Halaman 1 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

1 ACARBOSE Tab 100 mg (PN) FAHRENHEIT PT. Kebayoran Farma Acarbose Tablet 100 mg Tablet 57,350.00 1,911.67 16.00 1,605.80 48,174.00
30

2 ACARBOSE Tab 50 mg (PN) FAHRENHEIT PT. Kebayoran Farma Acarbose Tablet 50 mg Tablet 33,960.00 1,132.00 16.00 950.88 28,526.40
30

3 ACYCLOVIR Cream 5 % (IF) INDOFARMA PT. Indofarma Global Medika Acyclovir Krim 5.0% Tube 82,375.00 3,295.00 33.00 2,207.65 55,191.25
25

4 ACYCLOVIR Cream 5% 5 g (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Acyclovir Krim 5.0% Tube 3,162.00 3,162.00 17.50 2,608.65 2,608.65
1

5 ACYCLOVIR Tab 200 mg (PN) FAHRENHEIT PT. Kebayoran Farma Acyclovir Tablet 200 mg Tablet 50,000.00 500.00 15.00 425.00 42,500.00
100

6 ACYCLOVIR Tab 200 mg (NP) NOVELL PT. Antarmitra Sembada Acyclovir Tablet 200 mg Tablet 26,675.00 533.50 17.50 440.14 22,006.88
50

7 ACYCLOVIR Tab 200 mg (IF) INDOFARMA PT. Indofarma Global Medika Acyclovir Tablet 200 mg Tablet 59,500.00 595.00 15.00 505.75 50,575.00
100

8 ACYCLOVIR Tab 400 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Acyclovir Tablet 400 mg Tablet 60,000.00 600.00 35.00 390.00 39,000.00
100

9 ACYCLOVIR Tab 400 mg (IF) INDOFARMA PT. Indofarma Global Medika Acyclovir Tablet 400 mg Tablet 85,000.00 850.00 10.00 765.00 76,500.00
100

10 ACYCLOVIR Tab 400 mg (PN) FAHRENHEIT PT. Kebayoran Farma Acyclovir Tablet 400 mg Tablet 48,000.00 960.00 15.00 816.00 40,800.00
50

11 ALLOPURINOL Tab 100 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Allopurinol Tablet 100 mg Tablet 20,000.00 200.00 35.00 130.00 13,000.00
100

12 ALLOPURINOL Tab 100 mg (ID) IMFARMIND INDUSTRI PT. Indofarma Global Medika Allopurinol Tablet 100 mg Tablet 24,960.00 249.60 35.00 162.24 16,224.00
100

13 ALLOPURINOL Tab 100 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Allopurinol Tablet 100 mg Tablet 17,298.00 172.98 0.00 172.98 17,298.00 TIDAK
100

14 ALLOPURINOL Tab 300 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Allopurinol Tablet 300 mg Tablet 42,000.00 420.00 35.00 273.00 27,300.00
100

15 ALPRAZOLAM Tab 0.5 mg (MT) MERSIFARMA PT. Merapi Utama Pharma Alprazolam Tablet 0,5 mg Tablet 60,000.00 600.00 27.50 435.00 43,500.00
100

16 ALPRAZOLAM Tab 0,5 mg (OT) OTTO OGB PT. Mensa Bina Sukses Alprazolam Tablet 0,5 mg Tablet 57,433.00 574.33 15.00 488.18 48,818.05
100

17 ALPRAZOLAM Tab 1 mg (MT) MERSIFARMA PT. Merapi Utama Pharma Alprazolam Tablet 1 mg Tablet 97,500.00 975.00 27.50 706.88 70,687.50
100

18 ALPRAZOLAM Tab 1 mg (OT) OTTO OGB PT. Mensa Bina Sukses Alprazolam Tablet 1 mg Tablet 88,364.00 883.64 15.00 751.09 75,109.40
100

19 AMBROXOL Elixir 15 mg/5 ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ambroxol Sirup 15 mg / 5 ml Botol 6,000.00 6,000.00 50.00 3,000.00 3,000.00
1

20 AMBROXOL Syr 15 mg/5 ml (PR) PHAPROS PT. Rajawali Nusindo Ambroxol Sirup 15 mg / 5 ml Botol 5,000.00 5,000.00 40.00 3,000.00 3,000.00
1

21 AMBROXOL Elixir 30 mg/5 ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ambroxol Sirup 30 mg / 5 ml Botol 9,000.00 9,000.00 55.00 4,050.00 4,050.00
1

22 AMBROXOL Tab 30 mg (GF) GRAHA FARMA PT. Indofarma Global Medika Ambroxol Tablet 30 mg Tablet 10,914.55 109.15 10.00 98.23 9,823.09
100
PT. Penta Valent
PROMEDRAHARDJO FARMASI INDUSTRI
23 AMBROXOL Tab 30 mg (PM) PT. Millenium Pharmacon International Tbk Ambroxol Tablet 30 mg Tablet 18,000.00 180.00 35.00 117.00 11,700.00
OGB 100
PT. Merapi Utama Pharma
24 AMBROXOL Tab 30 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ambroxol Tablet 30 mg Tablet 30,000.00 300.00 50.00 150.00 15,000.00
100

25 AMIKASIN Inj 500 mg/2 ml (DM) DEXA MEDICA PT. Anugrah Argon Medica Amikacin Injeksi 500 mg / 2 ml Vial 132,000.00 132,000.00 92.60 9,766.36 9,766.36 YA
1

26 AMINOPHYLLINE Inj 24 mg/ml (EI) ETHICA INDUSTRI FARMASI PT. Anugerah Pharmindo Lestari Aminophylline Injeksi 24 mg / ml Ampul 170,100.00 7,087.50 10.00 6,378.75 153,090.00
24

27 AMITRIPTYLINE Tab 25 mg (PN) FAHRENHEIT PT. Kebayoran Farma Amitriptyline Tablet 25 mg Tablet 17,000.00 170.00 7.50 157.25 15,725.00
100

28 AMLODIPINE BESILATE Tab 10 mg (TP) TEMPO RX FARMA PT. Tempo Amlodipine Tablet 10 mg Tablet 19,909.00 66.36 0.00 66.36 19,909.00 YA
300

29 AMLODIPINE Tab 10 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Amlodipine Tablet 10 mg Tablet 25,000.00 500.00 78.00 110.00 5,500.00
50

30 AMLODIPIN Tab 10 mg (ID) IMFARMIND INDUSTRI PT. Indofarma Global Medika Amlodipine Tablet 10 mg Tablet 157,942.00 1,579.42 93.00 110.56 11,055.94
100

31 AMLODIPINE Tab 10 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Amlodipine Tablet 10 mg Tablet 85,000.00 850.00 85.00 127.50 12,750.00
100

32 AMLODIPINE Tab 5 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Amlodipine Tablet 5 mg Tablet 2,409.00 48.18 0.00 48.18 2,409.00 YA
50

33 AMLODIPINE BESILATE Tab 5 mg (TP) TEMPO RX FARMA PT. Tempo Amlodipine Tablet 5 mg Tablet 15,000.00 50.00 0.00 50.00 15,000.00 YA
300

34 AMLODIPIN Tab 5 mg (ID) IMFARMIND INDUSTRI PT. Indofarma Global Medika Amlodipine Tablet 5 mg Tablet 89,607.00 896.07 88.50 103.05 10,304.80
100

35 AMLODIPINE Tab 5 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Amlodipine Tablet 5 mg Tablet 43,350.00 433.50 75.00 108.38 10,837.50
100

36 AMOXICILLIN TRIHYDRATE Drops 100 mg/ml (MM) PT MEPROFARM MPI dan Penta Valen Amoxycillin Drops 100 mg/ml Botol 20,000.00 20,000.00 30.00 14,000.00 14,000.00
1

37 CO-AMOXICLAV Inj (IT) INTERBAT PT. Mensa Bina Sukses, PT. Enseval Megatrading Amoxycillin clavulanic acid Injeksi 1g Vial 650,000.00 65,000.00 50.00 32,500.00 325,000.00
10

38 AMOXICILLIN DS 125 mg/5 ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Amoxycillin Sirup Kering 125 mg / 5 ml Botol 5,000.00 5,000.00 7.00 4,650.00 4,650.00
1

39 AMOKSISILIN DS 125 mg/5 ml (HR) HARSEN LABORATORIES PT Kimia Farma Amoxycillin Sirup Kering 125 mg / 5 ml Botol 663,000.00 13,260.00 22.00 10,342.80 517,140.00
50

40 AMOKSISILIN DS 250 mg/5 ml (HR) HARSEN LABORATORIES PT Kimia Farma Amoxycillin Sirup Kering 250 mg/ 5 ml Botol 877,500.00 17,550.00 22.00 13,689.00 684,450.00
50

41 AMOXICILLIN Kapl 500 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Amoxycillin Tablet 500 mg Kaplet 67,272.00 336.36 20.00 269.09 53,817.60 Ya
200

42 AMOXICILLIN Kapl 500 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Amoxycillin Tablet 500 mg Kaplet 70,000.00 700.00 61.00 273.00 27,300.00
100

43 AMOXYCILLIN Kapl 500 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Amoxycillin Tablet 500 mg Kapsul 33,636.00 336.36 0.00 336.36 33,636.00 TIDAK
100

44 CO-AMOXYCLAV Tab 625 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Amoxycillin Asam clavulanat Tablet 625 mg Tablet 120,000.00 4,000.00 0.00 4,000.00 120,000.00 TIDAK
30

45 CO AMOXICLAV Tab 625 mg (IF) INDOFARMA PT. Indofarma Global Medika Amoxycillin Asam clavulanat Tablet 625 mg Tablet 158,404.00 5,280.13 20.00 4,224.11 126,723.20
30

46 AMPICILLIN Inj 1 g (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ampicillin Injeksi 1g Vial 120,000.00 12,000.00 42.00 6,960.00 69,600.00
10

47 ARIPIPRAZOLE Kapl 10 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Aripiprazole Kaplet 10 mg Kaplet 300,000.00 15,000.00 35.00 9,750.00 195,000.00
20

48 ARIPIPRAZOLE Kapl 20 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Aripiprazole Kaplet 20 mg Kaplet 350,000.00 17,500.00 35.00 11,375.00 227,500.00
20
PT. Penta Valent
PROMEDRAHARDJO FARMASI INDUSTRI
49 MEFENAMIC ACID FC Kapl 500 mg (PM) PT. Millenium Pharmacon International Tbk Asam Mefenamat Kaplet 500 mg Kaplet 26,000.00 260.00 20.00 208.00 20,800.00
OGB 100
PT. Merapi Utama Pharma
50 ASAM MEFENAMAT Tab 500 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Asam Mefenamat Tablet 500 mg Tablet 22,770.00 227.70 0.00 227.70 22,770.00 TIDAK
100

51 MEFENAMIC ACID Kapl 500 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Asam Mefenamat Tablet 500 mg Kaplet 27,500.00 275.00 45.00 151.25 15,125.00 Ya
100

52 ASAM TRANEKSAMAT Inj 250 mg/5 ml (NP) NOVELL PT. Antarmitra Sembada Asam Traneksamat Injeksi 250 mg / 5 ml Ampul 23,000.00 4,600.00 30.00 3,220.00 16,100.00
5
 Halaman 2 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

53 ASAM TRANEKSAMAT Inj 250 mg/5 mL (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Asam Traneksamat Injeksi 250 mg/5 ml Ampul 48,000.00 4,800.00 45.00 2,640.00 26,400.00
10

54 TRANEXAMIC ACID Inj 500 mg/5 ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Asam Traneksamat Injeksi 500 mg / 5 ml Ampul 52,500.00 5,250.00 60.00 2,100.00 21,000.00
10

55 ASAM TRANEKSAMAT Inj 500 mg/5 ml (NP) NOVELL PT. Antarmitra Sembada Asam Traneksamat Injeksi 500 mg / 5 ml Ampul 63,000.00 6,300.00 35.00 4,095.00 40,950.00
10

56 SODIUM VALPROATE Syr 250 mg/120 ml (PR) PHAPROS PT. Rajawali Nusindo Asam valproat Sirup 250 mg / 5 ml Botol 22,000.00 22,000.00 35.00 14,300.00 14,300.00
1

