Ecatalog Obat Bpjs

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.
39.
40.
41.
42.
43.
44.
45.
46.
47.
Nama GenerNama DaganNama PenyeKemasan

Harga Satuan Terkecil +PPN
ACT (Artesu n/a
PT. Kimia Fa 1 blister@241,375.00
Adefovir Dip Hepsera
PT. SmithKl Dus, 3 Blist 27,500.00
Albendazol n/a
PT. IndofarmDus, 10 dus 3,849.00
Albendazol tn/a
PT. Holi Pha Dus, 5 strip 338.00
Albumin ser Zenalb
PT. Ikaphar Vial 100 ml 750,000.00
Albumin ser Zenalb
PT. Ikaphar Vial 50 ml 345,000.00
Albumin ser PLASBUMIN PT. Dipa Ph botol @ 250 900,000.00
Albumin ser PLASBUMIN PT. Dipa Ph botol @ 50 283,000.00
Alopurinol t n/a
PT. Pertiwi Box, 10 stri 86.00
Alopurinol t n/a
PT. Bernofa Dus, 10 blis 199.50
Alprazolam tn/a
PT. Dexa Me Dus, 10 Stri 380.00
Alprazolam tn/a
PT. Otto Pha 1 box 10 Str 176.00
Alprazolam tn/a
PT. Kimia Fa Ktk 10x10 ta233.00
Alteplase in Actilyse
PT. BoehringDus, 1 vial 3,800,000.00
Amfoterisin Fungicide
PT. Cendo In tube 3.5 gr 18,500.00
Amikasin inj Glybotic 25 PT. Sanbe F Vial 2 ml
50,500.00
Aminofilin i n/a
PT. Lucas Dj dus 30 ampu3,822.00
Aminofilin t n/a
PT. Marin Li Botol @ 100 90.00
Amiodaron i Cordarone PT. Aventis Dus, 6 ampu12,480.00
Amiodaron t Kendaron TabPT. Darya Vastrip
1,200.00
Amitriptilin n/a
PT. IndofarmDus, 10 stri 112.00
Amlodipin tan/a
PT. Pertiwi Box, 3 strip 330.00
Amlodipin tan/a
PT. Pertiwi Box, 3 strip 187.00
Amoksisilin n/a
PT. Novaphardus 10 X 10'211.00
Amoksisilin n/a
PT. Bernofa Dus, 10 stri 272.00
Amoksisilin n/a
PT. Holi Pha Dus, Botol 6 4,045.00
Amoksisilin n/a
PT. Novapharbtl @ 60 ml 2,445.00
Ampisilin sern/a
PT. Bernofa Dus, 10 vial 5,100.00
Analog insuliLantus Solo PT. Aventis dus, 5 solos 85,000.00
Analog insul Novomix FlePT. Ferron P Injeksi 100 I 106,000.00
Analog insuliHumalog MixPT. Tempo ScPenfill cartr 97,500.00
Analog insuliNovorapid F PT. Ferron P Injeksi 100 I 85,345.00
Analog insuliNovorapid ViPT. Ferron P Dus, vial 10 200,000.00
Analog insuliApidra SolosPT. Aventis dus, 5 solos 79,165.00
Analog insuliHumalog
PT. Tempo ScPenfill cartr 79,167.00
Anastrozol t Arimidex 1 PT. AstraZenDus, 2 blist 32,000.00
Antasida DOn/a
PT. PromedraDus, 10 Stri 75.00
Antasida DOn/a
PT. Rama EmBoto 60 ml 2,100.00
Anti Bakteri n/a
PT. IndofarmDus, 25 tub 2,516.00
Antimalaria n/a
PT. Kimia Fa ktk 10 x 10 520.00
Antimigren: n/a
PT. Kimia Fa Btl 100 table135.00
Antiparkins Levopar TablPT. Meprofa Dus, 5 strip 1,500.00
Artemether iArtem
PT. Kimia Fa Dus 6 amp 22,000.00
Asam Asetilsn/a
PT. Phapros, Dus @ 10 X 1
116.00
Asam Askorba
n/a
PT. Kimia Fa ktk 10x10 ta159.00
Asam Askorba
n/a
PT. Kimia Fa Dus 10 strip 95.00
Asam Folat tStarfolat
PT. Dexa Me Dus, 10 stri 84.00
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
81.
82.
83.
84.
85.
86.
87.
88.
89.
90.
91.
92.
93.
94.
95.
Asam Folat tn/a

