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JKN 2

No Nama Obat / Spesifikasi Merk/Type Kemasan HNA+PPn

1 Ambroxol Tablet Ambroxol Tablet Ktk 100 tablet 15,000


2 Ambroxol Sirup Ambroxol Sirup Botol 60 ml 4,000
3 Gliseril Gualaikolat Tablet 100 mg Gliseril Gualaikolat Tablet 100 Pot 100 tablet 12,834

4 Piroksikam 10 mg Piroksikam 10 mg Ktk 100 tablet 13,105


5 Gentamisin SK Gentalex Tube 5 gr 3,575
6 Kloramfenikol TT 3% Reco tts telinga Botol 5 ml 7,700
7 Tiamfenicol Kapsul Tiamfenicol Kapsul Ktk 100 kaps 121,000
8 Obat Batuk Hitam (OBH) OBH Jeruk Nipis Botol 100 ml 8,000

9 Obat Batuk Kombinasi Anak Sirup, Solafluz Botol 60 ml 13,860


Tiap 5 ml mengandung :
Paracetamol 120 mg, Glyseril
guaiakolate 25 mg, CTM 1 mg,
Phenylephrine HCl 5 mg
10 Obat Batuk Kombinasi Dewasa, Lodecon Ktk 100 tablet 95,480
mengandung : Paracetamol 250 mg,
Dextromethorphan HBr 15 mg,
Phenylephrine HCL 2 mg, Glyseril
Guaiakolate 50 mg, Chlorpheniramie
Maleate 1 mg
11 Ambroxol Drop Mucos Drop Botol 20 ml 36,850
12 Pseudoefedrin Drop Devosix Drop Botol 15 ml 25,080
13 Vitamin Neurotropik, mengandung : Corsaneuron Ktk 100 tablet 75,900
Vit B1 100 mg, B6 200 mg, B12 200
mcg
14 Vitamin Neurotropik, mengandung : Etaneural Ktk 100 tablet 61,666
Metampiron 500 mg, Vitamin B1 50
mg, Vitamin B6 100 mg, Vitamin
B12 100 mcg
15 Tiamfenicol Sirup 125mg/ml Thiamfilex syr Botol 60 ml 7,150
16 Obat Penceranaan Pada Bayi/Anak, L-Bio Ktk 30 Sachet 198,000
mengandung :Rice starch,
maltodextrin, Lactobacillus
acidophilus, Lactobacillus casei,
Bifidobacterium infantis,
Lactobacillus salivarius,
Bifidobacterium lactis,
Bifidobacterium longum,
Lactobacillus lactis
17 pseudoefedrin HCl 60 mg, tripolidine Noza tab Ktk 100 tablet 79,750
2,5 mg tablet
18 pseudoefedrin HCl 30 mg, tripolidine zentra syr Botol 60 ml 18,700
1,25 mg sirup
19 pseudoefedrin HCl 15 mg, tripolidine Lapifed ekspectorant Botol 60 ml 23,650
1,25 mg, Gliseril Guaiakolat 100 mg
sirup
20 pseudoefedrin HCl 15 mg, tripolidine Zentra DM Botol 60 ml 19,800
1,25 mg, Desktrometorfan HBr 10
mg sirup
21 Deksametason 0,5 mg , Dextaco Tab Ktk 100 tablet 39,500
Deksklorfeniramine Maleat 2 mg
tablet
22 Deksametason 0,5 mg , Dextaco Syr Botol 60 ml 12,000
Deksklorfeniramine Maleat 2 mg
sirup
23 Salbutamol sulphate 1.2 mg, Lasal Expectorant Botol 100 ml 38,500
guaifenesin 50 mg (sirup)
24 Bromheksin 4 mg sirup Lexavon syr Botol 60 ml 6,050
25 Salep kombinasi Kortikosteroid Bufacort - N Tube 5 gr 7,700
26 Triamcinolone Salep Oral Bufacom IOB Tube 5 gr 19,975
27 Multivitamin Tablet, mengandung Fe Solvitral Ktk 100 tablet 91,300
fumarate 45 mg, Ca pantothenate
20 mg, vit A 5,000 IU, vit B1 3 mg,
vit B2 10 mg, vit B6 5 mg, vit B12 5
mcg, vit C 75 mg, vit D 400 IU,
manganese sulfate 1 mg, cupric
sulfate 1 mg, nicotinamide 100 mg,
Zn sulfate 1.5 mg, Ca 100 mg,
iodine 0.15 mg, Mg 6 mg