57 VALPROATE SODIUM Syr 120 ml (IP) IKAPHARMINDO PUTRAMAS PT. Distriversa Buanamas asam valproat Sirup 250 mg / 5 ml Botol 27,500.00 27,500.00 27.50 19,937.50 19,937.50
1

58 SODIUM VALPROATE Syr (MM) PT MEPROFARM MPI dan Penta Valen Asam valproat Sirup 250 mg / 5 ml Botol 66,350.00 66,350.00 60.00 26,540.00 26,540.00
1

59 ZOLEDRONIC ACID Inj 4 mg (FE) FERRON PAR PHARMACEUTICALS PT. Anugrah Argon Medica Asam Zoledronat Injeksi 4 mg Vial 1,600,000.00 1,600,000.00 40.00 960,000.00 960,000.00
1

60 ASCORBIC ACID Inj 1000 mg / 5 ml (NP) NOVELL PT. Antarmitra Sembada Ascorbic Acid Injeksi 1000 mg/5 ml Ampul 250,000.00 250,000.00 25.00 187,500.00 187,500.00
1

61 ASCORBIC ACID Inj 500 mg / 5 ml (NP) NOVELL PT. Antarmitra Sembada Ascorbic Acid Injeksi 500 mg / 5 mL Ampul 200,000.00 200,000.00 25.00 150,000.00 150,000.00
1

62 ASCORBIC ACID Inj 200 mg/ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ascorbic Acid Injeksi 1000 mg/5 ml Ampul 180,000.00 18,000.00 35.00 11,700.00 117,000.00
10
Kaplet Salut
63 VITAMIN C Tab 500 mg (MT) MERSIFARMA PT. Merapi Utama Pharma Ascorbic Acid 500 mg Kaplet Salut Selaput 40,000.00 1,333.33 25.00 1,000.00 30,000.00
Selaput 30

64 VITAMIN C Tab 100 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Ascorbic Acid Tablet 100 mg Tablet 15,036.00 150.36 12.50 131.57 13,156.50
100

65 VITAMIN C Tab 50 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Ascorbic Acid Tablet 50 mg Tablet 3,818.00 38.18 0.00 38.18 3,818.00 YA
100

66 ASTAXANTHIN NATURAL MPL Kaps 4 mg (ML) MEDIKON PT. Surya Prima Perkasa, PT. Merapi Utama Pharma, PT. Dos Ni Roha Astaxanthin 4 mg Kapsul 4 mg Kapsul 90,000.00 5,000.00 35.00 3,250.00 58,500.00
18

67 ATORVASTATIN Tab 10 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Atorvastatin Tablet 10 mg Tablet 112,320.00 1,248.00 52.00 599.04 53,913.60
90

68 ATORVASTATIN Tab 10 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Atorvastatin Tablet 10 mg Tablet 75,000.00 2,500.00 50.00 1,250.00 37,500.00
30

69 ATORVASTATIN Tab 20 mg (AM)) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Atorvastatin Tablet 20 mg Tablet 137,520.00 1,528.00 52.00 733.44 66,009.60
90

70 ATORVASTATIN Tab 20 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Atorvastatin Tablet 20 mg Tablet 120,000.00 4,000.00 80.00 800.00 24,000.00
30

71 ATORVASTATIN Tab 20 mg (NP) NOVELL PT. Antarmitra Sembada Atorvastatin Tablet 20 mg Tablet 120,000.00 4,000.00 70.00 1,200.00 36,000.00
30

72 ATORVASTATIN Tab 40 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Atorvastatin Tablet 40 mg Tablet 272,520.00 3,028.00 40.00 1,816.80 163,512.00
90

73 ATORVASTATIN Tab 40 mg (NP) NOVELL PT. Antarmitra Sembada Atorvastatin Tablet 40 mg Tablet 120,000.00 4,000.00 50.00 2,000.00 60,000.00
30

74 ATORVASTATIN Tab 40 mg (IN) INFION PT. United Dico Citas, PT. Merapi Utama Pharma Atorvastatin Tablet 40 mg Tablet 180,000.00 6,000.00 50.00 3,000.00 90,000.00
30

75 ATRACURIUM BESILATE Inj 25 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Atracurium Besilate Injeksi 25 mg Ampul 400,000.00 40,000.00 45.00 22,000.00 220,000.00
10

76 ATRACURIUM BESILATE Inj 50 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Atracurium Besilate Injeksi 50 mg Ampul 700,000.00 70,000.00 40.00 42,000.00 420,000.00
10

77 AZITHROMYCIN Kap 500 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Azithromycin Kaplet 500 mg Kaplet 270,000.00 9,000.00 80.00 1,800.00 54,000.00
30

78 AZITHROMYCIN Kapl 500 mg (NP) NOVELL PT. Antarmitra Sembada Azithromycin Kaplet 500 mg Kaplet 270,000.00 9,000.00 55.00 4,050.00 121,500.00
30

79 AZITROMYCINE Kapl 500 mg (OT) OTTO OGB PT. Mensa Bina Sukses Azithromycin Kaplet 500 mg Kaplet 54,000.00 9,000.00 45.00 4,950.00 29,700.00
6

80 AZITHROMYCIN Dry Syr 200 mg/5 ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Azithromycin Sirup Kering 200 mg / 5 ml Botol 64,000.00 64,000.00 65.00 22,400.00 22,400.00
1

81 AZITHROMYCIN Syr 200 mg/5 ml (IN) INFION PT. United Dico Citas, PT. Merapi Utama Pharma Azithromycin Sirup Kering 200 mg / 5 ml Botol 55,000.00 55,000.00 40.00 33,000.00 33,000.00
1

82 BETAHISTINE HYDROCLORIDE Tab 24 mg (YN) YARINDO PT. Kebayoran Farma ,PT PARIT PADANG Betahistine Tablet 24mg Tablet 150,000.00 5,000.00 10.00 4,500.00 135,000.00 YA
30

83 BETAHISTINE Tab 6 mg (NP) NOVELL PT. Antarmitra Sembada Betahistine Tablet 6 mg Tablet 25,200.00 840.00 57.50 357.00 10,710.00
30

84 BETAMETASON Cream 0,1% (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Betamethasone Krim 0,1% Tube 1,382.00 1,382.00 0.00 1,382.00 1,382.00 YA
1

85 BISOPROLOL FUMARATE Tab 2.5 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Bisoprolol Tablet 2,5 mg Tablet 50,000.00 500.00 20.00 400.00 40,000.00
100

86 BISOPROLOL FUMARATE Tab 2,5 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Bisoprolol Tablet 2,5 mg Tablet 105,000.00 3,500.00 80.00 700.00 21,000.00
30

87 BISOPROLOL Tab 5 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Bisoprolol Tablet 5 mg Tablet 63,318.00 2,110.60 94.10 124.55 3,736.36 YA
30

88 BISOPROLOL Tab 5 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Bisoprolol Tablet 5 mg Tablet 55,000.00 1,100.00 80.00 220.00 11,000.00
50

89 BISOPROLOL Tab 5 mg (LS) LANDSON PT. Mensa Bina Sukses Bisoprolol Tablet 5 mg Tablet 69,000.00 2,300.00 80.00 460.00 13,800.00
30

90 CALCIUM GLUCONATE Inj 10%/10 ml (DM) DEXA MEDICA PT. Anugrah Argon Medica Ca Glukonat Injeksi 10% Ampul 313,600.00 13,066.67 60.18 5,202.73 124,865.45 YA
Calcium Chloride Dihydrate 0.10 g 24
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT. Potassium Chloride 0.15 g
91 RINGER ACETATE Infus 500 ml (SR) SATORIA Calcium Chloride 3.00
Dihydrate 0.10 g WFI ad 500 ml Cairan Infus 500 ml Botol 160,000.00 8,000.00 0.00 8,000.00 160,000.00 YA
Perusahaan Perdagangan Indonesia Sodium Chloride g 20
Sodium Chloride 3.00
Trihydrate gg
1.90
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
92 RINGER LACTATE Infus 500 ml (SR) SATORIA Potassium Chloride
Calcium Chloride 0.15 g 0.10 g
Dihydrate WFI ad 500 ml Cairan Infus 500 ml Botol 138,720.00 6,936.00 0.00 6,936.00 138,720.00 YA
Perusahaan Perdagangan Indonesia 20
Sodium Lactate 1.55 g
Sodium Chloride 3.00 g
93 RINGER LAKTAT Infus (WB) WIDATRA BHAKTI PT. Merapi Utama Pharma Potassium Chloride 0.15 g Cairan Infus 500 ml Plabot Err:522 Err:522 0.00 Err:522 Err:522 YA
Calcium Chloride1.55
Sodium Lactate Dihydrate
g 0.10 g 20
Sodium Chloride 3.00 g
94 RINGER LAKTAT Infus 500 ml (MH) EMJEBE PT. Kimia Farma Trading & Distribution Potassium Chloride 0.15 g Cairan Infus 500 ml Botol Err:522 Err:522 7.00 Err:522 Err:522 Ya
Sodium Lactate 1.55 g 20

95 KALSIUM LAKTAT Tab 500 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Calcium Lactate Tablet 500 mg Tablet 18,876.00 188.76 15.00 160.45 16,044.60
100

96 CANDESARTAN CILEXETIL Tab 16 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Candesartan Tablet 16 mg Tablet 700,000.00 7,000.00 88.00 840.00 84,000.00
100

97 CANDESARTAN Tab 16 mg (PN) FAHRENHEIT PT. Kebayoran Farma, PT.Parit Padang Candesartan Tablet 16 mg Tablet 195,000.00 6,500.00 85.00 975.00 29,250.00
30

98 CANDESARTAN CILEXETIL Tab 8 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Candesartan Tablet 8 mg Tablet 500,000.00 5,000.00 88.00 600.00 60,000.00
100

99 CANDESARTAN Tab 8 mg (PN) FAHRENHEIT PT. Kebayoran Farma, PT.Parit Padang Candesartan Tablet 8 mg Tablet 135,000.00 4,500.00 85.00 675.00 20,250.00
30

100 CAPTOPRIL Tab 12.5 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Captopril Tablet 12,5 mg Tablet 8,182.00 81.82 10.00 73.64 7,363.80 TIDAK
100

101 CAPTOPRIL Tab 12,5 mg (IF) INDOFARMA PT. Indofarma Global Medika Captopril Tablet 12,5 mg Tablet 13,000.00 130.00 20.00 104.00 10,400.00
100

102 CAPTOPRIL Tab 12,5 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Captopril Tablet 12,5 mg Tablet 15,926.00 159.26 5.00 151.30 15,129.70
100

103 CAPTOPRIL Tab 25 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Captopril Tablet 25 mg Tablet 16,465.00 164.65 20.00 131.72 13,172.00
100
 Halaman 3 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

104 CAPTOPRIL Tab 25 mg (IF) INDOFARMA PT. Indofarma Global Medika Captopril Tablet 25 mg Tablet 20,540.00 205.40 35.00 133.51 13,351.00
100

105 CAPTOPRIL Tab 25 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Captopril Tablet 25 mg Tablet 20,398.00 203.98 5.00 193.78 19,378.10 TIDAK
100

106 CAPTOPRIL Tab 50 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Captopril Tablet 50 mg Tablet 12,523.00 125.23 3.00 121.47 12,147.31 TIDAK
100

107 CAPTOPRIL Tab 50 mg (IF) INDOFARMA PT. Indofarma Global Medika Captopril Tablet 50 mg Tablet 24,500.00 245.00 10.00 220.50 22,050.00
100

108 CARBAZOCHROME Inj 50 mg/10 ml (NP) NOVELL PT. Antarmitra Sembada Carbazochrome Injeksi 1g Ampul 119,200.00 11,920.00 30.00 8,344.00 83,440.00
10

109 CEFADROXIL Kaps 500 mg (ML) MEDIKON PT. Surya Prima Perkasa, PT. Merapi Utama Pharma, PT. Dos Ni Roha Cefadroxil Kapsul 500 mg Kapsul 76,364.00 763.64 30.00 534.55 53,454.80
100

