Katalog Obat

11
EKATALOG
8 SEPT 2014| 06.00 |

NO Nama Obat Generik
ACT (Artesunate tablet 50 mg + Amodiaquine anhydrida tablet 200
1
mg)
2 Adefovir Dipivoksil tablet/kaplet 10 mg
3 Albendazol suspensi 200 mg/5 ml
4 Albendazol tablet/kapsul/kaplet 400 mg
5 Albumin serum normal (human albumin) injeksi 20%, 100 ml
6 Albumin serum normal (human albumin) injeksi 20%, 50 ml
7 Alopurinol tablet/kapsul/kaplet 100 mg
8 Alopurinol tablet/kapsul/kaplet 300 mg
9 Alprazolam tablet/kapsul/kaplet 0,25 mg
10 Alprazolam tablet/kapsul/kaplet 0,5 mg
11 Alprazolam tablet/kapsul/kaplet 1 mg
12 Alteplase injeksi 50 mg/vial
13 Amfoterisin B salep mata 1%
14 Amikasin injeksi 250 mg/ml
15 Aminofilin injeksi 24 mg/ml
16 Aminofilin tablet scored 200 mg
17 Amiodaron injeksi 150 mg/3 ml
18 Amiodaron tablet/kaplet 200 mg
19 Amitriptilin tablet salut 25 mg (HCl)
20 Amlodipin tablet 10 mg
21 Amlodipin tablet 5 mg
22 Amoksisilin kapsul/kaplet 250 mg
23 Amoksisilin kapsul/kaplet/tablet scored 500 mg
24 Amoksisilin sirup kering forte 250 mg/5 ml
25 Amoksisilin sirup kering 125 mg/ 5 ml
26 Ampisilin serbuk injeksi i.v. 1000 mg/vial
Analog insulin long acting inj 100 UI/ml, vial/cartridge
27 disposible/penfill cartridge (Insulin glargine 100 IU/ml)
Analog insulin mix acting inj 100 UI/ml, Analog insulin mix acting
28 inj 100 UI/ml (Premix 30% Insulin Aspart + 70% Protaminated
Insulin Aspart (Analogue))
29 Analog insulin mix insulininj 100 UI/ml, vial/cartridge
disposible/penfill
Analog cartridge
insulin rapid acting (25%
inj 100insulin
UI/ml,lispro, 75% insulin lispro
vial/cartridge
30 protamine suspension, (rDNA))
disposible/penfill cartridge (Insulin Aspart (Analogue))
Analog insulin rapid acting inj 100 UI/ml, vial/cartridge
31
disposible/penfill cartridge (Insulin Aspart (Analogue))
Analog insulin rapid actinginj 100 UI/ml, vial/cartridge
32
disposible/penfill cartridge (Insulin glulisine 100 IU/ml)
Analog insulin rapid actinginj 100 UI/ml, vial/cartridge
33
disposible/penfill cartridge (Insulin lispro (rDNA origin))
34 Anastrozol tablet/kapsul/kaplet 1 mg
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida
35 200 mg Magnesium Hidroksida 200 mg
Page 1 of 45
22
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
36 mg/5 ml Magnesium Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g Polimiksin
37 10.000 IU/g
Antimalaria DOEN kombinasi : Pirimetamin 25 mg Sulfadoksin 500
38 mg
39 Antimigren: Ergotamin Tartrat 1 mg + Kofein 50 mg
Antiparkinson DOEN tablet kombinasi : Benserazid 25 mg
40 Levodopa 100 mg
41 Artemether injeksi 80 mg/ml
42 Asam Asetilsalisilat (asetosal) tablet 100 mg
43 Asam Askorbat (Vitamin C) tablet 250 mg
44 Asam Askorbat (Vitamin C) tablet 50 mg
45 Asam Folat tablet/kapsul/kaplet 0,4 mg
46 Asam Folat tablet/kapsul/kaplet 1 mg
47 Asam Ibandronat injeksi 6mg/6ml
48 Asam Mefenamat kapsul/kaplet 500 mg
49 Asam pipemidat kapsul 400 mg
50 Asam traneksamat injeksi 100 mg/ml
51 Asam traneksamat injeksi 50 mg/ml
52 Asiklovir salep mata 3%
53 Asiklovir tablet/kapsul/kaplet 200 mg
54 Asiklovir tablet/kapsul/kaplet 400 mg
55 Asparaginase serbuk injeksi 10.000 UI/vial
56 Atapulgit tablet 600 mg
57 Atrakurium injeksi 25 mg/2,5 ml
58 Atropin Sulfat tablet 0,5 mg
59 Azitromisin sir kering 200 mg/ 5 mL
60 Azitromisin tablet 500 mg
61 Azitromisin tablet 250 mg
62 Bedak salisil serbuk 2%
63 Benzatin Benzil Penisilin 1,2 juta IU/ vial
64 Benzatin Benzil Penisilin 2,4 juta IU/vial
65 Beractant injeksi / suspensi 25 mg/mL
66 Beraprost sodium tablet 20 mcg
67 Beraprost sodium tablet 20 mcg
68 Betametason krim 0,1% (sebagai Valerat)
69 Bikalutamid tablet salut 150 mg
70 Bikalutamid tablet salut 50 mg
71 Bisakodil suppositoria 10 mg
72 Bisoprolol tablet 2,5 mg
73 Bisoprolol tablet 5 mg
74 Bleomisin serbuk injeksi 15 mg/ampul
75 Bromokriptin tablet 2,5 mg
76 Budesonid inhaler 200 mcg/puff, 100 dosis
77 Budesonid respules / cairan inhaler 0,25mg/mL
78 Budesonid-formoterol inhaler 160/4,5 mcg
79 Budesonid-formoterol inhaler 80/4,5 mcg
Page 2 of 45
80 Bupivakain injeksi 0,50% (HCl) + glukosa 8% 33
81 Bupivakain injeksi 0,50% (P.V)
82 Dabigatran eteksilat kapsul 75 mg
83 Dabigatran eteksilat kapsul 110 mg
84 Dakarbazin serbuk injeksi 200 mg/vial
85 Daunorubisin serbuk injeksi 20 mg/vial
86 Deferasiroks tablet disp/ eff 250 mg
87 Deferasiroks tablet disp/ eff 500 mg
88 Deferipron larutan oral 100 mg/mL
89 Deferipron tablet 500 mg
90 Deferoksamin Mesilat serbuk injeksi 500 mg
91 Deksametason injeksi i.v./i.m. 5 mg/ml
92 Deksametason tablet 0,5 mg
93 Desogestrel tablet 75 mcg
94 Desoksimetason krim 0,25%
95 Diazepam tablet 2 mg
96 Difenhidramin injeksi i.v./i.m. 10 mg/ml (HCl)
97 Digoksin tablet 0,25 mg
98 Diltiazem HCl tablet 30 mg
99 Diltiazem infus injeksi 50 mg
100 Diltiazem injeksi 25 mg/5 mL
101 Diltiazem Kapsul SR 100 mg
102 Diltiazem Kapsul SR 200 mg
103 Dimenhidrinat tablet 50 mg
104 Dinatrium edetat tetes mata 0,35%
105 Dobutamin injeksi 50 mg/mL
106 Doksazosin mesilat tablet 1 mg
107 Doksazosin mesilat tablet 2 mg
108 Doksorubisin serbuk injeksi i.v. 10 mg/vial
109 Doksorubisin serbuk injeksi i.v. 50 mg/vial
110 Domperidon suspensi/sirup 5 mg/5 ml
111 Domperidon tablet 10 mg
112 Domperidon tetes 5 mg/mL
113 Dopamin injeksi 40 mg/ml
114 Dosetaksel injeksi 20 mg/0,5 ml
115 DTPA (diethylene triamine pentaacetic acid) 2,06-2,5 mg pentetate
116 calcium trisodium/mL
Dutasterid kaps lunak 0,5 mg
117 Efavirens tablet salut 600 mg
118 Eksemestan tablet 25 mg
119 Enoksaparin sodium inj 20 mg/0,2 mL
122 Epinefrin (Adrenalin) injeksi i.v/s.k./i.m 1 mg/ml
123 Epirubisin serb injeksi 50 mg/25ml
124 Epirubisin serb injeksi 10 mg/5 ml
125 Ergokalsiferol (vitamin D3/D2) kapsul 50.000 UI
126 Ergokalsiferol (vitamin D3/D2) suspensi 10.000 UI/ml
127 Eritromisin kapsul/kaplet 250 mg
Page 3 of 45
128 Eritromisin kapsul/kaplet 500 mg 44
129 Eritromisin sirup kering 200 mg/ 5 ml
130 Eritropoetin-alfa inj 3000 UI/mL
131 Eritropoetin-beta inj 2000 UI/0,3 mL
132 Etambutol tablet 250 mg (HCl)
133 Etambutol tablet salut 500 mg (HCl)
134 Etanol 70% cairan
135 Etinilestradiol tablet 0,05 mg
136 Etonogestrel implan 68 mcg
137 Etoposid injeksi 20 mg/ml
138 Eugenol cairan
139 Everolimus tab 0,25 mg
140 Everolimus tab 0,5 mg
141 Faktor VIIa (rekombinan) serb inj 1 mg/vial + pelarut
142 Fenitoin injeksi 50 mg/ml
143 Fenitoin kapsul/kaplet 100 mg
144 Fenitoin Na Inj 100 mg/2 ml
145 Fenobarbital injeksi i.m./i.v. 50 mg/ml
146 Fenofibrat kaps 100 mg
147 Fenofibrat kaps 300 mg
148 Fenoksimetil penisilin (penisilin V) tablet 250 mg
149 Fenoksimetil penisilin (penisilin V) tab 125 mg
150 Fenoksimetil penisilin (penisilin V)tablet 500 mg
151 Fenoterol HBr ih 100 mcg/puff
152 Fenoterol HBr inh solution 0,1%
153 Fentanil injeksi i.m/i.v 0,05 mg/ml, ampul 10 ml
154 Fentanil injeksi i.m/i.v 0,05 mg/ml, ampul 2 ml
155 Fentanil patch 12,5 mcg/jam
156 Fentanil patch 25 mcg/jam
157 Fentanil patch 50 mcg/jam
158 Filgrastim inj 300 mcg/mL
159 Fitomenadion (Vit.K1) tablet salut gula 10 mg
160 Fitomenadion (Vitamin K1) injeksi i.m. 2 mg/ml
161 Fludarabin inj 50 mg
162 Fludarabin tab 10 mg
163 Flufenazin injeksi i.m. 25 mg/ml
164 Flukonazol injeksi 2 mg/ml
165 Flukonazol tablet/kapsul 150 mg
166 Fluoksetin tablet 10 mg
167 Fluoksetin tablet 20 mg
168 Fluorourasil inj 250 mg/mL
169 Fluorourasil inj 500 mg/ 5 mL
170 Flusinolon asetonid krim 0,025%
171 Flutikason furoat intranasal spray
172 Flutikason propionat nebules 0,5 mg
173 Fondaparinuks inj 2,5 mg/0,5 mL
174 Fraksi protein plasma lar inf 5%
175 Furosemid injeksi i.v./i.m. 10 mg/ml
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176 Furosemid tablet 40 mg 55
177 Gadobutrol macrocyclic 5 mg
178 Gadobutrol macrocyclic 7,5 mg
179 Gadoksetat disodium 0,25 mmol gadoxetate disodium/mL
180 Gansiklovir serb inj 500 mg (50 mg/mL)
Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium
181 klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat
2,70 g
182 Gefitinib tab 250 mg
183 Gemfibrozil kapsul/kaplet 300 mg
184 Gemfibrozil tablet 600 mg
185 Gemsitabin inj 1000 mg/vial
186 Gemsitabin inj 200 mg/vial
187 Gentamisin injeksi 40 mg/ ml
188 Gentamisin salep mata 0,3%
189 Gentamisin tetes mata 0,3%
190 Glibenklamid tablet 5 mg
191 Gliklazid tab 80 mg
192 Gliklazid tab 30 mg
193 Glikuidon tab 30 mg
194 Glimepiride tablet 1 mg
198 Gliseril trinitrat kaps SR 2,5 mg
199 Gliseril trinitrat kaps SR 5 mg
200 Gliseril trinitrat tab sublingual 0,5 mg
201 Gliserin lar 50%
202 Glukosa larutan infus 10 % steril
203 Glukosa larutan infus 5 % steril
204 Goserelin asetat inj 10,8 mg/vial
205 Goserelin asetat inj 3,6 mg
206 Griseofulvin tablet 125 mg
207 Haloperidol inj 50 mg/mL
208 Haloperidol tablet 0,5 mg
209 Haloperidol tablet 5 mg
210 Haloperidol tablet 1,5 mg
211 Haloperidol tablet 2 mg
212 Halotan Inhalasi
213 Heparin injeksi i.v./s.k. 5000 UI/ml
214 Hepatitis B imunoglobulin (human)
215 Hidrokortison krim 2,5 %
216 Hiosin butilbromid injeksi 20 mg/ml
Human insulin intermediate acting inj 100 UI/ml, vial (Human
217 Insulin (Intermediate-Acting))
Human insulin intermediate acting inj 100 UI/ml, vial (Insulin

