikrogramů/dávka inh sus pss 25mcg/125mcg/dáv x 120dáv MYL0353 Solifenacin Mylan 10 mg tbl flm 100 x 10 mg MYL0352 Solifenacin Mylan 5 mg tbl flm 100 x 5 mg MYL0965 Sortis tbl flm 100 x 10 mg MYL0967 Sortis tbl flm 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg MYL0969 Sortis tbl flm 100 x 150 40 mg Rytmonorm 300 MYL0968 Sortis tbl flm 30 x 20 mg MYL0147 Sumatriptan Mylan 100 mg tbl flm 2 x 100 mg MYL0148 Sumatriptan Mylan 50 mg tbl flm 6 x 300 50 mg Rytmonorm 300 MYL0720 Taris 0,5 mg/0,4 mg 100 cps dur 90 x 300 0,5 mg/0,4 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 MYL0151 Topiramat Mylan 100 mg tbl flm 60 x 100 mg MYL0152 Topiramat Mylan 25 mg tbl flm 60 x 25 mg MYL0153 Topiramat Mylan 50 mg tbl flm 60 x 50 mg Uralyt U 280 g 1 x 280 g MYL0225 Valaciclovir Mylan 500 mg tbl flm 42 x 500 mg MYL0159 Venlafaxin Mylan 150 mg cps pro 30 x 150 mg MYL0307 Venlafaxin Mylan 150 mg cps pro 90 x 150 mg MIC kód/ MIC Code Název přípravku/ Name of the Product Forma přípravku/ Form of the Product Balení přípravku/ Package of the Product MYL0160 Venlafaxin Mylan 75 mg cps pro 30 x 75 mg MYL0306 Venlafaxin Mylan 75 mg cps pro 90 x 75 mg Zoledronic acid MYL0475 Vorikonazol Mylan 4 mg/5 200 mg tbl flm 14 x 200 mg MYL0981 Xalacom oph gtt sol 3 x 2.5 ml MYL0982 Xalatan oph gtt sol 1 x 4mg/5ml Zonisamide Mylan 2.5 ml MYL0983 Xalatan oph gtt sol 3 x 2.5 ml MYL0996 Zoloft tbl flm 100 x 50 mg 56 MYL0995 Zoloft tbl flm 28 x 100 mg MYL0997 Zoloft tbl flm 28 x 50 mg Příloha č. 2 - – Vzor a výpočet bonusu Annex 2 –– Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2Calculation

Xxxx. Xxxxx Xxxxxx, Jednatel / Executive Director MEDA Pharma s.r.o. XXX, Zmocněnec na základě plné moci / Authorised under a power of attorney Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg SUKL Název přípravku Forma přípravku Balení přípravku 215566 Betaserc 16 tbl nob 60 x 16 mg Betaserc 24 50 x 24 mg 215559 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg 215165 Cynt 0,4 tbl flm 30 x 0,4 mg 215166 Cynt 0,4 tbl flm 98 x 0,4 mg Dona 1500 179954 Desloratadin Mylan 5 mg 20 sačků Exemestan Mylan 25 mg tbl flm 30 x 25 5 mg 179955 Desloratadin Mylan 5 mg tbl flm 50 x 5 mg 179957 Desloratadin Mylan 5 mg tbl flm 90 x 5 mg 146374 Doxazosin Mylan 4 mg tbl pro 98 x 4 mg 215568 Duspatalin Retard cps rdr 30 x 200 mg 222551 Entecavir Mylan tbl flm 0,5mg x 30 222556 Entecavir Mylan tbl flm 1mg x 30 197372 Ezetimib Mylan 10 mg tbl nob 30 x10 mg 197376 Ezetimib Mylan 10 mg tbl nob 98 x10 mg 179604 Fentanyl Mylan 100 mikrogramů/ hodinu tdr emp 5 x 16,8 mg 179576 Fentanyl Mylan 12 mikrogramů/ hodinu tdr emp 5 x 2,1 mg 179583 Fentanyl Mylan 25 mikrogramů/ hodinu tdr emp 5 x 4,2 mg 179590 Fentanyl Mylan 50 mikrogramů/ hodinu tdr emp 5 x 8,4 mg 179597 Fentanyl Mylan 75 mikrogramů/ hodinu tdr emp 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg 144277 Granisetron Mylan 1 mg tbl flm 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg 215965 Isoptin SR 240 mg tbl pro 100 x 240 mg 238194 Hulio inj sol 40mg 2x0,8ml pfs 238197 Hulio inj sol 40mg 2x0,8ml pfp 215964 Isoptin SR 240 mg tbl pro 30 x 240 mg Isoptin SR 240 156537 Lansoprazol Mylan 30 mg 100 cps etd 28 x 240 30 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml 207098 Lipanthyl 267 M cps dur 30 x 267 mg 207100 Lipanthyl 267 M cps dur 90 x 267 mg 214919 Xxxxxxxxx Xx 000 mg tbl flm 30 x 145 mg 214922 Xxxxxxxxx Xx 000 mg tbl flm 90 x 145 mg 225967 Lipanthyl S 215 mg tbl flm 100 x 215 mg 207092 Lipanthyl S 215 mg tbl flm 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg 215904 Rytmonorm 150 mg tbl flm 50 x 150 mg 215906 Rytmonorm 150 mg tbl flm 100 x 150 mg 215907 Rytmonorm 300 mg tbl flm 50 x 300 mg 215909 Rytmonorm 300 mg tbl flm 100 x 300 mg Sevelamer Carbonate 211946 Solifenacin Mylan 800 10 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg tbl flm 100 x 0,4 10 mg Tarka 180/2 211928 Solifenacin Mylan 5 mg tbl. 28 Tarka 180/2 tbl flm 100 x 5 mg tbl. 98 Tarka 240/4 146283 Sumatriptan Mylan 50 mg tbl. 28 Tarka 240/4 tbl flm 6 x 50 mg tbl. 98 219169 Tenofovir disoproxil Mylan tbl flm 30 x 245mg 142333 Topiramat Mylan 100 mg tbl flm 60 x 100 mg Topiramat Mylan 25 mg 60 x 25 mg 142323 Topiramat Mylan 50 mg tbl flm 60 x 50 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 215851 Transmetil 500 mg 42 x 500 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg tbl ent 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2

Xxxx. Xxxxx Xxxxxx, Jednatel Zmocněnec na základě plné moci / Executive Director Authorised under a power of attorney Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg SUKL Produkt / Product forma balení 221379 Agomelatine Mylan 25 mg tbl flm 28 x 25 mg 221382 Agomelatine Mylan 25 mg tbl flm 84 x 25 mg Anastrozol 234247 Atomoxetin Mylan 1 10 mg 30 cps dur 28 x 1 10mg 234250 Atomoxetin Mylan 18 mg cps dur 28 x 18mg 234253 Atomoxetin Mylan 25 mg cps dur 28 x 25mg 234256 Atomoxetin Mylan 40 mg cps dur 28 x 40mg 234259 Atomoxetin Mylan 60 mg cps dur 28 x 60mg 234262 Atomoxetin Mylan 80 mg cps dur 28 x 80mg 215566 Betaserc 16 tbl nob 60 x 16 mg 215708 Betaserc 24 tbl nob 50 x 24 mg 215559 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I 212294 Buprenorfin Mylan 35 mikrogramů/h tdr emp 5 x 20 mg 212307 Buprenorfin Mylan 52,5 mikrogramů/h tdr emp 5 x 30 mg 212314 Buprenorfin Mylan 70 mikrogramů/h tdr emp 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 177606 Calcium/ Vitamin D3 Meda 500 mg 120 x 500 mg /800 IU tbl.mnd. 30 215162 Cynt 0,2 30 x 0,2 mg Cynt 0,2 tbl flm 98 x 0,2 mg 215163 Cynt 0,3 tbl flm 30 x 0,3 mg 215164 Cynt 0,3 tbl flm 98 x 0,3 mg 215166 Cynt 0,4 tbl flm 98 x 0,4 mg 215165 Cynt 0,4 tbl flm 30 x 0,4 mg Cynt 0,4 98 179954 Desloratadin Mylan 5 mg tbl flm 30 x 0,4 5 mg 179955 Desloratadin Mylan 5 mg tbl flm 50 x 5 mg 179957 Desloratadin Mylan 5 mg tbl flm 90 x 5 mg 150080 Dona 1500 mg por plv sol 20 sačků Exemestan Mylan 25 150000 Dona 400 mg inj sol 6 x 2 mla + 6 x 1 mlb 207889 Duspatalin Retard cps rdr 30 x 25 200 mg Fentanyl 222551 Entecavir Mylan tbl flm 0,5mg x 30 222556 Entecavir Mylan tbl flm 1mg x 30 238194 Hulio inj sol 40mg 2x0,8ml pfs 238197 Hulio inj sol 40mg 2x0,8ml pfp 238195 Hulio 40 mg inj sol 40 mg 6x0,8ml pfs 238198 Hulio 40 mg inj sol 40 mg 6x0,8ml pfp 179721 Hidrasec pro kojence 10 mg por gra sus 16 x 10 mg 179727 Xxxxxxxx pro deti 30 mg por gra sus 16 x 30 mg 192699 Hidrasec 100 mikrogramů/ hodinu 5 mg cps dur 10 x 16,8 100 mg Fentanyl 231055 Ibandronát Mylan 12 mikrogramů/ hodinu 5 150 mg tbl flm 3 x 2,1 150 mg Fentanyl 156537 Lansoprazol Mylan 25 mikrogramů/ hodinu 5 x 4,2 30 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg cps etd 28 x 0,5 30 mg Granisetron 156539 Lansoprazol Mylan 1 30 mg 10 cps etd 56 x 1 30 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg 215965 Isoptin SR 240 mg tbl pro 100 x 240 mg 215964 Isoptin SR 240 mg tbl pro 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 215168 Kreon 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 cps etd 50 Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg 215829 Levelanz 1000 mg tbl flm 56 x 1000 mg 215810 Levelanz 250 mg tbl flm 56 x 250 mg 215816 Levelanz 500 mg tbl flm 56 x 250 mg 215819 Levelanz 500 mg tbl flm 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml 207098 Lipanthyl 267 M cps dur 30 x 267 mg 207100 Lipanthyl 267 M cps dur 90 x 267 mg Xxxxxxxxx Xx 000 214919 Lipanthyl Nt 145 mg tbl flm 30 x 145 mg Xxxxxxxxx Xx 000 214922 Lipanthyl Nt 145 mg tbl flm 90 x 145 mg 207094 Lipanthyl S 215 mg tbl flm 100 x 215 mg 207092 Lipanthyl S 215 mg tbl flm 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg 207097 Lipanthyl Supra 160 mg tbl ret 90 x 160 mg 207095 Lipanthyl Supra 160 mg tbl ret 30 x 160 mg Lipanthyl Supra 160 150983 Meloxicam