110 CEFADROXIL Kaps 500 mg (IN) INFION PT. United Dico Citas, PT. Merapi Utama Pharma Cefadroxil Kapsul 500 mg Kapsul 115,000.00 1,150.00 52.50 546.25 54,625.00
100

111 CEFADROXIL Kaps 500 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Cefadroxil Kapsul 500 mg Kapsul 110,000.00 1,100.00 52.00 528.00 52,800.00
100

112 CEFADROXIL DS 125 mg/5 ml (MM) PT MEPROFARM MPI dan Penta Valen Cefadroxil Sirup Kering 125 mg / 5 ml Botol 6,750.00 6,750.00 20.00 5,400.00 5,400.00
1

113 CEFADROXIL DS 125 mg/5 mg 60 ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Cefadroxil Sirup Kering 125 mg / 5 ml Botol 7,455.00 7,455.00 10.00 6,709.50 6,709.50
1

114 CEFADROXIL Dry Syr 125 mg/5 ml (IF) INDOFARMA PT. Indofarma Global Medika Cefadroxil Sirup Kering 125 mg / 5 ml Botol 10,425.93 10,425.93 20.00 8,340.74 8,340.74
1

115 CEFADROXIL Dry Syr 250 mg/5 ml 60 ml (NP) NOVELL PT. Antarmitra Sembada Cefadroxil Sirup Kering 250 mg / 5 ml Botol 18,000.00 18,000.00 25.00 13,500.00 13,500.00
1

116 CEFADROXIL Dry Syr 250 mg/5 ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Cefadroxil Sirup Kering 250 mg / 5 ml Botol 45,000.00 45,000.00 48.00 23,400.00 23,400.00
1

117 CEFAZOLIN Inj 1 g (DM) DEXA MEDICA PT. Anugrah Argon Medica Cefazolin Injeksi 1g Vial 37,545.00 18,772.50 69.38 5,748.18 11,496.36 YA
2

118 CEFAZOLIN Inj 1 g (DV) DARYA VARIA PT. Anugerah Pharmindo Lestari Cefazolin Injeksi 1g Vial 11,500.00 11,500.00 0.00 11,500.00 11,500.00
1

119 CEFEPIME Dry Inj 1 g (NP) NOVELL PT. Antarmitra Sembada Cefepime Injeksi 1g Vial 125,000.00 125,000.00 58.00 52,500.00 52,500.00
1

120 CEFEPIME HCL Inj 1 g (MM) PT MEPROFARM MPI dan Penta Valen Cefepime Serbuk injeksi 1g Vial 264,000.00 26,400.00 5.00 25,080.00 250,800.00
10

121 CEFIXIME TRIHYDRATE Kapl 200 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Cefixime Kaplet 200 mg Kaplet 230,000.00 2,300.00 20.00 1,840.00 184,000.00
100

122 CEFIXIME Kaps 100 mg (ML) MEDIKON PT. Surya Prima Perkasa, PT. Merapi Utama Pharma, PT. Dos Ni Roha Cefixime Kapsul 100 mg Kapsul 68,250.00 1,365.00 30.00 955.50 47,775.00
50

123 CEFIXIME Kaps 100 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Cefixime Kapsul 100 mg Kapsul 65,000.00 1,300.00 55.00 585.00 29,250.00
50

124 CEFIXIME Kaps 100 mg (NP) NOVELL PT. Antarmitra Sembada Cefixime Kapsul 100 mg Kapsul 108,845.00 2,176.90 60.00 870.76 43,538.00
50

125 CEFIXIME Kaps 200 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Cefixime Kapsul 200 mg Kapsul 366,700.00 3,667.00 81.43 680.91 68,090.91 YA
100

126 CEFIXIME Kaps 200 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Cefixime Kapsul 200 mg Kapsul 135,000.00 4,500.00 60.00 1,800.00 54,000.00
30

127 CEFIXIME DS 100 mg/ 5 ml 30 ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Cefixime Sirup Kering 100 mg / 5 ml Botol 18,000.00 18,000.00 55.00 8,100.00 8,100.00
1

128 CEFIXIME Dry Syr 100 mg/5 ml 60 ml (NP) NOVELL PT. Antarmitra Sembada Cefixime Sirup Kering 100 mg / 5 ml Botol 27,500.00 27,500.00 60.00 11,000.00 11,000.00
1

129 CEFOPERAZONE+SULBACTAM Inj 1 g (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Cefoperazon Sulbactam Injeksi 1g Vial 130,000.00 130,000.00 87.20 16,640.00 16,640.00
1

130 CEFOPERAZONE Inj 1 g (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Cefoperazon Injeksi 1g Vial 80,000.00 40,000.00 40.00 24,000.00 48,000.00
2

131 CEFOPERAZONE SULBACTAM Dry Inj 1 g (NP) NOVELL PT. Antarmitra Sembada Cefoperazon Sulbactam Injeksi 1g Vial 95,000.00 95,000.00 60.00 38,000.00 38,000.00
1

132 CEFOPERAZONE SODIUM Inj 1 g (MM) PT MEPROFARM MPI dan Penta Valen Cefoperazon Serbuk injeksi 1g Vial 173,300.00 17,330.00 20.00 13,864.00 138,640.00
10

133 CEFOTAXIM Inj 1 g (PR) PHAPROS PT. Rajawali Nusindo Cefotaxim Injeksi 1g Vial 54,000.00 5,400.00 45.00 2,970.00 29,700.00
10

134 CEFOTAXIME Inj 1 g (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Cefotaxim Injeksi 1g Vial 17,000.00 8,500.00 55.00 3,825.00 7,650.00
2

135 CEFOTAXIME Inj 1 g (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Cefotaxim Injeksi 1g Vial 400,000.00 40,000.00 90.00 4,000.00 40,000.00
10

136 CEFOTAXIME SODIUM Inj 0,5 g (MM) PT MEPROFARM MPI dan Penta Valen Cefotaxim Serbuk injeksi 500 mg Vial 70,000.00 7,000.00 20.00 5,600.00 56,000.00
10

137 CEFOTIAM Inj 1 g (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Cefotiam Injeksi 1 gr Vial 150,000.00 150,000.00 35.00 97,500.00 97,500.00
1

138 CEFPIROME SULFATE Inj 1 g (MM) PT MEPROFARM MPI dan Penta Valen Cefpirome sulfate Injeksi 1 gram Vial 582,600.00 58,260.00 20.00 46,608.00 466,080.00
10

139 CEFTAZIDIME Inj 1 g (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ceftazidime Injeksi 1g Vial 600,000.00 60,000.00 82.00 10,800.00 108,000.00
10

140 CEFTAZIDIME Dry Inj 1 g (NP) NOVELL PT. Antarmitra Sembada Ceftazidime Injeksi 1g Vial 41,500.00 41,500.00 30.00 29,050.00 29,050.00
1

141 CEFTIZOXIME Dry Inj 1 g (NP) NOVELL PT. Antarmitra Sembada Ceftizoxime Injeksi 1g Vial 200,000.00 100,000.00 30.00 70,000.00 140,000.00

142 CEFTRIAXON Inj 1 g (DM) DEXA MEDICA PT. Anugrah Argon Medica Ceftriaxone Injeksi 1g Vial 78,127.00 7,812.70 60.00 3,125.08 31,250.80
10

143 CEFTRIAXONE Inj 1 g (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Ceftriaxone Injeksi 1g Vial 20,000.00 10,000.00 65.00 3,500.00 7,000.00
2

144 CEFTRIAXON Inj 1 g (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ceftriaxone Injeksi 1g Vial 3,500,000.00 35,000.00 89.00 3,850.00 385,000.00
100

145 CEFUROXIME Inj 750 mg (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Cefuroxime 750 mg Injeksi 750 mg Vial 80,000.00 40,000.00 35.00 26,000.00 52,000.00
2

146 CELECOXIB Kaps 100 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Celecoxib Kapsul 100 mg Kapsul 150,000.00 3,000.00 35.00 1,950.00 97,500.00
50

147 CELECOXIB Kaps 100 mg (NP) Celecoxib Kapsul 100 mg Kapsul 100,000.00 3,333.33 20.00 2,666.67 80,000.00
NOVELL PT. Antarmitra Sembada 30

148 CELECOXIB Kaps 200 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Celecoxib Kapsul 200 mg Kapsul 250,000.00 5,000.00 35.00 3,250.00 162,500.00
50

149 CELECOXIB Kaps 200 mg (NP) Celecoxib Kapsul 200 mg Kapsul 150,000.00 5,000.00 20.00 4,000.00 120,000.00
NOVELL PT. Antarmitra Sembada 30

150 CELECOXIB Tab 100 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Celecoxib Tablet 100 mg Tablet 150,000.00 3,000.00 10.00 2,700.00 135,000.00
50

151 CELECOXIB Tab 200 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Celecoxib Tablet 200 mg Tablet 250,000.00 5,000.00 10.00 4,500.00 225,000.00
50

152 CEPHALEXIN Kaps 500 mg (IF) INDOFARMA PT. Indofarma Global Medika Cephalexin Kapsul 500 mg Kapsul 65,000.00 1,300.00 10.00 1,170.00 58,500.00
50

153 CETIRIZINE Tab 10 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Cetirizine Kaplet 10 mg Tablet 28,500.00 285.00 70.00 85.50 8,550.00
100
 Halaman 4 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

154 CETIRIZIN Tab 10 mg (PR) PHAPROS PT. Rajawali Nusindo Cetirizine Kaplet 10 mg Tablet 7,500.00 150.00 50.00 75.00 3,750.00
50

155 CETIRIZINE Syr 5 mg/5 ml (ID) IMFARMIND INDUSTRI PT. Indofarma Global Medika Cetirizine Sirup 5 mg / 5ml Botol 12,825.00 12,825.00 75.00 3,206.25 3,206.25
1

156 CETIRIZINE Syr 5 mg/5 ml (PN) FAHRENHEIT PT. Kebayoran Farma Cetirizine Sirup 5 mg / 5ml Botol 9,490.00 9,490.00 25.00 7,117.50 7,117.50
1

157 CETIRIZINE Tab 10 mg (ID) IMFARMIND INDUSTRI PT. Indofarma Global Medika Cetirizine Tablet 10 mg Tablet 23,836.00 238.36 66.00 81.04 8,104.24
100

158 CHLORAMPHENICOL Kaps 250 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Chloramphenicole Kapsul 250 mg Kapsul 60,000.00 600.00 35.00 390.00 39,000.00
100

159 CHLORAMPENICOL Kaps 250 mg (PR) PHAPROS PT. Rajawali Nusindo Chloramphenicole Kapsul 250 mg Kapsul 55,000.00 550.00 20.00 440.00 44,000.00
100

160 CHLORAMPHENICOL PALMITATE Suspensi 125 mg/5 ml (MM) PT MEPROFARM MPI dan Penta Valen Chloramphenicole Suspensi 125 mg/5 ml Botol 5,550.00 5,550.00 10.00 4,995.00 4,995.00
1

161 CHLORPHENIRAMINE MALEAT (CTM) Tab 4 mg (PR) PHAPROS PT. Rajawali Nusindo Chlorpheniramine Maleate Tablet 4 mg Tablet 14,000.00 140.00 25.00 105.00 10,500.00
100

162 CHLORPROMAZINE Inj 25 mg/ml (PR) PHAPROS PT. Rajawali Nusindo Chlorpromazine Injeksi 25 mg / ml Ampul 52,500.00 1,750.00 10.00 1,575.00 47,250.00
30

163 CHLORPROMAZINE Inj 5 mg/ml (PR) PHAPROS PT. Rajawali Nusindo Chlorpromazine Injeksi 5 mg / ml Ampul 60,000.00 2,000.00 10.00 1,800.00 54,000.00
30

164 CHLORPROMAZINE Tab 100 mg (PR) PHAPROS PT. Rajawali Nusindo Chlorpromazine Tablet 100 mg Tablet 40,000.00 400.00 10.00 360.00 36,000.00
100

165 CHLORPROMAZINE Tab 25 mg (PR) PHAPROS PT. Rajawali Nusindo Chlorpromazine Tablet 25 mg Tablet 20,000.00 200.00 10.00 180.00 18,000.00
100

