PRICELIST HARGA ETALASE OBAT PROGRAM JKN 2023

PT.ETHICA INDUSTRI FARMASI

Harga
Isi Terbaik/ampul
Nama Generik pada Etalase Obat Kode HNA /box
No Kode APL Nama Produk Kemasan Reg. III Link e Cataloque Per Reg. III yang sudah
Program JKN 2023 Ethica
Box Reguler
muncul di sistem
E catalog

Amikasin/Amikacin/Amikacin sulfate AMIKACIN SULFATE INJEKSI

1
injeksi 250 mg/ml
EKACII2 FGA1-0073
500MG/ML 5AMP@2ML
Dus, 5 ampul @ 2mL 20,635 https://e-katalog.lkpp.go.id/katalog/produk/detail/49724864
5 92,948 165,000 19,449

AMINOPHYLLINE INJEKSI https://e-katalog.lkpp.go.id/

2 Aminofilin/Aminophylline inj 24 mg/ml EKAPLI2 FGA1-0001
24MG/ML 2AMP@10ML
Dus, 24 ampul @ 10 mL 11,450
katalog/produk/detail/55369708
24 247,568 250,000 10,000

AMIODARONE
3 Amiodaron inj 50 mg/ml (150 mg/ 3 mL) EKAMOI5 FGA1-0074 HYDROCHLORIDE INJEKSI Dus, 5 ampul @ 3 ml 11,800 https://e-katalog.lkpp.go.id/katalog/produk/detail/49721751
5 53,153 62,500 11,800
50MG/ML 3AMP@5ML

Atracurium Besilate/ Atracurium Besylate/ Atracurium InjLq 25mg/2.5mI https://e-katalog.lkpp.go.id/

4
Atrakurium injeksi 10mg/mL
EKATCI2 FGC1-0057
Amp 5s
Dus, 5 ampul @ 2,5mL 17,400
katalog/produk/detail/49479405
5 78,378 82,500 17,400

Atracurium Besilate/ Atracurium Besylate/ Atracurium InjLq 50mg/5mI https://e-katalog.lkpp.go.id/

5
Atrakurium injeksi 10mg/mL
EKATCI5 FGC1-0058
Amp 5s
Dus, 5 ampul @ 5 mL 48,400
katalog/produk/detail/49715059
5 218,018 242,000 45,980

ATROPINE SULFATE INJEKSI https://e-katalog.lkpp.go.id/

6 Atropin inj 0,25 mg/mL (i.v./s.k.) EKATRI2 FGA1-0006
0.25 MG/ML 100AMP@1ML
Dus, 100 ampul @ 1mL 3,778
katalog/produk/detail/49730928
100 340,360 500,000 3,700

BUPIVACAINE HCL
https://e-katalog.lkpp.go.id/
7 Bupivakain inj 0,5% EKBUPI1 FGR1-0075 MONOHYDRATE INJEKSI Dus, 10 ampul @ 4 ml 42,800
katalog/produk/detail/47796347
10 385,586 428,000 42,800
10AMP@4ML

Kalsium glukonat/ Calcium gluconate inj CALCIUM GLUCONATE INJEKSI https://e-katalog.lkpp.go.id/

8
10%
EKCAGU1 FGR1-0009
100MG/ML 24AMP @10ML
Dus, 24 ampul @ 10 mL 16,414
katalog/produk/detail/48094228
24 354,894 458,250 15,000

Dobutamin/ Dobutamin HCl/ Dobutamine Dobutamine HCI 50mg/ml Amp https://e-katalog.lkpp.go.id/

9
HCl injeksi 50 mg/mL
EKDBUI1 FGR1-0163
10s
Dus, 10 ampul @ 5 ml 17,472
katalog/produk/detail/58341375
10 157,404 175,950

Dopamin / Dopamine hidrochloride injeksi Dopamine HCI InjLq https://e-katalog.lkpp.go.id/

10 40 mg/ml EKDPOI1 FGR1-0165 200mg/5mI Amp 10s Dus, 10 ampul @5 ml 13,261 katalog/produk/detail/58315860 10 119,469 175,950

EPHEDRINE HCL INJEKSI 50MG https://e-katalog.lkpp.go.id/

11 Efedrin/ Ephedrine HCl Inj 50 mg/ml EKEPDI5 FGA1-0063
10AMP@1ML
Dus, 10 ampul @ 1 Ml 29,200
katalog/produk/detail/49474106
10 263,063 525,000 9,000

Epinefrin/ Epinephrine (Adrenalin) injeksi 1 EPINEPHRINE INJEKSI 1MG/ML https://e-katalog.lkpp.go.id/

