DAFTAR HARGA OBAT NON KATALOG

No. Nama Obat Satuan Harga

1 Acyclovir 400 mg tablet Tablet 415.00

2 Afolat tablet Tablet 155.20
3 Albuforce kapsul Kapsul 6,090.70

4 Alerfed tablet Tablet 1,355.20

5 Ambroksol 30 mg Tablet Tablet 297.00
6 Ambroxol 15 mg sirup Botol 3,790.00
7 Ambroxol 30 mg/ 5 ml Botol 8,910.00
8 Aminophilin 24 mg/ml Ampul 3,080.00
9 Amoxicillin 500 mg tab Tablet 265.00
10 Artoflam Tablet 5,866.60

11 Asam Traneksamat 500 mg tablet Tablet 1,386.00

12 Aspil Vial 94,050.00
13 Bamgetol Tablet 1,485.00
14 Betadine gargle 100 ml Botol 10,137.00
15 Bicnat tablet Tablet 45.40
16 Bone one 0,25 mcg Tablet 8,415.00
17 Bunascan spinal 0.5% Ampul 38,280.00
18 Buscopan Injeksi Ampul 32,920.47
19 Carbazochrome Ampul 11,800.80
20 Cartylo tablet Tablet 250.00
21 Cefixime kapsul 100 mg Kapsul 750.00
22 Ceftizoxime injeksi Vial 99,000.00
23 Cendo mydiatril 0,5 % 5 ml Botol 28,586.00
24 Cendo Tropin 0,5 % 5 ml Botol 11,137.50
25 Cendo Xitrol Botol 5,094.38
26 Citicolin 250mg/2 ml injeksi Ampul 9,293.63
27 Citicolin 500 mg tablet Tablet 5,600.00
28 Constantia drop Botol 23,265.00
29 Corsa Neuron tablet Tablet 363.00
30 Curcuma Tablet 827.81
31 Cycozam 100 mg tablet Tablet 4,928.00
32 Cycozam 25 mg tablet Tablet 1,488.30
33 Cystone Tablet 2,770.20
34 Cytistat Vial 1,430,000.00
35 Daryantule Tule 10,175.00
36 Depakote ER 250 mg Tablet 2,840.00
37 Depakote ER 500 mg Tablet 5,700.00
38 Dexocort (dexosimetason) cream Tube 7,793.00
39 Dextrose 40% Ampul 8,690.00
No. Nama Obat Satuan Harga

40 Diaform Tablet 183.90

41 Diazink 20 mg (Zinc) Tablet Tablet 360.00
42 Dibecasin 100 mg Injeksi Ampul 75,688.00
43 Dibecasin Opthalmic 0,3 % Botol 64,515.00
44 Dipsamol Can 41,241.90
45 Diuvar injeksi Ampul 8,250.00
46 Divalpi 250 mg EC Tablet 1,601.60
47 Doburan Ampul 28,028.44
48 Dulkolax 5 mg tablet Tablet 1,265.73
49 Efineprin 1 mg/ml Ampul 1,848.00
50 Endrolin 3,75 mg Vial 619,300.00
51 Eperisone HCL 50 mg Tablet 1,232.00
52 Ethambutol 500 mg tablet Tablet 543.00
53 Farelax Ampul 69,300.00
54 Farsorbid injeksi Ampul 31,890.00
55 Fartolin Inhalasi Can 14,960.00
56 Fatral tablet Tablet 3,300.00
57 Femaplex 2,5 mg Tablet 9,000.00
58 Fenofibrate 100 mg tablet Tablet 1,072.90
59 Fimahes Bag 90,200.00
60 Fitbon Tablet Tablet 1,173.00
61 Flutias 125 mg Can 107,525.00
62 Folid Acid tablet Tablet 172.78
63 Fosmisin Injeksi Vial 68,530.00
64 Fusicom salap kulit Tube 6,277.70
65 Gastrul tablet Tablet 8,250.00
66 Genoint 0,3 % salap mata Tube 3,000.00
67 Gentalex cream 5 gram Tube 1,900.00
68 Gentamisin salap kulit Tube 3,000.00
69 Glauseta Tablet 3,000.00