Asam IbandrBondronat PT. BoehringBoks, 1 amp2,209,000.00
Asam Mefena
n/a
Asam pipemiUrotractin PT. Sanbe F Strip
1,815.00
Asam tranekn/a
PT. Hexpharm
Dus, 10 amp3,334.00
Asam tranekn/a
PT. Bernofa Dus, 10 amp2,950.00
Asam zoledr ZOMETA
PT. Novartis Dus, 1 vial 900,000.00
Asiklovir sa Temiral Eye PT. Sanbe F Tube 3,5 gr 24,750.00
Asiklovir ta n/a
PT. IndofarmDus, 10 blis 237.00
Asiklovir ta n/a
AsparaginaseLeunase
PT. Widatra 10.000 UI/Vi 1,039,500.00
Atapulgit ta Pularex
PT. Zenith P Dus 5 strip 190.00
Atrakurium i Tracrium
PT. Glaxo WeDus, 5 ampu20,000.00
Atropin Sulf n/a
Azitromisin n/a
PT. Soho Ind botol @ 60 34,400.00
Azitromisin n/a
PT. Kimia Fa ktk 2x10 tab4,500.00
Azitromisin n/a
PT. Soho Ind Strip
3,333.00
Bedak salisi n/a
PT. Rama EmDus @ 50 g 1,250.00
Benzatin Benz
n/a
PT. Phapros, Ds 10 vial x 9,800.00
Benzatin Benz
n/a
PT. Phapros, Dus @ 10 Vi 13,400.00
Beractant in Survanta
PT. Abbott I Vial
3,200,000.00
Beraprost s Dorner 20 PT. Combiph Box/ 3 blist 3,600.00
Beraprost s Dorner
PT. Combiph Box @ 3 blis 3,600.00
Betametasonn/a
PT. Kimia Fa Tube 5 gr
1,520.00
BetametasonBetam OphtaPT. Sanbe F botol @ 5 ml25,106.00
BevasizumabAvastin
PT. BoehringDus, 1 vial 4,803,697.00
Bikalutamid Casodex 15 PT. AstraZenDus, 2 blist 72,400.00
Bikalutamid Casodex 50 PT. AstraZenDus, 2 blist 45,000.00
Bisakodil su Stolax supp PT. Sanbe F Supp
6,045.00
Bisoprolol t Concor 2.5 PT. Merck TbDus 10 blist 746.00
Bisoprolol t n/a
PT. Pratapa Box 3 X 10 t 645.00
Bleomisin seBLEOCIN
PT Kalbe Fa Vial
304,000.00
BromokriptinCripsa tab PT. Caprifar Box 3 x 10'S247,089.00
Budesonid inPulmicort Tu PT. AstraZenDus, 1 Turbu93,000.00
Budesonid rePulmicort RePT. AstraZenDus, 4 pak @8,900.00
Budesonid-foSymbicort T PT. AstraZenDus, 1 Turbu117,600.00
Budesonid-foSymbicort 8 PT. AstraZenDus, 1 Turbu110,500.00
Bupivakain i n/a
PT. Dexa Me Dus, 5 ampu25,600.00
Bupivakain i Bunascan PT. Pratapa ampul
30,800.00
Dabigatran ePradaxa
PT. BoehringDus, 3 blist 12,936.00
Dabigatran ePradaxa
PT. BoehringDus, 3 blist 12,936.00
Dakarbazin sDBL DacarbaPT. Tempo Scvial @ 20 ml305,000.00
DaunorubisinDAUNOCIN PT. Novell P vial
275,000.00
DeferasiroksExjade 250 PT. Novartis Dus, 4 bliste76,000.00
DeferasiroksExjade 500 PT. Novartis Dus, 4 bliste150,000.00
Deferipron l Ferriprox OraPT. Sydna F Dus, Botol 2,600,000.00
Deferipron t Ferriprox tabPT. Sydna F Dus, Botol @25,300.00
Deferoksamin
Desferal
PT. Novartis Dus, 10 via 112,000.00
96.
97.
98.
99.
100.
101.
102.
103.
104.
105.
106.
107.
108.
109.
110.
111.
112.
113.
114.
115.
116.
117.
118.
119.
120.
121.
122.
123.
124.
125.
126.
127.
128.
129.
130.
131.
132.
133.
134.
135.
136.
137.
138.
139.
140.
141.
142.
143.
Deksametason
n/a
PT. IndofarmDus, 100 am1,580.00
Deksametaso
n/a
Desogestrel Cerazette PT. Merck S Dus, 1 Blist 70,000.00
Desoksimetan/a
PT. Dexa Me Kotak, tube 9,983.00
Diazepam laSTESOLID PT. Actavis Dus, 5 alub 11,525.00
Diazepam laSTESOLID PT. Actavis Dus, 5 alub 16,748.00
Difenhidramin
n/a
PT. Lucas Dj ampul @ 1 m1,054.00
Digoksin inj Fargoxin inj PT. Pratapa Box @ 5 amp22,000.00
Digoksin tabn/a
PT. Yarindo Box 10 X 10 97.00
Diltiazem HCn/a
Diltiazem in Herbesser P PT. Tanabe I 10 vial @ 5 127,667.00
Diltiazem in Farmabes In PT. Pratapa Vial 5 mL
46,667.00
Diltiazem K Herbesser C PT. Tanabe I 3 blister @ 3,667.00
Diltiazem K Herbesser C PT. Tanabe I 3 blister @ 4,015.00
Dimenhidrinan/a
PT. Kimia Fa Btl 100 table104.00
Dinatrium e E.D.T.A
PT. Cendo In botol 15 ml 37,500.00
Dinatrium kl Bonefos InfuPT. Bayer In ampul
124,955.00
Dobutamin i DOBURAN PT. Dipa Ph ampul @ 5 m26,700.00
Doksazosin m
Cardura 1m PT. Pfizer In Dus, 5 blist 3,480.00
Doksazosin m
Cardura 2m PT. Pfizer In Dus, 5 blist 5,480.00
DoksorubisinDoxorubicin PT. Actavis Dus, 1 vial 55,500.00
DoksorubisinDoxorubicin PT. Actavis Dus, 1 vial 274,125.00
Domperidon n/a
PT. Novapharbtl @ 60 ml 3,333.00
Domperidon n/a
PT. Novaphardus 10 X 10'167.00
Domperidon n/a
PT. Bernofa Dus, botol @15,600.00
Dopamin inj UDOPA
PT. Dipa Ph ampul @ 5 m9,840.00
Dosetaksel i n/a
PT. Sanbe F Dus, 1 vial 970,200.00
DTPA (diethyRenalscan K PT. Kimia Fa Dus @ 5 vial455,000.00
Dutasterid k Avodart
PT. SmithKl Dus, Botol P 7,100.00
Efavirens ta n/a
PT. Kimia Fa Botol 30 tab 6,375.00
Efedrin Inj n/a
PT. Bernofa Ampul @ 1 m12,990.00
Eksemestan Aromasin
PT. Pfizer In Dus, 2 blist 42,600.00
Enoksaparin Lovenox 200PT. Aventis dus, 2 prefi 40,740.00
Epinefrin (Adn/a
PT. Phapros, Dus @ 30 A 8,100.00
Epirubisin s Epirubisin K PT Kalbe Fa Vial @ 25 ml500,000.00
Epirubisin s n/a
PT. Sanbe F Dus, 1 vial 128,000.00
Ergokalsifer D-Vit FT
PT. Gracia P Dus 3 strip 650.00
Ergokalsifer D-Vit Syrup PT. Gracia P Dus, Botol P 8,000.00
Eritromisin n/a
Eritromisin n/a
Eritromisin n/a
PT. Phyto K Botol @60 m7,700.00
Eritropoetin Hemapo 300PT Kalbe Fa Prefilled Sy 128,000.00
Eritropoetin Recormon PT. BoehringBoks, 6 amp139,500.00
Etambutol tan/a
Etambutol tan/a
Etanol 70% n/a
PT. Novapharbtl @ 100 m 2,500.00
144.
145.
146.
147.
148.
149.
150.
151.
152.
153.
154.
155.
156.
157.
158.
159.
160.
161.
162.
163.
164.
165.
166.
167.
168.
169.
170.
171.
172.
173.
174.
175.
176.
177.
178.
179.
180.
181.
182.
183.
184.
185.
186.
187.
188.
189.
190.
191.
Etinilestradi Lynoral
PT. Merck S Dus, botol @1,360.00
Etonogestre Implanon
PT. Merck S Dus, 1 blist 128,779.00
Etoposid inj Posyd
PT. Combiph Vial 100mg/ 100,000.00
Eugenol cairn/a
PT. Kimia Fa Botol 10 ml 16,667.00
Everolimus Certican 0,2 PT. Novartis Dus, 6 blist 11,813.00
Everolimus Certican 0,5 PT. Novartis Dus, 6 blist 23,250.00
Faktor VIIa Novoseven PT. Ferron P KOTAK @ 1 V9,200,000.00
Faktor VIII ( KOATE DVI 5PT. Dipa Ph vial
2,150,000.00
Fenitoin inj n/a
PT. Mersifa KOTAK @ 10 20,250.00
Fenitoin kap n/a
PT. Ikaphar Botol @ 100 133.00
Fenitoin Na n/a
PT. Mersifa KOTAK @ 10 20,250.00
Fenobarbital n/a
Fenofibrat n/a
PT. Hexpharm
Dus, 3 strip 1,075.00
Fenofibrat n/a
PT. Hexpharm
Dus, 3 strip 1,375.00
FenoksimetilFenocin
PT. Actavis Dus 45 x 12 235.00
Fenoksimetiln/a
PT. Phapros, Ds 10 str x 1510.00
Fenoterol HBBerotec MDI PT. BoehringBox, canist 72,900.00
Fenoterol HBBerotec SoluPT. BoehringDus, Caniste117,500.00
Fentanil inj n/a
PT. Kimia Fa Dus 5 ampu 128,000.00
Fentanil inj n/a
PT. Kimia Fa Dus 5 ampu 33,914.00
Fentanil pat Durogesic 1 PT. Kimia Fa Dus @ 5 pat 80,000.00
Fentanil pat Durogesic 2 PT. Kimia Fa Dus@ 5 patc153,000.00
Fentanil pat Durogesic 5 PT. Kimia Fa Dus@ 5 patc285,000.00
Filgrastim i Leucogen PT Kalbe Fa pfs @ 0,5 ml375,000.00
Finasterid t Prostacom PT. Combiph Box, isi 3 St 2,950.00
Fitomenadionn/a
Fitomenadionn/a
PT. Phapros, dus @ 30 am3,417.00
Fludarabin i Fludara IV L PT. Aventis Dus, 5 vial 1,248,319.00
Fludarabin Fludara Oral PT. Aventis Dus, 4 bliste275,000.00
Flufenazin i Sikzonoate I PT. Mersifa Dus, 5 ampu55,000.00
Flukonazol i n/a
PT. Novell P Botol
38,000.00
Flukonazol t n/a
PT. Kimia Fa ktk 1 x 10 k 22,000.00
Fluoksetin t Foransi 10 PT. Gracia P strip
419.00
Fluoksetin t NOPRES
PT. Dexa Me DUS, 30 TAB410.00
Fluorometol Ocuflam ED PT. Sanbe F botol @ 5 ml30,493.00
Fluorourasil Curacil
PT Kalbe Fa vial @ 1 ml 24,500.00
Fluorourasil Curacil
PT Kalbe Fa vial @ 10 ml33,000.00
Flusinolon a SYNARCUS PT. Ifars Ph Dus, Tube 5 2,400.00
Flutikason f Avamys
PT. Glaxo WeDus, Botol 1 93,333.00
Flutikason p Flixotide Nb PT. Glaxo WeDus, 2 flow 12,917.00
Fondaparinuk
Arixtra
PT. Glaxo WeDus, 2 pfs 0 241,667.00
Fraksi prote Plasmanate PT. Dipa Ph dus, vial @ 972,000.00
Furosemid inn/a
PT. IndofarmDus, 25 amp1,829.00
Furosemid t n/a
Gadobutrol Gadovist 5 PT. Bayer In Prefilled Syr 275,000.00
Gadobutrol Gadovist 7, PT. Bayer In Prefilled Syr 412,500.00
Gadoksetat Primovist
PT. Bayer In Prefilled Syr 2,570,000.00
Gansiklovir Cymevene PT. BoehringBoks, 1 amp399,500.00
192.
193.
194.
195.
196.
197.
198.
199.
200.
201.
202.
203.
204.
205.
206.
207.
208.
209.
210.
211.
212.
213.
214.
215.
216.
217.
218.
219.
220.
221.
222.
223.
224.
225.
226.
227.
228.
229.
230.
231.
232.
233.
234.
235.
236.
237.
238.
239.
Garam Oralitn/a
PT.
Gefitinib ta Iressa 250 PT.
Gemfibrozil n/a
PT.
Gemfibrozil n/a
PT.
Gemsitabin iGemzar 100 PT.
Gemsitabin in/a
PT.
Gentamisin in/a
PT.
Gentamisin Genoint Sal PT.
Gentamisin n/a
PT.
Glibenklamidn/a
PT.
Gliklazid ta Glicab
PT.
Gliklazid ta Diamicron MPT.
Glikuidon ta n/a
PT.
Glimepiride n/a
PT.
Glimepiride n/a
PT.
Glimepiride n/a
PT.
Glimepiride n/a
PT.
Gliseril trin Nitrokaf Ret PT.
Gliseril trin Nitrokaf FortPT.
Gliseril trin Nitral
PT.
Gliserin lar Gliserin lar PT.
Glukosa larun/a
PT.
Glukosa larutn/a
PT.
Goserelin as Zoladex 10, PT.
Goserelin as Zoladex 3,6 PT.
Griseofulvin n/a
PT.
Haloperidol Haldol Deca PT.
Haloperidol n/a
PT.
Haloperidol n/a
PT.
Haloperidol n/a
PT.
Haloperidol Lodomer 2 PT.
Halotan InhaHalothane PT.
Heparin injekInviclot
PT.
Hepatitis B Hyperhep B PT.
Hidrokortiso n/a
PT.
Hidroksi Ure HYDROXYURPT.
Hiosin butil n/a
PT.
Human insuliInsulatard ViPT.
Human insuliHumulin N ViPT.
Human insulin
n/a
PT.
Human insuliInsulatard PePT.
Human insuliSansulin N PT.
Human insuliHumulin N CPT.
Human insuliMixtard PenfiPT.
Human insuliHumulin 30/ PT.
Human insuliMixtard Vial PT.
Human insuliHumulin 30/7PT.
Human insuliActrapid PenfPT.
Rama EmKotak 100 S 285.00

