e Catalog Obat BPJS

Harga Satuan Terkecil
No Nama Obat Generik Nama Dagang Nama Penyedia Kemasan (Rp)

1. ACT (Artesunate tablet 50 mg + Amodiaquine n/a PT. Kimia Farma 1 blister@24 tablet 1,375.00
anhydrida tablet 200 mg)
2. Adefovir Dipivoksil tablet/kaplet 10 mg Hepsera PT. SmithKline Beecham Phamaceuticals Dus, 3 Blister @ 10 kapsul 27,500.00
3. Air untuk Injeksi 25 ml Otsu SWI 25 ml PT Otsuka Indonesia Dus, 120 ampul PE @ 25ML 2,200.00
4. Air untuk irigasi lar infus 1000 ml WIDA WI UNICAP PT. Widatra Bhakti Btl @ 1000 ml 7,500.00
5. Akarbose tablet/kaplet 100 mg n/a PT. Dexa Medica Dus, 10 strip @10tablet 990.00
6. Akarbose tablet/kaplet 50 mg n/a PT. Dexa Medica Dus, 10 strip @10tablet 780.00
7. Albendazol suspensi 200 mg/5 ml n/a PT. Indofarma Dus, 10 dus @ 1 botol @ 10 ml 3,849.00
8. Albendazol tablet/kapsul/kaplet 400 mg n/a PT. Holi Pharma Dus, 5 strip @ 6 tablet 344.00
9. Albumin serum normal (human albumin) injeksi Zenalb PT. Ikapharmindo Vial 100 ml 750,000.00
20%, 100 ml
10. Albumin serum normal (human albumin) injeksi Zenalb PT. Ikapharmindo Vial 50 ml 345,000.00
20%, 50 ml
11. Albumin serum normal (human albumin) injeksi PLASBUMIN 25% 100 ML PT. Dipa Pharmalab botol @ 100 ml 1,525,456.00
25%, 100 ml
12. Albumin serum normal (human albumin) injeksi PLASBUMIN 25% 20 ML PT. Dipa Pharmalab botol @ 20 ml 321,552.00
25%, 20 ml
25%, 50 ml
5% 250 ml
5% 50 ml
16. Alopurinol tablet/kapsul/kaplet 100 mg n/a PT. Pertiwi Agung Box, 10 strips @ 10 tablets 86.00
17. Alopurinol tablet/kapsul/kaplet 300 mg n/a PT. Bernofarm Dus, 10 blister @ 10 tablet 199.50
18. Alprazolam tablet/kapsul/kaplet 0,25 mg n/a PT. Dexa Medica Dus, 10 Strip @ 10 tablet 380.00
19. Alprazolam tablet/kapsul/kaplet 0,5 mg n/a PT. Kimia Farma Ktk 10x10 tablet 214.00
20. Alprazolam tablet/kapsul/kaplet 1 mg n/a PT. Kimia Farma Ktk 10x10 tablet 233.00
21. Alteplase injeksi 50 mg/vial Actilyse PT. Boehringer Ingelheim Dus, 1 vial@50mg + 1 vial pelarut @ 3,800,000.00
50ml
22. Amfoterisin B salep mata 1% Fungicide PT. Cendo Industri Farmasi tube 3.5 gr 18,500.00
23. Amikasin injeksi 250 mg/ml Glybotic 250 mg /ml PT. Sanbe Farma Vial 2 ml 50,500.00
24. Aminofilin injeksi 24 mg/ml n/a PT. Lucas Djaja dus 30 ampul @10 ml 3,823.00
25. Aminofilin tablet scored 200 mg n/a PT. Marin Liza Farmasi Botol @ 100 tablet salut selaput 90.00
26. Aminofilin tablet/kapsul/kaplet 150 mg n/a PT. Erela Btl @ 100 tablet 80.00
27. Amiodaron injeksi 150 mg/3 ml Cordarone PT. Aventis Pharma Dus, 6 ampul @ 3 ml 12,480.00
28. Amiodaron tablet/kaplet 200 mg Kendaron Tablet PT. Darya Varia strip 1,200.00
29. Amitriptilin tablet salut 25 mg (HCl) n/a PT. Indofarma Dus, 10 strip @ 10 tss 112.00
30. Amlodipin tablet 10 mg n/a PT. Pertiwi Agung Box, 3 strips @ 10 tablets 330.00
31. Amlodipin tablet 5 mg n/a PT. Pertiwi Agung Box, 3 strips @ 10 tablets 187.00
32. Amoksisilin kapsul/kaplet 250 mg n/a PT. Novapharin dus 10 X 10'S 211.00
33. Amoksisilin kapsul/kaplet/tablet scored 500 mg n/a PT. Bernofarm Dus, 10 strip @ 10 kaptab 272.00
34. Amoksisilin sirup kering forte 250 mg/5 ml n/a PT. Holi Pharma Dus, Botol 60 ml 4,070.00
35. Amoksisilin sirup kering 125 mg/ 5 ml n/a PT. Novapharin btl @ 60 ml 2,445.00
36. Ampisilin serbuk injeksi i.v. 1000 mg/vial n/a PT. Bernofarm Dus, 10 vial @ 1 g 5,100.00
37. Analog insulin long acting inj 100 UI/ml, Lantus Solostar 100IU/ml PT. Aventis Pharma dus, 5 solostar pen @ 3ml 85,000.00
vial/cartridge disposible/penfill cartridge (Insulin 5pens x3ml
glargine 100 IU/ml)
38. Analog insulin mix acting inj 100 UI/ml, Analog Novomix Flexpen PT. Ferron Par Pharmaceuticals Injeksi 100 IU/ml, Flexpen disposible 106,000.00
insulin mix acting inj 100 UI/ml (Premix 30% Insulin 3 ml (1 box isi 5 flexpen disposible)
Aspart + 70% Protaminated Insulin Aspart
(Analogue))
39. Analog Insulin Mix Insulin Inj 100 UI/ml Humalog Mix 25 Kwikpen PT. Bayer Indonesia Dus, 5 Prefilled pen @ 3 ml 102,990.00
40. Analog insulin mix insulininj 100 UI/ml, Humalog Mix 25 PT. Bayer Indonesia Penfill cartridge 97,500.00
vial/cartridge disposible/penfill cartridge (25%
insulin lispro, 75% insulin lispro protamine
suspension, (rDNA))
41. Analog Insulin Rapid Acting Inj 100 UI/ml Humalog Kwikpen PT. Bayer Indonesia Dus, 5 Prefilled pen @ 3 ml 82,495.00
42. Analog insulin rapid acting inj 100 UI/ml, Novorapid Vial PT. Ferron Par Pharmaceuticals Dus, vial 10 ml 200,000.00
vial/cartridge disposible/penfill cartridge (Insulin
Aspart (Analogue))
43. Analog insulin rapid acting inj 100 UI/ml, Novorapid Flexpen PT. Ferron Par Pharmaceuticals Injeksi 100 IU/ml, Flexpen disposible 85,345.00
vial/cartridge disposible/penfill cartridge (Insulin 3 ml (1 box isi 5 flexpen disposible)
Aspart (Analogue))
44. Analog insulin rapid actinginj 100 UI/ml, Apidra Solostar 100IU/ml PT. Aventis Pharma dus, 5 solostar pen @ 3ml 79,165.00
vial/cartridge disposible/penfill cartridge (Insulin 5pens x3ml
glulisine 100 IU/ml)
45. Analog insulin rapid actinginj 100 UI/ml, Humalog PT. Bayer Indonesia Penfill cartridge 79,167.00
vial/cartridge disposible/penfill cartridge (Insulin
lispro (rDNA origin))
46. Anastrozol tablet/kapsul/kaplet 1 mg Arimidex 1 mg PT. AstraZeneca indonesia Dus, 2 blister @ 14 Tablet 32,000.00
47. Antasida DOEN I tablet kunyah, kombinasi : n/a PT. Promedrahardjo Farmasi Industri Dus, 10 Strip@10 Tablet 75.00
Aluminium Hidroksida 200 mg Magnesium
Hidroksida 200 mg
48. Antasida DOEN II suspensi, kombinasi : Aluminium n/a PT. Erela Botol @ 60 ml 2,160.00
Hidroksida 200 mg/5 ml Magnesium Hidroksida
200 mg/5 ml
49. Anti Bakteri DOEN salep kombinasi: Basitrasin 500 n/a PT. Indofarma Dus, 25 tube @ 5 g 2,516.00
IU/g Polimiksin 10.000 IU/g
50. Antihemoroid, kombinasi: bismut subgalat 150 mg n/a PT. Kimia Farma DUS, 10 SUPP @ 2 GRAM 3,045.00
heksaklorofen 2,5 mg lidokain 10 mg seng oksida
120 mg
51. Antimalaria DOEN kombinasi : Pirimetamin 25 mg n/a PT. Kimia Farma ktk 10 x 10 tablet 520.00
Sulfadoksin 500 mg
52. Antimigren: Ergotamin Tartrat 1 mg + Kofein 50 mg n/a PT. Kimia Farma Btl 100 tablet 135.00
53. Antiparkinson DOEN tablet kombinasi : Benserazid Levopar Tablet PT. Meprofarm Dus, 5 strip @ 10 tablet 1,500.00
25 mg Levodopa 100 mg
54. Artemether injeksi 80 mg/ml Artem PT. Kimia Farma Dus 6 amp @ 1ml 22,000.00
55. Artesunate injeksi i.v./i.m. 60 mg/ml Artesunate PT. Pharma Laboratories Dus, 1 Vial @ 60 mg + 1 Ampul 38,999.00
Pelarut @ 1 mL
56. Asam Asetilsalisilat (asetosal) tablet 100 mg n/a PT. Phapros, Tbk Dus @ 10 X 10 's 116.00
57. Asam Asetilsalisilat (asetosal) tablet/kaplet/kapsul Miniaspi 80 PT. Mersifarma Tirmaku Mercusana KOTAK @ 10 x 10 TAB 148.00
80 mg
58. Asam Askorbat (Vitamin C) tablet 250 mg n/a PT. Kimia Farma ktk 10x10 tablet 159.00
59. Asam Askorbat (Vitamin C) tablet 50 mg n/a PT. Kimia Farma Dus 10 strip x 10 tab 95.00
60. Asam Folat tablet/kapsul/kaplet 0,4 mg Starfolat PT. Dexa Medica Dus, 10 strip @10 tablet 84.00
61. Asam Folat tablet/kapsul/kaplet 1 mg n/a PT. Marin Liza Farmasi Botol @ 100 tablet 48.00
62. Asam Ibandronat injeksi 6mg/6ml Bondronat PT. Boehringer Ingelheim Boks, 1 ampul 2,209,000.00
63. Asam Mefenamat kapsul/kaplet 250 mg n/a PT. Afifarma dus, 10 blister @ 10 kapsul 158.00
64. Asam Mefenamat kapsul/kaplet 500 mg n/a PT. Bernofarm Dus, 10 blister @ 10 kaptab ss 112.00
65. Asam pipemidat kapsul 400 mg Urotractin 400 mg PT. Sanbe Farma Strip 1,815.00
66. Asam traneksamat injeksi 50 mg/ml n/a PT. Bernofarm Dus, 10 ampul @ 5 ml 2,950.00
67. Asam zoledronat injeksi 4mg/5mL ZOMETA PT. Novartis Indonesia Dus, 1 vial plastik @ 5ml 900,000.00
68. Asiklovir salep mata 3% Temiral Eye Oint PT. Sanbe Farma Tube 3,5 gram 24,750.00
69. Asiklovir tablet/kapsul/kaplet 200 mg n/a PT. Indofarma Dus, 10 blister @ 10 tablet 237.00
70. Asiklovir tablet/kapsul/kaplet 400 mg n/a PT. Sampharindo Perdana Dus, 5 strip @ 10 tablet 336.00
71. Asparaginase serbuk injeksi 10.000 UI/vial Leunase PT. Widatra Bhakti 10.000 UI/Vial 1,039,500.00
72. Atapulgit tablet 600 mg Pularex PT. Zenith Pharmaceuticals Dus 5 strip @ 10 tablet 190.00
73. Atenolol tablet/kapsul/kaplet 100 mg Betablok PT Kalbe Farma strip 700.00
74. Atenolol tablet/kapsul/kaplet 50 mg Farnormin PT. Pratapa Nirmala Box @ 10 strip 10 tab 352.00
75. Atrakurium injeksi 25 mg/2,5 ml Tracrium PT. Glaxo Wellcome Indonesia Dus, 5 ampul @ 2.5 ml 20,000.00
76. Atropin injeksi i.v./i.m./s.k. 0,25 mg/ml n/a PT. Ethica Industri Farmasi 100 AMPUL @ 1 ML 1,350.00
77. Atropin Sulfat tablet 0,5 mg n/a PT. Indofarma Dus, 10 strip @ 10 tablet 74.00
78. Atropin Sulfat tetes mata 0,5% Cendo Tropin 0,5% PT. Cendo Industri Farmasi Botol 5ml 13,500.00
79. Atropin Sulfat tetes mata 1% Cendo Tropin 1% PT. Cendo Industri Farmasi Botol 5ml 13,500.00
80. Azitromisin sir kering 200 mg/ 5 mL n/a PT. Soho Industri Pharmasi botol @ 60 ml 34,400.00
81. Azitromisin tablet 500 mg n/a PT. Kimia Farma ktk 2x10 tablet 4,500.00
82. Azitromisin tablet 250 mg n/a PT. Soho Industri Pharmasi Strip 3,333.00
83. Bedak salisil serbuk 2% n/a PT. Rama Emerald Multi Sukses Dus @ 50 gram 1,250.00
84. Benzatin Benzil Penisilin 1,2 juta IU/ vial n/a PT. Phapros, Tbk Ds 10 vial x 1,2 Jt IU 9,800.00
85. Benzatin Benzil Penisilin 2,4 juta IU/vial n/a PT. Phapros, Tbk 10 vial @ 2.400.000 IU 13,400.00
86. Beractant injeksi / suspensi 25 mg/mL Survanta PT. Abbott Indonesia Vial 3,200,000.00
87. Beraprost sodium tablet 20 mcg Dorner PT. Combiphar Box/ 3 blister @ 10 Tablet 3,600.00
88. Betametason krim 0,1% (sebagai Valerat) n/a PT. Kimia Farma Tube 5 gr 1,520.00
89. Betametason tetes mata 1 mg/ml Betam Ophtal ED PT. Sanbe Farma botol @ 5 ml 25,106.00
90. Bevasizumab injeksi 25 mg/ml (Skema Risk Sharing Avastin PT. Boehringer Ingelheim Dus, 1 vial @ 4 ml 4,803,697.00
sesuai Kepmenkes RI Nomor
HK.02.02/Menkes/223/2014)
91. Bikalutamid tablet salut 150 mg Casodex 150 mg PT. AstraZeneca indonesia Dus, 2 blister @ 14 Tablet 72,400.00
92. Bikalutamid tablet salut 50 mg Casodex 50 mg PT. AstraZeneca indonesia Dus, 2 blister @ 14 Tablet 45,000.00
93. Bisakodil suppositoria 10 mg Stolax supp PT. Sanbe Farma Supp 6,045.00
94. Bisakodil suppositoria 5 mg Dulcolax Supp Infant PT. Boehringer Ingelheim 1 Box @ 6's 4,990.00
95. Bisoprolol tablet 2,5 mg Concor 2.5 PT. Merck Tbk Dus 10 blister @ 10 tablet 746.00
96. Bisoprolol tablet 5 mg n/a PT. Pratapa Nirmala Box 3 X 10 tab 645.00
97. Bleomisin serbuk injeksi 15 mg/ampul BLEOCIN PT Kalbe Farma Vial 304,000.00
98. Bromokriptin tablet 2,5 mg Cripsa tab PT. Caprifarmindo Box 3 x 10'S 247,089.00
99. Budesonid inhaler 200 mcg/puff, 100 dosis Pulmicort Turbuhaler PT. AstraZeneca indonesia Dus, 1 Turbuhaler @ 100 dosis 93,000.00
100 Budesonid inhaler 200 mcg/puff, 200 dosis Obucort Swinghaler PT Otsuka Indonesia Unit, 200 dosis 106,000.00
.
101 Budesonid respules / cairan inhaler 0,25mg/mL Pulmicort Respules PT. AstraZeneca indonesia Dus, 4 pak @ 5 respules @ 2 ml 8,900.00
.
102 Budesonid-formoterol (fixed combination) inhaler Symbicort Turbuhaler 160/4.5 PT. AstraZeneca indonesia Dus, 1 Turbuhaler @ 120 dosis 117,600.00
. 160/4,5 mcg mcg
103 Budesonid-formoterol (fixed combination) inhaler Symbicort 80/4.5 mcg PT. AstraZeneca indonesia Dus, 1 Turbuhaler @ 60 dosis 110,500.00
. 80/4,5 mcg
104 Bupivakain injeksi 0,50% (HCl) + glukosa 8% n/a PT. Dexa Medica Dus, 5 ampul @ 4 ml 25,600.00
.
105 Bupivakain injeksi 0,50% (P.V) Bunascan PT. Pratapa Nirmala ampul 30,800.00
.
106 Dabigatran eteksilat kapsul 75 mg Pradaxa PT. Boehringer Ingelheim Dus, 3 blister @ 10 kapsul 12,936.00
.
107 Dabigatran eteksilat kapsul 110 mg Pradaxa PT. Boehringer Ingelheim Dus, 3 blister @ 10 kapsul 12,936.00
.
108 Dakarbazin serbuk injeksi 200 mg/vial DBL Dacarbazine PT. Tempo Scan Pacific vial @ 20 ml 305,000.00
.
109 Daunorubisin serbuk injeksi 20 mg/vial DAUNOCIN PT. Novell Pharmaeutical Laboratories vial 275,000.00
.
110 Deferasiroks tablet disp/ eff 250 mg Exjade 250 mg Tab PT. Novartis Indonesia Dus, 4 blister @ 7 tablet 76,000.00
.
111 Deferasiroks tablet disp/ eff 500 mg Exjade 500 mg Tab PT. Novartis Indonesia Dus, 4 blister @ 7 tablet 150,000.00
.
112 Deferipron larutan oral 100 mg/mL Ferriprox Oral Solution PT. Sydna Farma Dus, Botol @ 500ml 2,600,000.00
.
113 Deferipron tablet 500 mg Ferriprox tablet PT. Sydna Farma Dus, Botol @ 100 tablet 25,300.00
.
114 Deferoksamin Mesilat serbuk injeksi 500 mg Desferal PT. Novartis Indonesia Dus, 10 vial @ 500mg 112,000.00
.
115 Deksametason injeksi i.v./i.m. 5 mg/ml n/a PT. Indofarma Dus, 100 ampul @ 1 ml 1,580.00
.
116 Deksametason tablet 0,5 mg n/a PT. Bernofarm Dus, 10 blister @ 10 tablet 67.50
.
117 Desogestrel tablet 75 mcg Cerazette PT. Merck Sharp Dohme Pharma Tbk Dus, 1 Blister @ 28 tablet 70,000.00
.
118 Desoksimetason krim 0,25% DEXIGEN PT. Ifars Pharmaceutical Laboratories Dus, tube @ 5 g 5,700.00
.
119 Desoksimetason krim 0,25% n/a PT. Dexa Medica Kotak, tube @ 15 gram 9,983.00
.
120 Desoksimetason salep 0,25% Dexocort PT. Kimia Farma Dus Tube 10 gram 9,818.00
.
121 Diazepam larutan rektal 5 mg/2,5 mL STESOLID PT. Actavis Indonesia Dus, 5 alubag @ 1 tube @ 2,5ml 11,525.00
.
122 Diazepam injeksi i.v./i.m 5 mg/ml n/a PT. Indofarma Dus, 30 ampul @ 2 ml 4,180.00
.
123 Diazepam larutan rektal 10 mg/2,5 mL STESOLID PT. Actavis Indonesia Dus, 5 alubag @ 1 tube @ 2,5ml 16,748.00
.
124 Diazepam tablet/kapsul/kaplet 2 mg n/a PT. Kimia Farma Botol Plastik @ 100 tablet 45.00
.
125 Dietilkarbamazin tablet scored 100 mg n/a PT. Holi Pharma Dus, 10 blister @10 tablet 136.00
.
126 Difenhidramin injeksi i.v./i.m. 10 mg/ml (HCl) n/a PT. Phapros, Tbk Dus @ 30 Ampul 1,050.00
.
127 Digoksin injeksi 0,25 mg/ml Fargoxin inj PT. Pratapa Nirmala Box @ 5 ampul 2 mL 22,000.00
.
128 Digoksin tablet 0,25 mg n/a PT. Yarindo Farmatama Box 10 X 10 Tab 97.00
.
129 Diltiazem HCl tablet 30 mg n/a PT. Indofarma Dus, 10 strip @ 10 tablet 134.00
.
130 Diltiazem infus injeksi 50 mg Herbesser Powder Injection PT. Tanabe Indonesia 10 vial @ 50mg 127,667.00
. 50mg
131 Diltiazem injeksi 25 mg/5 mL Farmabes Injeksi 25 mg PT. Pratapa Nirmala Vial 5 mL 46,667.00
.
132 Diltiazem Kapsul SR 100 mg Herbesser CD 100 PT. Tanabe Indonesia 3 blister @ 10 kapsul 3,667.00
.
133 Diltiazem Kapsul SR 200 mg Herbesser CD 200 PT. Tanabe Indonesia 3 blister @ 10 kapsul 4,015.00
.
134 Dimenhidrinat tablet/kapsul/kaplet 50 mg n/a PT. Kimia Farma Botol Plastik @ 100 tablet 104.00
.
135 Dinatrium edetat tetes mata 0,35% E.D.T.A PT. Cendo Industri Farmasi botol 15 ml 37,500.00
.
136 Dinatrium klodronat infus kons 60 mg/mL Bonefos Infus 60 mg / 5 ml PT. Bayer Indonesia ampul 124,955.00
.
137 Dobutamin injeksi 50 mg/mL DOBURAN PT. Dipa Pharmalab ampul @ 5 ml 26,700.00
.
138 Doksazosin mesilat tablet 1 mg Cardura 1mg PT. Pfizer Indonesia Dus, 5 blister @10's tab 3,480.00
.
139 Doksazosin mesilat tablet 2 mg Cardura 2mg PT. Pfizer Indonesia Dus, 5 blister @10's tab 5,480.00
.
140 Doksisiklin tablet/kapsul/kaplet 100 mg n/a PT. Yarindo Farmatama Box @ 10 strip 10 kapsul 270.00
.
141 Doksorubisin serbuk injeksi i.v. 10 mg/vial Doxorubicin kalbe PT Kalbe Farma vial @ 5 ml 59,000.00
.
142 Doksorubisin serbuk injeksi i.v. 50 mg/vial Doxorubicin Actavis 50 mg PT. Actavis Indonesia Dus, 1 vial @ 50 mg 258,000.00
.
143 Domperidon suspensi/sirup 5 mg/5 ml n/a PT. Novapharin btl @ 60 ml 3,333.00
.
144 Domperidon tablet 10 mg n/a PT. Novapharin dus 10 X 10'S 167.00
.
145 Domperidon tetes 5 mg/mL n/a PT. Bernofarm Dus, botol @ 10 ml 15,600.00
.
146 Dopamin injeksi 40 mg/ml UDOPA PT. Dipa Pharmalab ampul @ 5 ml 9,840.00
.
147 Dosetaksel injeksi 20 mg/0,5 ml n/a PT. Sanbe Farma Dus, 1 vial @0,5 ml+ 1 vial pelarut 970,200.00
. @1,5 ml
148 DTPA (diethylene triamine pentaacetic acid) 2,06- Renalscan KaeF PT. Kimia Farma Dus @ 5 vial 455,000.00
. 2,5 mg pentetate calcium trisodium/mL
149 Dutasterid kaps lunak 0,5 mg Avodart PT. SmithKline Beecham Phamaceuticals Dus, Botol Plastik @ 30 Tablet 7,100.00
.
150 Efavirens tablet salut 600 mg n/a PT. Kimia Farma Botol 30 tab 6,375.00
.
151 Efedrin Inj 50 mg/ml n/a PT. Bernofarm Ampul @ 1 ml 12,990.00
.
152 Eksemestan tablet 25 mg Aromasin PT. Pfizer Indonesia Dus, 2 blister @ 15 tablet 42,600.00
.
153 Enoksaparin sodium inj 20 mg/0,2 mL Lovenox 2000 ANTI-XA PT. Aventis Pharma dus, 2 prefilled syringe @ 0,2 ml 40,740.00
.
.
.
156 Epinefrin (Adrenalin) injeksi i.v/s.k./i.m 1 mg/ml n/a PT. Phapros, Tbk Dus @ 30 Ampul 8,100.00
.
157 Epirubisin serb injeksi 50 mg/25ml (Produk Kosong Epirubisin Kalbe PT Kalbe Farma Vial @ 25 ml 500,000.00
. s/d awal Agustus 2015)
158 Epirubisin serb injeksi 10 mg/5 ml n/a PT. Sanbe Farma Dus, 1 vial @5 ml 128,000.00
.
159 Ergokalsiferol (vitamin D3/D2) kapsul 50.000 UI D-Vit FT PT. Gracia Pharmindo Dus 3 strip @ 10 Flash tablet 650.00
.
160 Ergokalsiferol (vitamin D3/D2) suspensi 10.000 D-Vit Syrup PT. Gracia Pharmindo Dus, Botol Plastik @ 100 mL 8,000.00
. UI/ml
161 Eritromisin kapsul/kaplet 250 mg n/a PT. Kimia Farma ktk 10 x 10 kapsul 497.00
.
162 Eritromisin kapsul/kaplet 500 mg n/a PT. Indofarma Dus, 10 blister @ 10 kss 930.00
.
163 Eritromisin sirup kering 200 mg/ 5 ml n/a PT. Phyto Kemo Agung Farma Botol @60 ml 7,700.00
.
164 Eritropoetin-alfa inj 10000 UI/mL Hemapo 10.000 IU PT Kalbe Farma vial/ampul (Prefilled Syringe) 275,000.00
.
165 Eritropoetin-alfa inj 2000 UI/mL Eprex 2000 PT. Soho Industri Pharmasi Dus, 6 prefilled syrenge @ 0.5 ml 133,875.00
.
166 Eritropoetin-alfa inj 3000 UI/mL Hemapo 3000 PT Kalbe Farma Prefilled Syringe @ 1ml 128,000.00
.
167 Eritropoetin-beta inj 2000 UI/0,3 mL Recormon PT. Boehringer Ingelheim Boks, 6 ampul 139,500.00
.
168 Estrogen terkonjugasi tablet salut 0,625 mg Esthero 0.625mg PT SUNTHI SEPURI dus, 1 blister @ 28 kaptab salut gula 82,000.00
.
169 Etambutol tablet 250 mg (HCl) n/a PT. Kimia Farma ktk 20 x 10 tablet 314.00
.
170 Etambutol tablet salut 500 mg (HCl) n/a PT. Indofarma Dus, 10 strip @ 10 tss 451.00
.
171 Etanol 70% cairan n/a PT. Novapharin btl @ 100 ml 2,500.00
.
172 Etinilestradiol tablet 0,05 mg Lynoral PT. Merck Sharp Dohme Pharma Tbk Dus, botol @ 100 tablet 1,360.00
.
173 Etonogestrel implan 68 mcg Implanon PT. Merck Sharp Dohme Pharma Tbk Dus, 1 blister @ 1 subdermal implant 128,779.00
.
174 Etoposid injeksi 20 mg/ml Posyd PT. Combiphar Vial 100mg/5ml 100,000.00
.
175 Eugenol cairan n/a PT. Kimia Farma Botol 10 ml 16,667.00
.
176 Everolimus tab 0,25 mg Certican 0,25 mg Tab PT. Novartis Indonesia Dus, 6 blister @ 10 tablet 11,813.00
.
177 Everolimus tab 0,5 mg Certican 0,5 mg Tab PT. Novartis Indonesia Dus, 6 blister @ 10 tablet 23,250.00
.
178 Faktor IX kompleks serbuk injeksi 1.000 UI/vial + Nonafact 1000 IU PT. Graha Farma Dus, 1 vial @ 1000 IU+ 1 vial pelarut 8,500,000.00
. pelarut 10 ml @ 10ml
179 Faktor IX kompleks serbuk injeksi 500 UI/vial + Nonafact 500 IU PT. Graha Farma Dus, 1 vial @ 500 IU+ 1 vial pelarut 4,423,500.00
. pelarut 5 ml @ 5ml
180 Faktor koagulasi II 14-35 UI, faktor koagulasi VII 7- Cofact 500 IU/20 ml PT. Graha Farma Dual, vial 500 IU 4,400,000.00
. 20 UI, faktor koagulasi IX 25 UI, faktor koagulasi X
14-35 UI
181 Faktor Koagulasi II 14-35 UI, Faktor Koagulasi VIII 7- Cofact 250 IU PT. Graha Farma Dus, vial @ 250 IU+ 1 vial pelarut 2,095,000.00
. 20 UI, Faktor Koagulasi IX 25 UI, Faktor Koagulasi X @10 mL+ transfer needle+swab
14-35 UI (250 IU/10ml)
182 Faktor VIIa (rekombinan) serb inj 1 mg/vial + Novoseven PT. Ferron Par Pharmaceuticals KOTAK @ 1 VIAL SERBUK OBAT & 9,200,000.00
. pelarut untuk injeksi INFUSION KIT
183 Faktor VIII (konsentrat) serb inj 230 -340 UI Haemoctin PT. Kimia Farma vial 1,133,000.00
.
184 Faktor VIII (konsentrat) serb inj 250 UI/vial + Haemoctin PT. Kimia Farma vial 990,000.00
. pelarut 5 mL
185 Faktor VIII (konsentrat) serb inj 480 - 600 UI KOATE DVI 500 IU PT. Dipa Pharmalab vial 2,150,000.00
.
186 Faktor VIII (konsentrat) serb inj 500 UI/vial + Aafact 500 IU PT. Graha Farma 500 IU 1,990,417.00
. pelarut 5 ml
187 Fenitoin injeksi 50 mg/ml n/a PT. Mersifarma Tirmaku Mercusana KOTAK @ 10 ampul 20,250.00
.
188 Fenitoin kapsul/kaplet 100 mg n/a PT. Ikapharmindo Botol @ 100 133.00
.
189 Fenitoin Na Inj 100 mg/2 ml n/a PT. Mersifarma Tirmaku Mercusana KOTAK @ 10 ampul 20,250.00
.
190 Fenobarbital injeksi i.m./i.v. 50 mg/ml n/a PT. Phapros, Tbk Dus @ 30 Ampul 1,800.00
.
191 Fenobarbital tablet/kapsul/kaplet 100 mg n/a PT. Indofarma Dus, 10 strip @ 10 tablet 220.00
.
192 Fenofibrat kaps 100 mg n/a PT. Hexpharm Jaya Laboratories Dus, 3 strip @ 10 kapsul 1,075.00
.
193 Fenofibrat kaps 300 mg n/a PT. Hexpharm Jaya Laboratories Dus, 3 strip @ 10 kapsul 1,375.00
.
194 Fenoksimetil penisilin (penisilin V) tablet 250 mg n/a PT. Phapros, Tbk Dus @ 10 X 10 's 290.00
.
195 Fenoksimetil penisilin (penisilin V) tab 125 mg Fenocin PT. Actavis Indonesia Dus 45 x 12 tab 235.00
.
196 Fenoksimetil penisilin (penisilin V)tablet 500 mg n/a PT. Phapros, Tbk Dus @ 10 X 10 's 510.00
.
197 Fenoterol HBr ih 100 mcg/puff Berotec MDI PT. Boehringer Ingelheim Box, canister 10mL 72,900.00
.
198 Fenoterol HBr inh solution 0,1% Berotec Solution PT. Boehringer Ingelheim Dus, Canister 200 dosis 117,500.00
.
199 Fentanil injeksi i.m/i.v 0,05 mg/ml, ampul 10 ml n/a PT. Kimia Farma Dus 5 ampul@ 10ml 128,000.00
.
200 Fentanil injeksi i.m/i.v 0,05 mg/ml, ampul 2 ml n/a PT. Kimia Farma Dus 5 ampul@ 2ml 33,914.00
.
201 Fentanil patch 12,5 mcg/jam Durogesic 12,5 MU Matrix PT. Kimia Farma Dus @ 5 patch 80,000.00
.
202 Fentanil patch 25 mcg/jam Durogesic 25 MU Matrix PT. Kimia Farma Dus@ 5 patch 153,000.00
.
203 Fentanil patch 50 mcg/jam Durogesic 50 MU Matrix PT. Kimia Farma Dus@ 5 patch 285,000.00
.
204 Filgrastim inj 300 mcg/mL Leucogen PT Kalbe Farma pfs @ 0,5 ml 375,000.00
.
205 Finasterid tab 5 mg Prostacom PT. Combiphar Box, isi 3 Strip @ 10 tab 2,950.00
.
206 Fitomenadion (Vit.K1) tablet salut gula 10 mg n/a PT. Phapros, Tbk Dus @ 10 X 10 's 630.00
.
207 Fitomenadion (Vitamin K1) injeksi i.m. 2 mg/ml n/a PT. Phapros, Tbk dus @ 30 ampul 3,417.00
.
208 Fludarabin inj 50 mg Fludara IV LYO PT. Aventis Pharma Dus, 5 vial @ 50 mg 1,248,319.00
.
209 Fludarabin tab 10 mg Fludara Oral PT. Aventis Pharma Dus, 4 blister @ 5 tablet salut 275,000.00
. selaput
210 Flufenazin injeksi i.m. 25 mg/ml Sikzonoate Injeksi PT. Mersifarma Tirmaku Mercusana Dus, 5 ampul @ 1ml 55,000.00
.
211 Flukonazol injeksi 2 mg/ml n/a PT. Natura Laboratoria Prima Dus, 1 Botol @ 100 mL 47,100.00
.
212 Flukonazol tablet/kaplet/kapsul 50 mg Diflucan 50mg PT. Pfizer Indonesia Blister 4,862.00
.
213 Flukonazol tablet/kapsul 150 mg n/a PT. Kimia Farma ktk 1 x 10 kapsul 22,000.00
.
214 Fluoksetin tablet 10 mg Foransi 10 PT. Gracia Pharmindo strip 419.00
.
215 Fluoksetin tablet 20 mg NOPRES PT. Dexa Medica DUS, 30 TABLET 410.00
.
216 Fluorometolon tetes mata 0,1 % Ocuflam ED PT. Sanbe Farma botol @ 5 ml 30,493.00
.
217 Fluorourasil inj 250 mg/mL Curacil PT Kalbe Farma vial @ 1 ml 24,500.00
.
218 Fluorourasil inj 500 mg/ 5 mL Curacil PT Kalbe Farma vial @ 10 ml 33,000.00
.
219 Flusinolon asetonid krim 0,025% SYNARCUS PT. Ifars Pharmaceutical Laboratories Dus, Tube 5 g 2,400.00
.
220 flusinolon asetonid salep 0,025% Dermasolon oint PT. Ikapharmindo Dus, tube @ 10 g 5,489.00
.
221 Flutikason furoat intranasal spray Avamys PT. Glaxo Wellcome Indonesia Dus, Botol 120 Dosis Spay 93,333.00
.
