No.

kelas terapi Nama Obat Satuan

1 analgesik narkotik Fentanil injeksi 0,05 mg/mL (i.m./i.v.) Ampul
2 Fentanil patch 12,5 mcg/jam Patch
3 Fentanil patch 25mcg/jam Patch
4 Hidromorfon 8mg Tablet
5 Hidromorfon 16 mg Tablet
6 Codein 10mg Tablet
7 Codein 20mg Tablet
8 Morfin 10mg Tablet
Tablet Lepas
9 Morfin 10mg Lambat
Tablet Lepas
10 Morfin 15mg Lambat
Tablet Lepas
11 Morfin 30mg Lambat
12 Morfin Injeksi 10mg/ml (i.m/s.k/i.v) Vial
13 Oksikodon Kapsul 5mg Kapsul
14 Oksikodon kapsul 10mg Kapsul
15 Oksikodon kapsul 20mg Kapsul
Tablet Lepas
16 Oksikodon 10mg Lambat
Tablet Lepas
17 Oksikodon 15mg Lambat
Tablet Lepas
18 Oksikodon 20mg Lambat
19 Oksikodon Injeksi 10mg/ml Ampul
20 Petidin Injeksi 50mg/ml Ampul
21 Sufentanil injeksi 5mcg/ml Vial
22 analgesik non-narkotik Asam mefenamat kapsul 250mg Kapsul
23 Asam mefenamat tablet 500mg Tablet
24 Ibuprofen 200mg Tablet
25 Ibuprofen 400mg Tablet
26 Ibuprofen Suspensi 100mg Botol
27 Ibuprofen suspensi 200mg Botol
28 Ketoprofen injeksi 50mg/ml Ampul
29 Ketoprofen Supp 100mg Suppositoria
30 Ketorolac injeksi 30mg/ml Ampul
31 Metamizole Injeksi 500mg/ml Ampul
Tablet Salut
32 Natrium diclofenak 25mg Enterik
Tablet Salut
33 Natrium diclofenak 50mg Enterik
34 Natrium diclofenak injeksi 25mg/ml Ampul
35 Paracetamol 500mg Tablet
36 Paracetamol sirup 125mg/5ml Botol
37 Paracetamol drop 100mg/ml Botol
38 Paracetamol infus 10mg/ml Botol
39 antipirai Allopurinol 100mg Tablet
40 Allopurinol 300mg Tablet
41 Kolkisin 500mcg Tablet
42 Probenecid 500mg Tablet
43 nyeri neuropatik Amitriptiline 25mg Tablet
44 Gabapentin 100mg Kapsul
45 Gabapentin 300mg Kapsul
46 Karbamazepin 100mg Tablet
47 anestetik lokal Bupivakain Injeksi 0,5% Ampul
48 Bupivakain heavy Ampul
49 Etil klorida spray 100ml Botol
50 Lidokain Injeksi 2% Ampul
51 Lidocain gel Tube
52 Lidocain spray 10% Botol
53 anestetik umum dan Ropivakain injeksi 7,5mg/ml Ampul
54 oksigen Deksmedetomidin injeksi 100mcg/ml Ampul
55 Desfluran inhalasi Botol
56 Halotan Inhalasi Botol
57 Isofluran inhalasi Botol
58 Ketamin Injeksi 50mg/ml Vial
59 Ketamin injeksi 100mg/ml GasVial
dalam
60 Nitrogen oksida inhalasi tabung
Gas dalam
61 Oksigen tabung
62 Propofol injeksi 1% Ampul
63 Sevofluran inh Botol
64 Tiopental injeksi 500mg Ampul
65 Tiopental injeksi 1000mg Ampul
66 obat pre operatif Atropin injeksi 0,25mg/ml Ampul
67 Diazepam injeksi 5mg Ampul
68 Midazolam injeksi 1mg Ampul
69 Midazolam injeksi 5mg Ampul
70 antialergi dan anafilaksis Dexametason injeksi 5mg/ml Ampul
71 Difenhidramin injeksi 10mg/ml Ampul
72 Epinefrin injeksi 1mg/ml Ampul
73 Hidrocortison injeksi 100mg Ampul
74 Klorfeniramin 4mg Tablet
75 Loratadine Tablet
76 Cetirizine tablet 10mg Tablet
77 Cetirizine sirup 5mg/5ml Botol
78 Atropin tablet 0,5 mg Tablet
79 antidot khusus Atrofin injeksi 0,25mg/ml Ampul
80 Efedrin injeksi 50mg/ml Ampul
81 Kalsium glukonat injkesi 10% Ampul
82 Nalokson injeksi 0,4mg/ml Ampul
83 Natrium bikarbonat Tablet
84 Natrium bikarbonat injeksi 8,4% Ampul
85 Natrium tiosulfat injeksi 25% Ampul
86 Neostigmin injeksi 0,5% Ampul
87 Protamin sulfat injeksi 10mg/ml Ampul
88 antidot umum Magnesium sulfat Sachet
89 antiepilepsi-anti konvulsi Diazepam injeksi 5mg Ampul
90 Diazepam enema 5mg/2,5ml Rectal tube
 91 Diazepam enema 10mg/2,5ml Rectal tube
92 Fenitoin 30mg Kapsul
93 Fenitoin 100mg Kapsul
94 Fenitoin injeksi 50mg/ml Ampul
95 Fenobarbital 30mg Tablet
96 Fenobarbital 100mg Tablet
97 Fenobarbital injeksi 50mg/ml Ampul
98 Fenobarbital injeksi 100mg/ml Ampul
99 Karbamazepin 200mg Tablet
100 Karbamazepin sirup 100mg/ml Botol
101 Klonazepam 2mg Tablet
Tablet
102 Lamotrigin 25mg Dispersible
103 Lamotrigin 50mg Tablet
104 Lamotrigin 100mg Tablet
105 Magnesium sulfat injeksi 20% Ampul
106 Magnesium sulfat injeksi 40% Ampul
107 Okskarbazepin suspensi 60mg/ml Botol
108 Topiramat 25mg Tablet
109 Topiramat 50mg Tablet
110 Topiramat 100mg Tablet
Tablet Lepas
111 Valproat 250mg Lambat
Tablet Lepas
112 Valproat 500mg Lambat
Tablet Salut
113 Valproat tab.salut enterik 250mg Enterik
114 Valproat 250mg/ml Botol
115 antelmitik Albendazol 400mg Tablet
116 Albendazol suspensi 200mg/5ml Botol
117 Mebendazol 100mg Tablet
118 Mebendazol 500mg Tablet
119 Mebendazol sirup 100mg/ml Botol
120 Pirantel pamoat 125mg Tablet
121 Pirantel pamoat 250mg Tablet
122 Pirantel pamoat suspensi 125mg/5ml Botol
123 Prazikuantel 600mg Tablet
124 Dietilkarbamazepin 100mg Tablet
125 Bet laktam Amoksisilin 250mg Tablet
126 Amoksisilin 500mg Tablet
127 Amoksisilin drop 100mg/ml Botol
128 Amoksisilin sir kering 125 mg/5 mL Botol
129 Amoksisilin sir kering 250 mg/5 mL Botol
130 Ampisilin inj 250 mg (i.m./i.v.) Ampul
131 Ampisilin inj 1.000 mg (i.v.) Ampul
132 Benzatin benzilpenisilin inj 1,2 juta IU/mL (i.m.) Ampul
133 Benzatin benzilpenisilin inj 2,4 juta IU/mL (i.m.) Ampul
134 Fenoksimetil penisilin (penisilin V) 125mg Tablet
135 Fenoksimetil penisilin (penisilin V) 250mg Tablet
136 Fenoksimetil penisilin (penisilin V) 500mg Tablet
137 prokain benzilpenisilin inj 3 juta IU (i.m.) Vial
138 Sefadroksil 250mg Kapsul
139 Sefadroksil 500mg Kapsul
140 Sefadroksil 125mg/5ml Botol
141 Sefadroksil 250mg/5ml Botol
142 sefaleksin 500mg Kapsul
143 Sefazolin injeksi 1000mg Vial
144 Sefefim injeksi 1000mg Vial
145 Cefixime 100mg Kapsul
146 Cefixime 200mg Kapsul
147 Cefixime ds 100mg/ml Botol
148 Sefoperazon injeksi 1000mg Vial
149 Cefotaxime injeksi 500mg Vial
150 Cefotaxime injeksi 1000mg Vial
151 Sefpirom serb inj 1.000 mg VialSalut
Tablet
152 Sefpodoksim proksetil 100 mg Selaput
153 seftazidim serb inj 1.000 mg Vial
154 seftriakson inj 1.000 mg Vial
155 sefuroksim 250mg Vial
156 sefuroksim 500mg Vial
157 sefuroksim injeksi 750mg Vial
158 tetrasiklin Doksisiklin 50mg Kapsul
159 Doksisiklin 100mg Kapsul
160 Oksitetrasiklin injeksi 50mg/ml Ampul
161 Tetrasiklin 250mg Kapsul
162 Tetrasiklin 500mg Kapsul
163 kloramfenikol Kloramfenicol 250mg Kapsul
164 Kloramfenicol 500mg Kapsul
165 Kloramfenicol suspensi 125mg/5ml Botol
166 Kloramfenicol injeksi 1000mg Vial
167 kotrimoksazol Kotrimoksazole Tablet
168 Kotrimoksazol forte Tablet
169 Kotrimoksazol sirup Botol
170 makrolid Azitromisin 250mg Tablet
Tablet Salut
171 Azitromisin 500mg Selaput
172 Azitromisin ds 200mg/5ml Botol
173 Azitromisin serbuk injeksi 500mg Vial
174 Eritromisin 250mg Kapsul
175 Eritromisin 500mg Kapsul
176 Eritromisin 200mg/5ml Botol
Tablet Salut
177 Klaritromisin 500mg Selaput
178 Klaristromisin ds 125mg/5ml Botol
179 Klaritromisin ds 250mg/5ml Botol
Tablet Salut
180 Spiramisin 500mg Selaput
181 aminoglikosida Amikasin injeksi 250mg/ml Vial
182 Gentamicin injeksi 10mg/ml Ampul
183 Gentamicin injeksi 40mg/ml Ampul
184 Kanamisin Serbuk Injeksi 1000mg Vial
185 Streptomisin serbuk injeksi 1000mg Vial
186 kuinolon Levofloksasin 500mg Tablet
187 Levofloksasin infus 5mg/ml Botol
Tablet Salut
188 Ofloksasin 200mg Selaput
Tablet Salut
189 Ofloksasin 400mg Selaput
190 Siprofloksasin 500mg Tablet
191 Siprofloksasin infus 2mg/ml Botol
192 linkosamid Klindamisin 150mg Kapsul
193 Klindamisin 300mg Kapsul
194 lain-lain Fosfomisin trometamol granula 3 g Sachet
195 Meropenem serb inj 500 mg Vial
196 Meropenem serb inj 1.000 mg Vial
197 Metronidazole 250mg Tablet
198 Metronidazole 500mg Tablet
199 Metronidazole suspensi 125mg/5ml Botol
200 Metronidazole infus 5mg/ml Botol
201 Metronidazole suppo 500mg Suppositoria
202 Metronidazole ovula 500mg Ovula
203 Pirimetamin 25mg Tablet
204 Sulfadiazin 500mg Tablet
205 antilepra Dapson 100mg Tablet
206 Klofazimin 50mg Kapsul
207 Klofazimin 100mg Kapsul
208 Rifampisin 300mg Kapsul
209 Rifampisin 450mg Tablet
210 Rifampisin 600mg Tablet
211 OAT Isoniazid 100mg Tablet
212 Isoniazid 300mg Tablet
213 OAT Kategori 1 Tablet
214 OAT Kategori 2 Tablet
215 OAT KDT kategori anak Tablet
216 OAT Kombipak kategori 1 Tablet
217 OAT Kombipak kategori anak Tablet
218 antiseptik saluran kemih Asam pipemidat 400mg Kapsul
219 Metenamin mandelat (heksamin mandelat) 500mg Tablet
220 Nitrofurantoin 50mg Tablet
221 antifungi sistemik Amfoterisin B inj 5 mg/mL (i.v.) Vial
222 Flukonazole 50mg Tablet
223 Flukonazole 150 Tablet
224 Flukonazole infus 2mg/ml Botol
225 Griseofulvin 125mg Tablet
226 Griseofulvin 250mg Tablet
227 Griseofulvin 500mg Tablet
228 Itrakonazole 100mg Kapsul
229 Ketokonazole 200mg Tablet
230 Nistatin tablet 500IU Tablet
231 Nistatin suspensi Botol
232 Terbinafin 250mg Tablet
233 antimalaria Artesunat inj 60 mg (i.v./i.m.) Ampul
234 KDT/FDC (artemether+lumefantrin) Tablet
235 KDT/FDC (dihidroartemisinin+piperakuin) Tablet
236 Kuinin 200mg Tablet
237 Kuinin injeksi 25% Ampul
238 Primakuin 15mg Tablet
239 antiherpes Asiklovir 200mg Tablet
240 Asiklovir 400mg Tablet
241 Asiklovir serbuk injeksi 250mg Vial
242 Valasiklovir 500mg Tablet
243 CMV Gansiklovir serbuk injeksi 500mg VialSalut
Tablet
244 Valgansiklovir 450mg Selaput
245 ARV-NRTI KDT/FDC (zidovudin+lamivudin) Tablet
246 KDT/FDC (tenofovir+emtrisitabin) Tablet
247 Lamivudin 150mg Tablet
248 Stavudin 30mg Tablet
249 Tenofovir 300mg Tablet
250 Zidovudin 100mg Kapsul
251 NRTI Efavirenz 600mg Tablet
252 Efavirenz 200mg Tablet
253 Nevirapin 200mg Tablet
254 NNRTI KDT/FDC (tenofovir+lamivudin+efavirenz) Tablet
Tablet
255 KDT/FDC (zidovudin+lamivudin+nevirapin) dispersible
256 Protease inhibitor KDT/FDC (LPV/r) lopinavir+ritonavir Tablet
257 antihepatitis Adefovir dipivoksil 10mg Tablet
Tablet Salut
258 Daklatasvir 30 Selaput
Tablet Salut
259 Daklatasvir 60 Selaput
Tablet Salut
260 Entekavir 0,5mg Selaput
Tablet Salut
261 Entekavir 1mg Selaput
262 Lamivudin 100mg Tablet
263 Pegylated interferon alfa-2a inj 135 mcg/0,5 mL Ampul
264 Pegylated interferon alfa-2a inj 180 mcg/0,5 mL Ampul
265 Pegylated interferon alfa-2b serb inj 50 mcg Ampul
