No Item Name Unit Unit Price

1 Pelayanan Resep Non Racikan RCK 1,000.00

2 Pelayanan Resep Racikan RCK 1,500.00
3 Pelayanan Resep Racikan (pot krim/salep/botol) RCK 10,000.00
4 Pelayanan Resep Racikan RCK 2,000.00
5 ACT (Arthesunat tab 50 mg + amodiquin anhidrat tab 200 mg) tablet 4,300.00
6 Acyclovir 200 mg tablet 300.00
7 Acyclovir 400 mg tablet 500.00
8 Acyclovir Kream tube 2,900.00
9 Adalat Oros 30 mg tablet 4,343.00
10 Adenosin Injeksi ampul 1,150.00
11 Adimidon Injeksi (Paramidon/Benodon) vial 109,250.00
12 Aerrane 250 ml botol 1,125,300.00
13 Akarbose 50 mg tablet 800.00
14 Albumin serum normal 25% 20ML botol 446,100.00
15 Alinamin tab 5 mg tablet 150.00
16 Alinamin-F injeksi ampul 16,100.00
17 Allylestranol 5 mg (preabor) tablet 400.00
18 Alprazolam 0.25 mg tablet tablet 316.00
19 Alprazolam 0.5 mg tablet tablet 300.00
20 Alprazolam 1 mg tablet tablet 544.00
21 Ambroxol tab 30 mg tablet 197.00
22 Ambroxol syr botol 2,800.00
23 Aminofluid (Lar. Asam amino) 500 ml botol 76,300.00
24 Aminophillin 200 mg Tablet tablet 250.00
25 Aminophillin injeksi 24 mg/ml - 10 ml ampul 3,071.00
26 Aminovel larutan infus (aminofusin L600) botol 109,850.00
27 Amiodaron Inj 50 mg/ml ampul 8,700.00
28 Amitriptilin HCl tablet 25 mg tablet 168.00
29 Amlodipine tab 5 mg tablet 83.00
30 Amlodipine tab 10 mg tablet 94.00
31 Amoksisilin syr kering forte 250mg/5ml botol 4,150.00
32 Amoksisilin sirup kering 100 mg / 10 ml botol 5,700.00
33 Amoksisillin kaplet 500 mg tablet 300.00
34 Amoksicilin serbuk injeksi 1000mg vial 11,650.00
35 Ampiciliin tablet 500 mg tablet 800.00
36 Ampicillin serbuk injeksi 1 g ampul 11,484.00
37 Anesfar Injeksi (midazolam) ampul 14,850.00
38 Antalgin injeksi 500 mg/2 ml ampul 4,600.00
39 Antalgin injeksi 250 mg/2 ml ampul 1,900.00
40 Antalgin tablet 500 mg tablet 200.00
41 Antasida DOEN syrup 60 ml botol 4,620.00
42 Antasida DOEN tablet kombinasi tablet 277.00
43 Anti fungi salep tube 5,950.00
44 Anti Migrain:Ergotamin Tartrat 1 mg + Kofeein 50 mg Tab tablet 212.00
45 Akita tablet tablet 300.00
46 Aqua Pro Injeksi Steril Bebas Pirogen vial 2,860.00
47 Aqua Bidest 20 L galon 57,500.00
48 Aqua irigasi vial 40,250.00
49 Arcoxia 60 mg tablet 21,350.00
50 Arcoxia 90 mg tablet 23,700.00
51 Arixtra (Fondaparinuks inj 2,5 mg/0,5 mL) syringe 273,800.00
52 Arthemeter inj 1 ml 80 mg ampul 34,450.00
53 Artesunate injeksi ampul 38,900.00
54 Asam Folat tablet 1 mg / Profolat tablet 64.00
55 Asam Mefenamat kaplet 500 mg tablet 220.00
56 Asam pipemidat 400 mg tablet 1,600.00
57 Asam Retinoat salep 0.15 tube 12,900.00
58 Asam Salisilat Salep 2 % tube 3,450.00
59 Asam Traneksamat (nexitra) 500 mg Tablet tablet 2,000.00
60 Asam Traneksamat injeksi 500 mg ampul 2,374.00
61 Asam Ursodeoksikolat 250 mg tablet 2,268.00
62 Asering Larutan Infus botol 11,000.00
63 Asetosal Tablet 80 mg tablet 150.00
64 Aspilet 80 mg / Miniaspi 80 mg tablet 105.00
65 Atenolol 50 mg (Farnormin) tablet 350.00
66 Atracurium Besilate 10 mg/ml ampul 12,199.00
67 Atrovent Sol 10 ml botol 155,600.00
68 Atrovent Sol 20 ml botol 86,600.00
69 Atropin Sulfas ampul 1,859.00
70 Atorvastatin 10 mg kapsul 1,150.00
71 Atorvastatin 20 mg kapsul 900.00
72 Azhytromicin tablet 500 mg tablet 1,778.00
73 Bacitracin zalf tube 4,000.00
74 Beraprost Sodium 20 mcg tablet 5,250.00
75 Berotec Sol (Fenoterol HBr inh solution 0,1% ) botol 130,190.00
76 Betametason krim 0,1 % 10 g tube 1,465.00
77 Betadin kumur botol 12,500.00
78 Betadin salep kulit tube 11,300.00
79 Betahistin tablet 6 mg tablet 110.00
80 Bicolax tab tablet 1,200.00
81 Bisoprolol 5 mg tablet 237.00
 82 Bisoprolol 2,5 mg tablet 900.00
83 Bisolvon 10 mg/5 ml sol 50 ml botol 84,920.00
84 Bromocriptin (Crispa) tablet 172,500.00
85 Budesonid cairan ih 0,5 / ml vial 11,200.00
86 Budesonid serb inh 200mcg/dosis tube 118,450.00
87 Bunascan 20 ml ampul 100,500.00
88 Burnazin krem 35 g tube 46,000.00
89 Cafergot tablet tablet 9,900.00
90 Calos (Calsium Karbonat (setara dengan 500 mg Ca) tablet) tablet 916.00
91 Calsium Glukonas 100 mg/ml ampul 10,351.00
92 Calcianta 5 nefedifine tablet 1,000.00
93 Canarco ( Kanamisin) injeksi 1 gr vial 18,400.00
94 Captopril tablet 25 mg tablet 100.00
95 Captopril 12.5 mg tablet 100.00
96 Cardura 1 mg (Doksazosin mesilat tablet 1 mg) tablet 2,400.00
97 Catapres inj 0.15 mg/ml ampul 389,500.00
98 Candesartan 8mg tablet tablet 545.00
99 Candesartan 16mg tablet tablet 943.00
100 Carvedilol 25 mg tablet 3,850.00
101 Caviplek tablet tablet 650.00
102 Cazetin sdrop botol 31,000.00
103 Cefadroxil sirup kering 125 mg/5 ml botol 4,360.00
104 Cefadroxil caps 500 mg tablet 600.00
105 Cefotaxime 1g serbuk injeksi vial 5,000.00
106 Ceftriakson injeksi 1 g vial 5,146.00
107 Cefepime 1g serbuk injeksi vial 28,800.00
108 Cefixime 100 mg Kapsul kapsul 2,750.00
109 Cefixime 200 mg Kapsul kapsul 2,430.00
110 Cefixime Syrup botol 38,250.00
111 Celebrex 100 mg tablet 14,400.00
112 Cephalexin 500 mg Kapsul kapsul 1,950.00
113 Cetadop (Dopamin) inj 40 mg/ml ampul 6,160.00
114 Cemitidine tablet tablet 700.00
115 Citicoline 250mg inj ampul 8,650.00
116 Citicoline 500mg inj ampul 24,000.00
117 Cetirizine sirup 5 mg/5 ml botol 3,300.00
118 Cetirizin tablet 10 mg tablet 150.00
119 Cendo Cenfresh MD strip 2,300.00
120 Cendo Floxa MD strip 42,550.00
121 Cendo Glaucon tablet kotak 51,750.00