222 Flutikason propionat nebules 0,5 mg Flixotide Nbules PT. Glaxo Wellcome Indonesia Dus, 2 flow wrap@ 5 nebules @ 1 12,917.00
. dosis (2ml)
223 Fondaparinuks inj 2,5 mg/0,5 mL Arixtra PT. Glaxo Wellcome Indonesia Dus, 2 pfs 0.5 ml 241,667.00
.
224 Fraksi protein plasma lar inf 5% Plasmanate PT. Dipa Pharmalab dus, vial @ 250 ml 972,000.00
.
225 Furosemid injeksi i.v./i.m. 10 mg/ml n/a PT. Indofarma Dus, 25 ampul @ 2 ml 1,829.00
.
226 Furosemid tablet 40 mg n/a PT. Indofarma Dus, 10 strip @ 10 tablet 85.00
.
227 Gadobutrol macrocyclic 5 mg Gadovist 5 mg PT. Bayer Indonesia Prefilled Syringe 275,000.00
.
228 Gadobutrol macrocyclic 7,5 mg Gadovist 7,5 mg PT. Bayer Indonesia Prefilled Syringe 412,500.00
.
229 Gadoksetat disodium 0,25 mmol gadoxetate Primovist PT. Bayer Indonesia Prefilled Syringe 2,570,000.00
. disodium/mL
230 Gansiklovir serb inj 500 mg (50 mg/mL) Cymevene PT. Boehringer Ingelheim Boks, 1 ampul 399,500.00
.
231 Garam Oralit I serbuk, kombinasi : Natrium klorida n/a PT. Phapros, Tbk Dus @ 100 Sachet 288.00
. 0,52 g kalium klorida 0,30 g Trinatrium sitrat
dihidrat 0,58 g Glukosa Anhidrat 2,70 g
232 Gefitinib tab 250 mg Iressa 250 mg PT. AstraZeneca indonesia Dus, 1 blister @ 10 tablet 295,000.00
.
233 Gemfibrozil kapsul/kaplet 300 mg n/a PT. Indofarma Dus, 10 blister @ 12 kapsul 289.00
.
234 Gemfibrozil tablet 600 mg n/a PT. Indofarma Dus, 10 blister @ 10 kaptab 679.00
.
235 Gemsitabin inj 1000 mg/vial Gemzar 1000 mg PT. Bayer Indonesia vial 1,098,900.00
.
236 Gemsitabin inj 200 mg/vial n/a PT. Sanbe Farma Dus, 1 vial @200 mg 330,000.00
.
237 Gentamisin injeksi 40 mg/ ml n/a PT. Indofarma Dus, 5 ampul @ 2 ml 3,399.00
.
238 Gentamisin salep mata 0,3% Genoint Salep Mata PT. Erela Tube @ 3,5 gr 2,600.00
.
239 Gentamisin tetes mata 0,3% n/a PT. Indofarma Dus, botol plastik 5 ml 3,194.00
.
240 Glibenklamid tablet 5 mg n/a PT. Indofarma Dus, 10 blister @ 10 kaptab 56.00
.
241 Gliklazid tab 80 mg Glicab PT. Tempo Scan Pacific Strip 242.00
.
242 Gliklazid tab 30 mg Diamicron MR 30 PT. Pradja Pharin Dus, 6 strip @ 10 tablet lepas lambat 638.00
.
243 Gliklazid tablet lepas lambat 60 Mg Diamicron MR 60 PT. Darya Varia Box, 30 Tablet 5,500.00
.
244 Glikuidon tab 30 mg n/a PT. Dexa Medica Dus, 10 Strip @ 10 tablet 950.00
.
245 Glimepiride tablet 1 mg n/a PT. Kimia Farma ktk 5x10 tablet 265.00
.
.
.
.
249 Glipizid tablet/kaplet/kapsul 10 mg Glucotrol 10 mg PT. Pfizer Indonesia Dus, botol@TAB 10MG 30 3,207.00
.
250 Glipizid tablet/kaplet/kapsul 5 mg Glucotrol 5 mg PT. Pfizer Indonesia Dus, botol@TAB 10MG 31 3,000.00
.
251 Gliseril trinitrat inj 50 mg/10 mL DBL Gliceryl Trinitrate 50 PT. Tempo Scan Pacific 1 box isi 5 ampul 10 ml 119,900.00
. mg/10 ml inj.
252 Gliseril trinitrat kaps SR 2,5 mg Nitrokaf Retard PT. Kimia Farma Dus 10x10 1,493.00
.
253 Gliseril trinitrat kaps SR 5 mg Nitrokaf Forte PT. Kimia Farma Dus 10x10 2,171.00
.
254 Gliseril trinitrat tab sublingual 0,5 mg Nitral PT. Actavis Indonesia Btl @ 30 tablet 1,500.00
.
255 Gliserin lar 50% Gliserin lar 50% PT. Lucas Djaja Glycerin 100 ml 5,333.00
.
256 Glukosa larutan infus 10 % steril n/a PT. Widatra Bhakti botol @ 500 ml 5,700.00
.
257 Glukosa larutan infus 5 % steril n/a PT. Widatra Bhakti botol @ 500 ml 5,200.00
.
258 Goserelin asetat inj 10,8 mg/vial Zoladex 10,8 mg PT. AstraZeneca indonesia Dus, 1 syringe @ 10.8 mg 2,300,000.00
.
259 Goserelin asetat inj 3,6 mg Zoladex 3,6 mg PT. AstraZeneca indonesia Dus, 1 syringe @ 3.6 mg 840,000.00
.
260 Griseofulvin tablet 125 mg n/a PT. Indofarma Dus, 10 blister @ 10 tablet 219.00
.
261 Haloperidol inj 50 mg/mL Haldol Decanoas PT. Soho Industri Pharmasi Dus 5 Ampul@1mL 83,333.00
.
262 Haloperidol injeksi i.m 5 mg/ml Lodomer Injeksi PT. Mersifarma Tirmaku Mercusana KOTAK @ 12 ampul 6,250.00
.
263 Haloperidol tablet 0,5 mg n/a PT. Indofarma Dus, 10 blister @ 10 tablet 59.00
.
264 Haloperidol tablet 5 mg n/a PT. Indofarma Dus, 10 blister @ 10 tablet 96.00
.
265 Haloperidol tablet 1,5 mg n/a PT. Indofarma Dus, 10 blister @ 10 tablet 69.00
.
266 Haloperidol tablet 2 mg Lodomer 2 PT. Mersifarma Tirmaku Mercusana KOTAK @ 10 x 10 TAB 126.00
.
267 Haloperidol tts 2 mg/mL LODOMER DROPS PT. Mersifarma Tirmaku Mercusana BOTOL @ 15 ML 16,500.00
.
268 Halotan Inhalasi Halothane PT. Dexa Medica Botol 641,500.00
.
269 Heparin injeksi i.v./s.k. 5000 UI/ml Inviclot PT. Pratapa Nirmala vial 42,900.00
.
270 Hepatitis B imunoglobulin (human) Hyperhep B PT. Dipa Pharmalab Dus, 1 syringe @ 0.5 mL 1,328,000.00
.
271 hidroklorotiazid tab 25 mg n/a PT. Kimia Farma dus, 10 strip @ 10 tablet 149.00
.
272 Hidrokortison krim 1% n/a PT. Marin Liza Farmasi tube @ 5 ml 2,570.00
.
273 Hidrokortison krim 2,5 % n/a PT. Kimia Farma Tube 5 gr 2,798.00
.
274 Hidroksi Urea tablet/kaplet/kapsul 500 mg HYDROXYUREA MEDAC PT. Dipa Pharmalab vial 5,400.00
.
275 Hiosin butilbromid injeksi 20 mg/ml n/a PT. Otto Pharmaceuticals box 5ampul @1 ml 4,500.00
.
276 Homatropin tetes mata 2% Homatro 2% PT. Cendo Industri Farmasi Botol 5ml 18,000.00
.
277 Human Insulin Intermediate Acting Inj 100 UI/ml Humulin N Kwikpen PT. Bayer Indonesia Dus, 5 Prefilled pen @ 3 ml 76,125.00
.
278 Human insulin intermediate acting inj 100 UI/ml, Insulatard Vial PT. Ferron Par Pharmaceuticals Dus, vial 10 ml 138,000.00
. vial (Human Insulin (Intermediate-Acting))
279 Human insulin intermediate acting inj 100 UI/ml, Humulin N Vial PT. Bayer Indonesia Dus, vial 10 ml 138,000.00
. vial (Insulin human Basal)
280 Human insulin intermediate acting inj 100 Insulatard Penfill PT. Ferron Par Pharmaceuticals Injeksi 100 IU/ml, penfill disposible 3 76,125.00
. UI/ml,penfill cartridge (Human Insulin ml (1 box isi 5 penfill disposible)
(Intermediate-Acting))
281 Human insulin intermediate acting inj 100 Sansulin N PT. Sanbe Farma penfillcartridge @ 3ml 75,000.00
. UI/ml,penfill cartridge (Insulin human Basal)
282 Human insulin intermediate acting inj 100 Humulin N Cart PT. Bayer Indonesia Dus Isi 5 penfill/cartridge @ 3ml 76,125.00
. UI/ml,penfill cartridge (Insulin human Basal)
283 Human insulin intermediate acting inj 100iu/ml, Insuman Basal vial 5ml, PT. Aventis Pharma Dus, 1 Vial @ 5 ml 72,000.00
. vial (Insulin Human Basal) 100iu/ml
284 Human insulin mix inj 100iu/ml, vial (Insulin Insuman Comb 25 vial 5ml, PT. Aventis Pharma Dus, 1 Vial @ 5 ml 72,000.00
. Human Comb 25) 100iu/ml
285 Human Insulin Mix Insulin Inj 100 UI/ml Humulin 30/70 Kwikpen PT. Bayer Indonesia Dus, 5 Prefilled pen @ 3 ml 76,125.00
.
286 Human insulin mix insulin inj 100 UI/ml, penfill Mixtard Penfill PT. Ferron Par Pharmaceuticals Injeksi 100 IU/ml, penfill disposible 3 76,125.00
. cartridge (Human Insulin (Premix: 30% Soluble + ml (1 box isi 5 penfill disposible)
70 % NPH Insulin))
287 Human insulin mix insulin inj 100 UI/ml, penfill Humulin 30/70 Cart PT. Bayer Indonesia Dus Isi 5 penfill/cartridge @ 3ml 76,125.00
. cartridge (Insulin human Comb)
288 Human insulin mix insulin inj 100 UI/ml, vial Mixtard Vial PT. Ferron Par Pharmaceuticals Dus, vial 10 ml 138,000.00
. (Human Insulin (Premix: 30% Soluble + 70 % NPH
Insulin))
289 Human insulin mix insulin inj 100 UI/ml, vial Humulin 30/70 Vial PT. Bayer Indonesia Dus, vial 10 ml 138,000.00
. (Insulin human Comb)
290 Human Insulin Short Acting Inj 100 UI/ml Humulin R Kwikpen PT. Bayer Indonesia Dus, 5 Prefilled pen @ 3 ml 76,125.00
.
291 Human insulin short acting inj 100 UI/ml, penfill Actrapid Penfill PT. Ferron Par Pharmaceuticals Injeksi 100 IU/ml, penfill disposible 3 76,125.00
. cartridge (Human Insulin (Short Acting)) ml (1 box isi 5 penfill disposible)
292 Human insulin short acting inj 100 UI/ml, penfill Humulin R Cart PT. Bayer Indonesia Dus Isi 5 penfill/cartridge @ 3ml 76,125.00
. cartridge (Insulin human Rapd)
293 Human insulin short acting inj 100 UI/ml, penfill Sansulin R PT. Sanbe Farma penfill cartridge @ 3ml 75,000.00
. cartridge (Insulin human Rapd)
294 Human insulin short acting inj 100 UI/ml, vial Actrapid Vial PT. Ferron Par Pharmaceuticals Dus, vial 10 ml 138,000.00
. (Human Insulin (Short Acting))
295 Human insulin short acting inj 100 UI/ml, vial Humulin R Vial PT. Bayer Indonesia Dus, vial 10 ml 138,000.00
. (Insulin human Rapd)
296 Human insulin short acting inj 100iu/ml, vial Insuman Rapid vial 5ml, PT. Aventis Pharma Dus, 1 Vial @ 5 ml 72,000.00
. (Insulin Human Rapid) 100iu/ml
297 Human tetanus imunoglobulinn injeksi i.m. 250 UI Tetagam PT. Dexa Medica Prefilled syringe 170,000.00
.
298 Ibuprofen sirup 100 mg/5 ml n/a PT. Indofarma Dus, botol 60 ml 3,499.00
.
299 Ibuprofen suspensi 200 mg/5 ml n/a PT. Indofarma Dus, botol 60 ml 4,499.00
.
300 Ibuprofen tablet 200 mg n/a PT. Yarindo Farmatama botol @ 100 tablet 110.00
.
301 Ibuprofen tablet 400 mg n/a PT. Novapharin dus 10 X 10'S 150.00
.
302 Ifosfamid serbuk injeksi 1000 mg/vial Holoxan injeksi 1000 PT. Mugi Laboratories Dus, 1 vial @ 1 g 1,329,163.00
.
303 Imanitib Mesilat tablet salut selaput 100 mg Glivec PT. Novartis Indonesia Dus, 6 blister @ 10 tablet salut 211,000.00
. (Skema Risk Sharing sesuai Kepmenkes RI Nomor selaput
HK.02.02/Menkes/223/2014)
304 Imidapril tab 10 mg Tanapress 10mg PT. Tanabe Indonesia 3 blister @ 10 tablet 3,908.00
.
305 Imidapril tab 5 mg Tanapress 5mg PT. Tanabe Indonesia 3 blister @ 10 tablet 2,120.00
.
306 Iopamidol 200-300 mg Iodium/mL (300mg @ vial Iopamiro PT. Dipa Pharmalab Dus, botol @ 100 ml 350,000.00
. 100ml)
307 Iopamidol 200-300 mg Iodium/mL (300mg @ vial Iopamiro PT. Dipa Pharmalab Dus, vial @ 30 ml 122,000.00
. 30ml)
. 50ml)
309 Iopamidol 300-370 mg Iodium/mL (370mg @ vial Iopamiro PT. Dipa Pharmalab Dus, botol @ 100 ml 369,000.00
. 100ml)
. 30ml)
. 50ml)
312 Iopromide 300-370 mg Iodium/mL (300 mg / 100 Ultravist 300/100 mg PT. Bayer Indonesia Botol 245,000.00
. ml)
. ml)
. ml)
. ml)
316 Ipratropium bromida inhalasi 20 mcg/semprot Atrovent HFA PT. Boehringer Ingelheim Box, canister 10mL 80,000.00
.
317 Ipratropium bromida nebulizer 0,025% Atrovent solution for PT. Boehringer Ingelheim Box, bottle 20mL 90,000.00
. inhalation 0.025%
318 Irbesartan tab 150 mg n/a PT. Indofarma Dus, 5 blister @ 10 kss 1,425.00
.
319 Irbesartan tab 300 mg n/a PT. Indofarma Dus, 5 blister @ 10 kss 2,470.00
.
320 Irinotekan inf 20 mg/ml n/a PT. Sanbe Farma Dus, 1 vial @2 ml 510,000.00
.
321 Isofluran inhalasi Terrell PT. Pratapa Nirmala Botol 100 mL 270,000.00
.
322 Isoniazid tablet/kapsul/kaplet 100 mg n/a PT. Phyto Kemo Agung Farma Botol 100 tablet 65.00
.
323 Isoniazid tablet/kapsul/kaplet 300 mg n/a PT. Phyto Kemo Agung Farma Botol 100 tablet 158.00
.
324 Isosorbid Dinitrat injeksi i.v 10 mg/10 ml Farsorbid inj PT. Pratapa Nirmala vial 33,000.00
.
325 Isosorbid Dinitrat tablet sublingual 5 mg n/a PT. Indofarma Dus, 10 strip @ 10 tablet 88.00
.
326 Isosorbid dinitrat tablet/kaplet/kapsul 10 mg Isonat PT. Kimia Farma Dus, 5 strip @ 10 tablet 189.00
.
327 Kalium aspartat tab 300 mg Kalipar PT. Tempo Scan Pacific Strip 700.00
.
328 Kalium Klorida tablet 600 mg KSR PT. Merck Tbk Dus, 10 strip @ 10 tablet 1,580.00
.
329 Kalsium Folinat (Leukovorin Ca) inj 50 mg/ml DBL Leucovorin PT. Tempo Scan Pacific Vial 50 mg/5 ml 82,000.00
.
330 Kalsium Glukonat injeksi i.v 10% (100 mg/ml) Kalsium glukonat PT. Ethica Industri Farmasi Ampul 7,800.00
.
331 Kalsium Karbonat tablet/kapsul/kaplet 500 mg Calporosis D500 PT. Mersifarma Tirmaku Mercusana Dus, 3 blister @10 kaplet 405.00
.
332 Kalsium Laktat (Kalk) tablet/kapsul/kaplet 500 mg n/a PT. Afifarma Dus,10 Strip @ 10 tablet 70.00
.
333 Kalsium polistirena sulfonat ktg 5 g KALQUEST PT. Novell Pharmaeutical Laboratories kantong 5 g 7,700.00
.
334 Kanamisin inj 1000 mg/ vial n/a PT. Hexpharm Jaya Laboratories vial 5,000.00
.
335 Kandesartan tab 16 mg n/a PT. Dexa Medica Dus, 3 Blister @ 10 tablet 4,900.00
.
336 Kandesartan tab 8 mg n/a PT. Dexa Medica Dus, 3 Blister @ 10 tablet 3,100.00
.
337 Kapesitabin tab 500 mg Xeloda PT. Boehringer Ingelheim Boks, 120 tablet 27,500.00
.
338 Kaptopril tablet 50 mg n/a PT. Indofarma Dus, 10 strip @ 10 tablet 140.00
.
339 Kaptopril tablet scored 25 mg n/a PT. Errita Pharma Dus, 10 strip @10 tablet 84.00
.
340 Kaptopril tablet scored12,5 mg n/a PT. Indofarma Dus, 10 strip @ 10 tablet 62.00
.
341 Karbamazepin sirup 100 mg/5 ml Tegretol Syrup 100mg/5ml, PT. Novartis Indonesia Dus, botol @ 120 ml 44,770.00
. 120ml
342 Karbamazepin tablet 200 mg n/a PT. Indofarma Dus, 10 blister @ 10 tablet 245.00
.
343 Karbimazol tab 5 mg Neo-Mercazole PT. Nicholas Laboratories Indonesia Dus,botol 100 tablet 875.00
.
344 Karbogliserin tetes telinga 10% Karbogliserin tetes telinga PT. Lucas Djaja Fenol 100 mg / 1 ml 2,042.00
. 10%
345 Karboplatin 150 mg / 15 ml DBL Carboplatin 150 mg PT. Tempo Scan Pacific vial @ 15 ml 190,000.00
.
346 Karboplatin 450 mg / 45 ml DBL Carboplatin 450 mg PT. Tempo Scan Pacific vial @ 45 ml 408,000.00
.
347 Karvediol tablet/kaplet/kapsul 6,25 mg V - BLOC PT Kalbe Farma strip 1,360.00
.
348 Ketamin injeksi i.v. 100 mg/ml KTM PT. Guardian Pharmatama Vial @ 10 ml 110,000.00
.
349 Ketamin injeksi i.v. 50 mg/ml Ketamin Hameln PT. Combiphar Box, isi 1 vial @ 10 ml 60,300.00
.
350 Ketokonazol krim 2% n/a PT. Kimia Farma tube 10 gr 2,569.00
.
351 Ketokonazol krim 2% n/a PT. Hexpharm Jaya Laboratories tube 5 gr 2,850.00
.
352 Ketokonazol krim 2% n/a PT. Novell Pharmaeutical Laboratories Box isi 1 Tube @ 15 g 4,700.00
.
353 Ketokonazol scalp sol 2% Zoloral SS PT. Ikapharmindo Botol 80 ml 28,000.00
.
354 Ketokonazol tablet 200 mg n/a PT. Dexa Medica Dus, 5 Strip @ 10 tablet 300.00
.
355 Ketoprofen supositoria 100 mg Protofen Supp PT. Kimia Farma dus 2 's @ 10 supp 2,722.00
.
356 Ketorolac injeksi 30 mg/ml n/a PT. Phapros, Tbk Dus @ 12 Ampul 2,300.00
.
357 Klaritromisin tab 500 mg ORIXAL PT. Ifars Pharmaceutical Laboratories Dus, 3 Strip @ 10 Kaplet salut 3,200.00
. selaput
358 Klindamisin kapsul/kaplet 150 mg n/a PT. Indofarma Dus, 5 blister @ 10 kapsul 361.00
.
359 Klindamisin kapsul/kaplet 300 mg n/a PT. Indofarma Dus, 5 blister @ 10 kapsul 553.00
.
360 Klobazam tab 10 mg n/a PT. Dexa Medica Dus, 10 Strip @ 10 tablet 900.00
.
361 Klomifen sitrat tablet/kapsul/kaplet t 50 mg Clomifil 50mg PT SUNTHI SEPURI dus, 2 strip @ 10 tablet 1,625.00
.
362 Klonidin injeksi i.v 0,15 mg/ml (HCL) (150) Catapres Injeksi PT. Boehringer Ingelheim Box, 10 ampoules @ 1mL 30,600.00
.
363 Klonidin tablet 0,15 mg n/a PT. Kimia Farma Ktk 10X10 TAB 184.00
.
364 Klopidogrel tab 75 mg n/a PT. Hexpharm Jaya Laboratories Dus, 3 strip @ 10 tab 3,400.00
.
365 Kloramfenikol salep kulit 2% Bufacetin PT. Bufa Aneka Box isi 24 tube @ 15 gram 3,524.00
.
366 Kloramfenikol salep mata 1 % n/a PT. Kimia Farma Tube 5 gr 1,600.00
.
367 Kloramfenikol serb inj 1000 mg/mL Colsancetine Injeksi PT. Sanbe Farma vial 7,260.00
.
368 Kloramfenikol suspensi 125 mg/ 5 ml n/a PT. Bernofarm Botol @ 60 ml 3,680.00
.
369 Kloramfenikol tablet/kapsul/kaplet 500 mg Chloramex PT. Actavis Indonesia Dus, 10 Strip @ 10 Kapsul 850.00
.
370 Klorfeniramina Maleat (CTM) tablet/kapsul/kaplet n/a PT. Rama Emerald Multi Sukses kotak,10strip@10 tablet 51.00
. 4 mg
371 Klorpromazin injeksi i.m. 25 mg/ml (HCl) n/a PT. Phapros, Tbk Dus @ 30 Ampul 1,100.00
.
372 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) n/a PT. Phapros, Tbk Dus @ 30 Ampul 1,050.00
.
373 Klorpromazin tablet salut 100 mg (HCl) n/a PT. Mersifarma Tirmaku Mercusana Kotak @ 10 x 10 tab 144.00
.
374 Klorpromazin tablet salut 25 mg (HCl) n/a PT. Phapros, Tbk 10 X 10 68.00
.
375 Klozapin 100 mg n/a PT. Mersifarma Tirmaku Mercusana KOTAK @ 5 x 10 TAB 5,000.00
.
376 Klozapin 25 mg n/a PT. Mersifarma Tirmaku Mercusana KOTAK @ 5 x 10 TAB 1,550.00
.
377 Kodein tablet 10 mg n/a PT. Kimia Farma ktk 10x10 tablet 500.00
.
378 Kodein tablet 15 mg n/a PT. Kimia Farma ktk 10x10 tablet 850.00
.
379 Kodein tablet 20 mg n/a PT. Kimia Farma ktk 10x10 tablet 1,100.00
.
380 Kolekalsiferol (vitamin D3) kapsul lunak 0,25 mcg Ostriol PT. Pratapa Nirmala Btl @ 30 kapsul 2,500.00
.
381 Kolkisin tablet/kaplet/kapsul 500 mcg Recolfar PT. Pratapa Nirmala Box @ 3 strip 10 tab 3,950.00
.
382 Koloid HES BM 130 000 lar inf 6% Voluven PT. Fresenius Kabi Combiphar Botol Plastik @ 500 ml 33,000.00
.
383 Kombinasi : Ipratropium bromida inhalasi 0,5 mg Combivent UDV PT. Boehringer Ingelheim 1 dus @ 20 vial 5,990.00
. Salbutamol 2,5 mg
384 Kombinasi injeksi depot : Medroksi progesteron n/a PT. Triyasa Nagamas Farma Vial 5,350.00
. asetat 25 mg Estradiol sipionat 5 mg
385 Kombinasi suspensi : Parafin + gliserin + Laxadine Emulsi 60 ml PT. Galenium Pharmasia Laboratories Botol @ 60 ml 12,450.00
. fenolftalein
386 Kombinasi tablet salut : Besi (II) sulfat 7H2O 200 n/a PT. Kimia Farma 1 sase @30 tablet 50.00
. mg Asam folat 0,25 mg
387 Kombinasi tetes mata 2,5 mg/mL: Natrium klorida Cendo Lyteers PT. Cendo Industri Farmasi botol 15 ml 15,750.00
. 8,664 mg; Kalium klorida 1,32 mg
388 Kombinasi: Artemether 20 mg; Lumefantrin 120 Coartem PT. Novartis Indonesia Dus, 4 blister @ 6 tablet 3,220.00
. mg
389 Kombinasi: Levodopa 100 mg; Karbidopa 25 mg; Stalevo PT. Novartis Indonesia Dus, botol plastik @ 30 tablet salut 8,900.00
. Entekapon 200 mg selaput
390 Kombinasi: Lopinavir 200 mg; Ritonavir (LPV/r) 50 Aluvia PT. Abbott Indonesia botol @ 120 tablet 6,100.00
. mg
391 Kombinasi: Salmeterol 25 mcg; Flutikason Seretide Inhaler 50 mcg PT. Glaxo Wellcome Indonesia Dus, Botol 120 Dosis 90,667.00
. propionat 50 mcg
392 Kombinasi: Salmeterol 50 mcg; Flutikason Seretide Diskus 100 mcg PT. Glaxo Wellcome Indonesia Dus, foil strip @ 60 dosis 100,833.00
. propionat 100 mcg
393 Kombinasi: Salmeterol 50 mcg; Flutikason Seretide Diskus 250 mcg PT. Glaxo Wellcome Indonesia Dus, foil strip @ 60 dosis 113,333.00
. propionat 250 mcg
394 Kontrasepsi pil oral, kombinasi :* Levonorgestrel n/a PT. Kimia Farma Dus, 100 blister @ 28 tablet 2,089.00
. 150 mcg Etinilestradiol 30 mcg
395 Kotrimoksazol DOEN I (dewasa) kombinasi : n/a PT. Holi Pharma Dus, 10 strip @ 10 kaptab 152.00
. Sulfametoksazol 400 mg Trimetoprim 80 mg
396 Kotrimoksazol Suspensi komb: Sulfametoksazol n/a PT. Novapharin btl @ 60 ml 2,350.00
. 200 mg + Trimetoprim 40 mg / 5 ml
397 Kuinin (Kina) tablet 200 mg n/a PT. Kimia Farma ktk 60 tablet 670.00
.
398 Kuinin injeksi i.v. 25% (sebagai 2 HCl) n/a PT. Kimia Farma ktk 100 amp @ 2 ml 6,200.00
.
399 Kuinin tablet 222 mg (H2SO4.7H2O) n/a PT. Kimia Farma ktk 10 x 10 tablet 540.00
.
400 Laktulosa sir 3,335 g/5 mL n/a PT. Ikapharmindo Botol 60 ml 14,500.00
.
401 Lamivudin tablet/kaplet/kapsu 100 mg Heplav PT. Kimia Farma Botol 30 tab 2,000.00
.
402 Lamivudine tablet 150 mg n/a PT. Kimia Farma Botol 60 tablet 1,400.00
.
403 Lansoprazol inj 30 mg/ml Prosogan Inj. PT. Takeda Indonesia Serbuk vial 82,042.00
.
404 Lanzoprazol kapsul/kaplet 30 mg n/a PT. Indofarma Dus, 2 strip @ 10 kapsul 473.00
.
405 Lapatinib tab 250 mg Tykerb PT. SmithKline Beecham Phamaceuticals Dus, 7 Blister @ 10 tablet 67,200.00
.
406 Larutan mengandung Asam Amino (Asam Amino Kalbamin PT. Finusolprima Farma Internasional botol 500 ml 56,300.00
. 10%)
407 Larutan mengandung Asam Amino (Asam Amino Amiparen PT Otsuka Indonesia Softbag 500 ML 56,300.00
. 100 g, Total N 15,7 g, Na+ 2 mEq, Asetat 120 mEq)
408 Larutan mengandung Asam Amino (Asam Amino Pan-amin G PT Otsuka Indonesia Softbag 500 ML 37,500.00
. 27 g, Sorbitol 50 g, Cl- 52 mEq)
409 Larutan mengandung Asam Amino (Asam Amino Aminofluid PT Otsuka Indonesia Double Chamber Softbag 1000 ML 115,500.00
. 30 g, Glukosa 7,3 % dan elektrolit) 1000 ml
410 Larutan mengandung Asam Amino (Asam Amino Aminofluid PT Otsuka Indonesia Double Chamber Softbag 500 ML 61,600.00
. 30 g, Glukosa 7,3 % dan elektrolit) 500 ml
411 Larutan mengandung Asam Amino (Asam Amino Aminofusin Hepar PT Kalbe Farma botol 500 mL 75,350.00
. 5% dengan BCAA 45%, L-Ornithine L Aspartate
8.03 gr/L, Sorbitol 50 gr/L, Xylitol 50 gr/L)
412 Larutan mengandung Asam Amino (Asam Amino Aminosteril Infant 6% PT. Fresenius Kabi Combiphar Botol Gelas 100 ml 36,667.00
. 6%, mengandung Taurine 0,24 gr/l)
413 Larutan mengandung Asam Amino (Asam Amino Nephrosteril PT. Fresenius Kabi Combiphar Botol Gelas 250 ml 50,820.00
. 7%, Komposisi: Asam Amino esensial: Asam Amino
non esensial = 60 : 40)
414 Larutan mengandung Asam Amino (Asam Amino Kidmin PT Otsuka Indonesia Softbag 200 ML 46,000.00
. 72.05 g, Total N 11.53 g, AAE/AANE ratio 2.6, Na+ 2
mEq, Asetat 46 mEq)
415 Larutan mengandung Asam Amino (Asam Amino Aminoleban PT Otsuka Indonesia Softbag 500 ML 65,000.00
. 79.9 g, Total N 12.2 g, Na+ 14 mEq, Cl 94 mEq)
416 Larutan mengandung Asam Amino (Asam amino Aminosteril N-Hepa PT. Fresenius Kabi Combiphar Botol Gelas 500 ml 78,720.00
. 8%)
417 Larutan mengandung Asam Amino (Asam Amino Eas Pfrimer PT. Finusolprima Farma Internasional botol 250 ml 51,260.00
. esensial 7%+Xylitol 10 g/L)
418 Larutan mengandung Asam Amino (BCAA 25 gr/L, Comafusin Hepar PT. Finusolprima Farma Internasional botol 500 ml 64,900.00
. L-Ornithine L Aspartate 10 gr/L, Xylitol 50 gr/L,
Malic Acid 7 gr/L, Piridoxin 0.12 gr/L)
419 Larutan mengandung Asam Amino (Kombinasi Aminofusin L600 PT Kalbe Farma botol 500 mL 42,000.00
. Asam aminno 50 g/L, Sorbitol 50 g/L, Xylitol 50
g/L, Asam Askorbat (Vit C) 0.4 g/L, Inositol 0.5 g/L,
Nikotinamida (Niasinamida) 0.06 g/L, Piridoksin
HCl (Vit B6) 0.04 g/L, Riboflavin Natrium Fosfat 2.5
mg/L, elektrolit)
420 Larutan mengandung Asam Amino (Kombinasi Aminofusin Paed PT Kalbe Farma botol 250 mL 46,000.00
. Asam amino 50 g/L, vitamin dan elektrolit)
421 Larutan mengandung Asam Amino (Kombinasi Kabiven 1440 ml PT. Fresenius Kabi Combiphar Bag (3 Chamber) 1440 ml 295,240.00
. Asam Amino: 34gr, Glukosa: 97gr, Lipid: 51gr dan
Elektrolit (Kalori = 1000 kkal, Akses peripheral))
422 Larutan mengandung Asam Amino (Kombinasi Kabiven 1920 ml PT. Fresenius Kabi Combiphar Bag (3 Chamber) 1920 ml 343,842.00
. Asam Amino: 45gr, Glukosa: 130gr, Lipid: 68gr dan
Elektrolit (Kalori = 1400 kkal, Akses peripheral))
423 Larutan mengandung Asam Amino (Kombinasi Combiflex Plus (790 kcal) PT. Phapros, Tbk Bag Double chamber (Dua 322,000.00
. Glukosa dan elektrolit 150 gr + Asam Amino 48 gr compartement), 1000 mL
dgn akses sentral)
424 Larutan mengandung Asam Amino (Kombinasi Combiflex peri (480 kcal) PT. Phapros, Tbk Bag Double chamber (Dua 218,700.00
. Glukosa dan elektrolit 80 gr + Asam Amino 40 gr ) compartement), 1000 mL
425 Larutan mengandung Elektrolit (Kalium Klorida) Otsu - KCl 7,46% PT Otsuka Indonesia Ampoel 25 ML 2,050.00
.
426 Larutan mengandung Elektrolit (Larutan Ringer Wida RL PT. Widatra Bhakti Botol 1000 ml 8,000.00
. Laktat)
427 Larutan mengandung Elektrolit (Na 130 mEq, Cl Asering PT Otsuka Indonesia Plastic Bottle 500 ML 9,000.00
. 109 mEq, Ca 3 mEq, Asetat 28 mEq)
428 Larutan mengandung Elektrolit (NaCl 1.125 gr, KA EN 1B PT Otsuka Indonesia Plastic Bottle 500 ML 9,000.00
. Dekstrosa 18.75 gr)
429 Larutan mengandung Elektrolit (Sodium Lactate sol Totilac PT Kalbe Farma flexybag 250 mL 87,000.00
. (50%) 113 gr/L, Potassium Chloride 0.3 gr/L,
Calcium Chloride 0.2 gr/L, elektrolit)
430 Larutan mengandung Elektrolit (Tiap 1000 ml Ringerfundin 500 mL PT. Phapros, Tbk LDPE (Low Density Poly Ethilene), 12,650.00
. mengandung electrolit: Sodium 145 mmol/l, botol plastik
Potassium 4.0 mmol/l, Calcium 2.5 mmol/l,
Magnesium 1.0 mmol/l, Chloride 118 mmol/l,
Acetate 24 mmol/l, Malate 5.0 mmol/l)
