No

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
 Nama Zat Aktif

Fentanil/ Fentanyl injeksi 0,05 mg/ml (i.m/i.v)

Fentanil/ Fentanyl injeksi 0,05 mg/ml (i.m/i.v)
Efedrin/ Ephedrine HCl Inj 50 mg/ml
Pioglitazone/ pioglitazone hydrochloride (HCl)/ pioglitazon tablet 15 mg
Pioglitazone/ pioglitazone hydrochloride (HCl)/ Pioglitazon tablet/kapsul/kaplet 30 mg
Salbutamol/ Salbutamol Sulfate cairan ih 1 mg/mL
Esomeprazole Sodium/ Esomeprazol serbuk Inj. 40 mg (i.v)
Omeprazol/Omeprazole/ Omeoprazole Sodium inj 40 mg
Tramadol inj 50 mg/ml
Ondansetron hydrochloride (HCl)/ Ondansetron HCl dihydrate /Ondansetron tablet/kapsul/kaplet 4 mg
Ondansetron hydrochloride (HCl)/ Ondansetron HCl dihydrate /Ondansetron tablet/kapsul/kaplet 8 mg
Amlodipin/ Amlodipine/ Amlodipine besilate tablet/kapsul/kaplet 5 mg
Amlodipin/ Amlodipine/ Amlodipine besilate tablet/kapsul/kaplet 10 mg
Clopidogrel bisulfate/ Clopidogrel/ Clopidogrel hydrogen sulfate/ Klopidogrel tablet/kapsul/kaplet 75 mg
Pregabalin kaps 75 mg
Acetyl cysteine/ N-asetil sistein tablet/kapsul/kaplet 200 mg
Metilprednisolon/Methylprednisolone tablet/kapsul/kaplet 4 mg
Metilprednisolon/Methylprednisolone tablet/kapsul/kaplet 8 mg
Metilprednisolon/Methylprednisolone tablet/kapsul/kaplet 16 mg
Asam traneksamat/Tranexamic acid injeksi 50 mg/ml
Ondansetron hydrochloride (HCl)/ Ondansetron HCl dihydrate /Ondansetron inj 2 mg/mL
Methylprednisolone Sodium Succinate/ Metilprednisolon/ Methylprednisolone inj 125 mg
Cefazolin sodium/ Sefazolin serbuk injeksi 1.000 mg
Ceftazidime/ Ceftazidime Pentahydrate/ Seftazidim serb inj 1.000 mg
Ceftriaxone/ Ceftriaxone Sodium/ Seftriakson inj 1.000 mg
Kombinasi: sefoperazon/ cefoperazone sodium 500 mg + sulbaktam/ sulbactam sodium 500 mg, serb inj 1.000 mg
Meropenem/ Meropenem Trihydrate serb inj 1.000 mg
Cefoperazone sodium/Cefoperazone/ Sefoperazon serb inj 1.000 mg
Amikasin/Amikacin/Amikacin sulfate injeksi 250 mg/ml
Amikasin/Amikacin/Amikacin sulfate injeksi 500 mg/ml
Imipenem Monohydrate/Cilastatin Sodium serb inj 1.000 mg
Kandesartan/ Candesartan/ Candesartan Cilexetil tablet/kapsul/kaplet 16 mg
Kandesartan/ Candesartan/ Candesartan Cilexetil tablet/kapsul/kaplet 8 mg
Ketorolak/ Ketorolac / Ketorolac trometamol/ Ketorolac tromethamine inj 30 mg/ml (3%)
Levofloxacin hemihydrate/ Levofloxacin/ Levofloksasin inf 5 mg/mL
Metronidazole/ Metronidazol infus 5 mg/ ml
Moxifloxacin hydrochloride (HCl)/ Moxifloxacin/ Moksifloksasin infus 1,6 mg/mL (400mg/250ml)
Hepabumin Sachet
 Nilai BMP
TKDN (Tingkat
(Bobot Kemasan yang
Katagori Komponen TOTAL
Manfaat Dipersyaratkan
Dalam Negeri)
Perusahaan)