122 Cendo Mycetin E.O tube 20,150.00
123 Cendo Polydex MD strip 36,800.00
124 Cendo Polygran MD strip 44,300.00
125 Cendo Tobroson MD strip 47,450.00
126 Chloramfenicol tablet 500 mg tablet 1,600.00
127 Chlroramfenicol syr 125 mg/5 ml botol 8,650.00
128 Chlroramfenicol cr 1% Salep Mata tube 2,054.00
129 Chlroramfenicol cr 2% Salep Kulit (Bufnatin 15 g) tube 18,800.00
130 Chlorpheniramine maleat (CTM) tablet 26.00
131 Ciprofloxacin 500 mg Tablet tablet 1,000.00
132 Ciprofloxacin Infus 2 mg/ml botol 11,178.00
133 Cilostazol 100mg tablet 15,300.00
134 Citicoline ( Neurolin ) tablet tablet 9,950.00
135 Citicoline ( Serfac ) 250 mg injeksi ampul 8,650.00
136 Citicoline ( Serfac ) 500 mg injeksi ampul 3,450.00
137 Clast tab tablet 3,000.00
138 Clindamycin 150 mg tablet 900.00
139 Clindamycin caps 300 mg tablet 2,200.00
140 Clopidogrel 75 mg tablet 1,404.00
141 Co-Amoksiklave/Amoksisilin + As.Clavulanat 625 mg tab tablet 8,450.00
142 Codein 10 mg tablet 657.00
143 Colistine tab 250.000 IU tablet 1,600.00
144 Comafusin Hepar (Lar asam amino, vitamin, elektrolit) botol 82,094.00
145 Combivent inh vial 4,550.00
146 Conucol dry syrup botol 37,600.00
147 Concor (Bisoprolol 2,5 mg) tablet 820.00
148 Cotrimoksazol 960 mg tablet 400.00
149 Curcuma tablet /cavicur tablet 1,400.00
150 Cyclo Progynova tablet 207,000.00
151 Decafil (Aminofillin) 150 mg tablet 155.00
152 Dehydroartemisinin 40 mg + Piperaquine Phosphate 320 mg (DH tablet 10,600.00
153 Depakene syr 250 mg/5 ml (Valproic acid sir 250 mg/5 ml x 12 botol 256,300.00
154 Depakote ER 250 mg (Valproat tab SR 250 mg) tablet 3,400.00
155 Desoksimetasone Krim 2 % tube 29,350.00
156 Dexametason injeksi 5 mg / ml - 1 ml ampul 2,049.00
157 Dexametason tablet 0,5 mg tablet 200.00
158 Dextrometorfan 15 mg Tablet tablet 1,900.00
159 Diamicron MR 60 mg (Glikazid) tablet 3,014.00
160 Diazepam inj ampul 2,200.00
161 Diazepam Tab 2 mg tablet 95.00
162 Diazepam Tab 5 mg tablet 109.00
163 Digoxin 0,25 mg tablet 104.00
164 Dimenhidrinat 50 mg tablet 129.00
165 Diphendyramine injeksi ampul 1,489.00
166 Diltiazem 30 mg Tablet tablet 200.00
167 Dobutamin Inj ampul 12,211.00
168 Doksazozin 2 mg tablet 3,700.00
169 Doksisiklin kapsul 100 mg tablet 300.00
170 Dopamin Hcl 40 mg/10 ml injeksi ampul 7,000.00
171 Dopamet tablet tablet 1,088.00
172 Domperidon 10 mg tablet 86.00
173 Domperidon 5mg/ml Drop botol 30,200.00
174 Domperidon Suspensi botol 3,300.00
175 Dulcolax 5 mg tablet 1,850.00
176 Dulcolax 10 mg tablet 5,900.00
177 Dumin rektal tube 125 mg/2,5 ml tube 15,510.00
178 Duphaston 10 mg tablet tablet 14,950.00
179 Durogesic 50 mcg patches 388,424.00
180 DHP - (obat anti malaria) tablet 750.00
181 Epinefrin (Adrenalin) injeksi i.v/s.k./i.m 1 mg/ml ampul 1,518.00
182 Ephedrine HCL 25 mg Tablet tablet 950.00
183 Ephedrine HCL inj 50 mg/ml ampul 8,569.00
184 Equal tab 100 tablet 250.00
185 Ergotamin Tablet 10 mg tablet 300.00
186 Erlamycetin Tetes Telinga botol 5,850.00
187 Erythromicyn 500 mg tablet tablet 1,150.00
188 Erythromicyn 250 mg tablet tablet 750.00
189 Erythromicyn Syrup 60 ml botol 6,765.00
190 Esmeron Injeksi vial 120,750.00
191 E-som ( Esomeprazole ) 40 mg injeksi vial 33,800.00
192 Estazor tablet 9,750.00
193 Etambutol 250 mg Tablet tablet 500.00
194 Etil Klorida Semprot botol 86,250.00
195 Euthyrox (Levothyroxin) 100 mg tablet 1,072.00
196 Farbion 5000 inj ampul 9,200.00
197 Fargoxin injeksi ampul 29,100.00
198 Farelax injeksi ampul 81,400.00
199 Farmabes (Diltiazem) inj 5 mg/ml ampul 62,291.00
200 Farpresin (Vasopresin) inj 1 ml Vial 79,279.00
201 Farsobid ( Isosorbide Dinitrat ) Injeksi vial 26,300.00
202 Fenitoin Natrium Injeksi 50 mg/ml ampul 4,750.00
203 Fenitoin Natrium Kapsul 100 mg kapsul 158.00
204 Fenobarbital 30 mg Tablet tablet 197.00
205 Fenobarbital Injeksi ampul 2,278.00
206 Fentanyl Injeksi 0.05 MG/ML-2 ML ampul 48,400.00
207 Fentanyl patch 10 mcg patches 13,000.00
208 Fero Sulfat tablet (SF) tablet 500.00
209 Finasterid 5 mg tablet tablet 1,950.00
210 Fitomenadion ( Vitamin K ) 10 mg Tablet tablet 873.00
211 Fitomenadion inj ampul 4,759.00
212 Flagystatin Ovula ovula 26,250.00
213 Fluimucyl 200 mg kapsul kapsul 5,850.00
214 Fluimucyl syr botol 57,500.00
215 Flukonazole 150 mg kapsul 21,528.00
216 Fluoksetin 10 mg tablet 700.00
217 Folamil Genio kapsul 4,850.00
218 Flixotide (Flutikason Propionat) Cairan 0,5mg/dosis botol 15,675.00
219 Fluconazol 150 mg tablet 24,800.00
220 Flunarizine Tablet tablet 5,200.00
221 Fluocort N Krem tube 30,700.00
222 Fresofol 1 % ampul 11,308.00
223 Fucilex Oitment (Natrium fusidat salep 20 mg/g) tube 5,650.00
224 Furosemid tablet tablet 84.00
225 Furosemid inj ampul 1,333.00
226 Gabaptentin Kapsul 300 mg kapsul 1,015.00
227 Garam Oralit sachet 300.00
228 Gastrul ( Misoprostol ) Tablet tablet 40,250.00
229 Gemfibrozil 300 mg kapsul kapsul 500.00
230 Geriavita kapsul 3,450.00
231 Gentamicin Injeksi 40 mg/2 ml vial 10,714.00
232 Gentamycin salep kulit 1% tube 2,937.00
233 Gentian Violet Larutan 1 % botol 2,400.00
234 Glibenclamide 2.5 mg tablet tablet 250.00
235 Glikazid tablet 80 mg tablet 300.00
236 Glikuidon 30 mg tablet 1,140.00
237 Glimepiride tab 1 mg tablet 200.00
238 Glimepiride tab 2 mg tablet 245.00
239 Glimepiride tab 3 mg tablet 245.00
240 Glimepiride tab 4 mg tablet 300.00