266 Pegylated interferon alfa-2b serb inj 80 mcg Ampul
267 Pegylated interferon alfa-2b serb inj 100 mcg Ampul
Tablet Salut
268 Ribavirin 200mg Selaput
Tablet Salut
269 Sofosbuvir 400mg Selaput
270 Telbivudin 600mg Tablet
271 antimigren Propanolol 10mg Tablet
272 Propanolol 40mg Tablet
273 Ergotamin 1mg Tablet
274 KDT/FDC (ergotamin+kafein) Tablet
275 antivertigo Betahistine 6mg Tablet
276 Betahistine 24mg Tablet
278 Hormon dan antihormon Dexametason 0,5mg Tablet
279 Dexametason injeksi 5mg/ml Ampul
280 Dienogest 2mg Tablet
281 leuprorelin asetat serb inj 7,5 mg Ampul
282 leuprorelin asetat serb inj 22,5 mg Ampul
283 medroksi progesteron asetat tab 100 mg Ampul
284 medroksi progesteron asetat inj 50 mg/mL Ampul
285 medroksi progesteron asetat inj 150 mg/mL Ampul
288 Metilprednisolon 4mg Tablet
289 Metilprenisolon 16mg Tablet
290 Testosteron 40mg Kapsul Lunak
291 Testosteron inj 250 mg/mL Ampul
292 imunosupresan Metotreksat 2,5mg Tablet
293 antiparkinson benserazid + levodopa (neurologist) tablet
294 levodopa + karbidopa (neurologist) tablet
295 pramipeksol 0,125 mg (neurologist) tablet
296 roprinol 2 mg (neurologist) tablet
297 triheksifenidil 2 mg tablet
298 antianemi asam folat 0,4 mg tablet
299 asam folat 1 mg tablet
300 asam folat 5 mg tablet
301 garam Fe 60 mg tablet
302 garam Fe 15 mg/5 mL tablet
303 Fe sulfat + asam folat tab tablet
304 low molecule feeri sucrose inj 20 mg/mL vial
305 sianokobalamin tab 50 mcg tablet
306 obat yang memengaruhi sianokobalamin inj 500 mg/mL vial
307 koagulasi asam traneksamat 500 mg tablet
308 asam traneksamat inj 50 mg/mL vial
309 asam traneksamat injj 100 mg/mL vial
310 dabigatran eteksilat 75 mg tablet
311 dabigatran eteksilat 110 mg tablet
312 obat kelebihan besi deferoksamin inj 500mg bvial
313 hematopoietik eritropoietin alfa inj 2.000 IU vial
314 eritropoietin alfa inj 3.000 IU vial
315 eritropoietin alfa inj 4.000 IU vial
316 eritropoietin alfa inj 10.000 IU vial
317 eritropoietin beta inj 2.000 Iu vial
318 plasma expander albumin serum normal inj 5% vial
319 albumin serum normal inj 20% vial
320 albumin serum normal inj 25 % vial
321 pengganti plasma golongan gelatin infus labu
322 kontras radiologi barium sulfat serbuk 92 g/100 g Ampul
323 barium sulfat susp 95% Kapsul
324 iopamidol inj 300-370 mg/mL Ampul
325 iopromid 300-370 mg/mL Tablet
326 iodiksanol inj tablet
327 ioheksol inj tablet
328 iopamidol inj 300-370 mg/mL tablet
329 iopromid infus botol
330 galactose microparticle 200-400 mg micropart/mL botol
331 tes kulit tuberkulin inj 2 TU/0,1 mL ampul
332 K Y jelly botol
333 antiseptik disinfektan hidrogen peroksida 3% botol
334 klorheksidin 15% botol
335 povidon iodin 100mg/mL botol
336 etanol 70% botol
337 kalsium hipoklorit serbuk botol
338 paraformaldehid tablet 1 gram tablet
339 perawatan gigi eugenol botol
340 formokresol botol
341 gutta percha dan paper pints 15-40 mm box
342 gutta percha dan paper pints 45-80 mm box
343 kalsium hidroksida bubuk, pasta botol
344 klorfenol kamfer mentol botol
345 klorheksidin 0,2% botol
346 natrium hipoklorit 5% botol
347 pasta pengisi saluran akar botol
348 nistatin susp 100.000 IU/mL botol
349 fluor 1 mg tablet
350 bahan tumpatan sementara botol
351 glass ionomer ART botol
352 komposit resin box
353 anestesi gigi lidokain + epinefrin inj ampul
354 aquadest 500 mL labu
355 articulating paper box
356 etil klorid spray 100 mL botol
357 ferrakrilium 1% botol
358 triamsinolon + dementilklortetrasiklin pasta tube
359 lidokain inj 2 % ampul
360 lidokain salep pot
361 lidokain spray topikal 10 % botol
362 pasta devitalisasi non arsen tube
363 surgical ginggival pack pasta tube
364 diuretik furosemid 40 mg Tablet
365 furosemid inj 10 mg/mL Ampul
366 hidroklorotiazid 25 mg Tablet
367 hidroklorotiazid 12,5 mg tablet
368 manitol infus 20 % labu
369 spironolakton 25 mg tablet
370 spironolakton 100 mg tablet
371 hipertrofi prostat doksazosin 1 mg tablet
372 doksazosin 2 mg tablet
373 dutasterid 0,5 mg Tablet
374 finasterid 5 mg tablet
375 silodosin 4 mg Tablet
376 tamsulosin 0,2 mg tablet
377 tamsulosin 0,4 mg tablet
378 terazosin 1 mg tablet
379 terazosin 2 mg Tablet
380 hormon diuretik desmopresin 0,1 mg tablet
381 desmopresin 0,2 mg tablet
382 vasoprersin 20 IU/mL ampul
383 antidiabetes oral akarbose 50 mg tablet
384 akarbose 100 mg tablet
385 glibenklamid 2,5 mg tablet
386 glibenklamid 5 mg tablet
387 gliklazid 30 mg tablet
388 gliklazid 60 mg tablet
389 gliklazid 80 mg tablet
390 glikuidon 30 mg tablet
391 glimepirid 1 mg tablet
392 glimepirid 2 mg tablet
393 glimepirid 3 mg Tablet
394 glimepirid 4 mg tablet
395 glipizid 5 mg tablet
396 glipizid 10 mg tablet
397 metformin 500 mg Tablet
398 metformin 850 mg Tablet
399 pioglitazon 15 mg tablet
400 pioglitazon 30 mg Tablet
401 vildagliptin 50 mg tablet
402 Antidiabetik parenteral humulin short acting inj 100 IU/mL pen
403 humulin intermediate acting inj 100 IU/mL pen
404 Humulin Mix acting inj 100 IU/mL pen
405 analog rapid insulin inj 100 IU/mL pen
406 analog mix insulin inj 100 IU/mL pen
407 analog long insulin inj 100 IU/mL pen
408 kontrasepsi implan etonogestrel implan 68 mg dus
409 levonorgestrel implan 2 rod dus
410 kontrasepsi IUD copper T dus
411 IUD Cu T 380 A dus
412 IUD levonorgestrel dus
413 kontrasepsi parenteral medroksi progesteron + estradiol inj vial
414 medroksi progesteron inj vial
415 kontrasepsi oral desogestrel tablet
416 desogestrel + etinilestradiol Tablet
417 levonorgestrel + etinilestradiol tablet
418 Hormon Tiroid dan linestrenol tablet
419 antitiroid karbimazol 5 mg Tablet
420 levotiroksin 50 mcg Tablet
421 levotiroksin 100 mcg tablet
422 lugol larutan botol
423 propiltiourasil 5 mg tablet
424 propiltiourasil 10 mg Tablet
425 tiamazol 5 mg Tablet
426 tiamazol 10 mg tablet
427 Kortikosteroid deksametason 5 mg/mL ampul
428 deksametason 0,5 mg Tablet
429 hidrokortison 20 mg tablet
430 hidrokortison inj 100 mg Tablet
431 metilprednisolon 4 mg tablet
432 metilprednisolon 8 mg tablet
433 metilprednisolon 16 mg tablet
434 metilprednisolon inj 125 mg ampul
435 metilprednisolon inj 500 mg ampul
436 prednison 5 mg tablet
437 triamsinolon inj 10 mg/mL ampul
438 antiangina amlodipin 5 mg tablet
439 atenolol 50 mg Tablet
440 diltiazem 30 mg Tablet
441 gliseril trinitrat 0,5 mg tablet
442 gliseril trinitrat 2,5 mg tablet
443 gliseril trinitrat 5 mg tablet
444 gliseril trinitrat inj 5 mg/mL ampul
445 gliseril trinitrat inj 10 mg/mL ampul
446 ISDN 5 mg tablet
447 ISDN 10 mg Tablet
448 ISDN inj 1 mg/mL ampul
449 antiaritmia verapamil inj 2,5 mg/mL ampul
450 verapamil 80 mg tablet
451 propranolol inj 1 mg/mL ampul
452 propranolol 10 mg tablet
453 lidokain inj 100 mg/mL ampul
454 digoksin 0,25 mg/mL ampul
455 digoksin 0,25 mg Tablet
456 amiodaron inj 50 mg/mL ampul
457 amiodaron 200 mg tablet
458 adenosin inj 3 mg/mL ampul
459 antihipertensi verapamil 240 mg tablet
460 verapamil 80 mg Tablet
461 telmisartan 80 mg tablet
462 telmisartan 40 mg Tablet
463 ramipril 10 mg tablet
464 ramipril 5 mg tablet
465 ramipril 2,5 mg tablet
466 perindropil arginin 5 mg tablet
467 nikardipin inj 1 mg/mL ampul
468 nifedipin 30 mg tablet
469 nifedipin 20 mg tablet
470 nifedipin 10 mg Tablet
471 metoprolol tartrat inj 1 mg/mL ampul
472 metildopa 250 mg tablet
473 lisinopril 20 mg tablet
474 lisinopril 10 mg tablet
475 lisinopril 5 mg Tablet
476 klortalidon 50 mg Tablet
477 klonidin inj 150 mcg/mL ampul
478 klonidin 0,15 mg Tablet
479 irbesartan 300 mg Tablet
480 irbesartan 150 mg tablet
481 imidapril 10 mg tablet
482 imidapril 5 mg tablet
483 hidroklorotiazid 25 mg tablet
484 doksazosin 2 mg Tablet
485 doksazosin 1 mg Tablet
486 diltiazem inj 50 mg/mL ampul
487 diltiazem inj 10 mg/mL ampul
488 diltiazem inj 5 mg/mL ampul
489 diltiazem 200 mg Tablet
490 diltiazem 100 mg tablet
491 atenolol 100 mg tablet
492 atenolol 50 mg tablet
493 amlodipin 10 mg tablet
494 amlodipin 5 mg Tablet
495 antihipertensi pulmonal sildenafil 20 mg (bedah jantung) tablet
496 beraprost sodium 20 mcg tablet
497 antiagregasi platelet tikagrelor 90 mg tablet
498 silostazol 100 mg kapsul
499 silostazol 100 mg Tablet
500 klopidogrel 300 mg tablet
501 klopidogrel 75 mg tablet
502 asetosal 100 mg tablet
503 asetosal 80 mg tablet
504 trombolitik streptokinase inj 1,5 juta IU vial
505 alteplase serbuk inj 50 mg vial
506 obat gagal jantung spironolakton 25 mg tablet
507 ramipril 10 mg tablet
508 ramipril 5 mg tablet
509 karvedilol 25 mg tablet
510 karvedilol 6,25 mg tablet
511 kaptopril 50 mg tablet
512 kaptopril 25 mg tablet
513 kaptopril 12,5 mg tablet
514 kandesartan 16 mg tablet
515 kandesartan 8 mg tablet
516 isosorbid dinitrat 1 mg/mL ampul
517 furosemid 10 mg/mL ampul
518 furosemid 40 mg tablet
519 digoksin 0,25 mg/mL ampul
520 digoksin 0,25 mg Tablet
521 bisoprolol 10 mg Tablet
522 bisoprolol 5 mg tablet
523 bisoprolol 2,5 mg tablet
524 bisoprolol 1,25 mg Tablet
525 obat syok dan sepsis norepinefrin inj 1 mg/mL ampul
526 dopamin inj 40 mg/mL ampul
527 dobutamin inj 50 mg/mL ampul
528 dobutamin inj 25 mg/mL ampul
529 diobutamin inj 12,5 mg/mL ampul
530 antihiperlipidemia atorvastatin 20 mg tablet
531 atorvastatin 10 mg Tablet
532 fenofibrat 300 mg kapsul
533 fenifibrat 100 mg kapsul
534 gemfibrozil 600 mg kapsul
535 gemfibrozil 300 mg kapsul
536 kolestiramin serbuk 4 gram bungkus
537 pravastatin 20 mg tablet
538 pravastatin 10 mg tablet
539 rosuvastatin 10 mg tablet
540 simvastatin 40 mg tablet
541 simvastatin 20 mg tablet
542 simvastatin 10 mg tablet
543 antiakne asam retinoat 0,1% cr tube
544 asam retinoat 0,05% cr tube
545 antibakteri topikal perak sulfadiazin 1% krim tube
546 natrium fusidat 2% SK cr tube
547 natrium fusidat 2% SK tube