218
human Basal)
Human insulin intermediate acting inj 100 UI/ml, vial/cartridge
219
disposible/penfill cartridge
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66
Human insulin intermediate acting inj 100 UI/ml,penfill cartridge
220
(Human Insulin (Intermediate-Acting))
221
(Insulin human Basal)
222
(Insulin human Basal)
Human insulin mix insulin inj 100 UI/ml, penfill cartridge (Human
223
Insulin (Premix: 30% Soluble + 70 % NPH Insulin))
Human insulin mix insulin inj 100 UI/ml, penfill cartridge (Insulin
224
human Comb)
Human insulin mix insulin inj 100 UI/ml, vial (Human Insulin
225
(Premix: 30% Soluble + 70 % NPH Insulin))
Human insulin mix insulin inj 100 UI/ml, vial (Insulin human Comb)
226
Human insulin short acting inj 100 UI/ml, penfill cartridge (Human
227
Insulin (Short Acting))
Human insulin short acting inj 100 UI/ml, penfill cartridge (Insulin
228
human Rapd)
Human insulin short acting inj 100 UI/ml, penfill cartridge (Insulin
229
human Rapd)
Human insulin short acting inj 100 UI/ml, vial (Human Insulin (Short
230
Acting))
Human insulin short acting inj 100 UI/ml, vial (Insulin human Rapd)
231
Human insulin short acting inj 100 UI/ml, vial/cartridge

232
disposible/penfill cartridge
233 Human tetanus imunoglobulinn injeksi i.m. 250 UI
234 Ibuprofen sirup 100 mg/5 ml
235 Ibuprofen suspensi 200 mg/5 ml
236 Ibuprofen tablet 200 mg
237 Ibuprofen tablet 400 mg
238 Ifosfamid serbuk injeksi 1000 mg/vial
239 Imidapril tab 10 mg
240 Imidapril tab 5 mg
241 Iopamidol 200-300 mg Iodium/mL (300mg @ vial 100ml)
247 Iopromide 300-370 mg Iodium/mL (300 mg / 100 ml)
251 Ipratropium bromida inhalasi 20 mcg/semprot
252 Irbesartan tab 150 mg
253 Irbesartan tab 300 mg
254 Irinotekan inf 20 mg/ml
255 Isosorbid Dinitrat injeksi i.v 10 mg/10 ml
Page 6 of 45
256 Isosorbid Dinitrat tablet sublingual 5 mg 77
257 Kalium aspartat tab 300 mg
258 Kalium Klorida tablet 600 mg
259 Kalsium Folinat (Leukovorin Ca) inj 50 mg/ml
260 Kalsium Glukonat injeksi i.v 10% (100 mg/ml)
261 Kandesartan tab 16 mg
262 Kandesartan tab 8 mg
263 Kapesitabin tab 500 mg
264 Kaptopril tablet 50 mg
265 Kaptopril tablet scored 25 mg
266 Kaptopril tablet scored12,5 mg
267 Karbamazepin sirup 100 mg/5 ml
268 Karbamazepin tablet 200 mg
269 Karbimazol tab 5 mg
270 Karbogliserin tetes telinga 10%
271 Karboplatin 150 mg / 15 ml
272 Karboplatin 450 mg / 45 ml
273 Ketamin injeksi i.v. 100 mg/ml
274 Ketokonazol krim 2%
275 Ketokonazol krim 2%
276 Ketokonazol tablet 200 mg
277 Ketoprofen supositoria 100 mg
278 Ketorolac injeksi 30 mg/ml
279 Klaritromisin tab 500 mg
280 Klindamisin kapsul/kaplet 150 mg
281 Klindamisin kapsul/kaplet 300 mg
282 Klobazam tab 10 mg
283 Klonidin injeksi i.v 0,15 mg/ml (HCL) (150)
284 Klonidin tablet 0,15 mg
285 Klopidogrel tab 75 mg
286 Kloramfenikol kapsul/kaplet 250 mg
287 Kloramfenikol salep mata 1 %
288 Kloramfenikol suspensi 125 mg/ 5 ml
289 Klorpromazin injeksi i.m. 25 mg/ml (HCl)
290 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl)
291 Klozapin 100 mg
292 Klozapin 25 mg
293 Kodein tablet 10 mg
296 Koloid HES BM 130 000 lar inf 6%
297 Kombinasi suspensi : Parafin + gliserin + fenolftalein
298 Kombinasi tablet salut : Besi (II) sulfat 7H2O 200 mg Asam folat
0,25 mg tetes mata 2,5 mg/mL: Natrium klorida 8,664 mg;
Kombinasi
299 Kalium klorida 1,32 mg
300 Kombinasi: Artemether 20 mg; Lumefantrin 120 mg

301 Kombinasi: Levodopa 100 mg; Karbidopa 25 mg; Entekapon 200
302 mg
Kombinasi: Lopinavir 200 mg; Ritonavir (LPV/r) 50 mg
Page 7 of 45
88
303 Kombinasi: Salmeterol 25 mcg; Flutikason propionat 50 mcg
Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400
306
mg Trimetoprim 80 mg
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg +
307 Trimetoprim 40 mg / 5 ml
308 Kuinin (Kina) tablet 200 mg

309 Kuinin injeksi i.v. 25% (sebagai 2 HCl)
310 Kuinin tablet 222 mg (H2SO4.7H2O)
311 Lamivudine tablet 150 mg
312 Lansoprazol inj 30 mg/ml
313 Lanzoprazol kapsul/kaplet 30 mg
314 Lapatinib tab 250 mg
315 Larutan mengandung Asam Amino (Asam Amino 10%)
Larutan mengandung Asam Amino (Asam Amino 100 g, Total N
316 15,7 g, Na+ 2 mEq, Asetat 120 mEq)
Larutan mengandung Asam Amino (Asam Amino 27 g, Sorbitol 50

317 g, Cl- 52 mEq)
Larutan mengandung Asam Amino (Asam Amino 30 g, Glukosa 7,3

318
% dan elektrolit) 1000 ml
Larutan mengandung Asam Amino (Asam Amino 30 g, Glukosa 7,3
319
% dan elektrolit) 500 ml
Larutan mengandung Asam Amino (Asam Amino 5% dengan BCAA
320 45%, L-Ornithine L Aspartate 8.03 gr/L, Sorbitol 50 gr/L, Xylitol 50
gr/L)
Larutan mengandung Asam Amino (Asam Amino 6%, mengandung
321
Taurine 0,24 gr/l)
Larutan mengandung Asam Amino (Asam Amino 7%, Komposisi:
322
Asam Amino esensial: Asam Amino non esensial = 60 : 40)
Larutan mengandung Asam Amino (Asam Amino 72.05 g, Total N
323
11.53 g, AAE/AANE ratio 2.6, Na+ 2 mEq, Asetat 46 mEq)
Larutan mengandung Asam Amino (Asam Amino 79.9 g, Total N
324
12.2 g, Na+ 14 mEq, Cl 94 mEq)
325 Larutan mengandung Asam Amino (Asam amino 8%)
Larutan mengandung Asam Amino (Asam Amino esensial 7%
326
+Xylitol 10 g/L)
Larutan mengandung Asam Amino (BCAA 25 gr/L, L-Ornithine L
327 Aspartate 10 gr/L, Xylitol 50 gr/L, Malic Acid 7 gr/L, Piridoxin 0.12
gr/L)
Larutan mengandung Asam Amino (Kombinasi Asam aminno 50
g/L, Sorbitol 50 g/L, Xylitol 50 g/L, Asam Askorbat (Vit C) 0.4 g/L,
328 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)
Larutan mengandung Asam Amino (Kombinasi Asam amino 50 g/L,

329
vitamin dan elektrolit)
Page 8 of 45
Larutan mengandung Asam Amino (Kombinasi 99 Asam Amino: 34gr,
330 Glukosa: 97gr, Lipid: 51gr dan Elektrolit (Kalori = 1000 kkal, Akses
peripheral))
Larutan mengandung Asam Amino (Kombinasi Asam Amino: 45gr,
331 Glukosa: 130gr, Lipid: 68gr dan Elektrolit (Kalori = 1400 kkal,
Akses peripheral))
Larutan mengandung Asam Amino (Kombinasi Glukosa dan
332 elektrolit 150 gr + Asam Amino 48 gr dgn akses sentral)
Larutan mengandung Asam Amino (Kombinasi Glukosa dan

333
elektrolit 80 gr + Asam Amino 40 gr )
334 Larutan mengandung Elektrolit (Kalium Klorida)
335 Larutan mengandung Elektrolit (Larutan Ringer Laktat)
336 Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3
mEq, Asetat
Larutan 28 mEq) Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
mengandung
337
Larutan mengandung Elektrolit (Sodium Lactate sol (50%) 113 gr/L,

338 Potassium Chloride 0.3 gr/L, Calcium Chloride 0.2 gr/L, elektrolit)
Larutan mengandung Elektrolit (Tiap 1000 ml mengandung

339 electrolit: Sodium 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)
Larutan mengandung Karbohidrat (Fructose 120 g, glucose 66 g,
340 Xylitol 60 g/ L + elektrolit)
Larutan mengandung Karbohidrat (Fructose 60 g, glucose 33 g,

341 Xylitol 30 g/ L)
342 Larutan mengandung Karbohidrat (Maltose 100 gr)

Larutan mengandung Karbohidrat + Elektrolit (25.00g maltose,
343 3.00 g sodium chloride, 0.15 g potassium chloride, 0.10 g calcium
chloride dihydrate dan 1.55 g sodium lactate)
Larutan mengandung Karbohidrat + Elektrolit (Acetate, Na, K, Cl,
344 Ca, Mg, Sorbitol 50 gr/L)
Larutan mengandung Karbohidrat + Elektrolit (Asam amino 28