166 CIPROFLOXACIN Infus 200 mg/100 ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ciprofloxacin Infus 200 mg / 100 ml Botol 70,000.00 70,000.00 87.00 9,100.00 9,100.00
1

167 CIPROFLOXACIN Infus 200 mg/100 ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Ciprofloxacin Infus 200 mg / 100 ml Botol 26,000.00 26,000.00 57.00 11,180.00 11,180.00
1

168 CIPROFLOXACIN Infus 200 mg/100 ml (PR) PHAPROS PT. Rajawali Nusindo Ciprofloxacin Infus 200 mg / 100 ml Botol 37,500.00 37,500.00 35.00 24,375.00 24,375.00
1

169 CIPROFLOXACIN Tab 500 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ciprofloxacin Tablet 500 mg Tablet 70,000.00 700.00 61.00 273.00 27,300.00
100

170 CIPROFLOXACIN Tab 500 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Ciprofloxacin Tablet 500 mg Tablet 43,000.00 430.00 35.00 279.50 27,950.00
100
PT. Penta Valent
PROMEDRAHARDJO FARMASI INDUSTRI
171 CIPROFLOXACIN FC Tab 500 mg (PM) PT. Millenium Pharmacon International Tbk Ciprofloxacin Tablet 500 mg Tablet 60,000.00 600.00 25.00 450.00 45,000.00
OGB 100
PT. Merapi Utama Pharma
172 CISAPRIDE Tab 5 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Cisapride Tablet 5 mg Tablet 68,705.00 687.05 10.00 618.35 61,834.50
100

173 CITICHOLINE Inj 125 mg/ml (PR) PHAPROS PT. Rajawali Nusindo Citicholine Injeksi 125 mg / ml Ampul 37,500.00 7,500.00 50.00 3,750.00 18,750.00
5

174 CITICOLIN Inj 125 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Citicholine Injeksi 125 mg / ml Ampul 150,000.00 15,000.00 30.00 10,500.00 105,000.00
10

175 CITICOLIN Inj 250 mg/2 ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Citicholine Injeksi 250 mg / 2 ml Ampul 225,000.00 22,500.00 81.70 4,117.50 41,175.00
10

176 CITICOLINE Inj 250 mg/2 ml (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Citicholine Injeksi 250 mg / 2 ml Ampul 75,000.00 7,500.00 45.00 4,125.00 41,250.00
10

177 CITICOLINE Inj 500 mg/4 ml (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Citicholine Injeksi 500 mg / 4 ml Ampul 150,000.00 15,000.00 45.00 8,250.00 82,500.00
10

178 CITICHOLINE Inj 500 mg/4 ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Citicholine Injeksi 500 mg / 4 ml Ampul 109,091.00 21,818.20 60.00 8,727.28 43,636.40
5

179 CITICOLINE Kapl 500 mg (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Citicholine Kaplet 500 mg Kaplet 180,000.00 6,000.00 50.00 3,000.00 90,000.00
30

180 CITICOLINE Kaps 1000 mg (NP) NOVELL PT. Antarmitra Sembada Citicholine Kapsul 1000 mg Kapsul 262,500.00 8,750.00 25.00 6,562.50 196,875.00
30

181 CITICHOLINE Tab 500 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Citicholine Tablet 500 mg Tablet 500,000.00 5,000.00 46.00 2,700.00 270,000.00
100

182 CITICOLINE MPL Tab 500 mg (ML) MEDIKON PT. Surya Prima Perkasa, PT. Merapi Utama Pharma, PT. Dos Ni Roha Citicholine Tablet 500 mg Tablet 208,000.00 6,933.33 55.00 3,120.00 93,600.00
30

183 CLARITHROMYCIN Kapl 500 mg (NP) NOVELL PT. Antarmitra Sembada Clarithromycin Kaplet 500 mg Kaplet 210,000.00 7,000.00 30.00 4,900.00 147,000.00
30

184 CLINDAMYCIN Kaps 150 mg (IF) INDOFARMA PT. Indofarma Global Medika Clindamycin Kapsul 150 mg Kapsul 31,920.00 638.40 7.50 590.52 29,526.00
50

185 CLINDAMYCIN Kaps 150 mg (NP) NOVELL PT. Antarmitra Sembada Clindamycin Kapsul 150 mg Kapsul 36,200.00 724.00 15.00 615.40 30,770.00
50

186 CLINDAMYCIN Kaps 300 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Clindamycin Kapsul 300 mg Kapsul 181,818.00 1,818.18 49.00 927.27 92,727.18
100

187 CLINDAMYCIN Kaps 300 mg (IF) INDOFARMA PT. Indofarma Global Medika Clindamycin Kapsul 300 mg Kapsul 65,000.00 1,300.00 20.00 1,040.00 52,000.00
50

188 CLINDAMYCIN Kaps 300 mg (NP) NOVELL PT. Antarmitra Sembada Clindamycin Kapsul 300 mg Kapsul 62,520.00 1,250.40 15.00 1,062.84 53,142.00
50

189 CLOMIPHENE CITRATE Tab 50 mg (NP) NOVELL PT. Antarmitra Sembada Clomiphen Citrate Tablet 50 mg Tablet 173,250.00 5,775.00 35.00 3,753.75 112,612.50
30

190 CLONIDINE Tab 0,15 mg (IF) INDOFARMA PT. Indofarma Global Medika Clonidine Tablet 150 mcg Tablet 24,200.00 242.00 20.00 193.60 19,360.00
100

191 CLOPIDOGREL Kapl 75 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Clopidogrel Kaplet 75 mg Kapsul 251,500.00 5,030.00 88.00 603.60 30,180.00
50

192 CLOPIDOGREL Tab 75 mg (PR) PHAPROS PT. Rajawali Nusindo Clopidogrel Tablet 75 mg Tablet 18,000.00 600.00 10.00 540.00 16,200.00
30

193 CLOZAPINE Tab 100 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Clozapine Tablet 100 mg Tablet 284,091.00 5,681.82 84.05 906.36 45,318.18 YA
50

194 CLOZAPINE Tab 100 mg (MT) MERSIFARMA PT. Merapi Utama Pharma Clozapine Tablet 100 mg Tablet 52,000.00 1,040.00 5.00 988.00 49,400.00
50

195 CLOZAPINE Tab 25 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Clozapine Tablet 25 mg Tablet 88,068.00 1,761.36 75.59 430.00 21,500.00 YA
50

196 CLOZAPIN Tab 25 mg (IP) IKAPHARMINDO PUTRAMAS PT. Distriversa Buanamas Clozapine Tablet 25 mg Tablet 140,000.00 2,800.00 33.00 1,876.00 93,800.00
50

197 COLCHISIN Tab 0.5 mg (CB) COMBIPHAR PT. Anugerah Pharmindo Lestari Colchisin Tablet 0,5mg Tablet 70,000.00 2,333.33 25.00 1,750.00 52,500.00
30

198 DESLORATADINE Tab 5 mg (NP) Desloratadine tablet 5 mg tablet 90,000.00 3,000.00 15.00 2,550.00 76,500.00
NOVELL PT. Antarmitra Sembada 30

199 DESOXIMETHASONE Cream 0.25% 15 g (DM) DEXA MEDICA PT. Anugrah Argon Medica Desoximetason Krim 0,25% 15 g Tube 145,200.00 12,100.00 34.64 7,909.09 94,909.09 YA
12

200 DESOXIMETASON Krim 2,5 mgml (CB) COMBIPHAR PT. Anugerah Pharmindo Lestari Desoximetason Krim 2,5gr/mg Tube 9,200.00 9,200.00 10.00 8,280.00 8,280.00 YA
1

201 DEXAMETHASONE Inj 5 mg/ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Dexamethason Injeksi 5 mg / ml Ampul 218,400.00 2,184.00 55.00 982.80 98,280.00
100

202 DEKSAMETASON Inj 5 mg/ml (HR) HARSEN LABORATORIES PT Kimia Farma Dexamethason Injeksi 5 mg / ml Ampul 24,750.00 4,950.00 15.00 4,207.50 21,037.50
5

203 DEXAMETHASONE SODIUM PHOSPATE Inj (MM) PT MEPROFARM MPI dan Penta Valen Dexamethason Injeksi 5 mg/ml Ampul 30,320.00 3,032.00 55.00 1,364.40 13,644.00
10

204 DEXAMETHASONE Tab 0,5 mg (MA) MOLEX AYUS PT. Mensa Bina Sukses Dexamethason Tablet 0.5 mg Tablet 7,000.00 70.00 35.00 45.50 4,550.00
100
PT. Penta Valent
PROMEDRAHARDJO FARMASI INDUSTRI
205 DEXAMETHASONE Tab 0,5 mg (PM) PT. Millenium Pharmacon International Tbk Dexamethason Tablet 0.5 mg Tablet 16,000.00 160.00 47.00 84.80 8,480.00
OGB 100
PT. Merapi Utama Pharma
 Halaman 5 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

206 DEXAMETHAZON Tab 0,5 mg (PR) PHAPROS PT. Rajawali Nusindo Dexamethason Tablet 0.5 mg Tablet 12,500.00 125.00 25.00 93.75 9,375.00
100

207 DEXKETOPROFEN TROMETAMOL GENERIC (DV) DARYA VARIA PT. Anugerah Pharmindo Lestari Dexketoprofen trometamol Injeksi 25 mg/ml Vial 60,000.00 12,000.00 27.50 8,700.00 43,500.00
5

208 DEXKETOPROFEN Tab 25 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Dexketoprofen trometamol Tablet 25 mg Tablet 300,000.00 3,000.00 40.00 1,800.00 180,000.00
100

209 DEXKETOPROFEN TROMETAMOL Inj 25 mg/ml (IT) INTERBAT PT. Mensa Bina Sukses, PT. Enseval Megatrading dexketoprofen trometamol Injeksi 25 mg/ml Ampul 75,000.00 15,000.00 45.00 8,250.00 41,250.00
5

210 DEXKETOPROFEN TROMETAMOL Tab 25 mg (IT) INTERBAT PT. Mensa Bina Sukses, PT. Enseval Megatrading dexketoprofen trometamol Tablet 25 mg Tablet 125,000.00 2,500.00 45.00 1,375.00 68,750.00
50

211 DEXTROSE 5% SODIUM CHLORIDE 0.45% Infus (MH) EMJEBE PT. Kimia Farma Trading & Distribution Dextrose NaCl Cairan Infus 500 ml Botol Err:522 Err:522 7.00 Err:522 Err:522
20
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
212 DEXTROSE Infus 10% 500 ml (SR) SATORIA Dextrose Cairan Infus 10% 500 ml Botol 130,900.00 6,545.00 0.00 6,545.00 130,900.00 YA
Perusahaan Perdagangan Indonesia 20

213 GLUKOSA INFUS 10 % (WB) WIDATRA BHAKTI PT. Merapi Utama Pharma Dextrose Cairan Infus 10% 500 ml Plabot Err:522 Err:522 0.00 Err:522 Err:522 YA
20
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
214 DEXTROSE Infus 5% 100 ml (SR) SATORIA Dextrose Cairan Infus 5% 100 ml Botol 232,727.27 5,818.18 5.00 5,527.27 221,090.91
Perusahaan Perdagangan Indonesia 40
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
215 DEXTROSE Infus 5% 250 ml (SR) SATORIA Dextrose Cairan Infus 5% 250 ml Botol 272,727.27 6,818.18 5.00 6,477.27 259,090.91
Perusahaan Perdagangan Indonesia 40

216 GLUKOSA Infus 5 % (WB) WIDATRA BHAKTI PT. Merapi Utama Pharma Dextrose Cairan Infus 5% 500 ml Plabot Err:522 Err:522 0.00 Err:522 Err:522 YA
20
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
217 DEXTROSE Infus 5% 500 ml (SR) SATORIA Dextrose Cairan Infus 5% 500 ml Botol 120,500.00 6,025.00 0.00 6,025.00 120,500.00 YA
Perusahaan Perdagangan Indonesia 20