548 mupirosin 2 % salep tube
549 mupirosin 2 % cr tube
550 kloramfenikol SK 2% tube
551 framisetin sulfat 1% tulle
552 basitrasin + polimiksin B salep tube
553 antifungi nistatin tab vaginal 100.000 IU tablet
554 mikonazol 2% cr tube
555 mikonazol serbuk 2% botol
556 klotrimazol vaginal 100 mg tablet
557 ketokonazol 2% scalp sol botol
558 ketokonazol 2% cr tube
559 asam benzoat + asam salisilat tube
560 antiinflamasi pruritik mometason furoat 0,1% tube
561 klobetasol propionat 0,05% salep tube
562 klobetasol propionat 0,05% cr tube
563 kalamin lotion tube
564 hidrokortison 2,5% tube
565 hidrokortison 1% tube
566 fusinolon asetonid 0,025% salep tube
567 fusinolon asetonid 0,025% cr tube
568 diflukortolon valerat 0,1% TUBE
569 desoksimetason 0,05% gel tube
570 desoksimetason 0,25% salep tube
571 desoksimetason 0,25% cr tube
572 betametason 0,1% salep tube
573 betametason 0,1% cr tube
574 betametason 0,05% cr tube
575 antiskabies salep 2-4 pot
576 permetrin 5% tube
577 kaustik podofilin tingtur 25% botol
578 polikresulen larutan botol
579 perak nitrat 20% botol
580 keratolitik liquor carbonis detergens 5% botol
581 asam salisilat 10 % pot
582 asam salisilat 5% pot
583 asam salisilat 2% pot
584 urea 20% tube
585 urea 10 % tube
586 triamsinolon asetonid inj 40 mg/mL vial
587 triamsinolon asetonid inj 10 mg/mL vial
588 bedak salisil 2% botol
589 asam salisilat larutan 0,1 % botol
590 larutan dialisis larutan hemodialisa labu
591 larutan dialisa intraperitoneal labu
592 elektrolit nutrisi dll natrium bikarbonat 500 mg tablet
593 kalsium polistirena sulfonat 5 gram bungkus
594 kalium aspartat 300 mg tablet
595 kalium klorida 600 mg tablet
596 larutan asam amino + E + KH + L labu
597 larutan lipid labu
598 larutan karbohidrat + elektrolit labu
karbohidrat 24 % + kalsium fosfat botol
599 larutan karbohidrat 12 % botol
600 larutan elektrolit labu
601 larutan asam amino labu
AA 10%, untuk hiperkatabolik, endogenus formula, tinggi
labu
tirosin
AA 9%rendah fenilalaninginjal, AAE : AANE 6:5, Glisin
untuk gangguan
labu
sebagai sitoprotektif ginjal
602 air untuk irigasi labu
603 air untuk injeksi botol
604 obat untuk mata manitol infus 20% labu
605 tetrakain TM 0,5 % botol
606 tobramisin TM 0,3% botol
607 tetrasiklin SM 1% botol
608 oksitetrasiklin SM 1% tube
609 natamisin TM 5% botol
610 natamisin TM 50mg/mL botol
611 moksifloksasin TM 0,5% botol
612 levofloksasin TM 0,5% botol
613 Kloramfenikol SM 1 % tube
614 kloramfenikol TM 1% botol
615 kloramfenikol TM 0,5% botol
616 gentamisin TM 1 % botol
617 gentamisin TM 0,3% botol
618 gentamisin SM 0,3% tube
619 asiklovir SM 3% tube
620 asam fusidat TM 1 % botol
621 amfoterisin B SM 3 % tube
622 amfoterisin B SM 1 % tube
623 prednisolon TM 10mg/mL tablet
624 olopatadin TM 0,1% botol
625 natrium diklofenak TM 1mg/mL botol
626 flourometolon TM 0,1% botol
627 betametason TM 1mg/mL botol
628 siklopentolat TM 1% botol
629 homatropin TM 2 % botol
630 fenileprin TM 10% botol
631 atropin TM 1 % botol
632 atropin TM 0,5% botol
633 travoprost TM botol
634 timolol 0,5 % Botol
635 timolol 0,25 % botol
636 pilokarpin 2 % botol
637 latanoprost TM botol
638 travoprost + timolol botol
639 latanoprost + timolol botol
640 brinzolamid + timolol botol
641 gliserin 50% botol
642 brinzolamid TM Botol
643 betaksolol TM 0,5 % botol
644 asetazolamid 250 mg tablet
645 natrium hialuronat TM botol
646 natrium klorida 50 mg/mL TM botol
647 natrium klorida + kalium klorida TM botol
648 karboksimetilselulosa TM botol
649 dinatrium edetat TM 3,5 mg/mL botol
650 oksitosik oksitosin 10 IU/mL ampul
651 metilergometrin 0,2 mg/mL ampul
652 metilergometrin 0,125 mg Tablet
653 antiansietas lorazepam 2 mg Tablet
654 lorazepam 1 mg Tablet
655 lorazepam 0,5 mg Tablet
656 klobazam 10 mg Tablet
657 diazepam 5 mg/mL ampul
658 diazepam 5 mg tablet
659 diazepam 2 mg Tablet
660 alprazolam 1 mg Tablet
661 alprazolam 0,5 mg tablet
662 alprazolam 0,25 mg tablet
663 antidepresi sertralin 50 mg tablet
664 maprotilin 50 mg tablet
665 maprotilin 25 mg tablet
666 fluoksetin 20 mg kapsul
667 fluoksetin 10 mg kapsul
668 amitriptilin 25 mg tablet
669 klomipramin 25 mg tablet
670 fluoksetin 20 mg kapsul
671 fluoksetin 10 mg kapsul
672 aripiprazol 5 mg (jiwa) tablet
673 flufenazin 25 mg/mL (jiwa) ampul
674 haoperidol 0,5 mg (jiwa) tablet
675 klorpromazin 5mg/mL ampul
676 klorpromazin 25 mg Tablet
677 klorpromazin 100 mg Tablet
678 klozapin 100 mg tablet
679 klozapin 25 mg tablet
680 olanzapin 10 mg injek (jiwa) ampul
681 olanzapin 10 mg (jiwa) tablet
682 olanzapin 5 mg (jiwa) Tablet
683 palperidon palmitat 150 mg/1,5 mL (jiwa) ampul
684 palperidon palmitat 100 mg/mL (jiwa) ampul
685 palperidon palmitat 75 mg/0,75 mL (jiwa) ampul
686 palperidon palmitat 50 mg/0,5 mL (jiwa) ampul
687 quetiapin 400 mg (jiwa) tablet
688 quetiapin 300 mg (jiwa) tablet
689 quetiapin 200 mg (jiwa) tablet
690 quetiapin 100 mg (jiwa) tablet
691 risperidon 1 mg/mL (jiwa) botol
692 risperidon 3 mg (jiwa) tablet
693 risperidon 2 mg tablet
694 risperidon 1 mg Tablet
695 trifluoperazin 5 mg (jiwa) tablet
696 metilfenidat 36 mg tablet
697 metilfenidat 18 mg Tablet
698 metilfenidat 10 mg tablet
699 valproat 250 mg enterik tablet
700 valproat 500 mg tablet
701 valproat 250 mg tablet
702 litium karbonat 400 mg tablet
703 litium karbonat 200 mg Tablet
704 penghambat dan pemacu metadon 50 mg/5mL botol
705 neuromuskuler suksinilkolin serbuk injek 100 mg vial
706 suksinilkolin 50 mg/mL vial
707 suksinilkolin 20 mg/mL ampul
708 rokuronium 10 mg/mL vial
709 pankuronium 2 mg/mL vial
710 atrakurium 10 mg/mL ampul
711 miastenia gravis piridostigmin 60 mg tablet
712 penghambat neostigmin 0,5 mg/mL ampul
713 kolinesterase donepezil 10 mg tablet
714 antasida dan antiulkus antasida susp botol
715 antasida tab tablet
716 esomeprazol serbuk 40 mg vial
717 lansoprazol serbuk 30 mg vial
718 lansoprazol 30 mg kapsul
719 omeprazol 40 mg ampul
720 omeprazol 20 mg kapsul
721 ranitidin 25 mg/mL ampul
722 ranitidin 150 mg tablet
723 sukralfat 500 mg/ 5 mL botol
724 sukralfat 500 mg tablet
725 antiemetik deksametason 5 mg/mL ampul
726 dimenhidrinat 50 mg tablet
727 domperidon drop 5 mg/mL botol
728 domperidon 5 mg/ 5 mL botol
729 domperidon 10 mg tablet
730 klorpromazin 25 mg/mL ampul
731 klorpromazin 5 mg/mL ampul
732 klopromazin 25 mg Tablet
733 metoklopramid 5 mg/mL ampul
734 metoklopramid drop 2 mg/mL botol
735 metoklopramid 5mg/ 5 mL botol
736 metoklopramid 10 mg tablet
737 metoklopramid 5 mg tablet
738 ondansetron 2 mg/mL ampul
739 ondansetron 8 mg tablet
740 ondansetron 4 mg tablet
741 antihemoroid bismut + lidokain suppositoria
742 antispasmodik hiosin butilbromida 20 mg/mL ampul
743 hiosin butilbromida 10 mg Tablet
744 atropin 0,25 mg/mL ampul
745 atropin 0,5 mg tablet
746 obat diare zinc serbuk 10 mg bungkus
747 zinc 20 mg/5 mL botol
748 zinc 20 mg tablet
749 loperamid 2 mg tablet
750 kaolin pektin tablet
751 garam oralit bungkus
752 atapulgit Tablet
753 katartik polietilen glikol serbuk botol
754 natrium fosfat oral botol
755 laktulosa botol
756 parafin + gliserin + PP botol
757 gliserin 100mg/mL botol
758 bisakodil 10 mg supp
759 bisakodil 5 mg supp
760 bisakodil 5 mg tablet
761 antiinflamasi sulfazalazin 500 mg tablet
762 mesalazin 250 mg Tablet
763 lain-lain somatostatin 3 mg ampul
764 asam ursodeoksikolat 250 mg kapsul
765 antiasma aminofilin 24 mg/mL ampul
766 aminofilin 200 mg tablet
767 aminofilin 150 mg tablet
768 budesonid cairan ih 0,5 mg/mL respul
769 budesonid cairan ih 0,25 mg/mL respul
770 budesonid serbuk ih 200 mcg botol
771 budesonid serbuk ih 100 mcg botol
772 epinefrin 1 mg/mL ampul
773 deksametason 1mg/mL ampul
774 deksametason 0,5 mg tablet
775 fenoterol HBr cairan ih 0,1% botol
776 fenoterol HBr aerosol 100 mcg/puff botol
777 flutikason propionat MDI botol
778 flutikason propionat cairan ih 0,5mg vial
779 ipatropium bromida aerosol 0,02 mg/dosis botol
780 budesonid + formoterol 80/4,5 mcg inhalasi botol
781 budesonid + formoterol 160/4,5 mcg inhalasi botol
782 ipatropium + fenoterol aerosol botol
783 ipatropium + salbutamol cairan inhalasi vial
784 salmeterol + flutikason ih 50 mcg/puff tablet
785 salmeterol + flutikason ih 100 mcg/puff botol
786 salmeterol + flutikason propionat ih 250 mcg/puff botol
787 metilprednisolon 125 mg vial
788 metilprednisolon 16 mg tablet
789 metilprednisolon 8 mg tablet
790 metilprednisolon 4 mg tablet
791 prokaterol cairan ih 50 mcg kapsul
792 prokaterol cairan ih 30 mvg kapsul
793 prokaterol serbuk ih 10 mcg botol
794 salbutamol serbuk in 200mg/kapsul + rotahaler botol
795 salbutamol MDI 100 mcg/dosis botol
796 salbutamol 2 mg/ 5 mL botol
797 salbutamol cairan inhalasi 1 mg/mL vial
798 salbutamol 4 mg Tablet
799 salbutamol 2 mg tablet
800 teofilin lepas lambat 300 mg tablet
801 teofilin 150 mg tablet
802 terbutalin serbuk inhalasi 0,5 mg/dosis botol
803 terbutalin cairan inhalasi 2,5 mg/mL vial
804 terbutalin 0,5 mg/mL ampul
805 terbutalin 1,5 mg/5 mL Botol
806 terbutalin tab 2,5 mg tablet
807 antitusif kodein 20 mg tablet
808 kodein 15 mg tablet
809 kodein 10 mg tablet
810 ekspektoran n-asetil sistein granul 200 mg kapsul
811 n-asetil sistein cap 200 mg kapsul
812 n-asetil sistein ih 100mg/mL ampul
813 PPOK indakaterol serbuk ih 300 mcg kapsul
814 indakaterol serbuk ih 150 mcg kapsul
815 glikopironium serbuk ih 50 mcg kapsul
816 ipatropium bromida ih 0,025 % botol
817 ipatropium bromida 0,02 mg/dosis botol
818 tiotropim respimat ih 5 mcg botol
819 olodaterol 2,5 mcg/spray botol
820 salmeterol + flutikason propionat botol
821 ipatropium + salbutamol inhalasi botol
822 surfaktan 25 mg/mL ampul
823 serum dan imunoglobulin hepatitis B imunoglobulin manusia 220 IU/mL vial