345 gr/L, Glukosa 100 gr/L, elektrolit)
Larutan mengandung Karbohidrat + Elektrolit (Asam amino 28

346 gr/L, Glukosa 75 gr/L, elektrolit)
Larutan mengandung Karbohidrat + Elektrolit (Fructose 60 g,

347 glucose 33 g, Xylitol 30 g/ L)
Larutan mengandung Karbohidrat + Elektrolit (Glukosa 25 g, NaCl

348 2,0 g, KCl 1,3 g, Natrium Laktat 3,1 g, air untuk injeksi ad 1000 ml)
Larutan mengandung Karbohidrat + Elektrolit (Glukosa 55 g ;

349 Natrium Chloride 9 g, air untuk injeksi ad 1000 ml)
Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 25,0 g;

350 NaCl: 4,5 g)
Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g;

351 NaCl: 2.25 g)
Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g;

352 NaCl: 4.5 g)
Page 9 of 45
1010
Larutan mengandung Karbohidrat + Elektrolit (Larutan nutrisi
353 kombinasi infus per L: Na. 100mEQ, K 18mEQ, Ca. 4mEQ, Mg
6mEQ, Cl 90mEQ, Asetat 38mEQ, Sorbitol 50g)
Larutan mengandung Karbohidrat + Elektrolit (Larutan Ringer &
354 Glukosa 5%)
Larutan mengandung Karbohidrat + Elektrolit (NaCl 1.75 g, KCL

355 1.5g, Glukosa 100 gr)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5

356 gr, Na Lactat 2.24 gr, Dekstrosa 27 gr)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na

357 Laktat 2.24 gr, KCL 0.75 gr Dekstrosa 27 gr)
Larutan mengandung Lipid ( Infus Lipid Emulsi MCT/LCT 20% 100

358 ml)
359 Larutan mengandung Lipid (Emulsi lemak 20%)

Larutan mengandung Lipid (Infus Lipid Emulsi MCT/LCT 20% 250
360 ml)
361 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 180

gr + Asam Amino 71.8 gr + Lipid 50 gr dgn akses sentral)
362 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 80 gr

+ Asam Amino 40 gr + Lipid MCT/LCT 50 gr)
363 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 90 gr

+ Asam Amino 35.9 gr + Lipid 25 gr dgn akses sentral)
364 Larutan mengandung Lipid (Soybean Oil 200 g/L, Egg Lecithins 12
gr/L, Glycerol Ph 25 gr/L, Sodium Oleate 0.3 gr/L)
365 Latanoprost tetes mata 0,01%
366 Latanoprost tts mata 0,005% btl@2,5ml
367 Lenograstim inj 263 mcg/mL
368 Leuprorelin asetat inj depot 1,88 mg
369 Leuprorelin asetat inj depot 11,25 mg
370 Levofloksasin inf 5 mg/mL
371 Levofloksasin tablet 500 mg
372 Lidokain injeksi 2% (HCL)
373 Lidokain injeksi 2% (HCl) + Epinefrin 1 : 80.000 - 2ml
374 Lidokain jeli 2%
375 Lisinopril tablet 10 mg
376 Lisinopril tablet 5 mg
377 Litium karbonat tablet 200 mg
378 Litium karbonat tablet 400 mg
379 Loperamid tablet 2 mg
380 Loratadin tablet 10 mg
381 Lorazepam tablet 2 mg
382 Low molecule feri sucrose inj amp 100 mg/5 mL
383 Manitol
384 Maprotilin HCl tab 25 mg
385 Maprotilin HCl tab 50 mg
386 MDP (methylene diphosphonate) 1 mg methylene diphosphonic
387 acid/mL
Mebendazol tablet 500 mg
388 Melfalan tablet 2 mg
Page 10 of 45
389 Meropenem inj 1 g 1111
390 Meropenem serb inj 500 mg/vial
391 Mesna inj 100 mg/mL
392 Metadon sir 50mg/5ml
393 Metformin HCl tablet 500 mg
394 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg
395 Metilfenidat kapsul LA 20 mg
396 Metilprednisolon inj 125 mg/2 mL
397 Metilprednisolon inj 500 mg/8 mL
398 Metilprednisolon tablet 16 mg
401 Metoklopramide tablet 5 mg
402 Metronidazol infus 500 mg/100 ml
403 Metronidazol supositoria 500 mg
404 Metronidazol tablet 250 mg
405 Metronidazol tablet 500 mg
406 MIBI (metoxy iso butyl iso nitril) 5-mL reaction vial
407 Midazolam injeksi i.v. 1 mg/ml
408 Midazolam injeksi i.v. 5 mg/ml
409 Mikafungin Na serb inj 50 mg
410 Mikofenolat Mofetil 500 mg
411 Mikonazol krim/salep 2 % (Nitrat)
412 Mitomisin C (crystallin) serbuk inj 10 mg/vial
413 Moksifloksasin tetes mata 0,5%
414 Mometason furoat krim 0,1%
415 Morfin HCL inj 10 mg/ml
416 Morfin HCL tablet SR 10 mg
417 Morfin HCL tablet SR 15 mg
418 Morfin injeksi i.m./s.k./i.v. 10 mg/ml
419 Morfin tablet 10 mg
420 Nacl 0,9%
421 Nadroparin inj 9500 Axa/mL syringe 0,3 mL
422 Nadroparin inj 9500 Axa/mL, syringe 0,4 mL
423 Nadroparin inj 9500 Axa/mL, syringe 0,6 mL
424 Nalokson injeksi 0,4 mg/ml
425 Natrium Bikarbonat injeksi i.v 8,4%
426 Natrium Diklofenak tablet 50 mg
427 Natrium Diklofenak tablet 25 mg
428 Natrium fosfat lar oral 45 mL
429 Natrium fusidat salep 20 mg/g
430 Neostigmin injeksi 0,5 mg/ml
431 Nevirapin tablet 200 mg
432 Nifedipin tab 20 mg, slow release; oros
433 Nifedipin tab 30 mg, oros
434 Nifedipin tablet/kapsul 10 mg
435 Nistatin tablet salut 500.000 IU/ g
436 Nistatin vaginal tablet 100.000 IU/ g
Page 11 of 45
437 Norepinefrin injeksi 1 mg/ml 1212
438 Noretisteron tablet 5 mg
439 Obat Antituberkulosis FDC Kategori 1
440 Obat Antituberkulosis FDC Kategori 2
441 Obat Antituberkulosis FDC Kategori Anak
442 Obat Antituberkulosis FDC Sisipan
443 Obat Antituberkulosis Kategori 1 dewasa
444 Obat Antituberkulosis Kategori anak
445 Ofloxacin tablet 200 mg
446 Ofloxacin tablet 400 mg
447 Oksaliplatin serbuk injeksi 100 mg / vial
448 Oksaliplatin serbuk injeksi 50 mg / vial
449 Oksimetazolin tetes hidung 0,025%
450 Oktreotid 10 mg
451 Olanzapin inj 10 mg/vial
452 Olanzapin kapl salut 5 mg
453 Olanzapin tab 10 mg
454 Olopatadin tts mata 0,1%
455 Omeprazol injeksi 40 mg/ 10 ml
456 Omeprazol kapsul/kaplet 20 mg
457 ondansetron inj 4 mg/ 2 mL
458 Ondansetron tab 4 mg
459 Ondansetron tablet 8 mg
Paket CAPD Awal (Komposisi: 1 unit Transfer Set, 2 unit Ultaclam, 1
460 unit Tenckoff Catheter, Titanium Adaptor)
461 Paket CAPD Pergantian Transfer Set per 6 bulan

Paket CAPD Rutin 120 ( 4x ganti cairan perhari dengan komposisi
462 Larutan Dialisa 1.5 %, Larutan Dialisa 2.5 %, Larutan Dialisa 4.25
%, Minicap)
463 Paklitaksel inj 100 mg/vial
464 Paklitaksel inj 300 mg/vial
465 Paklitaksel injeksi 30 mg/vial
466 Parasetamol drop 100 mg/ml btl @15ml (60mg/0,6ml)
467 Parasetamol sirup 120 mg / 5 ml
468 Parasetamol tablet 500 mg
469 Parasetamol tetes 60 mg/0,6 mL
470 Pegylated interferon alfa-2a inj 135 mcg/0,5 ml
471 Pegylated interferon alfa-2a inj 180 mcg/0,5 ml
Pegylated Interferon alfa-2b serb inj 100 mcg
472

473

474

475
476 Perak sulfadiazin krim 1%
477 Perindoprilarginin tab 5 mg
Page 12 of 45
478 Permetrin krim 5% 1313
479 Petidin injeksi i.m/s.k/i.v lambat 50 mg/ml (HCl)
480 Pioglitazon tab 15 mg
481 Pioglitazon tab 30 mg
482 Pirantel suspensi 125 mg/5 ml
483 Pirantel tablet score (base) 125 mg
484 Pirazinamid tablet 500 mg
485 Polikresulen cairan
486 Povidon Iodida larutan 10% 1000 ml
489 Pramipeksol tab ER 0,375 mg
490 Pramipeksol tab ER 0,750 mg
491 Pravastatin tablet 20 mg
492 Propanolol tablet 10 mg ( HCl )
493 Propofol injeksi i.v., bolus 1%
494 Propranolol tablet 40 mg (HCl)
495 Quetiapin tab 200 mg
498 Ramipril tablet 2,5 mg
499 Ramipril tablet 5 mg
500 Ranitidin injeksi 25 mg/ml
501 Ranitidin tablet 150 mg
502 Retinol (Vitamin A) 100.000 IU
503 Retinol (Vitamin A) 200.000 IU kapsul lunak
504 Ringer Laktat larutan infus
505 Risperidon tablet 1 mg
508 Rivaroksaban tab 10 mg
511 Ropinirol Tablet Salut 2 mg
514 Salbutamol inhalasi/aerosol 100 mcg/dosis
515 Salbutamol serb inh 200 mcg/kaps
516 Salbutamol serb inh 200 mcg/kaps + rotahaler
517 Salbutamol tablet 2 mg (sebagai Sulfat)
518 Salbutamol tablet 4 mg (sebagai Sulfat)
Salep 2-4 , Kombinasi : Asam Salisilat 2% + Belerang endap 4%
519
520 Sefadroksil sirup kering 125 mg/5ml