AstraZenDus, 1 blist 295,000.00
IndofarmDus, 10 blis 289.00
Bayer In vial
1,098,900.00
Sanbe F Dus, 1 vial 330,000.00
IndofarmDus, 5 ampu3,399.00
Erela
Tube @ 3,5 g2,600.00
IndofarmDus, botol pl3,194.00
Tempo ScStrip
235.00
Pradja P Dus, 6 strip 638.00
Dexa Me Dus, 10 Stri 950.00
Kimia Fa ktk 5x10 tab265.00
Kimia Fa Dus 10x10 1,493.00
Kimia Fa Dus 10x10 2,171.00
Actavis Btl @ 30 tab1,500.00
Lucas Dj Glycerin 1005,333.00
Widatra botol @ 500 5,700.00
Widatra botol @ 500 5,200.00
AstraZenDus, 1 syri 2,300,000.00
AstraZenDus, 1 syri 840,000.00
Soho Ind Dus 5 Ampu 83,333.00
Mersifa KOTAK @ 10 126.00
Dexa Me Botol
641,500.00
Pratapa vial
42,900.00
Dipa Ph Dus, 1 syrin 1,328,000.00
Kimia Fa Tube 5 gr
2,798.00
Dipa Ph vial
5,400.00
Otto Pha box 5ampul 4,500.00
Ferron P Dus, vial 10 138,000.00
Bayer In Dus, vial 10 138,000.00
Aventis Dus, 1 Vial 72,000.00
Ferron P Injeksi 100 I 76,125.00
Sanbe F penfillcartr 75,000.00
Bayer In Dus Isi 5 pen76,125.00
240.
241.
242.
243.
244.
245.
246.
247.
248.
249.
250.
251.
252.
253.
254.
255.
256.
257.
258.
259.
260.
261.
262.
263.
264.
265.
266.
267.
268.
269.
270.
271.
272.
273.
274.
275.
276.
277.
278.
279.
280.
281.
282.
283.
284.
285.
286.
287.
Human insuliHumulin R CPT.