241 Gliserol tts telinga botol 2,950.00
242 Gliserin 50% botol 6,400.00
243 Glukosamin kaplet 500 mg kapsul 2,803.00
244 Gliseril Guaiakolat Tablet 100 mg tablet 50.00
245 Glukosa larutan infus 5 % steril botol 7,363.00
246 Glukosa larutan infus 10 % steril botol 8,003.00
247 Guanistrep (Kaolin + Pektin suspensi) botol 12,650.00
248 Grafachlor tablet tablet 350.00
249 Grafasma Tablet tablet 300.00
250 Haemacell ( Gelofusine ) Larutan Infus Koloidal 3,5% 500 ml botol 208,500.00
251 Haloperidol injeksi ampul 116,500.00
252 Harnal OCAS 0.4 mg tablet 6,281.00
253 Heparin Injeksi ( 5000 IU/ml) (INVICLOT) vial 50,600.00
254 Heptasan 4 mg tablet / GRAPERIDE (Cyproheptadine HCl 4 mg tablet 250.00
255 Hibicet Larutan botol 1,207,500.00
256 Hemorogard tablet 2,300.00
257 Herbesser CD 100 (Diltiazem) kapsul 4,460.00
258 Herbesser CD 200 (Diltiazem) kapsul 4,835.00
259 Hibloc 100 mg (atenolol) tablet 1,150.00
260 Hiopar Tablet tablet 1,600.00
261 Hidrokortison kream tube 3,131.00
262 Hydroxyethyl Strach 6% (VOLUVEN) botol 21,780.00
263 Hystolan Tablet (Isoxpurine HCl) tablet 6,000.00
264 HCT (Hidrokortiazide) 25 mg tablet 200.00
265 Histigo kaplet tablet 600.00
266 Hitrin 1 mg tablet 12,400.00
267 Hustab tab tablet 4,300.00
268 Ibuproven tablet 200 mg tablet 150.00
269 Ibuproven tablet 400 mg tablet 450.00
270 Ibuprofen Suspensi 100 mg/ 5 ml botol 2,858.00
271 Ibuprofen Suspensi 200 mg/ 5 ml botol 5,900.00
272 Ichtiol Salep tube 3,700.00
273 Illidin HCL 0.05 % botol 75,300.00
274 Infumal 10 % Larutan botol 38,400.00
275 Infus Aminofusin L 600 botol 69,700.00
276 Infus Aminofusin Paed 250 ml botol 65,500.00
277 Infus KA - EN 3A botol 13,000.00
278 Infus D5-1/4 botol 10,844.00
279 Infus Human Albumin 20% 100ml (Albapure) botol 880,000.00
280 Infus Nutriflex botol 329,830.00
281 Insulin (Levemir 100 U/ml) pen 83,950.00
282 Insulin (Novo Mix 30 100 U/ml) pen 110,968.00
283 Insulin (Novo Rapid 100 U/ml) pen 87,000.00
284 Interhistin tablet tablet 750.00
285 Inotrop Inj (Dobutamin Hcl Inj) vial 12,211.00
286 Irbesartan 150mg tablet 500.00
287 Irbesartan 300mg tablet 900.00
288 ISDN Inj vial 26,300.00
289 ISDN tablet tablet 89.00
290 Isoniazide 300 mg tablet tablet 500.00
291 Isotic Adretor 0,5% (Timolol tetes mata 0,5%) botol 12,900.00
292 KA-EN 3B Larutan Infus botol 13,000.00
293 Kalsitriol 0,25 mcg kapsul 1,900.00
294 Kalsitriol 0,5 mcg kapsul 3,700.00
295 Kalsium Karbonat tablet 300.00
296 Kalsium Lactat ( Kalk ) Tablet tablet 100.00
297 Kalipar kapsul 800.00
298 Kanamycin HJ 1 g inj vial 18,400.00
299 Karvedilol 25 mg tablet 2,000.00
300 Ketamin ( Ketalar ) 50 mg/ml Injeksi vial 68,948.00
301 KCl(Kalium Chlrida) 25 ml botol 3,223.00
302 Ketokonazole krim 2 % tube 2,577.00
303 Ketokonazol tablet 200 mg tablet 305.00
304 Ketoprofen 100 mg tablet tablet 2,700.00
305 Ketoprofen Inj ampul 9,200.00
306 Ketoprofen Supp supp 2,700.00
307 Ketorolac 10 mg tablet tablet 550.00
308 Ketosteril 630 mg tablet tablet 8,700.00
309 Klomifen Citrat 50mg tablet 1,600.00
310 Kloramfenikol Kapsul 250 mg kapsul 400.00
311 Kloramfenikol Salep Mata (Erlamycetin) tube 2,200.00
312 Kloramfenikol TM 0,5 % botol 11,500.00
313 Kloramfenikol TT 3 % botol 7,400.00
314 Klorpromazine HCl (CPZ) Injeksi ampul 1,900.00
315 Kodein Fosfat Tablet 10 mg tablet 750.00
316 Kolkisin tablet 500 mcg tablet 3,000.00
317 Ketorolac inj 30mg ampul 1,089.00
318 Kendaron 200 mg (Amiodaron) tablet 1,027.00
319 Kotrimoksazol tablet dewasa tablet 150.00
320 Kotrimoksazol Suspensi komb botol 2,300.00
321 Kompolak syr botol 6,300.00
322 Klonidin tab 0,15 mg tablet 201.00
323 KSR (Kalium Klorida tablet 600 mg) tablet 1,842.00
324 Lansprazol 30 tablet 1,000.00
325 Lacto - B sachet 6,600.00
326 Lactulax syrup / Lactulose botol 15,060.00
327 Lansoprazole 30 mg Kapsul kapsul 400.00
328 Lansoprazole serbuk injeksi 30 mg vial 105,800.00
329 Larutan yang Mengandung Asam Amino+ Elektrolit+ Karbohidr botol 98,300.00
330 Larutan yang Mengandung Lipid botol 86,500.00
331 Laxadine ( Kompolax ) Suspensi botol 6,300.00
332 Levemir Insulin pen ampul 83,950.00
333 Levopar tab (Antiparkinson DOEN tablet kombinasi : Benseraz tablet 1,100.00
334 Levoflokasasin Infus botol 20,262.00
335 Levofloaxacin 500 tablet 479.00
336 Lidocain 2% inj ampul 1,405.00
337 Lisinopril 10 mg tablet 400.00
338 Lisinopril 5 mg tablet 250.00
339 Lisol 1000 ml botol 57,500.00
340 Liver prime kapsul 7,400.00
341 Loratadin Tab 10 mg tablet 150.00
342 Longatin ( Noscarpine ) 25 kapsul kapsul 6,100.00
343 Loperamid 2 mg tablet 500.00
344 Lysmin Plus Syrup botol 33,300.00
345 Manitol 20 % Larutan Infus 500ml botol 50,000.00
346 Manitol 20% 250 ml pcs 28,275.00
347 Marcain 0,5% ampul 100,300.00
348 Mecobalamin 500 mg tablet 800.00
349 Mediamer B6 tablet tablet 3,700.00
350 Mediasma tablet tablet 500.00
351 Meloxicam 15 mg Tablet tablet 700.00
352 Mesalazin 250 mg tablet 4,100.00
353 Metamizole Injeksi 1000 mg/ml ampul 4,600.00
354 Methylprednisolon 125 mg injeksi vial 12,217.00
355 Methylprednisolon 500 mg injeksi vial 77,700.00
356 Metilergometrin Maleat injeksi 0.200 mg-1 ml ampul 3,399.00
357 Metilergometrin Maleat Tablet Salut 0,125 mg tablet 258.00
358 Metilprednisolon 16 mg Tablet tablet 558.00
359 Metilprednisolon 4 mg Tablet tablet 148.00
360 Metilprednisolon 8 mg Tablet tablet 700.00
