Katalog Obat

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8 SEPT 2014| 06.00 |
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Nama Obat Generik

ACT (Artesunate tablet 50 mg + Amodiaquine anhydrida tablet 200
mg)
Adefovir Dipivoksil tablet/kaplet 10 mg
Albendazol suspensi 200 mg/5 ml
Albendazol tablet/kapsul/kaplet 400 mg
Albumin serum normal (human albumin) injeksi 20%, 100 ml
Albumin serum normal (human albumin) injeksi 20%, 50 ml
Alopurinol tablet/kapsul/kaplet 100 mg
Alopurinol tablet/kapsul/kaplet 300 mg
Alprazolam tablet/kapsul/kaplet 0,25 mg
Alprazolam tablet/kapsul/kaplet 0,5 mg
Alprazolam tablet/kapsul/kaplet 1 mg
Alteplase injeksi 50 mg/vial
Amfoterisin B salep mata 1%
Amikasin injeksi 250 mg/ml
Aminofilin injeksi 24 mg/ml
Aminofilin tablet scored 200 mg
Amiodaron injeksi 150 mg/3 ml
Amiodaron tablet/kaplet 200 mg
Amitriptilin tablet salut 25 mg (HCl)
Amlodipin tablet 10 mg
Amlodipin tablet 5 mg
Amoksisilin kapsul/kaplet 250 mg
Amoksisilin kapsul/kaplet/tablet scored 500 mg
Amoksisilin sirup kering forte 250 mg/5 ml
Amoksisilin sirup kering 125 mg/ 5 ml
Ampisilin serbuk injeksi i.v. 1000 mg/vial
Analog insulin long acting inj 100 UI/ml, vial/cartridge
disposible/penfill cartridge (Insulin glargine 100 IU/ml)
Analog insulin mix acting inj 100 UI/ml, Analog insulin mix acting
inj 100 UI/ml (Premix 30% Insulin Aspart + 70% Protaminated
Insulin Aspart (Analogue))
Analog insulin mix insulininj 100 UI/ml, vial/cartridge
disposible/penfill
cartridge
insulin
75% insulin lispro
Analog
insulin rapid
acting (25%
inj 100
UI/ml,lispro,
vial/cartridge
protamine
suspension,
(rDNA))
disposible/penfill cartridge (Insulin Aspart (Analogue))
Analog insulin rapid acting inj 100 UI/ml, vial/cartridge
disposible/penfill cartridge (Insulin Aspart (Analogue))
Analog insulin rapid actinginj 100 UI/ml, vial/cartridge
disposible/penfill cartridge (Insulin glulisine 100 IU/ml)
Analog insulin rapid actinginj 100 UI/ml, vial/cartridge
disposible/penfill cartridge (Insulin lispro (rDNA origin))
Anastrozol tablet/kapsul/kaplet 1 mg
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida
200 mg Magnesium Hidroksida 200 mg
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EKATALOG
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Antasida DOEN II suspensi, kombinasi : Aluminium
Hidroksida 200
mg/5 ml Magnesium Hidroksida 200 mg/5 ml
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Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g Polimiksin

10.000 IU/g
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Antimalaria DOEN kombinasi : Pirimetamin 25 mg Sulfadoksin 500

mg
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Antimigren: Ergotamin Tartrat 1 mg + Kofein 50 mg

Antiparkinson DOEN tablet kombinasi : Benserazid 25 mg
Levodopa 100 mg
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Artemether injeksi 80 mg/ml

Asam Asetilsalisilat (asetosal) tablet 100 mg
Asam Askorbat (Vitamin C) tablet 250 mg
Asam Askorbat (Vitamin C) tablet 50 mg
Asam Folat tablet/kapsul/kaplet 0,4 mg
Asam Folat tablet/kapsul/kaplet 1 mg
Asam Ibandronat injeksi 6mg/6ml
Asam Mefenamat kapsul/kaplet 500 mg
Asam pipemidat kapsul 400 mg
Asam traneksamat injeksi 100 mg/ml
Asam traneksamat injeksi 50 mg/ml
Asiklovir salep mata 3%
Asiklovir tablet/kapsul/kaplet 200 mg
Asiklovir tablet/kapsul/kaplet 400 mg
Asparaginase serbuk injeksi 10.000 UI/vial
Atapulgit tablet 600 mg
Atrakurium injeksi 25 mg/2,5 ml
Atropin Sulfat tablet 0,5 mg
Azitromisin sir kering 200 mg/ 5 mL
Azitromisin tablet 500 mg
Azitromisin tablet 250 mg
Bedak salisil serbuk 2%
Benzatin Benzil Penisilin 1,2 juta IU/ vial
Benzatin Benzil Penisilin 2,4 juta IU/vial
Beractant injeksi / suspensi 25 mg/mL
Beraprost sodium tablet 20 mcg
Beraprost sodium tablet 20 mcg
Betametason krim 0,1% (sebagai Valerat)
Bikalutamid tablet salut 150 mg
Bikalutamid tablet salut 50 mg
Bisakodil suppositoria 10 mg
Bisoprolol tablet 2,5 mg
Bisoprolol tablet 5 mg
Bleomisin serbuk injeksi 15 mg/ampul
Bromokriptin tablet 2,5 mg
Budesonid inhaler 200 mcg/puff, 100 dosis
Budesonid respules / cairan inhaler 0,25mg/mL
Budesonid-formoterol inhaler 160/4,5 mcg
Budesonid-formoterol inhaler 80/4,5 mcg
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Bupivakain injeksi 0,50% (HCl) + glukosa 8%
Bupivakain injeksi 0,50% (P.V)
Dabigatran eteksilat kapsul 75 mg
Dabigatran eteksilat kapsul 110 mg
Dakarbazin serbuk injeksi 200 mg/vial
Daunorubisin serbuk injeksi 20 mg/vial
Deferasiroks tablet disp/ eff 250 mg
Deferasiroks tablet disp/ eff 500 mg
Deferipron larutan oral 100 mg/mL
Deferipron tablet 500 mg
Deferoksamin Mesilat serbuk injeksi 500 mg
Deksametason injeksi i.v./i.m. 5 mg/ml
Deksametason tablet 0,5 mg
Desogestrel tablet 75 mcg
Desoksimetason krim 0,25%
Diazepam tablet 2 mg
Difenhidramin injeksi i.v./i.m. 10 mg/ml (HCl)
Digoksin tablet 0,25 mg
Diltiazem HCl tablet 30 mg
Diltiazem infus injeksi 50 mg
Diltiazem injeksi 25 mg/5 mL
Diltiazem Kapsul SR 100 mg
Diltiazem Kapsul SR 200 mg
Dimenhidrinat tablet 50 mg
Dinatrium edetat tetes mata 0,35%
Dobutamin injeksi 50 mg/mL
Doksazosin mesilat tablet 1 mg
Doksazosin mesilat tablet 2 mg
Doksorubisin serbuk injeksi i.v. 10 mg/vial
Doksorubisin serbuk injeksi i.v. 50 mg/vial
Domperidon suspensi/sirup 5 mg/5 ml
Domperidon tablet 10 mg
Domperidon tetes 5 mg/mL
Dopamin injeksi 40 mg/ml
Dosetaksel injeksi 20 mg/0,5 ml
DTPA (diethylene triamine pentaacetic acid) 2,06-2,5 mg pentetate
calcium
trisodium/mL
Dutasterid
kaps lunak 0,5 mg
Efavirens tablet salut 600 mg
Eksemestan tablet 25 mg
Enoksaparin sodium inj 20 mg/0,2 mL
Epinefrin (Adrenalin) injeksi i.v/s.k./i.m 1 mg/ml
Epirubisin serb injeksi 50 mg/25ml
Epirubisin serb injeksi 10 mg/5 ml
Ergokalsiferol (vitamin D3/D2) kapsul 50.000 UI
Ergokalsiferol (vitamin D3/D2) suspensi 10.000 UI/ml
Eritromisin kapsul/kaplet 250 mg
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Eritromisin kapsul/kaplet 500 mg
Eritromisin sirup kering 200 mg/ 5 ml
Eritropoetin-alfa inj 3000 UI/mL
Eritropoetin-beta inj 2000 UI/0,3 mL
Etambutol tablet 250 mg (HCl)
Etambutol tablet salut 500 mg (HCl)
Etanol 70% cairan
Etinilestradiol tablet 0,05 mg
Etonogestrel implan 68 mcg
Etoposid injeksi 20 mg/ml
Eugenol cairan
Everolimus tab 0,25 mg
Everolimus tab 0,5 mg
Faktor VIIa (rekombinan) serb inj 1 mg/vial + pelarut
Fenitoin injeksi 50 mg/ml
Fenitoin kapsul/kaplet 100 mg
Fenitoin Na Inj 100 mg/2 ml
Fenobarbital injeksi i.m./i.v. 50 mg/ml
Fenofibrat kaps 100 mg
Fenofibrat kaps 300 mg
Fenoksimetil penisilin (penisilin V) tablet 250 mg
Fenoksimetil penisilin (penisilin V) tab 125 mg
Fenoksimetil penisilin (penisilin V)tablet 500 mg
Fenoterol HBr ih 100 mcg/puff
Fenoterol HBr inh solution 0,1%
Fentanil injeksi i.m/i.v 0,05 mg/ml, ampul 10 ml
Fentanil injeksi i.m/i.v 0,05 mg/ml, ampul 2 ml
Fentanil patch 12,5 mcg/jam
Fentanil patch 25 mcg/jam
Fentanil patch 50 mcg/jam
Filgrastim inj 300 mcg/mL
Fitomenadion (Vit.K1) tablet salut gula 10 mg
Fitomenadion (Vitamin K1) injeksi i.m. 2 mg/ml
Fludarabin inj 50 mg
Fludarabin tab 10 mg
Flufenazin injeksi i.m. 25 mg/ml
Flukonazol injeksi 2 mg/ml
Flukonazol tablet/kapsul 150 mg
Fluoksetin tablet 10 mg
Fluoksetin tablet 20 mg
Fluorourasil inj 250 mg/mL
Fluorourasil inj 500 mg/ 5 mL
Flusinolon asetonid krim 0,025%
Flutikason furoat intranasal spray
Flutikason propionat nebules 0,5 mg
Fondaparinuks inj 2,5 mg/0,5 mL
Fraksi protein plasma lar inf 5%
Furosemid injeksi i.v./i.m. 10 mg/ml
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Furosemid tablet 40 mg
Gadobutrol macrocyclic 5 mg
Gadobutrol macrocyclic 7,5 mg
Gadoksetat disodium 0,25 mmol gadoxetate disodium/mL
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
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Gefitinib tab 250 mg