Human insuliSansulin R PT.
Human insuliActrapid VialPT.
Human insuliHumulin R ViPT.
Human insulin
n/a
PT.
Human tetanu
Tetagam
PT.
Ibuprofen si n/a
PT.
Ibuprofen s n/a
PT.
Ibuprofen ta n/a
PT.
Ibuprofen ta n/a
PT.
Ifosfamid se Holoxan inje PT.
Imanitib MesGlivec
PT.
Imidapril ta Tanapress 1 PT.
Imidapril ta Tanapress 5 PT.
Iopamidol 2 Iopamiro
PT.
PT.
PT.
PT.
PT.
PT.
Iopromide 3 Ultravist 30 PT.
Ipratropium Atrovent HF PT.
Irbesartan n/a
PT.
Irbesartan n/a
PT.
Irinotekan i n/a
PT.
Isofluran inhTerrell
PT.
Isosorbid DinFarsorbid inj PT.
Isosorbid Di n/a
PT.
Kalium aspa Kalipar
PT.
Kalium Klori KSR
PT.
Kalsium Foli DBL LeucovoPT.
Kalsium GlukKalsium glu PT.
Kalsium poli KALQUEST PT.
Kandesartann/a
PT.
Kandesartann/a
PT.
Kapesitabin Xeloda
PT.
Kaptopril ta n/a
PT.
Kaptopril ta n/a
PT.
Kaptopril ta n/a
PT.
KarbamazepiTegretol Sy PT.
Karbamazepin/a
PT.
Karbimazol Neo-MercazoPT.
Karbogliseri Karbogliseri PT.
Karboplatin DBL CarboplPT.
Karboplatin DBL CarboplPT.

Sanbe F penfill cart 75,000.00
Aventis Dus, 1 Vial 72,000.00
Dexa Me Prefilled syr 170,000.00
IndofarmDus, botol 6 3,499.00
IndofarmDus, botol 6 4,499.00
Yarindo botol @ 100 110.00
Holi Pha Dus, 10 stri 149.00
Mugi LabDus, 1 vial 1,329,163.00
Novartis Dus, 6 bliste211,000.00
Tanabe I 3 blister @ 13,908.00
Tanabe I 3 blister @ 12,120.00
Dipa Ph Dus, botol 350,000.00
Dipa Ph Dus, vial @ 122,000.00
Dipa Ph Dus, botol 369,000.00
Bayer In Botol
245,000.00
Bayer In Botol
123,200.00
Bayer In Botol
299,000.00
Bayer In Botol
150,300.00
BoehringBox, canist 80,000.00
IndofarmDus, 5 blist 1,425.00
IndofarmDus, 5 blist 2,470.00
Sanbe F Dus, 1 vial 510,000.00
Pratapa Botol 100 m 270,000.00
Pratapa vial
33,000.00
IndofarmDus, 10 stri 88.00
Tempo ScStrip
694.00
Merck TbDus, 10 stri 1,580.00
Tempo ScVial 50 mg/582,000.00
Ethica In Ampul
7,800.00
Novell P kantong 5 g 7,700.00
Dexa Me Dus, 3 Blist 4,900.00
BoehringBoks, 120 ta27,500.00
Errita P Dus, 10 stri 80.00
Novartis Dus, botol 44,770.00
Nicholas Dus,botol 10875.00
Lucas Dj Fenol 100 mg
2,042.00
Tempo Scvial @ 15 ml190,000.00
Tempo Scvial @ 45 ml408,000.00
288.
289.
290.
291.
292.
293.
294.
295.
296.
297.
298.
299.
300.
301.
302.
303.
304.
305.
306.
307.
308.
309.
310.
311.
312.
313.
314.
315.
316.
317.
318.
319.
320.
321.
322.
323.
324.
325.
326.
327.
328.
329.
330.
331.
332.
333.
334.
335.
Ketamin injeKTM
PT. Guardia Vial @ 10 ml110,000.00
Ketamin injeKetamin Ha PT. Combiph Box, isi 1 vi 60,300.00
Ketokonazol n/a
PT. Kimia Fa tube 10 gr 2,569.00
Ketokonazol n/a
PT. Novell P Box isi 1 Tu 4,700.00
Ketokonazol n/a
PT. Dexa Me Dus, 5 Strip 300.00
Ketoprofen sProtofen Su PT. Kimia Fa dus 2 's @ 1 2,722.00
Ketorolac in n/a
Klaritromisi ORIXAL
PT. Ifars Ph Dus, 3 Strip 3,200.00
Klindamisin n/a
PT. IndofarmDus, 5 blist 361.00
Klindamisin n/a
PT. IndofarmDus, 5 blist 553.00
Klobazam tan/a
Klonidin inj Catapres Inj PT. BoehringBox, 10 amp30,600.00
Klonidin tab n/a
PT. Kimia Fa Ktk 10X10 T 184.00
Klopidogrel n/a
PT. Hexpharm
Dus, 3 strip 3,400.00
Kloramfenikon/a
PT. Bernofa Botol @ 60 3,680.00
Klorpromazinn/a
Klorpromazinn/a
Klozapin 10 n/a
PT. Mersifa KOTAK @ 5 x5,000.00
Klozapin 25 n/a
PT. Mersifa KOTAK @ 5 x1,550.00
Kodein tablen/a
Kodein tablen/a
Kodein tablen/a
PT. Kimia Fa ktk 10x10 ta1,100.00
Kolekalsifer Ostriol
PT. Pratapa Btl @ 30 kap2,500.00
Koloid HES BVoluven
PT. Freseniu Botol Plasti 33,000.00
Kombinasi suLaxadine EmPT. GaleniumBotol @ 60 12,450.00
Kombinasi tan/a
PT. Erela
Dus, 100 Sa 42.00
Kombinasi teCendo LyteePT. Cendo In botol 15 ml 15,750.00
Kombinasi: Coartem
PT. Novartis Dus, 4 bliste3,220.00
Kombinasi: Stalevo
PT. Novartis Dus, botol p 8,900.00
Kombinasi: LAluvia
PT. Abbott I botol @ 120 6,100.00
Kombinasi: SSeretide Inh PT. Glaxo WeDus, Botol 1 90,667.00
Kombinasi: SSeretide Di PT. Glaxo WeDus, foil str 100,833.00
Kombinasi: SSeretide Di PT. Glaxo WeDus, foil str 113,333.00
Kotrimoksaz n/a
PT. Holi Pha Dus, 10 stri 149.00
Kotrimoksaz n/a
PT. Lucas Dj Botol @ 60 2,145.00
Kuinin (Kina n/a
PT. Kimia Fa ktk 60 table 670.00
Kuinin injeksn/a
PT. Kimia Fa ktk 100 amp6,200.00
Kuinin tabl n/a
Lamivudine n/a
Lansoprazol Prosogan Inj PT. Takeda I Serbuk vial 82,042.00
Lanzoprazol n/a
PT. IndofarmDus, 2 strip 473.00
Lapatinib t Tykerb
PT. SmithKl Dus, 7 Blist 67,200.00
Larutan me Kalbamin
PT. Finusolp botol 500 ml56,300.00
Larutan menAmiparen PT Otsuka I Softbag 500 56,300.00
Larutan menPan-amin G PT Otsuka I Softbag 500 37,500.00
Larutan menAminofluid PT Otsuka I Double Cham115,500.00
Larutan menAminofluid PT Otsuka I Double Cham61,600.00
Larutan meng
Aminofusin PT Kalbe Fa botol 500 m 75,350.00
336.
337.
338.
339.
340.
341.
342.
343.
344.
345.
346.
347.
348.
349.
350.
351.
352.
353.
354.
355.
356.
357.
358.
359.
360.
361.
362.
363.
364.
365.
366.
367.
368.
369.
370.
371.
372.
373.
374.
375.
376.
377.
378.
379.
380.
381.
382.
383.
Larutan menAminosteril PT. Freseniu Botol Gelas 36,667.00