824 hepatitis B imunoglobulin manusia 150 IU/ 1,5 mL ampul

825 human tetanus imunoglobulin 500 IU vial
826 human tetanus imunoglobulin 250 IU vial
827 imunoglobulin intravena 50 mg/mL ampul
828 serum anti bisa ular ABU I vial
829 serum antidifteri (ADS) 10.000 IU vial
830 serum antirabies 200-400 IU vial
831 serum antirabies 100 IU vial
832 serum antitetanus 20.000 IU vial
833 serum antitetanus 10.000 IU vial
834 serum antitetanus (ATS) 5000 IU vial
835 serum antitetanus (ATS) 1500 IU vial
836 tetanus toxoid injek vial
837 vaksin BCG vial
838 vaksin DPT-HB-Hib vial
839 vaksin hepatitis B rekombinan vial
840 vaksin jerap difteri tetanus (DT) vial
841 vaksin jerap tetanus difteri (Td) vial
842 vaksin MR vial
843 vaksin polio oral (b-OPV) botol
844 vaksin polio IPV ampul
845 vaksin rabies manusia 2,5 IU ampul
846 vaksin rabies manusia injeksi + booster ampul
847 obat untuk telinga asam asetat encer botol
848 flutikason furoat 27,5 mcg/spray Botol
849 hidrogen peroksida 50% botol
850 hidrogen peroksida 3% botol
851 karbogliserin 10% TT botol
852 kloral hidrat botol
853 kloramfenikol tetes telinga botol
854 lidokain spray 10% botol
855 oksimetazolin 0,05% Botol
856 oksimetazolin 0,025% botol
857 ofloksasin 3% botol
858 triamsinolon asetonid 55 mcg/puff botol
859 vitamin dan mineral asam askorbat (vitamin C) 250 mg tablet
860 asam askorbat (vitamin C) 50 mg tablet
861 ergokalsiferol (vitamin D2) 10.000 IU/mL botol
862 ergokalsiferol (vitamin D2) 50.000 IU kapsul
863 garam Fe 60 mg tablet
864 kalsitriol 0,5 mcg kapsul
865 kalsitriol 0,25 mcg kapsul
866 kalsium glukonat injeksi 10% ampul
867 kalsium karbonat 500 mg tablet
868 kalsium laktat (kalk) 500 mg tablet
869 asam folat 0,4 mg tablet
870 piridoksin (vitamin b6) injeksi 50 mg/mL ampul
871 piridoksin (vitamin b6) 25 mg tablet
872 piridoksin (vitamin b6) 10 mg tablet
873 retinol (vitamin A) 200.000 IU kapsul
874 retinol (vitamin A) 100.000 IU kapsul
875 sianokobalamin (vitamin b12) 50 mcg tablet
876 tiamin (vitamin b1) 50 mg tablet
877 vitamin b kompleks tablet
878 lain-lain sevelamer karbonat tablet 800 mg tablet
 keteranga
usulan harga harga+PPN jumlah suplier n
5 0
5 0
5 0
28 0
28 0
100 0
100 0
30 0
30 0
30 0
0 0
10 0
0 0
28 20625 22688 635264 Kimia Farma Oxynorm
28 41250 45375 1270500 Kimia Farma Oxynorm
0 29464 32411 0 Kimia Farma Oxyneo
100 41545 45700 4570000 Kimia Farma Oxyneo
0 0
5 0
10 0
5 0
0 0
22,000 111 122 2684000 enseval generik
1,000 184 184000
4000 245 980000
300 4420 1326000
500 0
30 0
10 0
600 0
300 0
2000 297 327 654000 PT KIMIA FARMA
4000 367 404 1616000 PT KIMIA FARMA
50 0
70,000 250 275 19250000 PT KIMIA FARMA
1000 4583 5042 5042000 PT KIMIA FARMA
250 0
200 0
10,000 227 249.7 2497000 PT KIMIA FARMA
5,000 0
1000 0
500 0
100 0
1000 0
 1000 0
100 0
20 0
0 0
100 0
3000 0
10 0
5 0
10 0
5 0
3 2,238,000 2,461,800 7385400 Kalbe Farma Suprane
5 680,000 748,000 3740000 Dexa Medica Fluothane
3 0
5 0
5 0
20 0
0 0
30 0
10 0
30 0
30 0
50 0
100 0
10 0
10 0
3000 0
2000 0
200 0
100 0
10,000 24 26.4 264000 Imfarmind Farmasi Industri
3000 0
10000 367 404 4040000 PT KIMIA FARMA
2000 0
500 0
300 0
300 0
50 0
20 0
5000 0
20 0
10 0
10 0
10 0
10 0
0 0
20 0
 20 0
200 0
200 0
50 0
100 0
100 0
20 0
20 0
100 0
10 0
100 0
100 0
100 0 Glaxo Wellcome
100 6490 7139 713900 Indonesia Lamictal
100 0
100 0
20 0
100 0
100 0
100 0
1000 0
2000 0
1000 0
50 0
200 0
50 0
200 0
200 0
50 0
1000 466 513 513000 PT KIMIA FARMA
1000 0
100 0
100 0
100 0
3000 200 600000
10,000 201 201 2010000 enseval
50 0
300 2050 2255 676500 Mersifarma
300 3700 1110000
100 5100 5610 561000 Meiji Indonesia
100 0
30 11500 12650 379500 Phapros
30 14500 15950 478500 Phapros
500 0
500 425 468 234000 Phapros
500 0
 50 0
3000 0
7000 656 721.6 5051200 PT KIMIA FARMA
200 0
200 0
100 0
100 0
300 0 enseval/PT KIMIA
4000 387 / 350 426 1704000 FARMA
4000 0
200 0
20 0
100 0
200 0
100 0
20 0
50 0
1000 0
50 0
100 3500 3850 385000 Dexa Medica
50 0
100 0
500 588 647 323500 PT KIMIA FARMA
10 0
100 444 489 48900 PT KIMIA FARMA
100 950 1045 104500 PT KIMIA FARMA
500 617 678.7 339350 PT KIMIA FARMA
500 0
30 8044 8848.4 265452 PT KIMIA FARMA
20 0
3000 0
2000 267 293.7 587400 PT KIMIA FARMA
500 5994 6593.4 3296700 PT KIMIA FARMA
100 0
2000 4500 4950 9900000 PT KIMIA FARMA
50 0
200 0
100 854 939.4 93940 PT KIMIA FARMA
400 0
30 11112 12223.2 366696 PT KIMIA FARMA
200 0
50 0
50 0
300 0
50 0
1000 0
500 0
100 0
50 0
500 700 770 385000 PT KIMIA FARMA
50 0
500 0
500 0
8000 688 757 6056000 PT KIMIA FARMA
100 0
2000 0
3000 0
10 0
10 0
5 550000 605000 3025000 PT KIMIA FARMA
100 0
5000 263 289 1445000 PT KIMIA FARMA
50 0
50 0
100 0
200 0
100 1320 1452 145200 PT KIMIA FARMA Primet
100 0
100 0
100 0
100 0
500 0
500 165 182 91000 PT KIMIA FARMA
500 2160 2376 1188000 PT KIMIA FARMA
500 164 180 90000 PT KIMIA FARMA
500 150 165 82500 PT KIMIA FARMA
0 0
0 0
0 0
0 0
0 0
200 0
200 0
200 0
20 0
100 0
60 17000 18700 1122000
10 0
500 306 337 168500 PT KIMIA FARMA
500 0
500 0
100 0
2000 483 531.3 1062600 PT KIMIA FARMA
1000 0
100 0
100 0
10 0
0 0
0 0
0 1234 1357 0 PT KIMIA FARMA KINA
10 0
100 235 255.2 25520 PT. PHAPROS
2000 556 611.6 1223200 PT KIMIA FARMA
3000 851 936.1 2808300 PT KIMIA FARMA
20 0
1000 0
20 0
20 0
0 0 Ricovir-
0 4630 5093 0 PT. KIMIA FARMA EM
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 6800 7480 0 PT.KIMIA FARMA Tenolam E Kombinasi
0 0
0 0
100 0
100 0
100 0
100 9600 960000 enseval Tenva
100 0
100 0
100 0
100 0
100 0
100 0
100 0
100 0
100 0
100 0
500 0
500 269 295.9 147950 PT KIMIA FARMA
100 0
0 0
 500 0
500 0
10,000 0
0 0
100 13773 15150.3 1515030 PT. BAYER INDONESIA Visanne
5 954500 1049950 5249750 PT. MEPROFARM Eligard
3 2727000 3021700 9065100 PT. MEPROFARM Eligard
0 0
0 0
0 0
10,000 265 2650000
1000 0
100 0
0 1696845 1866530 0 PT. BAYER INDONESIA Nebido
1000 943 1038 1038000 PT. DANKOS Rheu-Trex
0 0
0 0
PT. GLAXO
0 1400 1540 0 PT. DEXA MEDICA
WELLCOME
0 4844 5328.4 0 INDONESIA Requip
100 0
1000 0
2000 0
500 0
1000 0
50 0
3000 0
10 0
2000 72 79.2 158400 PT KIMIA FARMA
500 0
1000 0
100 0
200 0
100 0
0 0
20 0 Hemapo
20 57000 1140000 enseval 2000