Mylan 15 mg 90 tbl nob 100 x 160 15 mg Metformin 150989 Meloxicam Mylan 1000 15 mg tbl nob 20 x 15 mg 150982 Meloxicam Mylan 15 mg tbl nob 60 x 15 mg 238289 Ogivri 150 mg inf plv csl 1 000 x 150 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg 139565 Oxykodon Mylan 10 mg tbl pro 60 x 10 mg 139580 Oxykodon Mylan 20 mg tbl pro 60 x 20 mg 139610 Oxykodon Mylan 40 mg tbl pro 60 x 40 mg 139655 Oxykodon Mylan 80 mg tbl pro 60 x 80 mg Pioglitazon 210716 Pregabalin Mylan 15 150 mg 28 cps dur 56 x 15 150 mg Pioglitazon Mylan 30 mg 28 x 30 mg 210703 Pregabalin Mylan 75 mg cps dur 14 x 75 mg 210704 Pregabalin Mylan 75 mg cps dur 56 x 75 mg Pregabalin Mylan 215906 Rytmonorm 150 mg 56 tbl flm 100 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg 215904 Rytmonorm 150 mg tbl flm 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg 215907 Rytmonorm 300 mg tbl flm 50 x 300 mg 215909 Rytmonorm 300 mg tbl flm 100 x 300 mg Sevelamer Carbonate 230086 Sertralin Mylan 800 100 mg 180 tbl flm 30 x 800 100mg Tamsulosin HCI 230071 Sertralin Mylan 0,4 50 mg 100 tbl flm 30 x 0,4 50mg Tarka 180/2 230081 Sertralin Mylan 50 mg tbl. 28 Tarka 180/2 tbl flm 90 x 50mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 142333 Topiramat Mylan 100 mg tbl flm 60 x 100 mg 234957 Topiramat Mylan 100 mg tbl flm 60 x 100 mg 142313 Topiramat Mylan 25 mg tbl flm 60 x 25 mg 234977 Topiramat Mylan 50 mg tbl flm 60 x 50 mg Uralyt U 280 g 1 135113 Twicor 10 mg/10 mg tbl flm 90 x 280 g Valaciclovir Mylan 500 10mg/10mg 42 x 500 135111 Twicor 10 mg/10 mg Venlafaxin Mylan 150 mg tbl flm 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 10mg/10mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2

Xxxx. Xxxxx Xxxxxx, Jednatel / Executive Director Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 MIC Produkt Forma přípravku Balení přípravku MYL0004 Alfuzosin Mylan 10 mg tbl pro 90 x 30 gm Afonilum SR 250 10 mg 50 MYL0619 Amisulprid Generics 200 mg tbl nob 150 x 250 200 mg Agomelatine MYL0014 Amlodipin Mylan 25 10 mg 28 tbl nob 100 x 25 10 mg Agomelatine MYL0015 Amlodipin Mylan 25 10 mg 84 x 25 mg Anastrozol Mylan 1 mg tbl nob 30 x 1 10 mg MYL0016 Amlodipin Mylan 5 mg tbl nob 100 x 5 mg MYL0017 Amlodipin Mylan 5 mg tbl nob 30 x 5 mg MYL0023 Atorvastatin Mylan 10 mg tbl flm 100 x 10 mg MYL0026 Atorvastatin Mylan 20 mg tbl flm 100 x 20 mg MYL0025 Atorvastatin Mylan 20 mg tbl flm 30 x 20 mg MYL0021 Atorvastatin Mylan 40 mg tbl flm 100 x 40 mg MYL0022 Atorvastatin Mylan 40 mg tbl flm 30 x 40 mg MYL0028 Azitromycin Mylan 500 mg tbl flm 3 x 500 mg MYL0369 Betaserc 16 tbl nob 60 x 16 mg MYL0823 Betaserc 24 tbl nob 100 x 24 mg MYL0370 Betaserc 24 tbl nob 50 x 24 mg MYL0371 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 28 MYL0033 Bisoprolol Mylan 10 mg tbl flm 100 x 200 mcg I Breakyl 400 mikrogramů 28 10 mg MYL0033 Bisoprolol Mylan 10 mg tbl flm 100 x 400 mcg I Breakyl 800 mikrogramů 28 10 mg MYL0034 Bisoprolol Mylan 10 mg tbl flm 30 x 800 mcg I 10 mg MYL0034 Bisoprolol Mylan 10 mg tbl flm 30 x 10 mg MYL0035 Bisoprolol Mylan 2,5 mg tbl flm 30 x 2,5 mg MYL0035 Bisoprolol Mylan 2,5 mg tbl flm 30 x 2,5 mg MYL0036 Bisoprolol Mylan 5 mg tbl flm 100 x 5 mg MYL0036 Bisoprolol Mylan 5 mg tbl flm 100 x 5 mg MYL0037 Bisoprolol Mylan 5 mg tbl flm 30 x 5 mg MYL0037 Bisoprolol Mylan 5 mg tbl flm 30 x 5 mg MYL0346 Buprenorfin Mylan 35 mikrogramů/h tdr emp 5 x 20 mg MYL0347 Buprenorfin Mylan 52,5 mikrogramů/h tdr emp 5 x 30 mg MYL0348 Buprenorfin Mylan 70 mikrogramů/h tdr emp 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine MYL0523 Calcium/ Vitamin D3 Mylan 500 mg 120 /800 IU tbl mnd 30 MYL0040 Ciclosporin Mylan 100 mg cps mol 50 x 500 100 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Exemestan MYL0041 Ciclosporin Mylan 25 mg 30 cps mol 50 x 25 mg MYL0042 Ciclosporin Mylan 50 mg cps mol 50 x 50 mg MYL0043 Clopidogrel Mylan 75 mg tbl flm 30 x 75 mg MYL0044 Clopidogrel Mylan 75 mg tbl flm 90 x 75 mg MYL0164 Desloratadin Mylan 5 mg tbl flm 30 x 5 mg MYL0165 Desloratadin Mylan 5 mg tbl flm 50 x 5 mg MYL0166 Desloratadin Mylan 5 mg tbl flm 90 x 5 mg MYL0046 Donepezil Mylan 10 mg tbl flm 28 x 10 mg MYL0045 Donepezil Mylan 10 mg por tbl dis 28 x 10 mg MYL0327 Donepezil Mylan 10 mg tbl flm 56 x 10 mg MYL0047 Donepezil Mylan 10 mg tbl flm 84 x 10 mg MYL0048 Donepezil Mylan 5 mg tbl flm 28 x 5 mg MYL0571 Emtricitabine/Tenofovir disoproxil Mylan 200 mg/245 mg tbl flm 30 x 200 mg/245 mg MYL0572 Entecavir Mylan 0,5 mg tbl flm 30 x 0,5 mg MYL0573 Entecavir Mylan 1 mg tbl flm 30 x 1 mg MYL0052 Escitalopram Mylan 10 mg tbl flm 30 x 10 mg MYL0053 Escitalopram Mylan 10 mg tbl flm 90 x 10 mg MYL0055 Escitalopram Mylan 20 mg tbl flm 90 x 20 mg MYL0690 Ezetimib Mylan 10 mg tbl nob 30 x 10 mg MYL0691 Ezetimib Mylan 10 mg tbl nob 98 x 10 mg MYL0188 Fentanyl Mylan 100 mikrogramů/ hodinu tdr emp 5 x 16,8 mg MYL0189 Fentanyl Mylan 12 mikrogramů/ hodinu tdr emp 5 x 2,1 mg MYL0190 Fentanyl Mylan 25 mikrogramů/ hodinu tdr emp 5 x 4,2 mg MYL0191 Fentanyl Mylan 50 mikrogramů/ hodinu tdr emp 5 x 8,4 mg MYL0192 Fentanyl Mylan 75 mikrogramů/ hodinu tdr emp 5 x 12,6 mg MYL0057 Finasterid Mylan 5 mg tbl flm 100 x 5 mg MYL0064 Glimepirid Mylan 2 mg tbl nob 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg MYL0066 Glimepirid Mylan 3 mg tbl nob 30 x 3 mg MYL0067 Glimepirid Mylan 3 mg tbl nob 90 x 3 mg MYL0068 Glimepirid Mylan 4 mg tbl nob 30 x 4 mg MYL0069 Glimepirid Mylan 4 mg tbl nob 90 x 4 mg MYL0393 Xxxxxx 0,5 mg cps dur 28 x 0,5 mg MYL0394 Xxxxxx 2 mg cps dur 28 x 2 mg MYL0395 Xxxxxx 2 mg cps dur 98 x 2 mg MYL0396 Xxxxxx 4 mg cps dur 28 x 4 mg MYL0397 Xxxxxx 4 mg cps dur 98 x 4 mg MYL0070 Granisetron Mylan 1 mg tbl flm 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 MYL0400 Isoptin 40 mg tbl flm 50 x 40 mg MYL0401 Isoptin 80 mg tbl flm 50 x 80 mg MYL0402 Isoptin SR 240 mg tbl pro 100 x 240 mg MYL0403 Isoptin SR 240 mg tbl pro 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg MYL0404 Klacid 125 mg/5 ml por gra sus 1 x 100 ml MYL0405 Klacid 125 mg/5 ml por gra sus 1 x 60 ml MYL0406 Klacid 250 mg tbl flm 10 x 250 mg MYL0407 Klacid 250 mg tbl flm 14 x 250 mg MYL0408 Klacid 250 mg/5 ml por gra sus 1 x 100 ml MYL0409 Klacid 250 mg/5 ml por gra sus 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml MYL0410 Klacid 500 mg tbl flm 14 x 500 mg MYL0413 Klacid SR 500 mg tbl ret 14 x 500 mg MYL0411 Klacid SR 500 mg tbl ret 7 x 500 mg Klacid SR 14 MYL0196 Leflugen 20 mg tbl flm 30 x 500 mg-d Kreon 25 000 50 20 mg MYL0299 Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg tbl flm 100 x 2,5 mg Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg MYL0679 Linezolid Mylan 2 mg/ml 600 mg tbl flm 10 x 1 x 300 ml 600 mg MYL0418 Lipanthyl 267 M cps dur 30 x 267 mg MYL0419 Lipanthyl 267 M cps dur 90 x 267 mg MYL0420 Xxxxxxxxx Xx 000 mg tbl flm 30 x 145 mg MYL0421 Xxxxxxxxx Xx 000 mg tbl flm 90 x 145 mg MYL0422 Lipanthyl S 215 mg tbl flm 100 x 215 mg MYL0423 Lipanthyl S 215 mg tbl flm 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg MYL0424 Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg tbl ret 90 x 160 mg MYL0091 Meloxicam Mylan 15 mg tbl nob 100 x 15 mg MYL0323 Memantin Mylan 10 mg tbl flm 28 x 10 mg MYL0203 Memantin Mylan 10 mg tbl flm 56 x 10 mg MYL0334 Memantin Mylan 10 mg tbl flm 84x10 mg MYL0204 Memantin Mylan 20 mg tbl flm 28 x 20 mg MYL0540 Mestinon 60 mg tbl obd 150 x 60 mg MYL0094 Metformin Mylan 1000 mg tbl flm 120 x 1 000 mg MYL0095 Metformin Mylan 1000 mg tbl flm 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg MYL0096 Metformin Mylan 500 mg tbl flm 120 x 500 mg MYL0097 Metformin Mylan 500 mg tbl flm 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg MYL0098 Metformin Mylan 850 mg tbl flm 120 x 850 mg MYL0099 Metformin Mylan 850 mg tbl flm 