Larutan menNephrosteril PT. Freseniu Botol Gelas 50,820.00
Larutan menKidmin
PT Otsuka I Softbag 200 46,000.00
Larutan menAminoleban PT Otsuka I Softbag 500 65,000.00
Larutan me Aminosteril PT. Freseniu Botol Gelas 78,720.00
Larutan menEas Pfrimer PT. Finusolp botol 250 ml51,260.00
Larutan meng
Comafusin HPT. Finusolp botol 500 ml64,900.00
Larutan meng
Aminofusin PT Kalbe Fa botol 500 m 42,000.00
Larutan menAminofusin PT Kalbe Fa botol 250 m 46,000.00
Larutan meng
Kabiven 144PT. Freseniu Bag (3 Cham295,240.00
Larutan meng
Kabiven 192PT. Freseniu Bag (3 Cham343,842.00
Larutan menCombiflex PlPT. Phapros, Bag Double 322,000.00
Larutan menCombiflex pePT. Phapros, Bag Double 218,700.00
Larutan meng
Otsu - KCl 7 PT Otsuka I Ampoel 25 2,050.00
Larutan meng
Wida RL
PT. Widatra Botol 1000 8,000.00
Larutan menAsering
PT Otsuka I Plastic Bott 9,000.00
Larutan meng
KA EN 1B
Larutan meng
Totilac
PT Kalbe Fa flexybag 25 87,000.00
Larutan meng
Ringerfundi PT. Phapros, LDPE (Low De
12,650.00
Larutan meng
Triofusin 10 PT Kalbe Fa botol 500 m 50,500.00
Larutan meng
Triofusin 50 PT Kalbe Fa Flexy bag 5 42,350.00
Larutan menMartos
Larutan meng
Potacol inj PT Otsuka I Plastic Bott 55,500.00
Larutan meng
Tutofusin OPPT Kalbe Fa botol 500 m 37,500.00
Larutan meng
Clinimix N9 PT Kalbe Fa Botol Plasti 210,000.00
Larutan meng
Clinimix N9 PT Kalbe Fa Botol Plasti 199,000.00
Larutan meng
Triofusin E1 PT Kalbe Fa botol 500 m 56,000.00
Larutan meng
Wida HSD PT. Widatra Botol 500 ml9,500.00
Larutan meng
Wida D5-NS PT. Widatra Botol 500 ml6,800.00
Larutan meng
WIDA 2A
PT. Widatra Botol 500 ml6,917.00
Larutan meng
WIDA D5-1/ PT. Widatra Botol 500 ml7,700.00
Larutan meng
WIDA D5-1/ PT. Widatra Botol 500 ml7,700.00
Larutan meng
Futrolit
PT. Sanbe F softbag 500 35,750.00
Larutan meng
Wida RD
Larutan meng
KA ENMG 3 PT Otsuka I Plastic Bott 9,167.00
Larutan meng
KA EN 3B
Larutan meng
KA EN 3A
Larutan meng
Lipofundin PT. Phapros, 20%, Botol K105,500.00
Larutan menIntralipid
PT. Freseniu Botol Gelas 60,500.00
Larutan menLipofundin PT. Phapros, 20%, Botol K210,000.00
Larutan meng
Nutriflex Li PT. Phapros, Bag, 3 cham591,000.00
Larutan meng
Nutriflex Lip PT. Phapros, Bag, 3 cham511,000.00
Larutan meng
Nutriflex Lip PT. Phapros, Bag, 3 cham358,000.00
Larutan meng
Ivelip
PT Kalbe Fa Flexy bag 1 89,800.00
Latanoprost Cendo Glao PT. Cendo In strip 5 x 0.6 72,000.00
Latanoprost Xalatan 0,0 PT. Pfizer In dus, Botol @127,000.00
LenograstimGranocyte 3 PT. Aventis Dus, 1 vial 550,000.00
Letrozol tab FEMARA
PT. Novartis Dus, 3 blist 17,500.00
384.
385.
386.
387.
388.
389.
390.
391.
392.
393.
394.
395.
396.
397.
398.
399.
400.
401.
402.
403.
404.
405.
406.
407.
408.
409.
410.
411.
412.
413.
414.
415.
416.
417.
418.
419.
420.
421.
422.
423.
424.
425.
426.
427.
428.
429.
430.
431.
Leuprorelin Tapros 1.88 PT.