Obat 38.83% 5.55% 44.38% ampul/vial @ 2 mL

Obat 38.85% 5.55% 44.40% ampul/vial, @ 10 mL
Obat 47.60% 5.55% 53.15% ampul/vial
Obat 36.42% 5.55% 41.97% strip/ blister
Obat 36.42% 5.55% 41.97% strip/ blister
Obat 35.91% 5.55% 41.46% ampul/vial/botol
Obat 20.70% 5.55% 26.25% ampul/vial
Obat 29.30% 5.55% 34.85% ampul/vial
Obat 38.85% 5.55% 44.40% ampul/vial
Obat 32.69% 5.55% 38.24% strip/ blister
Obat 34.88% 5.55% 40.43% strip/ blister
Obat 30.50% 5.55% 36.05% strip/blister
Obat 30.50% 5.55% 36.05% strip/blister
Obat 34.96% 5.55% 40.51% strip/ blister
Obat 35.70% 5.55% 41.25% strip/blister
Obat 34.00% 5.55% 39.55% strip/ blister
Obat 32.44% 5.55% 37.99% strip/ blister
Obat 34.00% 5.55% 39.55% strip/ blister
Obat 34.00% 5.55% 39.55% strip/ blister
Obat 47.60% 5.55% 53.15% ampul/vial
Obat 33.58% 5.55% 39.13% ampul/vial
Obat 33.56% 5.55% 39.11% ampul/vial
Obat 21.10% 5.55% 26.65% ampul/vial
Obat 20.50% 5.55% 26.05% ampul/vial
Obat 20.50% 5.55% 26.05% ampul/vial
Obat 20.50% 5.55% 26.05% ampul/vial
Obat 20.47% 5.55% 26.02% ampul/vial
Obat 20.48% 5.55% 26.03% ampul/vial
Obat 33.41% 5.55% 38.96% vial/ampul
Obat 33.41% 5.55% 38.96% vial/ampul
Obat 20.30% 5.55% 25.85% vial/ampul
Obat 36.00% 5.55% 41.55% strip/ blister
Obat 36.00% 5.55% 41.55% strip/ blister
Obat 38.85% 5.55% 44.40% ampul/vial
Obat 35.31% 5.55% 40.86% vial/ botol/ flexy bag @ 100 ml
Obat 35.31% 5.55% 40.86% botol
Obat 46.67% 5.55% 52.22% vial/ampul/botol/softbag
Kesehatan dan Obat Inovasi Sachet
 REGIONAL 1

Lampung Banten DKI Jakarta Jawa Barat Jawa Tengah

26,928 26,928 26,928 26,928 26,928

106,920 106,920 106,920 106,920 106,920
24,975 24,975 24,975 24,975 24,975
2,590 2,590 2,590 2,590 2,590
3,885 3,885 3,885 3,885 3,885
4,440 4,440 4,440 4,440 4,440
46,620 46,620 46,620 46,620 46,620
6,494 6,494 6,494 6,494 6,494
4,440 4,440 4,440 4,440 4,440
444 444 444 444 444
722 722 722 722 722
337 337 337 337 337
619 619 619 619 619
2,849 2,849 2,849 2,849 2,849
5,203 5,203 5,203 5,203 5,203
1,110 1,110 1,110 1,110 1,110
282 282 282 282 282
466 466 466 466 466
833 833 833 833 833
5,328 5,328 5,328 5,328 5,328
2,092 2,092 2,092 2,092 2,092
23,976 23,976 23,976 23,976 23,976
22,200 22,200 22,200 22,200 22,200
33,300 33,300 33,300 33,300 33,300
16,650 16,650 16,650 16,650 16,650
55,500 55,500 55,500 55,500 55,500
61,050 61,050 61,050 61,050 61,050
44,400 44,400 44,400 44,400 44,400
34,965 34,965 34,965 34,965 34,965
53,280 53,280 53,280 53,280 53,280
139,860 139,860 139,860 139,860 139,860
2,516 2,516 2,516 2,516 2,516
1,628 1,628 1,628 1,628 1,628
4,995 4,995 4,995 4,995 4,995
28,416 28,416 28,416 28,416 28,416
26,640 26,640 26,640 26,640 26,640
99,900 99,900 99,900 99,900 99,900
55,500 55,500 55,500 55,500 55,500
DI Yogyakarta Jawa Timur Bali Sumatera Utara Sumatera Barat