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg MYL0106 Mirtazapin Mylan 30 mg por tbl dis 30 x 30 mg MYL0107 Mirtazapin Mylan 45 mg por tbl dis 30 x 45 mg MYL0108 Montelukast Mylan 10 mg tbl flm 100 x 10 mg MYL0109 Montelukast Mylan 10 mg tbl flm 30 x 10 mg MYL0171 Montelukast Mylan 4 mg tbl mnd 30 x 4 mg MYL0110 Montelukast Mylan 5 mg tbl mnd 100 x 5 mg MYL0172 Montelukast Mylan 5 mg tbl mnd 30 x 5 mg MYL0677 Ogivri 150 mg inf plv csl 1 x 150 mg MYL0251 Olanzapin Mylan 10 mg por tbl dis 28 x 1 x 10 mg MYL0117 Olanzapin Mylan 10 mg tbl flm 28 x 10 mg MYL0881 Olanzapin Mylan 10 mg por tbl dis 56 x 1 x 10 mg MYL0822 Olanzapin Mylan 10 mg tbl flm 56 x 10 mg MYL0252 Olanzapin Mylan 5 mg por tbl dis 28 x 1 x 5 mg MYL0118 Olanzapin Mylan 5 mg tbl flm 28 x 5 mg MYL0880 Olanzapin Mylan 5 mg por tbl dis 56 x 1 x 5 mg MYL0885 Olanzapin Mylan 5 mg tbl flm 56 x 5 mg MYL0426 Olicard 40 mg Retard cps pro 50 x 40 mg MYL0427 Olicard 60 mg Retard cps pro 50 x 60 mg MYL0495 Oxykodon Mylan 10 mg tbl pro 60 x 10 mg MYL0497 Oxykodon Mylan 20 mg tbl pro 60 x 20 mg MYL0498 Oxykodon Mylan 40 mg tbl pro 60 x 40 mg MYL0499 Oxykodon Mylan 80 mg tbl pro 60 x 80 mg MYL0263 Pantomyl 40 mg tbl ent 100 x 40 mg MYL0287 Pantomyl 40 mg tbl ent 30 x 40 mg MYL0205 Pioglitazon Mylan 15 mg tbl nob 28 x 15 mg MYL0177 Pioglitazon Mylan 30 mg tbl nob 28 x 30 mg Pregabalin MYL0131 Quetiapin Mylan 75 100 mg 14 tbl flm 60 x 75 100 mg Pregabalin MYL0332 Quetiapin Mylan 75 200 mg 56 tbl flm 100 x 75 200 mg Pregabalin MYL0298 Quetiapin Mylan 200 mg tbl flm 30 x 200 mg MYL0136 Ropinirol Mylan 2 mg tbl flm 84 x 2 mg MYL0137 Ropinirol Mylan 5 mg tbl flm 84 x 5 mg MYL0429 Rytmonorm 150 mg 56 tbl flm 100 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg MYL0428 Rytmonorm 150 mg tbl flm 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg MYL0431 Rytmonorm 300 mg tbl flm 100 x 300 mg MYL0430 Rytmonorm 300 mg tbl flm 50 x 300 mg Rytmonorm 300 MYL0178 Sildenafil Mylan 100 mg tbl flm 4 x 100 mg MYL0179 Sildenafil Mylan 100 mg tbl flm 8 x 100 mg MYL0180 Sildenafil Mylan 50 mg tbl flm 4 x 50 mg MYL0353 Solifenacin Mylan 10 mg tbl flm 100 x 300 10 mg Sevelamer Carbonate MYL0352 Solifenacin Mylan 800 5 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg tbl flm 100 x 0,4 5 mg Tarka 180/2 MYL0147 Sumatriptan Mylan 100 mg tbl. 28 Tarka 180/2 tbl flm 2 x 100 mg tbl. 98 Tarka 240/4 MYL0148 Sumatriptan Mylan 50 mg tbl. 28 Tarka 240/4 tbl flm 6 x 50 mg tbl. 98 MYL0720 Taris 0,5 mg/0,4 mg cps dur 90 x 0,5 mg/0,4 mg MYL0356 Tenofovir disoproxil Mylan 245 mg tbl flm 30 x 245 mg MYL0151 Topiramat Mylan 100 mg tbl flm 60 x 100 mg MYL0152 Topiramat Mylan 25 mg tbl flm 60 x 25 mg MYL0153 Topiramat Mylan 50 mg tbl flm 60 x 50 mg Uralyt U 280 g 1 MYL0364 Uroxal 5 mg tbl nob 60 x 280 g 5 mg MYL0225 Valaciclovir Mylan 500 mg tbl flm 42 x 500 mg MYL0159 Venlafaxin Mylan 150 mg cps pro 30 x 150 mg MYL0307 Venlafaxin Mylan 150 mg cps pro 90 x 150 mg MYL0160 Venlafaxin Mylan 75 mg cps pro 30 x 75 mg MYL0306 Venlafaxin Mylan 75 mg cps pro 90 x 75 mg Zoledronic acid MYL0475 Vorikonazol Mylan 4 mg/5 ml 1 200 mg tbl flm 14 x 4mg/5ml Zonisamide 200 mg MYL0161 Zolpidem Mylan 10 mg tbl flm 20 x 10 mg MYL0187 Zolpidem Mylan 10 mg tbl flm 50 mg 56 x 50 10 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2Calculation

Xxxx. Xxxxx Xxxxxx, Jednatel Zmocněnec na základě plné moci / Executive Director Authorised under a power of attorney Příloha č. 1 – seznam Výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Přípravek Balení Forma Afonilum SR 250 mg 50 x 250 mg Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg cps pro Anastrozol Mylan 1 mg 30 x 1 mg tbl flm Azitromycin Mylan 500 mg 3 x 500 mg tbl flm Betaserc 8 100 x 8 mg tbl nob Betaserc 16 60 x 16 mg tbl nob Betaserc 24 50 x 24 mg Betaserc 8 tbl nob Bisoprolol Mylan 2,5 mg 30 x 2,5 mg tbl flm Bisoprolol Mylan 5 mg 30 x 5 mg tbl flm Bisoprolol Mylan 5 mg 100 x 8 5 mg Breakyl 200 mikrogramů 28 tbl flm Bisoprolol Mylan 10 mg 30 x 200 mcg I Breakyl 400 mikrogramů 28 10 mg tbl flm Bisoprolol Mylan 10 mg 100 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 10 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg tbl flm Cynt 0,2 30 x 0,2 mg tbl flm Cynt 0,2 98 x 0,2 mg tbl flm Cynt 0,3 30 x 0,3 mg tbl flm Cynt 0,3 98 x 0,3 mg tbl flm Cynt 0,4 30 x 0,4 mg tbl flm Cynt 0,4 98 x 0,4 mg Dona 1500 tbl flm Donepezil Mylan 5 mg 20 sačků 28 x 5 mg tbl flm Donepezil Mylan 10 mg 28 x 10 mg tbl flm Donepezil Mylan 10 mg 28 x 10 mg por tbl dis Donepezil Mylan 10 mg 56 x 10 mg tbl flm Donepezil Mylan 10 mg 84 x 10 mg tbl flm Doxazosin Mylan 4 mg 28 x 4 mg tbl pro Doxazosin Mylan 4 mg 98 x 4 mg tbl pro Duspatalin Retard 30 x 200 mg cps rdr Dymistin 137 mikrogramů/50 mikrogramů 1 x 23 g nas spr sus Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg tbl flm Glimepirid Mylan 2 mg 30 x 2 mg tbl nob Glimepirid Mylan 2 mg 90 x 2 mg tbl nob Glimepirid Mylan 3 mg 30 x 3 mg tbl nob Glimepirid Mylan 3 mg 90 x 3 mg tbl nob Glimepirid Mylan 4 mg 30 x 4 mg tbl nob Glimepirid Mylan 4 mg 90 x 4 mg tbl nob Xxxxxx 0,5 mg 28 x 0,5 mg cps dur Granisetron Mylan 1 mg 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 tbl flm Irinotecan Mylan 20 mg/ml 1 x 2 ml inf cnc sol Irinotecan Mylan 20 mg/ml 1 x 5 ml inf cnc sol Isoptin 40 mg 50 x 40 mg tbl flm Isoptin 80 mg 50 x 80 mg tbl flm Isoptin SR 240 mg 30 x 240 mg tbl pro Isoptin SR 240 mg 100 x 240 mg tbl pro Klacid 125 mg/5 ml 1 x 60 ml por gra sus Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg por gra sus Klacid 250 mg/5 ml 1 x 60 ml por gra sus Klacid 250 mg/5 ml 1 x 100 ml por gra sus Klacid 250 10 x 250 mg tbl flm Klacid 250 14 x 250 mg tbl flm Klacid 500 14 x 500 mg tbl flm Klacid SR 7 x 500 mg tbl ret Klacid SR 14 x 500 mg-d Kreon 25 000 50 Letmylan 2,5 tbl ret Levelanz 250 mg 30 56 x 2,5 250 mg Letmylan 2,5 tbl flm Levelanz 500 mg 100 56 x 2,5 500 mg tbl flm Levelanz 500 mg 98 x 500 mg tbl flm Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz tbl flm Levofloxacin Mylan 500 mg 56 10 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg tbl flm Lipanthyl 267 M 90 x 267 mg cps dur Xxxxxxxxx Xx 000 mg 30 x 145 mg tbl flm Xxxxxxxxx Xx 000 mg 90 x 145 mg tbl flm Lipanthyl S 215 mg 30 x 215 mg tbl flm Lipanthyl S 215 mg 100 x 215 mg tbl flm Lipanthyl Supra 160 mg 30 x 160 mg tbl ret Lipanthyl Supra 160 mg 90 x 160 mg Metformin tbl ret Olanzapin Mylan 1000 5 mg 60 28 x 1 000 x 5 mg Metformin por tbl dis Olanzapin Mylan 1000 10 mg 120 28 x 1 000 x 10 mg Metformin por tbl dis Olanzapin Mylan 1000 5 mg 180 28 x 1 000 5 mg Metformin tbl flm Olanzapin Mylan 500 10 mg 60 28 x 500 10 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg tbl flm Oxykodon Mylan 10 mg 60 x 10 mg tbl pro Oxykodon Mylan 20 mg 60 x 20 mg tbl pro Oxykodon Mylan 40 mg 60 x 40 mg tbl pro Oxykodon Mylan 80 mg 60 x 80 mg Pioglitazon tbl pro Paclitaxel Mylan 15 mg 28 6 mg/ml 1 x 15 mg Pioglitazon 5 ml inf cnc sol Paclitaxel Mylan 30 mg 28 6 mg/ml 1 x 30 mg Pregabalin 16,7 ml inf cnc sol Paclitaxel Mylan 75 mg 14 6 mg/ml 1 x 75 mg Pregabalin 50 ml inf cnc sol Pramipexol Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 0,18 mg 100 x 20 0,18 mg Rytmonorm 150 tbl nob Pramipexol Mylan 0,26 mg 10 x 0,26 mg tbl pro Pramipexol Mylan 0,52 mg 30 x 0,52 mg tbl pro Sumatriptan Mylan 50 mg 6 x 150 50 mg Rytmonorm 150 tbl flm Sumatriptan Mylan 100 mg 2 x 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg tbl flm Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 100 mg 60 x 100 mg Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2cps rdr

