Bab 11 Obat Obatan Dan Perlengkapan Laboratorium (OK)

XI.
OBAT - OBATAN DAN PERLENGKAPAN LABORATORIUM
NO NAMA BARANG SATUAN HARGA
(1) (2) (3) (4)

TABLET/CAPLET
1 ABILIFY 10 MG TAB BOX (10 x 10) Tab 89,000
2 ACETASOL 500 MG TAB TAB 1,000
3 ACLAM TAB Tab/500mg 23,200
4 ADALAT OROS 30 MG TAB 15,800
5 ADONA AC 17 TAB 4,500
6 ADONA FORTE TAB 6,800
7 ALBENDAZOL 400 MG TAB 600
8 ALERDEX TABLET Box/100's 149,400
9 ALERGINE 10 MG Box/50's 285,600
10 ALINAMIN F TAB BUAH 2,600
11 ALLOPURINOL TABLET 100 MG TABLET 100
12 ALPARA Box/150's 700
13 ALPHAMOL Box/100's 50,400
14 ALPHAMOL Box/150's 57,100
15 ALPHAMOL 500 MG BTL/1000'S 69,500
16 ALPHAMOL 600 MG BTL/1000'S 76,400
17 ALPRAZOLAM 0,5 MG TAB 700
18 ALPRAZOLAM 1 MG TABLET TAB 1,900
19 ALUDONNA D TABLET Box/160's 104,100
20 ALUDONNA TABLET Box/100's 104,900
21 ALUMY TAB Box/60's 16,300
22 ALUPENT TAB TAB 6,300
23 ALUPURINOL 300 MG TAB TAB 300
24 AMAROPO PLUS Box/100's 349,200
25 AMBROXOL TAB 30 MG TAB 300
26 AMINOFILIN 200 MG TABLET TAB 100
27 AMITRIPTILLINE 25 MG (HCL) TAB 100
28 AMLODIPIN 10 MG TAB TAB 3,200
29 AMLODIPIN 5 MG TAB TAB 1,900
30 AMOXYCILIN 500 MG TAB TAB 400
31 AMPICILIN 250 MG TAB TAB 400
32 AMPICILIN TAB 500 MG TAB 700
33 ANALGETIK Box/100's 403,100
34 ANAPRANIL 25 MG (ANAFRANIL TABLET) TAB 16,500
35 ANEMOLAT 1 MG Box/100's 31,100
36 ANGIOTEN TAB TAB 23,700
37 ANTALGIN 500 MG TAB 1,000
38 ANTASIDA DOEN TAB TAB 75
39 ANTASIDA DOEN BTL/1000'S 46,600
40 ANTIZA TABLET Box/100's 113,400
41 ANTIBIOTIK Box/100's 764,300
42 ANTIPERITIK Box/100's 184,800
43 APROVEL 150 MG BUAH 22,300
44 APTOR 100 MG TAB TAB 700
45 ARACLOF 50 Box/50's 133,500
46 ARCALLON TAB TAB 22,500
SHBJ TAHUN 2018 190

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47 ARCAMOX CAPLET 1000 MG Box/100's 755,900
48 ARCAMOX CAPLET 500 MG Box/100's 428,400
49 ARDIUM TABLET TAB 14,500
50 ARGESID TABLET TAB 2,200
51 ARICEPT 5 MG TABLET BUAH 75,700
52 ARMOLEV TABLET 500 MG Box/10's 300,700
53 ARTHRIFEN PLUS TABLET Box/100's 97,400
54 ARTHRIFEN TABLET Box/100's 85,700
55 ASABIUM TAB 10 MG TAB 3,300
56 ASAM ASKORBAT (VIT C) TABLET 50 MG TABLET 75
57 ASAM FOLAT TAB Tab/1mg 300
58 ASAM MEFENAMAT TAB Tab/500mg 300
59 ASAM TRANEZAMAT 500 MG TABLET BOX 2,900
60 ASCARDIA 80 MG TABLET TAB 1,500
61 ASIFIT BTL/'30s 52,300
62 ASETOSAL 80 MG TAB 2,900
63 ASIKLOVIR TABLET 200 MG TABLET 400
64 ASIKLOVIR TABLET 400 MG TAB 1,000
65 ASMACARE 2 MG Box/50's 20,200
66 ASMACARE 4 MG Box/50's 22,900
67 ASPAR K TAB TAB 5,900
68 ASPIRIN 500 MG TAB 800
69 ASPLLET 80 MG TAB 1,600
70 ATARAX 0,5 MG TAB 2,300
71 ATENOLOL 50 MG TAB TAB 700
72 ATIVAN 0,5 MG TAB BUAH 5,100
73 ATP TAB TAB 2,700
74 AVIL TAB TAB 3,600
75 AZATIOPRIN TAB 50 MG TAB 2,700
76 AZMACON 2 Box/100's 116,700
77 AZMACON 4 Box/100's 160,500
78 BACBUTINH FORTE TABLET Box/100's 327,600
79 BACBUTOL TABLET 500 MG Box/100's 377,900
80 BACTESYN 375 MG 30 TAB TAB 23,900
81 BECEFOPRT Box/100's 236,900
82 BEKARBON 500 MG TAB 106,700
83 BEKAMIN B. COMPLEKS FORTE BTL/1000'S 75,200
84 BEKAMIN C. FORTE 250 mg BTL/250's 49,000
85 BELLAMOX TAB Tab/500mg 21,800
86 BEREA TAB Box/100's 121,800
87 BERRY VISION TAB TAB 5,800
88 BESI II SULFAT 300 MG TAB TAB 75
89 BETABLOK TAB TAB 3,000
90 BETA-CE TAB TAB 3,000
91 BETAHISTINE 6 MG TAB BUAH 700
92 BETASERC TAB TAB 6,300
93 BICOLAX Box/18's 21,000
94 BIO ATP TAB TAB 5,100
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95 BIODIAR TAB 3,000
96 BIONEURON TAB TAB 150,300
97 BISOLVON SOLUTION BUAH 77,500
98 BISOPRLOL 5 MG TAB 4,700
99 BRAINACT TAB 500 MG BUAH 11,900
100 BRICASMA TAB TAB 3,200
101 BROMHEKSIN 8 MG TAB TAB 100
102 BRONSOLVAN TAB TAB 600
103 BUSCOPAN TAB TAB 4,800
104 CAL 95 TAB TAB 7,800
105 CALCIANTA 10 TABLET Box/100's 154,500
106 CALCIANTA 5 TABLET Box/100's 99,000
107 CALCIUM AD TABLET Box/100's 52,100
108 CALOS TABLET TAB 1,900
109 CAPESTIABIN 500 MG TAB TAB 53,100
110 CAPTOPRIL 50 MG FORTEN 50 TAB 300
111 CARDISMO Box/100's 414,400
112 CARNIQ Box/30's 188,100
113 CARTYLO 80 MG Box/100's 77,600
114 CARPIATON 100 MG TAB TAB 8,000
115 CARPIATON 25 MG TAB TAB 2,500
116 CEBEX TAB TAB 2,300
117 CEDANTRON 8 MG TAB TAB 39,000
118 CEFADROXIL 500 MG TAB TAB 1,400
119 CEFSPAN 100 MG TAB TAB 40,100
120 CEFSPAN 200 MG TAB 61,900
121 CEFSPAN 50 MG TAB TAB 18,100
122 CEFTIK TAB TAB 35,000
123 CENDO EYE FRESH 0,3% BUAH 30,600
124 CERADOLAN 200 MG TAB TAB 18,200
126 CETIRIZINE TAB 10 MG TABLET 700
125 CHILDRENS MULTI CHEW BTL/30's 149,800
126 CHLOROQUIN 150 MG TAB TAB 1,000
127 CHOLESVIT BUAH 8,900
128 CHOLEXIN TABLET Box/30's 280,500
129 CIMETIDIN TAB 300
130 CLABAT TAB Tab/500mg 23,900
131 CLOBAZAM 10 MG TAB 1,800
132 CLONIDIN 0,15 MG TAB 400
133 CO. AMOCYCLAV 625 MG TAB 9,700
134 CODITAM TAB BUAH 7,300
135 COLISTIN 1500000 IU BUAH 12,200
136 COMBATRIN TAB 250 MG TAB 5,600
137 CONCOR TAB TAB 6,000
138 CONDIABET 5 MG Box/100's 101,600
139 CONRANIN 150 TABLET Box/30's 115,100
140 COROBION DRAGEE Box/100's 2,000
141 CORSONA Box/100's 35,800
SHBJ TAHUN 2018 192

(1) (2) (3) (4)

142 COTRIMOXAZOLE 480 MG TAB 300
143 CRAVIT 500 MG TAB TAB 73,500
144 CRESTOR 10 MG TAB - 31,600
145 CURCUMA T AB TAB 1,900
146 CYCLOBRAIN 400 MG Box/100's 3,200
147 CYCLOBRAIN F 800 Box/100's 4,400
148 CYSTELIS TABELET Box/100's 125,900
149 CYTOTEC TAB TAB 52,100
150 DANALGIN TAB TAB 2,500
151 DAYHIST TABLET Box/30's 184,800
152 DEKSAMETASON TABLET 0.5 MG TABLET 75
153 DEMACOLIN TAB Box/100's 1,100
154 DEPAKOTE TAB TAB 9,900
155 DEXAFLOX 400 MG TAB TAB 51,700
156 DEXAMETHASON TAB 0,5 MG TAB 1,000
157 DEXTAMINE Box/30's 817,500
158 DEXTAMINE TAB TAB 3,700
159 DEXTRAL Box/150's 68,000
160 DEXTRAL FORTE Box/100's 80,700
161 DEXTROMETHORPHAN TAB 15 MG TAB 100
162 DIAFAC Box/50's 670,200
163 DIAFAC 500 Box/100's 142,800
164 DIAGIT TAB TAB 2,000
165 DIAMOX 250 MG TAB TAB 3,200
166 DIASEC TABLET Box/10's 28,500
167 DIAZINK DISPERSIBEL Box/100's 164,600
168 DIAZEFAM 5 MG TAB TAB 100
169 DIAZEPAM TAB 2 MG TAB 100
170 DICLOFLAM 25 MG Box/50's 20,200
171 DICLOFLAM 50 MG Box/50's 36,900
172 DIFLUCAN 150 MG TAB TAB 190,000
173 DIFLUCAN 50 MG TAB TAB 63,200
174 DIGOXIN 0,25 MG TAB TAB 100
175 DILBLOC 6,25 MG TAB 6,800
176 DILTIAZEM 30 MG TAB TAB 300
177 DIOVAN 80 MG TABLET TABLET 24,900
178 DISFLATYL TAB 2,000
179 DOMBAZ TAB Box/50's 210,000
180 DOMETIC 10 MG Box/50's 193,100
181 DOPAMET TAB TAB 700
182 DORMI COMP. Box/100's 201,600
183 DORMI TAB Box/100's 194,900
184 DOVERI 200 MG TAB BUAH 1,800
185 DOXYCYLIN 100 MG TAB 400
186 DULCOLAX TAB 5 MG TAB 2,500
187 DUPADILAN TAB TAB 9,700
188 DUVADILAN Box/50's 352,800
189 ECHINOX TABLET Box/20's 100,800
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190 ECHINOX TABLET Box/12's 153,600
191 ELITHRIS 50 TABLET Box/50's 114,300
192 ENFAVIT Box/100's 2,900
193 ENZYMFORT Box/100's 87,400
194 EPHEDRIN TAB 25 MG TAB 800
195 ERGOTAMIN COFFEIN 1 MG TAB 100
196 ERICAF TAB - 6,600
197 ERYTHROMYCIN 500 MG TAB TAB 700
198 ETHAMBUTOL 500 MG TAB TAB 1,000
199 EUPHYLIN RETARD MITE TAB TAB 3,200
200 EUPHYLIN RETARD TAB TAB 5,500
201 EUTHYROX TAB 100 UG TAB 2,600
202 EVION TAB TAB 1,900
203 EVIPON TABLET Box/100's 147,900
204 EXELSE TAB BUAH 3,000
205 EXTRAC BELLADONA T AB TAB 800
206 EYEVIT TAB TAB 8,000
207 FAMOCID 20 MG TAB TAB 7,000
208 FAMOCID 40 MG TAB TAB 10,400
209 FANSIDAR TAB TAB 15,200
210 FARGOXIN 0,25 MG TAB 600
211 FARGOXIN TAM TAB 1,100
212 FARSORBID TABLET 5 MG TAB 1,000
213 FENILBUTAZON 200 MG TAB 100
214 FEROFORT TAB TAB 3,600
215 FEVRIN TABLET Box/100's 62,100
216 FEVRIN TABLET KALENG Box/1000's 344,300
217 FITOGEN Box/30's 144,000
218 FITUNO BTL/30's 91,500
219 FITUNO BLISTER Box/30's 125,900
220 FIXEF 200 MG Box/10's 386,300
221 FLAMAR 50 MG TAB TAB 4,100
222 FLEET ENEMA BUAH 131,200
223 FLUCONASOL TAB Tab/50mg 42,100
224 FLUDANE PLUS TABLET Box/100's 117,600
225 FLUDANE TABLET Box/100's 97,400
226 FOLAC TAB TAB 2,000
227 FOLAPLUS T AB TAB 2,300
229 FOLAVIT 400 MICRO GR TAB TAB 2,300
230 FORNEURO TAB TAB 10,000
231 FREEMANIA 200 MG BUAH 5,100
232 FREGO 10 MG TAB TAB 12,900
233 FREGO 5 MG TAB TAB 9,200
234 FUNDAMIN-E TAB TAB 1,400
235 FUNGORAL 200 MG TABLET Box/50's 252,000
236 FUROSEMIDE 40 MG TAB 8,200
237 GABRIL TAB TAB 9,300
238 GABBRYL 250 MG Box/30's 176,400
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(1) (2) (3) (4)

239 GABRORAL BUAH 7,800
240 GASTULEN TAB Box/100's 84,000
241 GEMFIBROZIL 300 MG TAB 600
242 GERIAVITA BTL/30's 100,800
243 GITAS PLUS TAB TAB 5,100
244 GLIBENKLAMIDA TABLET 5 MG TAB 100
245 GLIMEPIRIDE 1 MG TAB TAB 1,800
249 GLIQUIDON 30 MG TAB 1,100
250 GLISERIL GUAIACOLAT (GG) TAB 75
251 GLISODIN TAB 11,900
252 GLUCOBAY 50 MG TAB TAB 4,000
253 GOVASOL 150 MG TAB TAB 102,500
254 GRAHABION TAB BUAH 1,800
255 GRAMASAL 100 MG TAB TAB 1,100
256 GRATHEOS 50 MG TAB 1,600
257 GRAVYNON 5/150 MG Box/30's 168,000
258 GRISEOFULVIN 125 MG TAB TAB 300
259 HALOPERIDOL 1,5 MG TAB TAB 100
260 HALOPERIDOL 2 MG TAB TAB 300
261 HALOPERIDOL 5 MG TAB 100
262 HALOPERIDOLL 0,5 MG TAB TAB 100
263 HEMAFORT Box/100's 11,100
264 HEPAGARD Box/30's 128,400
265 HEPTAMYL TAB 11,000
266 HEXYMER TAB 2 MG TAB 600
267 HIDROKLOROTIAZIDA TAB 25 MG TAB 40
268 HISDANE TAB Box/100's 113,400
269 HISTAPAN TAB TAB 1,100
270 HOMOCLOMIN BUAH 4,100
271 HPPRO TAB TAB 9,200
272 HYDREA 500 MG TAB TAB 20,900
273 HYOCIN-N BUTILBRAMIDA TAB 700
274 HYSCOPAN TABLET Box/100's 201,600
275 HYSTOLAN 20 MG TAB 8,800
276 HYTRIN 1 MG TAB 13,400
277 HYTRIN 2 MG TAB 23,500
278 IBUPROFEN TABLET 200 MG TAB 300
279 IBUPROFEN TABLET 400 MG TABLET 400
280 IMBOOST TAB TAB 6,700
281 IMODIUM TAB TAB 12,900
282 IMUNOS TAB TABLET 11,500
283 INCIDAL OD TAB TAB 5,100
284 INDOMETHASIN 25 MG TAB TAB 1,100
285 INFATRIM Box/100's 44,900
286 INFATRIM FORTE Box/100's 71,900
SHBJ TAHUN 2018 195

(1) (2) (3) (4)

287 INH 100 MG TAB 55
288 INH 300 MG TAB 100
289 INTERHISTIN TAB TAB 600
290 INVOMIT 4 MG TAB TAB 32,900
291 I-PLEX BTL/180's 755,900
292 IRGAPAN 200 MG TAB TAB 1,800
293 ISONAT 10 Box/50's 78,500
294 ISONAT 5 Box/50's 60,100
295 ISONIAZID 100 MG TABLET 100
296 JOODKALI PILL TUBE/20'S 6,000
297 KALMECO 250 MG TAB TABLET 2,900
298 KALMOXILLIN 500 MG Box/100's 319,200
299 KALNEX 250 MG TAB TAB 3,600
300 KALOBA Box/21's 151,200
301 KALTROFEN 100 MG TAB TAB 9,600
302 KALTROFEN 50 MG TAB TAB 5,500
303 KALXETIN 10 MG TAB TAB 7,400
304 KALXETIN 20 MG TAB TAB 11,900
305 KAMAFLAM 25 MG Box/50's 55,000
306 KAMAFLAM 50 MG Box/50's 90,700
307 KAPTENSAR 50 MG Box/30's 411,100
308 KARBAMAZOPIN TABLET 200 MG TAB 400
309 KETOKONAZOLE 200 MG TAB TAB 600
310 KIFADENE 20 MG Box/100's 92,400
311 KIFAROX 500 MG Box/30's 157,900
312 KIFLUZOL 150 MG TAB 59,200
313 KIFLUZOL 150 MG Box/10's 467,900
314 KIFLUZOL 50 MG Box/20's 332,600
315 KIMOXIL 500 MG Box/100's 263,700
316 KINA DRAG Box/12's 15,100
317 KLORPROMAZIN 100 MG TAB 100
318 KLORPROMAZIN 25 MG TAB 100
319 KLOTAREN 25 MG Box/50's 72,300
320 KLOTAREN 50 MG Box/50's 127,700
321 KOLKATRIOL 0,25M MCG BTL/30's 301,500
322 KOLKATRIOL FORTE BTL/30's 504,000
324 KOTRIMOKSAZOL TABLET (DEWASA) TABLET 100
325 KSR TAB TAB 5,100
326 KUTOIN 100 MG TAB TAB 2,600
327 LACBON BUAH 1,600
328 LACBON Box/100's 174,200
330 LANCOLIN TABLET TAB 22,900
331 LANITOP TAB TAB 3,700
333 LAPISTAN TAB Tab/500mg 2,700
334 LATROPIL 1200 MG TAB TAB 8,200
337 LAZAFIN 500 MG TAB TAB 5,200
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(1) (2) (3) (4)

338 LESICHOL 300 MG TAB TAB 16,300
339 LESICHOL 600 MGTAB TAB 27,800
340 LESIDES 10 MG Box/30's 226,700
341 LETONAL 25 MG TABLET TAB 3,300
342 LEVOFLOXACIN 500 MG BUAH 2,300
343 LEVOTHYROXINE 100 MCG TAB 2,200
345 LEXACORT Box/100's 23,500
346 LEXACORT BTL/1000'S 81,100
347 LEXACROL Box/150's 81,200
348 LEXADIUM Box/60's 50,400
349 LEXADON Box/50's 50,400
350 LEXAGIN Box/100's 30,300
351 LEXAGIN BTL/1000'S 154,500
352 LEXAHIST Box/200's 41,400
353 LEXAHIST BTL/1000'S 80,700
354 LEXAMET 200 MG Box/100's 31,800
355 LEXAPRAM Box/100's 31,800
356 LEXAPRAM Box/100's 50,400
357 LEXAVIT Box/100's 74,700
358 LEXAVON Box/100's 18,500
359 LEXMODINE 20 MG Box/30's 18,000
360 LEXMODINE 40 MG Box/30's 30,300
363 LIBROFED Box/50's 69,000
364 LINKOMISIN 500 MG TAB TAB 1,400
367 LIPITOR 20 MG TAB 31,100
369 LISINOPRIL 10 MG TAB 1,600
370 LISINOPRIL 5 MG TAB 800
372 LODOMER 2 MG TAB TAB 2,300
373 LODOMER 5 MG TAB TAB 4,000
374 LODOPIN 25 MG TAB TAB 16,800
375 LODOPIN 50 MG TAB TAB 28,000
376 LOMATUELL 10 X 10 CM BUAH 14,100
377 LONGATIN 25 MG TAB TAB 4,700
378 LONGATIN 50 MG TAB TAB 7,100
379 LUDIOMIL 25 MGT AB TAB 13,200
380 LUDIOMIL 50 MG TAB TAB 20,900
381 LYCOQ TAB TAB 9,300
382 LYCOTEN TAB 4,100
384 LYNORAL TAB TAB 3,000
385 LYCOXY TAB 8,800
386 MADOPAR 125 MG TAB 10,300
388 MAINTATE 2,5 mg TAB TAB 9,900
389 MAINTATE 5 mg TAB TAB 14,800
390 MANGASIDA TABLET Box/100's 80,000
392 MECOLA TAB TAB 7,700
393 MEDIAMER 86 TAB TAB 4,800
395 MEFINAL Tab/250mg 1,100
396 MEFINAL Tab/500mg 2,500
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(1) (2) (3) (4)