521 Sefadroksil kapsul/kaplet 250 mg
522 Sefadroksil kapsul/kaplet 500 mg
523 Sefadroksil sir kering 250 mg/5 mL
524 Sefaleksin kapsul/kaplet 500 mg
Page 13 of 45
525 Sefazolin serbuk injeksi 1 g/vial 1414
526 Sefepim inj 1 g
527 Sefiksim kapsul/kaplet 100 mg
528 Sefiksim sirup kering 100 mg/ 5 ml
529 Sefoperazon inj 1 g
530 Sefotaksim injeksi 0,5 g
531 Sefotaksim injeksi 1 g
532 Sefpodoksim proksetil tab 100 mg
533 Seftazidim injeksi 1 g
534 Seftriakson serbuk injeksi 1 g/vial
535 Sefuroksim tab 500 mg
536 Sertralin tab 50 mg
537 Setirizin tablet 10 mg
538 Sevofluran ih, btl
539 Sianokobalamin (vitamin B12) injeksi 500 mcg
540 Siklofosfamid serbuk injeksi i.v. 1000 mg
541 Siklofosfamid serbuk injeksi i.v. 200 mg
542 Siklosporin kaps 100 mg
543 Siklosporin kapsul lunak 25 mg
544 Simvastatin scored tablet 10 mg
545 Simvastatin tablet 20 mg
546 Siprofloksasin infus 2%
547 Siprofloksasin tablet 500 mg (sebagai HCl)
548 Sisplatin serbuk injeksi 10 mg
549 Sisplatin serbuk injeksi 50 mg
550 Sitarabin serbuk injeksi i.m./i.v./s.k. 1gr/10ml
551 Spiramisin tablet 500 mg
552 Spironolakton tablet 100 mg
553 Spironolakton tablet 25 mg
554 Streptokinase injeksi 1,5 juta UI/vial
555 Streptomisin serbuk injeksi i.v 1000 mg/ml
556 Sufentanil injeksi iv, epidural 5 mcg/ml
557 Sukralfat susp 500 mg/5 mL
558 Takrolimus kaps 0.5 mg
559 Takrolimus kaps 1 mg
560 Tamsulosin tab 0,2 mg
561 Tamsulosin tab 0,2 mg
562 Tamsulosin tab SR 0,4 mg
563 Telbivudin tab 600 mg
564 Telmisartan tab 40mg
565 Telmisartan tab 80 mg
566 Temozolamid kaps 100 mg
567 Temozolamid kaps 20 mg
568 Tenofovir tab 300 mg
569 Terbutalin cairan ih 2,5 mg/mL
570 Terbutalin tablet 2,5 mg
571 Terbutalin turbu (serbuk ih) 0,50 mg
572 Testoteron soft capsul 40 mg
Page 14 of 45
573 Tetrakain HCl tetes mata 0,5% 1515
574 Tetrasiklin kapsul/kaplet 250 mg
575 Tiamazol tab 10 mg
576 Tiamazol tab 5 mg
577 Timolol tetes mata 0,25%
578 Timolol tetes mata 0,5%
579 Tiotropium kaps 18 mcg + handihaller
580 Tramadol injeksi 50 mg/ml
581 Travoprost tetes mata 0,004%
582 Triamsinolon asetonid nasal spray 55 mcg/puff
583 Trifluoperazin tablet 5 mg
584 Urea krim 10%
585 Vaksin polio inj (Vaksin Poliomyelitis yang diinaktifkan)
586 Valgansiklovir tab 450 mg
587 Valproat sirup 250 mg/5 ml
588 Valproat tab SR 250 mg
589 Valproat tab SR 500 mg
590 Valsartan tab 80 mg
591 Valsartan tab 160 mg
592 Verapamil tab 240 mg
593 Verapamil tablet 80 mg (HCl)
594 Vinblastin serbuk injeksi 10 mg
595 Vinkristin serb inj i.v 2 mg/vial
596 Vinkristin serbuk injeksi i.v. 1 mg
597 Vinorelbin inj. 10 mg/ml
598 Vitamin B Kompleks tablet
599 Zidovudin 300 mg + Lamivudine 150 mg
600 Zinc drop 10 mg/mL
601 Zinc sir 20 mg/5 Ml
602 Zinc tablet dispersible20 mg
Page 15 of 45
1616
EKATALOG OBAT
Nama Dagang Nama Penyedia
n/a PT. Kimia Farma
Hepsera PT. SmithKline Beecham

n/a PT. Indofarma
n/a PT. Holi Pharma
Zenalb PT. Ikapharmindo
Zenalb PT. Ikapharmindo
n/a PT. Pertiwi Agung
n/a PT. Bernofarm
n/a PT. Dexa Medica
n/a PT. Kimia Farma
n/a PT. Kimia Farma
Actilyse PT. Boehringer Ingelheim
Fungicide PT. Cendo Industri Farmasi
Glybotic 250 mg /ml PT. Sanbe Farma
n/a PT. Lucas Djaja
n/a PT. Erela
Cordarone PT. Aventis Pharma
Kendaron Tablet PT. Darya Varia
n/a PT. Indofarma
n/a PT. Novapharin
n/a PT. Mersifarma
n/a PT. Holi Pharma
n/a PT. Novapharin
n/a PT. Bernofarm
Lantus Solostar 100IU/ml 5pens
PT. Aventis Pharma
x3ml
Novomix Flexpen PT. Ferron Par
Humalog Mix 25 PT. Tempo Scan Pacific
Novorapid Flexpen PT. Ferron Par
Novorapid Vial PT. Ferron Par
Apidra Solostar 100IU/ml 5pens

PT. Aventis Pharma
x3ml
Humalog PT. Tempo Scan Pacific

Arimidex 1 mg PT. AstraZeneca indonesia
n/a PT. Erela
Page 16 of 45
1717
n/a PT. Erela
n/a PT. Indofarma
n/a PT. Kimia Farma
n/a PT. Kimia Farma
Levopar Tablet PT. Meprofarm
Artem PT. Kimia Farma

n/a PT. Phapros, Tbk
n/a PT. Kimia Farma
n/a PT. Kimia Farma
Starfolat PT. Dexa Medica
n/a PT. Marin Liza Farmasi
Bondronat PT. Boehringer Ingelheim
n/a PT. Bernofarm
Urotractin 400 mg PT. Sanbe Farma
n/a PT. Hexpharm Jaya
n/a PT. Bernofarm
Temiral Eye Oint PT. Sanbe Farma
n/a PT. Indofarma
n/a PT. Sampharindo Perdana
Leunase PT. Widatra Bhakti
Pularex PT. Zenith Pharmaceuticals
Tracrium PT. Glaxo Wellcome
n/a PT. Indofarma
n/a PT. Soho Industri Pharmasi
n/a PT. Kimia Farma
n/a PT. Soho Industri Pharmasi
n/a PT. Rama Emerald Multi
Survanta PT. Abbott Indonesia
Dorner 20 g PT. Combiphar
Dorner PT. Combiphar
n/a PT. Kimia Farma
Casodex 150 mg PT. AstraZeneca indonesia
Casodex 50 mg PT. AstraZeneca indonesia
Stolax supp PT. Sanbe Farma
Concor 2.5 PT. Merck Tbk
n/a PT. Pratapa Nirmala
BLEOCIN PT Kalbe Farma
Cripsa tab PT. Caprifarmindo
Pulmicort Turbuhaler PT. AstraZeneca indonesia
Pulmicort Respules PT. AstraZeneca indonesia
Symbicort Turbuhaler 160/4.5 mcg PT. AstraZeneca indonesia
Symbicort 80/4.5 mcg PT. AstraZeneca indonesia
Page 17 of 45
n/a 1818
PT. Dexa Medica
Bunascan PT. Pratapa Nirmala
Pradaxa PT. Boehringer Ingelheim
Pradaxa PT. Boehringer Ingelheim
DBL Dacarbazine PT. Tempo Scan Pacific
DAUNOCIN PT. Novell PharmaeuticaL
Exjade 250 mg Tab PT. Novartis Indonesia
Exjade 500 mg Tab PT. Novartis Indonesia
Ferriprox Oral Solution PT. Sydna Farma
Ferriprox tablet PT. Sydna Farma
Desferal PT. Novartis Indonesia
n/a PT. Indofarma
n/a PT. Promedrahardjo
Cerazette PT. Merck Sharp Dohme
n/a PT. Dexa Medica
n/a PT. Kimia Farma
n/a PT. Yarindo Farmatama
n/a PT. Indofarma
Herbesser Powder Injection 50mg PT. Tanabe Indonesia
Farmabes Injeksi 25 mg PT. Pratapa Nirmala
Herbesser CD 100 PT. Tanabe Indonesia
Herbesser CD 200 PT. Tanabe Indonesia
n/a PT. Kimia Farma
E.D.T.A PT. Cendo Industri Farmasi
DOBURAN PT. Dipa Pharmalab
Cardura 1mg PT. Pfizer Indonesia
Cardura 2mg PT. Pfizer Indonesia
Doxorubicin Actavis 10 mg PT. Actavis Indonesia
Doxorubicin Actavis 50 mg PT. Actavis Indonesia
n/a PT. Novapharin
n/a PT. Novapharin
n/a PT. Bernofarm
UDOPA PT. Dipa Pharmalab
n/a PT. Sanbe Farma
Renalscan KaeF PT. Kimia Farma
Avodart PT. SmithKline Beecham
n/a PT. Kimia Farma
Aromasin PT. Pfizer Indonesia
Lovenox 2000 ANTI-XA PT. Aventis Pharma
Epirubisin Kalbe PT Kalbe Farma
n/a PT. Sanbe Farma
D-Vit FT PT. Gracia Pharmindo
D-Vit Syrup PT. Gracia Pharmindo
n/a PT. Kimia Farma
Page 18 of 45
n/a PT. Indofarma1919
n/a PT. Phyto Kemo Agung
Hemapo 3000 PT Kalbe Farma
Recormon PT. Boehringer Ingelheim
n/a PT. Kimia Farma
n/a PT. Indofarma
n/a PT. Novapharin
Lynoral PT. Merck Sharp Dohme
Implanon PT. Merck Sharp Dohme
Posyd PT. Combiphar
n/a PT. Kimia Farma
Certican 0,25 mg Tab PT. Novartis Indonesia
Certican 0,5 mg Tab PT. Novartis Indonesia
Novoseven PT. Ferron Par
n/a PT. Mersifarma
n/a PT. Ikapharmindo
n/a PT. Mersifarma
Fenocin PT. Actavis Indonesia
Berotec MDI PT. Boehringer Ingelheim
Berotec Solution PT. Boehringer Ingelheim
n/a PT. Kimia Farma
n/a PT. Kimia Farma
Durogesic 12,5 MU Matrix PT. Kimia Farma
Durogesic 25 MU Matrix PT. Kimia Farma
Durogesic 50 MU Matrix PT. Kimia Farma
Leucogen PT Kalbe Farma
Fludara IV LYO PT. Aventis Pharma
Fludara Oral PT. Aventis Pharma
Sikzonoate Injeksi PT. Mersifarma
n/a PT. Natura Laboratoria Prima
n/a PT. Kimia Farma
Foransi 10 PT. Gracia Pharmindo
NOPRES PT. Dexa Medica
Curacil PT Kalbe Farma
Curacil PT Kalbe Farma
SYNARCUS PT. Ifars Pharmaceutical
Avamys PT. Glaxo Wellcome
Flixotide Nbules PT. Glaxo Wellcome
Arixtra PT. Glaxo Wellcome
Plasmanate PT. Dipa Pharmalab
n/a PT. Indofarma
Page 19 of 45
n/a PT. 2020
Indofarma
Gadovist 5 mg PT. Bayer Indonesia
Gadovist 7,5 mg PT. Bayer Indonesia
Primovist PT. Bayer Indonesia
Cymevene PT. Boehringer Ingelheim
Iressa 250 mg PT. AstraZeneca indonesia