12
mg/mL
EKEPII1 FGR1-0079
100AMP@1ML
Dus, 100 ampul @ 1mL 10,500
katalog/produk/detail/49468814
100 945,946 950,000 10,000

Hiosin butilbromid/Hyoscine Hyoscine Butylbromide https://e-katalog.lkpp.go.id/

13 butylbromide/Hyoscine N Butylbromide inj EKHYOI1 FGR1-0164
20mg/ml Amp 10s
Dus, 10 ampul @ 1mL 10,237
katalog/produk/detail/57588432
10 92,226 163,750
20 mg/ml

Methylergometrine Maleate/ METHYLERGOMETRINE

https://e-katalog.lkpp.go.id/
14 Methylergometrine/ Metilergometrin inj EKMEGO2 FGC1-0029 MALEATE INJEKSI 0.2 MG/ML Dus, 100 ampul @ 1mL 3,215 katalog/produk/detail/48099618 100 289,597 350,000 3,000
0,2 mg/ml 100AMP@1ML

Midazolam hydrochloride/ Midazolam MIDAZOLAM HCL 1 MG INJEKSI https://e-katalog.lkpp.go.id/

15
injeksi 1 mg/ml (i.v.)
EKMDZI5 FGR1-0113
10AMP@5ML
Dus, 10 ampul @ 5 ml 8,250
katalog/produk/detail/49216057
10 74,324 75,000 8,000

Midazolam hydrochloride/ Midazolam MIDAZOLAM HCL 5 MG INJEKSI https://e-katalog.lkpp.go.id/

16
injeksi 5 mg/ml (i.v.)
EKMDZI1 FGR1-0112
10AMP@3ML
Dus, 10 ampul @ 3 ml 33,000
katalog/produk/detail/49475001
10 297,297 300,000 33,000

Naloxone hydrochloride/ Naloxone/ NALOXONE HCL DIHYDRATE https://e-katalog.lkpp.go.id/

17 Nalokson injeksi 0,4 mg/ml EKNXOI5 FGR1-0166 INJEKSI 0.5MG/ML Dus, 5 ampul @ 2 ml 78,825 katalog/produk/detail/47672677 5 355,067 397,000 78,825
5AMP@2ML

NEOSTIGMINE METILSULFATE
18 Neostigmin injeksi 0,5 mg/ml EKNEOI5 FGA1-0062
INJEKSI 5AMP@1ML
Dus, 5 ampul @ 1mL 12,100 https://e-katalog.lkpp.go.id/katalog/produk/detail/49447716
5 54,505 55,000 12,000

Norepinephrine bitartate/ Norepinephrine

NOREPINEPHRINE BITARTRATE
bitartate monohydrate / Norepinephrine/
19
Norepinephrine base/ Norepinefrin inj 1
EKNOBI4 FGR1-0100 MONOHYDRATE INJ 1MG/ML Dus, 5 ampul @ 4 ml 5 173,874 267,500
38,600 https://e-katalog.lkpp.go.id/katalog/produk/detail/58489034
5AMP@4ML
mg/ml

OXYTOCIN INJEKSI 10IU/ML

20 Oxytocin/ Oksitosin inj 10 IU/ml EKOCIN1 FGC1-0036
100AMP@1ML(CCP)
Dus, 100 ampul @ 1mL 3,297 https://e-katalog.lkpp.go.id/katalog/produk/detail/48074222
100 297,027 300,000 3,132

Fenitoin/ Phenytoin Sodium Injeksi 50 PHENYTOIN SODIUM INJEKSI https://e-katalog.lkpp.go.id/

21 mg/ml (100 mg/ 2 mL) EKPTOI1 FGR1-0135 100MG 20AMP@2ML Dus, 20 ampul @ 2 ml 6,259 katalog/produk/detail/49730924 20 112,780 138,000
 Rocuronium bromide/ Rokuronium inj 10 ROCURONIUM BROMIDE https://e-katalog.lkpp.go.id/
22
mg/ml
EKRCOI5 FGC1-0061
INJEKSI 50MG 5AMP@5ML
Dus, 5 ampul @ 1mL 63,800
katalog/produk/detail/49797019
5 287,387 302,500

Ketorolak/ Ketorolac / Ketorolac

KETOROLAC TROMETAMOL
23 trometamol/ Ketorolac tromethamine inj EKKROIC FGA1-0110 INJEKSI 30MG 100AMP@1ML Dus, 100 ampul @ 1 ml 3,300 https://e-katalog.lkpp.go.id/katalog/produk/detail/52559531
100 297,297 300,000
30 mg/ml (3%)