397 MELOXICAM 15 MG TAB TAB 2,900
398 MELOXICAM 7,5 MG TAB TAB 1,500
400 MELOXIN 15 MG TAB TAB 17,100
401 MELOXIN 7,5 MG TAB TAB 10,400
403 MEPTIN MINI 0,025 MG TAB 5,100
404 MERISLON TAB 557,600
406 MERTIGO TAB TAB 2,500
408 METAMPIRON 500 MG TAB TAB 100
409 METANEURON Box/30's 523,200
410 METFORMIN 500 MG TAB 400
411 METFORMIN 850 MG TAB 700
412 METHERGIN TAB TAB 6,800
413 METHERINAL TABLET TAB 3,000
414 METHICOL TAB TAB 2,200
416 METHOTREXAT TAB 2,5 MG TAB 3,300
417 METHOVIN TAB TAB 1,000
424 METRONIDAZOLE 500 MG TAB 400
427 MILMOR TAB 5,200
428 MOLACORT BTL/1000'S 42,300
429 MOLACORT 0,5 MG Box/100's 21,700
430 MOLACORT 0,75 MG Box/100's 31,800
431 MOLACORT 0,75 MG Box/200's 39,100
432 MOLAGIT Box/150's 73,100
433 MOLANEURON Box/50's 33,600
434 MOLAPECT Box/100's 73,800
435 MOLASIC Box/100's 55,400
437 MOLAZOL 500 MG Box/100's 52,100
438 MOLEXFLU Box/150's 63,000
439 MOLOCO B12 BUAH 5,600
440 MONURIL SACHET BUAH 292,200
442 MOTILEX 2 MG Box/100's 184,800
443 MST 10 MG TAB TAB 33,600
445 MST 30 MG TAB BUAH 87,900
446 MUCERA TAB TAB 2,200
447 MUCOHEXIN TAB TAB 1,600
448 MUCOPECT TAB TAB 4,800
449 MUCOSOLVAN TAB TAB 800
450 MULTI START MENS 45 + BTL/30's 227,200
451 MULTI START MENS 50 + BTL/30's 273,400
452 MYORES TAB 8,200
453 MYCOSTATIN TAB TAB 88,900
455 MYONAL TAB TAB 9,900
456 MYORES TAB 8,500
457 NACOFLAR 25 MG Box/50's 87,000
458 NACOFLARN 25 MG Box/50's 86,800
459 NACOFLARN 50 MG Box/50's 157,500
460 NASPRO 100 TAB 1,000
461 NATRIUM DIKLOFENAC 50 MG TAB 400
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462 NATRIUM DIKLOFENAK 25 TAB TAB 300
463 NATRIUM TIROKSIN TAB TAB 1,600
464 NAVOREN TAB Box/100's 71,300
465 NEO DIASTOP Box/100's 159,500
467 NEOROVIT E Box/60's 84,800
468 NERIPROS 2 MG TAB TAB 4,900
469 NERVA PLUS TAB 3,200
470 NEURALGIN RX TAB 1,500
471 NEURALGIN Box/100's 78,100
472 NEURALGIN Box/100's 115,900
473 NEURO PANSTOP CAPLET Box/100's 166,200
474 NEUROBION 1000 MG Box/250's 252,000
475 NEUROBION 5000 MG Box/250's 1,293,400
476 NEUROBION 5000 MG TAB TAB 4,400
478 NEUROBION TAB 100 MG TAB 2,200
479 NEURODEX TAB 1,800
480 NEURODEX Box/100's 90,700
481 NEUROFENAC 25 MG TAB 1,000
483 NEURONTIN 300 MG TAB TAB 25,200
484 NEUROTAM 400 MG TAB TAB 4,200
486 NEW DIATAB TAB TAB 1,800
487 NEW SKELAN TABLET TAB 4,000
488 NIFEDIPIN 10 MG TAB TAB 300
489 NIMOTOP TAB TAB 15,200
490 NISTATIN VAG TAB TAB 600
493 NON FLAMIN Box/250's 755,900
495 NOPERTEN 10 MG TAB 10,800
496 NOPERTEN 5 MG TAB 7,400
497 NOPRENIA 1 MG TAB 8,800
498 NOPRENIA TAB 2 MG TAB 14,100
499 NOPRIL 10 MG TAB 10,800
500 NOPRIL 10 MG Box/50's 254,200
502 NORELUT TAB TAB 7,800
503 NORETISTERON TABLET 5 MG TAB 4,000
504 NORIT TAB BUAH 1,400
505 NORVASK 5 MG TABLET TAB 14,800
506 NOVALGIN TAB TAB 2,900
508 NULCEFAM 20 MG Box/30's 142,800
509 NULCER TABLET Box/50's 110,000
511 NYSTATIN TAB 100 000 IU TAB 600
512 OCUGARD Box/30's 216,600
513 OFLOXACIN 200 MG TAB TAB 1,100
514 OMEPRAZOLE 20 MG TAB TAB 800
515 OPRAM TABLET Box/100's 112,500
516 OSPEN 250 MG TAB TAB 3,600
517 OSPEN 625 MG TAB TAB 6,300
518 OSSOPAN 800 MG TAB 7,100
519 OSSOPAN 200 MG TAB TAB 2,000
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(1) (2) (3) (4)

520 OSSOPAN 500 MG TAB TAB 9,200
522 OSSORAL 200 MG TAB TAB 6,600
523 OSSORAL 800 MG TAB 1,800
524 OSTEOCAL TAB 2,600
525 OSTEOTIN Box/60's 300,900
526 OTOPRIM TABLET TAB 6,000
527 OXTEN TAB TAB 3,600
529 PALENTIN 625 MG TAB 487,100
530 PANCREOPLAT TB TAB 4,400
531 PANSTOP TABLET Box/100's 102,500
532 PAPAVERIN 40 MG TAB TAB 100
533 PARACETAMOL TAB 500 MG TAB 100
534 PARACO TAB Box/240's 44,900
535 PARLODEL 2,5 MGTAB TAB 31,600
536 PEHADOXIL FORTE TAB 1,900
537 PEHADOXIN 200 MG TAB TAB 700
538 PEHADOXIN FORTE BTL/350's 494,800
540 PEHAMOXIL FORTE Box/50's 74,600
541 PEHAMOXIL125 SK Box/50's 24,900
542 PEHATIFEN Box/50's 75,600
543 PEHAVASK 10 MG Box/30's 367,800
544 PEHAVASK 5 MG Box/30's 209,100
545 PEHAVRAL DRAGEE Box/100's 108,100
546 PENTOXIFYLLINE 400 MG TAB TAB 2,900
547 PHADONIL Box/100's 33,600
548 PHALOL 10 MG Box/30's 147,900
553 PHENYLBUTAZONE Box/150's 32,600
554 PHENYLBUTAZONE BTL/1000'S 110,400
556 PHOSCAL TABLET Box/30's 75,600
558 PIL KB MIKRODIOL BLISTER/28'S 10,800
559 PIRACETAM 1200 MG TAB 2,600
560 PIRACETAM 800 MG TAB TAB 1,800
561 PIRACETAM TAB 400 MG TAB 1,000
562 PIRALEN TABLET TAB 1,900
563 PIRANTEL TAB TAB 400
565 PIROKSIKAM TABLET 10 MG TABLET 100
566 PIROKSIKAM TABLET 20 MG TABLET 100
567 PIROXICAM TAB 10 MG TAB 100
568 PLADEL Box/28's 517,400
569 PLANTACID FORTE Box/100's 112,500
570 PLASIL 10 MG Box/100's 47,100
571 PLAVIX TAB 40,600
573 PLETAAL 100 MG TAB TAB 24,400
574 PLETAAL 50 MG TAB TAB 14,700
575 POLOXANE CH TABLET Box/100's 201,600
577 PONCOBEX CAPLET Box/100's 188,100
578 PONCOFEN CAPLET 500 MG Box/100's 167,100
579 PONCOFLOX TABLET 500 MG Box/20's 272,100
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580 PONCOHIST Box/100's 57,900
581 PONCONEURON TABLET Box/100's 152,900
582 PONCOQUIN TABLET 200 MG Box/30's 302,300
583 PONCOQUIN TABLET 400 MG Box/30's 596,300
584 PONCOSOLVON TABLET Box/100's 89,000
586 PONFLU CAPLET Box/100's 119,300
587 PONURIC TABLET 100 mg Box/60's 99,000
588 PONURIC TABLET 300 mg Box/30's 104,100
589 POSPARAGIN AB TAB 1,800
591 PRAZINA CAPLET Box/100's 255,300
593 PREMASTON TAB TAB 8,000
594 PRENAMIA TAB TAB 2,000
596 PRIMAKUIN TABLET 15 MG TABLET 100
597 PRIMAQUIN 15 MG TAB 100
599 PRIMET Box/100's 168,000
600 PRIMPERAN 10 MG TAB TAB 2,600
601 PRIMPERAN 5 MG TAB TAB 1,800
603 PRITACORT Box/150's 90,700
604 PRITAGESIC Box/100's 57,900
605 PRITANOL Box/50's 21,800
606 PRITAVIT Box/100's 168,000
607 PRONALGES-E 100 MG TAB TAB 9,600
609 PROPRANOLOL 10 MG TAB 100
610 PROPRANOLOL 40 MG TAB 300
611 PRORIS SUPP BUAH 6,700
614 PROTAMOX Box/15's 277,200
615 PROTOFEN 100 MG Box/50's 142,700
616 PROVERA 10 MG TAB TAB 18,000
618 PYRAZINAMIDE 500 MGT AB TAB 400
621 RAHISTIN TABLET Box/100's 420,000
622 RANILEX 150 MG Box/100's 84,000
623 RANILEX 300 MG Box/100's 134,400
624 RANITIIDIN 150 MG TAB 300
626 REOTAL 400 MG TAB TAB 12,900
627 RESKULIN 250 MG Box/10's 260,400
628 RESKULIN 500 MG Box/10's 377,900
629 RETIVIT TABLET KAPLET 7,000
631 RIF CAPLET 450 MG Box/100's 609,800
632 RIF CAPLET 600 MG Box/100's 764,300
633 RIFAMPICIN 300 MG TAB 700
634 RIFAMPICIN 450 MG TAB 800
635 RIFAMPICIN 600 MG TAB TAB 1,500
636 RIFAMTIBI 600 MG TAB TAB 11,100
637 RISPERDAL 1 MG TAB TAB 25,400
640 RISPERIDONE 1 MG TAB 4,200
641 RISPERIDONE 2 MG TAB 4,100
SHBJ TAHUN 2018 201

(1) (2) (3) (4)

642 RISTONAT Box/4's 487,100
643 RYZEN TABLET TAB 10,600
644 SAKANEURON TAB 600
646 SALOFALK 250 MG TAB 11,900
647 SALOFALK 500 MG BUAH 12,200
648 SALTAM 2 MG Box/100's 27,700
649 SALTAM 4 MG Box/100's 31,400
651 SANGOBION TAB 1,800
653 SERCOL 8 MG Box/100's 405,900
654 SERADOL 0,5 MG TAB 1,000
656 SIFROL 125 MG TAB 10,400
657 SIFROL 250 MG TAB 18,400
658 SIKLOFOSFAMID TAB Tab/50mg 6,300
661 SIMVASTATIN 10 MG TAB TAB 1,000
662 SIMVASTATIN 20 MG TAB 2,000
664 SINDRAL 5 MG BUAH 5,200
665 SIPROFLOKSASIN 500 MG TABLET 400
667 SIRDALUDTAB BUAH 15,600
668 SITIKOLIN 500 MG TAB TAB 8,800
671 SOMEROL 4 MG TAB 5,500
673 SPASMACINE Box/50's 92,400
674 SPECTREM FORTE TABLET Box/100's 260,400
675 SPECTREM TABLET Box/100's 132,600
676 SPIRABIOTIC 500 MG Box/100's 665,300
677 SPIRADAN 500 MG Box/100's 772,700
678 SPIRAMYXIN 500 MG TAB TAB 2,700
681 SPIROLACTION 100 MG Box/100's 598,600
682 SPIROLACTION 25 MG Box/100's 202,000
683 SPIRONOLACTON 100 MG TAB 4,400
684 SPIRONOLACTON 25 MG TAB TAB 700
685 STABLON TAB TAB 11,500
686 STATCOL 10 Box/50's 583,800
687 STATCOL 20 Box/30's 453,500
692 SULCOLON TAB TAB 12,200
693 SULFASALAZIN 500 MG TAB TAB 800
694 SULFITISTAB 500 MG TAB 4,200
695 SUPRA FLU FORMULA BARU Box/100's 56,500
696 SUPRAZID 300 Box/100's 114,300
697 SUPRAZID FORTE TABLET Box/100's 58,800
698 SUPRAZID TABLET Box/100's 87,400
699 SURBEX-Z TAB TAB 2,300
700 SYSTABON TAB TAB 2,700
701 TAMBAH DARAH (Fe) Box/100's 42,800
702 TARIVID 200 MG Box/30's 377,900
703 TARIVID 400 MG Box/30's 621,500
704 TAMOKSIFEN TAB Tab/20mg 2,900
705 TAMOPEN TAB TAB 5,100
706 TEAMIC Box/100's 134,400
SHBJ TAHUN 2018 202

(1) (2) (3) (4)

707 TEBOKAN BTL/100's 776,000
708 TEBOKAN FORTE Box/30's 653,400
709 TEBOKAN SPESIAL BTL/30's 467,000
710 TEGRETOL 200 MG TAB 4,900
711 TEGRETOL CR 200 TAB 8,500
712 TELFAST PLUS TAB TAB 9,600
713 TENBLOX 50 MG TAB 1,800
714 TENBLOK 100 MG Box/30's 70,200
715 TENBLOK 50 MG Box/30's 37,000
716 TENSIGARD Box/30's 74,200
718 TENSIVASK 10 MG TAB TAB 12,100
719 TENSIVASK 5 MG TAB 5,900
720 TENSOBON TAB Box/100's 436,700
721 TEOFILIN 150 MG TAB TAB 100
722 TERBUTALIN SULFAT TAB 2,5 TAB 100
723 THIAMPHENICOL 250 MG TAB TAB 4,400
724 THIAMPHENICOL 500 MG TAB TAB 800
726 THYRAX TAB 1,1 MG TAB 4,500
728 TIAMIN (VIT B1) TABLET 50 MG TABLET 50
729 TIARIYT 200 (AMIODARONE) TAB 3,000
730 TICURING TAB TAB 12,500
732 TILIDON 10 MG TAB TAB 5,800
733 TILSAN 25 MG TAB 7,000
735 TOPGESIK 500 MG SALUT Box/100's 143,600
737 TOPRANIL 25 MG TAB 12,100
738 TRANEXID 500 MG TAB TAB 3,300
739 TRANSAMIN 250 MG TAB TAB 800
741 TREMENZA TAB TAB 2,700
742 TRENTAL 400 MG BUAH 5,200
744 TRIATEC 2.5 MG TAB TAB 13,400
746 TRIFED TABLET BUAH 3,400
747 TRIFLUOPERAZIN TAB 5 MG TAB 700
748 TRIHEXYPHENIDYL 2 MG TAB 100
750 TRINOLON 4 MG Box/50's 91,200
751 TRIZEDON TABL. 35 MG TAB 8,800
752 ULCUMET TAB TAB 2,600
753 ULSIDEX 500 MG TAB TAB 3,400
756 ULTRAVITA TAB TAB 2,200
757 UNALIUM 10 MG TAB TAB 12,900
758 UNALUN 5 MG TAB TAB 9,500
759 URINEG TABLET Box/100's 441,800
760 URINTER TAB TAB 8,000
761 URISPAS 200 MG TAB TAB 10,600
763 UROTRACTIN TAB TAB 6,800
765 VALDIMEX 5 MG TAB 1,400
766 VALISENBE 5 MG TAB TAB 1,400
768 VALPROAT 250 MG TAB TAB 7,300
769 VALSARTAN TAB TAB 8,400
SHBJ TAHUN 2018 203

(1) (2) (3) (4)

771 VASVITA CAPLET Box/50's 125,900
773 VERAPAMIL 80 MG TAB 700
776 VERMOX 500 MG TAB 26,900
778 VIACLAV 500 MG Box/30's 478,700
779 VICANATAL CAPLET Box/100's 133,500
780 VICANATAL PLUS CAPLET Box/100's 171,300
781 VIFERRON TAB 1,500
782 VILIRON TAB 1,100
785 VITACIM TAB TAB 600
787 VITAMIN B KOMPLEKS TABLET TABLET 45
794 VOLTADEX 25 MG TAB 1,100
796 VOLTADEX Box/100's 26,300
798 WARFAPIN 1 MG T AB TAB 8,000
803 ZANTAC TAB 10,000
805 ZENDIAB TAB Box/100's 134,400
806 ZENIBROZ 450 Box/30's 125,900
807 ZENICLAV Box/30's 478,700
808 ZENIFLOX 250 Box/30's 226,700
809 ZENIFLOX 500 Box/30's 478,700
810 ZENILEV 500 Box/10's 369,500
811 ZENTI 150 Box/100's 596,300
812 ZENTRA TAB Box/100's 125,900
813 ZEPHANAL Box/30's 121,000
814 ZEPRAZOL Box/20's 305,700
815 ZEVIBEX CAPLET Box/100's 314,100
818 ZOLOFT 50 MG TAB TAB 31,000
CAPSUL
1 NEO-MUNE 48 GR BKS 39,500
2 ALBIOTIN 150 MG CAPS 151,200
3 ALBIOTIN 300 MG CAPS 283,800
4 ARCAMOX CAPSUL 250 MG Box/100's 243,600
5 ARCAMOX CAPSUL 500 MG Box/100's 428,400
6 ARMOVIT CAPSUL Box/30's 62,100
7 ASAM MEFANAMAT 250 MG CAP 100
8 BIO ATP Box/100's 361,200
9 BIO ATP TABLET 5,100
10 BINOZYT KAP 500 MG CAP 56,200
11 BUFABRON KAPSUL Box/100's 104,900
12 BUFAMOXY 500 Box/100's 403,100
13 BUFARAMIN KAPSUL Box/100's 84,000
14 CHLORAMFENICOL 250 MG CAP 400
15 COBAZIM 1000 CAP CAP 5,600
16 CONMYCIN CAPSUL 500 MG Box/100's 166,200
17 CONTRAM 50 MG Box/20's 76,400
18 CONUCOL 500 MG Box/100's 450,200
19 DEXTRAL FORTE Box/100's 80,700
20 DIGEST 30 MG Box/20's 369,500
SHBJ TAHUN 2018 204

(1) (2) (3) (4)

21 DOXYCYLIN 100 MG KAPSUL 400
22 EPATIN Box/100's 6,600
23 FELDENE 10 MG KAPSUL 8,000
24 FELDENE 20 MG KAPSUL 14,000
25 FENICOL CAPSUL Box/100's 139,500
26 FENITOIN 100MG (ASKIN) KAPSUL 300
27 FENITOIN 100MG (JKBM) KAPSUL 300
28 FERCEE CAPSUL Box/100's 146,100
29 FIXEF 100 MG Box/30's 746,100
30 FIXEF 50 MG Box/30's 363,500
31 FIXEF 100 MG KAPSUL 31,600
32 FIXEF 200 KAPLET 49,400
33 FIXEF 50 MG TAB. KAPSUL 16,800
34 FLUDAN FORTE CAPSUL Box/100's 123,600
35 FLUIMUCIL 200 MG CAPS CAP 9,200
36 FOLAMIL GENIO SOFT CAPSUL KAPSUL 6,300
37 FOLAPLUS TAB KAPLET 2,300
38 FORMEL 500 MG KAPSUL 1,600
39 FORMEL 850 MG KAPSUL 2,300
40 GRIVIN FORTE Box/300's 772,700
41 KALTICOL 500 MG Box/50's 236,900
42 MICTONORM DUS/28'S 455,400
43 PRITAMOX 500 MG Box/100's 184,800
44 PRONITA KAPSUL Box/100's 134,400
45 RIF CAPSUL 150 MG Box/30's 101,600
46 RIF CAPSUL 300 MG Box/30's 173,100
47 STAFORIN 500 MG Box/30's 398,100
48 TAMCOCIN 500 CAPS. KAPSUL 7,400
49 TEAMIC KAPSUL 1,900
50 TEPAXIN 250 MG KAPSUL 14,400
51 TETRASIKLIN 250 MG KAPSUL KAPSUL 300
52 TETRASIKLIN 500 MG KAPSUL KAPSUL 600
53 THIAMFILEX 500 MG Box/100's 184,800
54 THIAMPHENICOL 250MG KAPSUL 4,400
55 THIAMPHENICOL 500 CAPS KAPSUL 800
56 THIAMYCIN 1000 MG CAP KAPSUL 14,900
57 THIAMYCIN 250 MG KAPSUL 5,400
58 THIAMYCIN 500 MG KAPSUL 8,400
59 TIAMFENIKOL 500MG (JKBM) KAPSUL 800
60 TRAMADOL KAPS CAP 600
61 TRIOMIN E Box/100's 184,800
62 UBI - Q TABLET KAPSUL 11,100
63 UPLORES KAPSUL 8,900
64 URDAFALK CAPS CAP 12,800
65 URDAHEX CAP 18,900
66 UROTRACTIN CAPS. KAPSUL 6,800
67 VIOPOR-M FORTE KAPLET 9,200
68 VIOSTIN COMPOSITUM KAPSUL 6,000
SHBJ TAHUN 2018 205

(1) (2) (3) (4)

69 VIOSTIN-X KAPLET KAPLET 13,000
70 VIRAZIDE CAPSUL 100 MG Box/10's 88,200
71 VITALEX Box/100's 67,200
72 ZENCOCIN 500 KAP Box/100's 635,000
73 ZEMYC 150 MG KAPSUL KAPSUL 103,100
74 XENICAL KAPSUL 16,300
75 ZENIFLOX 500 Box/30's 478,700
76 ZINKOVIT KAPS KAPSUL 4,000
77 ZINKOVIT PLUS KAPSUL 4,000
1 TETES MATA , TELINGA DAN HIDUNG