218 D5 Infus 500 ml (MH) EMJEBE PT. Kimia Farma Trading & Distribution Dextrose Cairan Infus 5% 500 ml Plabot Err:522 Err:522 5.00 Err:522 Err:522 Ya
20
Dextrose monohydrate 22 g ~ Dextrose
219 WIDA KDN-1 WIDATRA BHAKTI PT. Merapi Utama Pharma anhydrate 20 g; Potassium chloride 0.75 g; Cairan Infus Plabot Err:522 Err:522 25.00 Err:522 Err:522
Sodium chloride 0.9 g 22 g ~ Dextrose 20
Dextrose monohydrate
220 WIDA KDN-2 WIDATRA BHAKTI PT. Merapi Utama Pharma anhydrate 20 g; Potassium chloride 1.5 g; Cairan Infus Plabot Err:522 Err:522 25.00 Err:522 Err:522
Sodium chloride 0.9 g 20

221 DIAZEPAM ENEMA 10 mg/2,5 ml (NP) Diazepam enama 10 mg/2,5 ml enema 100,000.00 20,000.00 25.00 15,000.00 75,000.00
NOVELL PT. Antarmitra Sembada 5

222 DIAZEPAM ENEMA 5 MG/2,5 ML Diazepam enama 5 mg/2,5 ml enema 60,000.00 12,000.00 20.00 9,600.00 48,000.00
NOVELL PT. Antarmitra Sembada 5

223 DIAZEPAM Tab 2 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Diazepam Tablet 2 mg Tablet 6,364.00 63.64 0.00 63.64 6,364.00 YA
100

224 DICLOFENAC DIETHYLAMINE Gel 20 g((NP) Diclofenac Diethylamine gel 20 g Tube 9,000.00 9,000.00 15.00 7,650.00 7,650.00
NOVELL PT. Antarmitra Sembada 1

225 DICLOFENAC DIETHYLAMINE Gel 50 g (NP) Diclofenac Diethylamine gel 50 g Tube 25,000.00 25,000.00 15.00 21,250.00 21,250.00
NOVELL PT. Antarmitra Sembada 1

226 DICLOFENAC POTASSIUM Tab 50 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Diclofenac Kalium Tablet 50 mg Tablet 60,000.00 600.00 42.00 348.00 34,800.00
100

227 DICLOFENAC POTASSIUM Tab 50 mg (NP) NOVELL PT. Antarmitra Sembada Diclofenac Kalium Tablet 50 mg Tablet 32,183.00 643.66 45.00 354.01 17,700.65
50

228 DICLOFENAC POTASSIUM Tab 50 mg (ML) MEDIKON PT. Surya Prima Perkasa, PT. Merapi Utama Pharma, PT. Dos Ni Roha Diclofenac Kalium Tablet 50 mg Tablet 25,525.00 510.50 25.00 382.88 19,143.75
50

229 NATRIUM DIKLOFENAK Tab 25 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Diclofenac Na Tablet 25 mg Tablet 5,227.00 104.54 0.00 104.54 5,227.00 YA
50

230 NATRIUM DIKLOFENAK Tab 50 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Diclofenac Na Tablet 50 mg Tablet 4,500.00 90.00 0.00 90.00 4,500.00 YA
50
Tablet Salut
231 DICLOFENAC SODIUM ENTERIC COATED Tab 50 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Diclofenac Na 50 mg Tablet 20,000.00 200.00 50.00 100.00 10,000.00
Selaput 100

232 DIGOXIN Tab 0,25 mg (PN) FAHRENHEIT PT. Kebayoran Farma Digoxin Tablet 0.25 mg Tablet 13,000.00 130.00 22.50 100.75 10,075.00
100

233 DILTIAZEM Tab 30 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Diltiazem HCl Tablet 30 mg Tablet 15,853.00 158.53 26.02 117.27 11,727.27 YA
100

234 DILTIAZEM Tab 30 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Diltiazem HCl Tablet 30 mg Tablet 19,328.00 193.28 7.50 178.78 17,878.40
100

235 DIVALPROEX SODIUM Kapl 250 mg (YN) YARINDO PT. Kebayoran Farma ,PT PARIT PADANG Divalproat Na Kaplet 250mg Kaplet 84,000.00 2,800.00 30.00 1,960.00 58,800.00
30

236 DIVALPROEX SODIUM Kapl 500 mg (YN) YARINDO PT. Kebayoran Farma ,PT PARIT PADANG Divalproat Na Kaplet 500mg Kaplet 210,000.00 7,000.00 30.00 4,900.00 147,000.00
30

237 DOBUTAMINE Inj 50 mg (LS) LANDSON PT. Mensa Bina Sukses Dobutamine Injeksi 250 mg / 5 ml Ampul 140,000.00 28,000.00 28.57 20,000.40 100,002.00
5

238 DOBUTAMINE Inj 250 mg/5 ml (NP) NOVELL PT. Antarmitra Sembada Dobutamine Injeksi 250 mg / 5 ml Vial 37,100.00 37,100.00 30.00 25,970.00 25,970.00
1

239 DOCETAXEL TRIHYDRATE Inj 20 mg (FE) FERRON PAR PHARMACEUTICALS PT. Anugrah Argon Medica Docetaxel Injeksi 20 mg Vial 610,000.00 610,000.00 74.28 156,892.00 156,892.00
1

240 DOMPERIDONE Syr 5 mg/5 ml 60 ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Domperidon Sirup 5 mg / 5 ml 60 ml Botol 11,500.00 11,500.00 5.00 10,925.00 10,925.00
1

241 DOMPERIDON Maleat Syr 5 mg/5 ml (GF) GRAHA FARMA PT. Indofarma Global Medika Domperidon Sirup 5 mg/5ml 30 ml Botol 2,409.00 2,409.00 10.00 2,168.10 2,168.10
1

242 DOMPERIDONE Tab 10 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Domperidon Tablet 10 mg Kaplet 26,000.00 260.00 40.00 156.00 15,600.00
100

243 DOMPERIDON Tab 10 mg (IF) INDOFARMA PT. Indofarma Global Medika Domperidon Tablet 10 mg Tablet 36,656.24 366.56 45.00 201.61 20,160.93
100

244 DOMPERIDONE Tab 10 mg (NP) NOVELL PT. Antarmitra Sembada Domperidon Tablet 10 mg Tablet 18,346.00 366.92 45.00 201.81 10,090.30
50

245 DONEPEZIL HCL Tab 5 mg (NP) NOVELL PT. Antarmitra Sembada Donepezil Tablet 5 mg Tablet 180,000.00 6,000.00 40.00 3,600.00 108,000.00
30

246 DORIPENEM MONOHYDRATE Infus 500 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Doripenem Infus 500 mg Botol 400,000.00 400,000.00 35.00 260,000.00 260,000.00
1

247 DORIPENEM IV Inj 500 mg (DV) DARYA VARIA PT. Anugerah Pharmindo Lestari Doripenem Injeksi 500 mg Vial 300,000.00 300,000.00 32.50 202,500.00 202,500.00
1

248 DORIPENEM Inj 500 mg (YN) YARINDO PT. Kebayoran Farma ,PT PARIT PADANG Doripenem Injeksi 500 mg Vial 800,000.00 400,000.00 30.00 280,000.00 560,000.00
2

249 DOXYCYCLINE Kaps 100 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Doxycycline Kapsul 100 mg Kapsul 45,747.00 457.47 37.15 287.50 28,750.00 YA
100

250 DUTASTERIDE Tab 0,5 mg (NP) Dutasteride Kapsul 0,5 mg Kapsul 150,000.00 5,000.00 30.00 3,500.00 105,000.00
NOVELL PT. Antarmitra Sembada 30

251 ECHINACEA MPL Kapl 500 mg (ML) MEDIKON PT. Surya Prima Perkasa, PT. Merapi Utama Pharma, PT. Dos Ni Roha Echinacea Purpurea Extract 500 mg Kaplet 500 mg Kaplet 70,500.00 2,350.00 35.00 1,527.50 45,825.00
30

252 ENTECAVIR MONOHYDRATE Tab 0.5 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Entecavir Monohydrate Tablet 0.5 mg Tablet 300,000.00 10,000.00 10.00 9,000.00 270,000.00 Ya
30

253 EPERISONE Tab 50 mg (ML) MEDIKON PT. Surya Prima Perkasa, PT. Merapi Utama Pharma, PT. Dos Ni Roha Eperison Hcl Tablet 50 mg Tablet 141,900.00 1,419.00 45.00 780.45 78,045.00
100

254 EPHEDRIN HCL Inj 50 mg/ml (EI) ETHICA INDUSTRI FARMASI PT. Anugerah Pharmindo Lestari Ephedrin HCL Injeksi 50 mg / ml Ampul 500,000.00 50,000.00 52.50 23,750.00 237,500.00
10

255 EPINEPHRINE Inj 1 mg/ml (EI) ETHICA INDUSTRI FARMASI PT. Anugerah Pharmindo Lestari Epinephrine Injeksi 1 mg / ml Ampul 863,636.00 8,636.36 30.00 6,045.45 604,545.20
100

256 EPIRUBICIN HCI Inj 10 mg (FE) FERRON PAR PHARMACEUTICALS PT. Anugrah Argon Medica Epirubicin Injeksi 10 mg Vial 150,000.00 150,000.00 49.44 75,840.00 75,840.00
1

257 EPIRUBICIN HCI Inj 50 mg (FE) FERRON PAR PHARMACEUTICALS PT. Anugrah Argon Medica Epirubicin Injeksi 50 mg Vial 720,000.00 720,000.00 47.95 374,760.00 374,760.00
1
 Halaman 6 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

258 ERDOSTEINE Dry Syr 175 mg/5 ml (NP) NOVELL PT. Antarmitra Sembada Erdosteine Sirup Kering 175 mg / 5 ml Botol 28,000.00 28,000.00 25.00 21,000.00 21,000.00
1

259 ERDOSTEINE Tab 300 mg (NP) NOVELL PT. Antarmitra Sembada Erdosteine Tablet 300 mg Tablet 54,000.00 2,700.00 25.00 2,025.00 40,500.00
20

260 ERYTHROMYCIN Dry Syr 200 mg/5 ml (IF) INDOFARMA PT. Indofarma Global Medika Erythromycin 200 mg/5 ml Sirup Kering 200 mg / 5 ml Botol 12,000.00 12,000.00 12.50 10,500.00 10,500.00
1

261 ERYTHROMYCIN Syr 200 mg/5 ml (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Erythromycin 200 mg/5 ml Sirup Kering 200 mg/5 ml Botol 12,223.00 12,223.00 5.00 11,611.85 11,611.85
1

262 ESOMEPRAZOLE SODIUM Inj 40 mg (MM) PT MEPROFARM MPI dan Penta Valen Esomeprazole Injeksi 40 mg Vial 116,364.00 58,182.00 50.00 29,091.00 58,182.00
2

263 ESOMEPRAZOLE Inj 40 mg/ml (OT) OTTO OGB PT. Mensa Bina Sukses Esomeprazole Injeksi 40 mg / ml Vial 60,000.00 60,000.00 55.00 27,000.00 27,000.00
1

264 ESOMEPRAZOLE Tab 20 mg (NP) Esomeprazole tablet 20 mg Tablet 240,000.00 8,000.00 20.00 6,400.00 192,000.00
NOVELL PT. Antarmitra Sembada 30

265 ESOMEPRAZOLE Tab 40 mg (NP) Esomeprazole tablet 40 mg Tablet 300,000.00 10,000.00 20.00 8,000.00 240,000.00
NOVELL PT. Antarmitra Sembada 30

266 ETHAMBUTOL Tab 500 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Ethambutol 500 Tablet 500 mg Tablet 75,230.00 752.30 15.00 639.45 63,945.50
100

267 ETHAMBUTOL Tab 500 mg (IF) INDOFARMA PT. Indofarma Global Medika Ethambutol 500 Tablet 500 mg Tablet 80,000.00 800.00 5.00 760.00 76,000.00
100

268 ETORICOXIB Tab 120 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Etoricoxib Tablet 120 mg Tablet 165,840.00 5,528.00 20.00 4,422.40 132,672.00
30