431 Larutan mengandung Karbohidrat (Fructose 120 g, Triofusin 1000 PT Kalbe Farma botol 500 mL 50,500.00
. glucose 66 g, Xylitol 60 g/ L + elektrolit)
432 Larutan mengandung Karbohidrat (Fructose 60 g, Triofusin 500 PT Kalbe Farma Flexy bag 500 mL 42,350.00
. glucose 33 g, Xylitol 30 g/ L)
433 Larutan mengandung Karbohidrat (Maltose 100 gr) Martos PT Otsuka Indonesia Plastic Bottle 500 ML 29,167.00
.
434 Larutan mengandung Karbohidrat + Elektrolit Potacol inj PT Otsuka Indonesia Plastic Bottle 500 ML 55,500.00
. (25.00g maltose, 3.00 g sodium chloride, 0.15 g
potassium chloride, 0.10 g calcium chloride
dihydrate dan 1.55 g sodium lactate)
435 Larutan mengandung Karbohidrat + Elektrolit Tutofusin OPS PT Kalbe Farma botol 500 mL 37,500.00
. (Acetate, Na, K, Cl, Ca, Mg, Sorbitol 50 gr/L)
436 Larutan mengandung Karbohidrat + Elektrolit Clinimix N9G20E PT Kalbe Farma Botol Plastik 1000 mL 210,000.00
. (Asam amino 28 gr/L, Glukosa 100 gr/L, elektrolit)
437 Larutan mengandung Karbohidrat + Elektrolit Clinimix N9G15E PT Kalbe Farma Botol Plastik 1000 mL 199,000.00
. (Asam amino 28 gr/L, Glukosa 75 gr/L, elektrolit)
438 Larutan mengandung Karbohidrat + Elektrolit Triofusin E1000 PT Kalbe Farma botol 500 mL 56,000.00
. (Fructose 60 g, glucose 33 g, Xylitol 30 g/ L)
439 Larutan mengandung Karbohidrat + Elektrolit Wida HSD PT. Widatra Bhakti Botol 500 ml 9,500.00
. (Glukosa 25 g, NaCl 2,0 g, KCl 1,3 g, Natrium Laktat
3,1 g, air untuk injeksi ad 1000 ml)
440 Larutan mengandung Karbohidrat + Elektrolit Wida D5-NS PT. Widatra Bhakti Botol 500 ml 6,800.00
. (Glukosa 55 g ; Natrium Chloride 9 g, air untuk
injeksi ad 1000 ml)
441 Larutan mengandung Karbohidrat + Elektrolit WIDA 2A PT. Widatra Bhakti Botol 500 ml 6,917.00
. (Glukosa: 25,0 g; NaCl: 4,5 g)
442 Larutan mengandung Karbohidrat + Elektrolit WIDA D5-1/4NS PT. Widatra Bhakti Botol 500 ml 7,700.00
. (Glukosa: 55.0 g; NaCl: 2.25 g)
443 Larutan mengandung Karbohidrat + Elektrolit WIDA D5-1/2NS PT. Widatra Bhakti Botol 500 ml 7,700.00
. (Glukosa: 55.0 g; NaCl: 4.5 g)
444 Larutan mengandung Karbohidrat + Elektrolit Futrolit PT. Sanbe Farma softbag 500ml 35,750.00
. (Larutan nutrisi kombinasi infus per L: Na.
100mEQ, K 18mEQ, Ca. 4mEQ, Mg 6mEQ, Cl
90mEQ, Asetat 38mEQ, Sorbitol 50g)
445 Larutan mengandung Karbohidrat + Elektrolit Wida RD PT. Widatra Bhakti Botol 500 ml 6,930.00
. (Larutan Ringer & Glukosa 5%)
446 Larutan mengandung Karbohidrat + Elektrolit (NaCl KA ENMG 3 PT Otsuka Indonesia Plastic Bottle 500 ML 9,167.00
. 1.75 g, KCL 1.5g, Glukosa 100 gr)
447 Larutan mengandung Karbohidrat + Elektrolit (Nacl KA EN 3B PT Otsuka Indonesia Plastic Bottle 500 ML 10,000.00
. 1.75 gr, KCl 1.5 gr, Na Lactat 2.24 gr, Dekstrosa 27
gr)
448 Larutan mengandung Karbohidrat + Elektrolit (Nacl KA EN 3A PT Otsuka Indonesia Plastic Bottle 500 ML 10,000.00
. 2.34 gr, Na Laktat 2.24 gr, KCL 0.75 gr Dekstrosa 27
gr)
449 Larutan mengandung Lipid ( Infus Lipid Emulsi Lipofundin MCT/LCT 1% 100 PT. Phapros, Tbk 20%, Botol Kaca @100 ml, single 105,500.00
. MCT/LCT 20% 100 ml) bottle
450 Larutan mengandung Lipid (Emulsi lemak 20%) Intralipid PT. Fresenius Kabi Combiphar Botol Gelas 100 ml 60,500.00
.
451 Larutan mengandung Lipid (Infus Lipid Emulsi Lipofundin MCT/LCT 1% 250 PT. Phapros, Tbk 20%, Botol Kaca @250 ml, single 210,000.00
. MCT/LCT 20% 250 ml) bottle
452 Larutan mengandung Lipid (Kombinasi Glukosa dan Nutriflex Lipid Special 1250 PT. Phapros, Tbk Bag, 3 chamber ( 3 kompartemen), 591,000.00
. elektrolit 180 gr + Asam Amino 71.8 gr + Lipid 50 1250 ml
gr dgn akses sentral)
453 Larutan mengandung Lipid (Kombinasi Glukosa dan Nutriflex Lipid Peri 1250 PT. Phapros, Tbk Bag, 3 chamber ( 3 kompartemen), 511,000.00
. elektrolit 80 gr + Asam Amino 40 gr + Lipid 1250 ml
MCT/LCT 50 gr)
454 Larutan mengandung Lipid (Kombinasi Glukosa dan Nutriflex Lipid Special 625 PT. Phapros, Tbk Bag, 3 chamber ( 3 kompartemen), 358,000.00
. elektrolit 90 gr + Asam Amino 35.9 gr + Lipid 25 gr 625 ml
dgn akses sentral)
455 Latanoprost tetes mata 0,01% Cendo Glaopen PT. Cendo Industri Farmasi strip 5 x 0.6 ml 72,000.00
.
456 Latanoprost tts mata 0,005% btl@2,5ml Xalatan 0,005% PT. Pfizer Indonesia dus, Botol @ 2,5 ml 127,000.00
.
457 Lenograstim inj 263 mcg/mL Granocyte 34 1vl HSA Free PT. Aventis Pharma Dus, 1 vial @ 263 mcg + 1 prefilled 550,000.00
. syringe pelarut @ 1 ml
458 Letrozol tablet/kaplet/kapsul 2,5 mg FEMARA PT. Novartis Indonesia Dus, 3 blister @ 10 tablet 17,500.00
.
459 Leuprorelin asetat inj depot 1,88 mg Tapros 1.88mg PT. Takeda Indonesia Vial 700,000.00
.
460 Leuprorelin asetat inj depot 11,25 mg Tapros 3M PT. Takeda Indonesia Vial 2,700,000.00
.
461 Leuprorelin asetat inj depot 3,75 mg TAPROS 3.75 MG PT. Takeda Indonesia Vial 500,000.00
.
462 Levofloksasin inf 5 mg/mL n/a PT. Infion Pharmaceutical Box, 1 Botol @ 100 ml 40,000.00
.
463 Levofloksasin tablet 500 mg n/a PT. Promedrahardjo Farmasi Industri Dus, 5 Strip@10 Tablet 528.00
.
464 Levofloksasin tts mata 0,5% Optiflox PT. Erela Btl @ 5 ml 13,068.00
.
465 Levotiroksin tablet/kaplet/kapsul 100 mcg Euthyrox 100 PT. Merck Tbk Dus 4 blister @ 25 tablet 850.00
.
466 Levotiroksin tablet/kaplet/kapsul 50 mcg Euthyrox 50 PT. Merck Tbk Dus 4 blister @ 25 tablet 719.00
.
467 Lidokain injeksi 2% (HCL) n/a PT. Bernofarm Dus, 100 ampul @ 2 ml 839.00
.
468 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - n/a PT. Indofarma Dus, 30 ampul @ 2 ml 1,363.00
. 2ml
469 Lidokain jeli 2% Xylocaine Jelly 2% PT. AstraZeneca indonesia Dus, 10 syringe @ 10 g 40,000.00
.
470 Lidokain semprot 10% Xylocaine Spray 10 mg / dosis PT. AstraZeneca indonesia Dus,Botol @ 50 ml (500 dosis) 142,000.00
.
471 Lisinopril tablet 10 mg n/a PT. Novell Pharmaeutical Laboratories Box ,3 Strip @ 10 tablet 600.00
.
472 Lisinopril tablet 5 mg n/a PT. Novell Pharmaeutical Laboratories Box ,3 Strip @ 10 tablet 350.00
.
473 Litium karbonat tablet 200 mg Frimania 200 PT. Mersifarma Tirmaku Mercusana KOTAK @ 10 x 10 TAB 1,050.00
.
474 Litium karbonat tablet 400 mg Frimania 400 PT. Mersifarma Tirmaku Mercusana KOTAK @ 10 x 10 TAB 1,850.00
.
475 Loperamid tablet 2 mg n/a PT. Ifars Pharmaceutical Laboratories Dus, 10 Strip @ 10 Tablet 89.00
.
476 Loratadin tablet 10 mg n/a PT. Promedrahardjo Farmasi Industri Dus, 5 Strip@10 Tablet 154.00
.
477 Lorazepam tablet 0,5 mg MERLOPAM 0,5 mg PT. Mersifarma Tirmaku Mercusana KOTAK @ 10 x 10 TAB 685.00
.
478 Lorazepam tablet 2 mg Merlopam 2 PT. Mersifarma Tirmaku Mercusana KOTAK @ 10 x 10 TAB 1,341.00
.
479 Low molecule feri sucrose inj amp 100 mg/5 mL DIALIFER PT. Novell Pharmaeutical Laboratories ampul 52,000.00
.
480 Magnesium sulfat injeksi 20% OTSU-MgSO4 20 PT Otsuka Indonesia Dus, 120 ampul plastik @ 25 ml 2,800.00
.
481 Magnesium sulfat injeksi 40% OTSU-MgSO4 40 PT Otsuka Indonesia Dus, 120 ampul plastik @ 25 ml 3,500.00
.
482 Manitol n/a PT. Finusolprima Farma Internasional botol 500 ml 62,000.00
.
483 Maprotilin HCl tab 25 mg Ludios PT. Soho Industri Pharmasi Strip 1,200.00
.
484 Maprotilin HCl tab 50 mg Sandepril 50 PT. Mersifarma Tirmaku Mercusana KOTAK @ 5 x 10 TAB 3,276.00
.
485 MDP (methylene diphosphonate) 1 mg methylene Bonescan KaeF PT. Kimia Farma Dus @ 5 vial 473,000.00
. diphosphonic acid/mL
486 Mebendazol tablet 500 mg Vermox 500 PT. Taisho Pharmaceutical Indonesia Tbk Dus,24 Catch @ 1 tablet 7,140.00
.
487 Medroksi Progesteron Asetat tablet/kaplet/kapsul Provera 100mg PT. Pfizer Indonesia Dus, 10 blister @10 tablet 6,125.00
. 100 mg
488 Medroksi Progesteron asetat tablet/kaplet/kapsul Prothyra 10mg PT SUNTHI SEPURI dus, 3 blister @ 10 tablet 2,500.00
. 10 mg
489 Melfalan tablet 2 mg Alkeran PT. Glaxo Wellcome Indonesia Box, Tablet 2 mg/25's 12,210.00
.
490 Meropenem inj 1 g n/a PT. Bernofarm Dus, 1 vial @ 1 g 54,000.00
.
491 Meropenem serb inj 500 mg/vial n/a PT. Bernofarm Dus, 1 vial @ 0,5 g 44,960.00
.
492 Mesna inj 100 mg/mL Uromitexan injeksi. PT. Mugi Laboratories Dus, 15 Ampul 74,998.00
.
493 Metadon sir 50mg/5ml n/a PT. Kimia Farma Botol 1000 ml 254,100.00
.
494 Metformin HCl tablet 500 mg n/a PT. Bernofarm Dus, 10 blister @ 10 tablet 112.50
.
495 Metformin HCl tablet 850 mg n/a PT. Bernofarm Dus, 10 blister @ 10 kaptab 197.50
.
496 Metildopa tablet salut 250 mg DOPAMET PT. Actavis Indonesia Dus, 10 Strip @ 10 tablet salut 800.00
. selaput
497 Metilergometrin Maleat (Metilergometrin) tablet n/a PT. Kimia Farma ktk 10 x 10 tablet salut 154.00
. salut 0,125 mg
498 Metilergometrin Maleat injeksi 0,200 mg-1 ml n/a PT. Ethica Industri Farmasi ampul @ 1 ml 2,750.00
.
499 Metilfenidat kapsul LA 20 mg Ritalin LA PT. Novartis Indonesia Dus, botol plastik @ 30 kapsul 6,537.00
. pelepasan lambat
500 Metilfenidat tablet SR 10 mg RITALIN PT. Novartis Indonesia Dus, 2 blister @ 15 tablet 1,950.00
.
501 Metilprednisolon inj 125 mg/2 mL n/a PT. Dexa Medica Dus, 1 Vial @125mg + 1 ampul 19,200.00
. pelarut @ 2ml
502 Metilprednisolon inj 500 mg/8 mL n/a PT. Phapros, Tbk Dus @ 1 vial 93,393.00
.
503 Metilprednisolon tablet 16 mg n/a PT. Mahakam Beta Farma Strip 635.00
.
504 Metilprednisolon tablet 4 mg n/a PT. Natura Laboratoria Prima Dus, 10 Blister @ 10 Tablet 205.00
.
505 Metilprednisolon tablet 8 mg n/a PT. Dexa Medica Dus, 10 Blister @ 10 tablet 300.00
.
506 Metoklopramid drop botol 10 mL GAVISTAL drops PT. Meprofarm Dus, Botol 10 ml 5,280.00
.
507 Metoklopramide sirup 5 mg/ 5 ml LEXAPRAM SIRUP PT. Molex Ayus BOTOL 60 ML 2,600.00
.
508 Metoklopramide tablet 5 mg n/a PT. Kimia Farma ktk 10 x 10 tablet 108.00
.
509 Metotreksat serb inj 50 mg/2 mL Methotrexate Kalbe PT Kalbe Farma vial @ 2 ml 35,750.00
.
510 Metotreksat serbuk injeksi i.v/i.m./i.t. 5 mg METHOTREXATE EBEWE PT. Sandoz Indonesia Box 10 ampul @ 1 ml 21,120.00
.
511 Metotreksat tablet/kaplet/kapsul 2,5 mg METHOTREXATE EBEWE 2.5 PT. Sandoz Indonesia Box, bottle @ 50 tab 1,680.00
. MG
512 Metronidazol infus 500 mg/100 ml n/a PT. Natura Laboratoria Prima Dus, 1 Botol @ 100 ml 9,950.00
.
513 Metronidazol ovula 500 mg Vagizol PT. Kimia Farma dus 1 's @ 5 ovula 3,850.00
.
514 Metronidazol sirup 125 mg/5 Ml Farizol PT. Ifars Pharmaceutical Laboratories Dus, botol 60ml 4,100.00
.
515 Metronidazol supositoria 500 mg Flagyl PT. Aventis Pharma Dus, 2 blister @ 5 suppositoria 3,220.00
.
516 Metronidazol tablet 250 mg n/a PT. Phyto Kemo Agung Farma 10 strip @ 10 tab 110.00
.
517 Metronidazol tablet 500 mg n/a PT. Phyto Kemo Agung Farma 10 strip @ 10 tab 160.00
.
518 MIBG (meta-iodobenzylguanidine) Endoneuroscan KaeF 1 PT. Kimia Farma vial 1,925,000.00
.
519 MIBI (metoxy iso butyl iso nitril) 5-mL reaction vial Cardioscan KaeF PT. Kimia Farma Dus @ 5 vial 1,237,500.00
.
520 Midazolam injeksi i.v. 5 mg/ml Dormicum PT. Boehringer Ingelheim Boks 5 amp 12,060.00
.
521 Mikafungin Na serb inj 50 mg Mycamine PT. Combiphar Dus,1 vial@50mg 260,000.00
.
522 Mikofenolat Mofetil 500 mg Cellcept PT. Boehringer Ingelheim Boks, 50 tablet 16,000.00
.
523 Mikonazol krim/salep 2 % (Nitrat) n/a PT. Kimia Farma Tube 10 gram 3,000.00
.
524 Modified fluid gelatine BM 30 000 lar inf 4% Gelofusine 4% PT. Phapros, Tbk Btl @ 500 ml 72,000.00
.
525 Moksifloksasin tetes mata 0,5% Vigamox PT. Tempo Scan Pacific botol, tetes mata 3 ml 77,000.00
.
526 Mometason furoat krim 0,1% n/a PT. Guardian Pharmatama tube 10 gram 17,820.00
.
527 Morfin HCL inj 10 mg/ml n/a PT. Kimia Farma Dus 10 amp @ 1 ml 8,400.00
.
528 Morfin HCL tablet SR 10 mg MST Continus 10 mg PT. Mahakam Beta Farma Dus, 6 strip @ 10 tablet 15,620.00
.
529 Morfin HCL tablet SR 15 mg MST Continus 15 mg PT. Mahakam Beta Farma Dus, 6 strip @ 10 tablet 22,990.00
.
530 Morfin HCL tablet SR 30 mg MST Continus 30 mg PT. Mahakam Beta Farma Dus, 6 Strip @ 10 Tablet 41,470.00
.
531 Morfin tablet 10 mg n/a PT. Kimia Farma Botol 30 tablet 1,300.00
.
532 N-asetil sistein inj. nebules 100 mg N-ace cairan inhalasi PT. Pratapa Nirmala Box @ 5 ampul 13,200.00
.
533 Nacl 0,9% n/a PT. Widatra Bhakti Botol 500 ml 4,700.00
.
534 Nadroparin inj 9500 Axa/mL syringe 0,3 mL Fraxiparine 0.3 ml PT. Glaxo Wellcome Indonesia Dus, 5 blister @ 2 pfs 0.3 ml 54,144.00
.
535 Nadroparin inj 9500 Axa/mL, syringe 0,4 mL Fraxiparine 0.4 ml PT. Glaxo Wellcome Indonesia Dus, 5 blister @ 2 pfs 0.4 ml 66,640.00
.
536 Nadroparin inj 9500 Axa/mL, syringe 0,6 mL Fraxiparine 0.6 ml PT. Glaxo Wellcome Indonesia Dus, 5 blister @ 2 pfs 0.6 ml 94,962.00
.
537 Nalokson injeksi 0,4 mg/ml Nokoba PT. Pratapa Nirmala Dus, 5 Ampul @ 2ml 61,600.00
.
538 Natrium Bikarbonat injeksi i.v 8,4% Meylon PT Otsuka Indonesia Ampoel 25 ML 6,200.00
.
539 Natrium Diklofenak tablet 50 mg n/a PT. Novell Pharmaeutical Laboratories Box ,5 Blister @ 10 tablet 200.00
.
540 Natrium Diklofenak tablet 25 mg n/a PT. Phapros, Tbk Dus @ 5 X 10 's 133.00
.
541 Natrium fosfat btl, 133 mL Fleet Enema PT. Combiphar Botol, 133 ml 39,950.00
.
542 Natrium fosfat lar oral 45 mL Fleet Phosphosoda PT. Combiphar Botol, 45 ml 33,900.00
.
543 Natrium fusidat krim 20 mg/g Acdat PT. Ifars Pharmaceutical Laboratories Dus, tube @ 5 g 6,475.00
.
544 Natrium fusidat salep 20 mg/g Fucilex Ointment PT. Molex Ayus Tube 5 gr 6,490.00
.
545 Neostigmin injeksi 0,5 mg/ml Neostigmin Hameln inj PT. Pharma Health Care Box, isi 5 ampul @ 1 ml 9,500.00
.
546 Nevirapin tablet 200 mg n/a PT. Kimia Farma btl 60 tablet 2,800.00
.
547 Nifedipin tab 20 mg, slow release; oros Adalat Oros 20 mg PT. Bayer Indonesia blister 2,999.00
.
548 Nifedipin tab 30 mg, oros Adalat Oros 30 mg PT. Bayer Indonesia blister 3,500.00
.
549 Nifedipin tablet/kapsul 10 mg n/a PT. Dexa Medica Dus, 10 Strip @ 10 tablet salut 100.00
. selaput
550 Nikardipin inj 10 mg/vial n/a PT. Pratapa Nirmala Box @ 1 vial 66,000.00
.
551 Nilotinib kapsul 200 mg (Skema Risk Sharing sesuai Tasigna PT. Novartis Indonesia Dus, 2 blister @ 14 kapsul 380,875.00
. Kepmenkes RI Nomor
HK.02.02/Menkes/223/2014)
552 Nistatin tablet salut 500.000 IU/ g n/a PT. Phapros, Tbk Dus @ 10 X 10 's 640.00
.
553 Nistatin vaginal tablet 100.000 IU/ g n/a PT. Phapros, Tbk Dus @ 10 X 10 's 480.00
.
554 Norepinefrin injeksi 1 mg/ml Levosol PT. Kimia Farma Dus 5 amp @ 8 ml 53,900.00
.
555 Noretisteron tablet 5 mg Primolut N PT. Bayer Indonesia blister 2,618.00
.
556 Obat Antituberkulosis FDC Kategori 1 n/a PT. Phapros, Tbk Paket 359,900.00
.
557 Obat Antituberkulosis FDC Kategori 2 n/a PT. Kimia Farma Paket 1,199,990.00
.
558 Obat Antituberkulosis FDC Kategori Anak n/a PT. Kimia Farma Paket 214,990.00
.
559 Obat Antituberkulosis FDC Sisipan n/a PT. Indofarma Paket@84 tablet 160,000.00
.
560 Obat Antituberkulosis Kategori 1 dewasa n/a PT. Indofarma Dus, 1 dus @ 60 blister @ 8 tablet 288,199.00
. tahap intensif kategori 1 + 1 Dus @
54 blister @ 3 tablet tahap lanjutan
kategori 1
561 Obat Antituberkulosis Kategori anak n/a PT. Indofarma Dus, 60 sachet tahap intensif @ (1 171,195.00
. tablet Isoniazid, 2 kapsul Rifampicin,
2 tablet Pyrazinamide) + 120 sachet
tahap lanjutan @ (1 tablet Isoniazid,
2 kapsul Rifampicin)
562 Octreotide Acetate0,05 - 6 mg/mL Octide PT. Pratapa Nirmala Box @ 5 ampul 80,000.00
.
563 Ofloksasin tets telinga 3% Tarivid Otic Solution PT Kalbe Farma Btl @ 5 ml 48,500.00
.
564 Ofloxacin tablet 200 mg n/a PT. Novell Pharmaeutical Laboratories Box ,5 Strip @ 10 tablet 400.00
.
565 Ofloxacin tablet 400 mg n/a PT. Novell Pharmaeutical Laboratories Box ,5 Strip @ 10 tablet 650.00
.
566 Oksaliplatin serbuk injeksi 100 mg / vial ELOXATIN PT. Aventis Pharma Dus, 1 vial @ 20 ml 1,100,000.00
.
567 Oksaliplatin serbuk injeksi 50 mg / vial ELOXATIN PT. Aventis Pharma Dus, 1 vial @ 10 ml 550,000.00
.
568 Oksimetazolin tetes hidung 0,025% Ilaidin Drops PT. Merck Tbk botol @ 10 ml 27,550.00
.
569 Oksimetazolin tetes hidung 0,050% Iliadin Spray PT. Merck Tbk botol 15 ml 29,000.00
.
570 Oksitosin injeksi 10 IU/ml Oxytocin "S" PT. Ethica Industri Farmasi ampul @ 1 ml 2,200.00
.
571 Oktreotid 10 mg Sandostatin LAR PT. Novartis Indonesia Dus, vial @ 355m + 1 prefilled 2,950,000.00
. syringe pelarut @ 2,5 ml + 2 jarum
suntik
572 Olanzapin inj 10 mg/vial Zyprexa IM PT. Bayer Indonesia Vial 120,000.00
.
573 Olanzapin kapl salut 5 mg Olandoz 5 PT. Sandoz Indonesia 3 X 10 fcc 6,450.00
.
574 Olanzapin tab 10 mg Olandoz 10 PT. Sandoz Indonesia 3 X 10 fcc 11,200.00
.
575 Olopatadin tts mata 0,1% Patanol PT. Tempo Scan Pacific botol, tetes mata 5 ml 68,000.00
.
576 Omeprazol injeksi 40 mg/ 10 ml n/a PT. Natura Laboratoria Prima Dus, 1 Vial @ 40 mg 36,000.00
.
577 Omeprazol kapsul/kaplet 20 mg n/a PT. Novapharin dus 10 X 3'S 211.00
.
578 ondansetron inj 4 mg/ 2 mL n/a PT. Indofarma Dus, 5 Ampul @ 2ml 2,400.00
.
579 Ondansetron tab 4 mg n/a PT. Yarindo Farmatama Box 3 X 10 Tab 716.00
.
580 Ondansetron tablet 8 mg n/a PT. Yarindo Farmatama Box 3 X 10 Tab 1,189.00
.
581 Paket CAPD Awal (Komposisi: 1 unit Transfer Set, 2 n/a PT Kalbe Farma Transfer Set: Set; Ultaclam: Kantong 1,902,240.00
. unit Ultaclam, 1 unit Tenckoff Catheter, Titanium Plastik; Tenckoff Catheter: Box;
Adaptor) Titanium Adaptor: Kantong Plastik
582 Paket CAPD Pergantian Transfer Set per 6 bulan n/a PT Kalbe Farma Set 219,540.00
.
583 Paket CAPD Rutin 120 ( 4x ganti cairan perhari Larutan Dialisa 1.5%: Dianeal PT Kalbe Farma Larutan Dialisa 1.5 %: 2.000 ml; 5,522,580.00
. dengan komposisi Larutan Dialisa 1.5 %, Larutan Low Calcium with 1,5% Larutan Dialisa 2.5 %: 2.000 ml;
Dialisa 2.5 %, Larutan Dialisa 4.25 %, Minicap) Dextrose; Larutan Dialisa Larutan Dialisa 4.25 %: 2.000 ml;
2.5%: Dianeal Low Calcium Minicap: Kantong Plastik
with 2,5% Dextrose; Larutan
Dialisa 4.25%: Dianeal Low
Calcium with 4.25% Dextrose
584 Paklitaksel inj 100 mg/vial SINDAXEL 100 MG/16,67 ML PT. Actavis Indonesia Vial 6mg/ml (100mg/16.67ml) 984,000.00
.
585 Paklitaksel inj 300 mg/vial SINDAXEL 260mg/43.33 ML PT. Actavis Indonesia Vial 6mg/ml (260mg/43.33ml) 3,000,000.00
.
586 Paklitaksel injeksi 30 mg/vial SINDAXEL 30 MG/5 ML PT. Actavis Indonesia Vial 6mg/ml (30mg/5ml) 274,560.00
.
587 Parasetamol drop 100 mg/ml btl @15ml n/a PT. Indofarma Dus, 15 botol 5,200.00
. (60mg/0,6ml)
588 Parasetamol sirup 120 mg / 5 ml n/a PT. Afifarma botol 60 ml 1,438.00
.
589 Parasetamol tablet 500 mg n/a PT. Imfarmind Farmasi industri Dus, 10 strip @ 10 kaptab 89.00
.
590 Parasetamol tetes 60 mg/0,6 mL FASIDOL PT. Ifars Pharmaceutical Laboratories Dus, botol @ 15 ml 6,450.00
.
591 Pegylated interferon alfa-2a inj 135 mcg/0,5 ml Pegasys PT. Boehringer Ingelheim Boks, 1 pfs 1,077,815.00
.
592 Pegylated interferon alfa-2a inj 180 mcg/0,5 ml Pegasys PT. Boehringer Ingelheim Boks, 1 pfs 1,248,220.00
.
593 Pegylated Interferon alfa-2b serb inj 100 mcg Pegintron Vial 100 Mcg PT. Merck Sharp Dohme Pharma Tbk Dus, 1 vial 100 mcg + 1 ampul 973,500.00
. pelarut 0,7 ml + 1 syringe + 2 jarum
594 Pegylated Interferon alfa-2b serb inj 120 mcg Pegintron Pen 120 Mcg PT. Merck Sharp Dohme Pharma Tbk Dus, 1 prefilled syringe (serbuk 1,135,000.00
. injeksi 120mcg + pelarut 0.5 ml) + 1
jarum
595 Pegylated Interferon alfa-2b serb inj 50 mcg Pegintron PT. Merck Sharp Dohme Pharma Tbk Dus, 1 vial 50 mcg + 1 ampul pelarut 915,000.00
. 0,7 ml + 1 syringe + 2 jarum
596 Pegylated Interferon alfa-2b serb inj 80 mcg Pegintron Vial 80 Mcg PT. Merck Sharp Dohme Pharma Tbk Dus, 1 vial 80 mcg + 1 ampul pelarut 915,810.00
. 0,7 ml + 1 syringe + 2 jarum
597 Perak sulfadiazin krim 1% BURNAZIN 35 GR PT. Darya Varia tube @ 35 gram 23,000.00
.
598 Perindoprilarginin tab 5 mg Bioprexum 5 mg PT. Pradja Pharin Dus, botol plastik @ 30 tablet salut 2,420.00
. selaput
599 Permetrin krim 5% Scabimite Cream 10 PT. Galenium Pharmasia Laboratories Tube @ 10 g 11,475.00
.
600 Petidin injeksi i.m/s.k/i.v lambat 50 mg/ml (HCl) n/a PT. Kimia Farma Ktk 10 ampx2ml 14,500.00
.
601 Pioglitazon tab 15 mg DECULIN 15 MG PT. Dexa Medica 30 TAB/BOX 3,120.00
.
602 Pioglitazon tab 30 mg DECULIN 30 MG PT. Dexa Medica 30 TAB/BOX 4,525.00
.
603 Pirantel suspensi 125 mg/5 ml n/a PT. Holi Pharma Botol 60 ml 8,360.00
.
604 Pirantel tablet score (base) 125 mg n/a PT. Holi Pharma Dus, 25 Blister @ 4 tablet 298.00
.
605 Pirazinamid tablet 500 mg n/a PT. Holi Pharma Dus 10 strip @ 10 tablet 208.00
.
606 Piridoksin (Vitamin B6) tablet/kapsul/kaplet 10 mg n/a PT. Kimia Farma dus, 10 strip @ 10 tablet 110.00
. (HCl)
607 Piridoksin (vitamin B6) inj 100 mg/mL n/a PT. Ikapharmindo Ampul 1 ml 1,000.00
.
608 Polikresulen cairan Aptil PT. Pratapa Nirmala Dus, Botol @ 10ml 17,393.00
.
609 Povidon Iodida larutan 10% 1000 ml n/a PT. Afifarma botol @ 1000 ml 37,109.00
.
.
.
612 Povidon Iodida larutan 10% 60 ml n/a PT. Kimia Farma btl 60 ml 5,998.00
.
613 Pramipeksol tab ER 0,375 mg Sifrol ER 0,375mg PT. Boehringer Ingelheim Dus, 3 alu blister @ 10 tablet 7,200.00
.
614 Pramipeksol tab ER 0,750 mg Sifrol ER 0,750mg PT. Boehringer Ingelheim Dus, 3 alu blister @ 10 tablet 11,268.00
.
615 Pravastatin tablet 20 mg n/a PT. Novell Pharmaeutical Laboratories Box ,5 Strip @ 10 tablet 2,300.00
.
616 Prednison tablet/kapsul/kaplet 5 mg n/a PT. Holi Pharma Dus, 10 strip @ 10 tablet 114.00
.
617 Primakuin tablet 15 mg n/a PT. Phapros, Tbk Dus,10 blister @10 tablet 205.00
.
618 Probenesid tablet/kapsul/kaplet 500 mg Probenid PT. Dexa Medica Dus, 10 strip @ 10 tablet 1,650.00
.
619 Prokain Benzilpenisilin serbuk injeksi 3 juta IU/vial n/a PT. Bernofarm Vial @ 3 juta IU 7,190.00
.
620 Propanolol tablet 10 mg ( HCl ) n/a PT. Dexa Medica Dus, 10 Strip @ 10 tablet 65.00
.
621 Propiltiourasil tablet/kapsul/kaplet 100 mg n/a PT. Indofarma Botol @ 100 Tablet 319.00
.
622 Propofol injeksi i.v., bolus 1% Fresofol 1% MCT/LCT PT. Fresenius Kabi Combiphar Ampul 16,236.00
.
623 Propranolol tablet 40 mg (HCl) n/a PT. Holi Pharma Dus, 10 strip @ 10 tablet 107.00
.
624 Quetiapin tab 200 mg Seroquel XR 200 mg PT. AstraZeneca indonesia Dus, 1 blister @ 10 tablet 17,391.00
.
.
.
627 Ramipril tablet 2,5 mg Cardace 2.5mg 6x10 s tablet PT. Pharma Health Care Dus, 6 blister @ 10 tablet 995.00
.
628 Ramipril tablet 5 mg n/a PT. Dexa Medica Dus, 10 Strip @ 10 kaptab 580.00
.
629 Ramipril tablet/kaplet/kapsul 10 mg n/a PT. Novell Pharmaeutical Laboratories Dus, 10 strip @ 10 tablet 1,013.00
.
630 Ranitidin injeksi 25 mg/ml n/a PT. Natura Laboratoria Prima Dus, 10 Ampul @ 2 ml 1,140.00
.
631 Ranitidin tablet 150 mg n/a PT. Dexa Medica Dus, 10 Strip @ 10 tablet salut 120.00
. selaput
632 Retinol (Vitamin A) 100.000 IU n/a PT. Kimia Farma Botol 50 kapsul lunak 260.00
.
633 Retinol (Vitamin A) 200.000 IU kapsul lunak n/a PT. Lucas Djaja Botol 50 Kapsul 459.00
.
634 Rifampisin tablet salut 450 mg n/a PT. Indofarma Dus, 10 Strip @ 10 Kapsul 789.00
.
635 Rifampisin tablet/kapsul/kaplet 300 mg n/a PT. Indofarma Dus, 10 strip @ 10 kapsul 610.00
.
636 Rifampisin tablet/kapsul/kaplet 600 mg n/a PT. Indofarma Dus, 10 strip @10 kaptab 1,100.00
.
637 Ringer Laktat larutan infus n/a PT. Widatra Bhakti botol 500 ml 5,200.00
.
638 Risperidon tablet 1 mg n/a PT. Dexa Medica Dus, 5 Blister @ 10 tablet 1,200.00
.
639 Risperidon tablet 2 mg n/a PT. Mersifarma Tirmaku Mercusana KOTAK @ 5 x 10 TAB 1,008.00
.
640 Risperidon tablet 3 mg n/a PT. Dexa Medica Dus, 5 Blister @ 10 tablet 2,000.00
.
641 Rituksimab injeksi 10 mg/ml (Skema Risk Sharing Mabthera PT. Boehringer Ingelheim Dus, 1 vial @ 10 ml 3,164,805.00
. sesuai Kepmenkes RI Nomor
HK.02.02/Menkes/223/2014)
642 Rivaroksaban tab 10 mg Xarelto 10 mg PT. Bayer Indonesia Blister 23,500.00