Xxxx. Xxxxx Xxxxxx, Jednatel / Executive Director Annex 1 – Product List Příloha č. 1 – seznam Výrobků Annex 1 – SUKL Produkt / Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mgForma / Form Balení / Packages 219251 Emtricitabine/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 Tenofovir disoproxil Mylan 200 mg/245 mg 50 x 250 mg Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg tbl flm 30 x 1 200mg/245mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Betaserc 8 100 x 8 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů170508 Lamivudin/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Zidovudin Mylan 150 mg/300 mg tbl flm 60 x 150 mg/300 mg Capecitabine 145671 Levofloxacin Mylan 500 mg 120 mg/100 ml inf sol 10 x 500 mg Cynt 0,2 mg/100 ml 219169 Tenofovir disoproxil Mylan tbl flm 30 x 0,2 245mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Granisetron Mylan 1 mg 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 100 mg 60 x 100 mg Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Uralyt U 280 g 1 x 280 g 124231 Valaciclovir Mylan 500 mg tbl flm 42 x 500 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg 193478 Zoledronic acid Mylan 4 mg/5 ml inf cnc sol 1 x 4mg/5ml Zonisamide 138974 Escitalopram Mylan 10 mg tbl flm 30 x 10 mg 138979 Escitalopram Mylan 10 mg tbl flm 90 x 10 mg 139015 Escitalopram Mylan 20 mg tbl flm 90 x 20 mg 136168 Alfuzosin Mylan 10 mg tbl pro 90 x 10 mg 215566 Betaserc 16 tbl nob 60 x 16 mg 215708 Betaserc 24 tbl nob 50 x 24 mg 215559 Betaserc 8 tbl nob 100 x 8 mg 185625 Brufen 400 (Blistr) tbl flm 30 x 400 mg 185630 Brufen 400 (Lah) tbl flm 100 x 400 mg 185634 Brufen 600 mg gra eff 20 x 600 mg 185624 Brufen Sirup sir 1 x 100 ml/2 gm 215161 Cynt 0,2 tbl flm 30 x 0,2 mg 215162 Cynt 0,2 tbl flm 98 x 0,2 mg 215163 Cynt 0,3 tbl flm 30 x 0,3 mg 215164 Cynt 0,3 tbl flm 98 x 0,3 mg 215165 Cynt 0,4 tbl flm 30 x 0,4 mg 215166 Cynt 0,4 tbl flm 98 x 0,4 mg 59645 Dona 1500 mg por plv sol 20 sačků 150080 Dona 1500 mg por plv sol 20 sačků 157196 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 3 x 5 ml 146374 Doxazosin Mylan 4 mg Tbl pro 98 x 4mg 146366 Doxazosin Mylan 4 mg tbl pro 28 x 4 mg 215568 Duspatalin Retard cps rdr 30 x 200 mg 119755 Anastrozol Mylan 1 mg tbl flm 30 x 1 mg 145689 Letmylan 2,5 mg tbl flm 30 x 2,5 mg 145695 Letmylan 2,5 mg tbl flm 100 x 2,5 mg 215913 Xxxxxx 0,5 mg cps dur 28 x 0,5 mg 215914 Xxxxxx 2 mg cps dur 28 x 2 mg 215917 Xxxxxx 2 mg cps dur 98 x 2 mg 215920 Xxxxxx 4 mg cps dur 28 x 4 mg 215922 Xxxxxx 4 mg cps dur 98 x 4 mg 238194 Hulio inj sol 40mg 2x0,8ml pfs 238197 Hulio inj sol 40mg 2x0,8ml pfp 231055 Ibandronát Mylan 150 mg tbl flm 3 x 150 mg 207098 Lipanthyl 267 M cps dur 30 x 267 mg 207100 Lipanthyl 267 M cps dur 90 x 267 mg 214919 Lipanthyl Nt 145 mg tbl flm 30 x 145 mg 214922 Lipanthyl Nt 145 mg tbl flm 90 x 145 mg 207094 Lipanthyl S 215 mg tbl flm 100 x 215 mg 207092 Lipanthyl S 215 mg tbl flm 30 x 215 mg 207097 Lipanthyl Supra 160 mg tbl ret 90 x 160 mg 207095 Lipanthyl Supra 160 mg tbl ret 30 x 160 mg 215978 Magnosolv por gra sol scc 30 sáčků 136398 Mestinon 60 mg tbl obd 150 x 60 mg 215904 Rytmonorm 150 mg tbl flm 50 x 150 mg 215906 Rytmonorm 150 mg tbl flm 100 x 150 mg 215907 Rytmonorm 300 mg tbl flm 50 x 300 mg 215909 Rytmonorm 300 mg tbl flm 100 x 300 mg 146269 Sumatriptan Mylan 100 mg tbl flm 2 x 100 mg 146283 Sumatriptan Mylan 50 mg 56 tbl flm 6 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX 151239 Tamsulosin HCI Mylan 0,4 mg cps rdr 100 x 0,4 mg 136963 Tigecycline Mylan 50 mg inf plv sol 10 x 50 mg 135111 Twicor 10 g/10 mg tbl flm 30 x 10mg/10mg 135113 Twicor 10 mg/10 mg tbl flm 90 x 10mg/10mg Skupina výrobků č.1 /Group of Products No. 1 Název přípravku SUKL Produkt / Product Forma / Form Balení přípravku Agomelatine / Packages 219251 Emtricitabine/Tenofovir disoproxil Mylan 25 200 mg/245 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg tbl flm 30 x 1 200mg/245mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů170508 Lamivudin/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Zidovudin Mylan 150 mg/300 mg tbl flm 60 x 150 mg/300 mg Capecitabine 145671 Levofloxacin Mylan 500 mg/100 ml inf sol 10 x 500 mg/100 ml 219169 Tenofovir disoproxil Mylan tbl flm 30 x 245mg 124231 Valaciclovir Mylan 500 mg 120 tbl flm 42 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg 193478 Zoledronic acid Mylan 4 mg/5 ml inf cnc sol 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX 138974 Escitalopram Mylan 10 mg tbl flm 30 x 10 mg 138979 Escitalopram Mylan 10 mg tbl flm 90 x 10 mg 139015 Escitalopram Mylan 20 mg tbl flm 90 x 20 mg Skupina výrobků č.2 /Group of Products XxNo. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 2 SUKL Produkt / Product Forma / Form Balení / Packages 136168 Alfuzosin Mylan 10 mg tbl pro 90 x 30 gm Afonilum SR 250 10 mg 215566 Betaserc 16 tbl nob 60 x 16 mg 215708 Betaserc 24 tbl nob 50 x 250 24 mg 215559 Betaserc 8 tbl nob 100 x 8 mg Betaserc 16 60 185625 Brufen 400 (Blistr) tbl flm 30 x 16 400 mg Betaserc 24 50 185630 Brufen 400 (Lah) tbl flm 100 x 24 400 mg 185634 Brufen 600 mg gra eff 20 x 600 mg 185624 Brufen Sirup Sir 1 x 100 ml/2 gm 215161 Cynt 0,2 tbl flm 30 x 0,2 mg 215162 Cynt 0,2 tbl flm 98 x 0,2 mg 215163 Cynt 0,3 tbl flm 30 x 0,3 mg 215164 Cynt 0,3 tbl flm 98 x 0,3 mg 215165 Cynt 0,4 tbl flm 30 x 0,4 mg 215166 Cynt 0,4 tbl flm 98 x 0,4 mg 59645 Dona 1500 mg por plv sol 20 sačků Glimepirid Mylan 2 150080 Dona 1500 mg 30 por plv sol 20 sačků 157196 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 3 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid 5 ml 146374 Doxazosin Mylan 4 mg 30 Tbl pro 98 x 4mg 146366 Doxazosin Mylan 4 mg tbl pro 28 x 4 mg Glimepirid Mylan 4 215568 Duspatalin Retard cps rdr 30 x 200 mg 90 x 4 mg 215913 Xxxxxx 0,5 mg cps dur 28 x 0,5 mg Cholib 145 mg/20 215914 Xxxxxx 2 mg 30 Cholib 145 mg/40 cps dur 28 x 2 mg 30 Isoptin 40 215917 Xxxxxx 2 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg cps dur 98 x 500 2 mg Levelanz 1000 215920 Xxxxxx 4 mg 56 cps dur 28 x 1000 4 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200215922 Xxxxxx 4 mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200cps dur 98 x 4 mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml 207098 Lipanthyl 267 M cps dur 30 x 267 mg 207100 Lipanthyl 267 M cps dur 90 x 267 mg Xxxxxxxxx Xx 000 214919 Lipanthyl Nt 145 mg tbl flm 30 x 145 mg Xxxxxxxxx Xx 000 214922 Lipanthyl Nt 145 mg tbl flm 90 x 145 mg 207094 Lipanthyl S 215 mg tbl flm 100 x 215 mg 207092 Lipanthyl S 215 mg tbl flm 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg 207097 Lipanthyl Supra 160 mg tbl ret 90 x 160 mg 207095 Lipanthyl Supra 160 mg tbl ret 30 x 160 mg Lipanthyl Supra 160 215978 Magnosolv por gra sol scc 30 sáčků 136398 Mestinon 60 mg 90 tbl obd 150 x 160 60 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg 215904 Rytmonorm 150 mg tbl flm 50 x 150 mg 215906 Rytmonorm 150 mg tbl flm 100 x 150 mg 215907 Rytmonorm 300 mg tbl flm 50 x 300 mg 215909 Rytmonorm 300 mg tbl flm 100 x 300 mg Sevelamer Carbonate 146269 Sumatriptan Mylan 800 100 mg 180 tbl flm 2 x 800 100 mg 146283 Sumatriptan Mylan 50 mg tbl flm 6 x 50 mg 151239 Tamsulosin HCI Mylan 0,4 mg cps rdr 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat 136963 Tigecycline Mylan 50 mg 60 inf plv sol 10 x 50 mg Topiramat Mylan 100 135111 Twicor 10 g/10 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg tbl flm 30 x 75 10mg/10mg Venlafaxin Mylan 75 135113 Twicor 10 mg/10 mg tbl flm 90 x 75 10mg/10mg Venlafaxin Skupina výrobků č.3 /Group of Products No. 3 SUKL Produkt / Product Forma / Form Balení / Packages 119755 Anastrozol Mylan 150 1 mg tbl flm 30 x 150 1 mg Venlafaxin Mylan 150 145689 Letmylan 2,5 mg 90 tbl flm 30 x 150 2,5 mg Zonisamide Mylan 50 145695 Letmylan 2,5 mg 56 tbl flm 100 x 50 mg Bonusové pásmo pro skupinu č.22,5 mg