28 Multivitamin Sirup, mengandung Vit Solvita Plus Botol 60 ml 11,440


A 2,500 IU, vit B1 1,25 mg, vit B2
1,5 mg, vit B6 1,25 mg, vit B12 1
mcg, vit D 200 IU, nicotinamide 10
mg, dexpanthenol 2,5 mg, lysine
HCl 50 mg, Ca pantothenate 2,5
mg, Ca gluconate 150 mg
29 Multivitamin Drop, mengandung : caviplex drop Botol 15 ml 10,000
DHA 10 mg, L-lysine HCl 100 mg,
vit A 1,000 IU, vit D 200 IU, vit B1 3
mcg, vit B2 2 mg, vit B6 2 mg, vit
B12 2.5 mcg, nicotinamide 10 mg,
Ca pantothenate 3 mg
30 Kalium Dikofenak 50 mg Kaditic 50 Ktk 50 tablet 34,716
31 Meloksikam 15 mg Meloksikam 15 mg Ktk 50 tablet 59,890
32 Klindamisin Fosfat 1.2% Gel Mediklin gell Tube 10 gr 22,880
33 Fluocinolone acetonide 0,025% Synarcus Cr Tube 5 g 6,270
(0,25mg/gram)
34 Glukosamin 250mg, condroitin Osteotin Ktk 60 tablet 197,010
200mg,vit c 30mg, magnesium
2,5mg
35 Glyceryl guaiacolate 100 mg, Grantusif Ktk 100 tablet 53,150
dextromethorphan HBr 15 mg,
diphenhydramine HCl 5 mg
36 Asam salisilat 0.2 gr, Asam laktat Callusol Botol 10 ml 27,500
0,05 gr,Polidocanol 0,02 gr(callusol
(kutil/mata ikan))
37 Dexamethasone/Deksametason 0,1 Cendo xitrol Botol 5 ml 29,975
%, Neomisin sulfat 3,5 mg/mL,
Polimiksin B sulfat 6000 iu/mL.

38 Aluminium Hydroxide 300mg + Selesmag Ktk 100 tablet 35,904


Magnesium Hydroxide 300mg +
Simethicone 60mg
40 antihaemorhoid oral (Diosmin 450 Dios Ktk 30 tab 126,500
mg, Hesperidin 50 mg)
41 asam traneksamat 500 mg tablet Lexatrans 500 mg Ktk 50 tablet 69,300
42 Borax gliserin GOM Botol 10 ml 4,400
43 Bromhexine HCl Bronkris - Graha Ktk 100 tablet 14,967
44 Hyoscin-N-Butylbromide 10 mg Scopma Ktk 100 tablet 167,970
45 Per 5 mL Diphenhydramine HCl 5 Fortusin Botol 60 ml 12,540
mg, bromhexine HCl 4 mg,
phenylephrine HCl 5 mg, Na citrate
25 mg, ammon Cl 62.5 mg, succus
liquiritiae 180 mg
46 Per 5 mL Curcumin 95% 2 mg, vit Curviplex Botol 60 ml 12,500
B1 3 mg, vit B2 2 mg, vit B6 5 mg,
vit B12 5 mcg, vit A 1,500 IU, vit D3
400 IU, D-panthenol 3 mg, lysine
HCl 100 mg, niacinamide 10 mg,
folic acid 0.1 mg
47 Cavicur Ktk 100 tablet 62,618
Curcuma xanthorrhiza extract 20 mg
Dexpanthenol krim PASQUAM TUBE 26,846
50 Gentian violet Larutan 1 % - 10 ml Gentian violet Larutan 1 % - Botol 10 ml 4,400
10 ml
51 Glucosamine HCl 250 mg, Ostine Ktk 60 tablet 225,740
chondroitin sulphate 200 mg, vit C
25 mg, Mg 5 mg, Zn 2.5 mg,
manganese 0.25 mg
52 Tiap 5 ml suspensi mengandung : Kanina Botol 60 ml 5,800
Kaolin 986 mg, Pectin
40 mg
54 Clobetasol propionate 0.05% Clonaderm Tube 5 gr 13,306
55 Calamine 1%, Dexpanthenol 5%, CONFORTIN tube cream 26,400
Zinc Oxide 2%
56 Komb. : Na lauryl sulfoacetate 45 Microlax Botol 5 ml 24,750
mg, Na citrate 450 mg, sorbic acid 5
mg, sorbitol 4,465 mg, PEG-400 625
mg
57 Paracetamol 120 mg, Molexflu syr Botol 60 ml 6,710
Pseudoephedrine HCl 15 mg,
Chlorpheniramine Maleate 1 mg
58 Paracetamol 500 mg, Brocon Ktk 100 tablet 53,222
chlorpheniramine maleate 2 mg,
phenylephrine HCl 10 mg,
dextromethorphan HBr 10 mg,
59 Prometazine HCl 5 mg, Ipecac Guamin Syr Botol 60 ml 7,181
Extract 3 mg, Glyceril Guaiakolat 45
mg
60 multivitamin dan mineral tablet buat Hemafort Ktk 100 tablet 83,500
remaja, (minimal mengandung Fe
Fumarat 300 mg , Mg sulfat 400
mcg, faktor intrinsik 25 mg)