Gemfibrozil kapsul/kaplet 300 mg
Gemfibrozil tablet 600 mg
Gemsitabin inj 1000 mg/vial
Gemsitabin inj 200 mg/vial
Gentamisin injeksi 40 mg/ ml
Gentamisin salep mata 0,3%
Gentamisin tetes mata 0,3%
Glibenklamid tablet 5 mg
Gliklazid tab 80 mg
Gliklazid tab 30 mg
Glikuidon tab 30 mg
Glimepiride tablet 1 mg
Gliseril trinitrat kaps SR 2,5 mg
Gliseril trinitrat kaps SR 5 mg
Gliseril trinitrat tab sublingual 0,5 mg
Gliserin lar 50%
Glukosa larutan infus 10 % steril
Glukosa larutan infus 5 % steril
Goserelin asetat inj 10,8 mg/vial
Goserelin asetat inj 3,6 mg
Griseofulvin tablet 125 mg
Haloperidol inj 50 mg/mL
Haloperidol tablet 0,5 mg
Haloperidol tablet 5 mg
Haloperidol tablet 1,5 mg
Haloperidol tablet 2 mg
Halotan Inhalasi
Heparin injeksi i.v./s.k. 5000 UI/ml
Hepatitis B imunoglobulin (human)
Hidrokortison krim 2,5 %
Hiosin butilbromid injeksi 20 mg/ml
Human insulin intermediate acting inj 100 UI/ml, vial (Human
217 Insulin (Intermediate-Acting))
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Human insulin intermediate acting inj 100 UI/ml, vial (Insulin

human Basal)
Human insulin intermediate acting inj 100 UI/ml, vial/cartridge
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disposible/penfill cartridge
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Human insulin intermediate acting inj 100 UI/ml,penfill
cartridge
(Human Insulin (Intermediate-Acting))
Human insulin intermediate acting inj 100 UI/ml,penfill cartridge
(Insulin human Basal)
Human insulin intermediate acting inj 100 UI/ml,penfill cartridge
(Insulin human Basal)
Human insulin mix insulin inj 100 UI/ml, penfill cartridge (Human
Insulin (Premix: 30% Soluble + 70 % NPH Insulin))
Human insulin mix insulin inj 100 UI/ml, penfill cartridge (Insulin
human Comb)
Human insulin mix insulin inj 100 UI/ml, vial (Human Insulin
(Premix: 30% Soluble + 70 % NPH Insulin))
Human insulin mix insulin inj 100 UI/ml, vial (Insulin human Comb)
Human insulin short acting

Insulin (Short Acting))
228
human Rapd)
229
human Rapd)
230
Acting))
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inj 100 UI/ml, penfill cartridge (Human

inj 100 UI/ml, penfill cartridge (Insulin
inj 100 UI/ml, penfill cartridge (Insulin
inj 100 UI/ml, vial (Human Insulin (Short
inj 100 UI/ml, vial (Insulin human Rapd)
Human insulin short acting inj 100 UI/ml, vial/cartridge

disposible/penfill cartridge
Human tetanus imunoglobulinn injeksi i.m. 250 UI
Ibuprofen sirup 100 mg/5 ml
Ibuprofen suspensi 200 mg/5 ml
Ibuprofen tablet 200 mg
Ibuprofen tablet 400 mg
Ifosfamid serbuk injeksi 1000 mg/vial
Imidapril tab 10 mg
Imidapril tab 5 mg
Iopamidol 200-300 mg Iodium/mL (300mg @ vial 100ml)
Iopromide 300-370 mg Iodium/mL (300 mg / 100 ml)
Ipratropium bromida inhalasi 20 mcg/semprot
Irbesartan tab 150 mg
Irbesartan tab 300 mg
Irinotekan inf 20 mg/ml
Isosorbid Dinitrat injeksi i.v 10 mg/10 ml
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Isosorbid Dinitrat tablet sublingual 5 mg
Kalium aspartat tab 300 mg
Kalium Klorida tablet 600 mg
Kalsium Folinat (Leukovorin Ca) inj 50 mg/ml
Kalsium Glukonat injeksi i.v 10% (100 mg/ml)
Kandesartan tab 16 mg
Kandesartan tab 8 mg
Kapesitabin tab 500 mg
Kaptopril tablet 50 mg
Kaptopril tablet scored 25 mg
Kaptopril tablet scored12,5 mg
Karbamazepin sirup 100 mg/5 ml
Karbamazepin tablet 200 mg
Karbimazol tab 5 mg
Karbogliserin tetes telinga 10%
Karboplatin 150 mg / 15 ml
Karboplatin 450 mg / 45 ml
Ketamin injeksi i.v. 100 mg/ml
Ketokonazol krim 2%
Ketokonazol krim 2%
Ketokonazol tablet 200 mg
Ketoprofen supositoria 100 mg
Ketorolac injeksi 30 mg/ml
Klaritromisin tab 500 mg
Klindamisin kapsul/kaplet 150 mg
Klindamisin kapsul/kaplet 300 mg
Klobazam tab 10 mg
Klonidin injeksi i.v 0,15 mg/ml (HCL) (150)
Klonidin tablet 0,15 mg
Klopidogrel tab 75 mg
Kloramfenikol kapsul/kaplet 250 mg
Kloramfenikol salep mata 1 %
Kloramfenikol suspensi 125 mg/ 5 ml
Klorpromazin injeksi i.m. 25 mg/ml (HCl)
Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl)
Klozapin 100 mg
Klozapin 25 mg
Kodein tablet 10 mg
Kodein tablet 15 mg
Kodein tablet 20 mg
Koloid HES BM 130 000 lar inf 6%
Kombinasi suspensi : Parafin + gliserin + fenolftalein
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
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Kombinasi: Artemether 20 mg; Lumefantrin 120 mg

Kombinasi: Levodopa 100 mg; Karbidopa 25 mg; Entekapon 200
mg
Kombinasi: Lopinavir 200 mg; Ritonavir (LPV/r) 50 mg
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303 Kombinasi: Salmeterol 25 mcg; Flutikason propionat
50 mcg
304 Kombinasi: Salmeterol 50 mcg; Flutikason propionat 100 mcg
305 Kombinasi: Salmeterol 50 mcg; Flutikason propionat 250 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
Kuinin (Kina) tablet 200 mg
Kuinin injeksi i.v. 25% (sebagai 2 HCl)
Kuinin tablet 222 mg (H2SO4.7H2O)
Lamivudine tablet 150 mg
Lansoprazol inj 30 mg/ml
Lanzoprazol kapsul/kaplet 30 mg
Lapatinib tab 250 mg
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)
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315
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
% 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)
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321
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325
Larutan mengandung Asam Amino (Asam Amino 6%, mengandung

Taurine 0,24 gr/l)
Larutan mengandung Asam Amino (Asam Amino 7%, Komposisi:
Asam Amino esensial: Asam Amino non esensial = 60 : 40)
Larutan mengandung Asam Amino (Asam Amino 72.05 g, Total N
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
12.2 g, Na+ 14 mEq, Cl 94 mEq)
Larutan mengandung Asam Amino (Asam amino 8%)
Larutan mengandung Asam Amino (Asam Amino esensial 7%