361 Metoklopramid Tablet 10 mg tablet 124.00
362 Metoklopramid ( Vosea ) Sirup botol 3,100.00
363 Metoklopramide ( Sotatic ) Injeksi ampul 5,200.00
364 Metronidazol 500 mg tablet 4,100.00
365 Metronidazol 500 mg larutan infus botol 10,560.00
366 MgSO4 20 % 25 ml vial 3,328.00
367 MgSO4 40 % 25 ml vial 3,796.00
368 Micardis 40 mg tablet 3,045.00
369 Miconazol Krim tube 4,500.00
370 Microlax Rektal tube 23,000.00
371 Midazolam 5 mg Inj ampul 8,503.00
372 MST 10 mg tablet 29,300.00
373 Metergin inj ampul 17,250.00
374 Methysoprinol 500 mg tablet 2,800.00
375 Metformin 500 mg tablet tablet 109.00
376 Metformin 850 mg tablet tablet 178.00
377 Meropenem serb injeksi 1000 mg vial 32,344.00
378 Meylon 25 ml flakon 6,448.00
379 Midazolam Injeksi 1 mg/ml ampul 5,000.00
380 Midazolam Injeksi 5 mg/ml ampul 9,700.00
381 Mineral mix sachet sachet 3,300.00
382 Morfin 10 mg tablet 1,674.00
383 Mulsanol syr botol 5,100.00
384 Myomergyn injeksi ampul 7,400.00
385 N-Asetil Sistein 200 mg tablet 484.00
386 N-Asetil sistein ih 100 mg/ml ampul 11,500.00
387 N-Asetil Sistein Syr botol 85,100.00
388 Natrium diklofenak 25 mg tablet 200.00
389 Natrium diklofenak 50 mg tablet 145.00
390 NaCl 0,225 mg + Dextrose 5 % (cairan 1 : 4) NS Infus botol 8,300.00
391 Natrium Klorida larutan infus 0,9 % steril botol 8,755.00
392 Natur E tablet 1,000.00
393 Nephrolit tablet 800.00
394 Neodiastop Tablet (attapulgit)/New antides tablet 600.00
395 Neocenta 15 g Gel / Bioplacenton Gel tube 20,300.00
396 Neuralgin RX tablet 900.00
397 Neurodex tablet 800.00
398 Nexitra 500 mg kaplet tablet 3,400.00
399 Nutralix tablet 350.00
400 Neostigmine inj 0,5 ampul 9,400.00
401 Nokoba Inj vial 83,500.00
402 Notrixum Inj vial 13,150.00
403 Noveron Inj vial 9,200.00
404 Nitrocaf Retart 5 mg tablet 2,762.00
405 Nitrocaf Retart 2,5 mg tablet 1,794.00
406 Nifedipin 20 mg Tablet tablet 3,800.00
407 Nikardipin injeksi 10 mg / vial vial 24,000.00
408 Nistatin 100.000 UI Tablet Vaginal tablet 700.00
409 Nistatin tablet salut 500.000 IU tablet 1,000.00
410 Nitrogliserin Injeksi ampul 25,300.00
411 Nutriflex Lipid Spesial (Lar Komb asam amino, vitamin dan ele botol 427,273.00
412 Norelut Tablet 5 mg (Primolut) tablet 6,600.00
413 Norephinefrin bitartate inj 1 mg/ml ampul 25,839.00
414 Noxetine 20 mg tablet tablet 5,000.00
415 OAM (Obat Anti Malaria) tablet 800.00
416 OBH Syr botol 17,250.00
417 Obimin AF tablet 2,200.00
418 Octreotide 6 mg/ml (Sandostatin) ampul 67,410.00
419 Ofloxacin tetes telinga botol 125,900.00
420 Oksimetazolin tetes hidung botol 43,000.00
421 Oksitetrasiklin HCl salap kulit 3 % tube 5,000.00
422 Oksitosin Inj ampul 1,232.00
423 Omeprazole injeksi 40 mg vial 11,808.00
424 Omeprazol 20 mg tablet 445.00
425 Ondansetron tab 4 mg tablet 500.00
426 Ondansetron Inj ampul 1,258.00
427 Osteotin Kaps kapsul 4,500.00
428 Ofloxacin 200 g tablet 500.00
429 Pan Amin G Larutan Infus botol 58,150.00
430 Papaverin tab 40 mg tablet 4,000.00
431 Paraformaldehid ( Formalin ) Tablet tablet 2,900.00
432 Parasetamol tablet 500 mg tablet 261.00
433 Parasetamol Infus 1 g botol 12,389.00
434 Parasetamol 650 mg (Forte) tablet 450.00
435 Parasetamol drops 100 mg/ml botol 8,700.00
436 Pedialyte kotak 25,800.00
437 Pehavral Tablet tablet 1,400.00
438 Perak Sulfadiazin Krim 2 % tube 23,800.00
439 Pehacain Inj. ampul 4,300.00
440 Phenol gliserol 10 % botol 2,900.00
441 phytomenadion tab 10 mg tablet 900.00
442 Phytomenadion injeksi ampul 4,800.00
443 Pioglitazon 15 mg tablet 2,145.00
444 Piracetam injeksi 1 g ampul 4,042.00
445 Piracetam injeksi 3 g ampul 10,000.00
446 Piracetam tab 400 mg tablet 700.00
447 Piracetam tab 1200 mg tablet 2,378.00
448 Pirantel suspensi 125 mg/5 ml botol 12,700.00
449 Pirantel tablet 125 mg tablet 400.00
450 Pirazinamid tablet 500 mg tablet 376.00
451 Piridoksin HCL 10 mg Tab tablet 150.00
452 Piroksikam kapsul 20 mg kapsul 300.00
453 Piroksikam kapsul 10 mg kapsul 200.00
454 Pletaal tab (Cilostazol tab) tablet 4,600.00
455 Ponconeuron Tablet / Nutralix tab tablet 400.00
456 Poncosolvon Sirup / Bromhexin HCl syr (Miravon Syr) botol 16,000.00
457 Povidon Iodida larutan 10 % 30 ml botol 6,000.00
458 Povidon Iodida larutan 10 % 300 ml botol 25,100.00
459 Povidon Iodida larutan 10% 1000 ml botol 74,700.00
460 Prednison tablet 5 mg tablet 79.00
461 Pregabalin 75 mg tablet 4,504.00
462 Premaston Tablet tablet 5,600.00
463 Pronalges Suppo tube 10,350.00
464 Prontosan sol 350 ml botol 288,400.00
465 Prontosan sol 40 ml botol 69,000.00
466 Prostigmin Injeksi ampul 8,200.00
467 Propiltiourasil tablet 100 mg tablet 700.00
468 Propranolol 10 mg tablet 90.00
469 Propranolol 40 mg tablet 84.00
470 Provera tablet tablet 7,000.00
471 Provula Tablet tablet 22,400.00
472 Premaston/ Obstanon tablet 5,100.00
473 Primakuin tablet 15 mg tablet 300.00
474 Primolut N (Noretisteron tablet 5 mg) tablet 7,700.00
475 Pulmicort turbuhaler 160mg tube 11,200.00
476 Ramipril 5 mg tablet 245.00
477 Ramipril 10 mg tablet 350.00
478 Ranitidin injeksi 25 mg/ml ampul 1,300.00
479 Ranitidin tab 150 mg tablet 300.00
480 Recolfar (kolkisin 0,5 mg tablet) tablet 4,675.00
481 Retaphyl 300 mg tablet 1,292.00
482 Reco TM botol 10,900.00
483 Regumen Tablet tablet 5,100.00
484 Reprosid (Finasterid) tab 5 mg tablet 1,841.00
485 Rifampicine 300 tab tablet 950.00