Leuprorelin Tapros 3M PT.
Leuprorelin TAPROS 3.7 PT.
Levofloksasi n/a
PT.
Levofloksasi n/a
PT.
Levotiroksin Euthyrox 10 PT.
Lidokain inj n/a
PT.
Lidokain inj n/a
PT.
Lidokain jel Xylocaine Je PT.
Lisinopril ta n/a
PT.
Lisinopril ta n/a
PT.
Litium karboFrimania 20 PT.
Litium karboFrimania 40 PT.
Loperamid t n/a
PT.
Loratadin ta n/a
PT.
Lorazepam tMerlopam 2 PT.
Low molecule
DIALIFER
PT.
Manitol
n/a
PT.
Maprotilin H Ludios
PT.
Maprotilin H Sandepril 50PT.
MDP (methylBonescan KaPT.
Mebendazol Vermox 500 PT.
Melfalan tabAlkeran
PT.
Meropenem in/a
PT.
Meropenem sn/a
PT.
Mesna inj 1 Uromitexan iPT.
Metadon sir n/a
PT.
Metformin H n/a
PT.
Metformin H n/a
PT.
Metildopa taDOPAMET PT.
Metilergometn/a
PT.
Metilfenidat Ritalin LA
PT.
Metilfenidat RITALIN
PT.
Metilprednis n/a
PT.
Metilprednis n/a
PT.
Metilprednis n/a
PT.
Metilprednis n/a
PT.
Metilprednis n/a
PT.
MetoklopramGAVISTAL dr PT.
MetoklopramLEXAPRAM SPT.
Metoklopramn/a
PT.
Metronidazo n/a
PT.
MetronidazolFlagyl
PT.
Metronidazoln/a
PT.
Metronidazoln/a
PT.
MIBI (metoxyCardioscan PT.
Midazolam inDormicum PT.
Midazolam inDormicum PT.
Takeda I Vial
700,000.00
Takeda I Vial
2,700,000.00
Takeda I Vial
500,000.00
Infion P Box, 1 Botol 40,000.00
PromedraDus, 5 Strip 528.00
Merck TbDus 4 bliste 850.00
Bernofa Dus, 100 am839.00
IndofarmDus, 30 amp1,363.00
AstraZenDus, 10 syri 40,000.00
Novell P Box ,3 Strip 600.00
Novell P Box ,3 Strip 350.00
Mersifa KOTAK @ 10 1,050.00
Ifars Ph Dus, 10 Stri 89.00
PromedraDus, 5 Strip 154.00
Novell P ampul
52,000.00
Finusolp botol 500 ml62,000.00
Soho Ind Strip
1,200.00
Mersifa KOTAK @ 5 x3,276.00
Kimia Fa Dus @ 5 vial473,000.00
Taisho P Dus,24 Catch7,140.00
Glaxo WeBox, Tablet 12,210.00
Bernofa Dus, 1 vial 54,000.00
Mugi LabDus, 15 Amp74,998.00
Kimia Fa Botol 1000 254,100.00
Bernofa Dus, 10 blis 112.50
Actavis Dus, 10 Stri 800.00
Kimia Fa ktk 10 x 10 t154.00
Novartis Dus, botol p 6,537.00
Novartis Dus, 2 blist 1,950.00
Dexa Me Dus, 1 Vial 19,500.00
MahakamStrip
635.00
Natura L Dus, 10 Blis 205.00
Dexa Me Dus, 10 Blis 300.00
Meprofa Dus, Botol 1 5,280.00
Molex AyBOTOL 60 M2,600.00
Kimia Fa ktk 10 x 10 108.00
Natura L Dus, 1 Boto 9,950.00
Aventis Dus, 2 blist 3,220.00
Phyto K 10 strip @ 1 110.00
Phyto K 10 strip @ 1 160.00
Kimia Fa Dus @ 5 vial1,237,500.00
BoehringBoks 10 am 6,119.00
BoehringBoks 5 amp 12,060.00
432.
433.
434.
435.
436.
437.
438.
439.
440.
441.
442.
443.
444.
445.
446.
447.
448.
449.
450.
451.
452.
453.
454.
455.
456.
457.
458.
459.
460.
461.
462.
463.
464.
465.
466.
467.
468.
469.
470.
471.
472.
473.
474.
475.
476.
477.
478.
479.
Mikafungin NMycamine PT. Combiph Dus,1 vial 260,000.00