269 ETORICOXIB Tab 120 mg (NP) Etoricoxib tablet 120 mg Tablet 195,000.00 6,500.00 20.00 5,200.00 156,000.00
NOVELL PT. Antarmitra Sembada 30

270 ETORICOXIB Tab 60 mg (NP) Etoricoxib tablet 60 mg tablet 105,000.00 3,500.00 20.00 2,800.00 84,000.00
NOVELL PT. Antarmitra Sembada 30

271 ETORICOXIB Tab 60 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Etoricoxib Tablet 60 mg Tablet 105,840.00 3,528.00 20.00 2,822.40 84,672.00
30

272 ETORICOXIB Tab 90 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Etoricoxib Tablet 90 mg Tablet 135,840.00 4,528.00 20.00 3,622.40 108,672.00
30

273 ETORICOXIB Tab 90 mg (NP) Etoricoxib Tablet 90 mg Tablet 150,000.00 5,000.00 20.00 4,000.00 120,000.00
NOVELL PT. Antarmitra Sembada 30

274 FENOFIBRATE Kaps 300 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Fenofibrate Kapsul 300 mg Kapsul 120,000.00 4,000.00 70.00 1,200.00 36,000.00 Ya
30

275 FENOFIBRATE Kaps 100 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Fenofibrate Kapsul 100 mg Kapsul 60,000.00 2,000.00 60.00 800.00 24,000.00 Ya
30

276 FENOFIBRATE Kapl 200 mg (ML) MEDIKON PT. Surya Prima Perkasa, PT. Merapi Utama Pharma, PT. Dos Ni Roha Fenofibrate Kapsul 200 mg Kaplet 172,000.00 4,300.00 50.00 2,150.00 86,000.00
40

277 FENOFIBRATE Tab 100 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Fenofibrate Tablet 100 mg Tablet 100,000.00 2,000.00 78.50 430.00 21,500.00 YA
50

278 FENTANYL Inj 0,1 mg/2 ml (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Fentanyl Citrate Injeksi 0,1 mg/2 ml Ampul 170,000.00 34,000.00 0.00 34,000.00 170,000.00
5

279 FENTANYL Inj 0,5 mg/10 ml (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Fentanyl Citrate Injeksi 0,5 mg/10 ml Ampul 270,000.00 135,000.00 0.00 135,000.00 270,000.00
2

280 TABLET TAMBAH DARAH NEO-DUS Tab (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Ferrous Fumarate setara dengan Fe elemen Asam Folat Tablet 60 mg Tablet 20,545.00 205.45 0.00 205.45 20,545.00 YA
100

281 TAB TAMBAH DARAH WHO (PR) PHAPROS PT. Rajawali Nusindo Ferrous Fumarate setara dengan Fe elemen Asam Folat Tablet 60 mg Tablet 26,500.00 265.00 15.00 225.25 22,525.00
100

282 FLUCONAZOLE Infus 2 mg/ml (DM) DEXA MEDICA PT. Anugrah Argon Medica Fluconazole Infus 200 mg / 100 ml Botol 65,000.00 65,000.00 81.18 12,230.00 12,230.00 YA
1

283 FLUCONAZOLE Infus 200 mg/100 ml (NP) NOVELL PT. Antarmitra Sembada Fluconazole Infus 200 mg / 100 ml Botol 105,000.00 105,000.00 67.00 34,650.00 34,650.00
1

284 FLUCONAZOLE Kaps 150 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Fluconazole Kapsul 150 mg Kapsul 220,000.00 22,000.00 40.00 13,200.00 132,000.00
10

285 FLUNARIZIN Tab 5 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Flunarizine 5 mg Tablet 5 mg Tablet 200,000.00 2,000.00 59.00 820.00 82,000.00
100

286 FOSFOMYCIN SODIUM Serbuk Inj 1 g (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Fosfomycin Na Injeksi 1g Vial 72,500.00 72,500.00 40.00 43,500.00 43,500.00
1

287 FOSFOMYCIN SODIUM Serbuk Inj 2 g (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Fosfomycin Na Serbuk Injeksi 2 gr Vial 136,000.00 136,000.00 35.00 88,400.00 88,400.00
1

288 FUROSEMIDE Inj 10 mg/ml (DM) DEXA MEDICA PT. Anugrah Argon Medica Furosemide Injeksi 10 mg/ml Ampul 80,500.00 3,220.00 73.94 839.09 20,977.27 YA
25

289 FUROSEMIDE Tab 40 mg (PN) FAHRENHEIT PT. Kebayoran Farma Furosemide Tablet 40 mg Tablet 20,000.00 200.00 12.50 175.00 17,500.00
100

290 FUROSEMIDE Tab 40 mg (IF) INDOFARMA PT. Indofarma Global Medika Furosemide Tablet 40 mg Tablet 22,000.00 220.00 15.00 187.00 18,700.00
100

291 GABAPENTIN Kaps 100 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Gabapentin Kapsul 100 mg Kapsul 60,000.00 2,000.00 45.00 1,100.00 33,000.00
30

292 GABAPENTIN Kaps 300 mg (MT) MERSIFARMA PT. Merapi Utama Pharma Gabapentin Kapsul 300 mg Kapsul 118,000.00 2,360.00 30.00 1,652.00 82,600.00
50

293 GABAPENTIN Kaps 300 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Gabapentin Kapsul 300 mg Kapsul 150,000.00 5,000.00 57.50 2,125.00 63,750.00
30

294 GABAPENTIN Kaps 300 mg (OT) OTTO OGB PT. Mensa Bina Sukses Gabapentin Kapsul 300 mg Kapsul 225,000.00 4,500.00 35.00 2,925.00 146,250.00
50

295 GENTAMICIN SULFATE Krim 5 g (MA) MOLEX AYUS PT. Mensa Bina Sukses Gentamicine Sulfate Krim 1 mg Tube 2,100.00 2,100.00 20.00 1,680.00 1,680.00
1

296 GLIBENCLAMIDE Tab 5 mg (IF) INDOFARMA PT. Indofarma Global Medika Glibenclamide Tablet 5 mg Tablet 13,885.00 138.85 15.00 118.02 11,802.25
100

297 GLICLAZIDE Tab 80 mg (TP) TEMPO RX FARMA PT. Tempo Gliclazide 80 mg Tablet 80 mg Botol Err:522 Err:522 0.00 Err:522 Err:522
50

298 GLIMEPIRIDE Tab 1 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Glimepiride Tablet 1 mg Tablet 44,000.00 440.00 65.00 154.00 15,400.00
100

299 GLIMEPIRIDE Tab 1 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Glimepiride Tablet 1 mg Tablet 18,000.00 360.00 37.50 225.00 11,250.00
50

300 GLIMEPIRIDE Tab 1 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Glimepiride Tablet 1 mg Tablet 34,549.00 690.98 60.00 276.39 13,819.60
50

301 GLIMEPIRIDE Tab 2 mg (PR) PHAPROS PT. Rajawali Nusindo Glimepiride Tablet 2 mg Tablet 10,000.00 200.00 25.00 150.00 7,500.00
50

302 GLIMEPIRIDE Tab 2 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Glimepiride Tablet 2 mg Tablet 130,298.00 1,302.98 80.00 260.60 26,059.60
100

303 GLIMEPIRIDE Tab 2 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Glimepiride Tablet 2 mg Tablet 80,000.00 800.00 80.00 160.00 16,000.00
100

304 GLIMEPIRIDE Tab 3 mg (LS) LANDSON PT. Mensa Bina Sukses Glimepiride Tablet 3 mg Tablet 95,000.00 1,900.00 77.00 437.00 21,850.00
50

305 GLIMEPIRIDE Tab 3 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Glimepiride Tablet 3 mg Tablet 120,000.00 1,200.00 75.00 300.00 30,000.00
100

306 GLIMEPIRIDE Tab 3 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Glimepiride Tablet 3 mg Tablet 35,000.00 700.00 55.00 315.00 15,750.00
50

307 GLIMEPIRIDE Tab 4 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Glimepiride Tablet 4 mg Tablet 160,000.00 1,600.00 80.00 320.00 32,000.00
100

308 GLIMEPIRIDE Tab 4 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Glimepiride Tablet 4 mg Tablet 284,294.00 2,842.94 75.00 710.74 71,073.50
100

309 GLIMEPIRIDE Tab 4 mg (IF) INDOFARMA PT. Indofarma Global Medika Glimepiride Tablet 4 mg Tablet 130,168.00 2,603.36 65.00 911.18 45,558.80
50
 Halaman 7 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

310 GLYCERYL GUAIACOLAT Tab 100 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Glyceryl guaiacolate Tablet 100 mg Tablet 20,000.00 200.00 25.00 150.00 15,000.00
100

311 GRANISETRON Inj 1 mg (NP) NOVELL PT. Antarmitra Sembada Granisetron Injeksi 1 mg / ml Ampul 50,000.00 10,000.00 20.00 8,000.00 40,000.00
5

312 GRANISETRON Inj 1 mg/ml (OT) OTTO OGB PT. Mensa Bina Sukses Granisetron Injeksi 1 mg / ml Ampul 100,000.00 20,000.00 35.00 13,000.00 65,000.00
5

313 GRANISETRON Inj 3 mg (NP) NOVELL PT. Antarmitra Sembada Granisetron Injeksi 3 mg / ml Ampul 125,000.00 25,000.00 20.00 20,000.00 100,000.00
5

314 GRANISETRON Inj 3 mg/mL (YN) YARINDO PT. Kebayoran Farma ,PT PARIT PADANG Granisetron Injeksi 3 mg / ml Ampul 250,000.00 50,000.00 45.00 27,500.00 137,500.00
5

315 GRANISETRON Inj 3 mg/ml (OT) OTTO OGB PT. Mensa Bina Sukses Granisetron Injeksi 3 mg / ml Ampul 250,000.00 50,000.00 35.00 32,500.00 162,500.00
5

316 GRISEOFULVIN Tab 125 mg (IF) INDOFARMA PT. Indofarma Global Medika Griseofulvin 125 mg Tablet 125 mg Tablet 37,803.83 378.04 20.00 302.43 30,243.06
100

317 HALOPERIDOL Tab 0,5 mg (PN) FAHRENHEIT PT. Kebayoran Farma Haloperidol Tablet 0,5 mg Tablet 8,000.00 80.00 25.00 60.00 6,000.00
100

318 HALOPERIDOL Tab 5 mg (IF) INDOFARMA PT. Indofarma Global Medika Haloperidol Tablet 5 mg Tablet 26,500.00 265.00 15.00 225.25 22,525.00
100

319 HYDROCORTISONE Inj (PN) FAHRENHEIT PT. Kebayoran Farma Hydrocortisone Injeksi 100 mg Ampul 95,000.00 95,000.00 15.00 80,750.00 80,750.00
1

320 HYDROCORTISONE Cream 2,5 % (IF) INDOFARMA PT. Indofarma Global Medika Hydrocortisone Krim 2,5 % Tube 107,144.00 4,464.33 30.00 3,125.03 75,000.80
24

321 HYDROCORTISONE Cream 2.5% (PR) PHAPROS PT. Rajawali Nusindo Hydrocortisone Krim 2,5% Tube 4,150.00 4,150.00 25.00 3,112.50 3,112.50
1

322 HYDROCORTISON Cream 2.5% (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Hydrocortisone Krim 2,5% Tube 144,000.00 6,000.00 30.00 4,200.00 100,800.00
24

323 IBUPROFEN Suspensi 200 mg/5 ml (TP) TEMPO RX FARMA PT. Tempo Ibuprofen Syrup 200 mg/5 ml Botol 3,499.09 3,499.09 0.00 3,499.09 3,499.09
1
PT. Penta Valent
PROMEDRAHARDJO FARMASI INDUSTRI
324 IBUPROFEN FC Tab 400 mg (PM) PT. Millenium Pharmacon International Tbk Ibuprofen Tablet 400 mg Tablet 48,000.00 480.00 33.00 321.60 32,160.00
OGB 100
PT. Merapi Utama Pharma
325 IBUPROFEN Tab 400 mg (PN) FAHRENHEIT PT. Kebayoran Farma Ibuprofen Tablet 400 mg Tablet 35,000.00 350.00 5.00 332.50 33,250.00
100