Hemapo
10 80000 800000 enseval 3000
0 0
0 0
10 0 Octalbin
3 940000 1034000 3102000 PT. KALBE FARMA 5%
octalbin
3 822727 904999.7 2714999.1 enseval 20%
octalbin
3 721818 793999.8 2381999.4 enseval 25%
3 0
10 0
10 0
 10 0
10 0
10 0
10 0
10 0
10 0
10 0
100 0
100 0
20 0
100 0
500 0
200 4600 920000
10 0
100 0
10 0
3 0
3 0
3 0
3 0
3 0
10 0
3 0
3 0
50 0
100 0
5 0
3 0
3 0
100 0
50 0
3 0
0 0
3 0
3 0
0 0
10 0
10 0
3 0
3 0
5000 170 850000
1000 0
5000 165 182 910000 PT KIMIA FARMA
1000 0
40 43500 1740000 enseval Mannitol 500 mL
5000 0
 1000 0
100 0
100 0
100 0
100 0
100 0
100 0
100 0
100 0
100 0 PT. ABBOT
100 14000 15400 1540000 INDONESIA Manirin
0
10 0
500 0
500 0
100 0
100 190 209 20900 PT KIMIA FARMA
1000 0
1000 0
1000 0
2000 1000 1100 2200000 PT. DEXA MEDICA
5000 360 396 1980000 PT KIMIA FARMA
5000 600 660 3300000 PT KIMIA FARMA
500 700 770 385000 PT KIMIA FARMA
500 800 880 440000 PT KIMIA FARMA
100 0
100 0
10,000 0
2000 0
100 0
100 0 PT. NOVARTIS
100 1647 1811.7 181170 INDONESIA Galvus
20 0
20 0
20 0
20 0 PT. FERRON PAR
20 112000 123200 2464000 PHARMA Ryzodeg
20 89000 1780000 enseval ezelin
2 0
2 0
50 0
50 0
50 0
0 0
0 0
100 0
 100 0
100 0
100 0
300 0
300 0
300 0
5 0
1000 0
1000 0
100 0
100 0
0 0
0 0
0 0
0 0
0 0
5000 400 2000000
0 0
100 0
30 0
10,000 0
10 0
0 300 330 0 PT KIMIA FARMA
100 0
100 194 214 21400 PT KIMIA FARMA
0 0
100 0
0 0
10 0
10 0
1000 0
300 0
10 0
20 0
100 436 480 48000 PT KIMIA FARMA
20 0
2000 0
0 0
100 0
1000 0
30 0
100 0
30 0
100 0
300 436 479.6 143880 PT KIMIA FARMA
1000 0
1000 0
500 0
300 0
200 240 264 52800 PT. DEXA MEDICA
100 0
20 0
100 0
100 0
1000 201 221.1 221100 PT KIMIA FARMA
20 0
200 0
200 0
500 0
500 0
100 0
20 0
20 165 181.5 3630 PT KIMIA FARMA
1000 0
1000 0
100 0
100 0
0 0
100 0
100 0
30 0
50 0
30 0
100 0
100 0
300 0
300 0
1000 500 550 550000 PT KIMIA FARMA
0 300 330 0 PT KIMIA FARMA
0 36000 39600 0 PT. PFIZER INDONESIA Revatio
100 0 PT. ASTRA ZENECA
100 8404 9245 924500 INDONESIA Brilinta
500 0
500 0
100 17308 19039 1903900 PT. AVENTIS PHARMA Plavix
7,000 1667 1834 12838000 PT KIMIA FARMA
3000 0
3000 0
10 0
10 0
0 0
0 0
 0 0
100 1210 121000 enseval V-bloc
100 0
100 0
500 0
1000 133 146.3 146300 PT KIMIA FARMA
1000 0
3000 0
20 0
0 0
0 113 125 0 PT KIMIA FARMA
0 0
0 0
500 0
2000 0
5000 0
1000 0
50 0
50 0
50 0
30 0
20 0
500 0
500 0
500 0
500 0
500 0
500 0
50 0
50 0
50 0
50 0
100 0
500 540 594 297000 PT KIMIA FARMA
1000 140 154 154000 PT KIMIA FARMA
10 0
10 0
20 0
20 0
20 0
30 0
30 0
100 0
30 0
30 0
100 0
100 3750 4125 412500 PT KIMIA FARMA
20 0
20 0
20 0
100 4000 4400 440000 PT KIMIA FARMA
40 0
50 0
50 0
50 0
30 0
100 3458 3803.8 380380
100 0
10 0
10 0
10 0
30 0
30 0
30 0
100 0
100 2217 2439 243900 PT
PT.KIMIA
TEMPO FARMA
SCAN
100 1540 1694 169400 PACIFIC
100 3800 380000
50 0
10 0
5 0
5 0
5 0
5 0
5 0
5 0
20 0
20 0
30 0
30 0
30 4500 135000
10 0
10 0
10 0
0 0
10 0
500 0
100 0
30 0
50 0 Tutofusin
30 38500 1155000 enseval OpS
Triofusin
40 63000 2520000 enseval E
 Triofusin
40 51000 2040000 enseval 500
0 0
0 0
20 74220 1484400 enseval Kalbamin
20 49790 995800 enseval Renxamin
50 0
500 2300 1150000
0 0
10 0
10 0
30 0
30 3629 3991.9 119757 PT KIMIA FARMA
20 0
20 0 PT. FERRON PAR
10 48862 53748.2 537482 PHARM
20 0
50 4700 5170 258500 PT KIMIA FARMA
50 0
50 0
10 22300 24530 245300 PT. CENDO Genta 1%
10 0
10 0
20 0
3 0
3 0
3 0
3 54200 59620 178860 PT. CENDO PAR
PT FERRON P-PRED
3 43714 48085.4 144256.2 PHARM
3 0
3 0
3 0
3 0
3 0
3 0
3 0
3 0
3 0
3 0
3 0
3 0
3 0
3 0
3 0
3 0
3 0
3 0
 3 0
100 0
3 0
30 0
3 0
10 0
3 0
200 0
200 0
300 250 275 82500
0 0
100 0
0 0
100 0
0 0
100 0
300 125 137.5 41250
100 0
100 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 kalxtin 10
0 479 0 enseval mg
0 0
0 0
0 0
10 0
100 181 199.1 19910 PT. PHAPROS
0 0
0 0
0 0
0 137060 150766 0 PT. BAYER INDONESIA Zyprexa
0 0
0 0
0 993920 1093312 0 PT. SOHO Invega Sustena 150 mg/1,5 ml
0 993920 1093312 0 PT. SOHO Invega Sustena 100 mg/ml
0 993920 1093312 0 PT. SOHO Invega Sustena 75 mg/0,75
0 993920 1093312 0 PT. SOHO Invega Sustena 50 mg/0,5 ml
0 0
0 0
 0 0
0 0
0 0
0 0
100 0
0 0
0 0
0 0
0 0
0 0
100 0
100 0
100 0
0 0
0 0
0 0
10 0
0 0
0 0
10 0
0 0
0 0
100 0
10 0
100 0
1000 2000 2000000
5000 176 193.6 968000 PT KIMIA FARMA
20 0
50 0
4000 0
300 0
2000 600 660 1320000 PT KIMIA FARMA
10,000 0
5000 0
0 0
500 0
0 0
500 148 163 81500 PT KIMIA FARMA
30 0
50 0
500 0
30 0
30 0
0 0
50 0
20 0
 50 0
300 130 143 42900 PT KIMIA FARMA
0 120 132 0 PT KIMIA FARMA
100 0
100 755 75500
100 620 62000 antihemo
100 3000 3300 330000 PT KIMIA FARMA roid
50 0
100 0
0 0
0 0
100 0
50 0
1000 432 475.2 475200 PT KIMIA FARMA
500 0
500 0
500 280 308 154000 PT. PHAPROS
500 0
1 123495 135845 135845 PT. MEIJI INDONESIA
1 0
50 0
10 0
10 0
30 0 Dulcolax
50 5085 5593.5 279675 PT. AVENTIS PHARMA Supp
50 0
100 0
0 0
5 337986 371784 1858920 PT. COMBINED IMPERIAL PHARM
500 0
300 2800 840000
100 160 16000
100 140 14000
10 0 PT. ASTRA ZENECA
10 10478 11525.8 115258 INDONESIA Pulmicort
10 0
10 0
0 0
0 0
0 0
10 0
10 0
PT. GLAXO
10 0 WELLCOME Flixotide
10 84000 92400 924000 INDONESIA Inhaler
10 0 PT. ASTRA ZENECA
10 135577 149135 1491350 INDONESIA Symbicort
 PT. BOEHRINGER
10 0 INGELHEIM
10 131250 144375 1443750 INDONESIA Berodual
10 0
PT. GLAXO
10 0 WELLCOME
PT. GLAXO Seretide Diskus 100
10 111850 123035 1230350 INDONESIA
WELLCOME
10 137492 151241.2 1512412 INDONESIA Seretide Diskus 500 (adanya sediaan 500 mcg
0 0
0 0
0 0
0 0
10 0
10 0
0 0
10 0
10 0
10 0
100 0
1000 108 118.8 118800 PT KIMIA FARMA
1000 103 113.3 113300 PT KIMIA FARMA
500 1160 580000 PT KIMIA FARMA
200 0
10 0 PT. ASTRA ZENECA
10 7675 8442.5 84425 INDONESIA Bricasma
10 0
0 0
200 0
100 1360 136000 PT KIMIA FARMA
100 1015 101500 PT KIMIA FARMA
100 600 60000 PT KIMIA FARMA
500 3230 3553 1776500 PT. ERELA Fluimucil
500 0
10 8850 9735 97350 PT. DEXA MEDICA
10 0 PT. NOVARTIS
10 13500 14850 148500 INDONESIA Ultibro (serbuk inhalasi kombinasi indikaterol
10 0
10 0
10 0
PT. BOEHRINGER
10 0 INGELHEIM
3 345000 379500 1138500 INDONESIA STRIVERDI RESIMAT
10 0
10 0
10 0 PT. DIPA PHARMA
5 1375000 1512500 7562500 LAB Hyperhep