26,928 26,928 26,928 28,274 28,274

106,920 106,920 106,920 112,266 112,266
24,975 24,975 24,975 24,975 24,975
2,590 2,590 2,590 2,590 2,590
3,885 3,885 3,885 3,885 3,885
4,440 4,440 4,440 4,440 4,440
46,620 46,620 46,620 46,620 46,620
6,494 6,494 6,494 6,494 6,494
4,440 4,440 4,440 4,440 4,440
444 444 444 444 444
722 722 722 722 722
337 337 337 337 337
619 619 619 619 619
2,849 2,849 2,849 2,849 2,849
5,203 5,203 5,203 5,203 5,203
1,110 1,110 1,110 1,110 1,110
282 282 282 282 282
466 466 466 466 466
833 833 833 833 833
5,328 5,328 5,328 5,328 5,328
2,092 2,092 2,092 2,092 2,092
23,976 23,976 23,976 23,976 23,976
22,200 22,200 22,200 22,200 22,200
33,300 33,300 33,300 33,300 33,300
16,650 16,650 16,650 16,650 16,650
55,500 55,500 55,500 55,500 55,500
61,050 61,050 61,050 61,050 61,050
44,400 44,400 44,400 44,400 44,400
34,965 34,965 34,965 34,965 34,965
53,280 53,280 53,280 53,280 53,280
139,860 139,860 139,860 139,860 139,860
2,516 2,516 2,516 2,516 2,516
1,628 1,628 1,628 1,628 1,628
4,995 4,995 4,995 4,995 4,995
28,416 28,416 28,416 28,416 28,416
26,640 26,640 26,640 26,640 26,640
99,900 99,900 99,900 99,900 99,900
55,500 55,500 55,500 55,500 55,500
 REGIONAL 2

Riau Jambi Sumatera Selatan Bengkulu Kep. Bangka Belitung

28,274 28,274 28,274 28,274 28,274

112,266 112,266 112,266 112,266 112,266
24,975 24,975 24,975 24,975 24,975
2,590 2,590 2,590 2,590 2,590
3,885 3,885 3,885 3,885 3,885
4,440 4,440 4,440 4,440 4,440
46,620 46,620 46,620 46,620 46,620
6,494 6,494 6,494 6,494 6,494
4,440 4,440 4,440 4,440 4,440
444 444 444 444 444
722 722 722 722 722
337 337 337 337 337
619 619 619 619 619
2,849 2,849 2,849 2,849 2,849
5,203 5,203 5,203 5,203 5,203
1,110 1,110 1,110 1,110 1,110
282 282 282 282 282
466 466 466 466 466
833 833 833 833 833
5,328 5,328 5,328 5,328 5,328
2,092 2,092 2,092 2,092 2,092
23,976 23,976 23,976 23,976 23,976
22,200 22,200 22,200 22,200 22,200
33,300 33,300 33,300 33,300 33,300
16,650 16,650 16,650 16,650 16,650
55,500 55,500 55,500 55,500 55,500
61,050 61,050 61,050 61,050 61,050
44,400 44,400 44,400 44,400 44,400
34,965 34,965 34,965 34,965 34,965
53,280 53,280 53,280 53,280 53,280
139,860 139,860 139,860 139,860 139,860
2,516 2,516 2,516 2,516 2,516
1,628 1,628 1,628 1,628 1,628
4,995 4,995 4,995 4,995 4,995
28,416 28,416 28,416 28,416 28,416
26,640 26,640 26,640 26,640 26,640
99,900 99,900 99,900 99,900 99,900
55,500 55,500 55,500 55,500 55,500
 REGIONAL 3

Nusa Tenggara Barat Kepulauan Riau Aceh Kalimantan Barat Kalimantan Selatan

28,274 29,500 29,500 29,500 29,500

112,266 119,000 119,000 119,000 119,000
24,975 26,363 26,363 26,363 26,363
2,590 2,960 2,960 2,960 2,960
3,885 4,440 4,440 4,440 4,440
4,440 4,995 4,995 4,995 4,995
46,620 46,620 46,620 46,620 46,620
6,494 7,992 7,992 7,992 7,992
4,440 4,995 4,995 4,995 4,995
444 555 555 555 555
722 833 833 833 833
337 361 361 337 361
619 660 660 619 660
2,849 3,053 3,053 3,053 3,053
5,203 5,550 5,550 5,550 5,550
1,110 1,110 1,110 1,110 1,110
282 282 282 282 282
466 466 466 466 466
833 833 833 833 833
5,328 5,328 5,328 5,328 5,328
2,092 2,575 2,575 2,575 2,575
23,976 23,976 23,976 23,976 23,976
22,200 22,200 22,200 22,200 22,200
33,300 33,300 33,300 33,300 33,300
16,650 16,650 16,650 16,650 16,650
55,500 55,500 55,500 55,500 55,500
61,050 61,050 61,050 61,050 61,050
44,400 44,400 44,400 44,400 44,400
34,965 34,965 34,965 34,965 34,965
53,280 53,280 53,280 53,280 53,280
139,860 139,860 139,860 139,860 139,860
2,516 2,516 2,516 2,516 2,516
1,628 1,628 1,628 1,628 1,628
4,995 4,995 4,995 4,995 4,995
28,416 28,416 28,416 28,416 28,416
26,640 26,640 26,640 26,640 26,640
99,900 99,900 99,900 99,900 99,900
55,500 55,500 55,500 55,500 55,500
REGIONAL 3