Xxxx. Xxxxx Xxxxxx, Jednatel jednatel / Executive Director Příloha č. 1 – seznam Výrobků Annex 1 – –Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mgMIC kód/ MIC code Název přípravku/g + 0,25 mgName of the Product Forma přípravku/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Form of the Product Balení přípravku/ Package of the Product MYL0659 Agomelatine Mylan 25 mg tbl flm 28 x 25 mg MYL0660 Agomelatine Mylan 25 mg tbl flm 84 x 25 mg Anastrozol MYL0911 Arixtra inj sol 10 x 0,5 ml MYL0664 Atomoxetin Mylan 1 18 mg 30 cps dur 28 x 1 18 mg MYL0665 Atomoxetin Mylan 25 mg cps dur 28 x 25 mg MYL0666 Atomoxetin Mylan 40 mg cps dur 28 x 40 mg MYL0668 Atomoxetin Mylan 80 mg cps dur 28 x 80 mg MYL0369 Betaserc 16 tbl nob 60 x 16 mg MYL0370 Betaserc 24 tbl nob 50 x 24 mg MYL0823 Betaserc 24 tbl nob 100 x 24 mg MYL0371 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I MYL0346 Buprenorfin Mylan 35 mikrogramů/h tdr emp 5 x 20 mg MYL0347 Buprenorfin Mylan 52,5 mikrogramů/h tdr emp 5 x 30 mg MYL0348 Buprenorfin Mylan 70 mikrogramů/h tdr emp 5 x 40 mg Capecitabine Mylan 150 MYL0925 Caduet tbl flm 30 x 5 mg/10 mg 60 MYL0923 Caduet tbl flm 30 x 150 10 mg/10 mg Capecitabine MYL0523 Calcium/ Vitamin D3 Mylan 500 mg 120 x /800 IU tbl mnd 30 MYL0821 Calcium/ Vitamin D3 Mylan 500 mg /800 IU tbl mnd 90 MYL0377 Cynt 0,2 tbl flm 30 x 0,2 mg MYL0378 Cynt 0,2 tbl flm 98 x 0,2 mg MYL0379 Cynt 0,3 tbl flm 30 x 0,3 mg MYL0380 Cynt 0,3 tbl flm 98 x 0,3 mg MYL0382 Cynt 0,4 tbl flm 98 x 0,4 mg MYL0381 Cynt 0,4 tbl flm 30 x 0,4 mg Cynt 0,4 98 MYL0164 Desloratadin Mylan 5 mg tbl flm 30 x 0,4 5 mg MYL0165 Desloratadin Mylan 5 mg tbl flm 50 x 5 mg MYL0166 Desloratadin Mylan 5 mg tbl flm 90 x 5 mg MYL0819 Dona 1500 mg 20 por plv sol 30 sačků Exemestan Mylan 25 MYL0820 Dona 1500 mg por plv sol 90 sačků MYL0526 Dona 400 mg inj sol 6 x 2 mla + 6 x 1 mlb MYL0386 Duspatalin Retard 200 mg cps rdr 30 x 25 200 mg Fentanyl MYL0572 Entecavir Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 tbl flm 30 x 0,5 mg Granisetron MYL0573 Entecavir Mylan 1 mg tbl flm 30 x 1 mg MYL0917 Fraxiparine inj sol isp 10 x 0,3 ml MYL0918 Fraxiparine inj sol isp 10 x 0,4 ml MYL0919 Fraxiparine inj sol isp 10 x 0,6 ml MYL0920 Fraxiparine inj sol isp 10 x 0,8 ml MYL0921 Fraxiparine inj sol isp 10 x 1 ml MYL0913 Fraxiparine Forte inj sol isp 2 x 0,6 ml MYL0915 Fraxiparine Forte inj sol isp 10 x 0,6 ml MYL0914 Fraxiparine Forte inj sol isp 2 x 0,8 ml MYL0912 Fraxiparine Forte inj sol isp 10 x 0,8 ml MYL0916 Fraxiparine Forte inj sol isp 10 x 1 ml MYL0072 Ibandronát Mylan 150 mg Cholib 145 mg/20 tbl flm 3 x 150 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg MYL0402 Isoptin SR 240 mg tbl pro 100 x 240 mg MYL0403 Isoptin SR 240 mg tbl pro 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 MYL0414 Kreon 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 cps etd 50 Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg MYL0443 Levelanz 1000 mg tbl flm 56 x 1000 mg MYL0445 Levelanz 250 mg tbl flm 56 x 250 mg MYL0447 Levelanz 500 mg tbl flm 56 x 500 mg MYL0449 Levelanz 500 mg tbl flm 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml MYL0418 Lipanthyl 267 M cps dur 30 x 267 mg MYL0419 Lipanthyl 267 M cps dur 90 x 267 mg Xxxxxxxxx Xx 000 MYL0420 Lipanthyl Nt 145 mg tbl flm 30 x 145 mg Xxxxxxxxx Xx 000 MYL0421 Lipanthyl Nt 145 mg tbl flm 90 x 145 mg MYL0422 Lipanthyl S 215 mg tbl flm 100 x 215 mg MYL0423 Lipanthyl S 215 mg tbl flm 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg MYL0425 Lipanthyl Supra 160 mg tbl ret 30 x 160 mg MYL0424 Lipanthyl Supra 160 mg tbl ret 90 x 160 mg Metformin Mylan 1000 MYL0948 Lyrica cps dur 56 x 300 mg 60 MYL0949 Lyrica cps dur 56 x 1 000 50 mg Metformin Mylan 1000 MYL0952 Lyrica cps dur 56 x 75 mg 120 MYL0945 Lyrica cps dur 56 x 1 000 150 mg Metformin Mylan 1000 MYL0947 Lyrica cps dur 56 x 225 mg 180 MYL0944 Lyrica cps dur 14 x 1 000 150 mg Metformin Mylan 500 MYL0955 Neurontin cps dur 100 x 300 mg 60 MYL0958 Neurontin tbl flm 50 x 500 600 mg Metformin Mylan 500 MYL0957 Neurontin cps dur 50 x 400 mg 120 MYL0959 Neurontin tbl flm 50 x 500 800 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg MYL0495 Oxykodon Mylan 10 mg tbl pro 60 x 10 mg MYL0497 Oxykodon Mylan 20 mg tbl pro 60 x 20 mg MYL0498 Oxykodon Mylan 40 mg tbl pro 60 x 40 mg MYL0499 Oxykodon Mylan 80 mg tbl pro 60 x 80 mg Pioglitazon MYL0684 Oxykodon/Naloxon Mylan 15 tbl pro 60 x 10 mg 28 / 5 mg MYL0682 Oxykodon/Naloxon Mylan tbl pro 60 x 15 20 mg Pioglitazon / 10 mg MYL0683 Oxykodon/Naloxon Mylan 30 tbl pro 60 x 40 mg 28 x 30 / 20 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan MYL0429 Rytmonorm 150 mg 56 tbl flm 100 x 150 mg Reparil - Dragées 20 MYL0428 Rytmonorm 150 mg tbl flm 50 x 150 mg MYL0430 Rytmonorm 300 mg tbl flm 50 x 300 mg MYL0431 Rytmonorm 300 mg tbl flm 100 x 300 mg MYL0694 Sertralin Mylan 100 mg tbl flm 30 x 100 mg MYL0692 Sertralin Mylan 50 mg tbl flm 30 x 50 mg MYL0693 Sertralin Mylan 50 mg tbl flm 90 x 50 mg MYL0969 Sortis tbl flm 100 x 40 mg MYL0965 Sortis tbl flm 100 x 10 mg MYL0970 Sortis tbl flm 30 x 40 mg MYL0968 Sortis tbl flm 30 x 20 mg Reparil - Dragées 20 mg MYL0967 Sortis tbl flm 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 MYL0151 Topiramat Mylan 100 mg tbl flm 60 x 100 mg MYL0152 Topiramat Mylan 25 mg tbl flm 60 x 25 mg MYL0153 Topiramat Mylan 50 mg tbl flm 60 x 50 mg Uralyt U 280 g MYL0475 Vorikonazol Mylan 200 mg tbl flm 14 x 200 mg MYL0981 Xalacom oph gtt sol 3 x 2.5 ml MYL0980 Xalacom oph gtt sol 1 x 280 g Valaciclovir Mylan 500 mg 42 2.5 ml MYL0983 Xalatan oph gtt sol 3 x 500 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Zoledronic acid Mylan 4 mg/5 2.5 ml MYL0982 Xalatan oph gtt sol 1 x 4mg/5ml Zonisamide Mylan 2.5 ml MYL0996 Zoloft tbl flm 100 x 50 mg 56 MYL0995 Zoloft tbl flm 28 x 100 mg MYL0997 Zoloft tbl flm 28 x 50 mg Příloha č. 2 - – Vzor a výpočet bonusu Annex 2 –– Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2Calculation

Xxxx. Xxxxx Xxxxxx, Jednatel jednatel / Executive Director ____________________________ Oblastní nemocnice Kolín, a.s., nemocnice Středočeského kraje Oblastní nemocnice Kolín, a.s., nemocnice Středočeského kraje XXXx. Xxxx Xxxxxxxx, MBA, předseda představenstva / Chairman of the Board____________________________ Xxx. Xxxxxxx Xxxxxx, místopředseda představenstva / Vicechairman of the Board Příloha č. 1 – seznam Výrobků Annex 1 – –Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm MIC kód/ MIC Code Název přípravku/ Name of the Product Forma přípravku/ Form of the Product Balení přípravku/ Package of the Product MYL0367 Afonilum SR 250 mg cps pro 50 x 250 mg Agomelatine MYL0002 Alendrogen 70 mg tbl nob 12 x 70 mg MYL0661 Alendronic Acid/Vitamin D3 Mylan 25 mg 28 70 mg/2800 IU tbl nob 12 x 25 mg Agomelatine 70 mg/2800 IU MYL0662 Alendronic Acid/Vitamin D3 Mylan 25 mg 84 70 mg/5600 IU tbl nob 12 x 25 mg Anastrozol Mylan 1 mg 30 70 mg/5600 IU MYL0911 Arixtra inj sol 10 x 1 mg 0,5 ml MYL0369 Betaserc 16 tbl nob 60 x 16 mg MYL0823 Betaserc 24 tbl nob 100 x 24 mg MYL0370 Betaserc 24 tbl nob 50 x 24 mg MYL0371 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 28 MYL0598 Betaxolol Mylan 20 mg tbl flm 98 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I 20 mg MYL0346 Buprenorfin Mylan 35 mikrogramů/h tdr emp 5 x 20 mg MYL0347 Buprenorfin Mylan 52,5 mikrogramů/h tdr emp 5 x 30 mg MYL0348 Buprenorfin Mylan 70 mikrogramů/h tdr emp 5 x 40 mg Capecitabine Mylan 150 MYL0923 Caduet tbl flm 30 x 10 mg/10 mg 60 MYL0925 Caduet tbl flm 30 x 150 5 mg/10 mg Capecitabine Mylan 500 MYL0924 Caduet tbl flm 90 x 10 mg/10 mg 120 MYL0926 Caduet tbl flm 90 x 500 5 mg/10 mg MYL0377 Cynt 0,2 tbl flm 30 x 0,2 mg MYL0378 Cynt 0,2 tbl flm 98 x 0,2 mg MYL0379 Cynt 0,3 tbl flm 30 x 0,3 mg MYL0380 Cynt 0,3 tbl flm 98 x 0,3 mg MYL0381 Cynt 0,4 tbl flm 30 x 0,4 mg MYL0382 Cynt 0,4 tbl flm 98 x 0,4 mg Dona 1500 