2 ATROPIN 1% TETES MATA BTL 18,900
3 BREATHY TETES HIDUNG DROP 35,500
4 CENDO CENFRES TM (JKBM) STRIP 30,300
5 CENDO EYEPRES TM (JKBM) STRIP 30,600
6 CENDO LYTEERS 15 MG (JKBM) BOTOL 28,900
7 CENDO LYTEERS 15 ML(ASKES) BOTOL 34,700
8 CENDO LYTEERS 5 ML( ASKES) BOTOL 15,400
9 CENDO MYDRIATYL 0,5%(DINAS) BOTOL 35,500
10 CENDO NATACEN 0.6 ML TM (ASK) STRIP 83,700
11 CHLORAMFENICOL T. TELINGA BTL 2,000
12 KLORAMIXINE D EYE DROPS Btl/10'ml 39,500
13 KLORAMIXINE EYE DROPS Btl/10'ml 33,600
14 OTOLIN BTL 40,200
CREAM/OINMENT
1 BETOPIC CREAM Tube/10'G 35,400
2 BEVALEX TUBE/5 GRAM 10,100
3 BRAVODERM CREAM TUBE/5 GRAM 15,100
4 BRAVODERM N CREAM TUBE/5 GRAM 16,100
5 BUFABRON IOB TUBE/5 GRAM 18,500
6 BUFACOM IOB Tube 20,300
7 CHLORAMPECORT CREAM TUBE 17,300
8 CHLORAMPECORT H TUBE 11,300
9 CHLORAMPHENICOL S.M Tube 3,200
10 CLORAMIDINA DER. OINMENT Tube/10'G 17,700
11 CLORAMIDINA OPT. OINMENT Tube/5'G 21,800
12 FLUCORT N CREAM TUBE/5 GRAM 28,900
13 FRODENTA GEL 20 MG TUBE/20 GRAM 100,800
14 GARAPON CREAM Tube/10'G 23,500
15 GENTALEX 1 MG TUBE/5 GRAM 3,700
16 KLOFRESON TUBE/10 GRAM 8,700
17 LEXACORTON TUBE/5 GRAM 7,000
18 MOFULEX TUBE/5 GRAM 33,600
19 MOLASON TUBE/5 GRAM 5,600
20 MOLADERM TUBE/10 GRAM 8,200
21 MOLAKRIM TUBE/30 GRAM 11,800
22 NB. TOP OINT OINT 26,300
SHBJ TAHUN 2018 206

(1) (2) (3) (4)
SYRUP/DRY SYRUP
1 ACITRAL SYR BTL 51,700
2 ACTIGED SYR BTL 34,400
3 ALCO ORAL DROP BUAH 78,200
4 ALCO PLUS SYR 100 ML BUAH 49,400
5 ALERIN Btl/100'ml 35,400
6 ALPARA SIRUP BTL/60 ml 11,500
7 ALPHAMOL DROPS BTL/15 ml 20,200
8 ALPHAMOL SIRUP BTL/60 ml 8,800
9 ALUDONNA D SUSPENSION Btl/150'ml 49,500
10 ALUDONNA SUSPENSION Btl/150'ml 60,500
11 AMOXYLIN SYR BTL 7,100
12 AMPICILIN SYR BTL 5,100
13 ANTASIDA SYR BTL 7,800
14 ARCAMOX DRY SYRUP Btl/60'ml 34,400
15 ARCAMOX FORTE DS Btl/60'ml 45,300
16 ARTHRIFEN SYRUP Btl/60'ml 23,500
17 ATMACID SYR BTL 7,000
18 BECOMBION 110 CC SYR BTL 42,000
19 BECEFORT BTL/60 ml 26,500
20 BENACOL DTM BTL/60 ml 16,800
21 BENACOL EXPECTORANT BTL/60 ml 14,400
22 BENACOL EXPECTORANT BTL/100 ml 19,900
23 BEREA SYR Btl/24'ml 26,500
24 BETAFORT BTL/60 ml 40,100
25 BIOLYSIN SYR 100 ML BUAH 19,100
26 BISOLVON 60 CC SYR BTL 44,400
27 BUFABRON SYR Btl/24'ml 18,100
28 BUFAMOXY DRY SYR Btl/60'ml 28,500
30 C.CARPINE 2% 5 ML ED DROP 41,700
31 CEFADROXIL SYR BTL 17,000
32 CEFAT FORTE SYR BTL 26,100
33 CEFIXIM SYRUP BTL 60,900
34 CELESTAMIN SYR BTL 67,300
35 CHLORAMPHENICOL SYR BTL 6,800
36 CLABAT SYR BTL 168,300
37 CLANEKSI SYR BTL 91,600
38 COISTAN SYR BTL 23,500
39 CONUCOL DRY SYRUP Btl/60'ml 36,100
40 CURCUMA PLUS SYR BTL 19,100
41 DAYHISTY SYRUP Btl/60'ml 38,700
42 DEKSTROMETORFAN SYRUP 10MG/5ML HBR BOTOL 3,600
43 DEMACOLIN SYRUP Botol 11,300
44 DEMOTIC 5 MG/ 5 ML BTL/100 ml 40,200
45 DEPAKENE SYR BTL 269,400
46 DERMIZAN 5 OZ Btl/150'ml 136,100
47 DEXMOLEX SIRUP BTL/100 ml 9,300
SHBJ TAHUN 2018 207

(1) (2) (3) (4)

48 DEXTAMINE SYR BTL 46,200
49 DEXTRAL SIRUP BTL/60 ml 8,800
50 DEXTRAL SIRUP BTL/100 ml 12,100
51 DEXTROMETHORPAN SYR BTL 5,500
52 DEKSTROMETORFAN SYRUP 10MG/5ML HBR Btl/60'ml 3,600
53 DULCOLACTOL SYR BTL 62,300
54 ECHINOX SYRUP Btl/60'ml 72,300
55 EFEXOL BTL 30,300
56 FEBRINEX BTL/60 ml 24,300
57 ELKANA SYR BTL 40,400
58 ENCHEPABOL SYR BTL 107,600
59 ENERVON-C SYR BTL 19,600
60 ERYTHROMICIN SYR BTL 15,100
61 FENICOL SYRUP Btl/60'ml 24,300
63 FERLIN DROPS BOTOL 47,600
64 FERLIN SIRUP BOTOL 48,300
65 FEROKID DROP 30 ML BOTOL 50,500
66 FEROKID SYR 100 ML BOTOL 70,100
67 FEVRIN DROP Btl/15'ml 32,800
68 FEVRIN SYRUP Btl/60'ml 19,200
69 FIXEF 100 MG/ 5 ML BTL/30 ml 111,100
70 FLUDANE PLUS SYRUP Btl/60'ml 24,300
71 FLUDANE SYRUP Btl/60'ml 20,200
72 FLUIMUCIL DRY SIRUP 150 ML BOTOL 58,700
74 GABRYL SYRUP BTL 69,000
77 GROTAVIT SYRUP Btl/60'ml 28,500
78 HALFYLLIN SYR Btl/50'ml 11,100
79 HALMEZYN SYR Btl/50'ml 35,500
80 HISTRINE SYRUP 60 ML BOTOL 88,500
81 HUSTUREX Btl/60'ml 7,700
82 IM BOOST SYR 60 ML BOTOL 58,700
83 IM BOOST SYRUP 120 ML BOTOL 93,300
84 IMUNOS SYR BTL 116,300
85 INFATRIM SUSPENSIN (SULFAMETASOLE) 200 MG BTL/50 ml 9,300
86 INFATRIM SUSPENSIN (TRIMETROFIN) 40 MG BTL/50 ml 9,300
88 INPEPSA SUSP 100 ML BOTOL 98,500
89 INPEPSA SUSP.200 ML BOTOL 149,400
90 INTERHISTIN SYR BTL 44,700
91 INTERPECT 15 MG SUR BTL 45,800
92 KALMOXILLIN 250 MG/ 5 ML BTL/60 ml 42,000
93 KALMOXILLIN 125 MG/ 5 ML BTL/60 ml 26,900
94 KALTICOL 125 MG BTL 27,700
95 KLORAMFENIKOL SYR BOTOL 7,100
96 KLORAMFENIKOL SYRUP (JKBM) BOTOL 7,100
97 KOLIVIT SYR (KONSINASI) BOTOL 41,600
98 KOTRIMOKSAZOL SYR BOTOL 7,100
99 LACTULAC SYR 200 CC BOTOL 111,700
SHBJ TAHUN 2018 208

(1) (2) (3) (4)

100 LACTULAC SYR 60 ML BOTOL 42,800
101 LACTULAX SYR 120 ML BOTOL 80,200
103 LAPICEF FORTE SYR(250 MG) BOTOL 133,600
104 LAPICEF SYR 125 BOTOL 81,600
105 LAPIFED DM SYR 100 ML BOTOL 41,300
106 LAPIFED EXP SYR BOTOL 35,500
107 LAPIFED SYR BOTOL 33,200
108 LAPIFED SYR (JKBM) BOTOL 25,900
109 LASAL EXP SYR BOTOL 64,300
110 LASAL SYR BOTOL 41,300
111 LATROPIL SYR BTL 79,400
112 LAXADINE SYR 110 ML BOTOL 61,200
114 LAXADINE SYR(ASK) BOTOL 21,700
115 LEXACROL FORTE SUSPENSI BTL/100 ml 22,800
116 LEXACROL FORTE SUSPENSI BTL/190 ml 41,100
117 LEXAPRAM SIRUP BTL/60 ml 9,300
118 LEXAVON SIRUP BTL/60 ml 9,300
120 LEVOPRONT SYR 120 ML BOTOL 97,400
121 LONGCEF 125 MG SYR BOTOL 86,300
122 LONGCEF 250 MG SYR BOTOL 130,200
123 LIBROFED BTL/60 ml 23,200
125 LISOVIT SYR1@ Btl/20'ml 24,300
126 LYSMIN 60 CC SYR BTL 28,700
127 LYSMIN PLUS SYRUP Btl/60'ml 47,100
128 LYSMIN SYRUP Btl/125'ml 41,100
129 LYSMIN SYRUP Btl/60'ml 27,700
130 LYVIT SYR BTL 29,600
131 MAGTRAL FORTE SYR BOTOL 46,600
132 MAGTRAL SYRUP BOTOL 40,400
133 MATOVIT SYR BOTOL 58,700
134 MEBHIDROLIN SYR (JKBM) BOTOL 43,200
135 MEPTIN SWINGHALER BOTOL 174,600
136 MEPTIN SYRUP 60 ML BOTOL 90,700
137 MERCOTIN DROPS 20ML BOTOL 35,900
139 METROLET SYRUP BOTOL 9,200
140 MOLADEC DROP BTL/15 ml 21,000
141 MOLAPECT SIRUP 15 MG/5 ML BTL/60 ml 10,800
142 MOLAPECT SIRUP 30 MG/5 ML BTL/60 ml 14,800
143 MOLEXDRYL SIRUP BTL/60 ml 6,700
144 MOLEXFLU SIRUP BTL/60 ml 7,400
145 MUCERA DROP BOTOL 59,100
146 MUCERA SYRUP BOTOL 34,000
147 MUCOGARD SYR (ASK) BOTOL 48,400
148 MUCOGARD SYR (ASK) BOTOL 48,400
149 MUCOS SYR 60 ML BOTOL 30,400
150 MUCOS 15 ML SYR BTL 26,900
151 MUCOS DROP BTL 59,900
SHBJ TAHUN 2018 209

(1) (2) (3) (4)

153 MUCOSULVAN SYR.60 ML BOTOL 18,100
157 NAIRET SYRUP BOTOL 22,800
158 NARFOZ SYRUP 60 ML BOTOL 185,600
160 NEO KAOLANA SYR BOTOL 24,200
161 NEOKAOMINAL SUSPENSI BTL/60 ml 8,200
162 NEO NOVAPON SYR BOTOL 28,500
163 NEUROTAM SYR BTL 123,200
165 NIFUDIAR SYR BOTOL 72,100
166 NIFURAL SYR BOTOL 81,500
167 NOOCEPHAL SYRUP BOTOL 72,600
168 NOOTROPIL SYR.100 CC BOTOL 122,600
170 NOVALGIN SYR BTL 70,500
171 OBAT BATUK HITAM 200ML(ASKIN) BOTOL 5,200
172 OBAT BATUK HITAM 200ML(JKBM) BOTOL 5,200
173 OBAT BATUK PUTIH BOTOL 4,400
174 OBH COMBI 100 ML BOTOL 7,000
175 OBH COMBI PLUS 100 ML BOTOL 15,100
176 OBH COMBI PLUS 60ML BOTOL 10,400
177 OBH GENERIK 100 ML BOTOL 2,500
178 OBH NELCO SPECIAL 110 ML BOTOL 19,200
179 OBH SYR 200ML BOTOL 5,100
180 OPICEF FORTE SYR BOTOL 115,100
181 OPICEF SYR BOTOL 73,500
182 OPICEF SYR(ASKES) BOTOL 15,100
183 OPILAX SYR 120 ML BOTOL 84,000
184 OPILAX SYR 60 ML BOTOL 51,700
185 OPIMOX SYR 60 ML BOTOL 26,200
186 OPIMOX SYR FORTE 60 ML BOTOL 34,000
187 OPIPHEN DRY SYRUP BOTOL 27,400
188 OPITHROCIN SYR BOTOL 36,600
189 OPRAM SYRUP Btl/60'ml 22,800
190 OTOPAN DROP BTL 34,000
191 OTOPAN SYR BTL 21,500
192 OXORIL SIRUP BOTOL 51,300
193 OZEN DROP BOTOL 101,200
194 OZEN SYR BOTOL 89,200
195 PALENTIN BTL/60 ml 70,500
196 PAMOL DROP BOTOL 42,400
197 PAMOL SYRUP BOTOL 25,100
198 PANADOL SYR 30 ML BOTOL 22,600
199 PANADOL SYR 60 BOTOL 23,900
200 PARACETAMOL SYR BTL 3,200
202 PEHATIFEN SYRUP BTL/60 ml 22,300
203 PLANTACID FORTE BTL/100 ml 112,500
204 PONCODRYL DMP SYRUP Btl/60'ml 23,500
205 PONCODRYL DMP SYRUP Btl/100'ml 32,800
206 PONCODRYL SYRUP Btl/60'ml 18,500
207 PONCODRYL SYRUP Btl/100'ml 25,200
SHBJ TAHUN 2018 210

(1) (2) (3) (4)

209 PONCOLIN D SYRUP Btl/100'ml 31,800
210 PONCOLIN D SYRUP Btl/60'ml 21,800
211 PONCOLIN SYRUP Btl/100'ml 25,200
212 PONCOLIN SYRUP Btl/60'ml 19,200
213 PONFLU SYRUP Btl/60'ml 23,500
214 PRALAX SYR.100 ML BOTOL 89,500
215 PRAXION FORTE SYR BOTOL 44,700
216 PRAXION SYR BOTOL 32,000
217 PRIMPERAN SYR BTL 29,400
218 PRITAMOX 125 MG/ 5 ML BTL/60 ml 12,900
219 PROCELES SYR 60 ML BOTOL 59,000
220 PROMEDEX 60ML SYR BOTOL 30,300
221 PROTAMOX DRY SYRUP Btl/60'ml 79,800
222 PROTAMOX FORTE DRY SYRUP Btl/60'ml 122,600
223 PYREX SYR 60 ML BOTOL 28,500
224 PYREXINA SYR BOTOL 11,500
225 RHINATHIOL ADULT SYR BOTOL 55,400
226 RHINATHIOL INFANT SYR BOTOL 37,800
227 RHINATHIOL PROMETHASIN SYR BOTOL 45,300
228 RIHEST SYR BOTOL 30,900
229 ROVADIN SYR BOTOL 63,100
230 ROVAMYCINE SYRUP BOTOL 125,200
231 SANADRYL SYRUP 60 ML BTL 17,000
232 SANGOBION SYR BTL 34,300
233 SANMAG BTL 42,000
234 SANMOL SYR BTL 22,200
236 SENDICOL SYR Btl/50'ml 25,500
238 SOHOFIT SYRUP BOTOL 25,100
240 SPIRADAN 125 MG/5 ML BTL/100 ml 67,200
241 SPECTREM SYRUP Btl/60'ml 34,400
242 STAFORIN 125 MG/ 5 ML BTL/60 ml 52,100
243 STAFORIN 250 MG/ 5 ML BTL/60 ml 92,400
244 THIAMFILEX 125 MG/5 ML BTL/60 ml 10,800
246 THIAMYCIN FORTE SYR BOTOL 104,800
247 THIAMYCIN SYR 60 ML BOTOL 58,700
248 TRANSBRONCHO 15 MG/5 ML BTL/100 ml 28,500
249 TRANSBRONCHO 30 MG/5 ML BTL/60 ml 36,900
250 TILIDON SYR BTL 47,100
251 ULSAFATE SYR 100 ML (ASK) BOTOL 48,400
252 VALPROAT SYP (ASKIN) BOTOL 122,600
253 VALPROAT SYRUP (JKBM) BOTOL 122,600
254 VECTRINE DRY SYRUP BOTOL 67,500
255 VIACLAV 125 MG/5 ML BTL/60 ml 67,200
256 VICAL SUSPENSI BTL/60 ml 9,700
257 VICAL SUSPENSI BTL/100 ml 13,400
258 VOMITAS SYR BOTOL 81,600
260 VOMITROL SYR 30 ML BOTOL 8,900
261 VOMITROL SYR 60 BOTOL 20,900
SHBJ TAHUN 2018 211

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262 VOMITROL SYRUP 30 ML BOTOL 14,700
264 ZAMEL SYRUP BTL 58,700
266 ZENTRA SYR BTL/60 ml 21,100
268 GERDILLUM SYRUP BTL 33,200
INJEKSI
1 ABU VIAL 621,500
2 ACRAN 150 MG INJ AMP 37,300
3 ADONA-AC 17 INJ (10 ML) VIAL 47,100
4 ALINAMIN F INJF AMP 26,300
5 ALKOHOL 95% 1ltr BTL 54,600
6 AMCILLIN INJ 1 GRM VIAL 7,000
7 AMINOFILIN INJ AMP 7,000
8 AMINOFUSIN - L 600 INF VIAL 151,000
9 AMINOFUSIN HEPAR BTL 338,100
10 AMINOFUSIN PAED BTL 157,900
11 AMINOSTERIL 10% 500 ML INF VIAL 12,500
12 AMINOSTERIL 5% 500 ML INF VIAL 162,400
13 AMPICILIN 1 GR INJ VIAL 6,300
14 ANTALGINE INJ AMP 1,600
15 AQUABIDEST 25 CC BTL 4,500
16 ARIXTRA INJ 0,5 MG VIAL 757,700
17 ATROPIN SULFAS INJ AMP 4,400
18 ATS 1500 IU AMP 190,000
19 ATS 20,000 IU VIAL 978,200
20 BENZATIN PENICILLIN 2,4 ML VIAL 23,900
21 BLEOMISIN 15 MG INJ VIAL 480,500
22 BLEOMISIN 15 MG INJ AMP 480,500
23 BRAINACT 250 MG INJ VIAL 68,300
24 BRAINACT 500 MG INJ AMP 83,100
25 BUSCOPAN INJ AMP 41,300
26 CALCII GLUCONAS AMP 21,000
27 CEDANTRON 4 MG INJ AMP 49,400
28 CEDANTRON 8 MG INJ AMP 74,700
29 CEFIZOK 1 GR INJ VIAL 453,500
30 CEFOTAXIM 1 GR INJ VIAL 10,800
31 CEFTAZIDIM 1 GR INJ VIAL 58,000
32 CENDO XITROL 5 CC TUBE 74,700
33 CEROPID 1 G INJ VIAL VIAL 294,500
34 CHLORAMPENICOL 1 GR INJ VIAL 2,200
35 CIPROFLOXACINE INF BTL 50,200
37 CISPLATIN 10 MG INJ VIAL 160,900
40 CITICHOLIN 250 INJ AMP 34,600
41 CITICOLIN 100 MG INJ AMP 25,400
42 CLATAX INJ VIAL 161,300
43 CLATAX INJEKSI AMP 208,600
44 CRAVIT IV 100 ML INF VIAL 578,200
SHBJ TAHUN 2018 212

(1) (2) (3) (4)

45 CURACIL 250 MG INJ VIAL 73,300
46 CURACIL 500 MG INJ VIAL 133,600
47 DELLADRYL INJ VIAL 5,600
48 DEPO PROGESTIN INJ BTL 13,700
49 DEXTROSE 40% INJ FLS 4,700
50 DEXTROSE 40% INJ OTSU VIAL 2,500
51 DEXTROSE 5% + NACL 0,225 BTL 20,600
52 DEXTROSE 5% 100ML BTL 2,500
53 DEXTROSE 5% 500 ML WIDA BTL 18,000
54 DIAZEPAM INJ AMP 1,900
55 DIAZOLE INF BTL 23,900
56 DIBEKACIN 100 MG VIAL 107,600
57 DIFLUCAN 2 MG INF VIAL 250,200
58 DIFLUCAN IV 2 MG/ML VIAL 643,100
59 DIGOKSIN 0,25 MG INJ AMP 36,600
60 DILANTIN INJ VIAL 221,300
61 DILTIAZEM HCL 50 MG INJ AMP 90,700
62 DIPHENHIDRAMIN INJ 10 MG AMP 1,600
63 DOBUJECT VIAL 75,400
64 DOBUJET 250/5 ML AMP 209,200
65 DOBUTAMIN 250 MG INJ AMP 55,400
66 DOBUTAMIN GIULINI INJ VIAL 55,400
67 DOKSORUBICIN 10 MG INJ VIAL 121,700
68 DOKSORUBICIN 50 MG INJ VIAL 581,200
69 DOLGESIC INJ AMP 5,800
70 DOLSIC INJ VIAL 4,800
71 DOPAMIN 40 MG INJ AMP 17,800
72 DORMICUM 5 MG INJ VIAL 7,800
73 DURADIL VIAL 4,500
74 DURADRIL VIAL 6,200
75 DUROLANE INJ 3 ML AMP 4,158,300
76 DYNASTAN 40 MG INJ VIAL 197,900
77 EBETAXEL 30 MG VIAL 2,096,800
78 EPHEDRIN INJ AMP 12,900
79 EPHEDRINE INJ AMP 2,900
80 EPIDOSIN INJ AMP 5,100
81 EPINEFRIN INJ 0,1% ETHICA AMP 1,400
82 EPINEPHRINE INJ AMP 5,100
83 EPINEPRIN INJ AMP 1,400
84 EPIRUBICIN 10 MG AMP 595,000
85 EPIRUBICIN 50 MG AMP 2,753,400
86 EPOTREX-NP 10.000 IU AMP 1,386,700
87 ETASON INJ 5 MG/ML AMP 10,100
89 ETHIGEN/GENTAMICIN 80 MG AMP 22,000
90 FAKTOR VIII 250 IU INJ VIAL 2,071,400
91 FARMIN 20% 100 ML VIAL 878,600
92 FARSIX INJ AMP 15,200
93 FIMARINASE AMPUL 254,900
SHBJ TAHUN 2018 213

(1) (2) (3) (4)