486 Ringer Laktat infus botol 7,630.00
487 Risperidone 2 mg tablet tablet 300.00
488 Salap 2 – 4 Komb : As. Salisilat 2 % + Belerang Endap 4 % pot 3,450.00
489 Salbutamol tablet 2 mg tablet 100.00
490 Salbutamol tablet 4 mg tablet 100.00
491 Salbutamol Syrup 2mg/5ml botol 5,100.00
492 Salisil Bedak 2 % pcs 6,600.00
493 Seretide inhaler 250mcg botol 122,521.00
494 Seretide inhaler 500mcg botol 133,998.00
495 Scabimite krim 30 g tube 13,500.00
496 Scopamin Injeksi / Hyoscine N-Butylbromide inj ampul 21,800.00
497 Scopamin tablet tablet 1,400.00
498 Serum Anti Bisa Ular ( ABU I ) Polivalen injeksi 5 ml / BioSav vial 512,204.00
499 Serum Anti Tetanus ( ATS ) 1500 IU Injeksi ampul 150,600.00
500 Sevoflourane ( Sojourn ) 250 ml botol 1,179,590.00
501 Sildenafil 20 mg tablet 47,400.00
502 Simvastatin tab 10 mg tablet 250.00
503 Simvastatin tab 20 mg tablet 237.00
504 Spasminal tablet 1,000.00
505 Spiriva( tiotropium ) respimat ih 5 mcg/semprot canister 411,818.00
506 Spironolactone 100mg tablet 575.00
507 Spironolactone 25mg tablet 250.00
508 Stesolid Rectal 5 mg tube 25,696.00
509 Stesolid Rectal 10 mg tube 21,021.00
510 Sukralfat Susp botol 7,338.00
511 Suprafenid 100 mg Supp botol 2,380.00
512 Symbicort 160/4,5 Inhaler (budesonid + farmoterol) botol 144,700.00
513 Tamsulosin 0.4 mg tablet 6,700.00
514 Telmisartan 80 mg tablet 6,200.00
515 Telmisartan 40 mg tablet 3,500.00
516 Tenovofir 300 mg tablet 9,688.00
517 Tensidox (Doxazosin) tab 2 mg tablet 3,430.00
518 Teofilin Tab lepas lambat 300mg tablet 1,400.00
519 Terrel 100ml botol 339,895.00
520 Tramadol Tablet tablet 250.00
521 Tramadol injeksi 50 mg/ml ampul 2,000.00
522 Trilac (Triamcinolon) Inj 10 mg/ml ampul 39,401.00
523 Teosal tablet 300.00
524 Terasozin HCL (Hitrin) tablet 11,400.00
525 Terbutalin Tablet tablet 100.00
526 Thiamazole tab sal selaput 10 mg tablet 1,286.00
527 Thiamfenikol 500 mg Kapsul kapsul 700.00
528 Thrombophob gel 10 g tube 54,900.00
529 Tyarit tablet tablet 4,000.00
530 Thyrozol 10 mg tablet 1,286.00
531 Tremenza syrup botol 25,300.00
532 Tremenza tablet tablet 3,300.00
533 Triamcinolon inj 10 mg/ml vial 42,400.00
534 Tryhexilphenidil tablet tablet 100.00
535 Ulsafat tab (Sucralfat tablet 200 mg) tablet 2,600.00
536 Umaron Inj vial 172,500.00
537 Urdafalk 250 mg kapsul kapsul 11,900.00
538 Urispas tablet 6,500.00
539 Valsartan 160 mg tablet tablet 1,122.00
540 Valsartan 80 mg tablet tablet 4,700.00
541 Vascon injeksi 1 mg/ml (Norepinefrin Inj) tablet 57,500.00
542 Vasopresin Injeksi tablet 91,100.00
543 Vectrin 300 mg tablet 4,800.00
544 Ventolin Nebules 2,5 mg tablet 11,000.00
545 Verobac ( Vaksin Rabies ) tablet 189,750.00
546 Vicanatal Plus tablet 1,900.00
547 Vitamin A 100.000 (Biru) tablet 350.00
548 Vitamin A 200.000 (Merah) tablet 700.00
549 Vitamin B1 ( Thiamin HCl ) 50 mg Tablet tablet 100.00
550 Vitamin B12 ( Sianocobalamin ) Tablet tablet 50.00
551 Vitamin B12 injeksi tablet 1,250.00
552 Vitamin B6 ( Piridoksin ) 10 mg Tablet tablet 200.00
553 Vitamin B-Complex tablet 144.00
554 Vitamin C ( Asam Asakorbat ) 50 mg Tablet tablet 120.00
555 Vitazim tablet 150.00
556 Vomil B6 Tablet tablet 1,150.00
557 Vosea syr tablet 5,800.00
558 Warfarin tablet 2 mg tablet 800.00
559 WIDAHES (Hidroksietil Starch/HES) 200/0.5 60 g, NaCl 9 g/l tablet 86,250.00
560 Xarelto 10 mg tablet 28,289.00
561 Xarelto 15 mg tablet 28,289.00
562 Xylocain gel tablet 47,800.00
563 Zinc tab 20 mg tablet 700.00
564 Zinc drop 10 mg/mL tablet 7,200.00
565 Zircum Kid Sirup 20 mg/5 ml tablet 3,285.00
566 Warfarin 2 mg tablet 850.00
567 Abbocath / I.V. catater No. 14 pieces 23,595.00
568 Abbocath / I.V. Chateter No.16 pieces 23,595.00
569 Abbocath / I.V. catater No. 18 pieces 18,400.00
570 Abbocath / I.V. catater No. 18 G sine pieces 23,595.00
571 Abbocath / I.V. catater No. 18 G plus/Venplon pieces 14,625.00
572 Abbocath / I.V. catater No. 20 G sine pieces 8,250.00
573 Abbocath / I.V. catater No. 20 G plus/Venplon pieces 16,100.00
574 Abbocath / I.V. catater No. 22 G sine pieces 18,400.00
575 Abbocath / I.V. catater No. 22 G plus/Venplon pieces 16,100.00
576 Abbocath / I.V. catater No. 24 G sine pieces 23,595.00
577 Abbocath / I.V. catater No. 24 G plus/Venplon pieces 18,400.00
578 Abbocath / I.V. catater No. 26 G sine pieces 22,400.00
579 Abbocath / I.V. catater No. 26 G plus/Venplon pieces 14,823.00
580 Alat suntik sekali pakai 1 ml/ Spuit 1 cc pieces 7,040.00
581 Alat suntik sekali pakai 10 ml/ Spuit 10 cc pieces 1,463.00
582 Alat suntik sekali pakai 20 ml/ Spuit 20 cc pieces 13,970.00
583 Alat suntik sekali pakai 2,5ml/ Spuit 2,5 cc pieces 1,000.00
584 Alat suntik sekali pakai 3 ml/ Spuit 3 cc pieces 924.00
585 Alat Suntik Sekali Pakai 5 ml /Spuit 50 cc pieces 1,348.00
586 Alat suntik sekali pakai 50 ml catheter tip (NGT)/ Spuit 50 cc pieces 5,500.00
587 Alat suntik sekali pakai 50 ml luer slip (syringe pump)/Spuit 50 pieces 5,867.00
588 ARM Neck (Alat Bantu Leher) pieces 3,200.00
589 ARM Sling pieces 18,200.00
590 Bisturi no. 11 pieces 6,490.00
591 Bisturi no. 12 pieces 6,490.00
592 Bisturi no. 15 pieces 6,490.00
593 Bisturi no. 20 pieces 6,490.00
594 Catgut Chromic No.0, Taper, 1/2 circle, 37 mm, 75 cm pieces 21,500.00
595 Catgut Chromic No.1, Taper, 1/2 circle, 40 mm, 75 cm pieces 58,170.00
596 Catgut Chromic No.2/0, Taper, 1/2 circle, 30 mm pieces 58,170.00