326 IMIPENEM - CILASTATIN Inj 1 g (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Imipenem Cilastatin Injeksi 1g Vial 180,000.00 180,000.00 45.00 99,000.00 99,000.00
1

327 IMIPENEM CILASTATIN Inj 500 mg (QL) QUANTUM LABS PT. ANUGERAH PHARMINDO LESTARI Imipenem Cilastatin Na Injeksi 500 mg Vial 201,000.00 201,000.00 46.00 108,540.00 108,540.00
1
Inhalasi
328 IPRATROPIUM BROMIDA Inhalasi (PN) FAHRENHEIT PT. Kebayoran Farma Ipratropium 0,25mg/ml Ampul 62,500.00 6,250.00 38.46 3,846.25 38,462.50 YA
Nebulazer 10

329 IRBESARTAN Kapl 150 mg (IF) INDOFARMA PT. Indofarma Global Medika Irbesartan Kaplet 150 mg Kaplet 89,250.00 1,785.00 50.00 892.50 44,625.00
50

330 IRBESARTAN Kapl 300 mg (IF) INDOFARMA PT. Indofarma Global Medika Irbesartan Kaplet 300 mg Kaplet 172,750.00 3,455.00 50.00 1,727.50 86,375.00
50

331 IRBESARTAN Tab 150 mg (LS) LANDSON PT. Mensa Bina Sukses Irbesartan Tablet 150 mg Tablet 53,550.00 1,785.00 49.07 909.10 27,273.02
30

332 IRBESARTAN Tab 150 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Irbesartan Tablet 150 mg Tablet 90,000.00 3,000.00 70.00 900.00 27,000.00
30

333 IRBESARTAN Tab 300 mg (NP) NOVELL PT. Antarmitra Sembada Irbesartan Tablet 300 mg Tablet 69,100.00 3,455.00 57.50 1,468.38 29,367.50
20

334 IRBESARTAN Tab 300 mg (IP) IKAPHARMINDO PUTRAMAS PT. Distriversa Buanamas Irbesartan Tablet 300 mg Tablet 76,350.00 2,545.00 30.00 1,781.50 53,445.00
30

335 IRON SUCROSE Inj 20 mg /ml (NP) NOVELL PT. Antarmitra Sembada Iron Sucrose 20 mg / mL Injeksi 20 mg / mL Ampul 200,000.00 40,000.00 10.00 36,000.00 180,000.00
5

336 ISOFLURANE Sol 100 ml (MT) MERSIFARMA PT. Merapi Utama Pharma Isoflurane Cairan Inhalasi 100ml Botol 407,145.00 407,145.00 20.00 325,716.00 325,716.00
1

337 ISOFLURANESol 250 ml (PN) FAHRENHEIT PT. Kebayoran Farma Isoflurane Cairan inhalasi 250 ml Botol 990,000.00 990,000.00 30.00 693,000.00 693,000.00
1

338 ISOFLURANE Sol 250 ml (MT) MERSIFARMA PT. Merapi Utama Pharma Isoflurane Cairan Inhalasi 250ml Botol 745,651.00 745,651.00 30.00 521,955.70 521,955.70
1

339 ISOSORBIDE DINITRAT Tab 5 mg (PN) FAHRENHEIT PT. Kebayoran Farma Isosorbid Dinitrate Tablet 5 mg Tablet 11,000.00 110.00 20.00 88.00 8,800.00
100

340 ISOSORBIDE DINITRATE Tab 5 mg (IF) INDOFARMA PT. Indofarma Global Medika Isosorbid Dinitrate Tablet 5 mg Tablet 15,000.00 150.00 20.00 120.00 12,000.00
100

341 KETOKONAZOL Cream 2% 10 g (PR) PHAPROS PT. Rajawali Nusindo Ketokonazol Krim 2% 10 g Tube 4,000.00 4,000.00 25.00 3,000.00 3,000.00
1

342 KETOKONAZOL Cream 2% (DM) DEXA MEDICA PT. Anugrah Argon Medica Ketokonazol Krim 2% 10 g Krim 76,364.00 6,363.67 40.00 3,818.20 45,818.40
12

343 KETOCONAZOLE Cream 2% 10 g (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Ketokonazol Krim 2% 10 g Tube 4,242.00 4,242.00 5.00 4,029.90 4,029.90
1

344 KETOKONAZOL Cream 2% 15 g (PR) PHAPROS PT. Rajawali Nusindo Ketokonazol Krim 2% 15 g Tube 6,000.00 6,000.00 25.00 4,500.00 4,500.00
1

345 KETOCONAZOLE Cream 2% 15 g (NP) NOVELL PT. Antarmitra Sembada Ketokonazol Krim 2% 15 g Tube 6,364.00 6,364.00 17.50 5,250.30 5,250.30
1

346 KETOKONAZOL Tab 200 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Ketokonazol Tablet 200 mg Tablet 18,636.00 372.72 6.00 350.36 17,517.84
50
PT. Penta Valent
PROMEDRAHARDJO FARMASI INDUSTRI
347 KETOCONAZOLE Tab 200 mg (PM) PT. Millenium Pharmacon International Tbk Ketokonazol Tablet 200 mg Tablet 45,000.00 900.00 35.00 585.00 29,250.00
OGB 50
PT. Merapi Utama Pharma
348 KETEROLAC TROMETAMOL Inj 30 mg (IT) INTERBAT PT. Mensa Bina Sukses, PT. Enseval Megatrading Ketolorac tromethamine BOX 30 mg/ml Ampul 50,000.00 5,000.00 70.00 1,500.00 15,000.00
10

349 KETOROLAC Inj 10 mg/ml (PR) PHAPROS PT. Rajawali Nusindo Ketolorac tromethamine Injeksi 10 mg / ml Ampul 25,500.00 2,125.00 25.00 1,593.75 19,125.00
12

350 KETOROLAC Inj 10 mg/ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ketolorac tromethamine Injeksi 10 mg / ml Ampul 81,818.00 8,181.80 60.00 3,272.72 32,727.20
10

351 KETOROLAC TROMETAMOL Inj 30 mg/ml (MM) PT MEPROFARM MPI dan Penta Valen Ketolorac tromethamine Injeksi 30 mg/ml Ampul 12,400.00 1,240.00 15.00 1,054.00 10,540.00
10

352 KETOROLAC Inj 30 mg/ml (EI) ETHICA INDUSTRI FARMASI PT. Anugerah Pharmindo Lestari Ketolorac tromethamine Injeksi 30 mg/ml Ampul 120,000.00 1,200.00 5.00 1,140.00 114,000.00
100

353 KETOROLAC Tab 10 mg (NP) NOVELL PT. Antarmitra Sembada Ketolorac tromethamine Tablet 10 mg Tablet 287,000.00 2,870.00 65.00 1,004.50 100,450.00
100

354 KETOROLAC Tab 10 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ketolorac tromethamine Tablet 10 mg Tablet 69,000.00 2,300.00 65.00 805.00 24,150.00
30

355 KETOPROFEN Inj 100 mg/2 ml (NP) NOVELL PT. Antarmitra Sembada Ketoprofen Injeksi 50 mg / ml Ampul 25,682.00 5,136.40 30.00 3,595.48 17,977.40
5

356 KETOPROFEN Tab 100 mg (NP) NOVELL PT. Antarmitra Sembada Ketoprofen Tablet 100 mg Tablet 122,727.00 1,227.27 57.50 521.59 52,158.98
100

357 KETOPROFEN Tab 100 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Ketoprofen Tablet 100 mg Tablet 61,364.00 1,227.28 55.00 552.28 27,613.80
50

358 KETOPROFEN Tab 50 mg (NP) NOVELL PT. Antarmitra Sembada Ketoprofen Tablet 50 mg Tablet 64,000.00 640.00 52.50 304.00 30,400.00
100

359 LACTULOSA Syr 120 ml (IP) IKAPHARMINDO PUTRAMAS PT. Distriversa Buanamas Lactulose Sirup 120 ml Botol 42,000.00 42,000.00 35.00 27,300.00 27,300.00
1

360 LANSOPRAZOLE Kaps 30 mg (NP) NOVELL PT. Antarmitra Sembada Lansoprazole Kapsul 30 mg Kapsul 24,570.00 1,228.50 65.08 428.99 8,579.84
20

361 LANSOPRAZOLE Kaps 30 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Lansoprazole Kapsul 30 mg Kapsul 45,000.00 900.00 50.00 450.00 22,500.00
50
 Halaman 8 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

362 LANSOPRAZOLE Kaps 30 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Lansoprazole Kapsul 30 mg Kapsul 24,570.00 1,228.50 60.00 491.40 9,828.00
20

363 LATANOPROST Tetes Mata 2,5 ml (FE) FERRON PAR PHARMACEUTICALS PT. Anugrah Argon Medica Latanoprost Tetes mata 50 mcg/ml Botol 70,000.00 70,000.00 16.70 58,310.00 58,310.00
1

364 LATANOPROST Tetes Mata 2,5 ml (PN) FAHRENHEIT PT. Kebayoran Farma, PT.Parit Padang Latanoprost Tetes mata 50 mcg/ml Botol 100,000.00 100,000.00 25.00 75,000.00 75,000.00
1

365 LEVOFLOXACIN Infus 500 mg/100 ml (MT) MERSIFARMA PT. Merapi Utama Pharma levofloxacin Infus 500 mg / 100 ml Botol 24,444.00 24,444.00 30.00 17,110.80 17,110.80
1

366 LEVOFLOXACIN Infus 500 mg/100 mL (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Levofloxacin Infus 500 mg / 100 ml Botol 100,000.00 100,000.00 80.00 20,000.00 20,000.00
1

367 LEVOFLOXACIN Infus 500 mg/100 ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading levofloxacin Infus 500 mg / 100 ml Botol 80,000.00 80,000.00 74.10 20,720.00 20,720.00
1

368 LEVOFLOXACIN Infus 750 mg/150 ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Levofloxacin Infus 750 mg / 150 ml Botol 150,000.00 150,000.00 50.00 75,000.00 75,000.00
1

369 LEVOFLOXACIN 750 mg/ 150 ml ( IN ) INFION PT. United Dico Citas, PT. Merapi Utama Pharma levofloxacin Infus 750 mg / 150 ml Botol 120,000.00 120,000.00 35.00 78,000.00 78,000.00
1

370 LEVOFLOXACIN Infus 750 mg / 150 ml (NP) NOVELL PT. Antarmitra Sembada Levofloxacin Infus 750 mg / 150 ml Softbag 100,000.00 100,000.00 20.00 80,000.00 80,000.00
1

371 LEVOFLOXACIN Tab 500 mg (NP) NOVELL PT. Antarmitra Sembada Levofloxacin Kaplet 500 mg Tablet 52,440.00 1,048.80 40.00 629.28 31,464.00
50

372 LEVOFLOXACIN HEMIHYDRATE Kapl 750 mg (YN) YARINDO PT. Kebayoran Farma ,PT PARIT PADANG levofloxacin Kaplet 750mg Kaplet 99,000.00 3,300.00 30.00 2,310.00 69,300.00
30

373 LEVOFLOXACIN HEMIHYDRATE Tab 500 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading levofloxacin Tablet 500 mg Tablet 62,500.00 1,250.00 70.00 375.00 18,750.00
50

374 SUSUK KB II Tiga Tahunan HARSEN LABORATORIES PT Kimia Farma Levonorgestrel 150 mg Implant 150 mg Implant 2,400,000.00 240,000.00 18.00 196,800.00 1,968,000.00
10

375 LIDOCAIN HCL Inj 2 % (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Lidocaine HCl Injeksi 2% Ampul 150,000.00 1,500.00 37.00 945.00 94,500.00
100

376 LIDOCAINE HYDROCHLORIDE MONOHYDRATE Inj 2% (MM) PT MEPROFARM MPI dan Penta Valen Lidocaine HCl Injeksi 2% Ampul 144,000.00 1,440.00 10.00 1,296.00 129,600.00
100