94 FLAMICORT 10 MG VIAL 173,600
95 FLIXOTIDE NEBULES AMPUL 37,300
96 FLUIMUCIL INJEKSI AMPUL 75,200
97 FLUORASIL 250 INJ(MASKIN) VIAL 50,500
98 FLUORASIL 500 INJ(MASKIN) VIAL 83,100
99 FLUXUM 4250 IU 0,4ML VIAL 266,400
100 FORTUM 1 GR INJ VIAL 462,000
101 FOSMIDEX INJEKSI 2 GR VIAL 317,000
102 FOSMIDEX INJEKSI I GR VIAL 190,800
103 FOSMICIN 2 GR INJ VIAL 301,200
104 FOTARAM INJ VIAL 182,700
105 FOXIM INJ VIAL 178,700
106 FRAXIPARIN 0,3 INJ VIAL 128,900
107 FRAXIPARIN 0,6 INJ AMP 388,900
108 FUROSEMIDE INJ AMP 3,700
109 FURROSEMID INJ AMPUL 4,100
110 FUTAPROM 1 GR INJ VIAL 462,800
111 GARAMYCIN 20MG VIAL 39,000
112 GARAMYCIN 80 MG VIAL 97,000
113 GASTRIDIN INJ AMPUL 37,500
114 GASTROFER INJ 40 MG VIAL 150,100
115 GASTROFER INJ 40 MG (ASK) VIAL 137,300
116 GENTAMERCK 80 MG INJ. VIAL 7,100
117 GENTAMERK 80MG (ASKES) AMPUL 6,000
118 GENTAMISIN INJ (ASKIN) AMPUL 4,900
119 GENTAMISIN INJ (JPS) AMPUL 4,900
120 GENTAMYCIN 80 MG INJ. AMPUL 6,700
121 GRANON I MG INJ VIAL 110,400
122 HEPA-MERZ INJEKSI AMPUL 187,200
123 HEPARIN NA (ASKIN) VIAL 52,500
124 HEPARIN NA INJ (JKBM) VIAL 52,500
125 HEMAPO (ASK) AMPUL 314,100
126 HEMAPO INJ 3000 IU AMPUL 347,300
127 HEPA-MERZ INJEKSI AMPUL 187,200
128 HEPARIN VIAL 52,500
129 HEPAVAX-GENE 1 ML VIAL 111,700
130 HERBESSER 50 MG INJ(ASK) AMPUL 267,100
131 HERBESER INJEKSI AMPUL 624,400
132 HEXER INJEKSI 50 MG AMPUL 25,100
133 HEXILON 125 MG INJ VIAL 170,600
134 HUMALOG MIX 25 100 IU/ML VIAL 273,800
135 HUMULIN N AMPUL 214,300
136 HUMULIN N 100 I U AMPUL 534,200
137 HUMULIN R VIAL 175,000
138 HUMULIN R AMPUL 214,300
139 HUMULIN R.100 IU VIAL 493,700
140 HYPERHEP 0,5 ML VIAL 3,234,500
141 IKAPHEN 100 MG INJ AMPUL 184,500
SHBJ TAHUN 2018 214

(1) (2) (3) (4)

142 IMOGAM RABIES INJ VIAL 2,864,900
144 INCEPHIN 1 GR INJ VIAL 160,900
145 INDOP INJ VIAL 67,300
147 INDUXIN 10 IU INJEKSI AMPUL 18,100
148 INOTROP INJEKSI VIAL 220,400
149 INOVAD INJ VIAL 444,300
150 INSULATARD NOVOLET VIAL 190,800
151 INTERMIC INJEKSI AMPUL 15,800
152 INTERMOXIL INJ 1 GR VIAL 46,600
153 INTEROME INJ 1 GR VIAL 509,900
154 INTERPIM INJ 1 GR VIAL 558,700
155 INVICLOT VIAL 81,600
157 IOPAMIDOL 30 ML INJ (JKBM) VIAL 257,900
158 INVOMIT 8 INJEKSI AMPUL 116,300
159 IOPAMIRO 370/50 ML VIAL 578,800
160 ISOKET SOLUTION AMPUL 124,000
161 KALCEF INJ.0.75 GR VIAL 800
162 KALFOXIM 0,5 MG INJ VIAL 139,500
163 KALFOXIM 1000 MG INJEKSI VIAL 266,400
164 IOPAMIRO 370-50 ML VIAL 578,800
165 ISOKET INJ AMP 52,100
177 KALCEF INJ.0.75 GR VIAL 800
178 KALFOXIM 0,5 G VIAL 139,500
179 KALFOXIM 1 GR INJ VIAL 266,400
180 KALMECO INJ AMPUL 41,600
181 KALMETHASONE 4 MG INJ AMP 6,200
183 KALMETHASONE 5 MG INJ AMPUL 6,000
184 KALMETHASONE VIAL 5 CC VIAL 44,400
186 KALMOXILLIN 1 GR INJ VIAL 47,100
187 KALMETHASONE 4 MG INJEKSI AMPUL 6,200
188 KALMETHASONE 5 MG INJ AMPUL 6,000
189 KALMETHASONE VIAL 5 CC VIAL 44,400
190 KALMOXILIN INJ VIAL 47,100
191 KALNEX 100 MG INJ AMPUL 24,200
192 KALNEX 50MG INJ AMPUL 10,400
193 KALNEX INJ 500 MG (ASKES) AMPUL 8,700
194 KALPICILLIN INJ 1 GR VIAL 15,900
195 KALPICILIN 500 MG INJ VIAL 13,400
196 KALPICILIN INJEKSI 250 MG VIAL 10,400
197 KALSIUM FOLINAT 50 MG INJ VIAL 418,100
198 KALSIUM FOLINAT 50 MG INJ VIAL 418,100
199 KALSIUM GLUKONAT AMP 12,600
200 KALTROFEN INJ. AMPUL 51,700
201 KAMADOL INJ AMP 16,300
202 KATRASIC INJEKSI 50 MG AMPUL 24,900
203 KEDACILLIN 1 GRAM VIAL 75,400
204 KEMICETIN 1 GR INJ VIAL 17,700
205 KENACORT A INJ ( DINAS ) VIAL 134,700
SHBJ TAHUN 2018 215

(1) (2) (3) (4)

206 KENACORT INJ VIAL 201,100
207 KENDARON INJ AMPUL 41,800
208 KETESSE 50 MG INJ AMP 83,300
209 KETOPROFEN INJ AMPUL 23,900
210 KUTOIN INJ VIAL 169,100
211 LACEDIM 1 GR INJ VIAL 370,400
213 LANCOLIN 250 MG INJ AMPUL 63,100
214 LANCOLIN 500 MG INJ AMPUL 75,700
217 LANOXIN INJ AMP 95,500
221 LAPIBAL INJ AMP 37,800
223 LASIX INJ AMP 19,900
224 LEUCOGEN VIAL 1,155,800
225 LEUCOVORIN 100 MG AMPUL AMPUL 1,109,600
226 LEUCOVORIN 50 MG EBEWE VIAL 460,100
227 LEVEMIR FLEXPEN INJ VIAL 361,700
228 LEVOPHED BITATRATE 0.2% AMPUL 254,900
230 LIDOCAIN 2% INJ AMP 2,000
232 LIDODEX INJ AMP 33,700
238 LOSEC INJEKSI AMPUL 248,700
244 LYP ASSAY CHEMISTRY CONTROL VIAL 7,391,100
256 MECOBALAMIN INJ 500 AMP 17,700
257 MECONEURO INJ AMP 24,300
262 MEROBAT 0,5 GR INJ VIAL 439,600
263 MEROBAT INJ 1 GR VIAL 809,200
266 MEROFEN INJ 1 GR VIAL 1,004,500
267 MEROFENEM 1 GR INJ VIAL 376,900
271 MEROSAN 0.5 INJ VIAL 523,200
272 MEROSAN 1 GR INJ VIAL 1,020,800
279 METHOTREXATE 50 MG INJ VIAL 82,800
280 METHYCOBAL 500 MG INJESI AMPUL 40,900
281 METYL ERGOMETRIN INJ AMPUL 4,500
282 MIKASIN INJ 250 VIAL 137,300
283 MITOMYCIN-C 10 MG VIAL 2,264,400
284 MIXTARD 30 HM VIAL 267,600
285 AMYLUM SOLUBE Pot/100gr 1,915,000
286 EBT Pot/25 gr 3,006,800
287 KALIUM IODIDA Pot/250 gr 3,687,100
288 KERTAS PH UNIVERSAL KTK/14'S 504,000
289 KLOROFORM BTL/2,5 LT 1,469,800
290 NaCL Pot/500 GR 1,406,000
291 NATRIUM HIDROKSIDA Pot/500 GR 1,083,500
292 NATRIUM KARBONAT Pot/500 GR 2,669,200
CAIRAN
1 ARCORED INJEKSI Box/10's 188,100
2 BIONEURON 5 ML DUS/5 AMPL 33,600
3 CERCUL 2ML BOX/5 AMPL 191,500
4 CLORAMIDINA INJEKSI Box/10's 288,900
6 CORSONA DUS/100 AMPL 44,900
SHBJ TAHUN 2018 216

(1) (2) (3) (4)

5 DOLSIC DUS/5 AMPL 121,400
6 DURADRIL VIAL 5,900
7 HYPOBHAC 200 1,5 ML DUS/1 AMPL 392,600
8 HYPOBHAC 25 MG DUS/1 VIAL 89,000
9 KANARCO INJEKSI Box/10's 252,000
10 LACTOR 1 ML DUS/6 AMPL 257,200
11 PEHACAIN DUS/20 AMPL 95,700
12 PHADILON BOX/1 VIAL 91,600
13 PHADILON 500 8 ML PELARUT DUS/1 VIAL 324,500
14 PHAMINOV BOX/10 AMPL 125,900
15 PHAPIN BOX/1 VIAL 15,900
16 PHEAMOXIL BOX/1 VIAL 25,500
17 PHINEV DUS/10 AMPL 57,100
18 PROINFARK 10 ML DUS/5 AMPL 240,900
LAINNYA :
1 1/3 TUBULAR PLATE 4 HOLE BIJI 459,800
6 2LUMENKEF11P150C PIECE 1,176,100
7 2LUMENKEF11P150R PIECE 1,176,100
8 ABBOCATH 14 BIJI 14,900
14 ABILIFY 10 MG TABLET 43,200
15 ABILIFY 5 MG TABLET TABLET 24,000
16 ABP 50 MM X 10 HOLES BIJI 2,352,200
20 ABP 60 MM X 5 HOLE 2,352,200
21 ABP 60 MM X 7 HOLE BIJI 2,352,200
22 ABP 60 MM X 9 HOLE BIJI 2,352,200
23 ABP 60MM X 11 HOLE BIJI 2,352,200
24 ABU INJ / BIOSAVE INJ VIAL 498,100
25 ACC/ACETABULAR REC PLATE L6 BIJI 1,168,800
26 ACC/ACETUBULAR REC PLATE 8 BIJI 1,440,500
27 ACC/ACETUBULAR REC PLATE L10 BIJI 1,747,900
28 ACETENSA TABLET 10,300
29 ACETOSAL 100 TABLET 150
30 ACID SALYCIL 200MG BKS 2,200
31 ACTIMOVE MITELA ECO ARMSLING L PIECE 84,200
32 ACTIMOVE MITELA ECO ARMSLING M PIECE 84,100
SHBJ TAHUN 2018 217

(1) (2) (3) (4)

33 ACTIMOVE MITELA ECO ARMSLING S PIECE 84,100
34 ACTIMOVE VERTEBRACE S/M/L BIJI 242,700
35 ACTIVE LIFE PIECE 72,100
36 ACTOS TAB TABLET 3,700
37 ACYCLOVIR 200 MG TABLET 300
38 ACYCLOVIR 400 TABLET 400
39 ACYCLOVIR CREAM 5% TUBE 3,400
40 ADALAT OROS 30 MG TABLET 3,800
41 ADONA AC 17 INJ AMPUL 24,700
42 AFAMED KAPSUL KAPSUL 8,300
43 AHFC BIJI 16,800
44 AKARBOSE 50 MG TAB TABLET 900
45 ALAT CUKUR + SILET PIECE 8,300
46 ALBAPURE 20%100 ML BOTOL 810,000
47 ALBENDAZOL 400 TABLET 400
48 ALBOTHYL CONC.10 ML BOTOL 30,900
49 ALCO ORAL DROP 15 ML BOTOL 48,200
50 ALCO PLUS DMP SYR BOTOL 30,900
51 ALCO PLUS SYR BOTOL 31,700
52 ALDISA SR CAP TABLET 4,500
53 ALINAMIN F INJ AMPUL 15,800
54 ALINAMIN F TAB TABLET 900
55 ALKOHOL 70 % 1 LTR BOTOL 18,400
56 ALKOHOL 70% 300CC BOTOL 10,500
57 ALKOHOL 96% LITER 60,500
58 ALLETROL TM BOTOL 11,100
59 ALLOPURINOL 100 MG TAB TABLET 200
60 ALLOPURINOL 300 MG TAB TABLET 250
61 ALOCLAIR PLUS GEL 8 ML TUBE 89,100
62 ALPENTIN 100 MG TABLET 2,900
63 ALPHAMOL 600 MG TABLET 250
64 ALPRAZOLAM 0.5 TABLET TABLET 600
65 ALPRAZOLAM 1 MG TABLET 300
66 ALUPENT TAB TABLET 3,600
67 ALVOLGYL ( GIGI) POT 439,600
68 ALZIM TAB TABLET 18,200
69 AMBROXOL 30 MG TAB TABLET 150
70 AMBROXOL SYR BOTOL 3,300
71 AMIKASIN INJ 250 MG/ML VIAL 105,100
72 AMINOFLUID -L 500 ML BOX 66,500
73 AMINOFUSIN HEPAR BOTOL 81,400
74 AMINOFUSIN L-600 BOTOL 45,400
75 AMINOFUSIN PAED 250 ML BOTOL 49,700
76 AMINOLEBAN INFUS BOX 70,200
77 AMINOPHILIN INJ AMPUL 4,100
78 AMINOPHYLIN TAB 200MG TABLET 100
79 AMINORAL TABLET 7,100
80 AMITRIPTYLIN 25 MG TABLET 150
SHBJ TAHUN 2018 218

(1) (2) (3) (4)

81 AMLODIPINE 10 MG TABLET 400
82 AMLODIPINE 5 MG TABLET 200
83 AMOKSISILIN INJ VIAL 8,100
84 AMOXAN 250 KAPSUL 1,700
85 AMOXAN 500 KAPSUL 3,500
86 AMOXAN DRY SYR BOTOL 24,000
87 AMOXAN FORTE DRY SYR BOTOL 34,200
88 AMOXAN INJ VIAL 24,000
89 AMOXAN PAED DROP BOTOL 24,000
90 AMOXICILIN FORTE SYR BOTOL 4,400
91 AMOXYCILLIN 500 MG TABLET 300
92 AMOXYCILLIN DRY SYR BOTOL 2,600
93 AMP NARROW UK 51-52+BONE SMEN BIJI 7,684,900
94 AMPICILIN 500 MG TABLET 400
95 AMPICILIN INJ VIAL 4,300
96 AMTOCORT 4 MG TABLET 3,400
97 ANAFRANIL 25 TABLET 8,500
98 ANALSIK TABLET 1,300
99 ANALTRAM TAB TABLET 7,100
100 ANBACIM 500 MG TAB TABLET 22,000
101 ANBACIM INJ VIAL 62,500
102 ANEMOLAT TABLET 150
103 ANGIOTEN 50 MG TAB TABLET 11,500
104 ANTASIDA DOEN TAB TABLET 100
105 ANTASIDA SYR BOTOL 2,300
106 ANTERIOR CROWNS BIJI 611,800
107 ANTIHEMOROID SUPP SUPP 3,200
108 ANTIKUN/PIRABRAIN INJ AMPUL 17,700
109 ANTIPRESTIN 10 MG TABLET 4,200
110 ANTRAIN INJ AMPUL 10,200
111 APAZOL 0.5 TABLET 350
112 APIALYS DROP BOTOL 35,600
113 APIALYS SYR BOTOL 29,700
114 APOLAR N CREAM TUBE 38,000
115 APPAVISC/CATAGEL PIECE 89,100
116 APTIL BOTOL 18,800
117 APTOR TAB TABLET 200
118 AQRILIC LIQUID BIJI 427,700
119 AQRILIC POWDER BIJI 427,700
120 AQUA GEL/JELLY TUBE 37,300
121 AQUABIDEST 1000 ML LITER 8,100
122 AQUACEL DRESSING 10*10 PIECE 145,500
123 AQUACEL SILVER DRESSING 10*10 PIECE 218,300
124 AQUADEST 25 CC VIAL 2,400
125 AQUAGEL JELLI TUBE 37,300
126 ARCALION 200 TABLET 5,800
127 ARDIUM TABLET 8,400
128 ARIXTRA 2.5 MG INJ VIAL 369,900
SHBJ TAHUN 2018 219

(1) (2) (3) (4)

129 ARKINE 2 TAB TABLET 700
130 AROMAZIN TAB TABLET 69,500
131 ARSEN POT 508,500
132 ARTICULATING PAPER(GIGI) BOX 216,500
133 ARTRODAR 50 MG TABLET 9,500
134 ASAM FOLAT TAB TABLET 100
135 ASAM MEFENAMAT TABLET 150
136 ASAM TRANEKSAMAT INJ 250MG AMPUL 4,300
137 ASAM TRANEXAMAT 500 TABLET 1,100
138 ASAM TRANEXAMAT 500 INJ AMPUL 5,100
139 ASAM URSODEOKSIKOLAT KAPSUL 5,000
140 ASAM VALPROAT SYR BOTOL 42,400
141 ASERING 500 BOTOL 9,700
142 ASPAR K TABLET 2,400
143 ASPILET 80 MG TABLET 200
144 ASTHIN FORCE 6 MG KAP TABLET 9,600
145 ASTHIN FORCE GEL TUBE 71,300
146 ATOFAR 20 MG TABLET 10,800
147 ATORVASTATIN 20 MG TABLET 4,300
148 ATP DANKOS TABLET TABLET 1,600
149 ATP INJEKSI AMPUL 41,600
150 ATROPIN SULFAT INJ AMPUL 1,400
151 ATS 1500/ BIOSAT-1,5 AMPUL 133,200
152 ATS 20.000 UI VIAL 502,700
153 AVAMYS NASAL SPRAY BOTOL 100,800
154 AVITER POWDER SACHET 15,800
155 AVODART TABLET TABLET 7,700
156 AXAMED CAP TABLET 6,900
157 AZITHROMYCIN 200 MG SYR BOTOL 67,700
158 AZITROMYCIN 500 MG TABLET 4,900
159 AZOPT 5 ML TM BOTOL 255,400
160 BACTIROM INJ VIAL 303,600
161 BAQUINOR 0.3% T.M BOTOL 35,300
162 BAQUINOR FORTE TABLET 14,600
163 BAQUINOR INFUS BOTOL 243,200
164 BECOM-C TABLET 1,400
165 BEDAK SALICYL BOX 1,300
166 BEDAK SALICYL(KIMIA FARMA) BOX 5,000
167 BENANG PDS II 6-0 W9096 PIECE 163,900
168 BENANG PREMILE 5-0 DS 12 PIECE 78,800
169 BENANG PREMILENE 3-0 DS 24 PIECE 54,100
170 BENANG PREMILENE 7-0 PIECE 100,900
171 BENANG US IOL 10.0 NYLON PIECE 89,100
172 BENOZYT 500 MG TABLET 35,600
173 BENZATIN INJ VIAL 14,500
174 BEROTEC INH BOTOL 78,700
175 BESI II SULFAT 300 MG TABLET 50
176 BETABLOK 100MG TAB TABLET 800
SHBJ TAHUN 2018 220

(1) (2) (3) (4)

177 BETADIN SOL 1 LT BOTOL 155,900
178 BETADINE KUMUR BOTOL 9,100
179 BETAHISTIN TAB TABLET 500
180 BIFOTIK INJ VIAL 184,000
181 BIOCEF INJ VIAL 131,900
182 BIOCURKEM KAP KAPLET 11,900
183 BIOCURLIV KAP TABLET 7,100
184 BIOFOS SYRUP BOTOL 65,300
185 BIOPLACENTON TUBE 13,700
186 BIOPREXUM TABLET 2,600
187 BIORAZON I GR INJ VIAL 164,800
188 BIOSANBE KAP TABLET 1,000
189 BIOSIN I PIECE 136,700
190 BIOSTRUM SYR 100 ML BOTOL 47,500
191 BIOSYN 2/0 CUTING PIECE 147,000
192 BIOSYN 3/0 CUTING PIECE 123,000
193 BIOSYN 3/0 TAPER PIECE 134,300
194 BIOTHICOL 250 TABLET 1,700
195 BIOTHICOL 500 TABLET 3,800
196 BIOTHICOL DRY SYR BOTOL 20,400
197 BIOXON INJ VIAL 197,800
198 BIPRO TABLET TABLET 4,600
199 BISACODYL TAB TABLET 400
200 BISOLVON ELIXIR 60 ML BOTOL 24,800
201 BISOLVON INJ AMPUL 40,900
202 BISOLVON KIDS SYRUP BOTOL 23,300
203 BISOLVON TAB TABLET 1,300
204 BISOPROLOL 5 MG TAB TABLET 700
205 BLEOCIN 15 MG INJ VIAL 415,800
206 BLESIFEN TAB TABLET 13,200
207 BLOREC TAB TABLET 6,800
208 BLU TRACH 7 KIT BOX 784,400
209 BLU TRACH 7.5 KIT BOX 784,400
210 BONDRONAT INJ VIAL 2,385,700
211 BONE WAX PIECE 73,400
212 BRAINACT 500 MG INJEKSI AMPUL 51,400
213 BRAINACT 500 MG TAB TABLET 5,700
214 BRAINACT O DIS TAB TABLET 12,800
215 BRAXIDIN TABLET TABLET 900
216 BREATHY TTS HIDUNG BOTOL 17,800
217 BRM CAPSUL KAPSUL 8,900
218 BROAD PLATE 10 HOLES BIJI 1,267,000
219 BROAD PLATE 12 HOLES BIJI 1,347,800
220 BROADCED I GR INJ VIAL 207,900
221 BRONCHOPRONT SYR 100 ML BOTOL 47,000
222 BRONSOLVAN 150MG TAB TABLET 300
223 BUFEC FORTE SYR BOTOL 21,400
224 BUFEC SYR 60 ML BOTOL 15,200
SHBJ TAHUN 2018 221