597 catgut 3/0 cutting pieces 21,500.00
598 Catgut Chromic No.3/0, Taper, 1/2 circle, 26 mm, 75 cm pieces 58,170.00
599 Catgut Plain No.1, Taper, 1/2 circle, 26 mm, 75 cm pieces 21,800.00
600 Catgut Plain No.2/0, Taper, 37 mm pieces 21,800.00
601 Catgut Plain No.2/0, Taper, 1/2 circle, 26 mm, 75 cm pieces 21,800.00
602 Catheter Foley No. 20 pieces 6,900.00
603 Catheter Foley No. 18 pieces 10,160.00
604 Catheter Foley No. 22 pieces 6,900.00
605 Catheter Foley No. 16 pieces 21,700.00
606 Catheter Foley No. 14 pieces 8,000.00
607 Catheter Foley No. 12 pieces 6,900.00
608 Catheter Foley No. 10 pieces 6,900.00
609 Catheter Foley No. 8 pieces 9,400.00
610 Chateter Suction Bayi No.8 fr-41 CM pieces 9,400.00
611 Cystofix pieces 307,000.00
612 Cerfofix 14 pieces 684,500.00
613 Cerfofix 16 pieces 793,400.00
614 Cuticell pieces 5,520.00
615 Daclon No. 10/0, Reverse Cutting, 3/8 circle, 45 cm setara Opth pieces 225,600.00
616 Discofix 3 way stopcock/ Thee way pieces 20,000.00
617 E.T.T kinking No. 2,5 Cuffed" pieces 11,000.00
618 E.T.T kinking No. 3 UnCuffed" pieces 16,140.00
619 E.T.T kinking No. 3,5 UnCuffed" pieces 24,200.00
620 E.T.T kinking No. 3,5 Cuffed" pieces 11,000.00
621 E.T.T kinking No. 4 UnCuffed" pieces 30,800.00
622 E.T.T kinking No. 4,5 UnCuffed" pieces 30,800.00
623 E.T.T kinking No. 5 UnCuffed" pieces 19,390.00
624 E.T.T kinking No. 5 Cuffed" pieces 20,700.00
625 E.T.T kinking No. 5,5 Cuffed" pieces 20,700.00
626 E.T.T kinking No. 6 Cuffed" pieces 25,630.00
627 E.T.T kinking No. 6,5 Cuffed" pieces 25,630.00
628 E.T.T kinking No. 7 Cuffed" pieces 22,380.00
629 E.T.T kinking No. 7 UnCuffed" pieces 25,670.00
630 E.T.T kinking No. 7,5 Cuffed" pieces 30,800.00
631 E.T.T kinking No. 7,5 UnCuffed" pieces 19,390.00
632 E.T.T kinking No. 8 Cuffed" pieces 25,630.00
633 Elastis Verband 7.5 CMX 4.55M pieces 32,250.00
634 Elastis Verband 10 CMX 4.55M pieces 34,500.00
635 Elastis Verband 15 CMX 4.55M pieces 58,490.00
636 EKG Elektroda pieces 3,700.00
637 Gipsona 3" pieces 15,400.00
638 Gipsona 4" pieces 22,100.00
639 Gipsona 6" pieces 28,900.00
640 Guedel Airways No. 10 pieces 9,600.00
641 Guedel Airways No. 8 pieces 9,600.00
642 Guedel Airways No. 9 pieces 9,600.00
643 Guedel Airways No. 100 mm (10) dewasa pieces 34,100.00
644 Guedel Airways No. 110 mm (11) dewasa pieces 34,100.00
645 Guedel Airways No. 120 mm (12) dewasa pieces 9,600.00
646 Guedel Airways No. 40 mm (8) anak / bayi pieces 34,100.00
647 Guedel Airways No. 50 mm (9) anak / bayi pieces 38,610.00
648 Guedel Airways No. 60 mm (10) anak . Bayi pieces 12,574.00
649 Guedel Airways No. 80 mm dewasa pieces 9,600.00
650 Guedel Airways No. 90 mm dewasa pieces 9,600.00
651 Handschoend steril No.6 pieces 360,500.00
652 Handschoend steril No.6,5 pieces 7,040.00
653 Handschoend steril No.7 pieces 7,040.00
654 Handschoend steril No.7,5 pieces 7,040.00
655 Handschoend steril No.8 pieces 7,040.00
656 Handscoon Non Steril Size Small pieces 58,300.00
657 Handscoon Non Steril Size Medium pieces 58,300.00
658 Handscoon Non Steril Size Large pieces 61,500.00
659 Infus set Anak / Mikro Set pieces 22,867.00
660 Infus set Dewasa / Makro Set pieces 3,450.00
661 Intrafix Infuset pieces 27,600.00
662 Kanul nasal O2 dewasa pieces 5,500.00
663 Kanul O2 anak pieces 14,399.00
664 Kanul nasal O2 pieces 33,000.00
665 Kasa Kompres 40 x 40 steril pieces 1,500.00
666 Kasa Pembalut 2 m x 80 cm pieces 9,100.00
667 Kasa Pembalut Hidrofil uk. 40 x 80 cm pieces 5,700.00
668 Klem Tali Pusat pieces 2,662.00
669 L.M.A No.2 pieces 98,900.00
670 L.M.A No.2,5 pieces 98,900.00
671 L.M.A No.3 pieces 98,900.00
672 L.M.A No.4 pieces 98,900.00
673 L.M.A No.5 pieces 98,900.00
674 Mask ear loop pieces 16,500.00
675 Masker Non-Reabreathing Anak pieces 32,525.00
676 Masker Reabreathing Dewasa pieces 31,900.00
677 Masker Oksigen Anak (Maxiflow) pieces 13,552.00
678 Nebulezier mask anak pieces 49,247.00
679 Nebulezier mask Dewasa pieces 38,478.00
680 Needle 23 G x 1-1/4" pieces 1,463.00
681 Needle 24 G x 1-1/4" pieces 1,463.00
682 Needle 25 G x 1-1/4" pieces 330.00
683 Needle 27 G x 1-1/4" pieces 311.00
684 NGT/ feeding tube no. 3,5 pieces 5,942.00
685 NGT/ feeding tube no. 5 pieces 36,960.00
686 NGT/ feeding tube no. 8 pieces 10,106.00
687 NGT/ feeding tube no.12 pieces 36,960.00
688 NGT/ feeding tube no.14 pieces 36,960.00
689 NGT/ feeding tube no.16 pieces 47,795.00
690 NGT/ feeding tube no.18 pieces 67,760.00
691 Novotwist Needle pieces 3,900.00
692 Oral Gastric Tube (OGT) Bayi pieces 64,400.00
693 Original Perfusor / Extention Tube pieces 39,000.00
694 Pigtail Catheter pieces 670,000.00
695 Polypropylen No. 0 Reverse Cutting DS -24 mm pieces 31,000.00
696 Polypropilene no. 1 cutting pieces 87,010.00
697 Polypropylen No.2/0 Reverse Cutting DS -24 mm (BLUD) pieces 31,000.00
698 Polypropylen No.2/0 Reverse Cutting DS -24 mm pieces 31,765.00
699 Polypropylen No.3/0 Reverse Cutting DS -19 mm pieces 31,000.00
700 Polypropylen No.4/0 Reverse Cutting DS -19 mm pieces 31,000.00
701 Polypropylen 5/0 pieces 31,000.00
702 Polypropylen 6/0 pieces 110,110.00
703 Prontosan Gel 30 ml pieces 208,500.00
704 Silk No.0, Taper, 1/2 circle, 37 m, 75 cm pieces 16,400.00
705 Silk No.3/0, Reverse Cutting, 3/8 circle, 24 mm, 75 cm pieces 16,400.00