n/a PT. Indofarma
n/a PT. Indofarma
Gemzar 1000 mg PT. Bayer Indonesia
n/a PT. Sanbe Farma
n/a PT. Indofarma
Genoint Salep Mata PT. Erela
n/a PT. Indofarma
n/a PT. Indofarma
GLUCODEX PT. Dexa Medica
Diamicron MR 30 PT. Pradja Pharin
n/a PT. Dexa Medica
n/a PT. Kimia Farma
n/a PT. Kimia Farma
n/a PT. Kimia Farma
n/a PT. Kimia Farma
Nitrokaf Retard PT. Kimia Farma
Nitrokaf Forte PT. Kimia Farma
Nitral PT. Actavis Indonesia
Gliserin lar 50% PT. Lucas Djaja
n/a PT. Widatra Bhakti
Zoladex 10,8 mg PT. AstraZeneca indonesia
Zoladex 3,6 mg PT. AstraZeneca indonesia
Haldol Decanoas PT. Soho Industri Pharmasi
n/a PT. Indofarma
n/a PT. Indofarma
n/a PT. Indofarma
Lodomer 2 PT. Mersifarma
Halothane PT. Dexa Medica
Inviclot PT. Pratapa Nirmala
Hyperhep B PT. Dipa Pharmalab
n/a PT. Kimia Farma
n/a PT. Otto Pharmaceuticals
Insulatard Vial PT. Ferron Par
Humulin N Vial PT. Bayer Indonesia
n/a PT. Aventis Pharma
Page 20 of 45
2121
Insulatard Penfill PT. Ferron Par
Sansulin N PT. Sanbe Farma
Humulin N Cart PT. Bayer Indonesia
Mixtard Penfill PT. Ferron Par
Humulin 30/70 Cart PT. Bayer Indonesia
Mixtard Vial PT. Ferron Par
Humulin 30/70 Vial PT. Bayer Indonesia
Actrapid Penfill PT. Ferron Par
Humulin R Cart PT. Bayer Indonesia
Sansulin R PT. Sanbe Farma
Actrapid Vial PT. Ferron Par
Humulin R Vial PT. Bayer Indonesia
n/a PT. Aventis Pharma
Tetagam PT. Dexa Medica

n/a PT. Indofarma
n/a PT. Indofarma
n/a PT. Novapharin
Holoxan injeksi 1000 PT. Mugi Laboratories
Tanapress 10mg PT. Tanabe Indonesia
Tanapress 5mg PT. Tanabe Indonesia
Iopamiro PT. Dipa Pharmalab
Ultravist 300/100 mg PT. Bayer Indonesia
Atrovent HFA PT. Boehringer Ingelheim
n/a PT. Indofarma
n/a PT. Indofarma
n/a PT. Sanbe Farma
Farsorbid inj PT. Pratapa Nirmala
Page 21 of 45
n/a PT. Indofarma2222
Kalipar PT. Tempo Scan Pacific
KSR PT. Merck Tbk
DBL Leucovorin PT. Tempo Scan Pacific
Kalsium glukonat PT. Ethica Industri Farmasi
n/a PT. Dexa Medica
n/a PT. Dexa Medica
Xeloda PT. Boehringer Ingelheim
n/a PT. Indofarma
n/a PT. Errita Pharma
n/a PT. Indofarma
Tegretol Syrup 100mg/5ml, 120ml PT. Novartis Indonesia
n/a PT. Indofarma
Neo-Mercazole PT. Nicholas Laboratories
Karbogliserin tetes telinga 10% PT. Lucas Djaja
DBL Carboplatin 150 mg PT. Tempo Scan Pacific
DBL Carboplatin 450 mg PT. Tempo Scan Pacific
KTM PT. Guardian Pharmatama
n/a PT. Novell PharmaeuticaL
n/a PT. Kimia Farma
n/a PT. Dexa Medica
Protofen Supp PT. Kimia Farma
ORIXAL PT. Ifars Pharmaceutical
n/a PT. Indofarma
n/a PT. Indofarma
n/a PT. Dexa Medica
Catapres Injeksi PT. Boehringer Ingelheim
n/a PT. Kimia Farma
n/a PT. Kimia Farma
n/a PT. Kimia Farma
n/a PT. Bernofarm
n/a PT. Mersifarma
n/a PT. Mersifarma
n/a PT. Kimia Farma
n/a PT. Kimia Farma
n/a PT. Kimia Farma
Voluven PT. Fresenius Kabi
Laxadine Emulsi 60 ml PT. Galenium Pharmasia
n/a PT. Erela
Cendo Lyteers PT. Cendo Industri Farmasi
Coartem PT. Novartis Indonesia

Stalevo PT. Novartis Indonesia
Aluvia PT. Abbott Indonesia
Page 22 of 45
Seretide Inhaler 50 mcg 2323
PT. Glaxo Wellcome
Seretide Diskus 100 mcg PT. Glaxo Wellcome
Seretide Diskus 250 mcg PT. Glaxo Wellcome
n/a PT. Sampharindo Perdana
n/a PT. Kimia Farma

n/a PT. Kimia Farma
n/a PT. Kimia Farma
n/a PT. Kimia Farma
Prosogan Inj. PT. Takeda Indonesia
n/a PT. Indofarma
Tykerb PT. SmithKline Beecham
Kalbamin PT. Finusolprima Farma
Amiparen PT Otsuka Indonesia
Pan-amin G PT Otsuka Indonesia
Aminofluid PT Otsuka Indonesia
Aminofluid PT Otsuka Indonesia
Aminofusin Hepar PT Kalbe Farma
Aminosteril Infant 6% PT. Fresenius Kabi
Nephrosteril PT. Fresenius Kabi
Kidmin PT Otsuka Indonesia
Aminoleban PT Otsuka Indonesia
Aminosteril N-Hepa PT. Fresenius Kabi
Eas Pfrimer PT. Finusolprima Farma
Comafusin Hepar PT. Finusolprima Farma
Aminofusin L600 PT Kalbe Farma
Aminofusin Paed PT Kalbe Farma
Page 23 of 45
2424
Kabiven 1440 ml PT. Fresenius Kabi
Kabiven 1920 ml PT. Fresenius Kabi
Combiflex Plus (790 kcal) PT. Phapros, Tbk
Combiflex peri (480 kcal) PT. Phapros, Tbk

Otsu - KCl 7,46% PT Otsuka Indonesia
Wida RL PT. Widatra Bhakti
Asering PT Otsuka Indonesia
KA EN 1B PT Otsuka Indonesia
Totilac PT Kalbe Farma
Ringerfundin 500 mL PT. Phapros, Tbk
Triofusin 1000 PT Kalbe Farma
Triofusin 500 PT Kalbe Farma
Martos PT Otsuka Indonesia
Potacol inj PT Otsuka Indonesia
Tutofusin OPS PT Kalbe Farma
Clinimix N9G20E PT Kalbe Farma
Clinimix N9G15E PT Kalbe Farma
Triofusin E1000 PT Kalbe Farma
Wida HSD PT. Widatra Bhakti
Wida D5-NS PT. Widatra Bhakti
WIDA 2A PT. Widatra Bhakti
WIDA D5-1/4NS PT. Widatra Bhakti
WIDA D5-1/2NS PT. Widatra Bhakti
Page 24 of 45
2525
Futrolit PT. Sanbe Farma
Wida RD PT. Widatra Bhakti
KA ENMG 3 PT Otsuka Indonesia
KA EN 3B PT Otsuka Indonesia
KA EN 3A PT Otsuka Indonesia
Lipofundin MCT/LCT 1% 100 PT. Phapros, Tbk
Intralipid PT. Fresenius Kabi
Lipofundin MCT/LCT 1% 250 PT. Phapros, Tbk
Nutriflex Lipid Special 1250 PT. Phapros, Tbk
Nutriflex Lipid Peri 1250 PT. Phapros, Tbk
Nutriflex Lipid Special 625 PT. Phapros, Tbk
Ivelip PT Kalbe Farma
Cendo Glaopen PT. Cendo Industri Farmasi

Xalatan 0,005% PT. Pfizer Indonesia
Granocyte 34 1vl HSA Free PT. Aventis Pharma
Tapros 1.88mg PT. Takeda Indonesia
Tapros 3M PT. Takeda Indonesia
n/a PT. Infion Pharmaceutical
n/a PT. Bernofarm
n/a PT. Indofarma
Xylocaine Jelly 2% PT. AstraZeneca indonesia
Frimania 200 PT. Mersifarma
Frimania 400 PT. Mersifarma
n/a PT. Ifars Pharmaceutical
Merlopam 2 PT. Mersifarma
DIALIFER PT. Novell PharmaeuticaL
n/a PT. Finusolprima Farma
Ludios PT. Soho Industri Pharmasi
Sandepril 50 PT. Mersifarma
Bonescan KaeF PT. Kimia Farma
Vermox 500 PT. Taisho Pharmaceutica
Alkeran PT. Glaxo Wellcome
Page 25 of 45
n/a PT. Bernofarm2626
n/a PT. Bernofarm
Uromitexan injeksi. PT. Mugi Laboratories
n/a PT. Kimia Farma
n/a PT. Bernofarm
n/a PT. Kimia Farma
Ritalin LA PT. Novartis Indonesia
n/a PT. Dexa Medica
n/a PT. Bernofarm
n/a PT. Mahakam Beta Farma
n/a PT. Dexa Medica
n/a PT. Kimia Farma
Flagyl PT. Aventis Pharma
n/a PT. Phyto Kemo Agung Farma
n/a PT. Phyto Kemo Agung Farma
Cardioscan KaeF PT. Kimia Farma
Fortanest PT Kalbe Farma
Dormicum PT. Boehringer Ingelheim
Mycamine PT. Combiphar
Cellcept PT. Boehringer Ingelheim
n/a PT. Kimia Farma
Mitomycin C PT. Widatra Bhakti
Vigamox PT. Tempo Scan Pacific
n/a PT. Guardian Pharmatama
n/a PT. Kimia Farma
MST Continus 10 mg PT. Mahakam Beta Farma
MST Continus 15 mg PT. Mahakam Beta Farma
n/a PT. Kimia Farma
n/a PT. Kimia Farma
Fraxiparine 0.3 ml PT. Glaxo Wellcome
Nokoba PT. Pratapa Nirmala
Meylon PT Otsuka Indonesia
Fleet Phosphosoda PT. Combiphar
Fucilex Ointment PT. Molex Ayus
Neostigmin Hameln inj PT. Pharma Health Care
n/a PT. Kimia Farma
Adalat Oros 20 mg PT. Bayer Indonesia
Adalat Oros 30 mg PT. Bayer Indonesia
n/a PT. Dexa Medica
Page 26 of 45
Levosol PT. 2727
Kimia Farma
Primolut N PT. Bayer Indonesia
n/a PT. Kimia Farma
n/a PT. Indofarma
n/a PT. Indofarma
n/a PT. Indofarma
n/a PT. Indofarma
ELOXATIN PT. Aventis Pharma
ELOXATIN PT. Aventis Pharma
Ilaidin Drops PT. Merck Tbk
Sandostatin LAR PT. Novartis Indonesia
Zyprexa IM PT. Bayer Indonesia
Olandoz 5 PT. Sandoz Indonesia
Olandoz 10 PT. Sandoz Indonesia
Patanol PT. Tempo Scan Pacific
n/a PT. Novapharin
n/a PT. Indofarma
n/a PT Kalbe Farma
Larutan
n/a Dialisa 1.5%: Dianeal Low PT Kalbe Farma
Calcium with 1,5% Dextrose;
Larutan Dialisa 2.5%: Dianeal Low
PT Kalbe Farma
Calcium with 2,5% Dextrose;
Larutan Dialisa 4.25%: Dianeal Low
SINDAXEL 1004.25%
Calcium with MG/16,67 ML
Dextrose PT. Actavis Indonesia
SINDAXEL 260mg/43.33 ML PT. Actavis Indonesia
SINDAXEL 30 MG/5 ML PT. Actavis Indonesia
n/a PT. Indofarma
n/a PT. Afifarma
NAPREX DROPS PT. Darya Varia
Pegasys PT. Boehringer Ingelheim
Pegasys PT. Boehringer Ingelheim
Pegintron Vial 100 Mcg PT. Merck Sharp Dohme
Pegintron Pen 120 Mcg PT. Merck Sharp Dohme
Pegintron PT. Merck Sharp Dohme
Pegintron Vial 80 Mcg PT. Merck Sharp Dohme