Mikofenolat Cellcept
PT. BoehringBoks, 50 tab16,000.00
Mikonazol krn/a
PT. Kimia Fa Tube 10 gra 3,000.00
Mitomisin C (Mitomycin CPT. Widatra 10 mg /Vial 697,000.00
Modified flu Gelofusine PT. Phapros, Btl @ 500 m72,000.00
MoksifloksasVigamox
PT. Tempo Scbotol, tetes 77,000.00
Mometason fn/a
PT. Guardia tube 10 gra 17,820.00
Morfin HCL i n/a
PT. Kimia Fa Dus 10 amp 8,400.00
Morfin HCL t MST ContinuPT. MahakamDus, 6 strip 15,620.00
Morfin HCL t MST ContinuPT. MahakamDus, 6 strip 22,990.00
Morfin table n/a
N-asetil sist N-ace cairanPT. Pratapa Box @ 5 amp13,200.00
Nacl 0,9% n/a
Nadroparin i Fraxiparine PT. Glaxo WeDus, 5 blist 54,144.00
Nalokson inj Nokoba
PT. Pratapa Dus, 5 Ampu61,600.00
Natrium BikaMeylon
PT Otsuka I Ampoel 25 6,200.00
Natrium Dikln/a
PT. Novell P Box ,5 Blist 200.00
Natrium fosfFleet Phosp PT. Combiph Botol, 45 ml 33,900.00
Natrium fusi Fucilex Oint PT. Molex AyTube 5 gr
6,490.00
Neostigmin iNeostigmin PT. Pharma Box, isi 5 a 9,500.00
Nevirapin ta n/a
PT. Kimia Fa btl 60 tablet 2,800.00
Nifedipin ta Adalat Oros PT. Bayer In blister
2,999.00
Nifedipin ta Adalat Oros PT. Bayer In blister
3,500.00
Nifedipin ta n/a
Nilotinib k Tasigna
PT. Novartis Dus, 2 blist 380,875.00
Nistatin tabl n/a
640.00
Nistatin vag n/a
480.00
NorepinefrinRaivas
PT. Dexa Me ampul
52,000.00
Noretisteron Primolut N PT. Bayer In blister
2,618.00
Obat Antitubn/a
PT. Phapros, Paket
359,900.00
Obat Antitubn/a
PT. IndofarmPaket
1,199,990.00
Obat Antitubn/a
PT. Phapros, Paket
214,900.00
Obat Antitubn/a
PT. IndofarmPaket@84 ta160,000.00
Obat Antitubn/a
PT. IndofarmDus, 1 dus @288,199.00
Obat Antitubn/a
PT. IndofarmDus, 60 sach171,195.00
Octreotide AOctide
PT. Pratapa Box @ 5 amp80,000.00
Ofloxacin ta n/a
PT. Novell P Box ,5 Strip 400.00
Ofloxacin ta n/a
PT. Novell P Box ,5 Strip 650.00
Oksaliplatin ELOXATIN PT. Aventis Dus, 1 vial 1,100,000.00
Oksaliplatin ELOXATIN PT. Aventis Dus, 1 vial 550,000.00
Oksimetazol Ilaidin DropsPT. Merck Tbbotol @ 10 27,550.00
Oktreotid 1 Sandostatin PT. Novartis Dus, vial @ 2,950,000.00
Olanzapin inZyprexa IM PT. Bayer In Vial
120,000.00
Olanzapin kaOlandoz 5 PT. Sandoz I 3 X 10 fcc 6,450.00
Olanzapin t Olandoz 10 PT. Sandoz I 3 X 10 fcc 11,200.00
Olopatadin Patanol
480.
481.
482.
483.
484.
485.
486.
487.
488.
489.
490.
491.
492.
493.
494.
495.
496.
497.
498.
499.
500.
501.
502.
503.
504.
505.
506.
507.
508.
509.
510.
511.
512.
513.
514.
515.
516.
517.
518.
519.
520.
521.
522.
523.
524.
525.
526.
527.
Omeprazol inn/a
PT. Natura L Dus, 1 Vial 36,000.00
Omeprazol kn/a
PT. Novaphardus 10 X 3'S211.00
ondansetronn/a
PT. IndofarmDus, 5 Ampu2,400.00
Ondansetronn/a
PT. Yarindo Box 3 X 10 T716.00
Ondansetronn/a
PT. Yarindo Box 3 X 10 T1,189.00
Paket CAPD An/a
PT Kalbe Fa Transfer Set 1,902,240.00
Paket CAPD Pn/a
PT Kalbe Fa Set
219,540.00
Paket CAPD R
Larutan Dial PT Kalbe Fa Larutan Dial 5,522,580.00
Paklitaksel i SINDAXEL 1 PT. Actavis Vial 6mg/ml 984,000.00
Paklitaksel i SINDAXEL 2 PT. Actavis Vial 6mg/ml 3,000,000.00
Paklitaksel i SINDAXEL 3 PT. Actavis Vial 6mg/ml 274,560.00
Parasetamol n/a
PT. IndofarmDus, 15 boto5,200.00
Parasetamol n/a
PT. Afifarma botol 60 ml 1,438.00
Parasetamol n/a
PT. ImfarminDus, 10 stri 89.00
Parasetamol FASIDOL
PT. Ifars Ph Dus, botol @6,450.00
Pegylated in Pegasys
PT. BoehringBoks, 1 pfs 1,077,815.00
Pegylated in Pegasys
PT. BoehringBoks, 1 pfs 1,248,220.00
Pegylated In Pegintron Vi PT. Merck S Dus, 1 vial 973,500.00
Pegylated In Pegintron P PT. Merck S Dus, 1 prefi 1,135,000.00
Pegylated In Pegintron
PT. Merck S Dus, 1 vial 915,000.00
Pegylated In Pegintron Vi PT. Merck S Dus, 1 vial 915,810.00
Perak sulfad BURNAZIN 3PT. Darya Vatube @ 35 g 23,000.00
Perindoprila Bioprexum PT. Pradja P Dus, botol p 2,420.00
Permetrin k Scabimite C PT. GaleniumTube @ 10 g11,475.00
Petidin injek n/a
PT. Kimia Fa Ktk 10 amp 14,500.00
Pioglitazon DECULIN 15 PT. Dexa Me 30 TAB/BOX 3,120.00
Pioglitazon DECULIN 30 PT. Dexa Me 30 TAB/BOX 4,525.00
Pirantel sus n/a
PT. Holi Pha Botol 60 ml 8,360.00
Pirantel tab n/a
PT. Holi Pha Dus, 25 Blis 296.00
Pirazinamid n/a
PT. Holi Pha Dus 10 strip 206.00
Polikresulen Aptil
PT. Pratapa Dus, Botol 17,393.00
Povidon Iodi n/a
PT. Afifarma botol @ 100 37,109.00
Povidon Iodi n/a
Povidon Iodi n/a
Pramipeksol Sifrol ER 0, PT. BoehringDus, 3 alu bl7,200.00
Pramipeksol Sifrol ER 0, PT. BoehringDus, 3 alu bl11,268.00
Pravastatin n/a
PT. Novell P Box ,5 Strip 2,300.00
Prokain Benzin/a
PT. Bernofa Vial @ 3 juta7,190.00
Propanolol t n/a
Propiltioura n/a
PT. IndofarmBotol @ 100 319.00
Propofol inje Fresofol 1% PT. Freseniu Ampul
15,642.00
Propranolol n/a
Quetiapin t Seroquel XR PT. AstraZenDus, 1 blist 17,391.00
Ramipril tab Cardace 2.5 PT. Pharma Dus, 6 blist 995.00
Ramipril tab n/a
Ramipril tab n/a
PT. Novell P Dus, 10 stri 1,013.00
528.
529.
530.
531.
532.
533.
534.
535.
536.
537.
538.
539.
540.
541.
542.
543.
544.
545.
546.
547.
548.
549.
550.
551.
552.
553.
554.
555.
556.
557.
558.
559.
560.
561.
562.
563.
564.
565.
566.
567.
568.
569.
570.
571.
572.
573.
574.
575.
Ranitidin in n/a
PT.
Ranitidin ta n/a
PT.
Retinol (Vit n/a
PT.
Retinol (Vit n/a
PT.
Ringer Laktan/a
PT.
Risperidon t n/a
PT.
Risperidon t n/a
PT.
Risperidon t n/a
PT.
Rituksimab Mabthera
PT.
Rivaroksaba Xarelto 10 PT.
Ropinirol Ta Requip PD 2 PT.
Salbutamol cVentolin NebPT.
Salbutamol iVentolin Inh PT.
Salbutamol Ventolin Rot PT.
Salbutamol sVentolin Rot PT.
Salbutamol tn/a
PT.
Salep 2-4 , n/a
PT.
Sefadroksil n/a
PT.
Sefadroksil n/a
PT.
Sefadroksil n/a
PT.
Sefadroksil n/a
PT.
Sefaleksin k n/a
PT.
Sefazolin sern/a
PT.
Sefepim inj n/a
PT.
Sefiksim kapn/a
PT.
Sefiksim sir n/a
PT.
Sefoperazon n/a
PT.
Sefotaksim i n/a
PT.
Sefotaksim i n/a
PT.
SefpodoksimBanadoz 10 PT.
Seftazidim inn/a
PT.
Seftriakson sn/a
PT.
Sefuroksim tZinnat 250 PT.
Sefuroksim Zinnat 500 PT.
Sertralin ta Fatral
PT.
Setirizin si n/a
PT.
Setirizin ta n/a
PT.
Setuksimab Erbitux
PT.
Sevofluran ihSojourn
PT.
Sianokobalam
n/a
PT.
Siklofosfami Cyclovid 10 PT.
Siklofosfami Cyclovid 20 PT.
Siklofosfami CYCLOVID 5 PT.
Siklosporin Sandimmun PT.
Natura L Dus, 10 Amp1,140.00