Kalimantan Timur Sulawesi Utara Sulawesi Tengah Sulawesi Selatan Kalimantan Utara

29,500 29,500 29,500 29,500 29,500

119,000 119,000 119,000 119,000 119,000
26,363 26,363 26,363 26,363 26,363
2,960 2,960 2,960 2,960 2,960
4,440 4,440 4,440 4,440 4,440
4,995 4,995 4,995 4,995 4,995
46,620 46,620 46,620 46,620 46,620
7,992 7,992 7,992 7,992 7,992
4,995 4,995 4,995 4,995 4,995
555 555 555 555 555
833 833 833 833 833
361 361 361 361 361
660 660 660 660 660
3,053 3,053 3,053 3,053 3,053
5,550 5,550 5,550 5,550 5,550
1,110 1,110 1,110 1,110 1,110
282 282 282 282 282
466 466 466 466 466
833 833 833 833 833
5,328 5,328 5,328 5,328 5,328
2,575 2,575 2,575 2,575 2,575
23,976 23,976 23,976 23,976 23,976
22,200 22,200 22,200 22,200 22,200
33,300 33,300 33,300 33,300 33,300
16,650 16,650 16,650 16,650 16,650
55,500 55,500 55,500 55,500 55,500
61,050 61,050 61,050 61,050 61,050
44,400 44,400 44,400 44,400 44,400
34,965 38,850 38,850 38,850 34,965
53,280 59,940 59,940 59,940 53,280
139,860 179,820 179,820 179,820 139,860
2,516 2,988 2,988 2,988 2,516
1,628 1,933 1,933 1,933 1,628
4,995 6,000 6,000 6,000 4,995
28,416 35,520 35,520 35,520 28,416
26,640 33,300 33,300 33,300 26,640
99,900 99,900 99,900 99,900 99,900
55,500 55,500 55,500 55,500 55,500
 REGIONAL 4

Kalimantan Tengah Sulawesi Tenggara Gorontalo Sulawesi Barat Nusa Tenggara Timur

29,500 29,500 29,500 29,500 29,500

119,000 119,000 119,000 119,000 119,000
26,363 26,363 26,363 26,363 26,363
2,960 2,960 2,960 2,960 2,960
4,440 4,440 4,440 4,440 4,440
4,995 4,995 4,995 4,995 4,995
46,620 46,620 46,620 46,620 46,620
7,992 7,992 7,992 7,992 7,992
4,995 4,995 4,995 4,995 4,995
555 555 555 555 555
833 833 833 833 833
361 361 361 361 361
660 660 660 660 660
3,053 3,053 3,053 3,053 3,053
5,550 5,550 5,550 5,550 5,550
1,110 1,110 1,110 1,110 1,110
282 282 282 282 282
466 466 466 466 466
833 833 833 833 833
5,328 5,328 5,328 5,328 5,328
2,575 2,575 2,575 2,575 2,575
23,976 23,976 23,976 23,976 23,976
22,200 22,200 22,200 22,200 22,200
33,300 33,300 33,300 33,300 33,300
16,650 16,650 16,650 16,650 16,650
55,500 55,500 55,500 55,500 55,500
61,050 61,050 61,050 61,050 61,050
44,400 44,400 44,400 44,400 44,400
34,965 38,850 38,850 38,850 34,965
53,280 59,940 59,940 59,940 53,280
139,860 179,820 179,820 179,820 139,860
2,516 2,988 2,988 2,988 2,516
1,628 1,933 1,933 1,933 1,628
4,995 6,000 6,000 6,000 4,995
28,416 35,520 35,520 35,520 28,416
26,640 33,300 33,300 33,300 26,640
99,900 99,900 99,900 99,900 99,900
55,500 55,500 55,500 55,500 55,500
 REGIONAL 5 REGIONAL 6

Maluku Maluku Utara Papua Barat Papua

29,500 29,500 29,500 29,500

106,920 106,920 119,000 119,000

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