.
.
.
645 Rokuronium injeksi i.v. 50 mg/5ml Esmeron PT. Merck Sharp Dohme Pharma Tbk Dus, 10 vial @ 5 ml 46,539.00
.
646 Ropinirol Tablet Salut 2 mg Requip PD 24 Hour 2 mg PT. Glaxo Wellcome Indonesia Dus, 7 blister @ 4 Tablet lepas 5,248.00
. Lambat
. Lambat
. Lambat
649 Salbutamol cairan ih 0,1% Ventolin Nebules PT. Glaxo Wellcome Indonesia Dus, 4x5 Botol Plastik@2.5 ml 6,600.00
.
650 Salbutamol inhalasi/aerosol 100 mcg/dosis Ventolin Inhaler PT. Glaxo Wellcome Indonesia Dus, botol 200 dosis 63,750.00
.
651 Salbutamol serb inh 200 mcg/kaps Ventolin Rotacaps PT. Glaxo Wellcome Indonesia Dus, 10 Blister @ 10 Kapsul 431.00
.
652 Salbutamol serb inh 200 mcg/kaps + rotahaler Ventolin Rotahaler PT. Glaxo Wellcome Indonesia Dus, 1 Rotahaler 5,867.00
.
653 Salbutamol tablet 2 mg (sebagai Sulfat) n/a PT. Yarindo Farmatama strip @ 10 tablet 59.00
.
654 Salep 2-4 , Kombinasi : Asam Salisilat 2% + n/a PT. Marin Liza Farmasi Pot @ 30 gram 2,000.00
. Belerang endap 4%
655 Sefadroksil sirup kering 125 mg/5ml n/a PT. Holi Pharma Dus, Botol 60 ml 4,896.00
.
656 Sefadroksil kapsul/kaplet 250 mg n/a PT. Hexpharm Jaya Laboratories strip 513.00
.
657 Sefadroksil kapsul/kaplet 500 mg n/a PT. Bernofarm Dus, 10 strip @ 10 kapsul 509.00
.
658 Sefadroksil sir kering 250 mg/5 mL n/a PT. Holi Pharma Dus, Botol 60 ml 5,940.00
.
659 Sefaleksin kapsul/kaplet 500 mg n/a PT. Ifars Pharmaceutical Laboratories Dus, 5 Strip @ 10 Kapsul 1,000.00
.
660 Sefazolin serbuk injeksi 1 g/vial n/a PT. Dexa Medica Dus, 2 Vial @ 1 gram 16,500.00
.
661 Sefepim inj 1 g n/a PT. Novell Pharmaeutical Laboratories vial 43,000.00
.
662 Sefiksim kapsul/kaplet 100 mg n/a PT. Dexa Medica Dus, 5 Strip @ 10 kapsul 850.00
.
663 Sefiksim sirup kering 100 mg/ 5 ml n/a PT. Ifars Pharmaceutical Laboratories Dus, Botol 30 ml 8,800.00
.
664 Sefoperazon inj 1 g n/a PT. Holi Pharma Dus, 2 vial @ 1 g 12,775.00
.
665 Sefotaksim injeksi 0,5 g n/a PT. Hexpharm Jaya Laboratories vial 4,997.00
.
666 Sefotaksim injeksi 1 g n/a PT. Natura Laboratoria Prima Dus, 10 Vial @ 1 g 2,950.00
.
667 Seftazidim injeksi 1 g n/a PT. Hexpharm Jaya Laboratories Dus, 2 vial @ 1 g 17,060.00
.
668 Seftriakson serbuk injeksi 1 g/vial n/a PT. Natura Laboratoria Prima Dus, 10 Vial @ 1 g 3,300.00
.
669 Sefuroksim tablet/kapsul/kaplet 250 mg Zinnat 250 mg PT. Glaxo Wellcome Indonesia Dus, 1 Blister @ 10 Tablet salut 4,752.00
. selaput
670 Sefuroksim serbuk injeksi 750 mg/vial Sharox inj PT. Pratapa Nirmala Box @ 2 vial 52,800.00
.
671 Sefuroksim tab 500 mg Zinnat 500 PT. Glaxo Wellcome Indonesia Dus, 1 Blister @ 10 Tablet salut 7,200.00
. selaput
672 Sertralin tab 50 mg Fatral PT. Pratapa Nirmala strip @ 10 tab 3,300.00
.
673 Setirizin sirup 5 mg/5 ml n/a PT. Indofarma Botol @ 60 ml 7,999.00
.
674 Setirizin tablet 10 mg n/a PT. Pertiwi Agung Box, 10 strips @ 10 capsules 181.00
.
675 Setuksimab infus 5 mg/ml (Skema Risk Sharing Erbitux PT. Merck Tbk Dus, 1 vial @ 20 ml 3,650,000.00
. sesuai Kepmenkes RI Nomor
HK.02.02/Menkes/223/2014)
676 Sevofluran ih, btl Sojourn PT. Pratapa Nirmala tabung/botol 1,320,000.00
.
677 Sianokobalamin (vitamin B12) injeksi 500 mcg n/a PT. Lucas Djaja 100 ampul @ 1 ml 1,077.00
.
678 Sianokobalamin (vitamin B12) tablet/kapsul/kaplet n/a PT. Afifarma Dus, 10 Strip @ 10 tablet 57.00
. 50 mcg
679 Siklofosfamid serbuk injeksi i.v. 1000 mg CYCLOVID 1000 PT. Novell Pharmaeutical Laboratories Vial 256,000.00
.
680 Siklofosfamid serbuk injeksi i.v. 200 mg Cyclovid 200 mg PT. Novell Pharmaeutical Laboratories vial 82,000.00
.
681 Siklofosfamid serbuk injeksi i.v. 500 mg CYCLOVID 500 PT. Novell Pharmaeutical Laboratories Vial 120,000.00
.
682 Siklosporin kaps 100 mg Sandimmun Neoral 100mg PT. Novartis Indonesia Dus, 10 blister @ 5 kapsul lunak 43,000.00
. Kap
683 Siklosporin kapsul lunak 25 mg Sandimmun Neoral 25mg Kap PT. Novartis Indonesia Dus, 10 blister @ 5 kapsul lunak 12,000.00
.
684 Silostazol tablet/kapsul/kaplet 100 mg Citaz PT. Dankos Farma strip 7,000.00
.
685 Simvastatin scored tablet 10 mg n/a PT. Natura Laboratoria Prima Dus, 3 Strip @ 10 Kaplet salut 169.00
. selaput
686 Simvastatin tablet 20 mg n/a PT. Natura Laboratoria Prima Dus, 3 Strip @ 10 Kaplet salut 391.00
. selaput
687 Siprofloksasin infus 2% n/a PT. Dexa Medica Vial 200 ml 13,000.00
.
688 Siprofloksasin tablet 500 mg (sebagai HCl) n/a PT. Bernofarm Dus, 10 blister @ 10 tab ss 255.00
.
689 Sisplatin serbuk injeksi 10 mg Cisplatin PT Kalbe Farma vial 22,000.00
.
690 Sisplatin serbuk injeksi 50 mg Cisplatin PT Kalbe Farma vial 93,000.00
.
691 Sitarabin serbuk injeksi i.m./i.v./s.k. 1gr/10ml DBL Cytarabun PT. Tempo Scan Pacific dus, 1 vial @ 10 ml 575,000.00
.
692 Spiramisin tablet 500 mg n/a PT. Indofarma Dus, 5 strip @ 10 tablet 1,499.00
.
693 Spironolakton tablet 100 mg n/a PT. Dexa Medica Dus, 10 Strip @ 10 tablet 900.00
.
694 Spironolakton tablet 25 mg n/a PT. Dexa Medica Dus, 10 Strip @ 10 tablet 315.00
.
695 Stavudin tablet/kapsul/kaplet 30 mg n/a PT. Kimia Farma Botol @ 60 tablet 930.00
.
696 Streptokinase injeksi 1,5 juta UI/vial Streptase PT. Dexa Medica Vial 3,290,000.00
.
697 Streptomisin serbuk injeksi i.v 1000 mg/ml n/a PT. Phapros, Tbk Dus @ 56 Vial 3,650.00
.
698 Sufentanil injeksi iv, epidural 5 mcg/ml Sufentanyl Injeksi iv.Epidural 5 PT. Kimia Farma dus 5 amp @ dus 10 127,000.00
. mcg / ml
699 Sukralfat susp 500 mg/5 mL Ulsafate PT. Combiphar Botol, 100 ml 13,425.00
.
700 Sukralfat tab 500 mg ULSIDEX PT. Dexa Medica DUS, 10 STRIP @ 10 TAB 424.00
.
701 Takrolimus kaps 0.5 mg Prograf PT. Combiphar Pounch @ 5 blister @ 10 capsule 11,167.00
.
702 Takrolimus kaps 1 mg Prograf PT. Combiphar Dus, 1 pouch @5 blister@10 kaps 21,500.00
.
703 Tamoksifen tablet 20 mg TAMOXIFEN EBEWE PT. Sandoz Indonesia Botol @30tablet 2,654.00
.
704 Tamsulosin tab 0,2 mg Harnal D PT. Combiphar Box @ 2 blister @ 14 tablet 5,800.00
.
705 Tamsulosin tab 0,2 mg Harnal D PT. Combiphar Box/ 2 blister @ 14 tablet 5,800.00
.
706 Tamsulosin tab SR 0,4 mg Harnal OCAS PT. Combiphar Box/ 3 blister @ 10 Tablet 6,800.00
.
707 Telbivudin tab 600 mg Sebivo 600 mg Tab PT. Novartis Indonesia Dus, 2 blister @ 14 tablet 28,500.00
.
708 Telmisartan tab 40mg Micardis 40mg PT. Boehringer Ingelheim Dus, 2 alu-blister @10 tablet 3,900.00
.
709 Telmisartan tab 80 mg Micardis 80mg PT. Boehringer Ingelheim Box, 2 blisters @10 tablets 6,500.00
.
710 Temozolamid kaps 100 mg Temodal PT. Merck Sharp Dohme Pharma Tbk Dus, 5 sachet @ 1 kapsul 1,120,000.00
.
711 Temozolamid kaps 20 mg Temodal PT. Merck Sharp Dohme Pharma Tbk Dus, 5 sachet @ 1 kapsul 223,000.00
.
712 Tenofovir tab 300 mg n/a PT. Kimia Farma Botol 30 tab 8,100.00
.
713 Teofilin tab SR 300 mg Rethapyl PT. Kimia Farma Dus 10-s @ 10 Kaptab 1,050.00
.
714 Teofilin tablet 150 mg Bronsolvan PT Kalbe Farma strip 250.00
.
715 Terazosin HCl tablet/kapsul/kaplet 1 mg HYTROZ 1MG PT. Dexa Medica DUS, 10 BLISTER @ 10 TAB 1,669.00
.
716 Terazosin HCl tablet/kapsul/kaplet 2 mg HYTROZ 3MG PT. Dexa Medica DUS, 10 BLISTER @ 10 TAB 2,949.00
.
717 Terbutalin cairan ih 2,5 mg/mL Bricasma Respules PT. AstraZeneca indonesia Dus, 2 pak @ 5 respules 6,250.00
.
718 Terbutalin tablet 2,5 mg Molasma Tablet PT. Molex Ayus Box 50's 99.00
.
719 Terbutalin turbu (serbuk ih) 0,50 mg Bricasma Turbuhaler 0,5 mg PT. AstraZeneca indonesia Dus, 1 Turbuhaler @ 200 dosis 71,100.00
.
720 Testoteron soft capsul 40 mg Andriol Testocaps PT. Merck Sharp Dohme Pharma Tbk Dus, 6 blister @ 10 kapsul lunak 6,200.00
.
721 Tetrakain HCl tetes mata 0,5% Pantocain 0.5% PT. Cendo Industri Farmasi botol 5 ml 11,500.00
.
722 Tetrasiklin kapsul/kaplet 250 mg n/a PT. Holi Pharma Dus, 10 strip @ 10 kapsul 149.00
.
723 Tetrasiklin tablet/kapsul/kaplet 500 mg n/a PT. Afifarma DUS,10 STRIP @ 10 KAPSUL 300.00
.
724 Tiamazol tab 10 mg Thyrozol 10 PT. Merck Tbk Dus, 10 blister @ 10 tablet 1,135.00
.
725 Tiamazol tab 5 mg Thyrozol 5 PT. Merck Tbk Dus, 10 blister @ 10 tablet 563.00
.
726 Timolol tetes mata 0,25% Isotic Adretor 0,25% PT. Pratapa Nirmala Dus, Botol Plastik @ 5ml 9,128.00
.
727 Timolol tetes mata 0,5% Isotic Adretor 0,5% PT. Pratapa Nirmala Dus, Botol Plastik @ 5ml 9,722.00
.
728 Tiotropium 18 mcg refill Spiriva powder for inhalation PT. Boehringer Ingelheim Box, 3 blisters @10 capsules 13,867.27
. 18mcg 30s
729 Tiotropium kaps 18 mcg + handihaller Spiriva 10s + Handihaler PT. Boehringer Ingelheim Dus, 1 blister @10 kapsul + 152,543.00
. handihaler
730 Tramadol injeksi 50 mg/ml n/a PT. Natura Laboratoria Prima Dus, 10 Ampul @ 2 ml 2,395.00
.
731 Trastuzumab serbuk injeksi 440 mg/vial (Skema Herceptin PT. Boehringer Ingelheim Dus, 1 vial @ 440 mg + 1 vial pelarut 19,608,034.00
. Risk Sharing sesuai Kepmenkes RI Nomor @ 20 ml
HK.02.02/Menkes/223/2014)
732 Travoprost tetes mata 0,004% Travatan PT. Tempo Scan Pacific botol, tetes mata 2,5 ml 115,000.00
.
733 Triamsinolon asetonid nasal spray 55 mcg/puff Nasacort AQ PT. Aventis Pharma Dus, botol plastik 120 dosis 90,000.00
.
734 Triamsinolon inj 10 mg/mL Flamicort PT. Dexa Medica Dus,1 vial@ 5ml 65,500.00
.
735 Trifluoperazin tablet 5 mg n/a PT. Darya Varia strip 405.00
.
736 Tropikamid tetes mata 1% Cendo Mydriatil 1% PT. Cendo Industri Farmasi Botol 5ml 36,500.00
.
737 Urea krim 10% Soft U Derm PT. Galenium Pharmasia Laboratories tube 6,400.00
.
738 Vaksin BCG (Harga pengadaan di Kementerian BCG Vaccine (GS) PT. Bio Farma 20 ds / amp / vial 59,950.00
. Kesehatan Pusat franco ibukota provinsi (DIPA
Kemkes))
739 Vaksin BCG (Harga pengadaan di Kementerian BCG Vaccine (SII) PT. Bio Farma 20 ds / amp / vial 59,950.00
Kemkes))
740 Vaksin BCG (Harga pengadaan di Kementerian BCG Vaccine SSI PT. Bio Farma 20 ds / amp / vial 59,950.00
Kemkes))
741 Vaksin BCG (Harga pengadaan di Provinsi franco BCG Vaccine (SII) PT. Bio Farma 20 ds / amp / vial 70,521.00
. ibukota Provinsi (Non DIPA Kemkes))
742 Vaksin BCG (Harga pengadaan di Provinsi franco BCG Vaccine SSI PT. Bio Farma 20 ds / amp / vial 70,521.00
743 Vaksin BCG (Harga pengadaan di Provinsi franco BCG Vaccine (GS) PT. Bio Farma 20 ds / amp / vial 70,521.00
744 Vaksin BCG Kering (BF) (Harga pengadaan di n/a PT. Bio Farma 20 ds / amp / vial 59,950.00
. Kementerian Kesehatan Pusat franco ibukota
provinsi (DIPA Kemkes))
745 Vaksin BCG Kering (BF) (Harga pengadaan di n/a PT. Bio Farma 20 ds / amp / vial 70,521.00
. Provinsi franco ibukota Provinsi (Non DIPA
Kemkes))
746 Vaksin Campak Kering (Harga pengadaan di n/a PT. Bio Farma 10 ds / vial 28,204.00
747 Vaksin Campak Kering (Harga pengadaan di n/a PT. Bio Farma 10 ds / vial 33,176.00
Kemkes))
748 Vaksin DTP-HB-Hib (Harga pengadaan di Pentabio PT. Bio Farma 5 ds / vial 76,285.00
749 Vaksin DTP-HB-Hib (Harga pengadaan di Provinsi Pentabio PT. Bio Farma 5 ds / vial 89,738.00
. franco ibukota Provinsi (Non DIPA Kemkes))
750 Vaksin Hepatitis B Rekombinan (Harga pengadaan n/a PT. Bio Farma 1 ds / pouch 20,900.00
. di Kementerian Kesehatan Pusat franco ibukota
751 Vaksin Hepatitis B Rekombinan (Harga pengadaan n/a PT. Bio Farma 1 ds / pouch 24,585.00
. di Provinsi franco ibukota Provinsi (Non DIPA
Kemkes))
752 Vaksin Jerap DT (Adsorbed DT Vaccine) (Harga n/a PT. Bio Farma 10 ds / vial 17,798.00
. pengadaan di Kementerian Kesehatan Pusat franco
ibukota provinsi (DIPA Kemkes))
753 Vaksin Jerap DT (Adsorbed DT Vaccine) (Harga n/a PT. Bio Farma 10 ds / vial 20,933.00
. pengadaan di Provinsi franco ibukota Provinsi (Non
DIPA Kemkes))
754 Vaksin Jerap Td (Adsorbed Td Vaccine) (Harga n/a PT. Bio Farma 10 ds/ vial 16,500.00
. pengadaan di Kementerian Kesehatan Pusat franco
755 Vaksin Jerap Td (Adsorbed Td Vaccine) (Harga n/a PT. Bio Farma 10 ds/ vial 19,404.00
. pengadaan di Provinsi franco ibukota Provinsi (Non
DIPA Kemkes))
756 Vaksin Meningitis Meningokokus Menveo PT. Novartis Indonesia Dus, 1 dosis @ (1 vial serbuk injeksi + 307,400.00
. 1 vial larutan injeksi @ 0,6 ml)
757 Vaksin polio inj (Vaksin Poliomyelitis yang Imovax Polio PT. Aventis Pharma 1 vial of 10ml (10 d's) 285,000.00
. diinaktifkan)
758 Vaksin Poliomyelitis Oral (Harga pengadaan di n/a PT. Bio Farma 10 ds/ vial 19,954.00
759 Vaksin Poliomyelitis Oral (Harga pengadaan di n/a PT. Bio Farma 10 ds/ vial 23,474.00
Kemkes))
760 Vaksin rabies, untuk manusia serbuk injeksi s.k./i.k. Verorab PT. Bio Farma Dus, 1 vial@ 1dosis + 1 Syringe @ 78,000.00
. + booster 0,5 ml NaCl 4%
761 Vaksin rabies, untuk manusia serbuk injeksi s.k./i.k. Verorab PT. Bio Farma Dus, 1 vial@ 1dosis + 1 Syringe @ 78,000.00
. + booster 0,5 ml NaCl 4%
762 Vaksin TT (Harga pengadaan di Kementerian n/a PT. Bio Farma 10 ds/ vial 14,498.00
Kemkes))
763 Vaksin TT (Harga pengadaan di Provinsi franco n/a PT. Bio Farma 10 ds/ vial 17,050.00
764 Valasiklovir tablet/kapsul/kaplet 500 mg Valvir PT. Soho Industri Pharmasi 5 strip @ 10 kaptab 5,390.00
.
765 Valgansiklovir tab 450 mg Valcyte PT. Boehringer Ingelheim Boks, 60 tablet 170,000.00
.
766 Valproat sirup 250 mg/5 ml Ikalep PT. Ikapharmindo Botol 120 ml 40,000.00
.
767 Valproat tab SR 250 mg Depakote ER 250 mg PT. Abbott Indonesia Tablet 2,793.00
.
768 Valproat tab SR 500 mg Depakote ER 500 mg PT. Abbott Indonesia Tablet 5,450.00
.
769 Valproat tablet salut 250 mg Depakote Tab 250 mg PT. Abbott Indonesia Tablet salut 250 mg 1,680.00
.
770 Valsartan tab 80 mg Diovan 80mg Tab PT. Novartis Indonesia DUS, 3 ALU-ALU STRIP @ 10 tablet 3,900.00
. salut selaput.
771 Valsartan tab 160 mg DIOVAN 160 MG PT. Novartis Indonesia DUS, 3 ALU-ALU STRIP @ 10 tablet 6,500.00
. salut selaput.
772 Vankomisin serbuk injeksi 500 mg/vial Vancep PT. Pratapa Nirmala Box @ 2 vial 122,000.00
.
773 Verapamil tab 240 mg Isoptin 240 mg PT. Abbott Indonesia Tablet 6,200.00
.
774 Verapamil tablet 80 mg (HCl) n/a PT. Kimia Farma Ktk 10X10 TAB 234.00
.
775 Vinblastin serbuk injeksi 10 mg Vinblastine PT. Combiphar Vial 10mg/10ml 210,000.00
.
776 Vinkristin serb inj i.v 2 mg/vial Vincristine Kalbe PT Kalbe Farma vial @ 2 ml 77,000.00
.
777 Vinkristin serbuk injeksi i.v. 1 mg Vincristine Kalbe PT Kalbe Farma vial @ 1 ml 45,000.00
.
778 Vinorelbin inj. 10 mg/ml Navelbine injeksi 10 PT. Mugi Laboratories Dus, 1 vial @ 1 ml 1,229,998.00
.
779 Vitamin B Kompleks tablet n/a PT. Kimia Farma Dus 10 strip x 10 tab 107.00
.
780 Zidofudin 100 mg n/a PT. Kimia Farma Botol 60 Kapsul 1,575.00
.
781 Zidovudin 300 mg + Lamivudine 150 mg n/a PT. Kimia Farma Botol 60 tablet 3,429.00
.
782 Zinc drop 10 mg/mL Zincpro Drops PT. Combiphar Drops 10 mg/ml, Botol @15 ml 12,840.00
.
783 Zinc sir 10 mg/mL Zinkid PT. Indofarma Dus, botol @ 100 ml 14,980.00
.
784 Zinc sir 20 mg/5 Ml Zircum Kid Sirup PT. Meprofarm Dus, botol 60 ml 7,400.00
.
785 Zinc tablet dispersible20 mg n/a PT. Kimia Farma ktk 10 x 10 tablet 473.00
.
No Nama Obat Generik Nama Dagang
1. ACT (Artesunate tablet 50 mg + Amodiaquine anhydrida tablet 200 mg) n/a
2. Adefovir Dipivoksil tablet/kaplet 10 mg Hepsera
3. Air untuk Injeksi 25 ml Otsu SWI 25 ml
4. Air untuk irigasi lar infus 1000 ml WIDA WI UNICAP
5. Akarbose tablet/kaplet 100 mg n/a
6. Akarbose tablet/kaplet 50 mg n/a
7. Albendazol suspensi 200 mg/5 ml n/a
8. Albendazol tablet/kapsul/kaplet 400 mg n/a
9. Albumin serum normal (human albumin) injeksi 20%, 100 ml Zenalb
10. Albumin serum normal (human albumin) injeksi 20%, 50 ml Zenalb
11. Albumin serum normal (human albumin) injeksi 25%, 100 ml PLASBUMIN 25% 100 ML
14. Albumin serum normal (human albumin) injeksi 5% 250 ml PLASBUMIN 5% 250 ML
15. Albumin serum normal (human albumin) injeksi 5% 50 ml PLASBUMIN 5% 50 ML
16. Alopurinol tablet/kapsul/kaplet 100 mg n/a
17. Alopurinol tablet/kapsul/kaplet 300 mg n/a
18. Alprazolam tablet/kapsul/kaplet 0,25 mg n/a
19. Alprazolam tablet/kapsul/kaplet 0,5 mg n/a
20. Alprazolam tablet/kapsul/kaplet 1 mg n/a
21. Alteplase injeksi 50 mg/vial Actilyse
22. Amfoterisin B salep mata 1% Fungicide
23. Amikasin injeksi 250 mg/ml Glybotic 250 mg /ml
24. Aminofilin injeksi 24 mg/ml n/a
25. Aminofilin tablet scored 200 mg n/a
26. Aminofilin tablet/kapsul/kaplet 150 mg n/a
27. Amiodaron injeksi 150 mg/3 ml Cordarone
28. Amiodaron tablet/kaplet 200 mg Kendaron Tablet
29. Amitriptilin tablet salut 25 mg (HCl) n/a
30. Amlodipin tablet 10 mg n/a
31. Amlodipin tablet 5 mg n/a
32. Amoksisilin kapsul/kaplet 250 mg n/a
33. Amoksisilin kapsul/kaplet/tablet scored 500 mg n/a
34. Amoksisilin sirup kering forte 250 mg/5 ml n/a
35. Amoksisilin sirup kering 125 mg/ 5 ml n/a
36. Ampisilin serbuk injeksi i.v. 1000 mg/vial n/a
37. Analog insulin long acting inj 100 UI/ml, vial/cartridge disposible/penfill cartridg Lantus Solostar 100IU/ml 5
38. Analog insulin mix acting inj 100 UI/ml, Analog insulin mix acting inj 100 UI/m Novomix Flexpen
39. Analog Insulin Mix Insulin Inj 100 UI/ml Humalog Mix 25 Kwikpen
40. Analog insulin mix insulininj 100 UI/ml, vial/cartridge disposible/penfill cartrid Humalog Mix 25
41. Analog Insulin Rapid Acting Inj 100 UI/ml Humalog Kwikpen
42. Analog insulin rapid acting inj 100 UI/ml, vial/cartridge disposible/penfill Novorapid Vial
cartridge (Insulin Aspart (Analogue))
43. Analog insulin rapid acting inj 100 UI/ml, vial/cartridge disposible/penfill Novorapid Flexpen
cartridge (Insulin Aspart (Analogue))
44. Analog insulin rapid actinginj 100 UI/ml, vial/cartridge disposible/penfill Apidra Solostar 100IU/ml
cartridge (Insulin glulisine 100 IU/ml) 5pens x3ml
45. Analog insulin rapid actinginj 100 UI/ml, vial/cartridge disposible/penfill Humalog
cartridge (Insulin lispro (rDNA origin))
46. Anastrozol tablet/kapsul/kaplet 1 mg Arimidex 1 mg
47. Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg n/a
Magnesium Hidroksida 200 mg
48. Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg/5 ml n/a
Magnesium Hidroksida 200 mg/5 ml
49. Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g Polimiksin 10.000 IU/g n/a
50. Antihemoroid, kombinasi: bismut subgalat 150 mg heksaklorofen 2,5 mg n/a