+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)
326
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)
329
Larutan mengandung Asam Amino (Kombinasi Asam amino 50 g/L,

vitamin dan elektrolit)
Page 8 of 45
99 Asam Amino: 34gr,

Larutan mengandung Asam Amino (Kombinasi
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
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
28 mEq) Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
Larutan
mengandung
337
333
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
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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
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418
419
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421
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423
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425
426
427
428
429
430
431
432
433
434
435
436
1111
Meropenem inj 1 g
Meropenem serb inj 500 mg/vial
Mesna inj 100 mg/mL
Metadon sir 50mg/5ml
Metformin HCl tablet 500 mg
Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg
Metilfenidat kapsul LA 20 mg
Metilprednisolon inj 125 mg/2 mL
Metilprednisolon inj 500 mg/8 mL
Metilprednisolon tablet 16 mg
Metoklopramide tablet 5 mg
Metronidazol infus 500 mg/100 ml
Metronidazol supositoria 500 mg
Metronidazol tablet 250 mg
Metronidazol tablet 500 mg
MIBI (metoxy iso butyl iso nitril) 5-mL reaction vial
Midazolam injeksi i.v. 1 mg/ml
Midazolam injeksi i.v. 5 mg/ml
Mikafungin Na serb inj 50 mg
Mikofenolat Mofetil 500 mg
Mikonazol krim/salep 2 % (Nitrat)
Mitomisin C (crystallin) serbuk inj 10 mg/vial
Moksifloksasin tetes mata 0,5%
Mometason furoat krim 0,1%
Morfin HCL inj 10 mg/ml
Morfin HCL tablet SR 10 mg
Morfin HCL tablet SR 15 mg
Morfin injeksi i.m./s.k./i.v. 10 mg/ml
Morfin tablet 10 mg
Nacl 0,9%
Nadroparin inj 9500 Axa/mL syringe 0,3 mL
Nadroparin inj 9500 Axa/mL, syringe 0,4 mL
Nadroparin inj 9500 Axa/mL, syringe 0,6 mL
Nalokson injeksi 0,4 mg/ml
Natrium Bikarbonat injeksi i.v 8,4%
Natrium Diklofenak tablet 50 mg
Natrium Diklofenak tablet 25 mg
Natrium fosfat lar oral 45 mL
Natrium fusidat salep 20 mg/g
Neostigmin injeksi 0,5 mg/ml
Nevirapin tablet 200 mg
Nifedipin tab 20 mg, slow release; oros
Nifedipin tab 30 mg, oros
Nifedipin tablet/kapsul 10 mg
Nistatin tablet salut 500.000 IU/ g
Nistatin vaginal tablet 100.000 IU/ g
Page 11 of 45
1212
Norepinefrin injeksi 1 mg/ml
Noretisteron tablet 5 mg
Obat Antituberkulosis FDC Kategori 1
Obat Antituberkulosis FDC Kategori 2
Obat Antituberkulosis FDC Kategori Anak
Obat Antituberkulosis FDC Sisipan
Obat Antituberkulosis Kategori 1 dewasa
Obat Antituberkulosis Kategori anak
Ofloxacin tablet 200 mg
Ofloxacin tablet 400 mg
Oksaliplatin serbuk injeksi 100 mg / vial
Oksaliplatin serbuk injeksi 50 mg / vial
Oksimetazolin tetes hidung 0,025%
Oktreotid 10 mg
Olanzapin inj 10 mg/vial
Olanzapin kapl salut 5 mg
Olanzapin tab 10 mg
Olopatadin tts mata 0,1%
Omeprazol injeksi 40 mg/ 10 ml
Omeprazol kapsul/kaplet 20 mg
ondansetron inj 4 mg/ 2 mL
Ondansetron tab 4 mg
Ondansetron tablet 8 mg
Paket CAPD Awal (Komposisi: 1 unit Transfer Set, 2 unit Ultaclam, 1
460 unit Tenckoff Catheter, Titanium Adaptor)
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
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
464
465
466
467
468
469
470
471
472
473
474
475
Paklitaksel inj 100 mg/vial

Paklitaksel inj 300 mg/vial
Paklitaksel injeksi 30 mg/vial
Parasetamol drop 100 mg/ml btl @15ml (60mg/0,6ml)
Parasetamol sirup 120 mg / 5 ml
Parasetamol tablet 500 mg
Parasetamol tetes 60 mg/0,6 mL
Pegylated interferon alfa-2a inj 135 mcg/0,5 ml
Pegylated interferon alfa-2a inj 180 mcg/0,5 ml
Pegylated Interferon alfa-2b serb inj 100 mcg
476 Perak sulfadiazin krim 1%

477 Perindoprilarginin tab 5 mg
Page 12 of 45
478
479
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
1313
Permetrin krim 5%
Petidin injeksi i.m/s.k/i.v lambat 50 mg/ml (HCl)
Pioglitazon tab 15 mg
Pioglitazon tab 30 mg
Pirantel suspensi 125 mg/5 ml
Pirantel tablet score (base) 125 mg
Pirazinamid tablet 500 mg
Polikresulen cairan
Povidon Iodida larutan 10% 1000 ml
Pramipeksol tab ER 0,375 mg
Pramipeksol tab ER 0,750 mg
Pravastatin tablet 20 mg
Propanolol tablet 10 mg ( HCl )
Propofol injeksi i.v., bolus 1%
Propranolol tablet 40 mg (HCl)
Quetiapin tab 200 mg
Ramipril tablet 2,5 mg
Ramipril tablet 5 mg
Ranitidin injeksi 25 mg/ml
Ranitidin tablet 150 mg
Retinol (Vitamin A) 100.000 IU
Retinol (Vitamin A) 200.000 IU kapsul lunak
Ringer Laktat larutan infus
Risperidon tablet 1 mg
Rivaroksaban tab 10 mg
Ropinirol Tablet Salut 2 mg
Salbutamol inhalasi/aerosol 100 mcg/dosis
Salbutamol serb inh 200 mcg/kaps
Salbutamol serb inh 200 mcg/kaps + rotahaler
Salbutamol tablet 2 mg (sebagai Sulfat)
Salbutamol tablet 4 mg (sebagai Sulfat)
Salep 2-4 , Kombinasi : Asam Salisilat 2% + Belerang endap 4%
Sefadroksil sirup kering 125 mg/5ml
Sefadroksil kapsul/kaplet 250 mg
Sefadroksil kapsul/kaplet 500 mg
Sefadroksil sir kering 250 mg/5 mL
Sefaleksin kapsul/kaplet 500 mg
Page 13 of 45
525
526
527
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
1414
Sefazolin serbuk injeksi 1 g/vial
Sefepim inj 1 g
Sefiksim kapsul/kaplet 100 mg
Sefiksim sirup kering 100 mg/ 5 ml
Sefoperazon inj 1 g
Sefotaksim injeksi 0,5 g
Sefotaksim injeksi 1 g
Sefpodoksim proksetil tab 100 mg
Seftazidim injeksi 1 g
Seftriakson serbuk injeksi 1 g/vial
Sefuroksim tab 500 mg
Sertralin tab 50 mg
Setirizin tablet 10 mg
Sevofluran ih, btl
Sianokobalamin (vitamin B12) injeksi 500 mcg
Siklofosfamid serbuk injeksi i.v. 1000 mg
Siklofosfamid serbuk injeksi i.v. 200 mg
Siklosporin kaps 100 mg
Siklosporin kapsul lunak 25 mg
Simvastatin scored tablet 10 mg
Simvastatin tablet 20 mg
Siprofloksasin infus 2%
Siprofloksasin tablet 500 mg (sebagai HCl)
Sisplatin serbuk injeksi 10 mg
Sisplatin serbuk injeksi 50 mg
Sitarabin serbuk injeksi i.m./i.v./s.k. 1gr/10ml
Spiramisin tablet 500 mg
Spironolakton tablet 100 mg
Spironolakton tablet 25 mg
Streptokinase injeksi 1,5 juta UI/vial
Streptomisin serbuk injeksi i.v 1000 mg/ml
Sufentanil injeksi iv, epidural 5 mcg/ml
Sukralfat susp 500 mg/5 mL
Takrolimus kaps 0.5 mg
Takrolimus kaps 1 mg
Tamsulosin tab 0,2 mg
Tamsulosin tab 0,2 mg
Tamsulosin tab SR 0,4 mg
Telbivudin tab 600 mg
Telmisartan tab 40mg
Telmisartan tab 80 mg
Temozolamid kaps 100 mg
Temozolamid kaps 20 mg
Tenofovir tab 300 mg
Terbutalin cairan ih 2,5 mg/mL
Terbutalin tablet 2,5 mg
Terbutalin turbu (serbuk ih) 0,50 mg
Testoteron soft capsul 40 mg
Page 14 of 45
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574
575
576
577
578
579
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581
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583
584
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586
587
588
589
590
591
592
593
594
595
596
597
598
599
600
601
602
1515
Tetrakain HCl tetes mata 0,5%
Tetrasiklin kapsul/kaplet 250 mg
Tiamazol tab 10 mg
Tiamazol tab 5 mg
Timolol tetes mata 0,25%
Timolol tetes mata 0,5%
Tiotropium kaps 18 mcg + handihaller
Tramadol injeksi 50 mg/ml
Travoprost tetes mata 0,004%
Triamsinolon asetonid nasal spray 55 mcg/puff
Trifluoperazin tablet 5 mg
Urea krim 10%
Vaksin polio inj (Vaksin Poliomyelitis yang diinaktifkan)
Valgansiklovir tab 450 mg
Valproat sirup 250 mg/5 ml
Valproat tab SR 250 mg
Valproat tab SR 500 mg
Valsartan tab 80 mg
Valsartan tab 160 mg
Verapamil tab 240 mg
Verapamil tablet 80 mg (HCl)
Vinblastin serbuk injeksi 10 mg
Vinkristin serb inj i.v 2 mg/vial
Vinkristin serbuk injeksi i.v. 1 mg
Vinorelbin inj. 10 mg/ml
Vitamin B Kompleks tablet
Zidovudin 300 mg + Lamivudine 150 mg
Zinc drop 10 mg/mL
Zinc sir 20 mg/5 Ml
Zinc tablet dispersible20 mg
Page 15 of 45
EKATALOG OBAT
1616
Nama Dagang
Nama Penyedia
n/a
PT. Kimia Farma
Hepsera
n/a
n/a
Zenalb
Zenalb
n/a
n/a
n/a
n/a
n/a
Actilyse
Fungicide
Glybotic 250 mg /ml
n/a
n/a
Cordarone
Kendaron Tablet
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
Lantus Solostar 100IU/ml 5pens
x3ml
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
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