(1) (2) (3) (4)

225 BUNASCAN EPIDURAL MG 350
226 BUNASCAN SPINAL 0.5 HEAVY MG 1,400
227 BUR FISSUR PENDEK PIECE 28,900
228 BUR FISUR PANJANG PIECE 33,900
229 BURNAZIN CREAM TUBE 24,800
230 BUSCOPAN INJ AMPUL 25,100
231 BUSCOPAN PLUS TABLET 3,200
232 BUSCOPAN TAB TABLET 2,400
233 C. PANTOCAIN 0.5% 5ML BOTOL 12,400
234 C.ASTENOF 5 ML TM BOTOL 23,200
235 C.ASTHENOF STRIP BOTOL 22,600
236 C.AUGENTONIC 15 ML BOTOL 29,300
237 C.CARPINE 2% 5 CC BOTOL 21,000
238 C.CATARLENT 15 ML BOTOL 33,800
239 C.CATARLENT 5 ML TM BOTOL 25,000
240 C.CENFRESH STRIP BOTOL 25,400
241 C.CETAMID 5 CC BOTOL 12,400
242 C.EYEFRESH 0.3 ML STRIP BOTOL 25,500
243 C.FLOXA STRIP BOTOL 29,600
244 C.FLUORESCEIN 2% STRIP STRIP 18,800
245 C.FUNGICID SM TUBE 20,000
246 C.GENTAMICIN S.M 3.5 GR BOTOL 40,200
247 C.GENTAMYCIN 0.3% BOTOL 24,000
248 C.L F X TM STRIP STRIP 76,200
249 C.LYTEARS 15ML REGULER BOTOL 24,900
250 C.LYTEARS ED 15 CC BOTOL 17,000
251 C.POLYGRAN ED 5 ML BOTOL 34,900
252 C.POLYGRAN SM 3.5 GR BOTOL 20,400
253 C.POLYGRAN STRIP BOTOL 19,300
254 C.STATROL TM 5 CC BOTOL 20,200
255 C.TIMOL 0.25% 5 CC BOTOL 33,700
256 C.TIMOL 0.5 %5 ML BOTOL 52,800
257 C.TONOR 0.25 % STRIP STRIP 24,600
258 C.TONOR 0.5 % STRIP STRIP 26,900
259 C.TUBRUSAN STRIP STRIP 24,600
260 C.ULCORI STRIP STRIP 21,700
261 C.VASACON 15 ML BOTOL 18,000
262 C.VASACON A 15 ML BOTOL 24,700
263 C.VITROLENTA STRIP STRIP 31,600
264 C.XITROL 5 ML BOTOL 30,100
265 C.XITROL SALEP MATA BOTOL 39,600
266 C.XITROL STRIP STRIP 26,900
267 CAL-95 KAP TABLET 4,200
268 CALCII GLUKONAS INJ AMPUL 8,400
269 CALCIUM LACTATE 500 MG TABLET 100
270 CALOS TAB TABLET 600
271 CALSIVAS 10 MG TABLET 9,100
272 CALSIVAS 5 MG TABLET 5,100
SHBJ TAHUN 2018 222

(1) (2) (3) (4)

273 CANCELLOUS 3,5 FA NO 18 BIJI 237,600
277 CANCELLOUS 3,5 NO 24 PIECE 237,600
287 CANCELLOUS 4.0 1/2A NO 35 BIJI 237,600
289 CANCELLOUS 4.0 FA NO 28 BIJI 237,600
290 CANCELLOUS 6,5 1/3 ALR 70 PIECE 237,600
291 CANCELLOUS 6,5 1/3 ALR NO 75 BIJI 237,600
294 CANCELLOUS 6.5 1/2A NO 70 PIECE 237,600
296 CANCELLOUS 6.5 1/3 ALUR NO 90 PIECE 237,600
301 CANCELLOUS 6.5 FA NO 85 PIECE 237,600
302 CANCELLOUS 6.5 FA NO 90 PIECE 237,600
303 CANCELLUS 6,5 FA NO 50 PIECE 237,600
307 CANCELLUSN 3.5 FA NO 30 PIECE 237,600
308 CANDERIN 16 MG TABLET 8,000
309 CANDESARTAN 16 MG TABLET 5,300
310 CANDESARTAN 8 MG TAB TABLET 3,300
311 CAPD DIANEAL PD4 1.5% BOTOL 45,100
312 CAPD DIANEAL PD4 2.5% BOTOL 45,100
313 CAPD EXTENDED LIFE PD SET 237,100
314 CAPD MINICAP BOTOL 4,600
315 CAPTOPRIL 12.5 TABLET 100
316 CAPTOPRIL 25 MG TABLET 100
317 CAPTOPRIL 50 MG TABLET 200
318 CARBACHOL INJ BOX 41,600
319 CARBAMAZEPIN 200 MG TAB TABLET 300
320 CARDISAN 10 MG TAB TABLET 10,500
SHBJ TAHUN 2018 223

(1) (2) (3) (4)

321 CARDISAN 5 MG TABLET 5,900
322 CARDISMO TAB TABLET 2,900
323 CARPIATON 100 MG TABLET 3,600
324 CARPULE PIECE 1,200
325 CARPULE BIJI 1,200
326 CARTOGEN CAP TABLET 8,900
327 CASODEX TABLET 48,600
328 CATAPRES INJ AMPUL 44,000
329 CATGUT CHROMIC 1 48G PIECE 107,800
330 CATGUT CROMIC 3/0 ROL 2,089,700
331 CATGUT CROMIC N0 2/0 ROL 2,089,700
332 CATGUT CROMIC NO 1 ROL 2,089,700
333 CATHEJELL PIECE 44,900
334 CAVITON (GIGI) BIJI 224,300
335 CEBACTAM INJ 1 GR VIAL 178,200
336 CEDOCARD INJ VIAL 64,700
337 CEFADROXIL 500 KAPSUL 600
338 CEFADROXIL SYR BOTOL 5,300
339 CEFADROXYL SYR FORTE BOTOL 6,400
340 CEFAT 250 KAPSUL 5,700
341 CEFAT 500 MG KAPSUL 11,200
342 CEFAT DRY SYR BOTOL 46,000
343 CEFAT FORTE SYR BOTOL 79,200
344 CEFAZOL 1 GR VIAL 101,000
345 CEFAZOLIN INJ 1 GR VIAL 17,800
346 CEFEPIME INJ VIAL 46,400
347 CEFILA CAP 100 MG KAPSUL 17,800
348 CEFILA DROP BOTOL 84,300
349 CEFIM I GR INJ VIAL 196,000
350 CEFIR INJ VIAL 279,400
351 CEFIXIME CAP TABLET 900
352 CEFIXIME SYR BOTOL 9,500
353 CEFOPERAZONE 1 GR INJ VIAL 13,800
354 CEFOPERAZONE+SULBACTAM INJ VIAL 41,600
355 CEFORIM INJEKSI VIAL 330,700
356 CEFOTAXIME 1 GR VIAL 4,300
357 CEFPIROME 1 GR INJ VIAL 59,300
358 CEFSPAN 100 MG KAPSUL 22,600
359 CEFSPAN 200 MG KAPSUL 36,600
360 CEFSPAN DRY SYR BOTOL 103,400
361 CEFTAZIDIME I GR INJ VIAL 18,400
362 CEFTIZOXIME INJ 1 GR VIAL 101,000
363 CEFTRIAXONE 1 GR VIAL 4,500
364 CELLCEPT 500 MG TABLET 26,100
365 CEMENT LIQ (GIGI) BOTOL 433,600
366 CEMENT POWDER (GIGI) BOTOL 447,900
367 CENDO MYDRIATYL 0,5% BOTOL 31,900
368 CEPEZET 100 MG TABLET 500
SHBJ TAHUN 2018 224

(1) (2) (3) (4)

369 CEPEZET INJ AMPUL 7,700
370 CEPTIK SYR BOTOL 82,800
371 CERATOME PIECE 89,100
372 CEREMAX IV 50 ML HIJAU BOTOL 210,600
373 CEREMAX IV 50 ML ORANGE BOTOL 314,800
374 CERINI TAB TABLET 3,600
375 CERNEVIT INJ VIAL 171,100
376 CERTOFIX DUO PIECE 773,100
377 CERTOFIX MONO PIECE 705,400
378 CESTER CAP KAPSUL 2,600
379 CETINAL 10 MG TAB TABLET 5,300
380 CETIRIZINE SYR BOTOL 8,600
381 CETIRIZINE TAB KAPSUL 200
382 CHABRA PIECE 1,633,500
383 CHLOR ETHYL BOTOL 142,600
384 CHLORAMEX INJ VIAL 8,900
385 CHLORPROMAZINE 100MG TAB TABLET 200
386 CHOLESTAT 10 MG TABLET 4,000
387 CIDEX 14 GALON 270,500
388 CIDEX OPA 5 LT LITER 130,500
389 CIDEZYME LITER 154,200
390 CIFLON KAP KAPLET 6,800
391 CIMETIDINE 200 TABLET 150
392 CIPROFLOXACINE 500 TABLET 500
393 CIPROFLOXACINE INFUS BOTOL 16,200
394 CITAZ 100 MG TABLET 7,600
395 CITAZ 50 MG TABLET 7,500
396 CITICOLINE 250MG INJ AMPUL 5,800
397 CITICOLINE 500MG TAB TABLET 4,500
398 CITOBRUSH BIJI 2,600
399 CLABAT 500 MG TABLET 12,500
400 CLABAT DRY SYR 60 ML BOTOL 57,500
401 CLAVAMOX 500 MG TABLET 5,400
402 CLINDAMYCIN 150 MG KAPSUL 400
403 CLINDAMYCIN 300 MG KAPSUL 600
404 CLINIMIX 1 LITER BKS 214,900
405 CLINOLEIC 20% 100ML BKS 230,500
406 CLOBAZAM 10 MG TABLET 1,000
407 CLONIDIN TAB 0.15 MG TABLET 200
408 CLOPIDOGREL 75 MG TAB TABLET 3,600
409 CLOZER TABLET 5,400
410 CO AMOXICLAVE 625 MG TAB TABLET 5,400
411 COBAZIM CAP 1000 MG KAPSUL 2,700
412 CODEIN HCL 10 MG TABLET 550
413 CODIPRONT CUM EXP.SYR BOTOL 60,000
414 CODIPRONT SYR 60 ML BOTOL 55,200
415 CODITAM TAB TABLET 3,900
416 COLAR BRACE PHILADEPIA PIECE 653,400
SHBJ TAHUN 2018 225

(1) (2) (3) (4)

417 COLME SYR 60 ML BOTOL 15,000
418 COLME TETES TELINGA BOTOL 22,600
419 COLME TM 8 ML BOTOL 21,000
420 COLOSTOMY BAG NO 5 PIECE 9,500
421 COLSANCETINE INJ 1 GR VIAL 7,800
422 COMAFUSIN HEPAR INFUS BOTOL 70,100
423 COMBIVENT UDV VIAL 6,500
424 COMDIPIN 10 MG TAB TABLET 7,100
425 COMDIPIN 5 MG TAB TABLET 4,000
426 COMPOSIT CERAM ALL NO BIJI 321,900
427 COMPOSITE A2 GIGI BIJI 487,100
428 COMPOSITE A3 GIGI BIJI 487,100
429 COMPOSITE A3.5 GIGI BIJI 403,900
430 COMTRO 125 MG SYR BOTOL 53,500
431 COMTRO 250 TABLET 8,600
432 CONCOR 2.5MG TAB TABLET 800
433 CONDOM CATHETER STERIL L PIECE 7,700
434 CONDOM CATHETER STERIL M PIECE 7,700
435 CONDYLAR BUT 11 H RIGTH PIECE 3,314,500
436 CONDYLAR BUT 7 H LEFT BIJI 2,869,000
437 CONSTIPEN SYR BOTOL 71,700
438 CORDARONE INJ AMPUL 13,500
439 CORDARONE TABLET TABLET 6,600
440 CORSEL KAPL TABLET 5,700
441 CORTEX 3.5 NO 14 BIJI 128,300
442 CORTEX 3.5 NO 16 BIJI 128,300
443 CORTEX 3.5 NO 18 BIJI 128,300
444 CORTEX 3.5 NO 20 BIJI 128,300
445 CORTEX 3.5 NO 22 BIJI 128,300
446 CORTEX 3.5 NO 24 BIJI 128,300
447 CORTEX 3.5 NO 28 BIJI 128,300
448 CORTEX 4,5 NO 18 PIECE 117,600
449 CORTEX 4,5 NO 20 PIECE 117,600
450 CORTEX 4,5 NO 22 PIECE 117,600
451 CORTEX 4,5 NO 40 PIECE 117,600
452 CORTEX 4,5 NO 46 PIECE 117,600
453 CORTEX 4,5 NO 56 BIJI 159,700
454 CORTEX 4,5 NO 58 BIJI 159,700
455 CORTEX 4,5 NO 60 PIECE 112,900
456 CORTEX 4,5 NO 70 PIECE 112,900
457 CORTEX 4.5 NO 16 BIJI 112,900
458 CORTEX 4.5 NO 24 BIJI 112,900
459 CORTEX 4.5 NO 26 BIJI 112,900
460 CORTEX 4.5 NO 28 BIJI 106,900
461 CORTEX 4.5 NO 30 BIJI 106,900
462 CORTEX 4.5 NO 32 BIJI 112,900
463 CORTEX 4.5 NO 34 BIJI 112,900
464 CORTEX 4.5 NO 36 BIJI 112,900
SHBJ TAHUN 2018 226

(1) (2) (3) (4)

465 CORTEX 4.5 NO 38 BIJI 112,900
466 CORTEX 4.5 NO 42 BIJI 112,900
467 CORTEX 4.5 NO 44 BIJI 112,900
468 CORTEX 4.5 NO 48 BIJI 112,900
469 COTRIMOXAZOLE 480 TABLET 200
470 COTRIMOXAZOLE SYR BOTOL 2,300
471 COTTON BUD KOTAK 3,800
472 COTTON ROLL ROL 55,800
473 COUNTERPAIN 15 GR TUBE 22,500
474 CPG 75 MG TAB TABLET 14,900
475 CRAVIT 500 MG TAB TABLET 44,000
476 CRAVIT 750 MG 150 ML BOTOL 362,300
477 CRAVIT INFUS BOTOL 320,800
478 CRAVOX 500 MG TAB TABLET 35,600
479 CRAVOX INFUS BOTOL 237,600
480 CRESCENT PIECE 89,100
481 CRESTOR 10 MG TAB TABLET 15,800
482 CRESTOR 20 MG TABLET 17,900
483 CRYPTAL 100 ML INFUS BOTOL 205,300
484 CRYPTAL 50 MG TAB TABLET 16,600
485 CRYPTAL TAB 200 MG TABLET 57,000
486 CTM TABLET 100
487 CURCUMA DRAGE/STRIP TABLET 800
488 CURVIT CL SYR 175 ML BOTOL 47,500
489 CUSTODIOL TAB TABLET 500
490 CUTICELL 7.5 X 7.5 PIECE 10,000
491 CUTIMED SORBACT DRESING 10X10 PIECE 79,000
492 CUTISORB SORBACT TUPERS 3 CM PIECE 106,600
493 CUTISORB STERILE 10 X 10 CM PIECE 9,300
494 CYCLO-PROGYNOVA TAB BOX 122,100
495 CYGEST 200 MG SUPP 13,100
496 CYGEST 400 MG SUPP 23,800
497 D51/2 NS BOTOL 8,300
498 D51/4 NS BOTOL 8,300
499 DAKTARIN ORAL GEL 10 GR TUBE 62,200
500 DAMABEN TAB TABLET 400
501 DANSERA TABLET 5,500
502 DARYANTULLE-STERIL PIECE 10,400
503 DECUBAL CREAM 20 GR TUBE 21,400
504 DEFLAMAT - 100 MG CR KAPSUL 7,400
505 DEGIROL TABLET 700
506 DEPAKENE SYR BOTOL 186,200
507 DEPAKOTE TAB TABLET 1,800
508 DERMAKEL GEL 19 GR TUBE 130,700
509 DERMAKEL KIDS GEL 19 GR TUBE 148,500
510 DERMALON 3/0 PIECE 53,900
SHBJ TAHUN 2018 227

(1) (2) (3) (4)

514 DERMOVEL CR 10 GR TUBE 67,700
515 DESOKSIMETASHON CREAM TUBE 10,800
516 DEXAMETHASONE 0.5 TAB TABLET 100
517 DEXAMETHASONE INJ AMPUL 1,500
518 DEXOCORT SALEP BIJI 11,700
519 DEXTAMINE SYR BOTOL 29,400
520 DEXTAMINE TAB TABLET 1,700
521 DEXTRAN L /OTSUTRAN L BOTOL 100,600
522 DEXTROSE 10% WIDA BOTOL 11,700
523 DEXTROSE 40 % VIAL 2,100
524 DEXTROSE 5% WIDA BOTOL 9,700
525 DIABETASOL KOTAK 39,000
526 DIALIFER INJ AMPUL 56,200
527 DIALON CAP TABLET 4,200
528 DIAZEPAM 2 MG TABLET 100
529 DIAZOL INFUS SUPP 8,600
530 DIFLOXIN TAB TABLET 26,700
531 DIFLUCAN 150 MG TABLET 104,500
532 DIFLUCAN 50 MG TABLET 30,900
533 DIGOXINE TAB TABLET 100
534 DILANTINE KAPS KAPSUL 3,900
535 DILTIAZEM 30 MG TABLET 150
536 DIOVAN 80 MG TABLET 4,200
537 DIPHENHYDRAMINE INJ AMPUL 1,100
538 DISFLATYL TABLET 600
539 DISOLF 490 MG TABLET 7,700
540 DISPOSABLE BABY CUP FEEDER BIJI 14,500
541 DIVASK 10 MG TAB TABLET 8,900
542 DIVASK 5 MG TABLET 6,300
543 DOBURAN INJ AMPUL 28,800
544 DOBUTAMIN INJ AMPUL 28,800
545 DOGMATIL 50 MG KAPSUL TABLET 3,600
546 DOMINIC 250 MG INJ AMPUL 115,500
547 DOMPERIDON TAB TABLET 200
548 DOMPERIDONE SYR BOTOL 3,600
549 DOPAMET TAB TABLET 900
550 DORNER 20 MG TABLET 3,900
551 DOXYCICLIN 100 MG TABLET 300
552 DULCOLAX SUPP 10 MG SUPP 5,500
553 DULCOLAX SUPP 5 MG INFANT SUPP 5,400
554 DULCOLAX TABLET TABLET 1,000
555 DUMIN 125 RECTAL SUPP 12,600
556 DUMIN 250 RECTAL SUPP 17,600
557 DUODERM CGF DRESSING 4*4 PIECE 116,300
558 DUODERM EXTRA THIN 2*8 PIECE 73,400
559 DUODERM EXTRA THIN 4*4 PIECE 54,800
560 DUODERM GEL 30 GR TUBE 112,300
SHBJ TAHUN 2018 228

(1) (2) (3) (4)

561 DUROGESIC 25 PATCH AMPUL 165,200
562 DYNASTAT INJ 40 MG VIAL 112,000
563 EAS PRIMER BOTOL 55,400
564 ECG ELEKTRODE BIJI 3,000
565 ECG-ELECTRODE DEWASA PIECE 3,000
566 ECRON 10 MNG INJ MG 16,700
567 EFLAGEN 50 MG TAB TABLET 2,200
568 EFRISEL T M BOTOL 17,000
569 ELASTOMULL HAFF 10 CM X 4 M PIECE 39,500
570 ELKANA SYR BOTOL 22,400
571 ELKANA TABLET TABLET 800
572 ELOX CREAM 10 GR TUBE 72,500
573 ELSAZYM ANAK SACHET SACHET 8,800
574 EMULGIDE GR 125
575 ENDOMETHASONE(GIGI) BOTOL 910,500
576 ENERCORE SACHET SACHET 21,400
577 ENGRIX B INJ 20MCG VIAL 95,000
578 ENTRAMIX VANILA KOTAK 45,300
579 ENTROCARE 35 GR SACHET SACHET 10,100
580 ENYSTIN 12 ML BOTOL 35,600
581 EPEXOL 30 MG TABLET 900
582 EPEXOL SYR BOTOL 17,900
583 EPHEDRINE HCL INJ ampul 1,200
584 EPIDURAL CATHETER BIJI 310,400
585 EPINEPHRINE INJ AMPUL 8,700
586 ERGOTAMIN CAFEIN TAB TABLET 150
587 ERICAF TABLET TABLET 2,700
588 ERLAMICETIN/KLORAM SM BIJI 1,700
589 ERLAMYCETIN SM TUBE 4,400
590 ERYSANBE 200 TABLET 1,500
591 ERYSANBE 500 TABLET 2,700
592 ERYSANBE SYR BOTOL 23,000
593 ERYTHROMICIN 250 TABLET 550
594 ERYTROMISIN 500CAP TABLET 1,000
595 ERYTROMISIN SYR BOTOL 8,300
596 ESTESIA CREAM 5 GR TUBE 46,300
597 ESVAT 20 TABLET 550
598 ETHAMBUTOL 500 MG TABLET 300
599 ETT 2.5 PIECE 50,700
600 ETT 2.5 NON KINGKING PIECE 388,900
601 ETT 3 PIECE 50,700
602 ETT 3 NON KINGKING PIECE 388,900
603 ETT 3.5 PIECE 50,700
605 ETT 4 PIECE 50,700
607 ETT 4.5 PIECE 50,700
SHBJ TAHUN 2018 229

(1) (2) (3) (4)