706 Silk No.2/0, Reverse Cutting, 3/8 circle, 35 mm pieces 11,000.00
707 Silk No.3/0, Reverse Cutting, 3/8 circle, 35 mm pieces 11,000.00
708 Set Epidural pieces 173,650.00
709 Softband (Padding) 3 inci pieces 28,750.00
710 Softband (Padding) 4 inci pieces 30,300.00
711 Softband (Padding) 6 inci pieces 28,600.00
712 Spon (utk penghenti pendarahan saat Operasi) pieces 126,500.00
713 Suction Catether No. 18 FR pieces 1,600.00
714 Suction Catether No. 15 FR pieces 1,600.00
715 Suction Catether No. 11 FR pieces 1,600.00
716 Suction Catether No. 10 FR pieces 1,600.00
717 Suction Catether No. 8 FR pieces 67,760.00
718 Suction Catether No. 6 FR pieces 67,760.00
719 Surgicryl 910 No.1 Taper HR-40 mm pieces 89,700.00
720 Surgicryl 910 No.2 Cutting pieces 89,700.00
721 Surgicryl 910 No.2/0 Taper HR-26 mm pieces 89,700.00
722 Surgicryl 910 No.2/0 Cutting pieces 89,700.00
723 Surgicryl 910 No.3/0 Reverse cutting HR-48 mm pieces 89,700.00
724 Surgicryl 910 No.3/0 Tapper pieces 89,700.00
725 Surgicryl 910 No.4/0 Taper HR-22 mm pieces 89,700.00
726 Surgicryl 910 No.4/0 Cutting pieces 89,700.00
727 Spinocan 25 pieces 31,100.00
728 Spinocan 27 pieces 70,422.00
729 Tegaderm 6 x 7 cm pieces 9,200.00
730 Transfusi set pieces 13,976.00
731 Tree Way pieces 5,100.00
732 Umblical Catheter no 5 pieces 12,600.00
733 Under pad pieces 6,000.00
734 Urine bag pieces 8,880.00
735 Vasofix/ IV Canula No 20 pieces 10,900.00
736 Vasofix/ IV Canula No 22 pieces 10,900.00
737 Vasofix/ IV Canula No 24 pieces 10,900.00
738 Venflon No.18 Terumo pieces 22,000.00
739 Venflon No.24 Terumo pieces 20,700.00
740 Venflon No.20 pieces 20,700.00
741 Venflon No.26 Terumo pieces 20,700.00
742 Verban anti air (Tegaderm) 9 cm x 35 cm pieces 10,350.00
743 Wing Needle No.18 Terumo pieces 13,400.00
744 Wing Needle No.20 Terumo pieces 13,400.00
745 Wing Needle No.22 Terumo pieces 13,400.00
746 Wing Needle No.24 Terumo pieces 13,400.00
747 Wing Needle No.25 Terumo pieces 17,250.00
748 Wing Needle No.26 Terumo pieces 17,250.00
749 Wing Needle No.27 Terumo pieces 17,250.00
750 Galafusin botol 145,015.00
751 Abumin 20% 50ML botol 557,750.00
752 Abumin 25% 100ML botol 1,736,500.00
753 Abumin 25% 20ML botol 446,100.00
754 Hes botol 25,000.00
755 Ketamin botol 79,200.00
756 Acarbose 100 mg tablet 960.00
757 Allupurionol 100 mg tablet 105.00
758 Amicain Sulfate inj 250 mg ampul 32,285.00
759 Amoksisilin sirup kering 125 mg / 5 ml botol 6,600.00
760 Betablock (Atenolol) 100 mg tablet 758.00
761 Valproic acid sir 250 mg/5 ml botol 17,789.00
762 Asam Folat tablet 1 mg tablet 86.00
763 Asam Folat 400 mcg (Profolat) tablet 64.00
764 Asam Traneksamat 500 mg Tablet tablet 880.00
765 Benzatin Penisilin 2,4 Jt IU Vial 14,500.00
766 Bisolvon 10 mg/5 ml sol 1 ml ml 1,698.00
767 Bunascan Spinal inj 5 mg/ml ampul 72,500.00
768 Carbamazepin 200 mg tablet 250.00
769 Carvedilol 25 mg (Blorec) tablet 2,800.00
770 Cilostazol 100mg tablet 9,025.00
771 Cotrimoksazol 480 mg tablet 133.00
772 Dextrosa (Glucosa) 40 % flakon 10,010.00
773 Eperison Hcl 50 mg tablet 1,540.00
774 Etambutol 500 mg Tablet tablet 786.00
775 Etil Klorida Semprot botol 175,010.00
776 Euthyrox (Levothyroxin) 50 mg tablet 771.00
777 Fargoxin injeksi 0.25 mg/ml ampul 25,300.00
778 Farsobid ( Isosorbide Dinitrat ) Injeksi vial 63,112.00
779 Fenofibrat 100 mg kapsul 1,191.00
780 Fenofibrat 300 mg kapsul 1,446.00
781 Fenobarbital Injeksi ampul 3,114.00
782 Fentanyl Injeksi 0.05 MG/ML-2 ML ampul 44,391.00
783 Fluimucyl sachet 200 mg sachet 3,230.00
784 Fluimucyl inj 100 mg/ml ampul 10,000.00
785 Fluoksetin 20 mg (Elizac) kapsul 225.00
786 Flunarizine Tablet 5 mg tablet 1,600.00
787 Gabaptentin Kapsul 300 mg kapsul 1,258.00
788 Garam Oralit sachet 650.00
789 Gastrul ( Misoprostol ) Tablet tablet 10,285.00
790 Gentamicin Injeksi 40 mg/2 ml vial 10,714.00
791 Glukosamin kaplet 500 mg kapsul 2,803.00
792 Hemapo Epoetin Alfa box 75,000.00
793 Heparin Injeksi ( 5000 IU/ml) (INVICLOT) vial 43,995.00
794 Hydroxyurea medac 500 mg kapsul 3,800.00
795 Infus D5-1/2 botol 10,680.00
796 Ioniazide 100 mg tablet tablet 171.00
797 KA-EN 3B Larutan Infus botol 11,314.00
798 KA-EN 3A Larutan Infus botol 11,314.00
799 Kalitake 5 gr sachet 5,500.00
800 Kalnex (Asam Tranexamat) 500 mg kaplet tablet 3,350.00
801 Levemir Insulin IU 280.00
802 Lidocain comp inj ampul 2,227.00
803 Manitol 20 % Larutan Infus 500ml botol 28,275.00
804 Metoklopramid 5 mg tablet 124.00
805 Metoklopramide Injeksi 5 mg ampul 6,600.00
806 Metronidazol 500 mg larutan infus botol 8,250.00
807 MST 15 mg tablet 22,990.00
808 Mebo Ointment tube 99,562.00
809 Metformin 500 mg tablet tablet 112.00
810 Morfin HCl inj 10 mg/ml ampul 34,049.00
811 Monuril 3 gr (Fosfomysin Trometamol) sachet 128,749.00
812 Natrium Klorida larutan infus 0,9 % steril infus 500 ml botol 6,840.00
813 Natrium Klorida larutan infus 0,9 % steril infus 100 ml botol 15,180.00
814 Natrium Klorida 3% botol 30,334.00
815 Neviral (Nevirapine) tablet 3,658.00
816 Neodiagon (Attapulgite) 650 mg tablet 253.00
817 Nokoba Inj (Naloxone Hcl) 0.4 mg vial 72,600.00
818 Nifedipin 10 mg Tablet tablet 156.00
819 Norelut Tablet 5 mg (Primolut) tablet 4,455.00
820 Novomix Insulin IU 370.00
821 Novorapid Insulin IU 290.00
822 Oksitetrasiklin salep mata @3,5 gram tube 3,872.00
823 Oseltamivir 75 mg kapsul 12,969.00