x3ml
PT. Aventis Pharma
Humalog
Arimidex 1 mg
PT. AstraZeneca indonesia
n/a
PT. Erela
SmithKline Beecham
Indofarma
Holi Pharma
Ikapharmindo
Ikapharmindo
Pertiwi Agung
Bernofarm
Dexa Medica
Kimia Farma
Kimia Farma
Boehringer Ingelheim
Cendo Industri Farmasi
Sanbe Farma
Lucas Djaja
Erela
Aventis Pharma
Darya Varia
Indofarma
Pertiwi Agung
Pertiwi Agung
Novapharin
Mersifarma
Holi Pharma
Novapharin
Bernofarm
PT. Aventis Pharma
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
n/a
n/a
n/a
Starfolat
n/a
Bondronat
n/a
Urotractin 400 mg
n/a
n/a
Temiral Eye Oint
n/a
n/a
Leunase
Pularex
Tracrium
n/a
n/a
n/a
n/a
n/a
n/a
n/a
Survanta
Dorner 20 g
Dorner
n/a
Casodex 150 mg
Casodex 50 mg
Stolax supp
Concor 2.5
n/a
BLEOCIN
Cripsa tab
Pulmicort Turbuhaler
Pulmicort Respules
Symbicort Turbuhaler 160/4.5 mcg
Symbicort 80/4.5 mcg
PT. Kimia Farma

PT. Phapros, Tbk
PT. Kimia Farma
PT. Kimia Farma
PT. Dexa Medica
PT. Marin Liza Farmasi
PT. Boehringer Ingelheim
PT. Bernofarm
PT. Sanbe Farma
PT. Hexpharm Jaya
PT. Bernofarm
PT. Sanbe Farma
PT. Indofarma
PT. Sampharindo Perdana
PT. Widatra Bhakti
PT. Zenith Pharmaceuticals
PT. Glaxo Wellcome
PT. Indofarma
PT. Soho Industri Pharmasi
PT. Kimia Farma
PT. Soho Industri Pharmasi
PT. Rama Emerald Multi
PT. Phapros, Tbk
PT. Phapros, Tbk
PT. Abbott Indonesia
PT. Combiphar
PT. Combiphar
PT. Kimia Farma
PT. Sanbe Farma
PT. Merck Tbk
PT. Pratapa Nirmala
PT Kalbe Farma
PT. Caprifarmindo
Page 17 of 45
n/a
Bunascan
Pradaxa
Pradaxa
DBL Dacarbazine
DAUNOCIN
Exjade 250 mg Tab
Exjade 500 mg Tab
Ferriprox Oral Solution
Ferriprox tablet
Desferal
n/a
n/a
Cerazette
n/a
n/a
n/a
n/a
n/a
Herbesser Powder Injection 50mg
Farmabes Injeksi 25 mg
Herbesser CD 100
Herbesser CD 200
n/a
E.D.T.A
DOBURAN
Cardura 1mg
Cardura 2mg
Doxorubicin Actavis 10 mg
Doxorubicin Actavis 50 mg
n/a
n/a
n/a
UDOPA
n/a
Renalscan KaeF
Avodart
n/a
Aromasin
Lovenox 2000 ANTI-XA
n/a
Epirubisin Kalbe
n/a
D-Vit FT
D-Vit Syrup
n/a
1818
PT. Dexa Medica
PT. Pratapa Nirmala
PT. Novell PharmaeuticaL
PT. Novartis Indonesia
PT. Sydna Farma
PT. Sydna Farma
PT. Indofarma
PT. Promedrahardjo
PT. Merck Sharp Dohme
PT. Dexa Medica
PT. Kimia Farma
PT. Phapros, Tbk
PT. Yarindo Farmatama
PT. Indofarma
PT. Tanabe Indonesia
PT. Pratapa Nirmala
PT. Kimia Farma
PT. Cendo Industri Farmasi
PT. Dipa Pharmalab
PT. Pfizer Indonesia
PT. Actavis Indonesia
PT. Novapharin
PT. Novapharin
PT. Bernofarm
PT. Dipa Pharmalab
PT. Sanbe Farma
PT. Kimia Farma
PT. SmithKline Beecham
PT. Kimia Farma
PT. Aventis Pharma
PT. Aventis Pharma
PT. Aventis Pharma
PT. Phapros, Tbk
PT Kalbe Farma
PT. Sanbe Farma
PT. Gracia Pharmindo
PT. Kimia Farma
Page 18 of 45
n/a
n/a
Hemapo 3000
Recormon
n/a
n/a
n/a
Lynoral
Implanon
Posyd
n/a
Certican 0,25 mg Tab
Certican 0,5 mg Tab
Novoseven
n/a
n/a
n/a
n/a
n/a
n/a
n/a
Fenocin
n/a
Berotec MDI
Berotec Solution
n/a
n/a
Durogesic 12,5 MU Matrix
Durogesic 25 MU Matrix
Durogesic 50 MU Matrix
Leucogen
n/a
n/a
Fludara IV LYO
Fludara Oral
Sikzonoate Injeksi
n/a
n/a
Foransi 10
NOPRES
Curacil
Curacil
SYNARCUS
Avamys
Flixotide Nbules
Arixtra
Plasmanate
n/a
1919
PT. Indofarma
PT. Phyto Kemo Agung
PT Kalbe Farma
PT. Kimia Farma
PT. Indofarma
PT. Novapharin
PT. Combiphar
PT. Kimia Farma
PT. Ferron Par
PT. Mersifarma
PT. Ikapharmindo
PT. Mersifarma
PT. Phapros, Tbk
PT. Hexpharm Jaya
PT. Hexpharm Jaya
PT. Phapros, Tbk
PT. Phapros, Tbk
PT. Kimia Farma
PT. Kimia Farma
PT. Kimia Farma
PT. Kimia Farma
PT. Kimia Farma
PT Kalbe Farma
PT. Phapros, Tbk
PT. Phapros, Tbk
PT. Aventis Pharma
PT. Aventis Pharma
PT. Mersifarma
PT. Natura Laboratoria Prima
PT. Kimia Farma
PT. Dexa Medica
PT Kalbe Farma
PT Kalbe Farma
PT. Ifars Pharmaceutical
PT. Glaxo Wellcome
PT. Glaxo Wellcome
PT. Glaxo Wellcome
PT. Dipa Pharmalab
PT. Indofarma
Page 19 of 45
2020
Indofarma
Bayer Indonesia
Bayer Indonesia
Bayer Indonesia
n/a
Gadovist 5 mg
Gadovist 7,5 mg
Primovist
Cymevene
PT.
PT.
PT.
PT.
PT.
n/a
PT. Phapros, Tbk
Iressa 250 mg
n/a
n/a
Gemzar 1000 mg
n/a
n/a
Genoint Salep Mata
n/a
n/a
GLUCODEX
Diamicron MR 30
n/a
n/a
n/a
n/a
n/a
Nitrokaf Retard
Nitrokaf Forte
Nitral
Gliserin lar 50%
n/a
n/a
Zoladex 10,8 mg
Zoladex 3,6 mg
n/a
Haldol Decanoas
n/a
n/a
n/a
Lodomer 2
Halothane
Inviclot
Hyperhep B
n/a
n/a
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
Insulatard Vial
PT. Ferron Par
Humulin N Vial
PT. Bayer Indonesia
n/a
PT. Aventis Pharma
AstraZeneca indonesia
Indofarma
Indofarma
Bayer Indonesia
Sanbe Farma
Indofarma
Erela
Indofarma
Indofarma
Dexa Medica
Pradja Pharin
Dexa Medica
Kimia Farma
Kimia Farma
Kimia Farma
Kimia Farma
Kimia Farma
Kimia Farma
Actavis Indonesia
Lucas Djaja
Widatra Bhakti
Widatra Bhakti
Phapros, Tbk
Soho Industri Pharmasi
Indofarma
Indofarma
Indofarma
Mersifarma
Dexa Medica
Pratapa Nirmala
Dipa Pharmalab
Kimia Farma
Otto Pharmaceuticals
Page 20 of 45
Insulatard Penfill
2121
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
n/a
n/a
n/a
n/a
Holoxan injeksi 1000
Tanapress 10mg
Tanapress 5mg
Iopamiro
Iopamiro
Iopamiro
Iopamiro
Iopamiro
Iopamiro
Ultravist 300/100 mg
Ultravist 300/50 mg
Ultravist 370/100 mg
Ultravist 370/50 mg
Atrovent HFA
n/a
n/a
n/a
Farsorbid inj
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
Dexa Medica
Indofarma
Indofarma
Yarindo Farmatama
Novapharin
Mugi Laboratories
Tanabe Indonesia
Tanabe Indonesia
Dipa Pharmalab
Dipa Pharmalab
Dipa Pharmalab
Dipa Pharmalab
Dipa Pharmalab
Dipa Pharmalab
Bayer Indonesia
Bayer Indonesia
Bayer Indonesia
Bayer Indonesia
Indofarma
Indofarma
Sanbe Farma
Pratapa Nirmala
Page 21 of 45
2222
Indofarma
Tempo Scan Pacific
Merck Tbk
Tempo Scan Pacific
Ethica Industri Farmasi
Dexa Medica
Dexa Medica
Indofarma
Errita Pharma
Indofarma
Novartis Indonesia
Indofarma
Nicholas Laboratories
Lucas Djaja
Tempo Scan Pacific
Tempo Scan Pacific
Guardian Pharmatama
Novell PharmaeuticaL
Kimia Farma
Dexa Medica
Kimia Farma
Phapros, Tbk
Ifars Pharmaceutical
Indofarma
Indofarma
Dexa Medica
Kimia Farma
Hexpharm Jaya
Kimia Farma
Kimia Farma
Bernofarm
Phapros, Tbk
Phapros, Tbk
Mersifarma
Mersifarma
Kimia Farma
Kimia Farma
Kimia Farma
Fresenius Kabi
Galenium Pharmasia
Erela
n/a
Kalipar
KSR
DBL Leucovorin
Kalsium glukonat
n/a
n/a
Xeloda
n/a
n/a
n/a
Tegretol Syrup 100mg/5ml, 120ml
n/a
Neo-Mercazole
Karbogliserin tetes telinga 10%
DBL Carboplatin 150 mg
DBL Carboplatin 450 mg
KTM
n/a
n/a
n/a
Protofen Supp
n/a
ORIXAL
n/a
n/a
n/a
Catapres Injeksi
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
Voluven
Laxadine Emulsi 60 ml
n/a
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
Cendo Lyteers
PT. Cendo Industri Farmasi
Coartem
Stalevo
Aluvia