609 ETT 5 PIECE 50,700
611 ETT 5.5 PIECE 50,700
614 ETT 6.0 PIECE 50,700
615 ETT 6.5 PIECE 50,700
617 ETT 7 PIECE 50,700
619 ETT 7.5 PIECE 50,700
621 ETT 8 MG PIECE 50,700
623 EUGENOL (GIGI) BOTOL 133,100
624 EUTHYROX TABLET 900
625 EVOTHYL 300 MG CAP TABLET 10,700
626 EXTENTION 150 CM PIECE 28,200
627 EXTIMON INJEKSI VIAL 235,800
628 EXTRACE 1000 MG INJEKSI VIAL 29,700
629 EXTRACE 200 MG INJ AMPUL 11,900
630 EYEVIT SYR BOTOL 59,400
631 EYEVIT TABLET TABLET 3,300
632 FAKTU OINMENT TUBE 116,900
633 FAKTU SUPPOSITORIA SUPP 8,900
634 FALERGI OD DROP BOTOL 62,700
635 FARBION 5000 INJ AMPUL 5,400
636 FARBION TABLET TABLET 1,000
637 FARBIVENT VIAL 8,600
638 FARGOXIN INJ AMPUL 23,800
639 FARGOXIN TAB TABLET 300
640 FARLEV 750 MG TAB TABLET 39,900
641 FARMABES INJ VIAL 50,400
642 FARMABES TABLET TABLET 200
643 FARMADOL INFUS BOTOL 52,300
644 FARMALAT TAB TABLET 150
645 FARMASAL 100 MG TAB TABLET 750
646 FARNORMIN 50 MG TABLET 500
647 FARSIX INJ AMPUL 7,400
648 FARSIX TABLET TABLET 1,000
649 FARSORBID 5 MG TABLET 100
650 FARTOLIN INHALASI BOTOL 16,000
651 FATRAL TABLET TABLET 3,600
652 FEEDING NO 14 PIECE 10,800
654 FEEDING NO 3.5 PIECE 17,900
SHBJ TAHUN 2018 230

(1) (2) (3) (4)

657 FEEDING TUBE NO 10 PIECE 23,500
660 FELDENE GEL 15 G TUBE 72,800
661 FENDEX 50 MG INJ AMPUL 39,900
662 FENOFIBRATE 100 MG TABLET 1,200
663 FENOFIBRATE 300MG TABLET 1,500
664 FENOKSIMETIL PENISILIN 250 TABLET 300
665 FENTANYL INJEKSI AMPUL 400
666 FEROKID SYR 100 ML BOTOL 35,600
667 FIMAHES 200 ML BKS 56,200
668 FITBON 500 MG TABLET 1,200
669 FLADEX INFUS BOTOL 66,600
670 FLAGYL ORAL SUSP 60 ML BOTOL 46,700
671 FLAGYL SUPP 0,5 MG SUPP 3,500
672 FLAGYSTATIN OVULA SUPP SUPP 17,300
673 FLAMAR 25 MG TABLET 800
674 FLAMAR 50 MG TABLET 1,900
675 FLAMICORT 10 MG INJ VIAL 112,300
676 FLEET ENEMA TUBE 67,000
677 FLEET PHOSPOSODA 45 ML BOTOL 36,600
678 FLIXOTIDE NEBULES AMPUL 14,000
679 FLUCONAZOL 150 MG TAB TABLET 23,800
680 FLUCONAZOLE INFUS BOTOL 41,000
681 FLUCORAL TAB 150 MG TABLET 66,500
682 FLUIMUCIL 200 MG KAPS KAPSUL 5,000
684 FLUIMUCIL EFERVESCENT 600 MG TABLET 12,400
685 FLUIMUCIL GRANUL 200 DEWASA SACHET 5,400
686 FLUIMUCIL PEDIATRIC 100 MG SACHET 2,900
687 FLUOKSETIN 20 MG KAPSUL 500
688 FLUXUM 4250 IU 0.4 ML VIAL 136,900
689 FLUXUM 6400 IU 0.6 ML VIAL 199,600
690 FM CREPE 15X4.55 M ( 6” ) PIECE 56,500
691 FOLAC TAB TABLET 700
692 FOLAVIT 400 MG TAB TABLET 800
693 FORANSI 10 MG KAPSUL 500
694 FORMALIN CAIR 40% LITER 41,600
695 FORMALIN 40% 1 LITER BOTOL 41,600
696 FORMALIN TAB TABLET 900
697 FORMUNO TAB TABLET 6,600
698 FORMYCO 200 MG TABLET 5,300
699 FORMYCO CREAM TUBE 18,800
700 FORNEURO KAPSUL KAPSUL 5,400
701 FORRES 50 MG TABLET 4,800
702 FORUMEN EAR DROP 10 ML BOTOL 26,000
703 FREGO 10 MG TAB TABLET 8,300
704 FREGO 5 MG TABLET 6,400
SHBJ TAHUN 2018 231

(1) (2) (3) (4)

705 FRESOFOL INJ AMPUL 100
706 FUCILEX CREAM TUBE 7,000
707 FULADIC CREAM TUBE 48,700
708 FUNGASOL-SS 2% 80 ML BOTOL 71,300
709 FUNGISTOP FCT TAB TABLET 6,900
710 FUROSEMIDE INJ AMPUL 2,000
711 FUROSEMIDE TABLET 40 MG TABLET 100
712 FUTAFROM 1 GR INJ VIAL 237,600
713 GAAS 40X80 OK BUNGA BIRU SUPER ROL 172,700
714 GABBRYL 250 MG TABLET 5,000
715 GADOVIST 5 ML BOTOL 297,000
716 GADOVIST 7.5 ML BOTOL 445,500
717 GARAM INGGRIS SACHET 1,800
718 GASTRIDIN INJ AMPUL 18,800
719 GASTROFER INJ 40 MG VIAL 114,900
720 GASTRUL TAB TABLET 10,800
721 GELAFUSAL INF BOTOL 77,200
722 GELANG BAYI BIJI 2,300
723 GELANG IBU/DEWASA BIJI 2,300
724 GELITA SPON PIECE 95,000
725 GELOFUSINE 500 CC BOTOL 77,800
726 GEMFIBROZIL 300 MG TABLET 300
727 GENOINT SM TUBE 2,800
728 GENTAMICIN TM BOTOL 3,400
729 GENTAMYCIN 0.1% SK TUBE 2,000
730 GENTAMYCIN 80 MG INJ AMPUL 3,700
731 GIGLI WIRE SAW B BRAUN PIECE 297,000
732 GIPSONA 3 INCI PIECE 25,900
733 GIPSONA 4 INCHI PIECE 36,200
734 GIPSONA 6 INCHI PIECE 47,500
735 GIPSONA SPLINT 3 INCHI METER 210,500
738 GLAUCON TABLET TABLET 4,200
739 GLIBENCLAMIDE 5 MG TABLET 100
740 GLICAB TAB TABLET 300
741 GLIMEPIRIDE 1 MG TABLET 300
745 GLIQUIDONE 30 MG TAB TABLET 900
746 GLISODIN CAP KAPSUL 6,500
747 GLUCODEX TAB TABLET 350
748 GLUCOSA 10% 500 ML BOTOL 6,200
749 GLUCOSA 5% 500ML BOTOL 5,600
750 GLUCOSAMINE 250 MG TAB TABLET 700
751 GLURENORM TAB TABLET 2,600
752 GLUTROP TAB TABLET 13,700
SHBJ TAHUN 2018 232

(1) (2) (3) (4)

753 GLYCERIL GUAICOLAT TABLET 50
754 GLYCERIN BOTOL 64,800
755 GRANON I MG INJ VIAL 60,600
756 GRISEOFULVIN 125 MG TABLET 250
757 GUIDWIRE LUNDERQUIST BIJI 594,000
758 GUTA PERCHA POINT45-80 BOX 267,100
759 GUTTA PERCHA F1-F3 BIJI 248,300
760 GUTTA PERCHA F4-F5 BIJI 137,100
761 H202 3% BOTOL 11,900
762 HALOPERIDOL 0.5 TABLET 100
763 HALOPERIDOL 1.5 MG TABLET 100
764 HALOPERIDOL 5 MG TABLET 125
765 HARNAL D 0,2 TABLET TABLET 6,300
766 HARNAL OCAS 0.4 TAB TABLET 7,300
767 HD JKBM LENGKAP SET 451,400
768 HD JKBM REUSE SET 285,100
769 HD JKBM TANPA AV SET 272,100
770 HD JKN LENGKAP SET 451,400
771 HD JKN REUSE SET 285,100
772 HD JKN TANPA AV SET 272,100
773 HEMAPO VIAL 138,200
774 HEPAMAX KAP KAPSUL 8,900
775 HEPA-MERZ GRANULATE SACHET 38,800
776 HEPA-MERZ INJEKSI VIAL 111,700
777 HEPA-Q TABLET TABLET 5,000
778 HEPATIN KAPSUL KAPSUL 5,000
779 HEPATOSOL VANILA KOTAK 82,000
780 HERBESER INJEKSI 50 MG VIAL 320,800
781 HERBESSER CD 100 MG KAPSUL 4,000
782 HERBESSER CD 200 MG KAPSUL 4,300
783 HEXILON INJ 125 MG VIAL 89,100
784 HEXILON TAB 16 MG TAB TABLET 7,100
785 HEXILON TAB 4 MG TABLET 3,000
786 HEXIMER TABLET 350
787 HI-BONE TABLET 3,100
788 HI-BONE 600 MG TABLET 3,600
789 HIDONAC INJ VIAL 368,300
790 HIDROXY UREA 500 MG BIJI 6,800
791 HIOSIN N BUTILBROMIDA INJ AMPUL 6,500
792 HISTRINE SYR 60 ML BOTOL 51,100
793 HP PRO TABLET 5,500
794 HP PRO PLUS TAB TABLET 6,300
795 HSD INFUS BOTOL 12,800
796 HUMALOG PIECE 84,400
797 HUMALOG MIX PIECE 104,200
798 HUMERUS PROXIMAL L5 LEFT PIECE 1,368,000
799 HUMERUS PROXIMAL L5 RIGHT PIECE 1,368,000
800 HUMERUS PROXIMAL L7 LEFT PIECE 1,626,400
SHBJ TAHUN 2018 233

(1) (2) (3) (4)

801 HUMERUS PROXIMAL L7 RIGHT PIECE 1,626,400
802 HUMERUS PROXIMAL PLATE 4 H BIJI 1,238,500
803 HYDROCORTISON 1 % GENERIK TUBE 2,800
804 HYDROCORTISON 2.5% GENERIK TUBE 3,000
805 HYDROKLOROTIAZID 25 MG TABLET 150
806 HYPAFIX 15CM X 5M OK ROL 148,800
807 HYPAFIX 5CM X 1M PIECE 11,600
808 HYPAFIX 5X5M BOX 56,500
809 HYSTOLAN TAB TABLET 4,900
810 HYTRIN 1 MG TAB TABLET 6,500
811 HYTRIN 2 MG TABLET 11,600
812 HYTROZ 1 MG TABLET 2,000
813 HYTROZ 2 MG TABLET 5,600
814 IBUPROFEN 100 MG SYR BOTOL 3,800
815 IBUPROFEN 200 MG TAB TABLET 150
816 IBUPROFEN 400 MG TAB TABLET 200
817 IBUPROFEN SYR 200MG BOTOL 4,900
818 I-COL 1 TAPER PIECE 92,000
819 I-COL 2/0 CT BIJI 93,900
820 I-COL 2/0 TAPER PIECE 71,300
821 I-COL 3/0 TAPER PIECE 89,200
822 I-COL 5/0 CUTTING PIECE 90,300
823 I-COL 5/0 TP PIECE 90,300
824 IKALEP CAP KAPSUL 4,500
825 IKALEP SYR BOTOL 67,700
826 IKAPHEN 100 MG CAP KAPSUL 1,400
827 ILLIADIN SPRAY BOTOL 32,900
828 ILLIADIN TTS HIDUNG BOTOL 29,800
829 IMODIUM 2 MG TAB TABLET 7,400
830 IMREG KAP KAPSUL 8,900
831 IMUNOS PLUS SYR BOTOL 89,100
832 IMUNOS PLUS TABLET TABLET 8,900
833 IMUNOS SYR BOTOL 62,400
834 IMUNOS TABLET TABLET 6,500
835 INDOP INJ VIAL 13,300
836 INERSON SALEP 15 GR TUBE 32,800
837 INFUSET ANAK TERUMO PIECE 11,200
838 INFUSET DARAH HOSPITEC PIECE 18,800
839 INFUSET DARAH TERUMO PIECE 21,400
840 INFUSET DEWASA HOSPITEC PIECE 8,900
841 INHITRIL 10 MG TABLET 5,200
842 INHITRIL 5 MG TABLET 3,200
843 INMATROL TETES MATA BOTOL 24,900
844 INOTROP INJ VIAL 112,900
845 INOVAD INJ VIAL 250,900
846 INPEPSA SUSP 100 ML BOTOL 52,500
847 INTERHISTIN SYR BOTOL 22,600
848 INTERHISTIN TABLET TABLET 700
SHBJ TAHUN 2018 234

(1) (2) (3) (4)

849 INTERPEC 15 MG ELIXIR BOTOL 23,100
850 INTERPRIL 10 MG TABLET 4,500
851 INTERPRIL 5 MG TAB TABLET 2,900
852 INTRAFIX SAFESET PIECE 13,100
853 INTRALIPID 20% 100ML BOTOL 65,300
854 INVICLOT INJ VIAL 12,200
855 INVICLOT INJ VIAL 46,300
856 INVOMIT 4 MG INJEKSI AMPUL 32,300
857 INVOMIT 8 MG INJ AMPUL 59,400
861 IRBESARTAN 150 MG TABLET 1,500
862 IRBESARTAN 300 MG TABLET 2,700
863 IRVASK 300 MG TABLET 13,700
864 ISONIASID 300 TABLET 100
865 ISOSORBID DINITRAT 5 MG TABLET 100
866 ISOTIC ADRETOR 0.25 TM BOTOL 9,900
867 ISOTIC ADRETOR 0.5 TM BOTOL 10,500
868 ITRACONAZOLE 100 MG TAB TABLET 4,800
869 JARUM NO 25 TERUMO PIECE 800
870 JARUM 18 G TERUMO PIECE 600
871 JARUM 23 G TERUMO PIECE 400
872 JARUM 24 TERUMO PIECE 400
873 JARUM 27 TERUMO PIECE 450
874 JARUM AKUPUNTUR 25X25 BIJI 400
875 JARUM CITO JET CARPUL BOX 144,300
876 JARUM EXSTERVASI GIGI BIJI 27,100
877 JARUM KULIT 10,11, SET 76,700
878 JARUM KULIT 12-16 PIECE 76,700
879 JARUM KULIT NO 6-9 SET 76,700
880 JARUM KULIT NO5 PIECE 76,700
881 JARUM LENTULO BIJI 51,200
882 JARUM NO 18 BIJI 600
883 JARUM NOVOPEN BIRU PIECE 2,500
884 JARUM NOVOPEN UNGU PIECE 3,000
885 JARUM OTOT MACAM2 NO SET 76,700
886 KA EN 3A BOTOL 10,800
887 KA EN 3B BOTOL 10,800
888 KA EN 4A BOTOL 20,000
889 KA EN 4B BOTOL 20,000
890 KABIVEN PERIPHERAL BOTOL 318,900
891 KAIN PEMBALUT SIKU OM PIECE 15,400
892 KALBAMIN 500 ML BOTOL 60,800
893 KALFOXIM 0.5 MG INJ VIAL 71,300
894 KALIPAR TABLET 800
895 KALITAKE SACHET 18,700
896 KALMECO 500 MG KAPSUL 2,200
SHBJ TAHUN 2018 235

(1) (2) (3) (4)

897 KALMECO INJ VIAL 22,800
898 KALMICETIN OINMENT TUBE 9,800
899 KALNEX 500 MG TAB TABLET 3,100
900 KALTOSTAT DRESSING 7.5*12CM PIECE 113,400
901 KALTROFEN 100 MG TABLET 5,300
902 KALTROFEN 50 MG TABLET 3,000
903 KALTROFEN GEL TUBE 56,400
904 KALTROFEN SUPP SUPP 13,700
905 KALXETIN 10 MG KAPSUL 3,900
906 KAPAS PEMBALUT 1000 GR BKS 102,100
907 KAPSUL KOSONG NO 0/TANGGUNG BIJI 50
908 KAPSUL KOSONG NO 1/KECIL BIJI 50
909 KAPSUL KOSONG NO.00/BESAR BIJI 100
910 KAPSUL KOSONG NO.2 BIJI 50
911 KASA STERIL 16X16 BOX 5,900
912 KCL AMPUL 2,200
913 KENALOG IN ORABASE TUBE 54,300
914 KENDARON 200 TAB TABLET 1,300
915 KERTAS ECG /CTG BOX 210,600
916 KERTAS ECG 21,5 CM ROL 226,800
917 KERTAS ECG MAC 1000 BOX 423,500
918 KERTAS ECG ROLL 21 CM ROL 226,800
919 KERTAS ECG ROLL63MMX30M ROL 60,100
920 KERTAS EKG 160 X 20 ROL 101,000
921 KERTAS EKG KOTAK BOX 104,000
922 KERTAS EKG ROL ROL 51,200
923 KERTAS LAKMUS MERAH LEMBAR 113,400
924 KETOCONAZOLE CREAM 2% 10GR TUBE 6,400
925 KETOCONAZOLE TAB TABLET 350
926 KETOKONAZOL CREAM 5 GR TABLET 3,100
927 KETOPAIN 30 MG INJ AMPUL 41,600
928 KETOPROFEN 100 MG TABLET 900
929 KETOROLAC INJ AMPUL 2,500
930 KIDMIN INFUS BOTOL 88,000
931 KISNER WIRE 0,8 MM BIJI 320,800
932 KISNER WIRE 1,8 METER 320,800
933 KISNER WIRE 1.0 BIJI 320,800
934 KISNER WIRE 1.4 BIJI 320,800
935 KISNER WIRE 2,0 BIJI 320,800
936 KISNER WIRE 2,2 BIJI 320,800
937 KISNER WIRE 2,5 PIECE 320,800
938 KISNER WIRE NO 1.6 BIJI 320,800
939 KISNERWIRE 1.2 BIJI 320,800
940 KLORAMFENIKOL 250 KAPSUL 300
941 KLORAMFENIKOL SM TUBE 1,700
942 KLOZAPIN 100 MG TABLET 5,400
943 KLOZAPIN 25 MG TAB TABLET 1,700
944 KOMB.AMOX+CLAVULANAT TABLET 5,400
SHBJ TAHUN 2018 236

(1) (2) (3) (4)

945 KSR TABLET 1,700
946 KTM VIAL 150
947 KUTOIN INJ AMPUL 88,800
948 LACEDIM INJ VIAL 213,800
949 LAGESIL SUSP BOTOL 29,700
950 LAMESON 4 MG TABLET 3,300
951 LAMESON 8 MG TABLET 5,200
952 LAMESON INJ 125 MG VIAL 95,000
953 LANAKELOID KAPLET KAPLET 4,600
954 LANAKELOID-E CREAM TUBE 54,900
955 LANCID KAPSUL KAPSUL 15,400
956 LANSOPRAZOLE 30 MG KAPSUL 500
957 LANTUROL TABLET 4,200
958 LANTUS SOLOSTAR PEN VIAL 91,800
959 LAPIBAL 500 MG KAPSUL 2,200
960 LAPIBAL INJ 500 AMPUL 21,400
961 LAPICEF 500 MG KAPSUL 10,500
962 LAPICEF FORTE SYR 250 BOTOL 74,800
963 LAPICEF SYR 125 MG BOTOL 45,100
964 LAPIFED DM SYR 100 ML BOTOL 24,900
965 LAPIFED EXP SYR BOTOL 21,400
966 LAPIFED SYR BOTOL 20,200
967 LAPIFED TABLET TABLET 2,000
968 LAPIFLOX 500 MG TAB TABLET 13,100
969 LAPIMOX 500 MG TAB TABLET 2,600
970 LAPISTAN 500 MG TABLET 1,100
971 LASAL 2 MG KAPSUL 1,100
972 LASAL 4 MG KAPSUL 1,500
973 LASAL EXP SYR BOTOL 36,800
974 LASAL SYR BOTOL 23,800
975 LASGAN TABLET TABLET 14,300
976 LATROPIL 1200 TABLET 3,900
977 LATROPIL SYR BOTOL 46,300
979 LAXOBERON DROP BOTOL 63,900
980 L-BIO SACHET 5,900
981 LCD SALEP 2% 10GR POT 6,500
982 L-CORE SACHET 22,000
983 LENGHT 40MM X 5.5 MM BIJI 2,806,700
984 LENGHT 40MM X 6.0MM BIJI 2,806,700
985 LENGHT 45MM X 5.5MM BIJI 2,806,700
986 LENSA DURALENS 53 POWER PIECE 386,100
987 LENSA OPTIKA/OPTIMA PIECE 77,200
988 LENSA OPTIMA ANTERIOR 17.0 PIECE 118,800
989 LENSA OPTIMA ANTERIOR 17.5 PIECE 118,800
990 LENSA OPTIMA ANTERIOR 20 PIECE 118,800
991 LEPARSON TABLET 2,600
992 LESICHOL 175 MG TABLET 4,700
SHBJ TAHUN 2018 237

(1) (2) (3) (4)

995 LESIPAR 300 MG TABLET 3,600
996 LETONAL 100 MG TABLET 3,800
997 LETONAL 25 MG TABLET 1,400
998 LEUKOMED T PLUS 10 X 25 CM PIECE 23,200
999 LEUKOPOR 1.25CM ROL 8,400
1000 LEVEMIR FLEXPEN INJ VIAL 91,800
1001 LEVOCIN INFUS BOTOL 316,900
1002 LEVOCIN TM BOTOL 60,100
1003 LEVOFLOXACIN INFUS BOTOL 43,200
1004 LEVOFLOXACIN TABLET 500 TABLET 600
1005 LEVOPAR TAB TABLET 1,600
1006 LEVOPRONT SYR 120 ML BOTOL 64,100
1007 LEXA INFUS 750 MG BOTOL 324,200
1008 LIDOCAIN 2% AMPUL 900
1009 LIKURMIN 100 ML BOTOL 33,300
1010 LIPITOR 10 MG TABLET 17,800
1011 LIPITOR 20 MG TABLET 17,800
1012 LISINOPRIL 10 MG TABLET 650
1013 LISINOPRIL 5 MG TAB TABLET 400
1014 LITORCOM 10 MG TABLET 8,200
1015 LITORCOM 20 MG TABLET 8,200
1016 LIZOR KAPLET TABLET 27,500
1017 LODOMER 2MG TAB TABLET 150
1018 LOGUT 3-0 T PIECE 60,600
1019 LONGCEF 500 MG KAP BIJI 10,100
1020 LOPERAMIDE TAB TABLET 100
1021 LORATADINE TAB 10 MG TABLET 400
1022 LOVENOX 0.6 INJ VIAL 108,000
1023 LOVENOX O,4 MG INJ VIAL 77,600
1024 L-PLATE RIGHT 6 HOLES BIJI 1,603,800
1025 LUDIOS TAB TABLET 1,300
1026 LUFTEN 25 MG TABLET 5,500
1027 LYNORAL 50 Y TABLET 1,500
1028 LYOSTYPT 5 X 8 CM PIECE 101,600
1029 L-ZINC 100 ML SYR BOTOL 33,300
1030 MAGNESIUM SULFAT 20% BOTOL 3,900
1031 MAGNESIUM SULFAT 40 % BOTOL 3,800
1032 MAGTRAL FORTE SYR BOTOL 25,700
1033 MALEOLLAR 4,5 DIA 45 BIJI 237,600
1036 MALEOLLAR 4.5 DIA 50 PIECE 237,600
1037 MALEOLLAR 4.5 DIA 75 BIJI 237,600
1038 MALTOFER CHEW TABLET 2,700
1039 MALTOFER FOL CHEW TABLET 2,400
1040 MANITOL INFUS BOTOL 67,000
SHBJ TAHUN 2018 238