lidokain 10 mg seng oksida 120 mg
51. Antimalaria DOEN kombinasi : Pirimetamin 25 mg Sulfadoksin 500 mg n/a
52. Antimigren: Ergotamin Tartrat 1 mg + Kofein 50 mg n/a
53. Antiparkinson DOEN tablet kombinasi : Benserazid 25 mg Levodopa 100 mg Levopar Tablet
54. Artemether injeksi 80 mg/ml Artem

55. Artesunate injeksi i.v./i.m. 60 mg/ml Artesunate
56. Asam Asetilsalisilat (asetosal) tablet 100 mg n/a
57. Asam Asetilsalisilat (asetosal) tablet/kaplet/kapsul 80 mg Miniaspi 80
58. Asam Askorbat (Vitamin C) tablet 250 mg n/a
59. Asam Askorbat (Vitamin C) tablet 50 mg n/a
60. Asam Folat tablet/kapsul/kaplet 0,4 mg Starfolat
61. Asam Folat tablet/kapsul/kaplet 1 mg n/a
62. Asam Ibandronat injeksi 6mg/6ml Bondronat
63. Asam Mefenamat kapsul/kaplet 250 mg n/a
64. Asam Mefenamat kapsul/kaplet 500 mg n/a
65. Asam pipemidat kapsul 400 mg Urotractin 400 mg
66. Asam traneksamat injeksi 50 mg/ml n/a
67. Asam zoledronat injeksi 4mg/5mL ZOMETA
68. Asiklovir salep mata 3% Temiral Eye Oint
69. Asiklovir tablet/kapsul/kaplet 200 mg n/a
70. Asiklovir tablet/kapsul/kaplet 400 mg n/a
71. Asparaginase serbuk injeksi 10.000 UI/vial Leunase
72. Atapulgit tablet 600 mg Pularex
73. Atenolol tablet/kapsul/kaplet 100 mg Betablok
74. Atenolol tablet/kapsul/kaplet 50 mg Farnormin
75. Atrakurium injeksi 25 mg/2,5 ml Tracrium
76. Atropin injeksi i.v./i.m./s.k. 0,25 mg/ml n/a
77. Atropin Sulfat tablet 0,5 mg n/a
78. Atropin Sulfat tetes mata 0,5% Cendo Tropin 0,5%
79. Atropin Sulfat tetes mata 1% Cendo Tropin 1%
80. Azitromisin sir kering 200 mg/ 5 mL n/a
81. Azitromisin tablet 500 mg n/a
82. Azitromisin tablet 250 mg n/a
83. Bedak salisil serbuk 2% n/a
84. Benzatin Benzil Penisilin 1,2 juta IU/ vial n/a
85. Benzatin Benzil Penisilin 2,4 juta IU/vial n/a
86. Beractant injeksi / suspensi 25 mg/mL Survanta
87. Beraprost sodium tablet 20 mcg Dorner
88. Betametason krim 0,1% (sebagai Valerat) n/a
89. Betametason tetes mata 1 mg/ml Betam Ophtal ED
90. Bevasizumab injeksi 25 mg/ml (Skema Risk Sharing sesuai Kepmenkes RI Avastin
Nomor HK.02.02/Menkes/223/2014)
91. Bikalutamid tablet salut 150 mg Casodex 150 mg
92. Bikalutamid tablet salut 50 mg Casodex 50 mg
93. Bisakodil suppositoria 10 mg Stolax supp
94. Bisakodil suppositoria 5 mg Dulcolax Supp Infant
95. Bisoprolol tablet 2,5 mg Concor 2.5
96. Bisoprolol tablet 5 mg n/a
97. Bleomisin serbuk injeksi 15 mg/ampul BLEOCIN
98. Bromokriptin tablet 2,5 mg Cripsa tab
99. Budesonid inhaler 200 mcg/puff, 100 dosis Pulmicort Turbuhaler
100. Budesonid inhaler 200 mcg/puff, 200 dosis Obucort Swinghaler
101. Budesonid respules / cairan inhaler 0,25mg/mL Pulmicort Respules
102. Budesonid-formoterol (fixed combination) inhaler 160/4,5 mcg Symbicort Turbuhaler
160/4.5 mcg
103. Budesonid-formoterol (fixed combination) inhaler 80/4,5 mcg Symbicort 80/4.5 mcg
104. Bupivakain injeksi 0,50% (HCl) + glukosa 8% n/a
105. Bupivakain injeksi 0,50% (P.V) Bunascan
106. Dabigatran eteksilat kapsul 75 mg Pradaxa
107. Dabigatran eteksilat kapsul 110 mg Pradaxa
108. Dakarbazin serbuk injeksi 200 mg/vial DBL Dacarbazine
109. Daunorubisin serbuk injeksi 20 mg/vial DAUNOCIN
110. Deferasiroks tablet disp/ eff 250 mg Exjade 250 mg Tab
111. Deferasiroks tablet disp/ eff 500 mg Exjade 500 mg Tab
112. Deferipron larutan oral 100 mg/mL Ferriprox Oral Solution
113. Deferipron tablet 500 mg Ferriprox tablet
114. Deferoksamin Mesilat serbuk injeksi 500 mg Desferal
115. Deksametason injeksi i.v./i.m. 5 mg/ml n/a
116. Deksametason tablet 0,5 mg n/a
117. Desogestrel tablet 75 mcg Cerazette
118. Desoksimetason krim 0,25% DEXIGEN
119. Desoksimetason krim 0,25% n/a
120. Desoksimetason salep 0,25% Dexocort
121. Diazepam larutan rektal 5 mg/2,5 mL STESOLID
122. Diazepam injeksi i.v./i.m 5 mg/ml n/a
123. Diazepam larutan rektal 10 mg/2,5 mL STESOLID
124. Diazepam tablet/kapsul/kaplet 2 mg n/a
125. Dietilkarbamazin tablet scored 100 mg n/a
126. Difenhidramin injeksi i.v./i.m. 10 mg/ml (HCl) n/a
127. Digoksin injeksi 0,25 mg/ml Fargoxin inj
128. Digoksin tablet 0,25 mg n/a
129. Diltiazem HCl tablet 30 mg n/a
130. Diltiazem infus injeksi 50 mg Herbesser Powder
Injection 50mg
131. Diltiazem injeksi 25 mg/5 mL Farmabes Injeksi 25 mg
132. Diltiazem Kapsul SR 100 mg Herbesser CD 100
133. Diltiazem Kapsul SR 200 mg Herbesser CD 200
134. Dimenhidrinat tablet/kapsul/kaplet 50 mg n/a
135. Dinatrium edetat tetes mata 0,35% E.D.T.A
136. Dinatrium klodronat infus kons 60 mg/mL Bonefos Infus 60 mg / 5 ml
137. Dobutamin injeksi 50 mg/mL DOBURAN

138. Doksazosin mesilat tablet 1 mg Cardura 1mg
139. Doksazosin mesilat tablet 2 mg Cardura 2mg
140. Doksisiklin tablet/kapsul/kaplet 100 mg n/a
141. Doksorubisin serbuk injeksi i.v. 10 mg/vial Doxorubicin kalbe
142. Doksorubisin serbuk injeksi i.v. 50 mg/vial Doxorubicin Actavis 50 mg
143. Domperidon suspensi/sirup 5 mg/5 ml n/a

144. Domperidon tablet 10 mg n/a
145. Domperidon tetes 5 mg/mL n/a
146. Dopamin injeksi 40 mg/ml UDOPA
147. Dosetaksel injeksi 20 mg/0,5 ml n/a
148. DTPA (diethylene triamine pentaacetic acid) 2,06-2,5 mg pentetate calcium Renalscan KaeF
trisodium/mL
149. Dutasterid kaps lunak 0,5 mg Avodart
150. Efavirens tablet salut 600 mg n/a
151. Efedrin Inj 50 mg/ml n/a
152. Eksemestan tablet 25 mg Aromasin
153. Enoksaparin sodium inj 20 mg/0,2 mL Lovenox 2000 ANTI-XA
156. Epinefrin (Adrenalin) injeksi i.v/s.k./i.m 1 mg/ml n/a
157. Epirubisin serb injeksi 50 mg/25ml (Produk Kosong s/d awal Agustus 2015) Epirubisin Kalbe
158. Epirubisin serb injeksi 10 mg/5 ml n/a

159. Ergokalsiferol (vitamin D3/D2) kapsul 50.000 UI D-Vit FT
160. Ergokalsiferol (vitamin D3/D2) suspensi 10.000 UI/ml D-Vit Syrup
161. Eritromisin kapsul/kaplet 250 mg n/a
162. Eritromisin kapsul/kaplet 500 mg n/a
163. Eritromisin sirup kering 200 mg/ 5 ml n/a
164. Eritropoetin-alfa inj 10000 UI/mL Hemapo 10.000 IU
165. Eritropoetin-alfa inj 2000 UI/mL Eprex 2000
166. Eritropoetin-alfa inj 3000 UI/mL Hemapo 3000
167. Eritropoetin-beta inj 2000 UI/0,3 mL Recormon
168. Estrogen terkonjugasi tablet salut 0,625 mg Esthero 0.625mg
169. Etambutol tablet 250 mg (HCl) n/a
170. Etambutol tablet salut 500 mg (HCl) n/a
171. Etanol 70% cairan n/a
172. Etinilestradiol tablet 0,05 mg Lynoral
173. Etonogestrel implan 68 mcg Implanon
174. Etoposid injeksi 20 mg/ml Posyd
175. Eugenol cairan n/a
176. Everolimus tab 0,25 mg Certican 0,25 mg Tab
177. Everolimus tab 0,5 mg Certican 0,5 mg Tab
178. Faktor IX kompleks serbuk injeksi 1.000 UI/vial + pelarut 10 ml Nonafact 1000 IU
179. Faktor IX kompleks serbuk injeksi 500 UI/vial + pelarut 5 ml Nonafact 500 IU
180. Faktor koagulasi II 14-35 UI, faktor koagulasi VII 7-20 UI, faktor koagulasi IX Cofact 500 IU/20 ml
25 UI, faktor koagulasi X 14-35 UI
181. Faktor Koagulasi II 14-35 UI, Faktor Koagulasi VIII 7-20 UI, Faktor Koagulasi Cofact 250 IU
IX 25 UI, Faktor Koagulasi X 14-35 UI (250 IU/10ml)
182. Faktor VIIa (rekombinan) serb inj 1 mg/vial + pelarut untuk injeksi Novoseven
183. Faktor VIII (konsentrat) serb inj 230 -340 UI Haemoctin
184. Faktor VIII (konsentrat) serb inj 250 UI/vial + pelarut 5 mL Haemoctin
185. Faktor VIII (konsentrat) serb inj 480 - 600 UI KOATE DVI 500 IU
186. Faktor VIII (konsentrat) serb inj 500 UI/vial + pelarut 5 ml Aafact 500 IU
187. Fenitoin injeksi 50 mg/ml n/a
188. Fenitoin kapsul/kaplet 100 mg n/a
189. Fenitoin Na Inj 100 mg/2 ml n/a
190. Fenobarbital injeksi i.m./i.v. 50 mg/ml n/a
191. Fenobarbital tablet/kapsul/kaplet 100 mg n/a
192. Fenofibrat kaps 100 mg n/a
193. Fenofibrat kaps 300 mg n/a
194. Fenoksimetil penisilin (penisilin V) tablet 250 mg n/a
195. Fenoksimetil penisilin (penisilin V) tab 125 mg Fenocin
196. Fenoksimetil penisilin (penisilin V)tablet 500 mg n/a
197. Fenoterol HBr ih 100 mcg/puff Berotec MDI
198. Fenoterol HBr inh solution 0,1% Berotec Solution
199. Fentanil injeksi i.m/i.v 0,05 mg/ml, ampul 10 ml n/a
200. Fentanil injeksi i.m/i.v 0,05 mg/ml, ampul 2 ml n/a
201. Fentanil patch 12,5 mcg/jam Durogesic 12,5 MU Matrix
202. Fentanil patch 25 mcg/jam Durogesic 25 MU Matrix