Page 22 of 45
Seretide Inhaler 50 mcg

Seretide Diskus 100 mcg
Seretide Diskus 250 mcg
2323
PT. Glaxo Wellcome
PT. Glaxo Wellcome
PT. Glaxo Wellcome
n/a
PT. Promedrahardjo
n/a
PT. Sampharindo Perdana
n/a
n/a
n/a
n/a
Prosogan Inj.
n/a
Tykerb
Kalbamin
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
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
Kimia Farma
Kimia Farma
Kimia Farma
Kimia Farma
Takeda Indonesia
Indofarma
SmithKline Beecham
Finusolprima 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%

Wida RL
Asering
PT Otsuka Indonesia
PT. Widatra Bhakti
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
Xalatan 0,005%
Granocyte 34 1vl HSA Free
Tapros 1.88mg
Tapros 3M
n/a
n/a
n/a
n/a
Xylocaine Jelly 2%
n/a
n/a
Frimania 200
Frimania 400
n/a
n/a
Merlopam 2
DIALIFER
n/a
Ludios
Sandepril 50
Bonescan KaeF
Vermox 500
Alkeran
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
Cendo Industri Farmasi

Pfizer Indonesia
Aventis Pharma
Takeda Indonesia
Takeda Indonesia
Infion Pharmaceutical
Promedrahardjo
Bernofarm
Indofarma
Mersifarma
Mersifarma
Promedrahardjo
Mersifarma
Finusolprima Farma
Soho Industri Pharmasi
Mersifarma
Kimia Farma
Taisho Pharmaceutica
Glaxo Wellcome
Page 25 of 45
n/a
n/a
Uromitexan injeksi.
n/a
n/a
n/a
Ritalin LA
n/a
n/a
n/a
n/a
n/a
n/a
n/a
Flagyl
n/a
n/a
Cardioscan KaeF
Fortanest
Dormicum
Mycamine
Cellcept
n/a
Mitomycin C
Vigamox
n/a
n/a
MST Continus 10 mg
MST Continus 15 mg
n/a
n/a
n/a
Fraxiparine 0.3 ml
Fraxiparine 0.4 ml
Fraxiparine 0.6 ml
Nokoba
Meylon
n/a
n/a
Fleet Phosphosoda
Fucilex Ointment
Neostigmin Hameln inj
n/a
Adalat Oros 20 mg
Adalat Oros 30 mg
n/a
n/a
n/a
2626
PT. Bernofarm
PT. Bernofarm
PT. Mugi Laboratories
PT. Kimia Farma
PT. Bernofarm
PT. Kimia Farma
PT. Dexa Medica
PT. Bernofarm
PT. Mahakam Beta Farma
PT. Dexa Medica
PT. Kimia Farma
PT. Aventis Pharma
PT. Phyto Kemo Agung Farma
PT. Phyto Kemo Agung Farma
PT. Kimia Farma
PT Kalbe Farma
PT. Combiphar
PT. Kimia Farma
PT. Widatra Bhakti
PT. Guardian Pharmatama
PT. Kimia Farma
PT. Kimia Farma
PT. Kimia Farma
PT. Widatra Bhakti
PT. Glaxo Wellcome
PT. Glaxo Wellcome
PT. Glaxo Wellcome
PT. Pratapa Nirmala
PT Otsuka Indonesia
PT. Phapros, Tbk
PT. Phapros, Tbk
PT. Combiphar
PT. Molex Ayus
PT. Pharma Health Care
PT. Kimia Farma
PT. Bayer Indonesia
PT. Bayer Indonesia
PT. Dexa Medica
PT. Phapros, Tbk
PT. Phapros, Tbk
Page 26 of 45
2727
Kimia Farma
Bayer Indonesia
Kimia Farma
Indofarma
Phapros, Tbk
Indofarma
Indofarma
Indofarma
Aventis Pharma
Aventis Pharma
Merck Tbk
Novartis Indonesia
Bayer Indonesia
Sandoz Indonesia
Sandoz Indonesia
Tempo Scan Pacific
Natura Laboratoria Prima
Novapharin
Indofarma
Yarindo Farmatama
Yarindo Farmatama
Levosol
Primolut N
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
ELOXATIN
ELOXATIN
Ilaidin Drops
Sandostatin LAR
Zyprexa IM
Olandoz 5
Olandoz 10
Patanol
n/a
n/a
n/a
n/a
n/a
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
n/a
PT Kalbe Farma
Larutan
Dialisa 1.5%: Dianeal Low
n/a
Calcium with 1,5% Dextrose;
Larutan Dialisa 2.5%: Dianeal Low
Calcium with 2,5% Dextrose;
Larutan Dialisa 4.25%: Dianeal Low
SINDAXEL
1004.25%
MG/16,67
ML
Calcium with
Dextrose
SINDAXEL 260mg/43.33 ML
SINDAXEL 30 MG/5 ML
n/a
n/a
n/a
NAPREX DROPS
Pegasys
Pegasys
PT Kalbe Farma
Pegintron Vial 100 Mcg
Pegintron Pen 120 Mcg
Pegintron
Pegintron Vial 80 Mcg
BURNAZIN 35 GR
Bioprexum 5 mg
PT. Darya Varia