(1) (2) (3) (4)

1041 MARTOS 10 500 ML BOTOL 80,000
1042 MASKER BIJI 1,100
1043 MASKER BIJI 1,100
1044 MASKER ANAESTHESIA CHILD BIJI 44,600
1045 MASKER ANAESTHESIA L ADULT BIJI 44,600
1046 MASKER ANAESTHESIA M ADULT BIJI 44,600
1047 MASKER ANAESTHESIA S ADULT BIJI 38,900
1048 MEBO/SIBRO OINT TUBE 82,300
1049 MECOBALAMIN 500 MG KAPSUL 850
1050 MECOBALAMIN INJ AMPUL 9,500
1051 MECOLA FORTE TAB TABLET 5,900
1052 MECOLA TABLET TABLET 3,900
1053 MEDERMA CREAM TUBE 170,700
1054 MEDIAMER B6 TABLET 2,800
1055 MEDIATRIL TM 1 % BOTOL 42,300
1056 MEDIFIX MANOMETER PIECE 264,800
1057 MEFINAL 250 MG TAB TABLET 600
1058 MEFINAL 500 MG TABLET 1,400
1059 MEFINTER 500 MG TAB TABLET 1,500
1060 MEGAZING CAPS KAPSUL 2,200
1061 MELOXICAM 15 MG TAB TABLET 550
1062 MELOXICAM 7.5 MG TABLET 300
1063 MELOXICAM SUPP SUPP 5,400
1064 MELOXIN 7.5 MG TABLET 5,300
1065 MEPTIN MINI 25 MCG TABLET 2,500
1066 MEPTIN SYR 60 ML BOTOL 53,400
1067 MEROPENEM INJ 1 GR VIAL 128,500
1068 MERTIGO 6 MG TABLET TABLET 3,300
1069 MESS HERNIA 15 X 15 SURGIPRO PIECE 677,200
1070 MESS NO 10 BIJI 2,600
1071 MESS NO 11 PIECE 2,600
1072 MESS NO 15 PIECE 2,600
1073 MESS NO 20 STAINLESS STERIL PIECE 2,600
1074 MESTINON TAB TABLET 7,500
1075 METFORMIN 500 MG TABLET 150
1076 METFORMIN 850 MG TAB TABLET 250
1077 METHERINAL TAB TABLET 400
1078 METHICOL DRAG TABLET 1,000
1079 METHIOSON TAB TABLET 1,200
1080 METHYLERGOMETRINE INJ AMPUL 3,000
1081 METHYLERGOMETRINE TAB TABLET 200
1082 METHYLPREDNISOLONE 125 MG INJ VIAL 20,300
1083 METHYLPREDNISOLONE 16 MG TAB TABLET 700
1084 METHYLPREDNISOLONE 4 MG TABLET 300
1085 METHYLPREDNISOLONE TAB 8 MG TABLET 350
1086 METILEV TAB 500 MG TABLET 22,900
1087 METOCLOPRAMIDE TAB 10 MG TABLET 100
1088 METOCLORPRAMIDE TAB 5MG TABLET 125
SHBJ TAHUN 2018 239

(1) (2) (3) (4)

1089 METRONIDAZOLE 500 MG TAB TABLET 200
1090 METRONIDAZOLE INFUS BOTOL 11,400
1091 MEYLON INJEKSI BOTOL 6,700
1092 MICARDIS 80 MG TAB TABLET 7,000
1093 MICONAZOLE CREAM 2 % TUBE 3,200
1094 MICROLAX SUPP 18,200
1095 MICROSHIL 2%/1 LTR LITER 96,000
1096 MICROSHIL 4%/1 LTR LITER 134,500
1097 MIKASIN INJ 500 MG VIAL 190,100
1098 MILOZ INJ AMPUL 1,200
1099 MINIASPI 80 MG TABLET 200
1100 MIOZIDINE TAB TABLET 3,400
1101 MIX AIR BOTOL 225,700
1102 MOISDERM 20% 20 GR CREAM TUBE 23,800
1103 MOLOCO B12 TABLET 3,000
1104 MONURIL GRANULE 3 GR TABLET 162,200
1105 MORPHIN INJ AMPUL 9,100
1106 MOSARDAL 500 MG TAB TABLET 34,500
1107 MOVIX 15 MG TABLET 8,300
1108 MST 10 MG TAB TABLET 16,900
1109 MST 30 MG TAB TABLET 44,800
1110 MUCERA DROP BOTOL 35,200
1111 MUCERA SYR BOTOL 18,700
1112 MUCOS DROP BOTOL 38,000
1113 MUCOS SYR BOTOL 17,800
1114 MUCOSTA TABLET TABLET 4,500
1115 MUCOTEIN CAP TABLET 4,400
1116 MUCOTEIN DS 60 ML SYR BOTOL 29,900
1117 MYLANTA TAB TABLET 500
1118 MYONEP TABLET TABLET 4,000
1119 MYOVITON TAB TABLET 2,400
1120 N2O BOTOL 3,822,400
1121 NA CHLORIDA 0.9% 1000 ML BOTOL 8,600
1122 NA CHLORIDA 0.9% 500 ML BOTOL 5,100
1123 NA CHLORIDA 0.9% OTSU 25 ML BOTOL 3,300
1124 NA CHLORIDA 0.9%(WIDA) BOTOL 10,200
1125 NA CHLORIDA 3% BOTOL 13,700
1126 N-ACE INJ AMPUL 14,300
1127 NACL 0,9% 1000 ML BOTOL 8,600
1128 NACL 0,9% 500 ML BOTOL 5,100
1129 NAIRET TABLET TABLET 900
1130 NARROW DCP PLATE 12 HOLE PIECE 1,170,800
1131 NARROW DCP PLATE 13 HOLES BIJI 1,210,600
1132 NARROW DCP PLATE 16 HOLES BIJI 1,485,000
1133 NARROW DCP PLATE 6 HOLES BIJI 861,100
1134 NARROW DCP PLATE 8 HOLES BIJI 930,600
1135 NARROW DCP PLATE 9 HOLE BIJI 1,047,800
1136 NARROW PLATE 10 HOLES BIJI 1,122,700
SHBJ TAHUN 2018 240

(1) (2) (3) (4)

1137 NASACORT NASAL SPRAY BOTOL 97,200
1138 N-ASETIL SISTEIN KAPSUL 1,100
1139 NATAVIT TAB TABLET 3,200
1140 NATRIUM DILKOFENAK 50 MG TAB TABLET 200
1141 NATTO-10 TABLET 8,900
1142 NEBACETIN OINTMENT TUBE 19,600
1143 NEBACETIN POWDER BOTOL 22,000
1144 NECIBLOK SUSP 100 ML BOTOL 53,500
1145 NEFROFER INJ VIAL 123,600
1146 NELATHON CATHETER 14 PIECE 9,700
1147 NELATON CATHETER 16 PIECE 14,900
1148 NELATON CATHETER 18 PIECE 14,900
1149 NEO KAOLANA SYR BOTOL 13,300
1150 NEO-K 2 MG INJ AMPUL 12,800
1151 NEOSTIGMINE-HAMELN INJ VIAL 10,300
1152 NEPATIC KAPSUL BIJI 11,000
1153 NEUCITI 500 MG INJ AMPUL 52,300
1154 NEUCITI 5000 MG TABLET TABLET 9,500
1155 NEUROBAT DRAGEE TABLET 1,100
1156 NEURODEX TAB TABLET 300
1157 NEUROLIN 500 MG INJ AMPUL 57,000
1158 NEUROSANBE 5000 TAB TABLET 2,500
1159 NEUROSANBE TAB TABLET 1,100
1160 NEUROTAM 12 GR BOTOL 101,000
1161 NEUROTAM 1200 MG TAB TABLET 6,100
1162 NEUROTAM 3 GR INJ AMPUL 61,800
1163 NEUROTAM 800 MG TAB TABLET 3,700
1164 NEUROTAM SYR BOTOL 68,900
1165 NEVOX XR 500 MG TABLET 1,900
1166 NEW DIATAB TABLET 550
1167 NICARDIPINE INJ VIAL 131,300
1168 NIFEDIPIN 10 MG TABLET 125
1169 NIFUDIAR SYR BOTOL 41,600
1170 NIFURAL SYR BOTOL 48,000
1171 NIPE DROPS 15CC BOTOL 61,400
1172 NOCID TAB TABLET 7,200
1173 NOKOBA INJEKSI AMPUL 79,800
1174 NONEMI TAB TABLET 1,400
1175 NONFLAMIN CAP KAPSUL 4,100
1176 NOPANTIN 300 MG KAPSUL TABLET 9,100
1177 NOPERTEN 10 MG TAB TABLET 660
1178 NOPERTEN 5 MG TAB TABLET 400
1179 NOPRES 20 MG TABLET 500
1180 NORAGES 2 ML INJ AMPUL 9,500
1181 NORELUT TAB TABLET 3,600
1182 NOROID CR 80 MG TUBE 106,900
1183 NOROID LOTION 200 ML BOTOL 130,700
1184 NORVASK 10 MG TAB TABLET 12,200
SHBJ TAHUN 2018 241

(1) (2) (3) (4)

1185 NORVASK 5 MG TAB TABLET 6,800
1186 NOTRIXUM INJEKSI AMPUL 600
1187 NOVALGIN INJ AMPUL 11,300
1188 NOVALGIN SYR BOTOL 44,000
1189 NOVOMIX 30 INJ VIAL 114,500
1190 NOVORAPID INJ VIAL 92,200
1191 NULACTA PLUS CAPSUL KAPSUL 5,500
1192 NULACTA UNTUK IBU TABLET 4,200
1193 NURSE CUP BIJI 1,000
1194 NYSTIN DROP BOTOL 38,000
1195 OCTALBIN 25% 100 ML BOTOL 950,400
1196 ODR SYR BOTOL 101,000
1197 OFLOXACIN 200 MG TAB TABLET 450
1198 OFLOXACIN 400 MG TAB TABLET 700
1199 OKSITOSIN INJ AMPUL 2,400
1200 OLANDOZ 10 MG TAB TABLET 12,000
1201 OLANDOZ 5 MG TAB TABLET 7,000
1202 OMED 20 MG CAP TABLET 11,000
1203 OMEPRAZOLE 20 MG TABLET TABLET 250
1204 OMEPRAZOLE INJ VIAL 38,900
1205 OMEVEL INJ VIAL 37,400
1206 ONDANCENTRON 4 MG INJ AMPUL 2,600
1207 ONDANCENTRON 8 MG INJ AMPUL 4,800
1208 ONDANCENTRON 8 MG TAB TABLET 1,300
1209 ONDANCETRON 4 TAB TABLET 800
1210 OPICEF 500 MG KAPSUL 9,100
1211 OPICEF FORTE SYR BOTOL 68,100
1212 OPICEF SYR BOTOL 38,500
1213 OPIGRAN 1 INJ AMPUL 52,700
1214 OPIGRAN 3 MG INJ VIAL 109,900
1215 OPSITE ID 45 X 55 CM PIECE 178,300
1216 OPTIFLOX TM BOTOL 14,100
1217 ORALIT BKS 350
1218 OSCAL 0.25 TABLET 7,500
1219 OSMYSIN SYR 100 ML BOTOL 47,500
1220 OSSORAL 800 MG TABLET 4,600
1221 OSSOVIT SYR BOTOL 32,900
1222 OSTELOX 15 MG TAB TABLET 9,600
1223 OSTELOX 7,5 MG TAB TABLET 5,900
1224 OSTEOCAL TAB TABLET 600
1225 OSTEOKOM FORTE SACHET SACHET 15,400
1226 OSTEOKOM TABLET TABLET 7,100
1227 OTOPAIN EAR DROP BOTOL 38,900
1228 OTSU NACL PIGGYBACK BOTOL 12,000
1229 OTTOPAN DROP BOTOL 19,800
1230 OTTOPAN SYR BOTOL 12,100
1231 OTTOZOL 40 MG INJ VIAL 137,400
1232 OXOFERIN SOL BOTOL 77,200
SHBJ TAHUN 2018 242

(1) (2) (3) (4)

1233 OXYGEN ( O2 ) BOTOL 96,800
1234 OXYGEN MASK ADULT NON REB PIECE 70,000
1235 OXYGEN MASK ADULT REF 8110 PIECE 35,900
1236 OXYGEN MASK CHILD PIECE 35,900
1237 OXYGEN MASK CHILD NON REB PIECE 70,000
1238 OXYGEN MASK NEBULIZER ADULT PIECE 68,300
1239 OXYGEN MASK NEBULIZER CHILD PIECE 68,300
1240 OXYGEN MASK PED NON REB PIECE 70,000
1241 OXYGEN MASK PEDIATRIE PIECE 35,900
1242 OZID INJ VIAL 38,900
1243 PAMOL SUPP 125 MG SUPP 8,300
1244 PAMOL SUPP 250 MG SUPP 11,400
1245 PAN AMIN G BOTOL 40,500
1246 PANTOCAIN TM BOTOL 13,400
1247 PANTOPRAZOLE 40 MG INJ VIAL 41,600
1248 PANTOZOL 20 MG TAB TABLET 17,700
1249 PAPER POINT 15-40 BOX 47,500
1250 PAPER POINT 45-80 BOX 47,500
1251 PARA SPRAY (HI-CLEAN) BOTOL 411,400
1252 PARACETAMOL DROP BOTOL 5,600
1253 PARACETAMOL INFUS BOTOL 23,800
1254 PARACETAMOL SYR BOTOL 1,600
1255 PARACETAMOL TABLET TABLET 125
1256 PEHACAIN INJ AMPUL 3,000
1257 PEHAMOXIL INJ VIAL 9,100
1258 PEMBALUT WANITA BERSALIN BKS 19,400
1259 PERDIPINE INJ AMPUL 145,800
1260 PERFUSOR TUB.WHITE 150 CM PIECE 43,400
1261 PERIFAS TAB TABLET 1,600
1262 PERSANTIN 75 MG TABLET 5,200
1263 PETHIDIN INJ 2 ML/AMPUL ampul 200
1264 PGS LOX BOTOL 1,544,400
1265 PHENITOIN CAPS TABLET 250
1266 PHENITOIN INJ AMPUL 21,900
1267 PHENOBARBITAL 30 MG TAB TABLET 100
1268 PHENOBARBITAL INJ AMPUL 1,900
1269 PHENOXIMETHYL PENICILLIN 500 TABLET 600
1270 PHENTAL 100 MG INJ VIAL 8,600
1271 PHYTOMENADIONE INJ AMPUL 3,700
1272 PHYTOMENADIONE TABLET TABLET 700
1273 PIOGLITASON 15 MG TAB TABLET 3,700
1274 PIONIK M 500 MG TAB TABLET 7,700
1275 PIRACETAM 12 GR INFUS BOTOL 62,400
1276 PIRACETAM 1200 MG TABLET 1,400
1277 PIRACETAM 800 MG TAB TABLET 900
1278 PIRACETAM INJEKSI 1 GR AMPUL 4,800
1279 PIRACETAM INJEKSI 3 GR AMPUL 12,900
1280 PITOGIN INJ AMPUL 5,900
SHBJ TAHUN 2018 243

(1) (2) (3) (4)

1281 PK RENDAM BOTOL 4,000
1282 PLADOGREL TABLET 13,700
1283 PLAIN GUT 2/0 PIECE 58,800
1284 PLAIN GUT 3/0 PIECE 61,700
1285 PLASBUMIN 20% 100 ML BOTOL 810,000
1286 PLASBUMIN 20% 50ML BOTOL 372,600
1287 PLASBUMIN 25% 100ML BOTOL 1,647,500
1288 PLASMANATE 250 ML BOTOL 1,049,800
1289 PLASMIN KAPSUL KAPSUL 7,900
1290 PLASMINEX 500 MG INJ AMPUL 13,000
1291 PLAVIX TAB TABLET 21,000
1292 PLESTER 4 INC BSN ROL 27,200
1293 PLESTER 6 INC BSN ROL 39,600
1294 PLETAAL 100 MG TABLET 13,800
1295 PLETAAL 50 MG TABLET 8,300
1296 POLIBAN 15 X 2.7 METER ROL 25,500
1297 POLIDEMISIN EYE DROP BOTOL 26,300
1298 POLYCATETER 3 WAY NO 20 PIECE 88,800
1299 POLYCATETER 3 WAY NO 24 PIECE 88,800
1300 POLYCATETER 3WAY NO 22 PIECE 88,800
1301 POLYCATETER NO 10 PIECE 99,500
1309 POLYPROPILENE MESH PIECE 142,600
1310 POLYSORB 1 C PIECE 97,000
1311 POLYSORB 1 T PIECE 81,800
1312 POLYSORB 2/0 C PIECE 95,600
1313 POLYSORB 2/0 C 24MM PIECE 84,600
1314 POLYSORB 2/0 GL-123 PIECE 78,400
1315 POLYSORB 2/0 T PIECE 78,400
1318 POLYSORB 4/0 5629 C PIECE 81,800
1320 POLYSORB 5/0 202 T PIECE 90,300
1322 POSPARGIN INJ AMPUL 6,500
1323 POSPARGIN TAB TABLET 600
1324 POT PLASTIK 30 G PIECE 800
1325 POT PLASTIK 50 GR PIECE 1,100
1326 POVIDON IODIN 10% I L BOTOL 40,100
1327 PRALAX SYR 100 ML BOTOL 51,300
1328 PRANZA INJ VIAL 151,500
SHBJ TAHUN 2018 244

(1) (2) (3) (4)

1329 PRATROPIL 12 GR BOTOL 171,100
1330 PRAXION DROP BOTOL 21,400
1331 PRAXION FORTE SYR BOTOL 28,500
1332 PRAXION SYR BOTOL 23,200
1333 PRAZOTEC KAPSUL KAPSUL 12,500
1334 PREDNISON TAB TABLET 150
1335 PREMASTON TABLET 3,800
1336 PRENAMIA TABLET 1,100
1337 PRESEPT 0.5 GR TABLET 600
1338 PRIMOLUT N TABLET 2,800
1339 PROCELES SYR 60 ML BOTOL 32,700
1340 PROCELES TAB TABLET 1,800
1341 PROINFARK INJ AMPUL 13,400
1342 PROLENE 2/0 8685 PIECE 79,000
1343 PROLENE 3/0 PIECE 65,600
1344 PROLENE 7/0 PIECE 195,400
1345 PROLENE NO 5 W527 PIECE 72,200
1346 PROMAVIT CAPS TABLET 2,000
1347 PROMUBA SUSP BOTOL 43,400
1348 PROPANOLOL 10 MG TABLET 100
1349 PROPANOLOL 40 TABLET 125
1350 PROPYRETIC SUP 80 SUPP 6,500
1351 PROPYRETIC SUPP 160 SUPP 6,900
1352 PROSOGAN FD 15 MG TAB TABLET 14,900
1353 PROSOGAN FD 30 MG TAB TABLET 19,300
1354 PROSOGAN INJ VIAL 88,600
1355 PROTOPEN SUPP SUPP 4,500
1356 PROVELYN 75 MG CAP TABLET 10,500
1357 PROVITAL PLUS TAB TABLET 4,700
1358 PROXIME TAB TABLET 1,200
1359 PTU 100 MG TABLET 350
1360 PULAREX TAB TABLET 200
1361 PUMPITOR KAPSUL KAPSUL 13,500
1362 PYRAZINAMIDE 500 MG TABLET 250
1363 QUICKY SUCT.BOTLE NO 12 500CC PIECE 213,100
1366 QV CREAM 100 GR TUBE 73,200
1367 RAIVAS INJ AMPUL 56,200
1368 RAMIPRIL 10 MG TABLET 1,100
1369 RAMIPRIL 5 MG TABLET 600
1370 RANITIDINE 25 MG INJ AMPUL 1,200
1371 RANITIDINE TAB 150 MG TABLET 160
1372 RANIVEL SYR BOTOL 53,500
1373 RANTIN 150 MG TABLET 5,000
1374 RANTIN INJ 50 MG AMPUL 22,600
1375 RAPIME 1 GR INJ VIAL 285,100
1376 REBAL PLUS CAPSUL TABLET 2,100
SHBJ TAHUN 2018 245

(1) (2) (3) (4)