203. Fentanil patch 50 mcg/jam Durogesic 50 MU Matrix
204. Filgrastim inj 300 mcg/mL Leucogen
205. Finasterid tab 5 mg Prostacom
206. Fitomenadion (Vit.K1) tablet salut gula 10 mg n/a
207. Fitomenadion (Vitamin K1) injeksi i.m. 2 mg/ml n/a
208. Fludarabin inj 50 mg Fludara IV LYO
209. Fludarabin tab 10 mg Fludara Oral
210. Flufenazin injeksi i.m. 25 mg/ml Sikzonoate Injeksi
211. Flukonazol injeksi 2 mg/ml n/a
212. Flukonazol tablet/kaplet/kapsul 50 mg Diflucan 50mg
213. Flukonazol tablet/kapsul 150 mg n/a
214. Fluoksetin tablet 10 mg Foransi 10
215. Fluoksetin tablet 20 mg NOPRES
216. Fluorometolon tetes mata 0,1 % Ocuflam ED
217. Fluorourasil inj 250 mg/mL Curacil
218. Fluorourasil inj 500 mg/ 5 mL Curacil
219. Flusinolon asetonid krim 0,025% SYNARCUS
220. flusinolon asetonid salep 0,025% Dermasolon oint
221. Flutikason furoat intranasal spray Avamys
222. Flutikason propionat nebules 0,5 mg Flixotide Nbules
223. Fondaparinuks inj 2,5 mg/0,5 mL Arixtra
224. Fraksi protein plasma lar inf 5% Plasmanate
225. Furosemid injeksi i.v./i.m. 10 mg/ml n/a
226. Furosemid tablet 40 mg n/a
227. Gadobutrol macrocyclic 5 mg Gadovist 5 mg
228. Gadobutrol macrocyclic 7,5 mg Gadovist 7,5 mg
229. Gadoksetat disodium 0,25 mmol gadoxetate disodium/mL Primovist
230. Gansiklovir serb inj 500 mg (50 mg/mL) Cymevene
231. Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium klorida 0,30 g n/a
Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
232. Gefitinib tab 250 mg Iressa 250 mg
233. Gemfibrozil kapsul/kaplet 300 mg n/a
234. Gemfibrozil tablet 600 mg n/a
235. Gemsitabin inj 1000 mg/vial Gemzar 1000 mg
236. Gemsitabin inj 200 mg/vial n/a
237. Gentamisin injeksi 40 mg/ ml n/a
238. Gentamisin salep mata 0,3% Genoint Salep Mata
239. Gentamisin tetes mata 0,3% n/a
240. Glibenklamid tablet 5 mg n/a
241. Gliklazid tab 80 mg Glicab
242. Gliklazid tab 30 mg Diamicron MR 30
243. Gliklazid tablet lepas lambat 60 Mg Diamicron MR 60
244. Glikuidon tab 30 mg n/a
245. Glimepiride tablet 1 mg n/a
249. Glipizid tablet/kaplet/kapsul 10 mg Glucotrol 10 mg
250. Glipizid tablet/kaplet/kapsul 5 mg Glucotrol 5 mg
251. Gliseril trinitrat inj 50 mg/10 mL DBL Gliceryl Trinitrate 50
mg/10 ml inj.
252. Gliseril trinitrat kaps SR 2,5 mg Nitrokaf Retard
253. Gliseril trinitrat kaps SR 5 mg Nitrokaf Forte
254. Gliseril trinitrat tab sublingual 0,5 mg Nitral
255. Gliserin lar 50% Gliserin lar 50%
256. Glukosa larutan infus 10 % steril n/a
257. Glukosa larutan infus 5 % steril n/a
258. Goserelin asetat inj 10,8 mg/vial Zoladex 10,8 mg
259. Goserelin asetat inj 3,6 mg Zoladex 3,6 mg
260. Griseofulvin tablet 125 mg n/a
261. Haloperidol inj 50 mg/mL Haldol Decanoas
262. Haloperidol injeksi i.m 5 mg/ml Lodomer Injeksi
263. Haloperidol tablet 0,5 mg n/a
264. Haloperidol tablet 5 mg n/a
265. Haloperidol tablet 1,5 mg n/a
266. Haloperidol tablet 2 mg Lodomer 2
267. Haloperidol tts 2 mg/mL LODOMER DROPS
268. Halotan Inhalasi Halothane
269. Heparin injeksi i.v./s.k. 5000 UI/ml Inviclot
270. Hepatitis B imunoglobulin (human) Hyperhep B
271. hidroklorotiazid tab 25 mg n/a
272. Hidrokortison krim 1% n/a
273. Hidrokortison krim 2,5 % n/a
274. Hidroksi Urea tablet/kaplet/kapsul 500 mg HYDROXYUREA MEDAC
275. Hiosin butilbromid injeksi 20 mg/ml n/a
276. Homatropin tetes mata 2% Homatro 2%
277. Human Insulin Intermediate Acting Inj 100 UI/ml Humulin N Kwikpen
278. Human insulin intermediate acting inj 100 UI/ml, vial (Human Insulin Insulatard Vial
(Intermediate-Acting))
279. Human insulin intermediate acting inj 100 UI/ml, vial (Insulin human Basal) Humulin N Vial
280. Human insulin intermediate acting inj 100 UI/ml,penfill cartridge (Human Insulatard Penfill
Insulin (Intermediate-Acting))
281. Human insulin intermediate acting inj 100 UI/ml,penfill cartridge (Insulin Sansulin N
human Basal)
282. Human insulin intermediate acting inj 100 UI/ml,penfill cartridge (Insulin Humulin N Cart
human Basal)
283. Human insulin intermediate acting inj 100iu/ml, vial (Insulin Human Basal) Insuman Basal vial 5ml,
100iu/ml
284. Human insulin mix inj 100iu/ml, vial (Insulin Human Comb 25) Insuman Comb 25 vial 5ml,
100iu/ml
285. Human Insulin Mix Insulin Inj 100 UI/ml Humulin 30/70 Kwikpen
286. Human insulin mix insulin inj 100 UI/ml, penfill cartridge (Human Insulin Mixtard Penfill
(Premix: 30% Soluble + 70 % NPH Insulin))
287. Human insulin mix insulin inj 100 UI/ml, penfill cartridge (Insulin human Comb) Humulin 30/70 Cart
288. Human insulin mix insulin inj 100 UI/ml, vial (Human Insulin (Premix: 30% Mixtard Vial
Soluble + 70 % NPH Insulin))
289. Human insulin mix insulin inj 100 UI/ml, vial (Insulin human Comb) Humulin 30/70 Vial
290. Human Insulin Short Acting Inj 100 UI/ml Humulin R Kwikpen
291. Human insulin short acting inj 100 UI/ml, penfill cartridge (Human Insulin Actrapid Penfill
(Short Acting))
292. Human insulin short acting inj 100 UI/ml, penfill cartridge (Insulin human Humulin R Cart
Rapd)
293. Human insulin short acting inj 100 UI/ml, penfill cartridge (Insulin human Sansulin R
Rapd)
294. Human insulin short acting inj 100 UI/ml, vial (Human Insulin (Short Acting)) Actrapid Vial
295. Human insulin short acting inj 100 UI/ml, vial (Insulin human Rapd) Humulin R Vial
296. Human insulin short acting inj 100iu/ml, vial (Insulin Human Rapid) Insuman Rapid vial 5ml,
100iu/ml
297. Human tetanus imunoglobulinn injeksi i.m. 250 UI Tetagam
298. Ibuprofen sirup 100 mg/5 ml n/a
299. Ibuprofen suspensi 200 mg/5 ml n/a
300. Ibuprofen tablet 200 mg n/a
301. Ibuprofen tablet 400 mg n/a
302. Ifosfamid serbuk injeksi 1000 mg/vial Holoxan injeksi 1000
303. Imanitib Mesilat tablet salut selaput 100 mg (Skema Risk Sharing sesuai Glivec
Kepmenkes RI Nomor HK.02.02/Menkes/223/2014)
304. Imidapril tab 10 mg Tanapress 10mg
305. Imidapril tab 5 mg Tanapress 5mg
306. Iopamidol 200-300 mg Iodium/mL (300mg @ vial 100ml) Iopamiro
312. Iopromide 300-370 mg Iodium/mL (300 mg / 100 ml) Ultravist 300/100 mg
316. Ipratropium bromida inhalasi 20 mcg/semprot Atrovent HFA
317. Ipratropium bromida nebulizer 0,025% Atrovent solution for
inhalation 0.025%
318. Irbesartan tab 150 mg n/a
319. Irbesartan tab 300 mg n/a
320. Irinotekan inf 20 mg/ml n/a
321. Isofluran inhalasi Terrell
322. Isoniazid tablet/kapsul/kaplet 100 mg n/a
323. Isoniazid tablet/kapsul/kaplet 300 mg n/a
324. Isosorbid Dinitrat injeksi i.v 10 mg/10 ml Farsorbid inj
325. Isosorbid Dinitrat tablet sublingual 5 mg n/a
326. Isosorbid dinitrat tablet/kaplet/kapsul 10 mg Isonat
327. Kalium aspartat tab 300 mg Kalipar
328. Kalium Klorida tablet 600 mg KSR
329. Kalsium Folinat (Leukovorin Ca) inj 50 mg/ml DBL Leucovorin
330. Kalsium Glukonat injeksi i.v 10% (100 mg/ml) Kalsium glukonat
331. Kalsium Karbonat tablet/kapsul/kaplet 500 mg Calporosis D500
332. Kalsium Laktat (Kalk) tablet/kapsul/kaplet 500 mg n/a
333. Kalsium polistirena sulfonat ktg 5 g KALQUEST
334. Kanamisin inj 1000 mg/ vial n/a
335. Kandesartan tab 16 mg n/a
336. Kandesartan tab 8 mg n/a
337. Kapesitabin tab 500 mg Xeloda
338. Kaptopril tablet 50 mg n/a
339. Kaptopril tablet scored 25 mg n/a
340. Kaptopril tablet scored12,5 mg n/a
341. Karbamazepin sirup 100 mg/5 ml Tegretol Syrup 100mg/5ml,
120ml
342. Karbamazepin tablet 200 mg n/a
343. Karbimazol tab 5 mg Neo-Mercazole
344. Karbogliserin tetes telinga 10% Karbogliserin tetes telinga
10%
345. Karboplatin 150 mg / 15 ml DBL Carboplatin 150 mg
346. Karboplatin 450 mg / 45 ml DBL Carboplatin 450 mg
347. Karvediol tablet/kaplet/kapsul 6,25 mg V - BLOC
348. Ketamin injeksi i.v. 100 mg/ml KTM
349. Ketamin injeksi i.v. 50 mg/ml Ketamin Hameln
350. Ketokonazol krim 2% n/a
353. Ketokonazol scalp sol 2% Zoloral SS
354. Ketokonazol tablet 200 mg n/a
355. Ketoprofen supositoria 100 mg Protofen Supp
356. Ketorolac injeksi 30 mg/ml n/a
357. Klaritromisin tab 500 mg ORIXAL
358. Klindamisin kapsul/kaplet 150 mg n/a
359. Klindamisin kapsul/kaplet 300 mg n/a
360. Klobazam tab 10 mg n/a
361. Klomifen sitrat tablet/kapsul/kaplet t 50 mg Clomifil 50mg
362. Klonidin injeksi i.v 0,15 mg/ml (HCL) (150) Catapres Injeksi
363. Klonidin tablet 0,15 mg n/a
364. Klopidogrel tab 75 mg n/a
365. Kloramfenikol salep kulit 2% Bufacetin
366. Kloramfenikol salep mata 1 % n/a
367. Kloramfenikol serb inj 1000 mg/mL Colsancetine Injeksi
368. Kloramfenikol suspensi 125 mg/ 5 ml n/a
369. Kloramfenikol tablet/kapsul/kaplet 500 mg Chloramex
370. Klorfeniramina Maleat (CTM) tablet/kapsul/kaplet 4 mg n/a
371. Klorpromazin injeksi i.m. 25 mg/ml (HCl) n/a
372. Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) n/a
373. Klorpromazin tablet salut 100 mg (HCl) n/a
374. Klorpromazin tablet salut 25 mg (HCl) n/a
375. Klozapin 100 mg n/a
376. Klozapin 25 mg n/a
377. Kodein tablet 10 mg n/a
380. Kolekalsiferol (vitamin D3) kapsul lunak 0,25 mcg Ostriol
381. Kolkisin tablet/kaplet/kapsul 500 mcg Recolfar
382. Koloid HES BM 130 000 lar inf 6% Voluven
383. Kombinasi : Ipratropium bromida inhalasi 0,5 mg Salbutamol 2,5 mg Combivent UDV
384. Kombinasi injeksi depot : Medroksi progesteron asetat 25 mg Estradiol sipionat n/a
5 mg
385. Kombinasi suspensi : Parafin + gliserin + fenolftalein Laxadine Emulsi 60 ml
386. Kombinasi tablet salut : Besi (II) sulfat 7H2O 200 mg Asam folat 0,25 mg n/a
387. Kombinasi tetes mata 2,5 mg/mL: Natrium klorida 8,664 mg; Kalium klorida Cendo Lyteers
1,32 mg
388. Kombinasi: Artemether 20 mg; Lumefantrin 120 mg Coartem
389. Kombinasi: Levodopa 100 mg; Karbidopa 25 mg; Entekapon 200 mg Stalevo
390. Kombinasi: Lopinavir 200 mg; Ritonavir (LPV/r) 50 mg Aluvia
391. Kombinasi: Salmeterol 25 mcg; Flutikason propionat 50 mcg Seretide Inhaler 50 mcg
392. Kombinasi: Salmeterol 50 mcg; Flutikason propionat 100 mcg Seretide Diskus 100 mcg
393. Kombinasi: Salmeterol 50 mcg; Flutikason propionat 250 mcg Seretide Diskus 250 mcg
394. Kontrasepsi pil oral, kombinasi :* Levonorgestrel 150 mcg Etinilestradiol 30 n/a
mcg
395. Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg n/a
Trimetoprim 80 mg
396. Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Trimetoprim 40 mg / n/a
5 ml
397. Kuinin (Kina) tablet 200 mg n/a
398. Kuinin injeksi i.v. 25% (sebagai 2 HCl) n/a
399. Kuinin tablet 222 mg (H2SO4.7H2O) n/a
400. Laktulosa sir 3,335 g/5 mL n/a
401. Lamivudin tablet/kaplet/kapsu 100 mg Heplav
402. Lamivudine tablet 150 mg n/a
403. Lansoprazol inj 30 mg/ml Prosogan Inj.
404. Lanzoprazol kapsul/kaplet 30 mg n/a
405. Lapatinib tab 250 mg Tykerb
406. Larutan mengandung Asam Amino (Asam Amino 10%) Kalbamin
407. Larutan mengandung Asam Amino (Asam Amino 100 g, Total N 15,7 g, Na+ 2 Amiparen
mEq, Asetat 120 mEq)
408. Larutan mengandung Asam Amino (Asam Amino 27 g, Sorbitol 50 g, Cl- 52 Pan-amin G
mEq)
409. Larutan mengandung Asam Amino (Asam Amino 30 g, Glukosa 7,3 % dan Aminofluid
elektrolit) 1000 ml
410. Larutan mengandung Asam Amino (Asam Amino 30 g, Glukosa 7,3 % dan Aminofluid
elektrolit) 500 ml
411. Larutan mengandung Asam Amino (Asam Amino 5% dengan BCAA 45%, L- Aminofusin Hepar
Ornithine L Aspartate 8.03 gr/L, Sorbitol 50 gr/L, Xylitol 50 gr/L)
412. Larutan mengandung Asam Amino (Asam Amino 6%, mengandung Taurine Aminosteril Infant 6%
0,24 gr/l)
413. Larutan mengandung Asam Amino (Asam Amino 7%, Komposisi: Asam Amino Nephrosteril
esensial: Asam Amino non esensial = 60 : 40)
414. Larutan mengandung Asam Amino (Asam Amino 72.05 g, Total N 11.53 g, Kidmin
AAE/AANE ratio 2.6, Na+ 2 mEq, Asetat 46 mEq)
415. Larutan mengandung Asam Amino (Asam Amino 79.9 g, Total N 12.2 g, Na+ Aminoleban
14 mEq, Cl 94 mEq)
416. Larutan mengandung Asam Amino (Asam amino 8%) Aminosteril N-Hepa
417. Larutan mengandung Asam Amino (Asam Amino esensial 7%+Xylitol 10 g/L) Eas Pfrimer
418. Larutan mengandung Asam Amino (BCAA 25 gr/L, L-Ornithine L Aspartate 10 Comafusin Hepar
gr/L, Xylitol 50 gr/L, Malic Acid 7 gr/L, Piridoxin 0.12 gr/L)
419. Larutan mengandung Asam Amino (Kombinasi Asam aminno 50 g/L, Sorbitol Aminofusin L600
50 g/L, Xylitol 50 g/L, Asam Askorbat (Vit C) 0.4 g/L, Inositol 0.5 g/L,
Nikotinamida (Niasinamida) 0.06 g/L, Piridoksin HCl (Vit B6) 0.04 g/L,
Riboflavin Natrium Fosfat 2.5 mg/L, elektrolit)
420. Larutan mengandung Asam Amino (Kombinasi Asam amino 50 g/L, vitamin dan Aminofusin Paed
elektrolit)
421. Larutan mengandung Asam Amino (Kombinasi Asam Amino: 34gr, Glukosa: Kabiven 1440 ml
97gr, Lipid: 51gr dan Elektrolit (Kalori = 1000 kkal, Akses peripheral))
422. Larutan mengandung Asam Amino (Kombinasi Asam Amino: 45gr, Glukosa: Kabiven 1920 ml
130gr, Lipid: 68gr dan Elektrolit (Kalori = 1400 kkal, Akses peripheral))
423. Larutan mengandung Asam Amino (Kombinasi Glukosa dan elektrolit 150 gr + Combiflex Plus (790 kcal)
Asam Amino 48 gr dgn akses sentral)
424. Larutan mengandung Asam Amino (Kombinasi Glukosa dan elektrolit 80 gr + Combiflex peri (480 kcal)
Asam Amino 40 gr )
425. Larutan mengandung Elektrolit (Kalium Klorida) Otsu - KCl 7,46%
426. Larutan mengandung Elektrolit (Larutan Ringer Laktat) Wida RL
427. Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 Asering
mEq)
428. Larutan mengandung Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr) KA EN 1B
429. Larutan mengandung Elektrolit (Sodium Lactate sol (50%) 113 gr/L, Potassium Totilac
Chloride 0.3 gr/L, Calcium Chloride 0.2 gr/L, elektrolit)
430. Larutan mengandung Elektrolit (Tiap 1000 ml mengandung electrolit: Sodium Ringerfundin 500 mL
145 mmol/l, Potassium 4.0 mmol/l, Calcium 2.5 mmol/l, Magnesium 1.0
mmol/l, Chloride 118 mmol/l, Acetate 24 mmol/l, Malate 5.0 mmol/l)
431. Larutan mengandung Karbohidrat (Fructose 120 g, glucose 66 g, Xylitol 60 g/ L Triofusin 1000
+ elektrolit)
432. Larutan mengandung Karbohidrat (Fructose 60 g, glucose 33 g, Xylitol 30 g/ L) Triofusin 500
433. Larutan mengandung Karbohidrat (Maltose 100 gr) Martos

434. Larutan mengandung Karbohidrat + Elektrolit (25.00g maltose, 3.00 g sodium Potacol inj
chloride, 0.15 g potassium chloride, 0.10 g calcium chloride dihydrate dan 1.55
g sodium lactate)
435. Larutan mengandung Karbohidrat + Elektrolit (Acetate, Na, K, Cl, Ca, Mg, Tutofusin OPS
Sorbitol 50 gr/L)
436. Larutan mengandung Karbohidrat + Elektrolit (Asam amino 28 gr/L, Glukosa Clinimix N9G20E
100 gr/L, elektrolit)
437. Larutan mengandung Karbohidrat + Elektrolit (Asam amino 28 gr/L, Glukosa Clinimix N9G15E
75 gr/L, elektrolit)
438. Larutan mengandung Karbohidrat + Elektrolit (Fructose 60 g, glucose 33 g, Triofusin E1000
Xylitol 30 g/ L)
439. Larutan mengandung Karbohidrat + Elektrolit (Glukosa 25 g, NaCl 2,0 g, KCl Wida HSD
1,3 g, Natrium Laktat 3,1 g, air untuk injeksi ad 1000 ml)
440. Larutan mengandung Karbohidrat + Elektrolit (Glukosa 55 g ; Natrium Chloride Wida D5-NS
9 g, air untuk injeksi ad 1000 ml)
441. Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 25,0 g; NaCl: 4,5 g) WIDA 2A
442. Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g; NaCl: 2.25 g) WIDA D5-1/4NS
443. Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g; NaCl: 4.5 g) WIDA D5-1/2NS
444. Larutan mengandung Karbohidrat + Elektrolit (Larutan nutrisi kombinasi infus Futrolit
per L: Na. 100mEQ, K 18mEQ, Ca. 4mEQ, Mg 6mEQ, Cl 90mEQ, Asetat
38mEQ, Sorbitol 50g)
445. Larutan mengandung Karbohidrat + Elektrolit (Larutan Ringer & Glukosa 5%) Wida RD
446. Larutan mengandung Karbohidrat + Elektrolit (NaCl 1.75 g, KCL 1.5g, Glukosa KA ENMG 3
100 gr)
447. Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr, Na KA EN 3B
Lactat 2.24 gr, Dekstrosa 27 gr)
448. Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat 2.24 gr, KA EN 3A
KCL 0.75 gr Dekstrosa 27 gr)
449. Larutan mengandung Lipid ( Infus Lipid Emulsi MCT/LCT 20% 100 ml) Lipofundin MCT/LCT 1%
100
450. Larutan mengandung Lipid (Emulsi lemak 20%) Intralipid
451. Larutan mengandung Lipid (Infus Lipid Emulsi MCT/LCT 20% 250 ml) Lipofundin MCT/LCT 1%
250
452. Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 180 gr + Asam Nutriflex Lipid Special 1250
Amino 71.8 gr + Lipid 50 gr dgn akses sentral)
453. Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 80 gr + Asam Nutriflex Lipid Peri 1250
Amino 40 gr + Lipid MCT/LCT 50 gr)
454. Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 90 gr + Asam Nutriflex Lipid Special 625
Amino 35.9 gr + Lipid 25 gr dgn akses sentral)
455. Latanoprost tetes mata 0,01% Cendo Glaopen
456. Latanoprost tts mata 0,005% btl@2,5ml Xalatan 0,005%
457. Lenograstim inj 263 mcg/mL Granocyte 34 1vl HSA Free
458. Letrozol tablet/kaplet/kapsul 2,5 mg FEMARA

459. Leuprorelin asetat inj depot 1,88 mg Tapros 1.88mg
460. Leuprorelin asetat inj depot 11,25 mg Tapros 3M
461. Leuprorelin asetat inj depot 3,75 mg TAPROS 3.75 MG
462. Levofloksasin inf 5 mg/mL n/a
463. Levofloksasin tablet 500 mg n/a
464. Levofloksasin tts mata 0,5% Optiflox
465. Levotiroksin tablet/kaplet/kapsul 100 mcg Euthyrox 100
466. Levotiroksin tablet/kaplet/kapsul 50 mcg Euthyrox 50
467. Lidokain injeksi 2% (HCL) n/a
468. Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml n/a
469. Lidokain jeli 2% Xylocaine Jelly 2%
470. Lidokain semprot 10% Xylocaine Spray 10 mg /
dosis
471. Lisinopril tablet 10 mg n/a
472. Lisinopril tablet 5 mg n/a
473. Litium karbonat tablet 200 mg Frimania 200
474. Litium karbonat tablet 400 mg Frimania 400
475. Loperamid tablet 2 mg n/a
476. Loratadin tablet 10 mg n/a
477. Lorazepam tablet 0,5 mg MERLOPAM 0,5 mg
478. Lorazepam tablet 2 mg Merlopam 2
479. Low molecule feri sucrose inj amp 100 mg/5 mL DIALIFER
480. Magnesium sulfat injeksi 20% OTSU-MgSO4 20
481. Magnesium sulfat injeksi 40% OTSU-MgSO4 40
482. Manitol n/a
483. Maprotilin HCl tab 25 mg Ludios
484. Maprotilin HCl tab 50 mg Sandepril 50
485. MDP (methylene diphosphonate) 1 mg methylene diphosphonic acid/mL Bonescan KaeF
486. Mebendazol tablet 500 mg Vermox 500
487. Medroksi Progesteron Asetat tablet/kaplet/kapsul 100 mg Provera 100mg
488. Medroksi Progesteron asetat tablet/kaplet/kapsul 10 mg Prothyra 10mg
489. Melfalan tablet 2 mg Alkeran
490. Meropenem inj 1 g n/a
491. Meropenem serb inj 500 mg/vial n/a
492. Mesna inj 100 mg/mL Uromitexan injeksi.
493. Metadon sir 50mg/5ml n/a
494. Metformin HCl tablet 500 mg n/a
495. Metformin HCl tablet 850 mg n/a
496. Metildopa tablet salut 250 mg DOPAMET
497. Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg n/a
498. Metilergometrin Maleat injeksi 0,200 mg-1 ml n/a
499. Metilfenidat kapsul LA 20 mg Ritalin LA
500. Metilfenidat tablet SR 10 mg RITALIN
501. Metilprednisolon inj 125 mg/2 mL n/a
502. Metilprednisolon inj 500 mg/8 mL n/a
503. Metilprednisolon tablet 16 mg n/a
506. Metoklopramid drop botol 10 mL GAVISTAL drops
507. Metoklopramide sirup 5 mg/ 5 ml LEXAPRAM SIRUP
508. Metoklopramide tablet 5 mg n/a
509. Metotreksat serb inj 50 mg/2 mL Methotrexate Kalbe
510. Metotreksat serbuk injeksi i.v/i.m./i.t. 5 mg METHOTREXATE EBEWE
511. Metotreksat tablet/kaplet/kapsul 2,5 mg METHOTREXATE EBEWE
2.5 MG
512. Metronidazol infus 500 mg/100 ml n/a
513. Metronidazol ovula 500 mg Vagizol
514. Metronidazol sirup 125 mg/5 Ml Farizol
515. Metronidazol supositoria 500 mg Flagyl
516. Metronidazol tablet 250 mg n/a
517. Metronidazol tablet 500 mg n/a
518. MIBG (meta-iodobenzylguanidine) Endoneuroscan KaeF 1
519. MIBI (metoxy iso butyl iso nitril) 5-mL reaction vial Cardioscan KaeF
520. Midazolam injeksi i.v. 5 mg/ml Dormicum
521. Mikafungin Na serb inj 50 mg Mycamine
522. Mikofenolat Mofetil 500 mg Cellcept
523. Mikonazol krim/salep 2 % (Nitrat) n/a
524. Modified fluid gelatine BM 30 000 lar inf 4% Gelofusine 4%
525. Moksifloksasin tetes mata 0,5% Vigamox
526. Mometason furoat krim 0,1% n/a
527. Morfin HCL inj 10 mg/ml n/a
528. Morfin HCL tablet SR 10 mg MST Continus 10 mg
531. Morfin tablet 10 mg n/a
532. N-asetil sistein inj. nebules 100 mg N-ace cairan inhalasi
533. Nacl 0,9% n/a
534. Nadroparin inj 9500 Axa/mL syringe 0,3 mL Fraxiparine 0.3 ml
535. Nadroparin inj 9500 Axa/mL, syringe 0,4 mL Fraxiparine 0.4 ml
536. Nadroparin inj 9500 Axa/mL, syringe 0,6 mL Fraxiparine 0.6 ml
537. Nalokson injeksi 0,4 mg/ml Nokoba
538. Natrium Bikarbonat injeksi i.v 8,4% Meylon
539. Natrium Diklofenak tablet 50 mg n/a
540. Natrium Diklofenak tablet 25 mg n/a
541. Natrium fosfat btl, 133 mL Fleet Enema
542. Natrium fosfat lar oral 45 mL Fleet Phosphosoda
543. Natrium fusidat krim 20 mg/g Acdat
544. Natrium fusidat salep 20 mg/g Fucilex Ointment
545. Neostigmin injeksi 0,5 mg/ml Neostigmin Hameln inj
546. Nevirapin tablet 200 mg n/a
547. Nifedipin tab 20 mg, slow release; oros Adalat Oros 20 mg
548. Nifedipin tab 30 mg, oros Adalat Oros 30 mg
549. Nifedipin tablet/kapsul 10 mg n/a
550. Nikardipin inj 10 mg/vial n/a
551. Nilotinib kapsul 200 mg (Skema Risk Sharing sesuai Kepmenkes RI Nomor Tasigna
HK.02.02/Menkes/223/2014)
552. Nistatin tablet salut 500.000 IU/ g n/a
553. Nistatin vaginal tablet 100.000 IU/ g n/a
554. Norepinefrin injeksi 1 mg/ml Levosol
555. Noretisteron tablet 5 mg Primolut N
556. Obat Antituberkulosis FDC Kategori 1 n/a
557. Obat Antituberkulosis FDC Kategori 2 n/a
558. Obat Antituberkulosis FDC Kategori Anak n/a
559. Obat Antituberkulosis FDC Sisipan n/a
560. Obat Antituberkulosis Kategori 1 dewasa n/a
561. Obat Antituberkulosis Kategori anak n/a
562. Octreotide Acetate0,05 - 6 mg/mL Octide
563. Ofloksasin tets telinga 3% Tarivid Otic Solution
564. Ofloxacin tablet 200 mg n/a
565. Ofloxacin tablet 400 mg n/a
566. Oksaliplatin serbuk injeksi 100 mg / vial ELOXATIN
567. Oksaliplatin serbuk injeksi 50 mg / vial ELOXATIN
568. Oksimetazolin tetes hidung 0,025% Ilaidin Drops
569. Oksimetazolin tetes hidung 0,050% Iliadin Spray
570. Oksitosin injeksi 10 IU/ml Oxytocin "S"
571. Oktreotid 10 mg Sandostatin LAR
572. Olanzapin inj 10 mg/vial Zyprexa IM
573. Olanzapin kapl salut 5 mg Olandoz 5
574. Olanzapin tab 10 mg Olandoz 10
575. Olopatadin tts mata 0,1% Patanol
576. Omeprazol injeksi 40 mg/ 10 ml n/a
577. Omeprazol kapsul/kaplet 20 mg n/a
578. ondansetron inj 4 mg/ 2 mL n/a
579. Ondansetron tab 4 mg n/a
580. Ondansetron tablet 8 mg n/a
581. Paket CAPD Awal (Komposisi: 1 unit Transfer Set, 2 unit Ultaclam, 1 unit n/a
Tenckoff Catheter, Titanium Adaptor)
582. Paket CAPD Pergantian Transfer Set per 6 bulan n/a
583. Paket CAPD Rutin 120 ( 4x ganti cairan perhari dengan komposisi Larutan Larutan Dialisa 1.5%:
Dialisa 1.5 %, Larutan Dialisa 2.5 %, Larutan Dialisa 4.25 %, Minicap) Dianeal Low Calcium with
1,5% Dextrose; Larutan
Dialisa 2.5%: Dianeal Low
Calcium with 2,5%
Dextrose; Larutan Dialisa
4.25%: Dianeal Low
Calcium with 4.25%
Dextrose
584. Paklitaksel inj 100 mg/vial SINDAXEL 100 MG/16,67