PT. Pradja Pharin
PT Kalbe Farma
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
Actavis Indonesia
Actavis Indonesia
Actavis Indonesia
Indofarma
Afifarma
Promedrahardjo
Darya Varia
Page 27 of 45
Galenium2828
Pharmasia
Kimia Farma
Dexa Medica
Dexa Medica
Holi Pharma
Holi Pharma
Holi Pharma
Pratapa Nirmala
Afifarma
Afifarma
Afifarma
Dexa Medica
Fresenius Kabi
Holi Pharma
Pharma Health Care
Dexa Medica
Natura Laboratoria Prima
Dexa Medica
Kimia Farma
Kimia Farma
Widatra Bhakti
Dexa Medica
Mersifarma
Dexa Medica
Bayer Indonesia
Bayer Indonesia
Bayer Indonesia
Glaxo Wellcome
Glaxo Wellcome
Glaxo Wellcome
Glaxo Wellcome
Glaxo Wellcome
Glaxo Wellcome
Yarindo Farmatama
Kimia Farma
Scabimite Cream 10
n/a
DECULIN 15 MG
DECULIN 30 MG
n/a
n/a
n/a
Aptil
n/a
n/a
n/a
Sifrol ER 0,375mg
Sifrol ER 0,750mg
n/a
n/a
Fresofol 1% MCT/LCT
n/a
Seroquel XR 200 mg
Seroquel XR 300 mg
Seroquel XR 400 mg
Cardace 2.5mg 6x10 s tablet
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
Xarelto 10 mg
Xarelto 15 mg
Xarelto 20 mg
Requip PD 24 Hour 2 mg
Ventolin Inhaler
Ventolin Rotacaps
Ventolin Rotahaler
n/a
n/a
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
n/a
PT. Marin Liza Farmasi
n/a
n/a
n/a
n/a
n/a
PT.
PT.
PT.
PT.
PT.
Holi Pharma
Hexpharm Jaya
Bernofarm
Holi Pharma
Page 28 of 45
n/a
n/a
n/a
n/a
n/a
n/a
n/a
Banadoz 100
n/a
n/a
Zinnat 500
Fatral
n/a
Sojourn
n/a
Cyclovid 1000 mg
Cyclovid 200 mg
Sandimmun Neoral 100mg
Sandimmun Neoral 25mg
n/a
n/a
n/a
n/a
Cisplatin
Cisplatin
DBL Cytarabun
n/a
n/a
n/a
Streptase
n/a
Sufentanyl iv.Epidural 5 mcg/ml
Ulsafate
Prograf
Prograf
Harnal D
Harnal D 0.2 mg Disp. Tablet
Harnal OCAS 0.4 mg Tablet
Sebivo 600 mg Tab
Micardis 40mg
Micardis 80mg
Temodal
Temodal
n/a
Bricasma Respules
Molasma Tablet
Bricasma Turbuhaler 0,5 mg
Andriol Testocaps
2929
PT. Dexa Medica
PT. Yarindo Farmatama
PT. Bernofarm
PT. Ifars Pharmaceutical
PT. Holi Pharma
PT. Hexpharm Jaya
PT. Sandoz Indonesia
PT. Dexa Medica
PT. Glaxo Wellcome
PT. Pratapa Nirmala
PT. Pertiwi Agung
PT. Pratapa Nirmala
PT. Lucas Djaja
PT. Dexa Medica
PT. Bernofarm
PT Kalbe Farma
PT Kalbe Farma
PT. Indofarma
PT. Dexa Medica
PT. Dexa Medica
PT. Dexa Medica
PT. Phapros, Tbk
PT. Kimia Farma
PT. Combiphar
PT. Combiphar
PT. Combiphar
PT. Combiphar
PT. Combiphar
PT. Combiphar
PT. Kimia Farma
PT. Molex Ayus
Page 29 of 45
Pantocain 0.5%
n/a
Thyrozol 10
Thyrozol 5
Isotic Adretor 0,25%
Isotic Adretor 0,5%
Spiriva 10s + Handihaler
n/a
Travatan
Nasacort AQ
n/a
Soft U Derm
Imovax Polio
Valcyte
Ikalep
Depakote ER 250 mg
Depakote ER 500 mg
Diovan 80mg Tab
DIOVAN 160 MG
Isoptin 240 mg
n/a
Vinblastine
Vincristine Kalbe
Vincristine Kalbe
Navelbine injeksi 10
n/a
n/a
Zincpro Drops
Zircum Kid Sirup
n/a
3030 Farmasi
PT. Cendo Industri
PT. Holi Pharma
PT. Merck Tbk
PT. Merck Tbk
PT. Pratapa Nirmala
PT. Pratapa Nirmala
PT. Aventis Pharma
PT. Darya Varia
PT. Galenium Pharmasia
PT. Aventis Pharma
PT. Ikapharmindo
PT. Kimia Farma
PT. Combiphar
PT Kalbe Farma
PT Kalbe Farma
PT. Mugi Laboratories
PT. Kimia Farma
PT. Kimia Farma
PT. Combiphar
PT. Meprofarm
PT. Indofarma
Page 30 of 45
3131
Harga Satuan
Terkecil (Rp)
1,375.00
Kemasan
1 blister@24 tablet
Dus, 3 Blister @ 10 kapsul
Dus, 10 dus @ 1 botol @ 10 ml
Dus, 5 strip @ 6 tablet
Vial 100 ml
Vial 50 ml
Box, 10 strips @ 10 tablets
Dus, 10 blister @ 10 tablet
Dus, 10 Strip @ 10 tablet
Ktk 10x10 tablet
Ktk 10x10 tablet
Dus, 1 vial@50mg + 1 vial pelarut @ 50ml
tube 3.5 gr
Vial 2 ml
dus 30 ampul @10 ml
Botol @100 Tablet
Dus, 6 ampul @ 3 ml
strip
Dus, 10 strip @ 10 tss
dus 10 X 10'S
KOTAK @ 10 x 10 TAB
Dus, Botol 60 ml
btl @ 60 ml
Dus, 10 vial @ 1 g
27,500.00
3,849.00
344
750,000.00
345,000.00
86
199.5
380
214
233
3,800,000.00
18,500.00
50,500.00
3,822.00
80
12,480.00
1,200.00
112
330
187
211
261
4,070.00
2,445.00
5,100.00
dus, 5 solostar pen @ 3ml
85,000.00
Injeksi 100 IU/ml, Flexpen disposible 3 ml (1 box

isi 5 flexpen disposible)
Penfill cartridge
Injeksi 100 IU/ml, Flexpen disposible 3 ml (1 box
isi 5 flexpen disposible)
Dus, vial 10 ml
106,000.00
97,500.00
85,345.00
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
Botol @ 60 ml
Dus, 25 tube @ 5 g
3232
2,160.00
2,516.00
ktk 10 x 10 tablet
520
Btl 100 tablet
135

Dus 6 amp @ 1ml
Dus @ 10 X 10 's
ktk 10x10 tablet
Dus 10 strip x 10 tab
Dus, 10 strip @10 tablet
Botol @ 100 tablet
Boks, 1 ampul
Dus, 10 blister @ 10 kaptab ss
Strip
Dus, 10 ampul @ 5 ml
Tube 3,5 gram
10.000 UI/Vial
Dus 5 strip @ 10 tablet
Dus, 5 ampul @ 2.5 ml
botol @ 60 ml
ktk 2x10 tablet
Strip
Dus @ 50 gram
Dus @ 10 Vial
Dus @ 10 Vial
Vial
Box/ 3 blister @ 10 Tablet
Box @ 3 blister @ 10 Tablet
Tube 5 gr
Supp
Dus 10 blister @ 10 tablet
Box 3 X 10 tab
Vial
Box 3 x 10'S
Dus, 1 Turbuhaler @ 100 dosis
Dus, 4 pak @ 5 respules @ 2 ml
1,500.00
22,000.00
116
159
95
84
48
2,209,000.00
112
1,815.00
3,334.00
2,950.00
24,750.00
237
336
1,039,500.00
190
20,000.00
74
34,400.00
4,500.00
3,333.00
1,250.00
9,800.00
13,400.00
3,200,000.00
3,600.00
3,600.00
1,520.00
72,400.00
45,000.00
6,045.00
746
645
304,000.00
247,089.00
93,000.00
8,900.00
117,600.00
110,500.00
Page 32 of 45
Dus, 5 ampul @ 4 ml
ampul
Dus, 3 blister @ 10 kapsul
vial @ 20 ml
vial
Dus, Botol @ 500ml
Dus, Botol @ 100 tablet
Dus, 10 vial @ 500mg
Dus, 10 Strip@10 Tablet
Dus, 1 Blister @ 28 tablet
Kotak, tube @ 15 gram
Btl 100
Dus @ 30 Ampul
Box 10 X 10 Tab
10 vial @ 50mg
Vial 5 mL
3 blister @ 10 kapsul
3 blister @ 10 kapsul
Btl 100 tablet
botol 15 ml
ampul @ 5 ml
Dus, 5 blister @10's tab
Dus, 5 blister @10's tab
Dus, 1 vial @ 10 mg
Dus, 1 vial @ 50 mg
btl @ 60 ml
dus 10 X 10'S
Dus, botol @ 10 ml
ampul @ 5 ml
Dus, 1 vial @0,5 ml+ 1 vial pelarut @1,5 ml
Dus @ 5 vial
Dus, Botol Plastik @ 30 Tablet
Botol 30 tab
dus, 2 prefilled syringe @ 0,2 ml
Dus @ 30 Ampul
Vial @ 25 ml
Dus, 1 vial @5 ml
Dus 3 strip @ 10 Flash tablet
Dus, Botol Plastik @ 100 mL
ktk 10 x 10 kapsul
3333 25,600.00
30,800.00
12,936.00
12,936.00
305,000.00
275,000.00
76,000.00
150,000.00
2,600,000.00
25,300.00
112,000.00
1,580.00
62
70,000.00
9,983.00
45
1,050.00
97
134
127,667.00
46,667.00
3,667.00
4,015.00
104
37,500.00
26,700.00
3,480.00
5,480.00
55,500.00
258,000.00
3,333.00
167
15,600.00
9,840.00
970,200.00
455,000.00
7,100.00
6,375.00
42,600.00
40,740.00
71,875.00
100,000.00
8,100.00
500,000.00
128,000.00
650
8,000.00
497
Page 33 of 45
Dus, 10 blister @ 10 kss

Botol @60 ml
Prefilled Syringe @ 1ml
Boks, 6 ampul
ktk 20 x 10 tablet
Dus, 10 strip @ 10 tss
btl @ 100 ml
Dus, botol @ 100 tablet
Dus, 1 blister @ 1 subdermal implant
Vial 100mg/5ml
Botol 10 ml
KOTAK @ 1 VIAL SERBUK OBAT & INFUSION KIT
KOTAK @ 10 ampul
Botol @ 100
KOTAK @ 10 ampul
Dus @ 30 Ampul
Dus, 3 strip @ 10 kapsul
Dus @ 10 X 10 's
Dus 45 x 12 tab
Dus @ 10 X 10 's
Box, canister 10mL
Dus, Canister 200 dosis
Dus 5 ampul@ 10ml
Dus 5 ampul@ 2ml
Dus @ 5 patch
Dus@ 5 patch
Dus@ 5 patch
pfs @ 0,5 ml
Dus @ 10 X 10 's
dus @ 30 ampul
Dus, 5 vial @ 50 mg
Dus, 4 blister @ 5 tablet salut selaput
Dus, 5 ampul @ 1ml
Dus, 1 Botol @ 100 mL
ktk 1 x 10 kapsul
strip
DUS, 30 TABLET
vial @ 1 ml
vial @ 10 ml
Dus, Tube 5 g
Dus, Botol 120 Dosis Spay
Dus, 2 flow wrap@ 5 nebules @ 1 dosis (2ml)
Dus, 2 pfs 0.5 ml
dus, vial @ 250 ml
3434
930
7,700.00
128,000.00
139,500.00
314
451
2,500.00
1,360.00
128,779.00
100,000.00
16,667.00
11,813.00
23,250.00
9,200,000.00
20,250.00
133
20,250.00
1,800.00
1,075.00
1,375.00
290
235
510
72,900.00
117,500.00
128,000.00
33,914.00
80,000.00
153,000.00
285,000.00
375,000.00
630
3,417.00
1,248,319.00
275,000.00
55,000.00
47,550.00
22,000.00
419
432
24,500.00
33,000.00
2,400.00
93,333.00
12,917.00
241,667.00
972,000.00
1,829.00
Page 34 of 45

