Daftar Harga Generik Kimia Farma Pelayanan Regular/rutin

HNA HNA
NO SAP NAMA PRODUK KEMASAN excl. PPN Incl. PPN

1 11000000 ACYCLOVIR 200 MG (DUS 100 TAB) DUS 55,567 61,124

2 11000002 ACYCLOVIR 400 MG (DUS 100 TAB) DUS 85,084 93,592
3 11000004 ACYCLOVIR CREAM 5%(DUS 25 TUBE @ 5 GRAM) TUBE 3,162 3,478
4 11000145 ALBENDAZOL 400 MG (DUS 100 TAB KUNYAH) DUS 40,750 44,825
5 11000146 ALLOPURINOL 100 MG (DUS 100 TAB) DUS 22,683 24,951
6 11000008 ALPRAZOLAM 0,5 MG (DUS 100 TAB) DUS 35,000 38,500
7 11000009 ALPRAZOLAM 1 MG (DUS 100 TAB) DUS 55,000 60,500
8 11000147 AMBROXOL 30 MG (DUS 100 TAB) DUS 17,940 19,734
9 11000149 AMBROXOL SIRUP (BTL 60 ML) BT 4,509 4,960
10 11000150 AMLODIPINE 5 MG (DUS 50 TAB) DUS 15,000 16,500
11 11000151 AMLODIPINE 10 MG (DUS 50 TAB) DUS 25,000 27,500
12 11000011 AMOXICILLIN 500 MG (DUS 100 TAB) DUS 37,809 41,590
13 11000012 AMPICILLIN 500 MG (DUS 100 TAB) DUS 37,479 41,227
14 11000152 ANTASIDA DOEN (DUS 100 TAB) DUS 17,558 19,314
15 11001452 ANTASIDA DOEN SUSPENSI (BTL 60 ML) DUS 8,913 9,804
16 11000291 ANTIHEMOROID (DUS 10 SUPP) DUS 30,000 33,000
17 11000014 ASAM MEFENAMAT 500 MG (DUS 100 TAB) DUS 50,364 55,400
18 11000016 AZITHROMYCIN 500 MG (DUS 20 TAB) DUS 90,000 99,000
19 11000383 BETAMETASON 0,1% CR(DUS 25 TUBE@5 GRAM) TUBE 2,217 2,439
20 11000385 BETASON CREAM (TUBE 5 GRAM) TUBE 7,950 8,745
21 11000384 BETASON N CREAM (TUBE 5 GRAM) TUBE 12,250 13,475
22 11000386 CALCIUM LACTAT 500 MG (DUS 100 TAB) DUS 18,876 20,764
23 11000161 CAPTOPRIL 12.5 MG TAB (DUS 100 TAB) DUS 13,272 14,599
24 11000424 CAPTOPRIL 25 MG (DUS 100 TAB) DUS 16,465 18,112
25 11000022 CEFADROXIL 500 MG (DUS 50 KAPS) DUS 65,905 72,496
26 11000024 CEFIXIME 100 MG (DUS 30 KAPS) DUS 35,000 38,500
27 11000025 CETIRIZINE 10 MG (DUS 30 TAB) DUS 11,000 12,100
28 11000026 CHLORAMFECORT CREAM (TUBE 10 GRAM) TUBE 13,400 14,740
29 11000027 CHLORAMFECORT H CREAM (TUBE 10 GRAM) TUBE 11,500 12,650
30 11000295 CHLORAMFENICOL 1 % S. MATA (TUBE 5 GRAM) TUBE 4,700 5,170
31 11000388 CHLORAMPHENICOL 250 MG (DUS 100 KAPS) DUS 61,622 67,784
32 11000164 CHLORAMPHENICOL SUSPENSI (BTL 60 ML) BT 8,044 8,848
33 11000165 CHLOROQUIN 150 MG TAB (DUS 100) DUS 136,885 150,574
34 11000167 CHLORPROMAZIN 100 MG (DUS 100 TAB) DUS 37,643 41,407
35 11000169 CIMETIDINE 200 MG (DUS 100 TAB) DUS 27,839 30,623
36 11000029 CIPROFLOXACIN 500 MG (DUS 50 TAB) DUS 34,393 37,832
37 11000170 CLONIDINE 0.15 MG (DUS 100 TAB) DUS 16,422 18,064
38 11000171 CLOPIDOGREL 75 MG (DUS 30 TAB) DUS 50,000 55,000
39 11000033 CODEINE 10 MG (DUS 100 TAB) DUS 62,270 68,497