MYL0336 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 1 x 5 ml MYL0049 Dorzogen Combi 20 mg/ml + 5 mg/ml oph gtt sol 3 x 5 ml MYL0052 Escitalopram Mylan 10 mg 20 sačků Exemestan Mylan 25 mg tbl flm 30 x 25 10 mg Fentanyl MYL0053 Escitalopram Mylan 100 mikrogramů/ hodinu 5 x 16,8 10 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg tbl flm 90 x 2 10 mg Glimepirid MYL0055 Escitalopram Mylan 3 20 mg 30 x 3 mg Glimepirid Mylan 3 mg tbl flm 90 x 3 20 mg Glimepirid MYL0917 Fraxiparine inj sol isp 10 x 0,3 ml MYL0918 Fraxiparine inj sol isp 10 x 0,4 ml MYL0919 Fraxiparine inj sol isp 10 x 0,6 ml MYL0920 Fraxiparine inj sol isp 10 x 0,8 ml MYL0921 Fraxiparine inj sol isp 10 x 1 ml MYL0913 Fraxiparine Forte inj sol isp 2 x 0,6 ml MYL0914 Fraxiparine Forte inj sol isp 2 x 0,8 ml MYL0915 Fraxiparine Forte inj sol isp 10 x 0,6 ml MYL0912 Fraxiparine Forte inj sol isp 10 x 0,8 ml MYL0916 Fraxiparine Forte inj sol isp 10 x 1 ml MYL0062 Gliclazid Mylan 4 30 mg tbl ret 120 x 30 mg MYL0063 Gliclazid Mylan 30 mg tbl ret 60 x 4 30 mg Glimepirid Mylan 4 mg 90 x 4 mg MYL0393 Xxxxxx 0,5 mg cps dur 28 x 0,5 mg Granisetron MYL0394 Xxxxxx 2 mg cps dur 28 x 2 mg MYL0395 Xxxxxx 2 mg cps dur 98 x 2 mg MYL0396 Xxxxxx 4 mg cps dur 28 x 4 mg MYL0397 Xxxxxx 4 mg cps dur 98 x 4 mg MYL0681 Hulio 40 mg inj sol 40 mg 2x0,8ml pfp MYL0680 Hulio 40 mg inj sol 40 mg 2x0,8ml pfs MYL0826 Hulio 40 mg inj sol 40 mg 6x0,8ml pfs MYL0072 Ibandronát Mylan 1 150 mg 10 tbl flm 3 x 1 150 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 MYL0400 Isoptin 40 mg tbl flm 50 x 40 mg MYL0401 Isoptin 80 mg tbl flm 50 x 80 mg MYL0402 Isoptin SR 240 mg tbl pro 100 x 240 mg MYL0403 Isoptin SR 240 mg tbl pro 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml MYL0406 Klacid 250 mg tbl flm 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml MYL0410 Klacid 500 mg tbl flm 14 x 500 mg MYL0413 Klacid SR 500 mg tbl ret 14 x 500 mg MYL0411 Klacid SR 500 mg tbl ret 7 x 500 mg Klacid SR 14 x 500 mg-d MYL0414 Kreon 10 000 cps etd 50 MYL0416 Kreon 25 000 cps etd 50 MYL0196 Leflugen 20 mg tbl flm 30 x 20 mg MYL0299 Letmylan 2,5 mg tbl flm 100 x 2,5 mg MYL0265 Letmylan 2,5 mg tbl flm 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml MYL0418 Lipanthyl 267 M cps dur 30 x 267 mg MYL0419 Lipanthyl 267 M cps dur 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg MYL0422 Lipanthyl S 215 mg tbl flm 100 x 215 mg MYL0423 Lipanthyl S 215 mg tbl flm 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg MYL0424 Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg tbl ret 90 x 160 mg Metformin MYL0943 Lyrica cps dur 112 x 150 mg (2x56) MYL0944 Lyrica cps dur 14 x 150 mg MYL0945 Lyrica cps dur 56 x 150 mg MYL0947 Lyrica cps dur 56 x 225 mg MYL0948 Lyrica cps dur 56 x 300 mg MYL0949 Lyrica cps dur 56 x 50 mg MYL0952 Lyrica cps dur 56 x 75 mg MYL0091 Meloxicam Mylan 1000 15 mg 60 tbl nob 100 x 1 000 15 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg MYL0106 Mirtazapin Mylan 30 mg por tbl dis 30 x 30 mg MYL0107 Mirtazapin Mylan 45 mg por tbl dis 30 x 45 mg MYL0955 Neurontin cps dur 100 x 300 mg MYL0956 Neurontin cps dur 50 x 300 mg MYL0957 Neurontin cps dur 50 x 400 mg MYL0958 Neurontin tbl flm 50 x 600 mg MYL0959 Neurontin tbl flm 50 x 800 mg MYL0495 Oxykodon Mylan 10 mg tbl pro 60 x 10 mg MYL0497 Oxykodon Mylan 20 mg tbl pro 60 x 20 mg MYL0498 Oxykodon Mylan 40 mg tbl pro 60 x 40 mg MYL0499 Oxykodon Mylan 80 mg tbl pro 60 x 80 mg MYL0684 Oxykodon/Naloxon Mylan tbl pro 60 x 10 mg / 5 mg MYL0682 Oxykodon/Naloxon Mylan tbl pro 60 x 20 mg / 10 mg MYL0683 Oxykodon/Naloxon Mylan tbl pro 60 x 40 mg / 20 mg MYL0205 Pioglitazon Mylan 15 mg tbl nob 28 x 15 mg MYL0177 Pioglitazon Mylan 30 mg tbl nob 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan MYL0429 Rytmonorm 150 mg 56 tbl flm 100 x 150 mg Reparil - Dragées 20 MYL0428 Rytmonorm 150 mg 40 tbl flm 50 x 20 150 mg Reparil - Dragées 20 MYL0431 Rytmonorm 300 mg tbl flm 100 x 300 mg MYL0430 Rytmonorm 300 mg tbl flm 50 x 300 mg MYL0688 Serkep 25 mikrogramů/125 mikrogramů/dávka inh sus pss 25mcg/125mcg/dáv x 120dáv MYL0353 Solifenacin Mylan 10 mg tbl flm 100 x 10 mg MYL0352 Solifenacin Mylan 5 mg tbl flm 100 x 5 mg MYL0965 Sortis tbl flm 100 x 10 mg MYL0967 Sortis tbl flm 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg MYL0969 Sortis tbl flm 100 x 150 40 mg Rytmonorm 300 MYL0968 Sortis tbl flm 30 x 20 mg 50 MYL0720 Taris 0,5 mg/0,4 mg cps dur 90 x 300 0,5 mg/0,4 mg Rytmonorm 300 MYL0435 Tarka 180 mg/2 mg 100 x 300 tbl ret 28 MYL0436 Tarka 180 mg/2 mg Sevelamer Carbonate Mylan 800 tbl ret 98 MYL0437 Tarka 240 mg/4 mg 180 x 800 tbl ret 28 MYL0438 Tarka 240 mg/4 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. tbl ret 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 100 mg 60 x 100 mg Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg MYL0553 Uralyt U 280 g gra 1 x 280 g Valaciclovir Mylan 500 MYL0555 Uraplex 20 mg 42 tbl obd 50 x 500 20 mg Venlafaxin Mylan 150 MYL0364 Uroxal 5 mg 30 tbl nob 60 x 150 5 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Zoledronic acid Mylan 4 mg/5 ml MYL0980 Xalacom oph gtt sol 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 2.5 ml MYL0981 Xalacom oph gtt sol 3 x 2.5 ml MYL0982 Xalatan oph gtt sol 1 x 2.5 ml MYL0983 Xalatan oph gtt sol 3 x 2.5 ml MYL0996 Zoloft tbl flm 100 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg MYL0995 Zoloft tbl flm 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 MYL0997 Zoloft tbl flm 28 x 50 mg Bonusové pásmo pro skupinu č.2mg

Xxxx. Xxxxx Xxxxxx, Jednatel jednatel / Executive Director ____________________________ Revmatologický ústav xxxx. XXXx. Xxxxx Xxxxxxx, DrSc., ředitel / Director Příloha č. 1 – seznam Výrobků Annex 1 – –Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mgMIC kód/ MIC code Název přípravku/g + 0,25 mgName of the Product Forma přípravku/g Gel 1 Form of the Product Balení přípravku/ Package of the Product MYL0002 Alendrogen 70 mg tbl nob 12 x 70 mg MYL0661 Alendronic Acid/Vitamin D3 Mylan 70 mg/2800 IU tbl nob 12 x 70 mg/2800 IU MYL0662 Alendronic Acid/Vitamin D3 Mylan 70 mg/5600 IU tbl nob 12 x 70 mg/5600 IU MYL0372 Brufen 400 mg tbl flm 30 gm Afonilum SR 250 x 400 mg MYL0373 Brufen 400 mg tbl flm 100 x 400 mg MYL1010 Brufen 400 mg tbl flm 50 x 250 400 mg Agomelatine MYL0362 Brufen 600 mg gra eff 20 x 600 mg MYL0652 Brufen Rapid 400 mg tbl flm 24 x 400 mg MYL0523 Calcium/ Vitamin D3 Mylan 500 mg /800 IU tbl mnd 30 MYL0821 Calcium/ Vitamin D3 Mylan 500 mg /800 IU tbl mnd 90 MYL0929 Celebrex cps dur 30 x 100 mg MYL0930 Celebrex cps dur 30 x 200 mg MYL0040 Ciclosporin Mylan 100 mg cps mol 50 x 100 mg MYL0041 Ciclosporin Mylan 25 mg 28 cps mol 50 x 25 mg Agomelatine MYL0042 Ciclosporin Mylan 25 50 mg 84 cps mol 50 x 25 50 mg Anastrozol Mylan 1 MYL0819 Dona 1500 mg por plv sol 30 sačků MYL0820 Dona 1500 mg por plv sol 90 sačků MYL0526 Dona 400 mg inj sol 6 x 2 mla + 6 x 1 mlb MYL0680 Hulio 40 mg Betaserc 16 60 inj sol 40 mg 2x0,8ml pfs MYL0681 Hulio 40 mg inj sol 40 mg 2x0,8ml pfp MYL0072 Ibandronát Mylan 150 mg tbl flm 3 x 16 150 mg Betaserc 24 50 x 24 MYL0196 Leflugen 20 mg Betaserc 8 100 x 8 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 tbl flm 30 x 20 mg Buprenorfin MYL0086 Levofloxacin Mylan 52,5 mikrogramů/h 5 500 mg tbl flm 10 x 30 500 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 MYL0943 Lyrica cps dur 112 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Granisetron Mylan 1 mg 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 (2x56) MYL0950 Lyrica cps dur 112 x 75 mg Pregabalin Mylan 75 (2x56) MYL0945 Lyrica cps dur 56 x 150 mg MYL0947 Lyrica cps dur 56 x 225 mg MYL0948 Lyrica cps dur 56 x 300 mg MYL0949 Lyrica cps dur 56 x 50 mg MYL0952 Lyrica cps dur 56 x 75 mg Pregabalin