Prefilled Syringe
Prefilled Syringe
Prefilled Syringe
Boks, 1 ampul
3535
85
275,000.00
412,500.00
2,570,000.00
399,500.00
Dus @ 100 Sachet

Dus, 10 blister @ 10 kaptab
vial
Dus, 1 vial @200 mg
Dus, 5 ampul @ 2 ml
Tube @ 3,5 gr
Dus, botol plastik 5 ml
Dus, 10 blister @ 10 kaptab
DUS, 100 TABLET
Dus, 6 strip @ 10 tablet lepas lambat
ktk 5x10 tablet
ktk 5x10 tablet
ktk 5x10 tablet
ktk 5x10 tablet
Dus 10x10
Dus 10x10
Btl @ 30 tablet
Glycerin 100 ml
botol @ 500 ml
botol @ 500 ml
Dus, 1 syringe @ 10.8 mg
Dus, 1 syringe @ 3.6 mg
Dus @ 10 X 10 's
Dus 5 Ampul@1mL
KOTAK @ 10 x 10 TAB
Botol
vial
Dus, 1 syringe @ 0.5 mL
Tube 5 gr
box 5ampul @1 ml
288
295,000.00
289
679
1,098,900.00
330,000.00
3,399.00
2,600.00
3,194.00
56
236
638
950
265
436
404
430
1,493.00
2,171.00
1,500.00
5,333.00
5,700.00
5,200.00
2,300,000.00
840,000.00
209
83,333.00
59
96
69
126
641,500.00
42,900.00
1,328,000.00
2,798.00
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

isi 5 penfill disposible)
3636
76,125.00
penfillcartridge @ 3ml
75,000.00
Dus Isi 5 penfill/cartridge @ 3ml
76,125.00

76,125.00
76,125.00
Dus, vial 10 ml
138,000.00
Dus, vial 10 ml
138,000.00

76,125.00
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
Prefilled syringe
Dus, botol 60 ml
Dus, botol 60 ml
botol @ 100 tablet
dus 10 X 10'S
Dus, 1 vial @ 1 g
3 blister @ 10 tablet
3 blister @ 10 tablet
Dus, botol @ 100 ml
Dus, vial @ 30 ml
Dus, vial @ 50 ml
Dus, botol @ 100 ml
Dus, vial @ 30 ml
Dus, vial @ 50 ml
Botol
Botol
Botol
Botol
Box, canister 10mL
Dus, 1 vial @2 ml
vial
72,000.00
170,000.00
3,499.00
4,499.00
110
150
1,329,163.00
3,908.00
2,120.00
350,000.00
122,000.00
166,000.00
369,000.00
147,000.00
199,000.00
245,000.00
123,200.00
299,000.00
150,300.00
80,000.00
1,425.00
2,470.00
510,000.00
33,000.00
Page 36 of 45

Strip
Vial 50 mg/5 ml
Ampul
Boks, 120 tablet
Dus, 10 strip @10 tablet
Dus, botol @ 120 ml
Dus,botol 100 tablet
Fenol 100 mg / 1 ml
vial @ 15 ml
vial @ 45 ml
Vial @ 10 ml
Box isi 1 Tube @ 15 g
tube 10 gr
dus 2 's @ 10 supp
Dus @ 12 Ampul
Dus, 3 Strip @ 10 Kaplet salut selaput
Box, 10 ampoules @ 1mL
Ktk 10X10 TAB
Dus, 3 strip @ 10 tab
ktk 10x10 tablet
Tube 5 gr
Botol @ 60 ml
Dus @ 30 Ampul
Dus @ 30 Ampul
KOTAK @ 5 x 10 TAB
KOTAK @ 5 x 10 TAB
ktk 10x10 tablet
ktk 10x10 tablet
ktk 10x10 tablet
Botol Plastik @ 500 ml
Botol @ 60 ml
Dus, 100 Sachet @ 30 Tablet
botol 15 ml
Dus, botol plastik @ 30 tablet salut selaput
botol @ 120 tablet
3737
88
700
1,580.00
82,000.00
7,800.00
4,900.00
3,100.00
27,500.00
140
84
62
44,770.00
245
875
2,042.00
190,000.00
408,000.00
110,000.00
4,700.00
2,569.00
300
2,722.00
2,300.00
3,200.00
361
553
900
30,600.00
184
3,400.00
249
1,600.00
3,680.00
1,100.00
1,050.00
5,000.00
1,550.00
500
850
1,100.00
33,000.00
12,450.00
42
15,750.00
3,220.00
8,900.00
6,100.00
Page 37 of 45
Dus, Botol 120 Dosis

Dus, foil strip @ 60 dosis
Dus, foil strip @ 60 dosis
3838 90,667.00
100,833.00
113,333.00

Botol, 60 ml
138
2,167.00
ktk 60 tablet
ktk 100 amp @ 2 ml
ktk 10 x 10 tablet
Botol 60 tablet
Serbuk vial
botol 500 ml
670
6,200.00
540
1,400.00
82,042.00
473
67,200.00
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
Botol Gelas 250 ml
50,820.00
Softbag 200 ML
46,000.00
Softbag 500 ML
65,000.00
Botol Gelas 500 ml
78,720.00
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),

1000 mL
Bag Double chamber (Dua compartement),
1000 mL
Ampoel 25 ML
Botol 1000 ml
Plastic Bottle 500 ML
322,000.00
218,700.00
2,050.00
8,000.00
9,000.00
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
29,167.00
55,500.00
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
9,167.00
10,000.00
10,000.00
20%, Botol Kaca @100 ml, single bottle

Botol Gelas 100 ml
105,500.00
60,500.00
20%, Botol Kaca @250 ml, single bottle
210,000.00
Bag, 3 chamber ( 3 kompartemen), 1250 ml
591,000.00
511,000.00
358,000.00
Flexy bag 100 mL