ML
585. Paklitaksel inj 300 mg/vial SINDAXEL 260mg/43.33
ML
586. Paklitaksel injeksi 30 mg/vial SINDAXEL 30 MG/5 ML
587. Parasetamol drop 100 mg/ml btl @15ml (60mg/0,6ml) n/a
588. Parasetamol sirup 120 mg / 5 ml n/a
589. Parasetamol tablet 500 mg n/a
590. Parasetamol tetes 60 mg/0,6 mL FASIDOL
591. Pegylated interferon alfa-2a inj 135 mcg/0,5 ml Pegasys
592. Pegylated interferon alfa-2a inj 180 mcg/0,5 ml Pegasys
593. Pegylated Interferon alfa-2b serb inj 100 mcg Pegintron Vial 100 Mcg
594. Pegylated Interferon alfa-2b serb inj 120 mcg Pegintron Pen 120 Mcg
595. Pegylated Interferon alfa-2b serb inj 50 mcg Pegintron
596. Pegylated Interferon alfa-2b serb inj 80 mcg Pegintron Vial 80 Mcg
597. Perak sulfadiazin krim 1% BURNAZIN 35 GR
598. Perindoprilarginin tab 5 mg Bioprexum 5 mg
599. Permetrin krim 5% Scabimite Cream 10
600. Petidin injeksi i.m/s.k/i.v lambat 50 mg/ml (HCl) n/a
601. Pioglitazon tab 15 mg DECULIN 15 MG
602. Pioglitazon tab 30 mg DECULIN 30 MG
603. Pirantel suspensi 125 mg/5 ml n/a
604. Pirantel tablet score (base) 125 mg n/a
605. Pirazinamid tablet 500 mg n/a
606. Piridoksin (Vitamin B6) tablet/kapsul/kaplet 10 mg (HCl) n/a
607. Piridoksin (vitamin B6) inj 100 mg/mL n/a
608. Polikresulen cairan Aptil
609. Povidon Iodida larutan 10% 1000 ml n/a
613. Pramipeksol tab ER 0,375 mg Sifrol ER 0,375mg
614. Pramipeksol tab ER 0,750 mg Sifrol ER 0,750mg
615. Pravastatin tablet 20 mg n/a
616. Prednison tablet/kapsul/kaplet 5 mg n/a
617. Primakuin tablet 15 mg n/a
618. Probenesid tablet/kapsul/kaplet 500 mg Probenid
619. Prokain Benzilpenisilin serbuk injeksi 3 juta IU/vial n/a
620. Propanolol tablet 10 mg ( HCl ) n/a
621. Propiltiourasil tablet/kapsul/kaplet 100 mg n/a
622. Propofol injeksi i.v., bolus 1% Fresofol 1% MCT/LCT
623. Propranolol tablet 40 mg (HCl) n/a
624. Quetiapin tab 200 mg Seroquel XR 200 mg
627. Ramipril tablet 2,5 mg Cardace 2.5mg 6x10 s
tablet
628. Ramipril tablet 5 mg n/a
629. Ramipril tablet/kaplet/kapsul 10 mg n/a
630. Ranitidin injeksi 25 mg/ml n/a
631. Ranitidin tablet 150 mg n/a
632. Retinol (Vitamin A) 100.000 IU n/a
633. Retinol (Vitamin A) 200.000 IU kapsul lunak n/a
634. Rifampisin tablet salut 450 mg n/a
635. Rifampisin tablet/kapsul/kaplet 300 mg n/a
636. Rifampisin tablet/kapsul/kaplet 600 mg n/a
637. Ringer Laktat larutan infus n/a
638. Risperidon tablet 1 mg n/a
641. Rituksimab injeksi 10 mg/ml (Skema Risk Sharing sesuai Kepmenkes RI Nomor Mabthera
HK.02.02/Menkes/223/2014)
642. Rivaroksaban tab 10 mg Xarelto 10 mg
645. Rokuronium injeksi i.v. 50 mg/5ml Esmeron
646. Ropinirol Tablet Salut 2 mg Requip PD 24 Hour 2 mg
649. Salbutamol cairan ih 0,1% Ventolin Nebules
650. Salbutamol inhalasi/aerosol 100 mcg/dosis Ventolin Inhaler
651. Salbutamol serb inh 200 mcg/kaps Ventolin Rotacaps
652. Salbutamol serb inh 200 mcg/kaps + rotahaler Ventolin Rotahaler
653. Salbutamol tablet 2 mg (sebagai Sulfat) n/a
654. Salep 2-4 , Kombinasi : Asam Salisilat 2% + Belerang endap 4% n/a
655. Sefadroksil sirup kering 125 mg/5ml n/a
656. Sefadroksil kapsul/kaplet 250 mg n/a
657. Sefadroksil kapsul/kaplet 500 mg n/a
658. Sefadroksil sir kering 250 mg/5 mL n/a
659. Sefaleksin kapsul/kaplet 500 mg n/a
660. Sefazolin serbuk injeksi 1 g/vial n/a
661. Sefepim inj 1 g n/a
662. Sefiksim kapsul/kaplet 100 mg n/a
663. Sefiksim sirup kering 100 mg/ 5 ml n/a
664. Sefoperazon inj 1 g n/a
665. Sefotaksim injeksi 0,5 g n/a
666. Sefotaksim injeksi 1 g n/a
667. Seftazidim injeksi 1 g n/a
668. Seftriakson serbuk injeksi 1 g/vial n/a
669. Sefuroksim tablet/kapsul/kaplet 250 mg Zinnat 250 mg
670. Sefuroksim serbuk injeksi 750 mg/vial Sharox inj
671. Sefuroksim tab 500 mg Zinnat 500
672. Sertralin tab 50 mg Fatral
673. Setirizin sirup 5 mg/5 ml n/a
674. Setirizin tablet 10 mg n/a
675. Setuksimab infus 5 mg/ml (Skema Risk Sharing sesuai Kepmenkes RI Nomor Erbitux
HK.02.02/Menkes/223/2014)
676. Sevofluran ih, btl Sojourn
677. Sianokobalamin (vitamin B12) injeksi 500 mcg n/a
678. Sianokobalamin (vitamin B12) tablet/kapsul/kaplet 50 mcg n/a
679. Siklofosfamid serbuk injeksi i.v. 1000 mg CYCLOVID 1000
680. Siklofosfamid serbuk injeksi i.v. 200 mg Cyclovid 200 mg
681. Siklofosfamid serbuk injeksi i.v. 500 mg CYCLOVID 500
682. Siklosporin kaps 100 mg Sandimmun Neoral 100mg
Kap
683. Siklosporin kapsul lunak 25 mg Sandimmun Neoral 25mg
Kap
684. Silostazol tablet/kapsul/kaplet 100 mg Citaz
685. Simvastatin scored tablet 10 mg n/a
686. Simvastatin tablet 20 mg n/a
687. Siprofloksasin infus 2% n/a
688. Siprofloksasin tablet 500 mg (sebagai HCl) n/a
689. Sisplatin serbuk injeksi 10 mg Cisplatin
690. Sisplatin serbuk injeksi 50 mg Cisplatin
691. Sitarabin serbuk injeksi i.m./i.v./s.k. 1gr/10ml DBL Cytarabun
692. Spiramisin tablet 500 mg n/a
693. Spironolakton tablet 100 mg n/a
694. Spironolakton tablet 25 mg n/a
695. Stavudin tablet/kapsul/kaplet 30 mg n/a
696. Streptokinase injeksi 1,5 juta UI/vial Streptase
697. Streptomisin serbuk injeksi i.v 1000 mg/ml n/a
698. Sufentanil injeksi iv, epidural 5 mcg/ml Sufentanyl Injeksi
iv.Epidural 5 mcg / ml
699. Sukralfat susp 500 mg/5 mL Ulsafate
700. Sukralfat tab 500 mg ULSIDEX
701. Takrolimus kaps 0.5 mg Prograf
702. Takrolimus kaps 1 mg Prograf
703. Tamoksifen tablet 20 mg TAMOXIFEN EBEWE
704. Tamsulosin tab 0,2 mg Harnal D
705. Tamsulosin tab 0,2 mg Harnal D
706. Tamsulosin tab SR 0,4 mg Harnal OCAS
707. Telbivudin tab 600 mg Sebivo 600 mg Tab
708. Telmisartan tab 40mg Micardis 40mg
709. Telmisartan tab 80 mg Micardis 80mg
710. Temozolamid kaps 100 mg Temodal
711. Temozolamid kaps 20 mg Temodal
712. Tenofovir tab 300 mg n/a
713. Teofilin tab SR 300 mg Rethapyl
714. Teofilin tablet 150 mg Bronsolvan
715. Terazosin HCl tablet/kapsul/kaplet 1 mg HYTROZ 1MG
716. Terazosin HCl tablet/kapsul/kaplet 2 mg HYTROZ 3MG
717. Terbutalin cairan ih 2,5 mg/mL Bricasma Respules
718. Terbutalin tablet 2,5 mg Molasma Tablet
719. Terbutalin turbu (serbuk ih) 0,50 mg Bricasma Turbuhaler 0,5
mg
720. Testoteron soft capsul 40 mg Andriol Testocaps
721. Tetrakain HCl tetes mata 0,5% Pantocain 0.5%
722. Tetrasiklin kapsul/kaplet 250 mg n/a
723. Tetrasiklin tablet/kapsul/kaplet 500 mg n/a
724. Tiamazol tab 10 mg Thyrozol 10
725. Tiamazol tab 5 mg Thyrozol 5
726. Timolol tetes mata 0,25% Isotic Adretor 0,25%
727. Timolol tetes mata 0,5% Isotic Adretor 0,5%
728. Tiotropium 18 mcg refill Spiriva powder for
inhalation 18mcg 30s
729. Tiotropium kaps 18 mcg + handihaller Spiriva 10s + Handihaler
730. Tramadol injeksi 50 mg/ml n/a
731. Trastuzumab serbuk injeksi 440 mg/vial (Skema Risk Sharing sesuai Herceptin
Kepmenkes RI Nomor HK.02.02/Menkes/223/2014)
732. Travoprost tetes mata 0,004% Travatan
733. Triamsinolon asetonid nasal spray 55 mcg/puff Nasacort AQ
734. Triamsinolon inj 10 mg/mL Flamicort
735. Trifluoperazin tablet 5 mg n/a
736. Tropikamid tetes mata 1% Cendo Mydriatil 1%
737. Urea krim 10% Soft U Derm
738. Vaksin BCG (Harga pengadaan di Kementerian Kesehatan Pusat franco ibukota BCG Vaccine (GS)
739. Vaksin BCG (Harga pengadaan di Kementerian Kesehatan Pusat franco ibukota BCG Vaccine (SII)
740. Vaksin BCG (Harga pengadaan di Kementerian Kesehatan Pusat franco ibukota BCG Vaccine SSI
741. Vaksin BCG (Harga pengadaan di Provinsi franco ibukota Provinsi (Non DIPA BCG Vaccine (SII)
Kemkes))
742. Vaksin BCG (Harga pengadaan di Provinsi franco ibukota Provinsi (Non DIPA BCG Vaccine SSI
Kemkes))
743. Vaksin BCG (Harga pengadaan di Provinsi franco ibukota Provinsi (Non DIPA BCG Vaccine (GS)
Kemkes))
744. Vaksin BCG Kering (BF) (Harga pengadaan di Kementerian Kesehatan Pusat n/a
franco ibukota provinsi (DIPA Kemkes))
745. Vaksin BCG Kering (BF) (Harga pengadaan di Provinsi franco ibukota Provinsi n/a
(Non DIPA Kemkes))
746. Vaksin Campak Kering (Harga pengadaan di Kementerian Kesehatan Pusat n/a
747. Vaksin Campak Kering (Harga pengadaan di Provinsi franco ibukota Provinsi n/a
(Non DIPA Kemkes))
748. Vaksin DTP-HB-Hib (Harga pengadaan di Kementerian Kesehatan Pusat franco Pentabio
749. Vaksin DTP-HB-Hib (Harga pengadaan di Provinsi franco ibukota Provinsi (Non Pentabio
DIPA Kemkes))
750. Vaksin Hepatitis B Rekombinan (Harga pengadaan di Kementerian Kesehatan n/a
Pusat franco ibukota provinsi (DIPA Kemkes))
751. Vaksin Hepatitis B Rekombinan (Harga pengadaan di Provinsi franco ibukota n/a
Provinsi (Non DIPA Kemkes))
752. Vaksin Jerap DT (Adsorbed DT Vaccine) (Harga pengadaan di Kementerian n/a
Kesehatan Pusat franco ibukota provinsi (DIPA Kemkes))
753. Vaksin Jerap DT (Adsorbed DT Vaccine) (Harga pengadaan di Provinsi franco n/a
ibukota Provinsi (Non DIPA Kemkes))
754. Vaksin Jerap Td (Adsorbed Td Vaccine) (Harga pengadaan di Kementerian n/a
Kesehatan Pusat franco ibukota provinsi (DIPA Kemkes))
755. Vaksin Jerap Td (Adsorbed Td Vaccine) (Harga pengadaan di Provinsi franco n/a
ibukota Provinsi (Non DIPA Kemkes))
756. Vaksin Meningitis Meningokokus Menveo
757. Vaksin polio inj (Vaksin Poliomyelitis yang diinaktifkan) Imovax Polio
758. Vaksin Poliomyelitis Oral (Harga pengadaan di Kementerian Kesehatan Pusat n/a
759. Vaksin Poliomyelitis Oral (Harga pengadaan di Provinsi franco ibukota Provinsi n/a
(Non DIPA Kemkes))
760. Vaksin rabies, untuk manusia serbuk injeksi s.k./i.k. + booster Verorab
761. Vaksin rabies, untuk manusia serbuk injeksi s.k./i.k. + booster Verorab
762. Vaksin TT (Harga pengadaan di Kementerian Kesehatan Pusat franco ibukota n/a
763. Vaksin TT (Harga pengadaan di Provinsi franco ibukota Provinsi (Non DIPA n/a
Kemkes))
764. Valasiklovir tablet/kapsul/kaplet 500 mg Valvir
765. Valgansiklovir tab 450 mg Valcyte
766. Valproat sirup 250 mg/5 ml Ikalep
767. Valproat tab SR 250 mg Depakote ER 250 mg
768. Valproat tab SR 500 mg Depakote ER 500 mg
769. Valproat tablet salut 250 mg Depakote Tab 250 mg
770. Valsartan tab 80 mg Diovan 80mg Tab
771. Valsartan tab 160 mg DIOVAN 160 MG
772. Vankomisin serbuk injeksi 500 mg/vial Vancep
773. Verapamil tab 240 mg Isoptin 240 mg
774. Verapamil tablet 80 mg (HCl) n/a
775. Vinblastin serbuk injeksi 10 mg Vinblastine
776. Vinkristin serb inj i.v 2 mg/vial Vincristine Kalbe
777. Vinkristin serbuk injeksi i.v. 1 mg Vincristine Kalbe
778. Vinorelbin inj. 10 mg/ml Navelbine injeksi 10
779. Vitamin B Kompleks tablet n/a
780. Zidofudin 100 mg n/a
781. Zidovudin 300 mg + Lamivudine 150 mg n/a
782. Zinc drop 10 mg/mL Zincpro Drops
783. Zinc sir 10 mg/mL Zinkid
784. Zinc sir 20 mg/5 Ml Zircum Kid Sirup
785. Zinc tablet dispersible20 mg n/a
Nama Penyedia Kemasan Harga Satuan Terkecil (Rp) Distributor
PT. Kimia Farma 1 blister@24 tablet 1,375.00 Download
PT. SmithKline Beecham Phamaceuticals Dus, 3 Blister @ 10 kapsul 27,500.00 Download
PT Otsuka Indonesia Dus, 120 ampul PE @ 25ML 2,200.00 Download
PT. Widatra Bhakti Btl @ 1000 ml 7,500.00 Download
PT. Dexa Medica Dus, 10 strip @10tablet 990.00 Download
PT. Dexa Medica Dus, 10 strip @10tablet 780.00 Download
PT. Indofarma Dus, 10 dus @ 1 botol @ 10 ml 3,849.00 Download
PT. Holi Pharma Dus, 5 strip @ 6 tablet 344.00 Download
PT. Ikapharmindo Vial 100 ml 750,000.00 Download
PT. Ikapharmindo Vial 50 ml 345,000.00 Download
PT. Dipa Pharmalab botol @ 100 ml 1,525,456.00 Download
PT. Dipa Pharmalab botol @ 20 ml 321,552.00 Download
PT. Pertiwi Agung Box, 10 strips @ 10 tablets 86.00 Download
PT. Bernofarm Dus, 10 blister @ 10 tablet 199.50 Download
PT. Dexa Medica Dus, 10 Strip @ 10 tablet 380.00 Download
PT. Kimia Farma Ktk 10x10 tablet 214.00 Download
PT. Kimia Farma Ktk 10x10 tablet 233.00 Download
PT. Boehringer Ingelheim Dus, 1 vial@50mg + 1 vial pelaru 3,800,000.00 Download
PT. Cendo Industri Farmasi tube 3.5 gr 18,500.00 Download
PT. Sanbe Farma Vial 2 ml 50,500.00 Download
PT. Lucas Djaja dus 30 ampul @10 ml 3,823.00 Download
PT. Marin Liza Farmasi Botol @ 100 tablet salut selaput 90.00 Download
PT. Erela Btl @ 100 tablet 80.00 Download
PT. Aventis Pharma Dus, 6 ampul @ 3 ml 12,480.00 Download
PT. Darya Varia strip 1,200.00 Download
PT. Indofarma Dus, 10 strip @ 10 tss 112.00 Download
PT. Novapharin dus 10 X 10'S 211.00 Download
PT. Bernofarm Dus, 10 strip @ 10 kaptab 272.00 Download
PT. Holi Pharma Dus, Botol 60 ml 4,070.00 Download
PT. Novapharin btl @ 60 ml 2,445.00 Download
PT. Bernofarm Dus, 10 vial @ 1 g 5,100.00 Download
PT. Aventis Pharma dus, 5 solostar pen @ 3ml 85,000.00 Download
PT. Ferron Par Pharmaceuticals Injeksi 100 IU/ml, Flexpen disposibl 106,000.00 Download
PT. Bayer Indonesia Dus, 5 Prefilled pen @ 3 ml 102,990.00 Download
PT. Bayer Indonesia Penfill cartridge 97,500.00 Download
PT. Ferron Par Pharmaceuticals Dus, vial 10 ml 200,000.00 Download
PT. Ferron Par Pharmaceuticals Injeksi 100 IU/ml, Flexpen disposibl 85,345.00 Download
PT. Aventis Pharma dus, 5 solostar pen @ 3ml 79,165.00 Download
PT. Bayer Indonesia Penfill cartridge 79,167.00 Download
PT. AstraZeneca indonesia Dus, 2 blister @ 14 Tablet 32,000.00 Download
PT. Promedrahardjo Farmasi Industri Dus, 10 Strip@10 Tablet 75.00 Download
PT. Erela Botol @ 60 ml 2,160.00 Download
PT. Indofarma Dus, 25 tube @ 5 g 2,516.00 Download
PT. Kimia Farma DUS, 10 SUPP @ 2 GRAM 3,045.00 Download
PT. Kimia Farma ktk 10 x 10 tablet 520.00 Download
PT. Kimia Farma Btl 100 tablet 135.00 Download
PT. Meprofarm Dus, 5 strip @ 10 tablet 1,500.00 Download
PT. Kimia Farma Dus 6 amp @ 1ml 22,000.00 Download
PT. Pharma Laboratories Dus, 1 Vial @ 60 mg + 1 Ampul Pe 38,999.00 Download
PT. Phapros, Tbk Dus @ 10 X 10 's 116.00 Download
PT. Mersifarma Tirmaku Mercusana KOTAK @ 10 x 10 TAB 148.00 Download
PT. Kimia Farma ktk 10x10 tablet 159.00 Download
PT. Kimia Farma Dus 10 strip x 10 tab 95.00 Download
PT. Dexa Medica Dus, 10 strip @10 tablet 84.00 Download
PT. Marin Liza Farmasi Botol @ 100 tablet 48.00 Download
PT. Boehringer Ingelheim Boks, 1 ampul 2,209,000.00 Download
PT. Afifarma dus, 10 blister @ 10 kapsul 158.00 Download
PT. Bernofarm Dus, 10 blister @ 10 kaptab ss 112.00 Download
PT. Sanbe Farma Strip 1,815.00 Download
PT. Bernofarm Dus, 10 ampul @ 5 ml 2,950.00 Download
PT. Novartis Indonesia Dus, 1 vial plastik @ 5ml 900,000.00 Download
PT. Sanbe Farma Tube 3,5 gram 24,750.00 Download
PT. Indofarma Dus, 10 blister @ 10 tablet 237.00 Download
PT. Sampharindo Perdana Dus, 5 strip @ 10 tablet 336.00 Download
PT. Widatra Bhakti 10.000 UI/Vial 1,039,500.00 Download
PT. Zenith Pharmaceuticals Dus 5 strip @ 10 tablet 190.00 Download
PT Kalbe Farma strip 700.00 Download
PT. Pratapa Nirmala Box @ 10 strip 10 tab 352.00 Download
PT. Glaxo Wellcome Indonesia Dus, 5 ampul @ 2.5 ml 20,000.00 Download
PT. Ethica Industri Farmasi 100 AMPUL @ 1 ML 1,350.00 Download
PT. Indofarma Dus, 10 strip @ 10 tablet 74.00 Download
PT. Cendo Industri Farmasi Botol 5ml 13,500.00 Download
PT. Soho Industri Pharmasi botol @ 60 ml 34,400.00 Download
PT. Kimia Farma ktk 2x10 tablet 4,500.00 Download

PT. Soho Industri Pharmasi Strip 3,333.00 Download
PT. Rama Emerald Multi Sukses Dus @ 50 gram 1,250.00 Download
PT. Phapros, Tbk Ds 10 vial x 1,2 Jt IU 9,800.00 Download
PT. Phapros, Tbk 10 vial @ 2.400.000 IU 13,400.00 Download
PT. Abbott Indonesia Vial 3,200,000.00 Download
PT. Combiphar Box/ 3 blister @ 10 Tablet 3,600.00 Download
PT. Kimia Farma Tube 5 gr 1,520.00 Download
PT. Sanbe Farma botol @ 5 ml 25,106.00 Download
PT. Boehringer Ingelheim Dus, 1 vial @ 4 ml 4,803,697.00 Download
PT. Sanbe Farma Supp 6,045.00 Download
PT. Boehringer Ingelheim 1 Box @ 6's 4,990.00 Download
PT. Merck Tbk Dus 10 blister @ 10 tablet 746.00 Download
PT. Pratapa Nirmala Box 3 X 10 tab 645.00 Download
PT Kalbe Farma Vial 304,000.00 Download
PT. Caprifarmindo Box 3 x 10'S 247,089.00 Download
PT. AstraZeneca indonesia Dus, 1 Turbuhaler @ 100 dosis 93,000.00 Download
PT Otsuka Indonesia Unit, 200 dosis 106,000.00 Download
PT. AstraZeneca indonesia Dus, 4 pak @ 5 respules @ 2 ml 8,900.00 Download
PT. Dexa Medica Dus, 5 ampul @ 4 ml 25,600.00 Download
PT. Pratapa Nirmala ampul 30,800.00 Download
PT. Boehringer Ingelheim Dus, 3 blister @ 10 kapsul 12,936.00 Download
PT. Boehringer Ingelheim Dus, 3 blister @ 10 kapsul 12,936.00 Download
PT. Tempo Scan Pacific vial @ 20 ml 305,000.00 Download
PT. Novell Pharmaeutical Laboratories vial 275,000.00 Download
PT. Novartis Indonesia Dus, 4 blister @ 7 tablet 76,000.00 Download
PT. Sydna Farma Dus, Botol @ 500ml 2,600,000.00 Download
PT. Sydna Farma Dus, Botol @ 100 tablet 25,300.00 Download
PT. Novartis Indonesia Dus, 10 vial @ 500mg 112,000.00 Download
PT. Indofarma Dus, 100 ampul @ 1 ml 1,580.00 Download
PT. Merck Sharp Dohme Pharma Tbk Dus, 1 Blister @ 28 tablet 70,000.00 Download
PT. Ifars Pharmaceutical Laboratories Dus, tube @ 5 g 5,700.00 Download
PT. Dexa Medica Kotak, tube @ 15 gram 9,983.00 Download
PT. Kimia Farma Dus Tube 10 gram 9,818.00 Download
PT. Actavis Indonesia Dus, 5 alubag @ 1 tube @ 2,5ml 11,525.00 Download
PT. Actavis Indonesia Dus, 5 alubag @ 1 tube @ 2,5ml 16,748.00 Download
PT. Kimia Farma Botol Plastik @ 100 tablet 45.00 Download
PT. Holi Pharma Dus, 10 blister @10 tablet 136.00 Download
PT. Phapros, Tbk Dus @ 30 Ampul 1,050.00 Download
PT. Pratapa Nirmala Box @ 5 ampul 2 mL 22,000.00 Download
PT. Yarindo Farmatama Box 10 X 10 Tab 97.00 Download
PT. Tanabe Indonesia 10 vial @ 50mg 127,667.00 Download
PT. Pratapa Nirmala Vial 5 mL 46,667.00 Download
PT. Tanabe Indonesia 3 blister @ 10 kapsul 3,667.00 Download
PT. Tanabe Indonesia 3 blister @ 10 kapsul 4,015.00 Download
PT. Kimia Farma Botol Plastik @ 100 tablet 104.00 Download
PT. Cendo Industri Farmasi botol 15 ml 37,500.00 Download
PT. Bayer Indonesia ampul 124,955.00 Download
PT. Dipa Pharmalab ampul @ 5 ml 26,700.00 Download
PT. Pfizer Indonesia Dus, 5 blister @10's tab 3,480.00 Download
PT. Pfizer Indonesia Dus, 5 blister @10's tab 5,480.00 Download
PT. Yarindo Farmatama Box @ 10 strip 10 kapsul 270.00 Download
PT Kalbe Farma vial @ 5 ml 59,000.00 Download
PT. Actavis Indonesia Dus, 1 vial @ 50 mg 258,000.00 Download
PT. Bernofarm Dus, botol @ 10 ml 15,600.00 Download
PT. Dipa Pharmalab ampul @ 5 ml 9,840.00 Download
PT. Sanbe Farma Dus, 1 vial @0,5 ml+ 1 vial pelaru 970,200.00 Download
PT. Kimia Farma Dus @ 5 vial 455,000.00 Download
PT. SmithKline Beecham Phamaceuticals Dus, Botol Plastik @ 30 Tablet 7,100.00 Download
PT. Kimia Farma Botol 30 tab 6,375.00 Download
PT. Bernofarm Ampul @ 1 ml 12,990.00 Download
PT. Pfizer Indonesia Dus, 2 blister @ 15 tablet 42,600.00 Download
PT. Aventis Pharma dus, 2 prefilled syringe @ 0,2 ml 40,740.00 Download
PT Kalbe Farma Vial @ 25 ml 500,000.00 Download
PT. Sanbe Farma Dus, 1 vial @5 ml 128,000.00 Download
PT. Gracia Pharmindo Dus 3 strip @ 10 Flash tablet 650.00 Download
PT. Gracia Pharmindo Dus, Botol Plastik @ 100 mL 8,000.00 Download
PT. Kimia Farma ktk 10 x 10 kapsul 497.00 Download
PT. Indofarma Dus, 10 blister @ 10 kss 930.00 Download
PT. Phyto Kemo Agung Farma Botol @60 ml 7,700.00 Download
PT Kalbe Farma vial/ampul (Prefilled Syringe) 275,000.00 Download
PT. Soho Industri Pharmasi Dus, 6 prefilled syrenge @ 0.5 ml 133,875.00 Download
PT Kalbe Farma Prefilled Syringe @ 1ml 128,000.00 Download
PT. Boehringer Ingelheim Boks, 6 ampul 139,500.00 Download
PT SUNTHI SEPURI dus, 1 blister @ 28 kaptab salut gu 82,000.00 Download
PT. Indofarma Dus, 10 strip @ 10 tss 451.00 Download
PT. Merck Sharp Dohme Pharma Tbk Dus, botol @ 100 tablet 1,360.00 Download
PT. Merck Sharp Dohme Pharma Tbk Dus, 1 blister @ 1 subdermal impla 128,779.00 Download
PT. Combiphar Vial 100mg/5ml 100,000.00 Download
PT. Kimia Farma Botol 10 ml 16,667.00 Download
PT. Graha Farma Dus, 1 vial @ 1000 IU+ 1 vial pel 8,500,000.00 Download
PT. Graha Farma Dus, 1 vial @ 500 IU+ 1 vial pelar 4,423,500.00 Download
PT. Graha Farma Dual, vial 500 IU 4,400,000.00 Download
PT. Graha Farma Dus, vial @ 250 IU+ 1 vial pelar 2,095,000.00 Download
PT. Ferron Par Pharmaceuticals KOTAK @ 1 VIAL SERBUK OBAT & 9,200,000.00 Download
PT. Kimia Farma vial 1,133,000.00 Download
PT. Kimia Farma vial 990,000.00 Download
PT. Dipa Pharmalab vial 2,150,000.00 Download
PT. Graha Farma 500 IU 1,990,417.00 Download
PT. Mersifarma Tirmaku Mercusana KOTAK @ 10 ampul 20,250.00 Download
PT. Ikapharmindo Botol @ 100 133.00 Download
PT. Hexpharm Jaya Laboratories Dus, 3 strip @ 10 kapsul 1,075.00 Download
PT. Hexpharm Jaya Laboratories Dus, 3 strip @ 10 kapsul 1,375.00 Download
PT. Actavis Indonesia Dus 45 x 12 tab 235.00 Download
PT. Boehringer Ingelheim Box, canister 10mL 72,900.00 Download
PT. Boehringer Ingelheim Dus, Canister 200 dosis 117,500.00 Download
PT. Kimia Farma Dus 5 ampul@ 10ml 128,000.00 Download
PT. Kimia Farma Dus 5 ampul@ 2ml 33,914.00 Download
PT. Kimia Farma Dus @ 5 patch 80,000.00 Download
PT. Kimia Farma Dus@ 5 patch 153,000.00 Download
PT. Kimia Farma Dus@ 5 patch 285,000.00 Download
PT Kalbe Farma pfs @ 0,5 ml 375,000.00 Download
PT. Combiphar Box, isi 3 Strip @ 10 tab 2,950.00 Download
PT. Phapros, Tbk dus @ 30 ampul 3,417.00 Download
PT. Aventis Pharma Dus, 5 vial @ 50 mg 1,248,319.00 Download
PT. Aventis Pharma Dus, 4 blister @ 5 tablet salut sela 275,000.00 Download
PT. Mersifarma Tirmaku Mercusana Dus, 5 ampul @ 1ml 55,000.00 Download
PT. Natura Laboratoria Prima Dus, 1 Botol @ 100 mL 47,100.00 Download
PT. Pfizer Indonesia Blister 4,862.00 Download
PT. Kimia Farma ktk 1 x 10 kapsul 22,000.00 Download
PT. Gracia Pharmindo strip 419.00 Download
PT. Dexa Medica DUS, 30 TABLET 410.00 Download
PT. Sanbe Farma botol @ 5 ml 30,493.00 Download
PT. Ifars Pharmaceutical Laboratories Dus, Tube 5 g 2,400.00 Download
PT. Ikapharmindo Dus, tube @ 10 g 5,489.00 Download
PT. Glaxo Wellcome Indonesia Dus, Botol 120 Dosis Spay 93,333.00 Download
PT. Glaxo Wellcome Indonesia Dus, 2 flow wrap@ 5 nebules @ 1 12,917.00 Download
PT. Glaxo Wellcome Indonesia Dus, 2 pfs 0.5 ml 241,667.00 Download
PT. Dipa Pharmalab dus, vial @ 250 ml 972,000.00 Download
PT. Bayer Indonesia Prefilled Syringe 275,000.00 Download
PT. Bayer Indonesia Prefilled Syringe 412,500.00 Download
PT. Bayer Indonesia Prefilled Syringe 2,570,000.00 Download
PT. Boehringer Ingelheim Boks, 1 ampul 399,500.00 Download
PT. Phapros, Tbk Dus @ 100 Sachet 288.00 Download
PT. AstraZeneca indonesia Dus, 1 blister @ 10 tablet 295,000.00 Download
PT. Indofarma Dus, 10 blister @ 12 kapsul 289.00 Download
PT. Indofarma Dus, 10 blister @ 10 kaptab 679.00 Download
PT. Bayer Indonesia vial 1,098,900.00 Download
PT. Sanbe Farma Dus, 1 vial @200 mg 330,000.00 Download
PT. Erela Tube @ 3,5 gr 2,600.00 Download
PT. Indofarma Dus, botol plastik 5 ml 3,194.00 Download
PT. Indofarma Dus, 10 blister @ 10 kaptab 56.00 Download
PT. Tempo Scan Pacific Strip 242.00 Download
PT. Pradja Pharin Dus, 6 strip @ 10 tablet lepas lam 638.00 Download
PT. Darya Varia Box, 30 Tablet 5,500.00 Download
PT. Pfizer Indonesia Dus, botol@TAB 10MG 30 3,207.00 Download
PT. Pfizer Indonesia Dus, botol@TAB 10MG 31 3,000.00 Download
PT. Tempo Scan Pacific 1 box isi 5 ampul 10 ml 119,900.00 Download
PT. Kimia Farma Dus 10x10 1,493.00 Download
PT. Kimia Farma Dus 10x10 2,171.00 Download
PT. Actavis Indonesia Btl @ 30 tablet 1,500.00 Download
PT. Lucas Djaja Glycerin 100 ml 5,333.00 Download
PT. Widatra Bhakti botol @ 500 ml 5,700.00 Download
PT. Widatra Bhakti botol @ 500 ml 5,200.00 Download
PT. AstraZeneca indonesia Dus, 1 syringe @ 10.8 mg 2,300,000.00 Download
PT. AstraZeneca indonesia Dus, 1 syringe @ 3.6 mg 840,000.00 Download
PT. Soho Industri Pharmasi Dus 5 Ampul@1mL 83,333.00 Download
PT. Mersifarma Tirmaku Mercusana BOTOL @ 15 ML 16,500.00 Download
PT. Dexa Medica Botol 641,500.00 Download
PT. Pratapa Nirmala vial 42,900.00 Download
PT. Dipa Pharmalab Dus, 1 syringe @ 0.5 mL 1,328,000.00 Download
PT. Kimia Farma dus, 10 strip @ 10 tablet 149.00 Download
PT. Marin Liza Farmasi tube @ 5 ml 2,570.00 Download
PT. Dipa Pharmalab vial 5,400.00 Download
PT. Otto Pharmaceuticals box 5ampul @1 ml 4,500.00 Download
PT. Bayer Indonesia Dus, vial 10 ml 138,000.00 Download
PT. Ferron Par Pharmaceuticals Injeksi 100 IU/ml, penfill disposible 76,125.00 Download
PT. Sanbe Farma penfillcartridge @ 3ml 75,000.00 Download
PT. Bayer Indonesia Dus Isi 5 penfill/cartridge @ 3ml 76,125.00 Download

PT. Aventis Pharma Dus, 1 Vial @ 5 ml 72,000.00 Download
PT. Sanbe Farma penfill cartridge @ 3ml 75,000.00 Download

PT. Dexa Medica Prefilled syringe 170,000.00 Download
PT. Indofarma Dus, botol 60 ml 3,499.00 Download
PT. Indofarma Dus, botol 60 ml 4,499.00 Download
PT. Yarindo Farmatama botol @ 100 tablet 110.00 Download
PT. Mugi Laboratories Dus, 1 vial @ 1 g 1,329,163.00 Download
PT. Novartis Indonesia Dus, 6 blister @ 10 tablet salut sel 211,000.00 Download
PT. Tanabe Indonesia 3 blister @ 10 tablet 3,908.00 Download
PT. Tanabe Indonesia 3 blister @ 10 tablet 2,120.00 Download
PT. Dipa Pharmalab Dus, botol @ 100 ml 350,000.00 Download
PT. Dipa Pharmalab Dus, vial @ 30 ml 122,000.00 Download
PT. Dipa Pharmalab Dus, botol @ 100 ml 369,000.00 Download
PT. Bayer Indonesia Botol 245,000.00 Download
PT. Boehringer Ingelheim Box, canister 10mL 80,000.00 Download
PT. Boehringer Ingelheim Box, bottle 20mL 90,000.00 Download
PT. Indofarma Dus, 5 blister @ 10 kss 1,425.00 Download
PT. Indofarma Dus, 5 blister @ 10 kss 2,470.00 Download
PT. Sanbe Farma Dus, 1 vial @2 ml 510,000.00 Download
PT. Pratapa Nirmala Botol 100 mL 270,000.00 Download