40 11000035 CODEINE 15 MG TAB (DUS 100 TAB) DUS 112,180 123,398
41 11000037 CODEINE 20 MG TAB (DUS 100 TAB) DUS 147,600 162,360
42 11000173 COTRIMOXAZOLE ADULT (DUS 100 TAB) DUS 26,673 29,340
43 11000175 COTRIMOXAZOLE SUSPENSI (BTL 60 ML) BT 5,994 6,593
44 11000182 DEXAMETHASONE 0.5 MG (DUS 100 TAB) DUS 12,369 13,606
45 11000049 DIAZEPAM 2 MG (BTL 100 TAB) BT 12,478 13,726
46 11000187 DILTIAZEM 30 MG (DUS 100 TAB) DUS 19,328 21,261
47 11000188 DIMENHYDRINATE 50 MG (BTL 100 TAB) BT 14,755 16,231
48 11000056 DOXYCYCLINE (DUS 100 KAPS) DUS 58,760 64,636
49 11000192 ERGOTAMINE COFFEINE (BTL 100 TAB) BT 21,363 23,499
50 11000065 ERYTHROMYCIN 250 MG (DUS 100 KAPS) DUS 85,343 93,877
51 11000067 ERYTHROMYCIN SIRUP KERING (BTL 60 ML) BT 11,112 12,223
52 11000193 ETHAMBUTOL 250 MG (DUS 200 TAB) DUS 88,383 97,221
 53 11000194 ETHAMBUTOL 500 MG (DUS 100 TAB) DUS 75,230 82,753
54 11000071 FLUCONAZOLE 150 MG (DUS 10 KAPS) DUS 170,182 187,200
55 11000200 FUROSEMIDE 40 MG (DUS 200 TAB) DUS 22,500 24,750
56 11000391 GENTAMYCIN 0,1 % (DUS 10 TUBE @ 5 GRAM) TUBE 2,670 2,937
57 11000072 GLIBENCLAMIDE 5 MG (DUS 100 TAB) DUS 18,940 20,834
58 11000073 GLIMEPIRIDE 1 MG (DUS 50 TAB) DUS 18,000 19,800
59 11000074 GLIMEPIRIDE 2 MG (DUS 50 TAB) DUS 30,000 33,000
60 11000075 GLIMEPIRIDE 3 MG (DUS 50 TAB) DUS 35,000 38,500
61 11000076 GLIMEPIRIDE 4 MG (DUS 50 TAB) DUS 40,000 44,000
62 11000392 GLYCERIL GUAIACOLAT100 MG TAB(DUS100TAB) DUS 20,000 22,000
63 11000202 GRISEOFULVIN 125 MG(DUS 100 TAB) DUS 30,590 33,649
64 11000204 HYDROCLOROTIAZID 25 MG (DUS 100 TAB) DUS 16,500 18,150
65 11000394 HYDROCORTISONE 2,5%CR(DUS 24TUBE@ 5GRAM) TUBE 3,458 3,804
66 11000302 IODINE POVIDONE LAR 10 % (BTL 1000 ML) BT 48,818 53,700
67 11000306 IODINE POVIDONE LAR 10 % (BTL 300 ML) BT 15,636 17,200
68 11000303 IODINE POVIDONE LAR 10 % (BTL 60 ML) BT 5,711 6,282
69 11000305 IODINE POVIDONE LAR 10% (BTL 30 ML) BT 5,000 5,500
70 11000208 ISONIAZID 100 MG (DUS 100 TAB) DUS 16,340 17,974
71 11000210 ISONIAZID 300 MG (DUS 100 TAB) DUS 23,846 26,231
72 11000395 KETOCONAZOLE 2 % CREAM (TUBE 10 GRAM) TUBE 4,000 4,400
73 11000213 KETOCONAZOLE 200 MG (DUS 50 TAB) DUS 24,114 26,525
74 11000216 KINA (DUS 24 STRIP) DUS 14,800 16,280
75 11000217 LEVOFLOXACIN 500 MG (DUS 50 TAB) DUS 35,000 38,500
76 11000220 MELOXICAM 15 MG (DUS 20 TAB) DUS 14,500 15,950
77 11000219 MELOXICAM 7,5 MG (DUS 20 TAB) DUS 8,000 8,800
78 11001733 MEROPENEM INJ 1 G DUS 550,000 605,000
79 11001386 METAMIZOLE SODIUM 500 MG TAB DUS 10X10 DUS 26,500 29,150
80 11000104 METHYLERGOMETRINE 0,125 MG (DUS 100 TAB) DUS 24,944 27,438