1377 RECOFOL INJ 20 ML ampul 500
1378 RECOLFAR TABLET TABLET 4,900
1379 RECONSTRUCTION PLATE 5 HOLES BIJI 1,024,700
1380 RECORMON VIAL 150,700
1381 REMOPAIN 3 % AMPUL 39,400
1382 RENALIN 100 GALON 4,241,200
1383 RENALOF CAP TABLET 11,900
1384 RENAPAR TABLET TABLET 2,400
1385 RENASISTIN OD DROP BOTOL 57,000
1386 RENAX TAB TABLET 4,000
1387 RENVOL EMULGEL 20 GR TUBE 22,000
1388 RENXAMIN INFUS BOTOL 104,500
1389 REUCID 100 MG TABLET 800
1390 REUCID 300 TABLET 1,400
1391 RILLUS /BIOGAIA TAB TABLET 7,300
1392 RING WASHER PIECE 200
1393 RINGER LACTAT BOTOL 5,600
1394 RINGER LACTAT (WIDA) BOTOL 11,200
1395 RINOFER INJ AMPUL 56,100
1396 RISPERIDONE 2 MG TABLET 1,100
1397 ROCULAX INJ MG 2,400
1398 RONEM 1 GR INJ VIAL 456,200
1399 SAFECATH 2LUMEN12FRP15 PIECE 736,300
1400 SAFECATH2LUMEN12FRP17 PIECE 712,800
1401 SAFIL 2/0 HR 37 TAPER PIECE 86,000
1402 SAFIL 2/0 HS 26 CUTING PIECE 115,900
1403 SAFIL 3/0 DS 24 CUTTING PIECE 75,400
1404 SAFIL 3/0 HR 26 TAPER PIECE 88,900
1405 SAGESTAM 10 GR CREAM TUBE 12,800
1406 SALBUTAMOL 2 MG TABLET TABLET 100
1407 SALBUTAMOL 4 MG TAB TABLET 100
1408 SALEP 2-4 TUBE 4,300
1409 SALIVA EJECTOR OBAT GIGI BIJI 600
1410 SANDOSTATIN INJ AMPUL 89,100
1411 SANMAG SUSPEN BOTOL 26,200
1412 SANMETIDIN 200 TABLET 1,500
1413 SANMOL DROP BOTOL 16,300
1414 SANMOL FORTE TAB TABLET 300
1415 SANMOL INFUS BOTOL 38,900
1416 SANMOL SYR BOTOL 12,100
1417 SANMOL TAB TABLET 300
1418 SANOSKIN MELLADERM PLUS GEL TUBE 136,600
1419 SANOSKIN OXY GEL TUBE 261,800
1420 SANPRIMA FORTE TAB TABLET 2,100
1421 SANPRIMA SYR BOTOL 26,700
1422 SANPRIMA TAB TABLET 900
1423 SANTA E TAB TABLET 900
1424 SANVITA-B PLUS TAB EFF TUBE 37,700
SHBJ TAHUN 2018 246

(1) (2) (3) (4)

1425 SARUNG TANGAN NON STERIL WIN BOX 70,900
1426 SARUNG TANGAN STERIL NO 7 WIN BKS 6,100
1427 SARUNG TANGAN STERIL NO 7.5 WIN BKS 6,100
1428 SARUNG TANGAN STERIL NO 8 WIN BKS 6,100
1429 SCABIMITE CR 10 GR TUBE 12,400
1430 SCHANZ SCREW 150 X 5 M BIJI 272,600
1431 SCOBUTRIN TAB TABLET 800
1432 SEDACUM INJ 5 MG/5ML MG 3,600
1433 SEMI TUBULAR 6 HOLE PIECE 592,300
1434 SEMI TUBULAR PLATE 5 HOLES BIJI 507,300
1435 SEMI TUBULAR PLATE 7 HOLE PIECE 622,300
1436 SEMI TUBULAR PLATE 8 HOLES BIJI 652,200
1437 SEPTOCAIN (GIGI) PIECE 8,600
1438 SEPTOCAIN INJ VIAL 10,300
1439 SERETIDE DISKUSS 100 MCG BOTOL 108,900
1440 SEROLIN 10 MG TABLET TABLET 7,200
1441 SESDEN TAB TABLET 2,200
1442 SEVORANE INJ botol 5,700
1443 SHAROX 500 TAB TABLET 24,000
1444 SHAROX INJEKSI VIAL 59,100
1445 SIBITAL INJ AMPUL 10,700
1446 SICLIDON KAPSUL 5,200
1447 SIFROL 0.375 TABLET 7,800
1448 SILET PIECE 2,000
1449 SILICON CATH 10 PIECE 341,600
1453 SILK BLACK 1 BOX 914,800
1454 SILK BLACK 2/0 ROL 914,800
1455 SILK BLACK 3/0 ROL 914,800
1456 SILK BLACK NO 4/0 ROL 914,800
1457 SILKAM 2/0 DS 24 CUTING PIECE 38,700
1458 SILKAM 2/0 TAPER/RONDE PIECE 38,700
1460 SILKAM 3/0 HR 22 RONDE PIECE 59,600
1462 SILKAM 4/0 HR 17 RONDE PIECE 57,900
1463 SILOSTAZOL TABLET 6,200
1464 SIMARC TABLET 1,500
1465 SIMVASTATIN 10 MG TABLET 200
1466 SIMVASTATIN 20 MG TABLET 400
1467 SINCRONIK TAB TABLET 7,700
1468 SISTENOL CAPLET TABLET 1,600
1469 SKIN STAPLER PMW 35 PIECE 5,800
1470 SKIN TRAKSI ANAK BIJI 78,900
1471 SKIN TRAKSI DEWASA BIJI 108,000
1472 SMAL DCP PLATE 5 HOLE BIJI 481,100
SHBJ TAHUN 2018 247

(1) (2) (3) (4)

1473 SMALL DCP LATE 7 HOLE PIECE 534,600
1474 SMALL DCP PLATE 6 HOLES PIECE 499,000
1475 SMALL DCP PLATE 8 HOLES BIJI 546,700
1476 SNAR-WIRE 0,4 METER 338,600
1477 SNAR-WIRE 0,8 METER 338,600
1478 SNAR-WIRE 1.0 METER 338,600
1479 SNAR-WIRE 1.25 METER 338,600
1480 SOCLOR SYR 60 ML BOTOL 83,200
1481 SOFBAND 3 INCHI PIECE 15,000
1482 SOFBAND 4 INCHI BIJI 18,900
1483 SOFBAND 6 INCHI BIJI 27,200
1484 SOFNOLIME GALON 756,000
1485 SOFSILK 2/0 CUT PIECE 51,900
1486 SOFSILK 2/0 TAPER PIECE 58,700
1487 SOFSILK 3/0 SS-684 CUT PIECE 49,000
1488 SOFSILK 3/0 TAPER PIECE 50,500
1489 SOFT UDERM TUBE 6,900
1490 SOFTAMAN 500 ML GALON 69,500
1491 SOJOURN 250 ML MILI LITER 5,700
1492 SOLAC 120 ML BOTOL 78,400
1493 SOMATOSTATIN INJ AMPUL 752,700
1494 SOROV TAB 500 MG TABLET 1,300
1495 SOTATIC INJEKSI AMPUL 4,000
1496 SPALEX PANJANG 9X90 BIJI 14,300
1497 SPALK PENDEK 5X15 BIJI 4,500
1498 SPALK SEDANG 10 X 60 BIJI 11,900
1499 SPINAL NEEDLE 20G TRM BIJI 22,200
1500 SPINAL ROAD 400 X 5 MM BIJI 3,118,500
1501 SPINAL ROAD 500 X 5 MM BIJI 3,118,500
1502 SPINOCAN 27G BBRAUN BIJI 41,800
1503 SPIRAMYCIN 500 MG TAB TABLET 1,600
1504 SPIRANTER 500 MG TABLET 5,600
1505 SPIRIVA REFILL KAPSUL 15,000
1506 SPIRONOLACTON 100 MG TABLET 1,000
1507 SPIRONOLACTON 25 MG TABLET 350
1508 SPORETIK 100 MG CAPS KAPSUL 20,200
1509 SPORETIK DRY SYR BOTOL 87,500
1510 SPUIT 1 CC TERUMO PIECE 3,200
1511 SPUIT 1 CC UNZEN BIJI 800
1512 SPUIT 10 CC TERUMO BIJI 3,100
1513 SPUIT 10 CC UNZEN/WIN BIJI 1,600
1514 SPUIT 20 CC UNZEN BIJI 2,900
1515 SPUIT 20CC TERUMO BIJI 7,700
1517 SPUIT 3 CC UNZEN/WIN BIJI 950
1518 SPUIT 5 CC TERUMO PIECE 2,600
1519 SPUIT 5 CC UNZEN / WIN BIJI 1,000
1520 SPUIT 50 CC BIJI 6,800
SHBJ TAHUN 2018 248

(1) (2) (3) (4)

1521 SPUIT 50 CC OMNIFIX BIJI 19,000
1523 SPUIT 50 CC UNZEN BIJI 6,800
1524 SPUIT 50 CC UROLOGI TERUMO BIJI 21,600
1525 ST AMBUMAX BIJI 8,900
1526 ST GAMEX ALL PASANG 16,000
1527 ST JIRUKO ALL PASANG 10,300
1528 ST NON STERIL WIN PIECE 700
1529 ST PANJANG NON STERIL BIJI 29,700
1530 ST PANJANG STERIL PASANG 29,700
1531 ST STERIL WIN PASANG 6,100
1532 STABACTAM INJ VIAL 171,100
1533 STALEVO KAPLET TABLET 9,600
1534 STAPLES 14 MM BIJI 262,500
1535 STAPLES 18 MM BIJI 262,500
1536 STARMUNO KAPLET BIJI 6,700
1537 STARMUNO KIDS 60 ML BOTOL 65,300
1538 STARXON INJ 1 GR VIAL 210,100
1539 STEAK PAN PLASTIK BIRU/PINK BIJI 59,400
1540 STELASINE 5 MG BIJI 1,200
1541 STERICAT 2/0 TP PIECE 58,200
1542 STERICRYL 1 PIECE 118,800
1543 STERILENE 7/0 PIECE 160,400
1544 STERILON 3/0 PIECE 52,300
1545 STERILON 4/0 PIECE 52,300
1546 STERILON 5-0 59,400
1547 STERISIL 2/0 TP PIECE 49,900
1548 STERISIL 2-0 CUT PIECE 49,900
1549 STERISIL 3/0 TP PIECE 49,900
1550 STERISIL 3-0 CUT PIECE 47,500
1551 STESOLID 10 RECTAL SUPP 18,100
1552 STESOLID 5 RECTAL SUPP 12,400
1553 STESOLID INJEKSI 2 MG AMPUL 12,400
1554 STESOLID SYR BOTOL 36,800
1555 STIMUPLEX NEED A 100 MM BIJI 191,900
1556 STIMUPLEX NEED A 50 MM PIECE 191,900
1557 STOBLED CAP TABLET 8,000
1558 STOLAX SUPP 10 MG SUPP 6,500
1559 STOMACAIN TAB TABLET 1,200
1560 STOP COCK 3 WAY B BRAUN+EKOR PIECE 25,900
1561 STREPTASE INJ VIAL 3,553,200
1562 SUCTION CATETER N0 CH 8 PIECE 6,800
1563 SUCTION CATETER NO 10 PIECE 6,800
1567 SUCTION CATHETER CH 6 PIECE 6,800
1568 SURGICEL W1913T PIECE 83,500
SHBJ TAHUN 2018 249

(1) (2) (3) (4)

1569 SURGIPRO 2/0 CUTING PIECE 81,300
1570 SURGIPRO 2/0 TAPER PIECE 131,300
1571 SURGIPRO 3/0 CUTING PIECE 89,700
1573 SURGIPRO 4/0 USI VP-521X PIECE 155,200
1574 SURGIPRO 5/0 VP-710 USSC PIECE 163,600
1575 SURGIPRO 6/0 VP-706 USSC PIECE 132,300
1577 SYSMUCO 100 MG TAB TABLET 4,000
1578 TAIL CLOSER PIECE 61,400
1579 TANAPRESS 10 MG TABLET 4,200
1580 TANAPRESS 5 MG TABLET 2,300
1581 TAPROS 3 M VIAL 2,915,700
1582 TAPROS 3.75 MG VIAL 594,000
1583 TAPROS/LEUPROLELIN 1.88 VIAL 810,000
1584 TELFAST OD TAB TABLET 7,100
1585 TELFAST PLUS TABLET 4,500
1586 TEMIRAL SM TUBE 26,700
1587 TENACE 10 MG TAB TABLET 4,100
1588 TENACE 5 MG TAB TABLET 2,600
1589 TENSILO INJ VIAL 182,500
1590 TENSOCREPE 3 INCHI PIECE 51,600
1593 TEOSAL TABLET TABLET 200
1594 TEQUINOL 500 MG TAB TABLET 10,200
1595 TERMISIL CREAM 10 GR TUBE 54,600
1596 TETAGAM VIAL 183,600
1597 TETRACYCLIN 250 MG TAB KAPSUL 200
1598 THECORT CREAM TUBE 58,200
1599 THEOBRON CAPS KAPSUL 1,300
1600 THEOBRON ELIXIR 100 ML BOTOL 23,100
1601 THERMOMETER SAFETY BIJI 17,800
1602 THIAMINE TAB TABLET 50
1603 THIAMYCIN 250 MG TABLET 2,300
1604 THIAMYCIN 500 MG TABLET 4,000
1605 THIAMYCIN FORTE SYR BOTOL 54,800
1606 THIAMYCIN SYR 60 ML BOTOL 30,400
1607 THRICOSTATIC OVULA SUPP 13,700
1608 THROMBOPHOP GEL 20 MG TUBE 54,700
1609 THROMBOPHOP OINT 15 TUBE 41,600
1610 THYRAX 100 MG TABLET 2,000
1611 TIACINON INJ AMPUL 2,100
1612 TIARYT INJ AMPUL 25,700
1613 TIARYT TABLET TABLET 4,100
1614 TILSAN 25 MG TAB TABLET 1,600
1615 TIRIZ DROPS BOTOL 65,300
1616 TIRIZ TABLET TABLET 3,600
SHBJ TAHUN 2018 250

(1) (2) (3) (4)

1617 TISU DADA/POLIBIB BKS 900
1618 TIZACOM 100 TAB TABLET 3,300
1619 TOCO-E CAP 50 MG TABLET 9,100
1620 TOPAZOL INJ VIAL 148,500
1621 TOPCORT CREAM 10 GR TUBE 23,400
1622 TORACIC CH/THORAXDRAIN 24 PIECE 205,700
1623 TORACIC CH/THORAXDRAIN 28 PIECE 205,700
1624 TORASIC INJ AMPUL 30,300
1625 TOTILAC 250 ML BIJI 130,700
1626 T-PLATE 8 HOLE PIECE 1,659,400
1627 T-PLATE TIBIA 3 HOLES BIJI 1,357,900
1632 TRACETATE SUSPENSI 200 ML BOTOL 399,200
1633 TRAMADOL 50 MG TAB TABLET 300
1634 TRAMADOL 50 MG/ML INJ AMPUL 2,600
1635 TRAMAL SUPP SUPP 17,800
1636 TRAMIFEN TAB TABLET 7,100
1637 TRAMSET TAB TABLET 6,800
1638 TRAMUS 1% 2.5 ML MG 1,900
1639 TRANEXID INJ 500MG AMPUL 9,600
1640 TRANSPULMIN BB BALSEM 10 GR TUBE 41,300
1641 TREMENZA TAB TABLET 1,200
1642 TRICOFIX 10 M X 4 CM METER 5,500
1645 TRIFLUOPERAZIN 5 MG TABLET TABLET 450
1646 TRIOFUSIN 500 BOTOL 45,700
1647 TRIVAM INJEKSI 10 MG/ML MG 550
1648 TROGYL 500 MG TABLET TABLET 1,300
1649 TROMBOLES TABLET 10,100
1650 TRUVAZ 10 MG TAB TABLET 13,700
1651 TRUVAZ 20 MG TAB TABLET 14,500
1652 TRYPAN BLUE / MEDE BLUE PIECE 53,500
1653 TUDERM N KRIM TUBE 11,800
1654 TUTOFUSIN OPS BOTOL 40,500
1655 TUZALOS TABLET 800
1656 TWIN NASAL OXYGEN CANNULA DWS PIECE 17,100
1657 TWIN NASAL OXYGEN CHILD PIECE 17,100
1658 TWIN NASAL OXYGEN INFANT PIECE 21,800
1659 TWINRIX 1ML INJ VIAL 308,900
1660 UDOPA INJ AMPUL 10,600
1661 ULCERANIN INJ AMPUL 17,600
1662 ULSAFAT SUSP BOTOL 14,500
1663 ULSIDEX TABLET TABLET 500
1664 ULSIKUR INJEKSI AMPUL 8,100
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(1) (2) (3) (4)

1665 UMBILICAL CORD CLAMP PIECE 4,300
1666 UNALIUM 10 MG TAB TABLET 7,500
1667 UNALIUM 5 MG TAB TABLET 5,500
1668 UNDERPAD NON STERIL BKS 5,600
1669 UNDERPAD NON STERIL BIJI 5,600
1670 UNDERPAD STERIL BKS 8,900
1671 UNDERPEAD STERIL BIJI 8,900
1672 URDAHEX KAPSUL TABLET 9,700
1673 URETRAL CATH OPEN FR 6 BIRU/UK PIECE 118,800
1674 URETRAL STENT CLOSED 6FR+GW PIECE 415,800
1675 URINAL PLASTIK LAKI PIECE 11,900
1676 URINAL PLASTIK WANITA PIECE 11,900
1677 URINE BAG PIECE 4,800
1678 URINTER TABLET 3,700
1679 URISPAS 200 TAB TABLET 5,000
1680 UROTRACTIN CAPS TABLET 2,000
1681 URUGARD TERUMO PIECE 61,500
1682 UTROGESTAN-100 TABLET 8,900
1683 UTROGESTAN-200 TABLET 17,200
1684 VACLO TABLET TABLET 12,600
1685 VAGISTIN OVULA SUPP 14,700
1686 VAGIZOLE OVULA SUPP 5,700
1687 VALDIMEX 5 MG TAB TABLET 300
1688 VALEPTIK SYR BOTOL 66,500
1689 VALISANBE 2 MG TAB TABLET 200
1690 VALISANBE 5 MG TAB TABLET 300
1691 VANCEP 0.5 MG INJ VIAL 202,000
1692 VASCON INJEKSI AMPUL 56,000
1693 VASELIN KALENG 90,700
1694 VASTIGO TAB TABLET 450
1695 V-BLOC 25 MG TAB TABLET 6,900
1696 V-BLOC 6.25 MG TAB TABLET 1,500
1697 VECTRINE 300 MG CAP TABLET 4,600
1698 VELBAN 6 INC/ 15 CM PIECE 31,900
1699 VENOCATH 16 HOSPITECH PIECE 12,000
1703 VENTOLIN INHALER BOTOL 68,900
1704 VENTOLIN NEBULE AMPUL 7,100
1705 VERAPAMIL 80 MG TABLET 300
1706 VERBAN 10 CM BUNGA BIRU ROL 2,000
1707 VESTEIN 300 MG CAP TABLET 4,500
1708 VESTEIN DRY SYR BOTOL 41,600
1709 VICRYL 1 W9465 PIECE 83,900
1710 VICRYL 4/0 W9106 PIECE 77,800
1711 VICRYL 6-0 W9552 PIECE 213,400
1712 VICRYL 8/0 W9560 PIECE 216,500
SHBJ TAHUN 2018 252

(1) (2) (3) (4)

1713 VIGAMOX TM BOTOL 83,200
1714 VIOPOR-M FORTE TABLET 4,900
1715 VIOXY FM TAB TABLET 4,000
1716 VIP ALBUMIN CAP TABLET 6,400
1717 VIPIME 1 GR VIAL 326,700
1718 VITACHOL SOFT CAPSUL KAPSUL 4,400
1719 VITACUR SYR BOTOL 27,300
1720 VITAMIN B 12 TAB TABLET 100
1721 VITAMIN B COMPLEX TABLET 125
1722 VITAMIN C 50 MG TAB TABLET 125
1723 VITAZET TAB TABLET 2,400
1724 VOLTAREN EMULGEL 10 GR TUBE 33,600
1725 VOLUVEN 8% 500ML BOTOL 35,600
1726 VOMCERAN 4 MG INJ AMPUL 34,500
1727 VOMCERAN 8 MG INJEKSI AMPUL 65,300
1728 VOMCERAN TAB 4 MG TABLET 16,000
1729 VOMCERAN TAB 8 MG TABLET 21,400
1730 VOMITAS FDT TABLET TABLET 4,200
1731 VOMITAS SYR BOTOL 45,100
1732 VOMITAS TABLET TABLET 3,500
1733 VOSTEM FORTE KAPLET TABLET 6,400
1734 WIDAHES BOTOL 59,300
1735 WING NEEDLE 21 terumo PIECE 11,300
1738 XALATAN TM BOTOL 137,200
1739 X-FLAM 50 MG TAB TABLET 1,900
1740 XYLOCAIN SPRAY BOTOL 306,900
1741 XYLOCAINE 10% SPRAY BOTOL 153,300
1742 XYLOCAINE 2% JELLY BOTOL 43,200
1743 XYLOCAINE 2% JELLY 10GR TUBE 43,200
1744 XYLOCAINE 2% PDF 20 ML VIAL 60,300
1745 YAL COLON CLEANER TUBE 83,200
1746 ZALDIAR TAB TABLET 9,000
1747 ZANTADIN INJ AMPUL 20,200
1748 ZENAB 50 ML BOTOL 402,400
1749 ZINAT TAB TABLET 7,800
1750 ZINC 20 MG TAB TABLET 500
1751 ZINCARE 20 MG TAB TABLET 2,300
1752 ZINCPRO DROPS BOTOL 13,900
1753 ZITHROMAX SYR 600/15 ML BOTOL 103,000
1754 ZOLMIA TABLET TABLET 5,100
1755 ZOMETA INJ VIAL 972,000
1756 ZOTER CREAM 5 GR TUBE 39,200
1757 ZYCIN 500 MG TAB TABLET 27,400
SHBJ TAHUN 2018 253

Bab 11 Obat Obatan Dan Perlengkapan Laboratorium (OK)

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Bab 11 Obat Obatan Dan Perlengkapan Laboratorium (OK)

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XI.

OBAT - OBATAN DAN PERLENGKAPAN LABORATORIUM

NO NAMA BARANG SATUAN HARGA

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1 TETES MATA , TELINGA DAN HIDUNG

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(1) (2) (3) (4)

SHBJ TAHUN 2018 209

(1) (2) (3) (4)

SHBJ TAHUN 2018 210

(1) (2) (3) (4)

SHBJ TAHUN 2018 211

(1) (2) (3) (4)

SHBJ TAHUN 2018 212

(1) (2) (3) (4)

SHBJ TAHUN 2018 213

(1) (2) (3) (4)

SHBJ TAHUN 2018 214

(1) (2) (3) (4)

SHBJ TAHUN 2018 215

(1) (2) (3) (4)

SHBJ TAHUN 2018 216

(1) (2) (3) (4)

SHBJ TAHUN 2018 217

(1) (2) (3) (4)

SHBJ TAHUN 2018 218

(1) (2) (3) (4)