5 0
10 0
 Tetagam
10 146800 161480 1614800 PT. DEXA MEDICA P
10 0
3 517132 568845.2 1706535.6 PT. BIOFARMA
3 0 PT. DIPA PHARMA Hyperrab
3 1653399 1818673 5456019 LAB INT PHARMA
PT. DIPA 300 IU
3 1880000 2068000 6204000 LAB INT Hyperrab 150 (adanya dosis yang 150)
10 0
10 0
5 0
5 0
5 0
0 0
10 85103 93613.3 936133 PT. BIOFARMA Pentabio
10 25839 28423 284230 PT. BIOFARMA
10 0
10 0
10 167860 184646 1846460 PT. BIOFARMA
10 21494 23643.4 236434 PT. BIOFARMA
10 158994 174893.4 1748934 PT. BIOFARMA
3 153000 168300 504900 PT. BIOFARMA
3 0
3 0
3 0
3 0
3 0
3 0
3 0
50 0
0 0
10 0
10 0 tarivid
10 34000 340000 enseval otic
3 0
10,000 182 200.2 2002000 PT KIMIA FARMA
5000 42 46.2 231000 PT. IMFARMIND FARMASI INDUSTRI
100 0
100 0
500 0
100 2600 2860 286000 PT. PHAPROS
100 0
30 0
100 0
3000 189 207.9 623700 PT KIMIA FARMA
0 0
100 0
1000 222 244.2 244200 PT. IMFARMIND FARMASI INDUSTRI
 1000 128 140.8 140800 PT KIMIA FARMA
1000 753 828.3 828300 PT KIMIA FARMA
1000 450 495 495000 PT KIMIA FARMA
1000 72 79.2 79200 PT KIMIA FARMA
1000 0
10,000 130 143 1430000 PT KIMIA FARMA
50 0
241519706.3
(adanya sediaan 500 mcg)

asi kombinasi indikaterol 110 mcg dan glikopironium 50 mcg)

ya dosis yang 150)
No. kelas terapi Nama Obat Satuan usulan Catatan
1 analgesik narkotik Fentanil injeksi 0,05 mg/mL (i.m./i.v.) Ampul 5
2 Fentanil patch 12,5 mcg/jam Patch 5
3 Fentanil patch 25mcg/jam Patch 5
4 Hidromorfon 8mg Tablet 28
5 Hidromorfon 16 mg Tablet 28
Tablet
6 Morfin 10mg Tablet
Lepas 30
Tablet
7 Morfin 10mg Lambat
Lepas 30
Tablet
8 Morfin 15mg Lambat
Lepas 30
9 Morfin 30mg Lambat 0
10 Morfin Injeksi 10mg/ml (i.m/s.k/i.v) Vial 10
11 Oksikodon Kapsul 5mg Kapsul 0
12 Oksikodon kapsul 10mg Kapsul 28
Tablet
13 Oksikodon kapsul 20mg Kapsul
Lepas 28
14 Oksikodon 15mg Lambat 100
15 Oksikodon Injeksi 10mg/ml Ampul 5
16 Petidin Injeksi 50mg/ml Ampul 10
17 Sufentanil injeksi 5mcg/ml Vial 5
18 analgesik non-narkotik Asam mefenamat tablet 500mg Tablet 22,000
19 Ibuprofen 200mg Tablet 1,000
20 Ibuprofen 400mg Tablet 4000
21 Ibuprofen Suspensi 100mg Botol 300
22 Ibuprofen suspensi 200mg Botol 500
23 Ketoprofen injeksi 50mg/ml Ampul
Suppositori 30
24 Ketoprofen Supp 100mg a 300
25 Ketorolac injeksi 30mg/ml Ampul 600
Tablet
26 Metamizole Injeksi 500mg/ml Ampul
Salut 300
27 Natrium diclofenak 50mg Enterik 5000
28 Paracetamol 500mg Tablet 50,000
29 Paracetamol sirup 125mg/5ml Botol 900
30 Paracetamol drop 100mg/ml Botol 50
31 Paracetamol infus 10mg/ml Botol 250
32 antipirai Allopurinol 100mg Tablet 10,000
33 Allopurinol 300mg Tablet 5,000
34 Kolkisin 500mcg Tablet 1000
35 Probenecid 500mg Tablet 500
36 nyeri neuropatik Amitriptiline 25mg Tablet 100
37 Gabapentin 100mg Kapsul 1000
38 Gabapentin 300mg Kapsul 1000
39 Karbamazepin 100mg Tablet 100
40 anestetik lokal Etil klorida spray 100ml Botol 10
41 Lidokain Injeksi 2% Ampul 3000
42 Ketamin Injeksi 50mg/ml Vial 5
43 Ketamin injeksi 100mg/ml Vial 5
44 obat pre operatif Midazolam injeksi 1mg Ampul 20
45 Midazolam injeksi 5mg Ampul 10
46 antialergi dan anafilaksis Dexametason injeksi 5mg/ml Ampul 3000
47 Difenhidramin injeksi 10mg/ml Ampul 2000
48 Epinefrin injeksi 1mg/ml Ampul 200
49 Klorfeniramin 4mg Tablet 5,000
50 Loratadine Tablet 3000
51 Cetirizine tablet 10mg Tablet 10000
52 Atropin tablet 0,5 mg Tablet 500
53 antidot khusus Atrofin injeksi 0,25mg/ml Ampul 300
54 Efedrin injeksi 50mg/ml Ampul 300
55 Kalsium glukonat injkesi 10% Ampul 50
56 Nalokson injeksi 0,4mg/ml Ampul 20
57 Natrium bikarbonat Tablet 5000
58 Natrium bikarbonat injeksi 8,4% Ampul 20
59 Natrium tiosulfat injeksi 25% Ampul 10
60 Neostigmin injeksi 0,5% Ampul 10
61 Protamin sulfat injeksi 10mg/ml Ampul 10
62 antidot umum Magnesium sulfat Sachet 10

63 antiepilepsi-anti konvulsi Diazepam injeksi 5mg Ampul 100

64 Diazepam enema 5mg/2,5ml Rectal tube 20
65 Diazepam enema 10mg/2,5ml Rectal tube 20
66 Fenitoin injeksi 50mg/ml Ampul 50
67 Fenobarbital 30mg Tablet 100
68 Fenobarbital 100mg Tablet 100
69 Fenobarbital injeksi 100mg/ml Ampul 20
70 Karbamazepin 200mg Tablet 100
71 Karbamazepin sirup 100mg/ml Botol 10
72 Klonazepam 2mg Tablet
Tablet 100
73 Lamotrigin 25mg Dispersible 100
74 Lamotrigin 50mg Tablet 100
75 Lamotrigin 100mg Tablet 100
76 Magnesium sulfat injeksi 40% Ampul 100
77 Okskarbazepin suspensi 60mg/ml Botol 20
78 Topiramat 25mg Tablet 100
79 Topiramat 50mg Tablet 100
Tablet
80 Topiramat 100mg Tablet
Lepas 100
Tablet
81 Valproat 250mg Lambat
Lepas 1000
Tablet
82 Valproat 500mg Lambat
Salut 2000
83 Valproat tab.salut enterik 250mg Enterik 1000
84 Valproat 250mg/ml Botol 50
85 antelmitik Mebendazol 500mg Tablet 200
86 Mebendazol sirup 100mg/ml Botol 50
87 Dietilkarbamazepin 100mg Tablet 100
88 Bet laktam Amoksisilin 500mg Tablet 5,000
89 Amoksisilin drop 100mg/ml Botol 50
90 Amoksisilin sir kering 125 mg/5 mL Botol 300
91 Amoksisilin sir kering 250 mg/5 mL Botol 300
92 Ampisilin inj 1.000 mg (i.v.) Ampul 100
93 Benzatin benzilpenisilin inj 1,2 juta IU/mL (i.m.) Ampul 30
94 Benzatin benzilpenisilin inj 2,4 juta IU/mL (i.m.) Ampul 30
95 Fenoksimetil penisilin (penisilin V) 125mg Tablet 500
96 Fenoksimetil penisilin (penisilin V) 250mg Tablet 500
97 Fenoksimetil penisilin (penisilin V) 500mg Tablet 500
98 prokain benzilpenisilin inj 3 juta IU (i.m.) Vial 50
99 Sefadroksil 500mg Kapsul 7000
100 Sefadroksil 125mg/5ml Botol 200
101 Sefadroksil 250mg/5ml Botol 200
102 sefaleksin 500mg Kapsul 100
103 Sefazolin injeksi 1000mg Vial 100
104 Sefefim injeksi 1000mg Vial 300
105 Cefixime 100mg Kapsul 4000
106 Cefixime 200mg Kapsul 4000
107 Cefixime ds 100mg/ml Botol 50
108 Sefoperazon injeksi 1000mg Vial 20
109 Cefotaxime injeksi 1000mg Vial 200
Tablet
110 Sefpirom serb inj 1.000 mg Vial
Salut 100
111 Sefpodoksim proksetil 100 mg Selaput 20
112 seftazidim serb inj 1.000 mg Vial 50
113 seftriakson inj 1.000 mg Vial 1000
114 sefuroksim 250mg Vial 100
115 sefuroksim 500mg Vial 100
116 sefuroksim injeksi 750mg Vial 50
117 tetrasiklin Doksisiklin 100mg Kapsul 500
118 Oksitetrasiklin injeksi 50mg/ml Ampul 10
119 kloramfenikol Kloramfenicol 250mg Kapsul 500
120 Kloramfenicol 500mg Kapsul 500
121 Kloramfenicol suspensi 125mg/5ml Botol 30
122 Kloramfenicol injeksi 1000mg Vial 20
123 kotrimoksazol Kotrimoksazole Tablet 3000
124 Kotrimoksazol forte Tablet 2000
Tablet
125 Kotrimoksazol sirup Botol
Salut 500
126 makrolid Azitromisin 500mg Selaput 2000
127 Azitromisin ds 200mg/5ml Botol 20
128 Azitromisin serbuk injeksi 500mg Vial 100
129 Eritromisin 250mg Kapsul 100
130 Eritromisin 500mg Kapsul 400
Tablet
131 Eritromisin 200mg/5ml Botol
Salut 30
132 Spiramisin 500mg Selaput 300
133 aminoglikosida Amikasin injeksi 250mg/ml Vial 20
134 Gentamicin injeksi 40mg/ml Ampul 1000
135 Kanamisin Serbuk Injeksi 1000mg Vial 100
136 Streptomisin serbuk injeksi 1000mg Vial 50
137 kuinolon Levofloksasin 500mg Tablet 500
Tablet
138 Levofloksasin infus 5mg/ml Botol
Salut 50
Tablet
139 Ofloksasin 200mg Selaput
Salut 500
140 Ofloksasin 400mg Selaput 500
141 Siprofloksasin 500mg Tablet 8000
142 linkosamid Klindamisin 150mg Kapsul 2000
143 Klindamisin 300mg Kapsul 3000
144 antimikroba lain-lain Fosfomisin trometamol granula 3 g Sachet 10
145 Meropenem serb inj 500 mg Vial 10
146 Meropenem serb inj 1.000 mg Vial 5
147 Metronidazole 500mg Tablet 5000
148 Metronidazole suspensi 125mg/5ml Botol 50
149 Metronidazole infus 5mg/ml Botol 500
150 Metronidazole ovula 500mg Ovula 200
151 Pirimetamin 25mg Tablet 100
152 Sulfadiazin 500mg Tablet 100
153 antilepra Dapson 100mg Tablet 100
154 Klofazimin 50mg Kapsul 100
155 Klofazimin 100mg Kapsul 100
156 Rifampisin 300mg Kapsul 500
157 Rifampisin 450mg Tablet 500
158 Rifampisin 600mg Tablet 500
159 OAT Isoniazid 100mg Tablet 500
160 Isoniazid 300mg Tablet 500