61 ros Selkom C Ktk 100 kaps 108,180


62 Multivitamin Sirup Pertumbuhan Per Truvit Botol 60 ml 12,540
5 mL syr Vit A 2,000 IU, vit B1 1
mg, vit B2 0.5 mg, vit B6 1 mg, vit
B12 1 mcg, vit C 10 mg, vit D 400
IU, Ca pantothenate 5 mg, Ca
gluconate 50 mg, DHA 8 mg, lysine
HCl 100 mg, colostrum bovine 250
mg
63 Salep luka bakar Bioplacenton tube 15 gr 19,958
64 Betametason + neomycin Nisagon Cream Tube 5 gr 9,293
65 Vitamin B1 (tiamina HCl) 100mg Bioneuron inj Ktk 5 amp 27,135
•Vitamin B6 100mg •Vitamin B12
1000mcg •Lidokaina HCl 10mg
66 nistatin drop/oral suspensi - 15 ml Cazetin drop Botol 15 ml 33,264
67 obat tradisional pemulihan hati Hepagard Ktk 30 tab 83,853
untuk penderita tbc
68 piracetam 400 mg tab piracetam 400 mg tab Ktk 100 tablet 54,120
Pyrathiazine theoclate 40 mg,
PROVOMER Ktk 100 tablet 242,000
pyridoxine HCl 37.5 mg
70 Na 15 meq, K 4 meq, glucose 4 g, Renalyte Botol 200 ml 16,400
Cl 13 meq, citrate 2 meq
72 Sulfasetamida Natrium tetes mata Albuvit Botol 5 ml 12,375
15% - 5 ml
73 Ekstrak Apii herba , extract Tensigard Ktk 30 tab 63,800
orthosiphon folium
75 Isosorbide mononitrat Cardismo Ktk 100 tablet 271,343
Methisoprinol 500 mg Methisoprinol 500 mg Ktk 100 tablet 165,000
77 Ibuprofen 200 + paracetamol 350 + Farsifen plus Ktk 100 tablet 47,080
caffein 50 mg
78 Heparin gel Thromboflas gel tube 10 gr 30,800
79 Tablet Diazepam 2mg, metamizol Metaneuron Ktk 300 tab 342,599
500mg
80 Suplemen untuk kelelahan otot Bio - ATP Ktk 100 tablet 235,600
mengandung ATP 150mg, vit B1
disulfida 100mg, Vit B6 HCl 200mg,
Vit B12 200mcg, Vit E 30 mg

81 Suplemen untuk Geriatri Geriavita Botol 30 kaplet 65,227


mengandung Beta Karoten 6mg,
Vit.C 500mg, Vit.E 30mg, Asam
Folat 0,4mg, Vit.B1 15mg, Vit.B2
15mg, Nikotinamida 100mg, Vit.B6
20mg, Vit.B12 10mcg, Biotin
45mcg, Kalsium 20mg, Iron 20mg,
Selenium 25mcg, Zinc 20mg
82 Suplemen obat untuk mual dan Vomil Ktk 50 kaps 220,000
muntah, minimal mengandung :eks.
ginger rhizoma 400mg, Vit B6
40mg, Asam Folat 400 mcg
83 Suplemen obat untuk meningkatkan Lactasin Botol 50 kaps 143,000
ASI, minimal mengandung :eks.
Sauropus androgynus 200mg, Vit B1
10mg, Vit B6 15mg, Vit B12 20mcg