Metoclopramide hydrochloride (HCl)/ METOCLOPRAMIDE HCL

https://e-katalog.lkpp.go.id/
24 Metoclopramide/ Metoklopramid inj 5 EKMTOI1 FGA1-0095 MONOHYDRATE INJ 5MG/ML Dus, 6 ampul @ 2 ml 5,500
katalog/produk/detail/52559531
6 29,730 36,000
mg/mL 6AMP@AML

Furosemid/ Furosemide inj 10 mg/mL FUROSEMIDE INJEKSI 100APM https://e-katalog.lkpp.go.id/

25
(i.v./i.m)
EKFROI2 FGA1-0094
@2ML
Dus, 100 ampul @ 2 ml 3,960
katalog/produk/detail/52556150
100 356,757 450,000

Ondansetron hydrochloride (HCl)/ ONDANSETRON HCL https://e-katalog.lkpp.go.id/

26 Ondansetron HCl dihydrate /Ondansetron EKODAI4CN FGR1-0157 DIHYDRATE INJ Dus, 100 ampul @ 2 ml 3,600
katalog/produk/detail/58844289
100 324,324 462,000
inj 2 mg/mL 4MG100AMP@2ML

https://e-katalog.lkpp.go.id/
27 Protamin sulfat inj 10 mg/mL (i.v.) EKPROS5 FGR1-0286 PROSUL InjL 50mg/5mL Amp 5s Dus, 5 ampul @ 5 ml 88,200 katalog/produk/detail/57286645 5 397,297 401,250

Ropivacaine hydrochloride (HCl)/ ROPIVACAINE HCL INJEKSI https://e-katalog.lkpp.go.id/

28
Ropivakain inj 7,5 mg/ml
EKROPI150 FGR1-0249
150MG 5AMP@20ML
Dus, 5 ampul @ 20 ml 74,945
katalog/produk/detail/58484306
5 337,590 341,000

Ranitidine hydrochloride (HCl)/ Ranitidin RANITIDINE HCL INJEKSI 50MG https://e-katalog.lkpp.go.id/

29
injeksi 25 mg/ml
EKRANIC FGA1-0133
100AMP@2ML
Dus, 100 ampul @ 2 ml 3,880
katalog/produk/detail/58844134
100 349,550 350,000

Ketamin/Ketamine Hydrochloride injeksi KETAMIN INJEKSI 100MG/ML 5 https://e-katalog.lkpp.go.id/

30 100 mg/mL ( i.v.) EKKTMI1 FGA1-0059 AMPUL Dus, 5 ampul @ 10 ml 64,100 katalog/produk/detail/59547641 5 288,739 385,000

Ketamin/Ketamine Hydrochloride injeksi KETAMIN INJEKSI 50MG/ML 5 https://e-katalog.lkpp.go.id/

31
50 mg/mL ( i.v.)
EKKTMI5 FGA1-0060
AMPUL
Dus, 5 ampul @ 10 ml 59,500
katalog/produk/detail/59546313
5 268,018 357,500

32 Dobutamin/ Dobutamin HCl/ Dobutamine EKDBUI25 FGR1-0253 DOBUTAMINE INJ 250 Dus, 5 ampul @ 20 ml 139,860 https://e-katalog.lkpp.go.id/ 5 630,000 700,000
HCl injeksi 12,5 mg/mL MG/20ML 5'S katalog/produk/detail/59548133

Keterangan :
1 Harga sesuai dengan harga tayang di e - cataloque pada Etalase Obat Program JKN 2023

2 Regional I : Lampung, Banten, Daerah Khusus Ibukota (DKI) Jakarta, Jawa Barat, Jawa Tengah, Daerah Istimewa (DI) Yogyakarta, JawaTimur, dan Bali.

3 Regional II : Sumatera Utara, Sumatera Barat, Riau, Jambi, Sumatera Selatan, Bengkulu, Kepulauan Bangka Belitung, dan Nusa Tenggara Barat.

4 Regional III : Aceh, Kalimantan Barat, Kalimantan Selatan, Kalimantan Timur, Sulawesi Utara, Sulawesi Tengah, Sulawesi Selatan, dan Kepulauan Riau.

5 Regional IV : Kalimantan Utara, Kalimantan Tengah, Sulawesi Tenggara, Gorontalo, dan Sulawesi Barat.

6 Regional V : Nusa Tenggara Timur, Maluku, Maluku Utara, dan Papua Barat.

7 Regional VI: Papua