161 antiseptik saluran kemih Asam pipemidat 400mg Kapsul 100

162 Metenamin mandelat (heksamin mandelat) 500mg Tablet 200

163 Nitrofurantoin 50mg Tablet 200
164 antifungi sistemik Flukonazole 150 Tablet 60
165 Itrakonazole 100mg Kapsul 100
166 Ketokonazole 200mg Tablet 800
167 Nistatin tablet 500IU Tablet 1000
168 Terbinafin 250mg Tablet 100
169 antimalaria Artesunat inj 60 mg (i.v./i.m.) Ampul 10
170 Kuinin injeksi 25% Ampul 10
171 antiherpes Asiklovir 200mg Tablet 500
172 Asiklovir 400mg Tablet 3000
173 Asiklovir serbuk injeksi 250mg Vial 20
Tablet
174 Valasiklovir 500mg Tablet
Salut 1000
175 CMV Valgansiklovir 450mg Selaput 20
176 antihepatitis Lamivudin 100mg Tablet 100
177 Pegylated interferon alfa-2a inj 135 mcg/0,5 mL Ampul 100
178 Pegylated interferon alfa-2a inj 180 mcg/0,5 mL Ampul 100
179 Pegylated interferon alfa-2b serb inj 50 mcg Ampul 100
180 Pegylated interferon alfa-2b serb inj 80 mcg Ampul 100
Tablet
181 Pegylated interferon alfa-2b serb inj 100 mcg Ampul
Salut 100
182 Ribavirin 200mg Selaput 100
183 Telbivudin 600mg Tablet 100
184 antimigren Propanolol 40mg Tablet 500
185 antivertigo Betahistine 6mg Tablet 900
186 Betahistine 24mg Tablet 100

187 Hormon dan antihormon Dexametason 0,5mg Tablet 3,000

188 leuprorelin asetat serb inj 7,5 mg Ampul 5
189 leuprorelin asetat serb inj 22,5 mg Ampul 3
190 Metilprednisolon 4mg Tablet 10,000
191 Metilprenisolon 16mg Tablet 1000
192 imunosupresan Metotreksat 2,5mg Tablet 1000
193 antiparkinson triheksifenidil 2 mg tablet 100
194 antianemi asam folat 0,4 mg tablet 1000
195 asam folat 1 mg tablet 500
196 asam folat 5 mg tablet 500
197 Fe sulfat + asam folat tab tablet 1500
198 low molecule feeri sucrose inj 20 mg/mL vial 10
199 sianokobalamin tab 50 mcg tablet 2000
200 sianokobalamin inj 500 mg/mL vial 500

obat yang memengaruhi

201 koagulasi asam traneksamat 500 mg tablet 1000
202 asam traneksamat injj 100 mg/mL vial 200
203 dabigatran eteksilat 75 mg tablet 100
204 dabigatran eteksilat 110 mg tablet 0

205 obat kelebihan besi deferoksamin inj 500mg bvial 20

206 hematopoietik eritropoietin alfa inj 2.000 IU vial 20
207 eritropoietin alfa inj 3.000 IU vial 10
208 eritropoietin alfa inj 4.000 IU vial 0
209 eritropoietin alfa inj 10.000 IU vial 0
210 eritropoietin beta inj 2.000 Iu vial 10
211 plasma expander albumin serum normal inj 25 % vial 3
212 pengganti plasma golongan gelatin infus labu 3
213 kontras radiologi barium sulfat serbuk 92 g/100 g Ampul 10
214 barium sulfat susp 95% Kapsul 10
215 iopamidol inj 300-370 mg/mL Ampul 10
216 iopromid 300-370 mg/mL Tablet 10
217 iodiksanol inj tablet 10
218 ioheksol inj tablet 10
219 iopamidol inj 300-370 mg/mL tablet 10
220 iopromid infus botol 10

221 galactose microparticle 200-400 mg micropart/mL botol 10

222 tes kulit K Y jelly botol 100
223 antiseptik disinfektan povidon iodin 100mg/mL botol 100
224 etanol 70% botol 200
225 perawatan gigi klorheksidin 0,2% botol 30
226 nistatin susp 100.000 IU/mL botol 50
227 glass ionomer ART botol 3
228 anestesi gigi lidokain + epinefrin inj ampul 100
229 aquadest 500 mL labu 50
230 diuretik furosemid 40 mg Tablet 5000
231 furosemid inj 10 mg/mL Ampul 1000
232 hidroklorotiazid 25 mg Tablet 5000
233 manitol infus 20 % labu 40
234 spironolakton 25 mg tablet 5000
235 spironolakton 100 mg tablet 1000
236 hipertrofi prostat doksazosin 1 mg tablet 100
237 doksazosin 2 mg tablet 100
238 dutasterid 0,5 mg Tablet 100
239 finasterid 5 mg tablet 100
240 silodosin 4 mg Tablet 100
241 tamsulosin 0,2 mg tablet 100
242 tamsulosin 0,4 mg tablet 100
243 terazosin 1 mg tablet 100
244 terazosin 2 mg Tablet 100
245 hormon diuretik vasoprersin 20 IU/mL ampul 10
246 antidiabetes oral akarbose 100 mg tablet 500
247 glibenklamid 5 mg tablet 200
248 gliklazid 30 mg tablet 1000
249 gliklazid 60 mg tablet 1000
250 gliklazid 80 mg tablet 1000
251 glikuidon 30 mg tablet 2000
252 glimepirid 1 mg tablet 5000
253 glimepirid 2 mg tablet 5000
254 glimepirid 3 mg Tablet 500
255 glimepirid 4 mg tablet 500
256 glipizid 5 mg tablet 100
257 glipizid 10 mg tablet 100
258 metformin 500 mg Tablet 10,000
259 pioglitazon 15 mg tablet 100
260 pioglitazon 30 mg Tablet 100
261 vildagliptin 50 mg tablet 100

262 Antidiabetik parenteral humulin short acting inj 100 IU/mL pen 20
263 humulin intermediate acting inj 100 IU/mL pen 20
264 Humulin Mix acting inj 100 IU/mL pen 20
265 analog rapid insulin inj 100 IU/mL pen 20
266 analog mix insulin inj 100 IU/mL pen 20
267 analog long insulin inj 100 IU/mL pen 20
Hormon Tiroid dan
268 antitiroid karbimazol 5 mg Tablet 300
269 levotiroksin 50 mcg Tablet 300
270 levotiroksin 100 mcg tablet 300
271 lugol larutan botol 5
272 propiltiourasil 10 mg Tablet 1000
273 tiamazol 5 mg Tablet 100
274 tiamazol 10 mg tablet 100
275 Kortikosteroid metilprednisolon 8 mg tablet 5000
276 metilprednisolon inj 125 mg ampul 250
277 prednison 5 mg tablet 10,000
278 antiangina amlodipin 5 mg tablet 0
279 diltiazem 30 mg Tablet 100
280 gliseril trinitrat 0,5 mg tablet 0
281 gliseril trinitrat 2,5 mg tablet 100
282 gliseril trinitrat 5 mg tablet 0
283 gliseril trinitrat inj 5 mg/mL ampul 10
284 gliseril trinitrat inj 10 mg/mL ampul 10
285 ISDN 5 mg tablet 1000
286 ISDN inj 1 mg/mL ampul 10
287 antiaritmia verapamil inj 2,5 mg/mL ampul 20
288 verapamil 80 mg tablet 100
289 propranolol inj 1 mg/mL ampul 20
290 propranolol 10 mg tablet 2000
291 digoksin 0,25 mg/mL ampul 100
292 digoksin 0,25 mg Tablet 1000
293 amiodaron inj 50 mg/mL ampul 30
294 amiodaron 200 mg tablet 100
295 adenosin inj 3 mg/mL ampul 30
296 antihipertensi verapamil 240 mg tablet 100
297 verapamil 80 mg Tablet 300
298 telmisartan 80 mg tablet 1000
299 telmisartan 40 mg Tablet 1000
300 ramipril 10 mg tablet 500
301 ramipril 5 mg tablet 300
302 ramipril 2,5 mg tablet 200
303 perindropil arginin 5 mg tablet 100
304 nikardipin inj 1 mg/mL ampul 20
305 nifedipin 30 mg tablet 100
306 nifedipin 20 mg tablet 100
307 nifedipin 10 mg Tablet 1000
308 metoprolol tartrat inj 1 mg/mL ampul 20
309 metildopa 250 mg tablet 200
310 lisinopril 20 mg tablet 200
311 lisinopril 10 mg tablet 500
312 lisinopril 5 mg Tablet 500
313 klortalidon 50 mg Tablet 100
314 klonidin inj 150 mcg/mL ampul 20
315 klonidin 0,15 mg Tablet 20
316 irbesartan 300 mg Tablet 1000
317 irbesartan 150 mg tablet 1000
318 imidapril 10 mg tablet 100
319 imidapril 5 mg tablet 100
320
321 diltiazem inj 50 mg/mL ampul 30
322 diltiazem inj 10 mg/mL ampul 50
323 diltiazem inj 5 mg/mL ampul 30
324 diltiazem 200 mg Tablet 100
325 diltiazem 100 mg tablet 100
326 atenolol 100 mg tablet 300
327 atenolol 50 mg tablet 300
328 amlodipin 10 mg tablet 1000
329 amlodipin 5 mg Tablet 0