84 Cendo Lyteers Cendo lyteers Botol 5 ml 24,750


85 Colcicine Kaps 0,5 mg Recolfar Ktk 30 tab 141,900
86 paraetamol 650mg Fasidol Forte Ktk 100 tablet 35,860
87 H2O2 3% H2O2 3% botol 5,060
88 Erytromisin cap 500 mg Erytromisin cap 500 mg Ktk 100 tablet 151,250
89 ceftriaxon inj ceftriaxon inj Ktk 10 vial 385,000
90 Sumatriptan Triptagic Ktk 10 tab 639,936
91 Atorvastin 10 mg Atovar 10 ktk 30 tab 330,000
92 Betahistin tab Betahistin tab ktk 30 tab 19,800
93 Multivitamin Ibu Hamil mengandung Obhdamin Ktk 50 tablet 220,000
Calcium Lactate 100 mg, DHA 50
mg, Omega3 10 mg, Lecithin 150
mg, Vit A 500 IU, Thiamine HCl 5
mg, Riboflavin HCl 2 mg, Pyridoxine
HCl 10 mg, Cyancobalamine 5 mcg,
Ascorbic Acid 15 mg, Vit D3 400 IU,
Nicotinamide 10 mg, Calcium
Pantothenate 5 mg, Folic Acid 0.4
mg, Fe Fumarat 90 mg, Cupric
Sulphate 0.1 mg, Potasium Iodine
0.1 mg

94 Antidiabetes Herbal Mengandung Vegamon Ktk 30 tablet 148,500


Cinnamon ext 250 mg, Gymnema
sylvestre ext 200 mg, Banaba
(Lagerstroemia speciosa) 50 mg,
Bilberry ext 50 mg
95 Balsem Dekongestan mengandung Bital Pot 40 g 33,000
Camphora 5%, Menthol 2%, Oleum
Anisi 1%, Eucalyptus Oil 2%

96 Cefixim Kapsul 200 mg Cefixim Kapsul 200 mg box 30 tablet 148,500


97 Methylprednisolone 8mg Methylprednisolone 8mg box 100 tablet 70,200
98 Mecobalamin 500 mg Oxicobal box 100 tablet 88,000
99 Erdostein syr Vectrine Syr botol 39,600
100 Elkana Syr Elkana Syr botol 21,835
101 Oxycan Oxycan botol 500 ml 60,000
102 Kloramphenicol tetes mata Reco tts mata btl 10 ml 7,700
103 Klindamycin 300 mg milorin Ktk 50 tablet 118,800
104 Aletrol TM Aletrol TM btl 5 ml 13,055
106 Supplemen Mata mengandung Occugard ktk 3x10 141,838
Lutein 6mg dan Ekstraks Buah
Bilberrry 80mg
107 Sopros Sopros ktk 3x10 231,000
Combivent nebu box 20 vial 362,220
109 Oksitosin inj Oksitosin inj ktk 100 amp 375,000
TAMBAHAN
1 acyclovir tab 200 acyclovir tab 200 ktk 100 38,817
4 alupurinol alupurinol ktk 100 27,500
6 Bisakodil Laxacod tab Ktk 100 tab 59,500
7 Bisoprolol 5 mg Bisoprolol 5 mg Ktk 30 tab 115,500
8 Carbo glicerin tetes telinga btl 5 ml 6,267
9 cefixim syr btl 30 ml 19,800
10 demacolin Tablet : Parasetamol 500 Molexflu tab ( Parasetamol Ktk 150 59,510
mg Pseudoefedrin HCI 7,5 mg 500 mg Phenylpropalamin 12,5
Klorfeniramin maleat 2 mg Kofein mg Klorfeniramin maleat 2 mg
10 mg

11 dexigen sk dexigen sk tube 5 gr 14,045


15 fuconazol cream/clotrimazol cream Dermifar cr 5 gr tube 5 gr 6,230

16 Gemfibrozil Lapibroz 300 ktk 100 132,000


17 Mebhydrolin Katergi ktk 100 69,880
18 kanamisin inj KANAMYCIN INJ.1 GR @ 1 VIALBOX/10 VIAL 122,815
19 ketoprofen Ketoprofen 100 mg tab ktk 100 132,000
20 kompolax syr kompolax syr btl 60 ml 11,827
21 lacto b lacto b Ktk 40 sachet 229,900
22 lespain gel lespain gel tube 15 gr 10,780
23 Lodecon Forte Lodecon Forte Ktk 100 96,800
24 Minosep obat kumur Minosep obat kumur btl 150 ml 38,500
30 peditox peditox btl 50 ml 20,000
31 rhinos SR Capsul RHINOS SR @50 ktk 50 261,250
32 Tramadol HCl 37.5 mg + Trampara Ktk 30 159,500
Paracetampl 325 mg
33 spray pembersil saluran nasal, Marimer Hypertonic Botol 100mL 104,500
dekongestan mengandung 100%
Larutan air laut steril dan hipertonis

34 Suplemen Nutrisi otak mengandung Tebokan Spc Ktk 30 351,450


Ekstraks Ginkgo Biloba (EGb761)
80mg
35 Ventolin Nebu Ventolin Nebu 217,510
TOTAL BELANJA

Keterangan : Harga Sudah dalam Kemasan Box

: Isi Yang diblock Kuning


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