BURNAZIN 35 GR PT. Darya Varia
Bioprexum 5 mg PT. Pradja Pharin
Page 27 of 45
Scabimite Cream 10 PT. Galenium2828
Pharmasia
n/a PT. Kimia Farma
DECULIN 15 MG PT. Dexa Medica
DECULIN 30 MG PT. Dexa Medica
n/a PT. Holi Pharma
n/a PT. Holi Pharma
n/a PT. Holi Pharma
Aptil PT. Pratapa Nirmala
n/a PT. Afifarma
n/a PT. Afifarma
n/a PT. Afifarma
Sifrol ER 0,375mg PT. Boehringer Ingelheim
Sifrol ER 0,750mg PT. Boehringer Ingelheim
n/a PT. Dexa Medica
Fresofol 1% MCT/LCT PT. Fresenius Kabi
n/a PT. Holi Pharma
Seroquel XR 200 mg PT. AstraZeneca indonesia
Cardace 2.5mg 6x10 s tablet PT. Pharma Health Care
n/a PT. Dexa Medica
n/a PT. Dexa Medica
n/a PT. Kimia Farma
n/a PT. Kimia Farma
n/a PT. Dexa Medica
n/a PT. Mersifarma
n/a PT. Dexa Medica
Xarelto 10 mg PT. Bayer Indonesia
Requip PD 24 Hour 2 mg PT. Glaxo Wellcome
Ventolin Inhaler PT. Glaxo Wellcome
Ventolin Rotacaps PT. Glaxo Wellcome
Ventolin Rotahaler PT. Glaxo Wellcome
n/a PT. Kimia Farma
n/a PT. Marin Liza Farmasi
n/a PT. Holi Pharma

n/a PT. Bernofarm
n/a PT. Holi Pharma
Page 28 of 45
n/a 2929
PT. Dexa Medica
n/a PT. Bernofarm
n/a PT. Holi Pharma
Banadoz 100 PT. Sandoz Indonesia
n/a PT. Dexa Medica
Zinnat 500 PT. Glaxo Wellcome
Fatral PT. Pratapa Nirmala
Sojourn PT. Pratapa Nirmala
n/a PT. Lucas Djaja
Cyclovid 1000 mg PT. Novell PharmaeuticaL
Cyclovid 200 mg PT. Novell PharmaeuticaL
Sandimmun Neoral 100mg PT. Novartis Indonesia
Sandimmun Neoral 25mg PT. Novartis Indonesia
n/a PT. Dexa Medica
n/a PT. Bernofarm
Cisplatin PT Kalbe Farma
Cisplatin PT Kalbe Farma
DBL Cytarabun PT. Tempo Scan Pacific
n/a PT. Indofarma
n/a PT. Dexa Medica
n/a PT. Dexa Medica
Streptase PT. Dexa Medica
Sufentanyl iv.Epidural 5 mcg/ml PT. Kimia Farma
Ulsafate PT. Combiphar
Prograf PT. Combiphar
Prograf PT. Combiphar
Harnal D PT. Combiphar
Harnal D 0.2 mg Disp. Tablet PT. Combiphar
Harnal OCAS 0.4 mg Tablet PT. Combiphar
Sebivo 600 mg Tab PT. Novartis Indonesia
Micardis 40mg PT. Boehringer Ingelheim
Micardis 80mg PT. Boehringer Ingelheim
Temodal PT. Merck Sharp Dohme
Temodal PT. Merck Sharp Dohme
n/a PT. Kimia Farma
Bricasma Respules PT. AstraZeneca indonesia
Molasma Tablet PT. Molex Ayus
Bricasma Turbuhaler 0,5 mg PT. AstraZeneca indonesia
Andriol Testocaps PT. Merck Sharp Dohme
Page 29 of 45
Pantocain 0.5% 3030 Farmasi
PT. Cendo Industri
n/a PT. Holi Pharma
Thyrozol 10 PT. Merck Tbk
Thyrozol 5 PT. Merck Tbk
Isotic Adretor 0,25% PT. Pratapa Nirmala
Isotic Adretor 0,5% PT. Pratapa Nirmala
Spiriva 10s + Handihaler PT. Boehringer Ingelheim
Travatan PT. Tempo Scan Pacific
Nasacort AQ PT. Aventis Pharma
n/a PT. Darya Varia
Soft U Derm PT. Galenium Pharmasia
Imovax Polio PT. Aventis Pharma
Valcyte PT. Boehringer Ingelheim
Ikalep PT. Ikapharmindo
Depakote ER 250 mg PT. Abbott Indonesia
Depakote ER 500 mg PT. Abbott Indonesia
Diovan 80mg Tab PT. Novartis Indonesia
DIOVAN 160 MG PT. Novartis Indonesia
Isoptin 240 mg PT. Abbott Indonesia
n/a PT. Kimia Farma
Vinblastine PT. Combiphar
Vincristine Kalbe PT Kalbe Farma
Vincristine Kalbe PT Kalbe Farma
Navelbine injeksi 10 PT. Mugi Laboratories
n/a PT. Kimia Farma
n/a PT. Kimia Farma
Zincpro Drops PT. Combiphar
Zircum Kid Sirup PT. Meprofarm
n/a PT. Indofarma
Page 30 of 45
3131
Harga Satuan
Kemasan
Terkecil (Rp)
1 blister@24 tablet 1,375.00
Dus, 3 Blister @ 10 kapsul 27,500.00

Dus, 10 dus @ 1 botol @ 10 ml 3,849.00
Dus, 5 strip @ 6 tablet 344
Vial 100 ml 750,000.00
Vial 50 ml 345,000.00
Box, 10 strips @ 10 tablets 86
Dus, 10 blister @ 10 tablet 199.5
Dus, 10 Strip @ 10 tablet 380
Ktk 10x10 tablet 214
Ktk 10x10 tablet 233
Dus, 1 vial@50mg + 1 vial pelarut @ 50ml 3,800,000.00
tube 3.5 gr 18,500.00
Vial 2 ml 50,500.00
dus 30 ampul @10 ml 3,822.00
Botol @100 Tablet 80
Dus, 6 ampul @ 3 ml 12,480.00
strip 1,200.00
Dus, 10 strip @ 10 tss 112
dus 10 X 10'S 211
KOTAK @ 10 x 10 TAB 261
Dus, Botol 60 ml 4,070.00
btl @ 60 ml 2,445.00
Dus, 10 vial @ 1 g 5,100.00
dus, 5 solostar pen @ 3ml 85,000.00
Injeksi 100 IU/ml, Flexpen disposible 3 ml (1 box

106,000.00
isi 5 flexpen disposible)
Penfill cartridge 97,500.00

Injeksi 100 IU/ml, Flexpen disposible 3 ml (1 box
85,345.00
isi 5 flexpen disposible)
Dus, vial 10 ml 200,000.00
dus, 5 solostar pen @ 3ml 79,165.00
Penfill cartridge 79,167.00

Dus, 2 blister @ 14 Tablet 32,000.00
Dus, 10 Strip @ 10 Tablet 72
Page 31 of 45
3232
Botol @ 60 ml 2,160.00
Dus, 25 tube @ 5 g 2,516.00
ktk 10 x 10 tablet 520
Btl 100 tablet 135
Dus, 5 strip @ 10 tablet 1,500.00
Dus 6 amp @ 1ml 22,000.00

Dus @ 10 X 10 's 116
ktk 10x10 tablet 159
Dus 10 strip x 10 tab 95
Dus, 10 strip @10 tablet 84
Botol @ 100 tablet 48
Boks, 1 ampul 2,209,000.00
Dus, 10 blister @ 10 kaptab ss 112
Strip 1,815.00
Dus, 10 ampul @ 5 ml 3,334.00
Dus, 10 ampul @ 5 ml 2,950.00
Tube 3,5 gram 24,750.00
Dus, 10 blister @ 10 tablet 237
10.000 UI/Vial 1,039,500.00
Dus 5 strip @ 10 tablet 190
Dus, 5 ampul @ 2.5 ml 20,000.00
botol @ 60 ml 34,400.00
ktk 2x10 tablet 4,500.00
Strip 3,333.00
Dus @ 50 gram 1,250.00
Dus @ 10 Vial 9,800.00
Dus @ 10 Vial 13,400.00
Vial 3,200,000.00
Box/ 3 blister @ 10 Tablet 3,600.00
Box @ 3 blister @ 10 Tablet 3,600.00
Tube 5 gr 1,520.00
Supp 6,045.00
Dus 10 blister @ 10 tablet 746
Box 3 X 10 tab 645
Vial 304,000.00
Box 3 x 10'S 247,089.00
Dus, 1 Turbuhaler @ 100 dosis 93,000.00
Dus, 4 pak @ 5 respules @ 2 ml 8,900.00
Page 32 of 45
Dus, 5 ampul @ 4 ml 3333 25,600.00
ampul 30,800.00
Dus, 3 blister @ 10 kapsul 12,936.00
Dus, 3 blister @ 10 kapsul 12,936.00
vial @ 20 ml 305,000.00
vial 275,000.00
Dus, 4 blister @ 7 tablet 76,000.00
Dus, Botol @ 500ml 2,600,000.00
Dus, Botol @ 100 tablet 25,300.00
Dus, 10 vial @ 500mg 112,000.00
Dus, 100 ampul @ 1 ml 1,580.00
Dus, 10 Strip@10 Tablet 62
Dus, 1 Blister @ 28 tablet 70,000.00
Kotak, tube @ 15 gram 9,983.00
Btl 100 45
Dus @ 30 Ampul 1,050.00
Box 10 X 10 Tab 97
10 vial @ 50mg 127,667.00
Vial 5 mL 46,667.00
3 blister @ 10 kapsul 3,667.00
3 blister @ 10 kapsul 4,015.00
Btl 100 tablet 104
botol 15 ml 37,500.00
ampul @ 5 ml 26,700.00
Dus, 5 blister @10's tab 3,480.00
Dus, 5 blister @10's tab 5,480.00
Dus, 1 vial @ 10 mg 55,500.00
Dus, 1 vial @ 50 mg 258,000.00
btl @ 60 ml 3,333.00
dus 10 X 10'S 167
Dus, botol @ 10 ml 15,600.00
ampul @ 5 ml 9,840.00
Dus, 1 vial @0,5 ml+ 1 vial pelarut @1,5 ml 970,200.00
Dus @ 5 vial 455,000.00
Dus, Botol Plastik @ 30 Tablet 7,100.00
Botol 30 tab 6,375.00
dus, 2 prefilled syringe @ 0,2 ml 40,740.00
Dus @ 30 Ampul 8,100.00
Vial @ 25 ml 500,000.00
Dus, 1 vial @5 ml 128,000.00
Dus 3 strip @ 10 Flash tablet 650
Dus, Botol Plastik @ 100 mL 8,000.00
ktk 10 x 10 kapsul 497
Page 33 of 45
Dus, 10 blister @ 10 kss 3434 930
Botol @60 ml 7,700.00
Prefilled Syringe @ 1ml 128,000.00
Boks, 6 ampul 139,500.00
Dus, 10 strip @ 10 tss 451
btl @ 100 ml 2,500.00
Dus, botol @ 100 tablet 1,360.00
Dus, 1 blister @ 1 subdermal implant 128,779.00
Vial 100mg/5ml 100,000.00
Botol 10 ml 16,667.00
KOTAK @ 1 VIAL SERBUK OBAT & INFUSION KIT 9,200,000.00
KOTAK @ 10 ampul 20,250.00
Botol @ 100 133
KOTAK @ 10 ampul 20,250.00
Dus @ 30 Ampul 1,800.00
Dus, 3 strip @ 10 kapsul 1,075.00
Dus, 3 strip @ 10 kapsul 1,375.00
Dus @ 10 X 10 's 290
Dus 45 x 12 tab 235
Dus @ 10 X 10 's 510
Box, canister 10mL 72,900.00
Dus, Canister 200 dosis 117,500.00
Dus 5 ampul@ 10ml 128,000.00
Dus 5 ampul@ 2ml 33,914.00
Dus @ 5 patch 80,000.00
Dus@ 5 patch 153,000.00
Dus@ 5 patch 285,000.00
pfs @ 0,5 ml 375,000.00
Dus @ 10 X 10 's 630
dus @ 30 ampul 3,417.00
Dus, 5 vial @ 50 mg 1,248,319.00
Dus, 4 blister @ 5 tablet salut selaput 275,000.00
Dus, 5 ampul @ 1ml 55,000.00
Dus, 1 Botol @ 100 mL 47,550.00
ktk 1 x 10 kapsul 22,000.00
strip 419
DUS, 30 TABLET 432
vial @ 1 ml 24,500.00
vial @ 10 ml 33,000.00
Dus, Tube 5 g 2,400.00
Dus, Botol 120 Dosis Spay 93,333.00
Dus, 2 flow wrap@ 5 nebules @ 1 dosis (2ml) 12,917.00
Dus, 2 pfs 0.5 ml 241,667.00
dus, vial @ 250 ml 972,000.00
Dus, 25 ampul @ 2 ml 1,829.00
Page 34 of 45
Dus, 10 strip @ 10 tablet 3535 85
Prefilled Syringe 275,000.00
Prefilled Syringe 412,500.00
Prefilled Syringe 2,570,000.00
Boks, 1 ampul 399,500.00
Dus @ 100 Sachet 288