70 Goflex 500 tablet Tablet 9,652.50

71 Hemapo 3000 IU Sringer 139,949.40
72 Hidrokortison 1% Tube 3,293.40
73 Ialuset plus Tube 109,120.00
74 Imipenem cilastin Vial 220,000.00
75 Itramol sirup Botol 2,717.00
76 Kalium diklofenac 50mg Tablet 424.80
77 Kalxetin 20 mg Kapsul 5,298.30
78 Kamolas 500 mg tablet Tablet 130.00
79 Klindamisin 300 mg Kapsul 660.00
No. Nama Obat Satuan Harga

80 KTM injeksi Vial 115,995.88

81 Kutoin Kapsul 948.75
82 Lacbon tablet Tablet 1,573.00
83 Lacto B Sachet 4,702.50
84 Lapibion Tablet 1,072.50
85 Laxadine emulsi Botol 50,688.00
86 Loratadine 10 mg Tablet Tablet 216.50
87 Matovit kapsul Tablet 2,992.00
88 Mecobalamin 0,5 Injeksi Ampul 7,920.00
89 Mecobalamin 500 mcg Kapsul 500.50
90 Meloksikam 15 mg Tablet 369.99
91 Meloxicam 7,5 mg tablet Tablet 230.00
92 Misoprostol tablet Tablet 4,950.00
93 MST Continus Tablet 15,620.00
94 N-Ace Tablet Tablet 1,870.00
95 NaCl 0,9% 500 ml Botol 6,410.00
96 Natrium diklofenak 50 mg Tablet 352.64
97 Neo Diaform Tablet Tablet 183.90
98 Nepatic Tablet 3,234.00
99 Neurohax Tablet 765.60
100 New diatabs Tablet 557.15
101 Nopres 20 mg tablet Tablet 410.00
102 Nyndia Botol 20,020.00
103 Nystatin drop Botol 20,000.00
104 Otopain Tetes Telinga Botol 34,651.00
105 Otsu Salin 3 % Botol 24,200.00
106 Oxytetrasiklin salap kulit Tube 2,009.70
107 Pantocain 2% Botol 13,117.00
108 Pantoprazole Injeksi Vial 22,440.00
109 Pedilis sirup Botol 15,400.00
110 Perosal 2x6 Box 3,049,200.00
111 Pethidin Hcl Ampul 13,191.42
112 Phytomenadion Injeksi Ampul 4,166.40
113 Piracetam 3 gram injeksi Ampul 6,930.00
114 Polidemisin tetes mata Botol 20,625.00
115 Prestin 20 mg Tablet Tablet 254.98
116 Pro TB 2 Tablet 5,797.00
117 Pro TB 4 Tablet 4,341.30
118 Prohem injeksi Ampul 9,900.00
119 Reco salap mata Tube 5,225.00
No. Nama Obat Satuan Harga

120 recofol 10 mg/ml Ampul 84,100.00

121 Sagestam ED Botol 18,711.75
122 Sagestam salap kulit Tube 9,724.50
123 Sagestam salap mata Tube 19,064.00
124 Sanbe tears Botol 15,248.00

125 Santagesic ampul Ampul 4,200.34

126 Scasid cream Tube 25,025.00

127 Simarc 2 mg Tablet 949.99
128 Sodium Bicarbonat tablet Tablet 45.40
129 Solaneuron tablet Tablet 935.00
130 Solathim 500 mg tab Tablet 700.00
131 Spironolacton 100 Tablet 745.00
132 Spironolacton 25 mg Tablet 277.00
133 Sulfasalazine 500 mg Tablet 1,100.00
134 Tablet Penambah darah Tablet 73.34
135 Tamofen tablet Tablet 1,790.00
136 Tarivid otic tetes telinga Botol 36,900.00
137 Terastarch Bag 89,100.00
138 Umarone injeksi Vial 84,700.00
139 Valesco 160 mg Tablet 2,688.40
140 Valesco 80 mg Tablet 1,760.00
141 Valisanbe 2 mg Tablet 214.50
142 Valisanbe 5 mg Tablet 335.50
143 Vertikaf 8 mg Tablet 1,650.00
144 Vitamin B Kompleks Tablet 120.00
145 Vopicain Vial 49,500.00
146 Wida D5 1/4 NS Botol 9,350.00
147 Wida D5 NS 500 ml Botol 8,024.50