81 11000222 METOCLOPRAMID 10 MG (DUS 100 TAB) DUS 13,000 14,300
82 11000221 METOCLOPRAMID 5 MG (DUS 100 TAB) DUS 12,000 13,200
83 11000223 METRONIDAZOLE 250 MG (DUS 100 TAB) DUS 21,303 23,433
84 11000225 METRONIDAZOLE 500 MG (DUS 100 TAB) DUS 26,250 28,875
85 11000296 MICONAZOLE 2 % CR(DUS 24 TUBE@10 GRAM) TUBE 3,750 4,125
86 11001043 MORFINA 10 MG/ML INJEKSI (IMPOR) DUS 309,545 340,500
87 11000106 MORPHINE 10 MG (BTL 30 TAB) BT 39,709 43,680
88 11000107 NATRIUM DIKLOFENAK 25 MG (DUS 50 TAB) DUS 14,854 16,339
89 11000108 NATRIUM DIKLOFENAK 50 MG (DUS 50 TAB) DUS 18,346 20,181
90 11000227 NIFEDIPIN 10 MG (DUS 100 TAB) DUS 20,016 22,018
91 11000115 OMEPRAZOLE 20 MG (DUS 30 KAPS) DUS 17,996 19,796
92 11000229 ORALIT (DUS 100 SASE) DUS 66,550 73,205
93 11000297 OXYTETRACYCLIN 1% SM(DUS 25TUBE@3,5GRAM) TUBE 3,629 3,992
94 11000298 OXYTETRACYCLIN 3% SK(DUS 25 TUBE@5 GRAM) TUBE 1,881 2,069
95 11000230 PAPAVERIN 40 MG (DUS 100 TAB) DUS 15,681 17,249
96 11000397 PARACETAMOL 500 MG (DUS 100 TAB) DUS 24,953 27,448
97 11000232 PARACETAMOL SIRUP (BTL 60 ML) BT 4,583 5,041
98 11001044 PETHIDIN HCL 50 MG/ML INJEKSI (IMPOR) DUS 177,100 194,810
99 11000233 PHENOBARBITAL 30 MG TAB (DUS 100 TAB) DUS 17,000 18,700
100 11000241 PIROXICAM 10 MG (DUS 100 TAB) DUS 13,307 14,638
101 11000243 PIROXICAM 20 MG (DUS 100 TAB) DUS 14,080 15,488
102 11001426 PREGABALIN CAPS 150 MG DUS 270,000 297,000
103 11001425 PREGABALIN CAPS 75 MG DUS 195,000 214,500
104 11000121 PROPRANOLOL HCL 40 MG (DUS 100 TAB) DUS 26,904 29,594
105 11000248 PYRANTEL 125 MG (DUS 100 TAB) DUS 46,606 51,267
106 11000251 PYRAZINAMIDE 500 MG (DUS 100 TAB) DUS 34,205 37,626
107 11000122 QUININE HCL 250MG/ML INJ (DUS 100 AMP) DUS 230,000 253,000
108 11000256 RANITIDIN 150 MG (DUS 30 TAB) DUS 12,905 14,196
109 11000309 RETINOL (VIT A 100.000 UI)(BTL 50 KAPS) BT 22,500 24,750
110 11000304 RETINOL (VIT A 200.000 UI) (BTL 50 KAPS) BT 37,650 41,415
111 11000124 RIFAMPICIN 450 MG (DUS 100 TAB) DUS 164,145 180,560
112 11000125 RIFAMPICIN 600 MG (DUS 100 TAB) DUS 215,916 237,508
113 11000259 SALBUTAMOL 2 MG (DUS 100 TAB) DUS 10,298 11,328
114 11000262 SALBUTAMOL 4 MG (DUS 100 TAB) DUS 10,794 11,873
115 11000264 SIMVASTATIN 10 MG (DUS 50 TAB) DUS 14,000 15,400
116 11000266 SIMVASTATIN 20 MG (DUS 50 TAB) DUS 27,000 29,700
117 11000268 SULFADOXINE PYRIMETHAMINE (DUS 100 TAB) DUS 97,147 106,862
118 11000793 TABLET TAMBAH DARAH NEO (TSG)(DUS100TAB) DUS 45,000 49,500
119 11000128 TETRACYCLINE 250 MG (DUS 100 KAPS) DUS 44,361 48,797