Dus, 10 blister @ 12 kapsul 289
Dus, 10 blister @ 10 kaptab 679
vial 1,098,900.00
Dus, 1 vial @200 mg 330,000.00
Dus, 5 ampul @ 2 ml 3,399.00
Tube @ 3,5 gr 2,600.00
Dus, botol plastik 5 ml 3,194.00
Dus, 10 blister @ 10 kaptab 56
DUS, 100 TABLET 236
Dus, 6 strip @ 10 tablet lepas lambat 638
ktk 5x10 tablet 265
ktk 5x10 tablet 436
ktk 5x10 tablet 404
ktk 5x10 tablet 430
Dus 10x10 1,493.00
Dus 10x10 2,171.00
Btl @ 30 tablet 1,500.00
Glycerin 100 ml 5,333.00
botol @ 500 ml 5,700.00
botol @ 500 ml 5,200.00
Dus, 1 syringe @ 10.8 mg 2,300,000.00
Dus, 1 syringe @ 3.6 mg 840,000.00
Dus @ 10 X 10 's 209
Dus 5 Ampul@1mL 83,333.00
KOTAK @ 10 x 10 TAB 126
Botol 641,500.00
vial 42,900.00
Dus, 1 syringe @ 0.5 mL 1,328,000.00
Tube 5 gr 2,798.00
box 5ampul @1 ml 4,500.00
Dus, vial 10 ml 138,000.00
Dus, vial 10 ml 138,000.00
Dus, 1 Vial @ 5 ml 72,000.00
Page 35 of 45
Injeksi 100 IU/ml, penfill disposible 3 ml (1 box 3636
76,125.00
isi 5 penfill disposible)
penfillcartridge @ 3ml 75,000.00
Dus Isi 5 penfill/cartridge @ 3ml 76,125.00
Injeksi 100 IU/ml, penfill disposible 3 ml (1 box

76,125.00
Dus, vial 10 ml 138,000.00
Dus, vial 10 ml 138,000.00
Injeksi 100 IU/ml, penfill disposible 3 ml (1 box

76,125.00
penfill cartridge @ 3ml 75,000.00
Dus, vial 10 ml 138,000.00
Dus, vial 10 ml 138,000.00
Dus, 1 Vial @ 5 ml 72,000.00
Prefilled syringe 170,000.00

Dus, botol 60 ml 3,499.00
botol @ 100 tablet 110
dus 10 X 10'S 150
Dus, 1 vial @ 1 g 1,329,163.00
3 blister @ 10 tablet 3,908.00
3 blister @ 10 tablet 2,120.00
Dus, botol @ 100 ml 350,000.00
Dus, vial @ 30 ml 122,000.00
Dus, vial @ 50 ml 166,000.00
Dus, botol @ 100 ml 369,000.00
Dus, vial @ 30 ml 147,000.00
Dus, vial @ 50 ml 199,000.00
Botol 245,000.00
Botol 123,200.00
Botol 299,000.00
Botol 150,300.00
Box, canister 10mL 80,000.00
Dus, 5 blister @ 10 kss 1,425.00
Dus, 5 blister @ 10 kss 2,470.00
Dus, 1 vial @2 ml 510,000.00
vial 33,000.00
Page 36 of 45
Dus, 10 strip @ 10 tablet 3737 88
Strip 700
Vial 50 mg/5 ml 82,000.00
Ampul 7,800.00
Boks, 120 tablet 27,500.00
Dus, 10 strip @10 tablet 84
Dus, botol @ 120 ml 44,770.00
Dus,botol 100 tablet 875
Fenol 100 mg / 1 ml 2,042.00
vial @ 15 ml 190,000.00
vial @ 45 ml 408,000.00
Vial @ 10 ml 110,000.00
Box isi 1 Tube @ 15 g 4,700.00
tube 10 gr 2,569.00
dus 2 's @ 10 supp 2,722.00
Dus @ 12 Ampul 2,300.00
Dus, 3 Strip @ 10 Kaplet salut selaput 3,200.00
Box, 10 ampoules @ 1mL 30,600.00
Ktk 10X10 TAB 184
Dus, 3 strip @ 10 tab 3,400.00
Tube 5 gr 1,600.00
Botol @ 60 ml 3,680.00
Dus @ 30 Ampul 1,100.00
Dus @ 30 Ampul 1,050.00
KOTAK @ 5 x 10 TAB 5,000.00
KOTAK @ 5 x 10 TAB 1,550.00
ktk 10x10 tablet 1,100.00
Botol Plastik @ 500 ml 33,000.00
Botol @ 60 ml 12,450.00
Dus, 100 Sachet @ 30 Tablet 42
botol 15 ml 15,750.00

Dus, botol plastik @ 30 tablet salut selaput 8,900.00
botol @ 120 tablet 6,100.00
Page 37 of 45
Dus, Botol 120 Dosis 3838 90,667.00
Dus, foil strip @ 60 dosis 100,833.00
Dus, foil strip @ 60 dosis 113,333.00
Botol, 60 ml 2,167.00
ktk 60 tablet 670

ktk 100 amp @ 2 ml 6,200.00
Botol 60 tablet 1,400.00
Serbuk vial 82,042.00
Dus, 2 strip @ 10 kapsul 473
botol 500 ml 56,300.00
Softbag 500 ML 56,300.00
Softbag 500 ML 37,500.00
Double Chamber Softbag 1000 ML 115,500.00
Double Chamber Softbag 500 ML 61,600.00
botol 500 mL 75,350.00
Botol Gelas 100 ml 36,667.00
Softbag 200 ML 46,000.00
Softbag 500 ML 65,000.00
botol 250 ml 51,260.00
botol 500 ml 64,900.00
botol 500 mL 42,000.00
botol 250 mL 46,000.00
Page 38 of 45
3939
Bag (3 Chamber) 1440 ml 295,240.00
Bag (3 Chamber) 1920 ml 343,842.00
Bag Double chamber (Dua compartement),

322,000.00
1000 mL
Bag Double chamber (Dua compartement),
218,700.00
1000 mL
Ampoel 25 ML 2,050.00
Botol 1000 ml 8,000.00
Plastic Bottle 500 ML 9,000.00
flexybag 250 mL 87,000.00
LDPE (Low Density Poly Ethilene), botol plastik 12,650.00
botol 500 mL 50,500.00
Flexy bag 500 mL 42,350.00
botol 500 mL 37,500.00
Botol Plastik 1000 mL 210,000.00
Botol Plastik 1000 mL 199,000.00
botol 500 mL 56,000.00
Botol 500 ml 9,500.00
Botol 500 ml 6,800.00
Botol 500 ml 6,917.00
Botol 500 ml 7,700.00
Botol 500 ml 7,700.00
Page 39 of 45
4040
softbag 500ml 35,750.00
Botol 500 ml 6,930.00
20%, Botol Kaca @100 ml, single bottle 105,500.00
20%, Botol Kaca @250 ml, single bottle 210,000.00
Bag, 3 chamber ( 3 kompartemen), 1250 ml 591,000.00
Flexy bag 100 mL 89,800.00
strip 5 x 0.6 ml 72,000.00