strip 5 x 0.6 ml
dus, Botol @ 2,5 ml
Dus, 1 vial @ 263 mcg + 1 prefilled syringe
pelarut @ 1 ml
Vial
Vial
Box, 1 Botol @ 100 ml
Dus, 10 syringe @ 10 g
Box ,3 Strip @ 10 tablet
KOTAK @ 10 x 10 TAB
KOTAK @ 10 x 10 TAB
Dus, 10 Strip @ 10 Tablet
KOTAK @ 10 x 10 TAB
ampul
botol 500 ml
Strip
KOTAK @ 5 x 10 TAB
Dus @ 5 vial
Dus,24 Catch @ 1 tablet
Box, Tablet 2 mg/25's
89,800.00
72,000.00
127,000.00
550,000.00
700,000.00
2,700,000.00
40,000.00
528
839
1,363.00
40,000.00
600
350
1,050.00
1,850.00
89
154
1,341.00
52,000.00
62,000.00
1,200.00
3,276.00
473,000.00
7,140.00
12,210.00
Page 40 of 45
Dus, 1 vial @ 1 g
Dus, 1 vial @ 0,5 g
Dus, 15 Ampul
Botol 1000 ml
ktk 10 x 10 tablet salut
Dus, botol plastik @ 30 kapsul pelepasan
lambat
Dus, 1 Vial @125mg + 1 ampul pelarut @ 2ml
Dus, 1 vial @ 500 mg
Strip
Dus, 10 Blister @ 10 Tablet
ktk 10 x 10 tablet
Dus, 1 Botol @ 100 ml
Dus, 2 blister @ 5 suppositoria
10 strip @ 10 tab
10 strip @ 10 tab
Dus @ 5 vial
Box isi 5 ampul
Boks 5 amp
Dus,1 vial@50mg
Boks, 50 tablet
Tube 10 gram
10 mg /Vial
botol, tetes mata 3 ml
tube 10 gram
Dus 10 amp @ 1 ml
Ktk 10 ampul @ 1ML
Botol 30 tablet
Botol 500 ml
Dus, 5 blister @ 2 pfs 0.3 ml
Dus, 5 Ampul @ 2ml
Ampoel 25 ML
Dus @ 5 X 10 's
Dus @ 5 X 10 's
Botol, 45 ml
Tube 5 gr
Box, isi 5 ampul @ 1 ml
btl 60 tablet
blister
blister
Dus, 10 Strip @ 10 tablet salut selaput
Dus @ 10 X 10 's
Dus @ 10 X 10 's
4141 54,000.00
44,960.00
74,998.00
254,100.00
112.5
154
6,537.00
19,200.00
89,990.00
635
205
300
108
9,950.00
3,220.00
110
160
1,237,500.00
6,000.00
12,060.00
260,000.00
16,000.00
3,000.00
697,000.00
77,000.00
17,820.00
8,400.00
15,620.00
22,990.00
10,499.00
1,300.00
4,700.00
54,144.00
66,640.00
94,962.00
61,600.00
6,200.00
176
133
33,900.00
6,490.00
9,500.00
2,800.00
2,999.00
3,500.00
110
640
480
Page 41 of 45
Dus 5 amp @ 8 ml
blister
Paket
Paket
Paket
Dus, 3
@ 28
kss @ 8 tablet tahap
1 blister
dus @ 60
blister
Dus,
60
sachet
tahap
tablet@ 3
intensif kategori 1 + 1intensif
Dus @ @
54(1
blister
Isoniazid,
2
kapsul
Rifampicin,
2
tablet
tablet tahap lanjutan kategori 1
Pyrazinamide) + 120 sachet tahap lanjutan @
Box
,5 Strip
@ 10 tablet
(1 tablet
Isoniazid,
2 kapsul Rifampicin)
Dus, 1 vial @ 20 ml
Dus, 1 vial @ 10 ml
botol @ 10 ml
Dus, vial @ 355m + 1 prefilled syringe pelarut
@ 2,5 ml + 2 jarum suntik
Vial
3 X 10 fcc
3 X 10 fcc
botol, tetes mata 5 ml
Dus, 1 Vial @ 40 mg
dus 10 X 3'S
Dus, 5 Ampul @ 2ml
Box 3 X 10 Tab
Box 3 X 10 Tab
Transfer Set: Set; Ultaclam: Kantong Plastik;
Tenckoff Catheter: Box; Titanium Adaptor:
Kantong Plastik
4242 53,900.00
2,618.00
359,990.00
1,199,990.00
214,900.00
160,000.00
288,199.00
171,195.00
400
650
1,100,000.00
550,000.00
27,550.00
2,950,000.00
120,000.00
6,450.00
11,200.00
68,000.00
36,000.00
211
2,400.00
716
1,189.00
1,902,240.00
Set
Larutan Dialisa 1.5 %: 2.000 ml; Larutan Dialisa
2.5 %: 2.000 ml; Larutan Dialisa 4.25 %: 2.000
ml; Minicap: Kantong Plastik
Vial 6mg/ml (100mg/16.67ml)
Vial 6mg/ml (260mg/43.33ml)
Vial 6mg/ml (30mg/5ml)
Dus, 15 botol
botol 60 ml
Dus, 10 Strip@10 Kaplet Salut Selaput
botol @ 15 ml
Boks, 1 pfs
Boks, 1 pfs
Dus, 1 vial 100 mcg + 1 ampul pelarut 0,7 ml +
1 syringe + 2 jarum
Dus, 1 prefilled syringe (serbuk injeksi 120mcg
+ pelarut 0.5 ml) + 1 jarum
1 syringe + 2 jarum
1 syringe + 2 jarum
tube @ 35 gram
Dus, botol plastik @ 30 tablet salut selaput
219,540.00
5,522,580.00
984,000.00
3,000,000.00
274,560.00
5,200.00
1,438.00
79
6,730.00
1,077,815.00
1,248,220.00
973,500.00
1,135,000.00
915,000.00
915,810.00
23,000.00
2,420.00
Page 42 of 45
Tube @ 10 g
Ktk 10 ampx2ml
30 TAB/BOX
30 TAB/BOX
Botol 60 ml
Dus 10 strip @ 10 tablet
Dus, Botol @ 10ml
botol @ 1000 ml
botol @ 30 ml
botol @ 300 ml
Dus, 3 alu blister @ 10 tablet
Dus, 3 alu blister @ 10 tablet
Ampul
Dus, 10 Strip @ 10 kaptab
Dus, 10 Ampul @ 2 ml
Dus, 10 Strip @ 10 tablet salut selaput
Botol 50 kapsul lunak
Botol 50 Kapsul
botol 500 ml
KOTAK @ 5 x 10 TAB
Blister
Blister
Blister
Dus, 7 blister @ 4 Tablet lepas Lambat
Dus, botol 200 dosis
Dus, 10 Blister @ 10 Kapsul
Dus, 1 Rotahaler
strip @ 10 tablet
ktk 10 x 10 tablet
4343 11,475.00
14,500.00
3,120.00
4,525.00
8,360.00
298
208
17,393.00
37,109.00
2,163.00
14,203.00
7,200.00
11,268.00
2,300.00
65
15,642.00
107
17,391.00
19,500.00
23,185.00
995
580
1,140.00
120
260
459
5,200.00
1,200.00
1,008.00
2,000.00
23,500.00
23,500.00
23,500.00
5,248.00
6,275.00
7,383.00
63,750.00
431
5,867.00
59
89
Pot @ 30 gram
2,000.00
Dus,
strip
Dus,
Dus,
Dus,
4,896.00
513
509
5,940.00
1,000.00
Botol 60 ml
10 strip @ 10 kapsul
Botol 60 ml
5 Strip @ 10 Kapsul
Page 43 of 45
Dus, 2 Vial @ 1 gram

Box 2 Vial @ 1000mg
Dus, Botol 30 ml
Dus, 2 vial @ 1 g
vial
Dus, 10 Vial @ 1 g
Dus, 2 Vial @ 1 gram
Dus, 10 Vial @ 1 g
Dus, 1 Blister @ 10 Tablet salut selaput
strip @ 10 tab
Box, 10 strips @ 10 capsules
tabung/botol
100 ampul @ 1 ml
vial
vial
Dus, 10 blister @ 5 kapsul lunak
Vial 200 ml
Dus, 10 blister @ 10 tab ss
vial
vial
dus, 1 vial @ 10 ml
Vial
Dus @ 56 Vial
dus 5 amp @ dus 10
Botol, 100 ml
Pounch @ 5 blister @ 10 capsule
Dus, 1 pouch @5 blister@10 kaps
Box @ 2 blister @ 14 tablet
Box/ 2 blister @ 14 tablet
Box/ 3 blister @ 10 Tablet
Dus, 2 alu-blister @10 tablet
Box, 2 blisters @10 tablets
Dus, 5 sachet @ 1 kapsul
Dus, 5 sachet @ 1 kapsul
Botol 30 tab
Dus, 2 pak @ 5 respules
Box 50's
4444 16,500.00
48,060.00
859
8,800.00
12,775.00
4,800.00
2,950.00
3,700.00
16,000.00
3,300.00
7,200.00
3,300.00
181
1,320,000.00
1,078.00
256,000.00
82,000.00
43,000.00
12,000.00
169
391
13,000.00
255
22,000.00
93,000.00
575,000.00
1,499.00
900
315
3,290,000.00
3,650.00
127,000.00
13,425.00
11,167.00
21,500.00
5,800.00
5,800.00
6,800.00
28,500.00
3,900.00
6,500.00
1,120,000.00
223,000.00
8,100.00
6,250.00
99
71,100.00
6,200.00
Page 44 of 45
botol 5 ml
Dus, Botol Plastik @ 5ml
Dus, Botol Plastik @ 5ml
Dus, 1 blister @10 kapsul + handihaler
Dus, 10 Ampul @ 2 ml
botol, tetes mata 2,5 ml
Dus, botol plastik 120 dosis
strip
tube
1 vial of 10ml (10 d's)
Boks, 60 tablet
Botol 120 ml
Tablet
Tablet
Tablet
Ktk 10X10 TAB
Vial 10mg/10ml
vial @ 2 ml
vial @ 1 ml
Dus, 1 vial @ 1 ml
Dus 10 strip x 10 tab
Botol 60 tablet
Drops 10 mg/ml, Botol @15 ml
Dus, botol 60 ml
Dus, 10 strip @ 10 tablet dispersible
4545 11,500.00
149
1,135.00
563
9,128.00
9,722.00
152,543.00
2,395.00
115,000.00
90,000.00
405
6,400.00
285,000.00
170,000.00
40,000.00
2,793.00
5,450.00
3,900.00
6,500.00
6,200.00
234
210,000.00
78,000.00
46,000.00
1,229,998.00
107
3,429.00
12,840.00
7,400.00
474
Page 45 of 45

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11

8 SEPT 2014| 06.00 |

Nama Obat Generik

Anti Bakteri DOEN salep kombinasi: Basitrasin 500 IU/g Polimiksin

Antimalaria DOEN kombinasi : Pirimetamin 25 mg Sulfadoksin 500

Antimigren: Ergotamin Tartrat 1 mg + Kofein 50 mg

Artemether injeksi 80 mg/ml

Gefitinib tab 250 mg

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

Human insulin short acting

inj 100 UI/ml, penfill cartridge (Human

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

Kombinasi: Artemether 20 mg; Lumefantrin 120 mg

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

Larutan mengandung Asam Amino (Asam Amino 6%, mengandung

Larutan mengandung Asam Amino (Asam Amino esensial 7%

Larutan mengandung Asam Amino (Kombinasi Asam aminno 50

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

99 Asam Amino: 34gr,

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

461 Paket CAPD Pergantian Transfer Set per 6 bulan

Paklitaksel inj 100 mg/vial

476 Perak sulfadiazin krim 1%

PT. Kimia Farma

PT. Ferron Par

PT. Tempo Scan Pacific

PT. Ferron Par

PT. Ferron Par

Apidra Solostar 100IU/ml 5pens

PT. Aventis Pharma

PT. Tempo Scan Pacific

PT. AstraZeneca indonesia

PT. Aventis Pharma

PT. Kimia Farma

PT. Kimia Farma

PT. Kimia Farma

PT. Phapros, Tbk

PT. Ferron Par

PT. Bayer Indonesia

PT. Aventis Pharma

PT. Sanbe Farma

PT. Bayer Indonesia

PT. Ferron Par

Humulin 30/70 Cart

PT. Bayer Indonesia

PT. Ferron Par

Humulin 30/70 Vial

PT. Bayer Indonesia

PT. Ferron Par

PT. Bayer Indonesia

PT. Sanbe Farma

PT. Ferron Par

PT. Bayer Indonesia

PT. Aventis Pharma

PT. Cendo Industri Farmasi

PT. Novartis Indonesia

Seretide Inhaler 50 mcg

PT. Sampharindo Perdana

PT. Fresenius Kabi

PT. Fresenius Kabi

PT. Fresenius Kabi

PT. Finusolprima Farma

PT. Finusolprima Farma