MYL0091 Meloxicam Mylan 150 15 mg 56 tbl nob 100 x 150 15 mg Reparil - Dragées 20 MYL0955 Neurontin cps dur 100 x 300 mg MYL0956 Neurontin cps dur 50 x 300 mg MYL0957 Neurontin cps dur 50 x 400 mg MYL0958 Neurontin tbl flm 50 x 600 mg MYL0959 Neurontin tbl flm 50 x 800 mg MYL0960 Relpax 40 mg tbl flm 2 x 20 40 mg Reparil - Dragées 20 MYL0961 Relpax 80 mg tbl flm 2 x 80 mg MYL0965 Sortis tbl flm 100 x 10 mg MYL0967 Sortis tbl flm 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg MYL0969 Sortis tbl flm 100 x 150 40 mg Rytmonorm 300 MYL0966 Sortis tbl flm 30 x 10 mg 50 MYL0968 Sortis tbl flm 30 x 300 20 mg Rytmonorm 300 MYL0970 Sortis tbl flm 30 x 40 mg 100 MYL0971 Sortis tbl flm 30 x 300 80 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat MYL0147 Sumatriptan Mylan 100 mg 60 tbl flm 2 x 100 mg Topiramat Mylan 25 mg 60 x 25 mg Topiramat MYL0148 Sumatriptan Mylan 50 mg 60 tbl flm 6 x 50 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg MYL0159 Venlafaxin Mylan 150 mg cps pro 30 x 150 mg MYL0307 Venlafaxin Mylan 150 mg cps pro 90 x 150 mg MYL0160 Venlafaxin Mylan 75 mg cps pro 30 x 75 mg MYL0306 Venlafaxin Mylan 75 mg cps pro 90 x 75 mg Zoledronic acid Mylan 4 mg/5 ml MYL0980 Xalacom oph gtt sol 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 2.5 ml MYL0981 Xalacom oph gtt sol 3 x 2.5 ml MYL0982 Xalatan oph gtt sol 1 x 2.5 ml MYL0983 Xalatan oph gtt sol 3 x 2.5 ml MYL0996 Zoloft tbl flm 100 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg MYL0995 Zoloft tbl flm 28 x 25 100 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů MYL0997 Zoloft tbl flm 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 50 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon MYL0161 Zolpidem Mylan 10 mg 60 tbl flm 20 x 10 mg Oxykodon MYL0187 Zolpidem Mylan 20 10 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg tbl flm 50 x 250 10 mg Betaserc 8 MYL0892 Zolpidem Mylan 10 mg tbl flm 100 x 8 10 mg Betaserc 16 60 MYL0998 Zorem tbl nob 100 x 16 10 mg Betaserc 24 50 MYL1000 Zorem tbl nob 100 x 24 5 mg Cynt 0,2 MYL0999 Zorem tbl nob 30 x 0,2 10 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 MYL1001 Zorem tbl nob 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 5 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2

Xxxx. Xxxxx Xxxxxx, Jednatel jednatel / Executive Director Příloha č. 1 – seznam Výrobků Annex 1 – –Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg MIC kód*/ MIC Code Název přípravku/ Name of the Product Forma přípravku/ Form of the Product Balení přípravku/ Package of the Product MYL0659 Agomelatine Mylan 25 mg tbl flm 28 x 25 mg Agomelatine MYL0514 Aldara 5% krém crm 12 x 250 mg MYL0661 Alendronic Acid/Vitamin D3 Mylan 25 70 mg/2800 IU tbl nob 12 x 70 mg/2800 IU MYL0662 Alendronic Acid/Vitamin D3 Mylan 70 mg/5600 IU tbl nob 12 x 70 mg/5600 IU MYL0004 Alfuzosin Mylan 10 mg 84 tbl pro 90 x 25 10 mg Anastrozol MYL0014 Amlodipin Mylan 1 10 mg tbl nob 100 x 10 mg MYL0016 Amlodipin Mylan 5 mg tbl nob 100 x 5 mg MYL0023 Atorvastatin Mylan 10 mg tbl flm 100 x 10 mg MYL0026 Atorvastatin Mylan 20 mg tbl flm 100 x 20 mg MYL0025 Atorvastatin Mylan 20 mg tbl flm 30 x 1 20 mg MYL0021 Atorvastatin Mylan 40 mg tbl flm 100 x 40 mg MYL0022 Atorvastatin Mylan 40 mg tbl flm 30 x 40 mg MYL0517 Aurorix 150 mg tbl flm 30 x 150 mg MYL0369 Betaserc 16 tbl nob 60 x 16 mg MYL0823 Betaserc 24 tbl nob 100 x 24 mg MYL0370 Betaserc 24 tbl nob 50 x 24 mg MYL0371 Betaserc 8 tbl nob 100 x 8 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin MYL0598 Betaxolol Mylan 35 mikrogramů/h 5 20 mg tbl flm 98 x 20 mg Buprenorfin MYL0033 Bisoprolol Mylan 52,5 mikrogramů/h 10 mg tbl flm 100 x 10 mg MYL0035 Bisoprolol Mylan 2,5 mg tbl flm 30 x 2,5 mg MYL0036 Bisoprolol Mylan 5 mg tbl flm 100 x 5 mg MYL0923 Caduet tbl flm 30 x 10 mg/10 mg MYL0925 Caduet tbl flm 30 x 5 mg/10 mg MYL0924 Caduet tbl flm 90 x 10 mg/10 mg MYL0926 Caduet tbl flm 90 x 5 mg/10 mg MYL0523 Calcium/ Vitamin D3 Mylan 500 mg /800 IU tbl mnd 30 MYL0821 Calcium/ Vitamin D3 Mylan 500 mg /800 IU tbl mnd 90 MYL0043 Clopidogrel Mylan 75 mg tbl flm 30 x 75 mg MYL0044 Clopidogrel Mylan 75 mg tbl flm 90 x 75 mg MYL0527 Dymistin 137 mikrogramů/50 mikrogramů nas spr sus 1 x 23 g MYL0057 Finasterid Mylan 5 mg tbl flm 100 x 5 mg MYL0062 Gliclazid Mylan 30 mg tbl ret 120 x 30 mg Buprenorfin MYL0064 Glimepirid Mylan 70 mikrogramů/h 5 x 40 2 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Cynt 0,2 tbl nob 30 x 2 mg MYL0067 Glimepirid Mylan 3 mg tbl nob 90 x 3 mg MYL0068 Glimepirid Mylan 4 mg tbl nob 30 x 4 mg MYL0464 Cholib 145 mg/20 mg tbl flm 30 MYL0465 Cholib 145 mg/40 mg tbl flm 30 MYL0511 Leponex 25 mg tbl nob 50 x 25 mg MIC kód*/ MIC Code Název přípravku/ Name of the Product Forma přípravku/ Form of the Product Balení přípravku/ Package of the Product MYL0203 Memantin Mylan 10 mg tbl flm 56 x 10 mg MYL0112 Moxonidin Mylan 0,2 mg Cynt 0,2 tbl flm 98 x 0,2 mg Cynt 0,3 30 x MYL0114 Moxonidin Mylan 0,3 mg Cynt 0,3 tbl flm 98 x 0,3 mg Cynt MYL0115 Moxonidin Mylan 0,4 30 mg tbl flm 28 x 0,4 mg Cynt MYL0116 Moxonidin Mylan 0,4 mg tbl flm 98 x 0,4 mg Dona 1500 mg 20 sačků Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Granisetron Mylan 1 mg 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Levelanz 1000 mg 56 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg MYL0495 Oxykodon Mylan 10 mg tbl pro 60 x 10 mg Oxykodon MYL0684 Oxykodon/Naloxon Mylan 20 tbl pro 60 x 10 mg / 5 mg MYL0682 Oxykodon/Naloxon Mylan tbl pro 60 x 20 mg Oxykodon / 10 mg MYL0683 Oxykodon/Naloxon Mylan 40 mg tbl pro 60 x 40 mg Oxykodon / 20 mg MYL0177 Pioglitazon Mylan 80 30 mg 60 tbl nob 28 x 80 30 mg MYL0205 Pioglitazon Mylan 15 mg tbl nob 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg MYL0616 Reparil - Dragées 20 mg tbl ent 100 x 20 mg MYL0543 Reparil Dragées 20 mg tbl ent 40 x 20 mg Reparil - Dragées MYL0139 Rosuvastatin Mylan 10 mg tbl flm 90 x 10 mg MYL0141 Rosuvastatin Mylan 20 mg tbl flm 90 x 20 mg MYL0429 Rytmonorm 150 mg tbl flm 100 x 150 mg MYL0428 Rytmonorm 150 mg tbl flm 50 x 150 mg MYL0431 Rytmonorm 300 mg tbl flm 100 x 300 mg MYL0965 Sortis tbl flm 100 x 10 mg MYL0967 Sortis tbl flm 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg MYL0969 Sortis tbl flm 100 x 150 40 mg Rytmonorm 300 MYL0968 Sortis tbl flm 30 x 20 mg 50 MYL0720 Taris 0,5 mg/0,4 mg cps dur 90 x 300 0,5 mg/0,4 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 100 mg 60 x 100 mg Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg MYL0553 Uralyt U 280 g gra 1 x 280 g MYL0364 Uroxal 5 mg tbl nob 60 x 5 mg MYL0225 Valaciclovir Mylan 500 mg tbl flm 42 x 500 mg MYL0159 Venlafaxin Mylan 150 mg cps pro 30 x 150 mg MYL0307 Venlafaxin Mylan 150 mg cps pro 90 x 150 mg MYL0160 Venlafaxin Mylan 75 mg cps pro 30 x 75 mg MYL0306 Venlafaxin Mylan 75 mg cps pro 90 x 75 mg Zoledronic acid MYL0475 Vorikonazol Mylan 4 mg/5 200 mg tbl flm 14 x 200 mg MYL0981 Xalacom oph gtt sol 3 x 2.5 ml MYL0982 Xalatan oph gtt sol 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 2.5 ml MYL0983 Xalatan oph gtt sol 3 x 2.5 ml MYL0996 Zoloft tbl flm 100 x 50 mg MYL0995 Zoloft tbl flm 28 x 100 mg MYL0997 Zoloft tbl flm 28 x 50 mg * MIC kód je interní identifikační kód, unikátní pro každou variantu přípravku Dodavatele. MIC kód je nezávislý na SÚKL kódu/ The MIC code is an internal identification code, unique for each variant of the Supplier's product. The MIC code is independent of the SIDC code. Příloha č. 2 - – Vzor a výpočet bonusu Annex 2 –– Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2Calculation