120 11000130 TETRACYCLINE 500 MG (DUS 100 KAPS) DUS 95,000 104,500
121 11000133 TRAMADOL 50 MG (DUS 50 KAPS) DUS 23,425 25,768
122 11000136 TRINOLON 4 MG (DUS 50 TAB) DUS 65,000 71,500
123 11000274 VERAPAMIL 80 MG (DUS 100 TAB) DUS 43,550 47,905
124 11000487 VITAMIN B KOMPLEKS(SUPLEMEN)(DUS100TAB) DUS 12,917 14,209
125 11000275 VITAMIN B1 100 MG TAB(SUPL)(DUS 100 TAB) DUS 23,700 26,070
126 11000488 VITAMIN B1 50 MG (SUPLEMEN)(DUS100TAB) DUS 14,675 16,143
127 11000279 VITAMIN B12 0.05 MG TAB(OLD)(DUS 100TAB) DUS 9,868 10,855
128 11000485 VITAMIN B12 50 MCG (SUPLEMEN)(DUS100TAB) DUS 7,105 7,816
129 11000486 VITAMIN B6 10 MG (SUPLEMEN)(DUS100TAB) DUS 12,800 14,080
130 11000283 VITAMIN C 100 MG TAB(SUPL)(DUS 100TAB) DUS 15,036 16,540
131 11000489 VITAMIN C 250 MG (SUPLEMEN)(DUS100TAB) DUS 18,200 20,020
132 11000288 VITAMIN C 50 MG TAB (SUPL)(DUS 100 TAB) DUS 14,291 15,720
133 11000144 ZINK DISPERSIBEL (DUS 100 TAB) DUS 43,180 47,498
134 11002004 HYDROXYCHLOROQUINE SULFATE 200 MG (100 TAB) DUS 874,000 961,400
 faktur (Box)
3. Ap. Puji : 5 box 3 ok
4. Ap. Antika musi : 2 karton 3 ok
5. Ap. Orchid : 3 karton 3 ok
10. ap pratama : 5 box 5 ok
11. ap mega j j : 3 box 3 ok
16. K24 bukit 2 box 2 ok
21.Apotik sentosa 2 box 2 ok
22. Apotik Debby 2 box 2 ok
23. Ap. Puji agung 10box 3 ok
24. Ap akbar 5 box 5 ok
29. Ap. Mandiri 2box 2 ok
31. Ap. Sehat musi 10 box 3 ok
15. RS Siti Khodijah 2 box 2 ok
19.klinik Rizky Az-Zahra 5 3 ok
25.Rs.graha mandiri 5box 5 ok
RS martapura 10 ok
Ap.sehat jaya 5 ok
7. Ap anindia: 5 box 5 ok
8. ap aldo : 5 box 3 ok
14. Ap sejahtera belitang 5 box 5 ok
18.to hj Faridah 5 box 5 ok
26.Ap mizan 2box 2 ok
28.apotik Al-Fath 3 box 3 ok
30.ap embun pagi 6 box 5 ok
ap. Dua putra 3 ok
9. Ap ilham : 5 karton 5 ok
17.apotik melati 1 karton 5 ok
20.apotik sehat jaya 1 karton 5 ok
1. Ap Kito : 1 karton 5 ok
Ap. Khadijah 5 ok
Ap. Sehat segar 5 ok
27.to Musi 1 karton 5 ok
2. Ap. Royan medika : 1 karton 5 ok
 faktur (Box)
Ap. Puji 3 ok
Ap. Antika musi 5 ok
Ap. Orchid 3 ok
ap pratama 5 ok
ap mega j j 3 ok
K24 bukit 2 ok
Apotik sentosa 2 ok
Apotik Debby 2 ok
Ap. Puji agung 3 ok
Ap akbar 5 ok
Ap. Mandiri 2 ok
Ap. Sehat musi 3 ok
RS Siti Khodijah 2 ok
klinik Rizky Az-Zahra 3 ok
Rs.graha mandiri 5 ok
RS martapura 10 ok
Ap.sehat jaya 5 ok
Ap anindia 5 ok
ap aldo 3 ok
Ap sejahtera belitang 5 ok
to hj Faridah 5 ok
Ap mizan 2 ok
28.apotik Al-Fath 3 ok
30.ap embun pagi 5 ok
ap. Dua putra 3 ok
Ap ilham 5 ok
Apotik melati 5 ok
Apotik sehat jaya 5 ok
Ap Kito 5 ok
Ap. Khadijah 5 ok
Ap. Sehat segar 5 ok
to Musi 5 ok
Ap. Royan medika 5 ok
To. Tiara 5 ok