330 antihipertensi pulmonal beraprost sodium 20 mcg tablet 100

331 antiagregasi platelet tikagrelor 90 mg tablet 100
332 silostazol 100 mg kapsul 500
333 silostazol 100 mg Tablet 500
334 klopidogrel 300 mg tablet 100
335 klopidogrel 75 mg tablet 7,000
336 asetosal 100 mg tablet 1000
337 asetosal 80 mg tablet 3000
338 trombolitik streptokinase inj 1,5 juta IU vial 10
339 obat gagal jantung karvedilol 25 mg tablet 100
340 karvedilol 6,25 mg tablet 100
341 kaptopril 50 mg tablet 100
342 kaptopril 25 mg tablet 500
343 kaptopril 12,5 mg tablet 1000
344 kandesartan 16 mg tablet 1000
345 kandesartan 8 mg tablet 3000
346 isosorbid dinitrat 1 mg/mL ampul 20
347 bisoprolol 5 mg tablet 2000
348 bisoprolol 2,5 mg tablet 5000
349 obat syok dan sepsis norepinefrin inj 1 mg/mL ampul 50
350 dopamin inj 40 mg/mL ampul 50
351 dobutamin inj 50 mg/mL ampul 50
352 dobutamin inj 25 mg/mL ampul 30
353 diobutamin inj 12,5 mg/mL ampul 20
354 antihiperlipidemia atorvastatin 20 mg tablet 500
355 atorvastatin 10 mg Tablet 500
356 fenofibrat 300 mg kapsul 500
357 fenofibrat 100 mg kapsul 500
358 gemfibrozil 600 mg kapsul 500
359 kolestiramin serbuk 4 gram bungkus 50
360 pravastatin 20 mg tablet 50
361 pravastatin 10 mg tablet 50
362 rosuvastatin 10 mg tablet 50
363 simvastatin 40 mg tablet 100
364 simvastatin 20 mg tablet 500
365 simvastatin 10 mg tablet 1000
366 antibakteri topikal perak sulfadiazin 1% krim tube 20
367 kloramfenikol SK 2% tube 100
368 framisetin sulfat 1% tulle 30
369 basitrasin + polimiksin B salep tube 30
370 antifungi nistatin tab vaginal 100.000 IU tablet 100
371 ketokonazol 2% cr tube 100
372 asam benzoat + asam salisilat tube 10
373 antiinflamasi pruritik kalamin lotion tube 30
374 hidrokortison 2,5% tube 100
375 hidrokortison 1% tube 100
376 betametason 0,1% salep tube 100
377 betametason 0,1% cr tube 100
378 betametason 0,05% cr tube 100
379 antiskabies permetrin 5% tube 50
380 kaustik podofilin tingtur 25% botol 10
381 polikresulen larutan botol 5
382 perak nitrat 20% botol 5
383 keratolitik triamsinolon asetonid inj 40 mg/mL vial 30
384 triamsinolon asetonid inj 10 mg/mL vial 30
385 bedak salisil 2% botol 30
386 larutan dialisis larutan hemodialisa labu 10
387 larutan dialisa intraperitoneal labu 10
388 elektrolit nutrisi dll kalsium polistirena sulfonat 5 gram bungkus 10
389 kalium aspartat 300 mg tablet 500
390 kalium klorida 600 mg tablet 100
391 larutan asam amino + E + KH + L labu 30
392 larutan lipid labu 50
393 larutan karbohidrat + elektrolit labu 30
394 karbohidrat 24 % + kalsium fosfat botol 40
395 larutan karbohidrat 12 % botol 40
396 larutan asam amino labu 0
397 air untuk injeksi botol 500
398 obat untuk mata Kloramfenikol SM 1 % tube 50
399 kloramfenikol TM 1% botol 50
400 kloramfenikol TM 0,5% botol 50
401 gentamisin TM 1 % botol 10
402 gentamisin TM 0,3% botol 10
403 gentamisin SM 0,3% tube 10
404 asiklovir SM 3% tube 20
405 gliserin 50% botol 3
406 oksitosik oksitosin 10 IU/mL ampul 100
407 metilergometrin 0,2 mg/mL ampul 200
408 metilergometrin 0,125 mg Tablet 300
409 antiansietas lorazepam 2 mg Tablet 0
410 lorazepam 1 mg Tablet 100
411 klobazam 10 mg Tablet 100
412 diazepam 5 mg tablet 100
413 diazepam 2 mg Tablet 300
414 alprazolam 1 mg Tablet 100
415 alprazolam 0,5 mg tablet 100
416 alprazolam 0,25 mg tablet 0
417 antidepresi amitriptilin 25 mg tablet 0
418 klorpromazin 5mg/mL ampul 10
419 klorpromazin 25 mg Tablet 100
420 risperidon 2 mg tablet 100
421 valproat 250 mg enterik tablet 100
422 valproat 500 mg tablet 100
423 valproat 250 mg tablet 100

penghambat dan pemacu

424 neuromuskuler suksinilkolin serbuk injek 100 mg vial 10
425 rokuronium 10 mg/mL vial 10
426 miastenia gravis piridostigmin 60 mg tablet 100
427 penghambat neostigmin 0,5 mg/mL ampul 10
428 kolinesterase donepezil 10 mg tablet 100
429 antasida dan antiulkus lansoprazol 30 mg kapsul 4000
430 omeprazol 40 mg ampul 300
431 omeprazol 20 mg kapsul 2000
432 ranitidin 25 mg/mL ampul 10,000
433 ranitidin 150 mg tablet 5000
434 antiemetik dimenhidrinat 50 mg tablet 200
435 domperidon drop 5 mg/mL botol 30
436 domperidon 5 mg/ 5 mL botol 50
437 klorpromazin 25 mg/mL ampul 30
438 klorpromazin 5 mg/mL ampul 30
439 ondansetron 2 mg/mL ampul 1500

440 ondansetron 8 mg tablet

suppositori 100
441 antihemoroid bismut + lidokain a 100
442 antispasmodik hiosin butilbromida 10 mg Tablet 100
443 obat diare zinc 20 mg tablet 5000
444 loperamid 2 mg tablet 500
445 kaolin pektin tablet 500
446 atapulgit Tablet 1000
447 katartik polietilen glikol serbuk botol 1
448 natrium fosfat oral botol 1
449 laktulosa botol 50
450 parafin + gliserin + PP botol 10
451 gliserin 100mg/mL botol 10
452 bisakodil 10 mg supp 30
453 bisakodil 5 mg supp 50
454 bisakodil 5 mg tablet 50
455 antiinflamasi sulfazalazin 500 mg tablet 100
456 lain-lain asam ursodeoksikolat 250 mg kapsul 500
457 antiasma aminofilin 24 mg/mL ampul 300
458 aminofilin 200 mg tablet 100
459 aminofilin 150 mg tablet 100
460 budesonid cairan ih 0,5 mg/mL respul 10
461 budesonid cairan ih 0,25 mg/mL respul 10
462 budesonid serbuk ih 200 mcg botol 10
463 budesonid serbuk ih 100 mcg botol 10
464 fenoterol HBr aerosol 100 mcg/puff botol 10
465 flutikason propionat MDI botol 10
466 flutikason propionat cairan ih 0,5mg vial 10
467 ipatropium bromida aerosol 0,02 mg/dosis botol 10
468 budesonid + formoterol 80/4,5 mcg inhalasi botol 10
469 budesonid + formoterol 160/4,5 mcg inhalasi botol 10
470 ipatropium + fenoterol aerosol botol 10
471 ipatropium + salbutamol cairan inhalasi vial 10
472 salmeterol + flutikason ih 50 mcg/puff tablet 10
473 salmeterol + flutikason ih 100 mcg/puff botol 10
474 salmeterol + flutikason propionat ih 250 mcg/puff botol 10
475 prokaterol cairan ih 50 mcg kapsul 10
476 prokaterol cairan ih 30 mvg kapsul 10
477 salbutamol serbuk in 200mg/kapsul + rotahaler botol 10
478 salbutamol MDI 100 mcg/dosis botol 10
479 salbutamol cairan inhalasi 1 mg/mL vial 100
480 salbutamol 4 mg Tablet 1000
481 salbutamol 2 mg tablet 1000
482 teofilin lepas lambat 300 mg tablet 500
483 teofilin 150 mg tablet 200
484 terbutalin serbuk inhalasi 0,5 mg/dosis botol 10
485 terbutalin cairan inhalasi 2,5 mg/mL vial 10
486 terbutalin 0,5 mg/mL ampul 10
487 terbutalin tab 2,5 mg tablet 200
488 antitusif kodein 20 mg tablet 100
489 kodein 15 mg tablet 100
490 kodein 10 mg tablet 100
491 ekspektoran n-asetil sistein granul 200 mg kapsul 500
492 n-asetil sistein cap 200 mg kapsul 500
493 n-asetil sistein ih 100mg/mL ampul 10
494 PPOK indakaterol serbuk ih 300 mcg kapsul 10
495 indakaterol serbuk ih 150 mcg kapsul 10
496 glikopironium serbuk ih 50 mcg kapsul 10
497 ipatropium bromida ih 0,025 % botol 10
498 ipatropium bromida 0,02 mg/dosis botol 10
499 tiotropim respimat ih 5 mcg botol 10
500 olodaterol 2,5 mcg/spray botol 3
501 salmeterol + flutikason propionat botol 10
502 ipatropium + salbutamol inhalasi botol 10
503 surfaktan 25 mg/mL ampul 10

504 serum dan imunoglobulin hepatitis B imunoglobulin manusia 220 IU/mL vial 5

505 hepatitis B imunoglobulin manusia 150 IU/ 1,5 mL ampul 5

506 human tetanus imunoglobulin 500 IU vial 30
507 imunoglobulin intravena 50 mg/mL ampul 10
508 serum anti bisa ular ABU I vial 4
509 serum antidifteri (ADS) 10.000 IU vial 4
510 serum antirabies 200-400 IU vial 4
511 serum antirabies 100 IU vial 4
512 serum antitetanus 20.000 IU vial 10
513 serum antitetanus 10.000 IU vial 10
514 serum antitetanus (ATS) 5000 IU vial 6
515 serum antitetanus (ATS) 1500 IU vial 6
516 vaksin rabies manusia 2,5 IU ampul 3
517 vaksin rabies manusia injeksi + booster ampul 3
518 obat untuk telinga asam asetat encer botol 3
519 flutikason furoat 27,5 mcg/spray Botol 3
520 hidrogen peroksida 50% botol 3
521 karbogliserin 10% TT botol 3
522 kloral hidrat botol 3
523 kloramfenikol tetes telinga botol 50
524 triamsinolon asetonid 55 mcg/puff botol 3
525 vitamin dan mineral asam askorbat (vitamin C) 250 mg tablet 10,000
526 ergokalsiferol (vitamin D2) 10.000 IU/mL botol 100
527 ergokalsiferol (vitamin D2) 50.000 IU kapsul 100
528 kalsitriol 0,5 mcg kapsul 100
529 kalsitriol 0,25 mcg kapsul 100
530 kalsium glukonat injeksi 10% ampul 30
531 kalsium karbonat 500 mg tablet 100
532 kalsium laktat (kalk) 500 mg tablet 3000
533 piridoksin (vitamin b6) injeksi 50 mg/mL ampul 100
534 piridoksin (vitamin b6) 25 mg tablet 1000
535 piridoksin (vitamin b6) 10 mg tablet 1000
536 tiamin (vitamin b1) 50 mg tablet 1000
537 vitamin b kompleks tablet 10,000
538 lain-lain sevelamer karbonat tablet 800 mg tablet 50