Xxxx. Xxxxx Xxxxxx, Jednatel Zmocněnec na základě plné moci / Executive Director Authorised under a power of attorney Příloha č. 1 – seznam Výrobků Seznam výrobků Annex 1 – Product List Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Agomelatine Amlodipin Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Betaserc 8 100 x 8 10 mg Breakyl 200 mikrogramů 28 Amlodipin Mylan 100 x 200 mcg I Breakyl 400 mikrogramů 28 5 mg Amoxicillin/Clavulanic Mylan 14x875 mg /125mg Amoxicillin/Clavulanic Mylan 21x500 mg /125mg Armolipid Plus Atorvastatin Mylan 100 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin 10 mg Atorvastatin Mylan 35 mikrogramů/h 5 100 x 20 mg Buprenorfin Atorvastatin Mylan 52,5 mikrogramů100 x 40 mg Atorvastatin Mylan 10mg por.tbl.flm. 30x10mg Atorvastatin Mylan 20mg por.tbl.flm. 30x20mg Azitromycin Mylan 3 x 500 mg Betaserc 100x8mg Betaserc 50x24mg Betaserc 60x16mg Bisoprolol Mylan 100 x 10 mg Bisoprolol Mylan 100 x 5 mg Bisoprolol Mylan 30 x 10 mg Bisoprolol Mylan 30 x 2.5mg Bisoprolol Mylan 30 x 5 mg Cynt 98 x 0,4 Dorzogen Combi 20 mg/h ml + 5 mg/ml - 3 x 5 ml Doxazosin Mylan 98 x 4 mg Duspatalin Retard 30 x 200mg Finasterid Mylan 100 x 5 mg Gliclazid Mylan 120 x 30 mg Buprenorfin Glimepirid Mylan 70 mikrogramů/h 5 3 mg - 90 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 3 mg Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg - 90 x 4 mg Xxxxxx 0,5 mg Irbesartan Hydrochlorothiazid Mylan 28 x 0,5 150 mg Granisetron / 12.5mg Irbesartan Hydrochlorothiazid Mylan 1 28 x 300 mg 10 x 1 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 / 12.5mg Isoptin 80 mg 50 x 80 50x40mg Isoptin SR 240 mg 30 x 240 100x240 mg Isoptin SR 240 mg 100 x 240 30x240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 14x500mg Klacid 250 14 x 250 SR 7x500mg Klacid 250 mg/5 ml 1 SR 14x 500 mg Kreon 25000/50 Lansoprazol Mylan 30 mg - 56 x 60 ml Klacid 250 mg/5 ml 1 30 mg Lipanthyl 100x215mg Lipanthyl 30x145mg Lipanthyl 30x267mg Lipanthyl 90x145mg Lipanthyl 90x267mg Lipanthyl SUPRA 30x160mg Lipanthyl SUPRA 90x160mg Meloxicam Mylan 15 mg - 20 x 100 ml Klacid 500 14 15 Metformin Mylan 120 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Levelanz 1000 mg 56 Metformin Mylan 60 x 1000 mg Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Montelukast Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Oxykodon Mylan 10 mg 60 100 x 10 mg Oxykodon Montelukast Mylan 20 100 x 5 mg 60 Montelukast Mylan 30 x 20 10 mg Oxykodon Montelukast Mylan 40 30 x 4 mg 60 Montelukast Mylan 30 x 40 5 mg Oxykodon Moxonidin Mylan 80 mg 60 x 80 mg Pioglitazon Mylan 15 0.2 mg 28 x 15 200 ug Moxonidin Mylan 0.2 mg 98 x 200 ug Moxonidin Mylan 0.3 mg 28 x 300 ug Moxonidin Mylan 0.3 mg 98 x 300 ug Moxonidin Mylan 0.4 mg 28 x 400 ug Moxonidin Mylan 0.4 mg 98 x 400 ug Olicard 50x40mg Pantomyl 40mg 100 x 40mg Perindopril Mylan 30 x 4 mg Perindopril Mylan 30 x 8 mg Perindopril Mylan 90 x 4 mg Perindopril Mylan 90 x 8 mg Perindopril/Indapamid Mylan 30 x 4 mg / 1.25 mg Pioglitazon Mylan 30 mg - 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg - 40 x 20 mg Reparil - Dragées Rosuvastatin Mylan 30 x 10 mg Rosuvastatin Mylan 30 x 20 mg Rosuvastatin Mylan 90 x 10 mg Rosuvastatin Mylan 90 x 20 mg Rytmonorm 100x150mg Rytmonorm 100x300mg Rytmonorm 50x150mg Rytmonorm 50x300mg Sildenafil Mylan 100 mg - 4 x 100 mg Sildenafil Mylan 100 mg - 8 x 100 mg Sildenafil Mylan 50 mg - 4 x 50 mg Simvastatin Mylan 20 mg - 100 x 20 mg Rytmonorm 150 Simvastatin Mylan 40 mg 50 x 150 mg Rytmonorm 150 mg - 100 x 150 40 mg Rytmonorm 300 Sumatriptan Mylan 100 mg - 2 x 100 mg Sumatriptan Mylan 50 mg - 6 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 50 mg Tamsulosin HCI Mylan 0,4 mg - 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 100 mg 60 x 100 mg Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Zonisamide Mylan 50 mg 56 x 50 mg Příloha č. 2 - Vzor a výpočet bonusu Annex 2 –Bonus Pattern and Calculation Referenční období / reference period: XXXXXXXXXXXXXX Skupina výrobků č.1 /Group of Products No. 1 Název přípravku Balení přípravku Agomelatine Mylan 25 mg 28 x 25 mg Agomelatine Mylan 25 mg 84 x 25 mg Anastrozol Mylan 1 mg 30 x 1 mg Breakyl 200 mikrogramů 28 x 200 mcg I Breakyl 400 mikrogramů 28 x 400 mcg I Breakyl 800 mikrogramů 28 x 800 mcg I Buprenorfin Mylan 35 mikrogramů/h 5 x 20 mg Buprenorfin Mylan 52,5 mikrogramů/h 5 x 30 mg Buprenorfin Mylan 70 mikrogramů/h 5 x 40 mg Capecitabine Mylan 150 mg 60 x 150 mg Capecitabine Mylan 500 mg 120 x 500 mg Exemestan Mylan 25 mg 30 x 25 mg Fentanyl Mylan 12 mikrogramů/ hodinu 5 x 2,1 mg Fentanyl Mylan 25 mikrogramů/ hodinu 5 x 4,2 mg Fentanyl Mylan 50 mikrogramů/ hodinu 5 x 8,4 mg Fentanyl Mylan 75 mikrogramů/ hodinu 5 x 12,6 mg Fentanyl Mylan 100 mikrogramů/ hodinu 5 x 16,8 mg Granisetron Mylan 1 mg 10 x 1 mg Letmylan 2,5 mg 30 x 2,5 mg Letmylan 2,5 mg 100 x 2,5 mg Oxykodon Mylan 10 mg 60 x 10 mg Oxykodon Zolpidem Mylan 20 mg 60 x 20 mg Oxykodon Mylan 40 mg 60 x 40 mg Oxykodon Mylan 80 mg 60 x 80 mg Zoledronic acid Mylan 4 mg/5 ml 1 x 4mg/5ml Bonusové pásmo pro skupinu č.1 XXXXXXXXXXXXXX Skupina výrobků č.2 /Group of Products Xx. 0 Xxxxx xxxxxxxxx Xxxxxx xxxxxxxxx Xxxxxxx 00 10mg/g + 0,25 mg/g Gel 1 x 30 gm Afonilum SR 250 mg 50 x 250 mg Betaserc 8 100 x 8 mg Betaserc 16 60 x 16 mg Betaserc 24 50 x 24 mg Cynt 0,2 30 x 0,2 mg Cynt 0,2 98 x 0,2 mg Cynt 0,3 30 x 0,3 mg Cynt 0,3 98 x 0,3 mg Cynt 0,4 30 x 0,4 mg Cynt 0,4 98 x 0,4 mg Dona 1500 mg 20 sačků Glimepirid Mylan 2 mg 30 x 2 mg Glimepirid Mylan 2 mg 90 x 2 mg Glimepirid Mylan 3 mg 30 x 3 mg Glimepirid Mylan 3 mg 90 x 3 mg Glimepirid Mylan 4 mg 30 x 4 mg Glimepirid Mylan 4 mg 90 x 4 mg Xxxxxx 0,5 mg 28 x 0,5 mg Cholib 145 mg/20 mg 30 Cholib 145 mg/40 mg 30 Isoptin 40 mg 50 x 40 mg Isoptin 80 mg 50 x 80 mg Isoptin SR 240 mg 30 x 240 mg Isoptin SR 240 mg 100 x 240 mg Klacid 125 mg/5 ml 1 x 100 ml Klacid 250 mg/5 ml 1 x 60 ml Klacid 250 mg/5 ml 1 x 100 ml Klacid 250 10 x 250 mg Klacid 250 14 x 250 mg Klacid 500 14 x 500 mg Klacid SR 7 x 500 mg Klacid SR 14 x 500 mg-d Kreon 25 000 50 Levelanz 250 mg 56 x 250 mg Levelanz 500 mg 56 x 500 mg Levelanz 500 mg 98 x 500 mg Levelanz 1000 mg 56 x 1000 mg Levodopa/Carbidopa/Entacapone Mylan 100x50/12,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x100/25/200mg Levodopa/Carbidopa/Entacapone Mylan 100x150/37,5/200mg Levodopa/Carbidopa/Entacapone Mylan 100x200/50/200mg Linezolid Mylan 2 mg/ml 10 x 1 x 300 ml Lipanthyl 267 M 30 x 267 mg Lipanthyl 267 M 90 x 267 mg Xxxxxxxxx Xx 000 mg 30 x 145 mg Xxxxxxxxx Xx 000 mg 90 x 145 mg Lipanthyl S 215 mg 30 x 215 mg Lipanthyl S 215 mg 100 x 215 mg Lipanthyl Supra 160 mg 30 x 160 mg Lipanthyl Supra 160 mg 90 x 160 mg Metformin Mylan 500 mg 60 x 500 mg Metformin Mylan 500 mg 120 x 500 mg Metformin Mylan 500 mg 180 x 500 mg Metformin Mylan 850 mg 60 x 850 mg Metformin Mylan 850 mg 120 x 850 mg Metformin Mylan 850 mg 180 x 850 mg Metformin Mylan 1000 mg 60 x 1 000 mg Metformin Mylan 1000 mg 120 x 1 000 mg Metformin Mylan 1000 mg 180 x 1 000 mg Mirtazapin Mylan 30 mg 30 x 30 mg Mirtazapin Mylan 45 mg 30 x 45 mg Pioglitazon Mylan 15 mg 28 x 15 mg Pioglitazon Mylan 30 mg 28 x 30 mg Pregabalin Mylan 75 mg 14 x 75 mg Pregabalin Mylan 75 mg 56 x 75 mg Pregabalin Mylan 150 mg 56 x 150 mg Reparil - Dragées 20 mg 40 x 20 mg Reparil - Dragées 20 mg 100 x 20 mg Rytmonorm 150 mg 50 x 150 mg Rytmonorm 150 mg 100 x 150 mg Rytmonorm 300 mg 50 x 300 mg Rytmonorm 300 mg 100 x 300 mg Sevelamer Carbonate Mylan 800 mg 180 x 800 mg Tamsulosin HCI Mylan 0,4 mg 100 x 0,4 mg Tarka 180/2 mg tbl. 28 Tarka 180/2 mg tbl. 98 Tarka 240/4 mg tbl. 28 Tarka 240/4 mg tbl. 98 Topiramat Mylan 25 mg 60 x 25 mg Topiramat Mylan 50 mg 60 x 50 mg Topiramat Mylan 100 mg 60 x 100 mg Uralyt U 280 g 1 x 280 g Valaciclovir Mylan 500 mg 42 x 500 mg Venlafaxin Mylan 75 mg 30 x 75 mg Venlafaxin Mylan 75 mg 90 x 75 mg Venlafaxin Mylan 150 mg 30 x 150 mg Venlafaxin Mylan 150 mg 90 x 150 mg Zonisamide Mylan 50 mg 56 x 50 mg Bonusové pásmo pro skupinu č.2