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NO SAP Nama Produk Kemasan Ogb & Produk Khusus Reguler Bpjs
NO SAP Nama Produk Kemasan Ogb & Produk Khusus Reguler Bpjs
GENERIK
1 11000000 ACYCLOVIR 200 MG (DUS 100 TAB) DUS 55,567
2 11000002 ACYCLOVIR 400 MG (DUS 100 TAB) DUS 93,593
3 11000004 ACYCLOVIR CREAM 5%(DUS 25 TUBE @ 5 GRAM) TUB 3,162
4 11000145 ALBENDAZOL 400 MG (DUS 100 TAB KUNYAH) DUS 51,164
5 11000146 ALLOPURINOL 100 MG (DUS 100 TAB) DUS 22,683
6 11000008 ALPRAZOLAM 0,5 MG (DUS 100 TAB) DUS 35,000
7 11000009 ALPRAZOLAM 1 MG (DUS 100 TAB) DUS 55,000
8 11000147 AMBROXOL 30 MG (DUS 100 TAB) DUS 21,528
9 11000149 AMBROXOL SIRUP (BTL 60 ML) BT 4,509
10 11000150 AMLODIPINE 5 MG (DUS 50 TAB) DUS 15,000 2,409
11 11000151 AMLODIPINE 10 MG (DUS 50 TAB) DUS 25,000
12 11000011 AMOXICILLIN 500 MG (DUS 100 TAB) DUS 37,809
13 11000012 AMPICILLIN 500 MG (DUS 100 TAB) DUS 37,479
14 11000152 ANTASIDA DOEN (DUS 100 TAB) DUS 34,239
15 11001452 ANTASIDA DOEN SUSPENSI-BJN (BTL60ML)-BJN BT 8,913
16 11000291 ANTIHEMOROID (DUS 10 SUPP) DUS 33,000 29,545
17 11000014 ASAM MEFENAMAT 500 MG (DUS 100 TAB) DUS 50,364
18 11001586 ATORVASTATIN TABLET 10 MG DUS 50,000
19 11001587 ATORVASTATIN TABLET 20 MG DUS 75,000
20 11001588 ATORVASTATIN TABLET 40 MG DUS 100,000
21 11000016 AZITHROMYCIN 500 MG (DUS 20 TAB) DUS 26,880 22,727
22 11000383 BETAMETASON 0,1% CR(DUS 25 TUBE@5 GRAM) TUB 2,217
23 11000385 BETASON CREAM (TUBE 5 GRAM) TUB 7,950
24 11000384 BETASON N CREAM (TUBE 5 GRAM) TUB 13,475
25 11000386 CALCIUM LACTAT 500 MG (DUS 100 TAB) DUS 18,876
26 11000161 CAPTOPRIL 12.5 MG TAB (DUS 100 TAB) DUS 15,926
27 11000424 CAPTOPRIL 25 MG (DUS 100 TAB) DUS 16,465
28 11000022 CEFADROXIL 500 MG (DUS 50 KAPS) DUS 65,905
29 11000024 CEFIXIME 100 MG (DUS 30 KAPS) DUS 35,000
30 11000025 CETIRIZINE 10 MG (DUS 30 TAB) DUS 11,000
31 11000026 CHLORAMFECORT CREAM (TUBE 10 GRAM) TUB 13,400
32 11000027 CHLORAMFECORT H CREAM (TUBE 10 GRAM) TUB 11,500
33 11000295 CHLORAMFENICOL 1 % S. MATA (TUBE 5 GRAM) TUB 4,700
34 11000388 CHLORAMPHENICOL 250 MG (DUS 100 KAPS) DUS 61,622
35 11000164 CHLORAMPHENICOL SUSPENSI (BTL 60 ML) BT 8,044
36 11000165 CHLOROQUIN 150 MG TAB (DUS 100) DUS 37,568 25,909
37 11000167 CHLORPROMAZIN 100 MG (DUS 100 TAB) DUS 41,407
38 11000169 CIMETIDINE 200 MG (DUS 100 TAB) DUS 33,407
39 11000029 CIPROFLOXACIN 500 MG (DUS 50 TAB) DUS 34,393
40 11000170 CLONIDINE 0.15 MG (DUS 100 TAB) DUS 16,422 13,273
41 11000171 CLOPIDOGREL 75 MG (DUS 30 TAB) DUS 50,000 15,682
42 11000033 CODEINE 10 MG (DUS 100 TAB) DUS 62,270 54,545
43 11000035 CODEINE 15 MG TAB (DUS 100 TAB) DUS 112,180 92,273
44 11000037 CODEINE 20 MG TAB (DUS 100 TAB) DUS 147,600 123,636
45 11000173 COTRIMOXAZOLE ADULT (DUS 100 TAB) DUS 33,341
46 11000175 COTRIMOXAZOLE SUSPENSI (BTL 60 ML) BT 5,994
47 11002019 D-5 GLUKOSA LARUTAN INFUS 5% BT 6,680
48 11000182 DEXAMETHASONE 0.5 MG (DUS 100 TAB) DUS 14,843
49 11000049 DIAZEPAM 2 MG (BTL 100 TAB) BT 12,478 6,364
50 11000185 DIETHYLCARBAMAZINE 100 MG (DUS 100 TAB) DUS 20,000
51 11000187 DILTIAZEM 30 MG (DUS 100 TAB) DUS 19,328
52 11000188 DIMENHYDRINATE 50 MG (BTL 100 TAB) BT 14,755 9,818
53 11000056 DOXYCYCLINE (DUS 100 KAPS) DUS 58,760
54 11002063 ENTECAVIR 0,5 MG BT 174,000
55 11002064 ENTECAVIR 1 MG BT 218,182
56 11000192 ERGOTAMINE COFFEINE (BTL 100 TAB) BT 21,363
57 11000065 ERYTHROMYCIN 250 MG (DUS 100 KAPS) DUS 85,343
58 11000067 ERYTHROMYCIN SIRUP KERING (BTL 60 ML) BT 12,223
59 11000193 ETHAMBUTOL 250 MG (DUS 200 TAB) DUS 88,383
60 11000194 ETHAMBUTOL 500 MG (DUS 100 TAB) DUS 75,230
61 11000310 EUGENOL (BTL 10 ML) BT 24,000 18,318
NO SAP NAMA PRODUK KEMASAN HARGA (99) HARGA (02) BPJS
Reguler