dus, Botol @ 2,5 ml 127,000.00
Dus, 1 vial @ 263 mcg + 1 prefilled syringe
550,000.00
pelarut @ 1 ml
Vial 700,000.00
Vial 2,700,000.00
Box, 1 Botol @ 100 ml 40,000.00
Dus, 100 ampul @ 2 ml 839
Dus, 30 ampul @ 2 ml 1,363.00
Dus, 10 syringe @ 10 g 40,000.00
Box ,3 Strip @ 10 tablet 600
KOTAK @ 10 x 10 TAB 1,050.00
KOTAK @ 10 x 10 TAB 1,850.00
Dus, 10 Strip @ 10 Tablet 89
KOTAK @ 10 x 10 TAB 1,341.00
ampul 52,000.00
botol 500 ml 62,000.00
Strip 1,200.00
KOTAK @ 5 x 10 TAB 3,276.00
Dus @ 5 vial 473,000.00
Dus,24 Catch @ 1 tablet 7,140.00
Box, Tablet 2 mg/25's 12,210.00
Page 40 of 45
Dus, 1 vial @ 1 g 4141 54,000.00
Dus, 1 vial @ 0,5 g 44,960.00
Dus, 15 Ampul 74,998.00
Botol 1000 ml 254,100.00
Dus, 10 blister @ 10 tablet 112.5
ktk 10 x 10 tablet salut 154
Dus, botol plastik @ 30 kapsul pelepasan
6,537.00
lambat
Dus, 1 Vial @125mg + 1 ampul pelarut @ 2ml 19,200.00
Dus, 1 vial @ 500 mg 89,990.00
Strip 635
Dus, 10 Blister @ 10 Tablet 205
Dus, 10 Blister @ 10 tablet 300
Dus, 1 Botol @ 100 ml 9,950.00
Dus, 2 blister @ 5 suppositoria 3,220.00
10 strip @ 10 tab 110
10 strip @ 10 tab 160
Dus @ 5 vial 1,237,500.00
Box isi 5 ampul 6,000.00
Boks 5 amp 12,060.00
Dus,1 vial@50mg 260,000.00
Boks, 50 tablet 16,000.00
Tube 10 gram 3,000.00
10 mg /Vial 697,000.00
botol, tetes mata 3 ml 77,000.00
tube 10 gram 17,820.00
Dus 10 amp @ 1 ml 8,400.00
Ktk 10 ampul @ 1ML 10,499.00
Botol 500 ml 4,700.00
Dus, 5 blister @ 2 pfs 0.3 ml 54,144.00
Dus, 5 Ampul @ 2ml 61,600.00
Ampoel 25 ML 6,200.00
Dus @ 5 X 10 's 176
Dus @ 5 X 10 's 133
Botol, 45 ml 33,900.00
Tube 5 gr 6,490.00
Box, isi 5 ampul @ 1 ml 9,500.00
btl 60 tablet 2,800.00
blister 2,999.00
blister 3,500.00
Dus, 10 Strip @ 10 tablet salut selaput 110
Dus @ 10 X 10 's 640
Dus @ 10 X 10 's 480
Page 41 of 45
Dus 5 amp @ 8 ml 4242 53,900.00
blister 2,618.00
Paket 359,990.00
Paket 1,199,990.00
Paket 214,900.00
Dus, 31 blister
dus @ 60@ 28 kss @ 8 tablet tahap
blister 160,000.00
Dus,
intensif kategori 1 + 1intensif
60 sachet tahap Dus @ @54(1 tablet@ 3
blister 288,199.00
Isoniazid, 2 kapsul Rifampicin,
tablet tahap lanjutan kategori 1 2 tablet
171,195.00
Pyrazinamide) + 120 sachet tahap lanjutan @
Box ,5 Strip
(1 tablet @ 10 tablet
Isoniazid, 2 kapsul Rifampicin) 400
Dus, 1 vial @ 20 ml 1,100,000.00
Dus, 1 vial @ 10 ml 550,000.00
botol @ 10 ml 27,550.00
Dus, vial @ 355m + 1 prefilled syringe pelarut
2,950,000.00
@ 2,5 ml + 2 jarum suntik
Vial 120,000.00
3 X 10 fcc 6,450.00
3 X 10 fcc 11,200.00
botol, tetes mata 5 ml 68,000.00
Dus, 1 Vial @ 40 mg 36,000.00
dus 10 X 3'S 211
Dus, 5 Ampul @ 2ml 2,400.00
Box 3 X 10 Tab 716
Box 3 X 10 Tab 1,189.00
Transfer Set: Set; Ultaclam: Kantong Plastik;
Tenckoff Catheter: Box; Titanium Adaptor: 1,902,240.00
Kantong Plastik
Set 219,540.00
Larutan Dialisa 1.5 %: 2.000 ml; Larutan Dialisa
2.5 %: 2.000 ml; Larutan Dialisa 4.25 %: 2.000 5,522,580.00
ml; Minicap: Kantong Plastik
Vial 6mg/ml (100mg/16.67ml) 984,000.00
Vial 6mg/ml (260mg/43.33ml) 3,000,000.00
Vial 6mg/ml (30mg/5ml) 274,560.00
Dus, 15 botol 5,200.00
botol 60 ml 1,438.00
Dus, 10 Strip@10 Kaplet Salut Selaput 79
botol @ 15 ml 6,730.00
Boks, 1 pfs 1,077,815.00
Boks, 1 pfs 1,248,220.00
Dus, 1 vial 100 mcg + 1 ampul pelarut 0,7 ml +
973,500.00
1 syringe + 2 jarum
Dus, 1 prefilled syringe (serbuk injeksi 120mcg
1,135,000.00
+ pelarut 0.5 ml) + 1 jarum
915,000.00
1 syringe + 2 jarum
915,810.00
1 syringe + 2 jarum
tube @ 35 gram 23,000.00
Dus, botol plastik @ 30 tablet salut selaput 2,420.00
Page 42 of 45
Tube @ 10 g 4343 11,475.00
Ktk 10 ampx2ml 14,500.00
30 TAB/BOX 3,120.00
30 TAB/BOX 4,525.00
Botol 60 ml 8,360.00
Dus, 25 Blister @ 4 tablet 298
Dus 10 strip @ 10 tablet 208
Dus, Botol @ 10ml 17,393.00
botol @ 1000 ml 37,109.00
botol @ 30 ml 2,163.00
botol @ 300 ml 14,203.00
Dus, 3 alu blister @ 10 tablet 7,200.00
Dus, 3 alu blister @ 10 tablet 11,268.00
Box ,5 Strip @ 10 tablet 2,300.00
Ampul 15,642.00
Dus, 10 Strip @ 10 kaptab 580
Dus, 10 Ampul @ 2 ml 1,140.00
Dus, 10 Strip @ 10 tablet salut selaput 120
Botol 50 kapsul lunak 260
Botol 50 Kapsul 459
botol 500 ml 5,200.00
KOTAK @ 5 x 10 TAB 1,008.00
Blister 23,500.00
Blister 23,500.00
Blister 23,500.00
Dus, 7 blister @ 4 Tablet lepas Lambat 5,248.00
Dus, botol 200 dosis 63,750.00
Dus, 10 Blister @ 10 Kapsul 431
Dus, 1 Rotahaler 5,867.00
strip @ 10 tablet 59
Pot @ 30 gram 2,000.00

strip 513
Dus, 5 Strip @ 10 Kapsul 1,000.00
Page 43 of 45
Dus, 2 Vial @ 1 gram 4444 16,500.00
Box 2 Vial @ 1000mg 48,060.00
Dus, 2 vial @ 1 g 12,775.00
vial 4,800.00
Dus, 10 Vial @ 1 g 2,950.00
Dus, 2 Vial @ 1 gram 16,000.00
Dus, 10 Vial @ 1 g 3,300.00
Dus, 1 Blister @ 10 Tablet salut selaput 7,200.00
strip @ 10 tab 3,300.00
Box, 10 strips @ 10 capsules 181
tabung/botol 1,320,000.00
100 ampul @ 1 ml 1,078.00
vial 256,000.00
vial 82,000.00
Dus, 10 blister @ 5 kapsul lunak 43,000.00
Dus, 3 Strip @ 10 Kaplet salut selaput 169
Dus, 3 Strip @ 10 Kaplet salut selaput 391
Vial 200 ml 13,000.00
Dus, 10 blister @ 10 tab ss 255
vial 22,000.00
vial 93,000.00
dus, 1 vial @ 10 ml 575,000.00
Vial 3,290,000.00
Dus @ 56 Vial 3,650.00
dus 5 amp @ dus 10 127,000.00
Botol, 100 ml 13,425.00
Pounch @ 5 blister @ 10 capsule 11,167.00
Dus, 1 pouch @5 blister@10 kaps 21,500.00
Box @ 2 blister @ 14 tablet 5,800.00
Box/ 2 blister @ 14 tablet 5,800.00
Box/ 3 blister @ 10 Tablet 6,800.00
Dus, 2 alu-blister @10 tablet 3,900.00
Box, 2 blisters @10 tablets 6,500.00
Dus, 5 sachet @ 1 kapsul 1,120,000.00
Dus, 5 sachet @ 1 kapsul 223,000.00
Botol 30 tab 8,100.00
Dus, 2 pak @ 5 respules 6,250.00
Box 50's 99
Page 44 of 45
botol 5 ml 4545 11,500.00
Dus, Botol Plastik @ 5ml 9,128.00
Dus, Botol Plastik @ 5ml 9,722.00
Dus, 1 blister @10 kapsul + handihaler 152,543.00
Dus, 10 Ampul @ 2 ml 2,395.00
botol, tetes mata 2,5 ml 115,000.00
Dus, botol plastik 120 dosis 90,000.00
strip 405
tube 6,400.00
1 vial of 10ml (10 d's) 285,000.00
Boks, 60 tablet 170,000.00
Botol 120 ml 40,000.00
Tablet 2,793.00
Tablet 5,450.00
Tablet 6,200.00
Ktk 10X10 TAB 234
Vial 10mg/10ml 210,000.00
vial @ 2 ml 78,000.00
vial @ 1 ml 46,000.00
Dus, 1 vial @ 1 ml 1,229,998.00
Dus 10 strip x 10 tab 107
Drops 10 mg/ml, Botol @15 ml 12,840.00
Dus, 10 strip @ 10 tablet dispersible 474
Page 45 of 45

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11

Human insulin intermediate acting inj 100 UI/ml, vial (Insulin

Human insulin short acting inj 100 UI/ml, vial/cartridge

300 Kombinasi: Artemether 20 mg; Lumefantrin 120 mg

308 Kuinin (Kina) tablet 200 mg

Larutan mengandung Asam Amino (Asam Amino 27 g, Sorbitol 50

Larutan mengandung Asam Amino (Asam Amino 30 g, Glukosa 7,3

Larutan mengandung Asam Amino (Kombinasi Asam amino 50 g/L,

Larutan mengandung Asam Amino (Kombinasi Glukosa dan

Larutan mengandung Elektrolit (Sodium Lactate sol (50%) 113 gr/L,

Larutan mengandung Elektrolit (Tiap 1000 ml mengandung

Larutan mengandung Karbohidrat (Fructose 60 g, glucose 33 g,

342 Larutan mengandung Karbohidrat (Maltose 100 gr)

Larutan mengandung Karbohidrat + Elektrolit (Asam amino 28

Larutan mengandung Karbohidrat + Elektrolit (Asam amino 28

Larutan mengandung Karbohidrat + Elektrolit (Fructose 60 g,

Larutan mengandung Karbohidrat + Elektrolit (Glukosa 25 g, NaCl

Larutan mengandung Karbohidrat + Elektrolit (Glukosa 55 g ;

Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 25,0 g;

Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g;

Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g;

Larutan mengandung Karbohidrat + Elektrolit (NaCl 1.75 g, KCL

Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5

Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na

Larutan mengandung Lipid ( Infus Lipid Emulsi MCT/LCT 20% 100

359 Larutan mengandung Lipid (Emulsi lemak 20%)

361 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 180

362 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 80 gr

363 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 90 gr

461 Paket CAPD Pergantian Transfer Set per 6 bulan

Pegylated Interferon alfa-2b serb inj 120 mcg

Pegylated Interferon alfa-2b serb inj 50 mcg

Pegylated Interferon alfa-2b serb inj 80 mcg

520 Sefadroksil sirup kering 125 mg/5ml

Nama Dagang Nama Penyedia

n/a PT. Kimia Farma

Hepsera PT. SmithKline Beecham

Novomix Flexpen PT. Ferron Par

Humalog Mix 25 PT. Tempo Scan Pacific

Novorapid Flexpen PT. Ferron Par

Novorapid Vial PT. Ferron Par

Apidra Solostar 100IU/ml 5pens

Humalog PT. Tempo Scan Pacific

n/a PT. Erela

n/a PT. Indofarma

n/a PT. Kimia Farma

n/a PT. Kimia Farma

Levopar Tablet PT. Meprofarm

Artem PT. Kimia Farma

n/a PT. Phapros, Tbk

Iressa 250 mg PT. AstraZeneca indonesia

Insulatard Vial PT. Ferron Par

Humulin N Vial PT. Bayer Indonesia

n/a PT. Aventis Pharma

Sansulin N PT. Sanbe Farma

Humulin N Cart PT. Bayer Indonesia

Mixtard Penfill PT. Ferron Par

Humulin 30/70 Cart PT. Bayer Indonesia

Mixtard Vial PT. Ferron Par

Humulin 30/70 Vial PT. Bayer Indonesia

Actrapid Penfill PT. Ferron Par

Humulin R Cart PT. Bayer Indonesia

Sansulin R PT. Sanbe Farma