824 Parasetamol sirup 120 mg/5ml botol 6,078.00
825 Pethidin Hcl Inj 50 mg/ml ampul 19,481.00
826 Potassium Permanganat/PK 5 mg tube 6,050.00
827 Prosogan (Lansoprazol) inj 30 mg vial 92,040.00
828 Probenid (Probenesid) 500 mg tablet 2,009.00
829 Profofol ampul 11,308.00
830 Pulmicort Replues 0,5/ml resplus 24,657.00
831 Ranitidin injeksi 25 mg/ml ampul 2,293.00
832 Roculax (Rocuronium Bromide) ampul 212,800.00
833 Rifampicine 450 mg tablet 2,058.00
834 Salofalk 250 mg tablet 3,575.00
835 Seretide inhaler 500mcg botol 134,000.00
836 Scabimite krim 10 g tube 11,825.00
837 Serum Anti Tetanus ( ATS ) 1500 IU Injeksi ampul 130,999.00
838 Soft U Derm 10% Cream 20 gr tube 6,809.00
839 Spiriva (tiotropium) respimat ih 5 mcg/semprot canister 411,818.00
840 Symbicort 80/4,5 Inhaler (budesonid + farmoterol) box 134,284.00
841 Tramadol 50 mg tablet 880.00
842 Tracetat (Magestrol Acetat) tab 160 mg tablet 19,625.00
843 Tracetat (Magestrol Acetat) 200 mg Suspensi botol 215,050.00
844 Valved tab tablet 809.00
845 Vermox (Metronidazol) 500 mg tablet 8,800.00
846 Abbocath / I.V. Chateter No.16 pieces 0.00
847 Abbocath / I.V. catater No. 18 G plus pieces 9,570.00
848 Abbocath 18 Jelco pieces 9,350.00
849 Abbocath / I.V. catater No. 20 G plus pieces 18,400.00
850 Abbocath / I.V. catater No. 22 G plus pieces 18,400.00
851 Abbocath / I.V. catater No. 24 Otsu Catch pieces 24,805.00
852 Abbocath / I.V. catater No. 26 G sine pieces 98,450.00
853 Alat suntik sekali pakai 0,5 ml pieces 503.00
854 Alat suntik sekali pakai 1 ml pieces 5,475.00
855 Alat suntik sekali pakai 10 ml pieces 1,858.00
856 Alat suntik sekali pakai 20 ml pieces 11,176.00
857 Alat suntik sekali pakai 3 ml pieces 3,935.00
858 Alat Suntik Sekali Pakai 5 ml pieces 1,348.00
859 Alat suntik sekali pakai 50 ml catheter tip (NGT) pieces 35,200.00
860 Alat suntik sekali pakai 50 ml luer slip (syringe pump) pieces 5,867.00
861 Catgut Chromic Sututure With Needle ( 2/0) Cuting pieces 11,220.00
862 CatheterFoley No.24 pieces 1,845.00
863 Dermafix 5 x 7 cm pieces 1,792.00
864 Dermafix T Plester 10 cm x 25 cm pieces 27,134.00
865 Discofix 3 way stopcock pieces 67,100.00
866 Extention Tube pieces 18,890.00
867 Guedel Airways No. 11 pieces 34,100.00
868 Guedel Airways No. 6 pieces 34,100.00
869 Guedel Airways No. 5 pieces 16,598.00
870 Infus set Anak pieces 22,867.00
871 Kanul nasal O2 bayi pieces 14,399.00
872 Masker Non-Reabreathing Dewasa pieces 36,520.00
873 NGT/ feeding tube no. 3,5 (OGT) pieces 42,350.00
874 NGT/ feeding tube no. 5 (OGT) pieces 42,350.00
875 Original Perfusor pieces 39,000.00
876 Polygyp 3" (7,5 cm X 2,7 cm) pieces 26,600.00
877 Polygyp 4" (10 cm X 2,7 cm) pieces 33,300.00
878 Polygyp 6" (15 cm X 2,7 cm) pieces 32,150.00
879 Polypropylen Acid 3-0 (2,0 metric) 1/2 (26 mm) pieces 110,110.00
880 Polypropylen Acid No.1 (4,0 Metric) 1/2 pieces 159,962.00
881 Polypropylen 7/0 DS 12 mm pieces 45,100.00
882 Silk 2-0 (3,0 metric) 3/8 (30mm cutting) pieces 69,575.00
883 Silk 3-0 (2,0 metric) 1/2 (22 m Reverse cutting) pieces 69,575.00
884 Silk 3-0 (2,0 metric) 3/8 (26mm cutting) pieces 69,575.00
885 Suction Catether No. 12 FR pieces 12,833.00
886 Suction Catether No. 5 FR pieces 67,760.00
887 Sungkup O2 anak pieces 48,400.00
888 Sungkup O2 dewasa (MAXYFLOW) pieces 48,400.00
889 Sungkup O2 bayi (MAXYFLOW) pieces 48,400.00
890 Bisacodyl (Laxana) 5 mg Tablet 429.00
891 Chloramfenicol Tetes Telinga/Reco 9,680.00
892 Chloramfenicol Tetes Mata/Erlamycetin 11,000.00
893 Cendo Cenfresh Tetes Mata 38,830.00
894 Etadium (Loperamid) Tablet 165.00
895 Cloramfenicol Salep Kulit/ Bufacetin 3,585.00
896 Diaform (Kaolin) 330.00
897 Rosidon (Domperidon) syr 4,950.00
898 Curviplex sirup 7,260.00
899 Cetirizin Sirup/Lerzin syr 15,620.00
900 Cefixime sirup/Helixime syr 16,940.00
901 Imunos Tablet 11,330.00
902 Neurobion 5000 tablet 2,717.00
903 Paracetamol Drop/Grafadon Drop 13,090.00
904 Antihemoroid supp/Superhoid 4,400.00
905 Scopma/hyoscine+paracetamol 1,430.00
906 Ezelin Insulin 88,999.00
907 Osteocal 946.00
908 Rapid Test Antigen 150,000.00
No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
 82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523
524
525
526
527
528
529
530
531
532
533
534
535
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
586
587
588
589
590
591
592
593
594
595
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655
656
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
687
688
689
690
691
692
693
694
695
696
697
698
699
700
701
702
703
704
705
706
707
708
709
710
711
712
713
714
715
716
717
718
719
720
721
722
723
724
725
726
727
728
729
730
731
732
733
734
735
736
737
738
739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
763
764
765
766
767
768
769
770
771
772
773
774
775
776
777
778
779
780
781
782
783
784
785
786
787
788
789
790
791
792
793
794
795
796
797
798
799
800
801
802
803
804
805
806
807
808
809
810
811
812
813
814
815
816
817
818
819
820
821
822
823
824
825
826
827
828
829
830
831
832
833
834
835
836
837
838
839
840
841
842
843
844
845
846
847
848
849
850
851
852
853
854
855
856
857
858
859
860
861
862
863
864
865
866
867
868
869
870
871
872
873
874
875
876
877
878
879
880
881
882
883
884
885
886
887
888
889
890
891
892
893
894
895
896
897
898
899
900
901
902
903
904
905
906
907
908