Dexa Me Dus, 10 Stri 120.00
Kimia Fa Botol 50 kap260.00
Lucas Dj Botol 50 Kap459.00
Widatra botol 500 ml5,200.00
Mersifa KOTAK @ 5 x1,008.00
BoehringDus, 1 vial 3,164,805.00
Bayer In Blister
23,500.00
Bayer In Blister
23,500.00
Bayer In Blister
23,500.00
Glaxo WeDus, 7 blist 5,248.00
Glaxo WeDus, 4x5 Bot6,600.00
Glaxo WeDus, botol 2 63,750.00
Glaxo WeDus, 10 Blis 431.00
Glaxo WeDus, 1 Rotah5,867.00
Yarindo strip @ 10 t 59.00
Marin Li Pot @ 30 gr 2,000.00
Holi Pha Dus, Botol 6 4,746.00
Hexpharm
strip
513.00
Holi Pha Dus, 10 stri 509.00
Holi Pha Dus, Botol 6 5,895.00
Ifars Ph Dus, 5 Strip 1,000.00
Yarindo Box 2 Vial 48,060.00
Ifars Ph Dus, Botol 3 8,800.00
Yarindo vial
38,500.00
Hexpharm
vial
4,800.00
Natura L Dus, 10 Vial 2,950.00
Sandoz I Dus, 3 blist 3,700.00
Natura L Dus, 10 Vial 3,300.00
Glaxo WeDus, 1 Blist 4,752.00
Glaxo WeDus, 1 Blist 7,200.00
Pratapa strip @ 10 t 3,300.00
IndofarmBotol @ 60 7,999.00
Pertiwi Box, 10 stri 181.00
Merck TbDus, 1 vial 3,650,000.00
Pratapa tabung/botol1,320,000.00
Lucas Dj 100 ampul @1,078.00
Novell P vial
256,000.00
Novell P vial
82,000.00
Novell P Vial
120,000.00
Novartis Dus, 10 blis 43,000.00
576.
577.
578.
579.
580.
581.
582.
583.
584.
585.
586.
587.
588.
589.
590.
591.
592.
593.
594.
595.
596.
597.
598.
599.
600.
601.
602.
603.
604.
605.
606.
607.
608.
609.
610.
611.
612.
613.
614.
615.
616.
617.
618.
619.
620.
621.
622.
623.
Siklosporin Sandimmun PT. Novartis Dus, 10 blis 12,000.00

Simvastatin n/a
PT. Natura L Dus, 3 Strip 169.00
Simvastatin n/a
PT. Natura L Dus, 3 Strip 391.00
Siprofloksas n/a
PT. Dexa Me Vial 200 ml 13,000.00
Siprofloksas n/a
Sisplatin se Cisplatin
PT Kalbe Fa vial
22,000.00
Sisplatin se Cisplatin
PT Kalbe Fa vial
93,000.00
Sitarabin serDBL CytarabPT. Tempo Scdus, 1 vial 575,000.00
Spiramisin t n/a
PT. IndofarmDus, 5 strip 1,499.00
Spironolakton/a
Spironolakton/a
Streptokinase
Streptase PT. Dexa Me Vial
3,290,000.00
Streptomisinn/a
PT. Phapros, Dus @ 56 Vi 3,650.00
Sufentanil inSufentanyl InPT. Kimia Fa dus 5 amp @127,000.00
Sukralfat s Ulsafate
PT. Combiph Botol, 100 m13,425.00
Takrolimus Prograf
PT. Combiph Pounch @ 5 b
11,167.00
Takrolimus Prograf
PT. Combiph Dus, 1 pouc 21,500.00
Tamsulosin Harnal D
PT. Combiph Box @ 2 blis 5,800.00
Tamsulosin Harnal D 0PT. Combiph Box/ 2 blist 5,800.00
Tamsulosin Harnal OCPT. Combiph Box/ 3 blist 6,800.00
Telbivudin t Sebivo 600 PT. Novartis Dus, 2 blist 28,500.00
Telmisartan Micardis 40 PT. BoehringDus, 2 alu-b 3,900.00
Telmisartan Micardis 80 PT. BoehringBox, 2 blist 6,500.00
TemozolamidTemodal
PT. Merck S Dus, 5 sache1,120,000.00
TemozolamidTemodal
PT. Merck S Dus, 5 sache223,000.00
Tenofovir ta n/a
Terbutalin c Bricasma RePT. AstraZenDus, 2 pak @6,250.00
Terbutalin t Molasma TabPT. Molex AyBox 50's
99.00
Terbutalin t Bricasma Tu PT. AstraZenDus, 1 Turbu71,100.00
Testoteron s Andriol Test PT. Merck S Dus, 6 blist 6,200.00
Tetrakain HCPantocain 0 PT. Cendo In botol 5 ml 11,500.00
Tetrasiklin n/a
Tiamazol ta Thyrozol 10 PT. Merck TbDus, 10 blis 1,135.00
Tiamazol ta Thyrozol 5 PT. Merck TbDus, 10 blis 563.00
Timolol tet Isotic Adret PT. Pratapa Dus, Botol P 9,128.00
Timolol tete Isotic Adret PT. Pratapa Dus, Botol P 9,722.00
Tiotropium kSpiriva 10s PT. BoehringDus, 1 blist 152,543.00
Tramadol inj n/a
PT. Natura L Dus, 10 Amp2,395.00
TrastuzumabHerceptin PT. BoehringDus, 1 vial 19,608,034.00
Travoprost Travatan
TriamsinolonNasacort AQPT. Aventis Dus, botol p 90,000.00
Trifluoperaz n/a
PT. Darya Vastrip
405.00
Urea krim 1 Soft U Derm PT. Galeniumtube
6,400.00
Vaksin polio Imovax PolioPT. Aventis 1 vial of 10m285,000.00
Vaksin rabie RABIPUR
PT. Novartis Dus, 1 vial 78,500.00
ValgansiklovValcyte
PT. BoehringBoks, 60 tab170,000.00
Valproat sir Ikalep
PT. Ikaphar Botol 120 ml40,000.00
Valproat ta Depakote E PT. Abbott I Tablet
2,793.00
624.
625.
626.
627.
628.
629.
630.
631.
632.
633.
634.
635.
636.
637.
638.
Valproat ta Depakote E PT. Abbott I Tablet

5,450.00
Valsartan ta Diovan 80mgPT. Novartis Dus, 2 blist 3,900.00
Valsartan t DIOVAN 160 PT. Novartis Dus, 2 blist 6,500.00
Vankomisin sVancep
PT. Pratapa Box @ 2 vial122,000.00
Verapamil t Isoptin 240 PT. Abbott I Tablet
6,200.00
Verapamil tan/a
PT. Kimia Fa Ktk 10X10 T 234.00
Vinblastin s Vinblastine PT. Combiph Vial 10mg/1 210,000.00
Vinkristin se Vincristine PT Kalbe Fa vial @ 2 ml 78,000.00
Vinkristin se Vincristine PT Kalbe Fa vial @ 1 ml 46,000.00
Vinorelbin i Navelbine inPT. Mugi LabDus, 1 vial 1,229,998.00
Vitamin B Kon/a
PT. Kimia Fa Dus 10 strip 107.00
Zidovudin 3 n/a
Zinc drop 1 Zincpro Dro PT. Combiph Drops 10 mg12,840.00
Zinc sir 20 Zircum Kid SPT. Meprofa Dus, botol 6 7,400.00
Zinc tablet n/a
Terkecil +PPN

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Nama GenerNama DaganNama PenyeKemasan

Asam Folat tn/a

Rama EmKotak 100 S 285.00

Human insuliHumulin R CPT.

Bayer In Dus Isi 5 pen76,125.00

Larutan menAminosteril PT. Freseniu Botol Gelas 36,667.00

Leuprorelin Tapros 1.88 PT.

Mikafungin NMycamine PT. Combiph Dus,1 vial 260,000.00

Natura L Dus, 10 Amp1,140.00

Siklosporin Sandimmun PT. Novartis Dus, 10 blis 12,000.00

Valproat ta Depakote E PT. Abbott I Tablet

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