PT. Phyto Kemo Agung Farma Botol 100 tablet 65.00 Download
PT. Phyto Kemo Agung Farma Botol 100 tablet 158.00 Download
PT. Pratapa Nirmala vial 33,000.00 Download
PT. Kimia Farma Dus, 5 strip @ 10 tablet 189.00 Download
PT. Tempo Scan Pacific Strip 700.00 Download
PT. Merck Tbk Dus, 10 strip @ 10 tablet 1,580.00 Download
PT. Tempo Scan Pacific Vial 50 mg/5 ml 82,000.00 Download
PT. Ethica Industri Farmasi Ampul 7,800.00 Download
PT. Mersifarma Tirmaku Mercusana Dus, 3 blister @10 kaplet 405.00 Download
PT. Afifarma Dus,10 Strip @ 10 tablet 70.00 Download
PT. Novell Pharmaeutical Laboratories kantong 5 g 7,700.00 Download
PT. Hexpharm Jaya Laboratories vial 5,000.00 Download
PT. Dexa Medica Dus, 3 Blister @ 10 tablet 4,900.00 Download
PT. Boehringer Ingelheim Boks, 120 tablet 27,500.00 Download
PT. Errita Pharma Dus, 10 strip @10 tablet 84.00 Download
PT. Novartis Indonesia Dus, botol @ 120 ml 44,770.00 Download
PT. Nicholas Laboratories Indonesia Dus,botol 100 tablet 875.00 Download
PT. Lucas Djaja Fenol 100 mg / 1 ml 2,042.00 Download
PT Kalbe Farma strip 1,360.00 Download
PT. Guardian Pharmatama Vial @ 10 ml 110,000.00 Download
PT. Combiphar Box, isi 1 vial @ 10 ml 60,300.00 Download
PT. Kimia Farma tube 10 gr 2,569.00 Download
PT. Hexpharm Jaya Laboratories tube 5 gr 2,850.00 Download
PT. Novell Pharmaeutical Laboratories Box isi 1 Tube @ 15 g 4,700.00 Download
PT. Ikapharmindo Botol 80 ml 28,000.00 Download
PT. Kimia Farma dus 2 's @ 10 supp 2,722.00 Download
PT. Ifars Pharmaceutical Laboratories Dus, 3 Strip @ 10 Kaplet salut sela 3,200.00 Download
PT SUNTHI SEPURI dus, 2 strip @ 10 tablet 1,625.00 Download
PT. Boehringer Ingelheim Box, 10 ampoules @ 1mL 30,600.00 Download
PT. Kimia Farma Ktk 10X10 TAB 184.00 Download
PT. Hexpharm Jaya Laboratories Dus, 3 strip @ 10 tab 3,400.00 Download
PT. Bufa Aneka Box isi 24 tube @ 15 gram 3,524.00 Download
PT. Sanbe Farma vial 7,260.00 Download
PT. Bernofarm Botol @ 60 ml 3,680.00 Download
PT. Actavis Indonesia Dus, 10 Strip @ 10 Kapsul 850.00 Download
PT. Rama Emerald Multi Sukses kotak,10strip@10 tablet 51.00 Download
PT. Mersifarma Tirmaku Mercusana Kotak @ 10 x 10 tab 144.00 Download
PT. Phapros, Tbk 10 X 10 68.00 Download
PT. Mersifarma Tirmaku Mercusana KOTAK @ 5 x 10 TAB 5,000.00 Download
PT. Kimia Farma ktk 10x10 tablet 1,100.00 Download
PT. Pratapa Nirmala Btl @ 30 kapsul 2,500.00 Download
PT. Pratapa Nirmala Box @ 3 strip 10 tab 3,950.00 Download
PT. Fresenius Kabi Combiphar Botol Plastik @ 500 ml 33,000.00 Download
PT. Boehringer Ingelheim 1 dus @ 20 vial 5,990.00 Download
PT. Triyasa Nagamas Farma Vial 5,350.00 Download
PT. Galenium Pharmasia Laboratories Botol @ 60 ml 12,450.00 Download
PT. Kimia Farma 1 sase @30 tablet 50.00 Download

PT. Novartis Indonesia Dus, botol plastik @ 30 tablet salu 8,900.00 Download
PT. Abbott Indonesia botol @ 120 tablet 6,100.00 Download
PT. Glaxo Wellcome Indonesia Dus, Botol 120 Dosis 90,667.00 Download
PT. Glaxo Wellcome Indonesia Dus, foil strip @ 60 dosis 100,833.00 Download
PT. Glaxo Wellcome Indonesia Dus, foil strip @ 60 dosis 113,333.00 Download
PT. Kimia Farma Dus, 100 blister @ 28 tablet 2,089.00 Download
PT. Holi Pharma Dus, 10 strip @ 10 kaptab 152.00 Download
PT. Kimia Farma ktk 60 tablet 670.00 Download
PT. Kimia Farma ktk 100 amp @ 2 ml 6,200.00 Download
PT. Kimia Farma Botol 60 tablet 1,400.00 Download
PT. Takeda Indonesia Serbuk vial 82,042.00 Download
PT. Indofarma Dus, 2 strip @ 10 kapsul 473.00 Download
PT. SmithKline Beecham Phamaceuticals Dus, 7 Blister @ 10 tablet 67,200.00 Download
PT. Finusolprima Farma Internasional botol 500 ml 56,300.00 Download
PT Otsuka Indonesia Softbag 500 ML 56,300.00 Download
PT Otsuka Indonesia Double Chamber Softbag 1000 ML 115,500.00 Download
PT Otsuka Indonesia Double Chamber Softbag 500 ML 61,600.00 Download
PT Kalbe Farma botol 500 mL 75,350.00 Download
PT. Fresenius Kabi Combiphar Botol Gelas 100 ml 36,667.00 Download


PT. Fresenius Kabi Combiphar Bag (3 Chamber) 1440 ml 295,240.00 Download
PT. Fresenius Kabi Combiphar Bag (3 Chamber) 1920 ml 343,842.00 Download
PT. Phapros, Tbk Bag Double chamber (Dua compar 322,000.00 Download
PT. Phapros, Tbk Bag Double chamber (Dua compar 218,700.00 Download
PT Otsuka Indonesia Ampoel 25 ML 2,050.00 Download
PT. Widatra Bhakti Botol 1000 ml 8,000.00 Download
PT Otsuka Indonesia Plastic Bottle 500 ML 9,000.00 Download
PT Kalbe Farma flexybag 250 mL 87,000.00 Download
PT. Phapros, Tbk LDPE (Low Density Poly Ethilene), b 12,650.00 Download

PT Kalbe Farma Flexy bag 500 mL 42,350.00 Download

PT Kalbe Farma Botol Plastik 1000 mL 210,000.00 Download
PT Kalbe Farma Botol Plastik 1000 mL 199,000.00 Download
PT. Sanbe Farma softbag 500ml 35,750.00 Download

PT. Phapros, Tbk 20%, Botol Kaca @100 ml, single b 105,500.00 Download
PT. Phapros, Tbk 20%, Botol Kaca @250 ml, single b 210,000.00 Download
PT. Phapros, Tbk Bag, 3 chamber ( 3 kompartemen) 591,000.00 Download
PT. Cendo Industri Farmasi strip 5 x 0.6 ml 72,000.00 Download
PT. Pfizer Indonesia dus, Botol @ 2,5 ml 127,000.00 Download
PT. Aventis Pharma Dus, 1 vial @ 263 mcg + 1 prefille 550,000.00 Download
PT. Takeda Indonesia Vial 700,000.00 Download
PT. Takeda Indonesia Vial 2,700,000.00 Download
PT. Takeda Indonesia Vial 500,000.00 Download
PT. Infion Pharmaceutical Box, 1 Botol @ 100 ml 40,000.00 Download
PT. Erela Btl @ 5 ml 13,068.00 Download
PT. Bernofarm Dus, 100 ampul @ 2 ml 839.00 Download
PT. AstraZeneca indonesia Dus, 10 syringe @ 10 g 40,000.00 Download
PT. AstraZeneca indonesia Dus,Botol @ 50 ml (500 dosis) 142,000.00 Download
PT. Novell Pharmaeutical Laboratories Box ,3 Strip @ 10 tablet 600.00 Download
PT. Ifars Pharmaceutical Laboratories Dus, 10 Strip @ 10 Tablet 89.00 Download
PT. Novell Pharmaeutical Laboratories ampul 52,000.00 Download
PT Otsuka Indonesia Dus, 120 ampul plastik @ 25 ml 2,800.00 Download
PT Otsuka Indonesia Dus, 120 ampul plastik @ 25 ml 3,500.00 Download
PT. Soho Industri Pharmasi Strip 1,200.00 Download
PT. Kimia Farma Dus @ 5 vial 473,000.00 Download
PT. Taisho Pharmaceutical Indonesia Tbk Dus,24 Catch @ 1 tablet 7,140.00 Download
PT. Pfizer Indonesia Dus, 10 blister @10 tablet 6,125.00 Download
PT SUNTHI SEPURI dus, 3 blister @ 10 tablet 2,500.00 Download
PT. Glaxo Wellcome Indonesia Box, Tablet 2 mg/25's 12,210.00 Download
PT. Bernofarm Dus, 1 vial @ 1 g 54,000.00 Download
PT. Bernofarm Dus, 1 vial @ 0,5 g 44,960.00 Download
PT. Mugi Laboratories Dus, 15 Ampul 74,998.00 Download
PT. Kimia Farma Botol 1000 ml 254,100.00 Download
PT. Bernofarm Dus, 10 blister @ 10 kaptab 197.50 Download
PT. Actavis Indonesia Dus, 10 Strip @ 10 tablet salut sel 800.00 Download
PT. Kimia Farma ktk 10 x 10 tablet salut 154.00 Download
PT. Ethica Industri Farmasi ampul @ 1 ml 2,750.00 Download
PT. Novartis Indonesia Dus, botol plastik @ 30 kapsul pel 6,537.00 Download
PT. Dexa Medica Dus, 1 Vial @125mg + 1 ampul pe 19,200.00 Download
PT. Phapros, Tbk Dus @ 1 vial 93,393.00 Download
PT. Mahakam Beta Farma Strip 635.00 Download
PT. Natura Laboratoria Prima Dus, 10 Blister @ 10 Tablet 205.00 Download
PT. Dexa Medica Dus, 10 Blister @ 10 tablet 300.00 Download
PT. Meprofarm Dus, Botol 10 ml 5,280.00 Download
PT. Molex Ayus BOTOL 60 ML 2,600.00 Download
PT. Sandoz Indonesia Box 10 ampul @ 1 ml 21,120.00 Download
PT. Sandoz Indonesia Box, bottle @ 50 tab 1,680.00 Download
PT. Natura Laboratoria Prima Dus, 1 Botol @ 100 ml 9,950.00 Download
PT. Kimia Farma dus 1 's @ 5 ovula 3,850.00 Download
PT. Ifars Pharmaceutical Laboratories Dus, botol 60ml 4,100.00 Download
PT. Aventis Pharma Dus, 2 blister @ 5 suppositoria 3,220.00 Download
PT. Phyto Kemo Agung Farma 10 strip @ 10 tab 110.00 Download
PT. Phyto Kemo Agung Farma 10 strip @ 10 tab 160.00 Download
PT. Kimia Farma vial 1,925,000.00 Download
PT. Kimia Farma Dus @ 5 vial 1,237,500.00 Download
PT. Boehringer Ingelheim Boks 5 amp 12,060.00 Download
PT. Combiphar Dus,1 vial@50mg 260,000.00 Download
PT. Kimia Farma Tube 10 gram 3,000.00 Download
PT. Phapros, Tbk Btl @ 500 ml 72,000.00 Download
PT. Tempo Scan Pacific botol, tetes mata 3 ml 77,000.00 Download
PT. Guardian Pharmatama tube 10 gram 17,820.00 Download
PT. Kimia Farma Dus 10 amp @ 1 ml 8,400.00 Download
PT. Mahakam Beta Farma Dus, 6 strip @ 10 tablet 15,620.00 Download
PT. Mahakam Beta Farma Dus, 6 strip @ 10 tablet 22,990.00 Download
PT. Mahakam Beta Farma Dus, 6 Strip @ 10 Tablet 41,470.00 Download
PT. Pratapa Nirmala Box @ 5 ampul 13,200.00 Download
PT. Glaxo Wellcome Indonesia Dus, 5 blister @ 2 pfs 0.3 ml 54,144.00 Download
PT. Pratapa Nirmala Dus, 5 Ampul @ 2ml 61,600.00 Download
PT Otsuka Indonesia Ampoel 25 ML 6,200.00 Download
PT. Novell Pharmaeutical Laboratories Box ,5 Blister @ 10 tablet 200.00 Download
PT. Combiphar Botol, 133 ml 39,950.00 Download
PT. Ifars Pharmaceutical Laboratories Dus, tube @ 5 g 6,475.00 Download
PT. Molex Ayus Tube 5 gr 6,490.00 Download
PT. Pharma Health Care Box, isi 5 ampul @ 1 ml 9,500.00 Download
PT. Kimia Farma btl 60 tablet 2,800.00 Download
PT. Bayer Indonesia blister 2,999.00 Download
PT. Dexa Medica Dus, 10 Strip @ 10 tablet salut sel 100.00 Download
PT. Pratapa Nirmala Box @ 1 vial 66,000.00 Download
PT. Novartis Indonesia Dus, 2 blister @ 14 kapsul 380,875.00 Download
PT. Kimia Farma Dus 5 amp @ 8 ml 53,900.00 Download
PT. Phapros, Tbk Paket 359,900.00 Download
PT. Kimia Farma Paket 1,199,990.00 Download
PT. Kimia Farma Paket 214,990.00 Download
PT. Indofarma Paket@84 tablet 160,000.00 Download
PT. Indofarma Dus, 1 dus @ 60 blister @ 8 tablet 288,199.00 Download
PT. Indofarma Dus, 60 sachet tahap intensif @ (1 171,195.00 Download
PT. Pratapa Nirmala Box @ 5 ampul 80,000.00 Download
PT Kalbe Farma Btl @ 5 ml 48,500.00 Download
PT. Aventis Pharma Dus, 1 vial @ 20 ml 1,100,000.00 Download
PT. Aventis Pharma Dus, 1 vial @ 10 ml 550,000.00 Download
PT. Merck Tbk botol @ 10 ml 27,550.00 Download
PT. Merck Tbk botol 15 ml 29,000.00 Download
PT. Ethica Industri Farmasi ampul @ 1 ml 2,200.00 Download
PT. Novartis Indonesia Dus, vial @ 355m + 1 prefilled syr 2,950,000.00 Download
PT. Bayer Indonesia Vial 120,000.00 Download
PT. Sandoz Indonesia 3 X 10 fcc 6,450.00 Download
PT. Sandoz Indonesia 3 X 10 fcc 11,200.00 Download
PT. Tempo Scan Pacific botol, tetes mata 5 ml 68,000.00 Download
PT. Natura Laboratoria Prima Dus, 1 Vial @ 40 mg 36,000.00 Download
PT. Indofarma Dus, 5 Ampul @ 2ml 2,400.00 Download
PT. Yarindo Farmatama Box 3 X 10 Tab 716.00 Download
PT. Yarindo Farmatama Box 3 X 10 Tab 1,189.00 Download
PT Kalbe Farma Transfer Set: Set; Ultaclam: Kanto 1,902,240.00 Download
PT Kalbe Farma Set 219,540.00 Download
PT Kalbe Farma Larutan Dialisa 1.5 %: 2.000 ml; L 5,522,580.00 Download
PT. Actavis Indonesia Vial 6mg/ml (100mg/16.67ml) 984,000.00 Download

PT. Actavis Indonesia Vial 6mg/ml (260mg/43.33ml) 3,000,000.00 Download
PT. Actavis Indonesia Vial 6mg/ml (30mg/5ml) 274,560.00 Download
PT. Indofarma Dus, 15 botol 5,200.00 Download
PT. Afifarma botol 60 ml 1,438.00 Download
PT. Imfarmind Farmasi industri Dus, 10 strip @ 10 kaptab 89.00 Download
PT. Ifars Pharmaceutical Laboratories Dus, botol @ 15 ml 6,450.00 Download
PT. Boehringer Ingelheim Boks, 1 pfs 1,077,815.00 Download
PT. Boehringer Ingelheim Boks, 1 pfs 1,248,220.00 Download
PT. Merck Sharp Dohme Pharma Tbk Dus, 1 vial 100 mcg + 1 ampul pel 973,500.00 Download
PT. Merck Sharp Dohme Pharma Tbk Dus, 1 prefilled syringe (serbuk i 1,135,000.00 Download
PT. Merck Sharp Dohme Pharma Tbk Dus, 1 vial 50 mcg + 1 ampul pela 915,000.00 Download
PT. Merck Sharp Dohme Pharma Tbk Dus, 1 vial 80 mcg + 1 ampul pela 915,810.00 Download
PT. Darya Varia tube @ 35 gram 23,000.00 Download
PT. Pradja Pharin Dus, botol plastik @ 30 tablet salu 2,420.00 Download
PT. Galenium Pharmasia Laboratories Tube @ 10 g 11,475.00 Download
PT. Kimia Farma Ktk 10 ampx2ml 14,500.00 Download
PT. Dexa Medica 30 TAB/BOX 3,120.00 Download
PT. Dexa Medica 30 TAB/BOX 4,525.00 Download
PT. Holi Pharma Botol 60 ml 8,360.00 Download
PT. Holi Pharma Dus, 25 Blister @ 4 tablet 298.00 Download
PT. Holi Pharma Dus 10 strip @ 10 tablet 208.00 Download
PT. Kimia Farma dus, 10 strip @ 10 tablet 110.00 Download
PT. Ikapharmindo Ampul 1 ml 1,000.00 Download
PT. Pratapa Nirmala Dus, Botol @ 10ml 17,393.00 Download
PT. Afifarma botol @ 1000 ml 37,109.00 Download
PT. Kimia Farma btl 60 ml 5,998.00 Download
PT. Boehringer Ingelheim Dus, 3 alu blister @ 10 tablet 7,200.00 Download
PT. Boehringer Ingelheim Dus, 3 alu blister @ 10 tablet 11,268.00 Download
PT. Novell Pharmaeutical Laboratories Box ,5 Strip @ 10 tablet 2,300.00 Download
PT. Phapros, Tbk Dus,10 blister @10 tablet 205.00 Download
PT. Dexa Medica Dus, 10 strip @ 10 tablet 1,650.00 Download
PT. Bernofarm Vial @ 3 juta IU 7,190.00 Download
PT. Indofarma Botol @ 100 Tablet 319.00 Download
PT. Fresenius Kabi Combiphar Ampul 16,236.00 Download
PT. Pharma Health Care Dus, 6 blister @ 10 tablet 995.00 Download
PT. Dexa Medica Dus, 10 Strip @ 10 kaptab 580.00 Download

PT. Novell Pharmaeutical Laboratories Dus, 10 strip @ 10 tablet 1,013.00 Download
PT. Natura Laboratoria Prima Dus, 10 Ampul @ 2 ml 1,140.00 Download
PT. Dexa Medica Dus, 10 Strip @ 10 tablet salut sel 120.00 Download
PT. Kimia Farma Botol 50 kapsul lunak 260.00 Download
PT. Lucas Djaja Botol 50 Kapsul 459.00 Download
PT. Indofarma Dus, 10 Strip @ 10 Kapsul 789.00 Download
PT. Indofarma Dus, 10 strip @ 10 kapsul 610.00 Download
PT. Indofarma Dus, 10 strip @10 kaptab 1,100.00 Download
PT. Widatra Bhakti botol 500 ml 5,200.00 Download
PT. Boehringer Ingelheim Dus, 1 vial @ 10 ml 3,164,805.00 Download
PT. Bayer Indonesia Blister 23,500.00 Download
PT. Merck Sharp Dohme Pharma Tbk Dus, 10 vial @ 5 ml 46,539.00 Download
PT. Glaxo Wellcome Indonesia Dus, 7 blister @ 4 Tablet lepas La 5,248.00 Download
PT. Glaxo Wellcome Indonesia Dus, 4x5 Botol Plastik@2.5 ml 6,600.00 Download
PT. Glaxo Wellcome Indonesia Dus, botol 200 dosis 63,750.00 Download
PT. Glaxo Wellcome Indonesia Dus, 10 Blister @ 10 Kapsul 431.00 Download
PT. Glaxo Wellcome Indonesia Dus, 1 Rotahaler 5,867.00 Download
PT. Yarindo Farmatama strip @ 10 tablet 59.00 Download
PT. Marin Liza Farmasi Pot @ 30 gram 2,000.00 Download
PT. Hexpharm Jaya Laboratories strip 513.00 Download
PT. Bernofarm Dus, 10 strip @ 10 kapsul 509.00 Download
PT. Ifars Pharmaceutical Laboratories Dus, 5 Strip @ 10 Kapsul 1,000.00 Download
PT. Dexa Medica Dus, 2 Vial @ 1 gram 16,500.00 Download
PT. Dexa Medica Dus, 5 Strip @ 10 kapsul 850.00 Download
PT. Ifars Pharmaceutical Laboratories Dus, Botol 30 ml 8,800.00 Download
PT. Holi Pharma Dus, 2 vial @ 1 g 12,775.00 Download
PT. Hexpharm Jaya Laboratories vial 4,997.00 Download
PT. Natura Laboratoria Prima Dus, 10 Vial @ 1 g 2,950.00 Download
PT. Hexpharm Jaya Laboratories Dus, 2 vial @ 1 g 17,060.00 Download
PT. Natura Laboratoria Prima Dus, 10 Vial @ 1 g 3,300.00 Download
PT. Glaxo Wellcome Indonesia Dus, 1 Blister @ 10 Tablet salut se 4,752.00 Download
PT. Glaxo Wellcome Indonesia Dus, 1 Blister @ 10 Tablet salut se 7,200.00 Download
PT. Pratapa Nirmala strip @ 10 tab 3,300.00 Download
PT. Indofarma Botol @ 60 ml 7,999.00 Download
PT. Pertiwi Agung Box, 10 strips @ 10 capsules 181.00 Download
PT. Merck Tbk Dus, 1 vial @ 20 ml 3,650,000.00 Download
PT. Pratapa Nirmala tabung/botol 1,320,000.00 Download
PT. Lucas Djaja 100 ampul @ 1 ml 1,077.00 Download
PT. Afifarma Dus, 10 Strip @ 10 tablet 57.00 Download
PT. Novell Pharmaeutical Laboratories Vial 256,000.00 Download
PT. Novell Pharmaeutical Laboratories Vial 120,000.00 Download
PT. Novartis Indonesia Dus, 10 blister @ 5 kapsul lunak 43,000.00 Download
PT. Novartis Indonesia Dus, 10 blister @ 5 kapsul lunak 12,000.00 Download
PT. Dankos Farma strip 7,000.00 Download
PT. Natura Laboratoria Prima Dus, 3 Strip @ 10 Kaplet salut sela 169.00 Download
PT. Natura Laboratoria Prima Dus, 3 Strip @ 10 Kaplet salut sela 391.00 Download
PT. Dexa Medica Vial 200 ml 13,000.00 Download
PT. Bernofarm Dus, 10 blister @ 10 tab ss 255.00 Download
PT Kalbe Farma vial 22,000.00 Download
PT Kalbe Farma vial 93,000.00 Download
PT. Tempo Scan Pacific dus, 1 vial @ 10 ml 575,000.00 Download
PT. Indofarma Dus, 5 strip @ 10 tablet 1,499.00 Download
PT. Kimia Farma Botol @ 60 tablet 930.00 Download
PT. Dexa Medica Vial 3,290,000.00 Download
PT. Phapros, Tbk Dus @ 56 Vial 3,650.00 Download
PT. Kimia Farma dus 5 amp @ dus 10 127,000.00 Download
PT. Dexa Medica DUS, 10 STRIP @ 10 TAB 424.00 Download
PT. Combiphar Pounch @ 5 blister @ 10 capsule 11,167.00 Download
PT. Combiphar Dus, 1 pouch @5 blister@10 kaps 21,500.00 Download
PT. Sandoz Indonesia Botol @30tablet 2,654.00 Download
PT. Combiphar Box @ 2 blister @ 14 tablet 5,800.00 Download
PT. Combiphar Box/ 2 blister @ 14 tablet 5,800.00 Download
PT. Combiphar Box/ 3 blister @ 10 Tablet 6,800.00 Download
PT. Boehringer Ingelheim Dus, 2 alu-blister @10 tablet 3,900.00 Download
PT. Boehringer Ingelheim Box, 2 blisters @10 tablets 6,500.00 Download
PT. Merck Sharp Dohme Pharma Tbk Dus, 5 sachet @ 1 kapsul 1,120,000.00 Download
PT. Merck Sharp Dohme Pharma Tbk Dus, 5 sachet @ 1 kapsul 223,000.00 Download
PT. Kimia Farma Dus 10-s @ 10 Kaptab 1,050.00 Download
PT Kalbe Farma strip 250.00 Download
PT. Dexa Medica DUS, 10 BLISTER @ 10 TAB 1,669.00 Download
PT. Dexa Medica DUS, 10 BLISTER @ 10 TAB 2,949.00 Download
PT. AstraZeneca indonesia Dus, 2 pak @ 5 respules 6,250.00 Download
PT. Molex Ayus Box 50's 99.00 Download
PT. Merck Sharp Dohme Pharma Tbk Dus, 6 blister @ 10 kapsul lunak 6,200.00 Download

PT. Holi Pharma Dus, 10 strip @ 10 kapsul 149.00 Download
PT. Afifarma DUS,10 STRIP @ 10 KAPSUL 300.00 Download
PT. Merck Tbk Dus, 10 blister @ 10 tablet 1,135.00 Download
PT. Merck Tbk Dus, 10 blister @ 10 tablet 563.00 Download
PT. Pratapa Nirmala Dus, Botol Plastik @ 5ml 9,128.00 Download
PT. Pratapa Nirmala Dus, Botol Plastik @ 5ml 9,722.00 Download
PT. Boehringer Ingelheim Box, 3 blisters @10 capsules 13,867.27 Download
PT. Boehringer Ingelheim Dus, 1 blister @10 kapsul + handih 152,543.00 Download
PT. Natura Laboratoria Prima Dus, 10 Ampul @ 2 ml 2,395.00 Download
PT. Boehringer Ingelheim Dus, 1 vial @ 440 mg + 1 vial pel 19,608,034.00 Download
PT. Tempo Scan Pacific botol, tetes mata 2,5 ml 115,000.00 Download
PT. Aventis Pharma Dus, botol plastik 120 dosis 90,000.00 Download
PT. Dexa Medica Dus,1 vial@ 5ml 65,500.00 Download
PT. Darya Varia strip 405.00 Download
PT. Galenium Pharmasia Laboratories tube 6,400.00 Download
PT. Bio Farma 20 ds / amp / vial 59,950.00 Download
PT. Bio Farma 10 ds / vial 28,204.00 Download
PT. Bio Farma 1 ds / pouch 20,900.00 Download
PT. Bio Farma 1 ds / pouch 24,585.00 Download
PT. Bio Farma 10 ds/ vial 16,500.00 Download
PT. Novartis Indonesia Dus, 1 dosis @ (1 vial serbuk injeks 307,400.00 Download
PT. Aventis Pharma 1 vial of 10ml (10 d's) 285,000.00 Download
PT. Bio Farma Dus, 1 vial@ 1dosis + 1 Syringe 78,000.00 Download
PT. Bio Farma Dus, 1 vial@ 1dosis + 1 Syringe 78,000.00 Download
PT. Soho Industri Pharmasi 5 strip @ 10 kaptab 5,390.00 Download
PT. Abbott Indonesia Tablet 2,793.00 Download
PT. Abbott Indonesia Tablet salut 250 mg 1,680.00 Download
PT. Novartis Indonesia DUS, 3 ALU-ALU STRIP @ 10 tablet 3,900.00 Download
PT. Novartis Indonesia DUS, 3 ALU-ALU STRIP @ 10 tablet 6,500.00 Download
PT. Kimia Farma Ktk 10X10 TAB 234.00 Download
PT. Combiphar Vial 10mg/10ml 210,000.00 Download
PT. Mugi Laboratories Dus, 1 vial @ 1 ml 1,229,998.00 Download
PT. Kimia Farma Dus 10 strip x 10 tab 107.00 Download
PT. Kimia Farma Botol 60 Kapsul 1,575.00 Download
PT. Combiphar Drops 10 mg/ml, Botol @15 ml 12,840.00 Download
PT. Indofarma Dus, botol @ 100 ml 14,980.00 Download
PT. Meprofarm Dus, botol 60 ml 7,400.00 Download
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Nama Generik Nama Dagang Pabrik Distributor Harga Per Kemasan Terkecil
NO. Nama Barang Merk Distributor Harga e catalog
1 SN Medika
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e Catalog Obat BPJS

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e Catalog Obat BPJS

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Harga Satuan Terkecil

No Nama Obat Generik Nama Dagang Nama Penyedia Kemasan (Rp)

642 Rivaroksaban tab 10 mg Xarelto 10 mg PT. Bayer Indonesia Blister 23,500.00

50. Antihemoroid, kombinasi: bismut subgalat 150 mg heksaklorofen 2,5 mg n/a

54. Artemether injeksi 80 mg/ml Artem

137. Dobutamin injeksi 50 mg/mL DOBURAN

143. Domperidon suspensi/sirup 5 mg/5 ml n/a

158. Epirubisin serb injeksi 10 mg/5 ml n/a

202. Fentanil patch 25 mcg/jam Durogesic 25 MU Matrix

433. Larutan mengandung Karbohidrat (Maltose 100 gr) Martos

458. Letrozol tablet/kaplet/kapsul 2,5 mg FEMARA

584. Paklitaksel inj 100 mg/vial SINDAXEL 100 MG/16,67

PT. Kimia Farma ktk 2x10 tablet 4,500.00 Download

PT. Bayer Indonesia Dus Isi 5 penfill/cartridge @ 3ml 76,125.00 Download

PT. Ferron Par Pharmaceuticals Dus, vial 10 ml 138,000.00 Download

PT. Pratapa Nirmala Botol 100 mL 270,000.00 Download

PT. Novartis Indonesia Dus, 4 blister @ 6 tablet 3,220.00 Download

PT. Fresenius Kabi Combiphar Botol Gelas 100 ml 36,667.00 Download

PT Kalbe Farma botol 250 mL 46,000.00 Download

PT Kalbe Farma botol 500 mL 50,500.00 Download

PT Kalbe Farma botol 500 mL 37,500.00 Download

PT. Widatra Bhakti Botol 500 ml 6,930.00 Download

PT. Actavis Indonesia Vial 6mg/ml (100mg/16.67ml) 984,000.00 Download

PT. Dexa Medica Dus, 10 Strip @ 10 kaptab 580.00 Download

PT. Cendo Industri Farmasi botol 5 ml 11,500.00 Download

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