377 LIDOCAIN Compositum Inj (PR) PHAPROS PT. Rajawali Nusindo Lidocaine HCl epinephrin Injeksi 2% Ampul 60,000.00 2,000.00 30.00 1,400.00 42,000.00
30

378 LIDOCAIN HCL Inj 5% (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Lidocaine HCl Injeksi 5% Ampul 200,000.00 20,000.00 30.00 14,000.00 140,000.00
10

379 LYNCOMYCIN Kaps 500 mg (PR) PHAPROS PT. Rajawali Nusindo Lincomycin Kapsul 500 mg Kapsul 73,500.00 1,470.00 20.00 1,176.00 58,800.00
50

380 LINCO MPL Kaps 500 mg (ML) MEDIKON PT. Surya Prima Perkasa, PT. Merapi Utama Pharma, PT. Dos Ni Roha Lincomycin Kapsul 500 mg Kapsul 330,000.00 3,300.00 45.00 1,815.00 181,500.00
100

381 LISINOPRIL Tab 10 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Lisinopril Tablet 10 mg Tablet 68,000.00 680.00 81.42 126.36 12,636.36 YA
100

382 LISINOPRIL Tab 5 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Lisinopril Tablet 5 mg Tablet 44,000.00 440.00 70.04 131.82 13,181.82 YA
100

383 LORATADINE Tab 10 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Loratadine Tablet 10 mg Tablet 36,364.00 363.64 70.00 109.09 10,909.20
100

384 LORATADINE Tab 10 mg (NP) NOVELL PT. Antarmitra Sembada Loratadine Tablet 10 mg Tablet 15,140.00 302.80 40.00 181.68 9,084.00
50

385 LORATADINE Tab 10 mg (IF) INDOFARMA PT. Indofarma Global Medika Loratadine Tablet 10 mg Tablet 15,124.93 302.50 35.00 196.62 9,831.20
50

386 L-ORNITHIN L-ASPARTATE Inj 500 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica L-Ornithine L-Aspartate Injeksi 500 mg Ampul 300,000.00 60,000.00 10.00 54,000.00 270,000.00
5

387 LOSARTAN Tab 50 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Losartan Tablet 50 mg Tablet 90,909.00 3,030.30 65.00 1,060.61 31,818.15
30

388 MANNITOL Infus 20 g/ 500 ml (MT) MERSIFARMA PT. Merapi Utama Pharma Mannitol Cairan Infus 20gr/500ml Botol 55,236.00 55,236.00 30.00 38,665.20 38,665.20
1

389 MECOBALAMINE Inj 500 mcg/ml (NP) NOVELL PT. Antarmitra Sembada Mecobalamin Injeksi 500 mcg / ml Ampul 80,000.00 8,000.00 42.00 4,640.00 46,400.00
10

390 MECOBALAMINE Kaps 250 mcg (NP) NOVELL PT. Antarmitra Sembada Mecobalamin Kapsul 250 mcg Kapsul 60,000.00 600.00 45.00 330.00 33,000.00
100

391 MECOBALAMIN Kaps 500 mcg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Mecobalamin Kapsul 500 mcg Kapsul 70,000.00 700.00 40.00 420.00 42,000.00
100

392 MELOXICAM Tab 15 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Meloxicam Tablet 15 mg Tablet 35,000.00 700.00 57.00 301.00 15,050.00
50

393 MELOXICAM Tab 15 mg (NP) NOVELL PT. Antarmitra Sembada Meloxicam Tablet 15 mg Tablet 54,500.00 1,090.00 70.00 327.00 16,350.00
50

394 MELOXICAM Tab 15 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Meloxicam Tablet 15 mg Tablet 109,000.00 1,090.00 70.00 327.00 32,700.00
100

395 MELOXICAM Tab 7.5 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Meloxicam Tablet 7,5 mg Tablet 75,480.00 754.80 74.70 190.96 19,096.44
100

396 MELOXICAM Tab 7,5 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Meloxicam Tablet 7,5 mg Tablet 19,000.00 380.00 47.00 201.40 10,070.00
50

397 MELOXICAM Tab 7,5 mg (NP) NOVELL PT. Antarmitra Sembada Meloxicam Tablet 7,5 mg Tablet 31,450.00 629.00 65.00 220.15 11,007.50
50

398 MEROPENEM Inj 1 g (IT) INTERBAT PT. Mensa Bina Sukses, PT. Enseval Megatrading Meropenem BOX 1g Vial 110,000.00 110,000.00 73.26 29,414.00 29,414.00 YA
1

399 MEROPENEM Inj 0.5 g (IT) INTERBAT PT. Mensa Bina Sukses, PT. Enseval Megatrading Meropenem BOX 500 mg Vial 75,000.00 75,000.00 70.00 22,500.00 22,500.00
1

400 MEROPENEM Inj 1 g (DM) DEXA MEDICA PT. Anugrah Argon Medica Meropenem Injeksi 1g Vial 2,000,000.00 200,000.00 87.53 24,940.91 249,409.09 YA
10

401 MEROPENEM Inj 1 g (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Meropenem Injeksi 1g Vial 100,000.00 100,000.00 72.00 28,000.00 28,000.00
1

402 MEROPENEM Inj 1 g (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Meropenem Injeksi 1g Vial 2,000,000.00 200,000.00 85.30 29,400.00 294,000.00
10

403 MEROPENEM Inj 0.5 g (MM) PT MEPROFARM MPI dan Penta Valen Meropenem Injeksi 500 mg Vial 582,540.00 58,254.00 50.00 29,127.00 291,270.00
10

404 ANTALGIN Inj 25 % (PR) PHAPROS PT. Rajawali Nusindo Metamphyrone Injeksi 250 mg Ampul 52,500.00 1,750.00 10.00 1,575.00 47,250.00
30

405 METFORMIN Tab 500 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Metformin Tablet 500 mg Tablet 16,500.00 165.00 5.00 156.75 15,675.00
100

406 METFORMIN Tab 500 mg (PR) PHAPROS PT. Rajawali Nusindo Metformin Tablet 500 mg Tablet 30,000.00 300.00 20.00 240.00 24,000.00
100

407 METFORMIN Tab 500 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Metformin Tablet 500 mg Tablet 25,000.00 250.00 55.00 112.50 11,250.00
100

408 METFORMIN Tab 850 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Metformin Tablet 850 mg Tablet 36,000.00 360.00 46.00 194.40 19,440.00
100

409 METFORMIN XR Tab 500 mg (OT) OTTO OGB PT. Mensa Bina Sukses Metformin Tablet XR 500 mg XR Tablet 80,000.00 800.00 17.50 660.00 66,000.00
100

410 METFORMIN Tab 850 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Metformin Tablet 850 mg Tablet 39,000.00 390.00 5.00 370.50 37,050.00
100

411 METHISOPRINOL Syr (LS) LANDSON PT. Mensa Bina Sukses Methisoprinol Sirup 250 mg/5 ml Botol 50,000.00 50,000.00 36.00 32,000.00 32,000.00
1

412 METHISOPRINOL Tab 500 Mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Methisoprinol Tablet 500 mg Tablet 150,000.00 3,000.00 30.00 2,100.00 105,000.00
50

413 METHISOPRINOL Tab 500 mg (LS) LANDSON PT. Mensa Bina Sukses Methisoprinol Tablet 500 mg Tablet 40,000.00 5,000.00 27.50 3,625.00 29,000.00
8
 Halaman 9 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

414 METHYL PREDNISOLON Inj 125 mg/ml (PR) PHAPROS PT. Rajawali Nusindo Methyl Prednisolone Injeksi 125 mg / ml Vial 15,000.00 15,000.00 38.00 9,300.00 9,300.00
1

415 METHYLPREDNISOLON Inj 125 mg/ml (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Methyl Prednisolone Injeksi 125 mg / ml Vial 21,600.00 21,600.00 40.00 12,960.00 12,960.00
1

416 METHYL PREDNISOLON Inj 500 mg/ml (PR) PHAPROS PT. Rajawali Nusindo Methyl Prednisolone Injeksi 500 mg / ml Vial 55,000.00 55,000.00 35.00 35,750.00 35,750.00
1

417 METHYLPREDNISOLON Inj 500 mg/ml (QL) QUANTUM LABS PT. ANUGERAH PHARMINDO LESTARI Methyl Prednisolone Injeksi 500 mg / ml Ampul 135,000.00 135,000.00 51.00 66,150.00 66,150.00
1

418 METHYLPREDNISOLONE Tab 16 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Methyl Prednisolone Tablet 16 mg Kaplet 53,182.00 1,063.64 55.00 478.64 23,931.90
50

419 METHYLPREDNISOLONE Tab 16 mg (NP) NOVELL PT. Antarmitra Sembada Methyl Prednisolone Tablet 16 mg Tablet 94,091.00 940.91 35.00 611.59 61,159.15
100

420 METHYLPREDNISOLONE Tab 4 mg (MA) MOLEX AYUS PT. Mensa Bina Sukses Methyl Prednisolone Tablet 4 mg Tablet 30,000.00 300.00 52.50 142.50 14,250.00
100

421 METHYLPREDNISOLONE Tab 4 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Methyl Prednisolone Tablet 4 mg Kaplet 40,050.00 400.50 62.55 149.99 14,998.73
100

422 METHYLPREDNISOLON Tab 4 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Methyl Prednisolone Tablet 4 mg Tablet 48,060.00 480.60 67.00 158.60 15,859.80
100

423 METHYLPREDNISOLON Tab 8 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Methyl Prednisolone Tablet 8 mg Tablet 63,818.00 638.18 55.00 287.18 28,718.10
100

424 METHYLPREDNISOLONE Tab 8 mg (NP) NOVELL PT. Antarmitra Sembada Methyl Prednisolone Tablet 8 mg Tablet 53,182.00 531.82 40.00 319.09 31,909.20
100
PT. Penta Valent
PROMEDRAHARDJO FARMASI INDUSTRI
425 METHYLPREDNISOLON Tab 8 mg (PM) PT. Millenium Pharmacon International Tbk Methyl Prednisolone Tablet 8 mg Tablet 45,000.00 900.00 60.00 360.00 18,000.00
OGB 50
PT. Merapi Utama Pharma
426 METHYLERGOMETRINE MALEATE Inj 0,2 mg/ml (MM) PT MEPROFARM MPI dan Penta Valen Methylergometrine Maleate Injeksi 0,2 mg/ml Ampul 336,000.00 3,360.00 25.00 2,520.00 252,000.00
100

427 METOCLOPRAMIDE Inj 10 mg/2 ml (IT) INTERBAT PT. Mensa Bina Sukses, PT. Enseval Megatrading Metoclopramide Injeksi 10 mg/ml Ampul 45,000.00 4,500.00 45.00 2,475.00 24,750.00
10

428 METOCLOPRAMIDE HYDROCHLORIDE Inj 5 mg/ml (MM) PT MEPROFARM MPI dan Penta Valen Metoclopramide Injeksi 5 mg/ml Ampul 450,000.00 4,500.00 30.00 3,150.00 315,000.00
100

429 METOCLOPRAMIDE HCL Tab 10 mg (PR) PHAPROS PT. Rajawali Nusindo Metoclopramide Tablet 10 mg Tablet 13,500.00 135.00 15.00 114.75 11,475.00
100

430 METRONIDAZOLE Infus 500 mg/100 mL (DV) DARYA VARIA PT. Anugerah Pharmindo Lestari Metronidazole Infus 500 mg/100 ml Botol 7,500.00 7,500.00 15.00 6,375.00 6,375.00
1

431 METRONIDAZOLE Infus 500 mg/100 ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Metronidazole Infus 500 mg/100 ml Botol 50,000.00 50,000.00 87.00 6,500.00 6,500.00
1

432 METRONIDAZOL Infus 500 mg/100 mL (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Metronidazole Infus 500 mg/100 ml Botol 20,000.00 20,000.00 67.00 6,600.00 6,600.00
1

433 METRONIDAZOL Tab 500 mg (IF) INDOFARMA PT. Indofarma Global Medika Metronidazole Tablet 500 mg Tablet 35,385.00 353.85 15.00 300.77 30,077.25
100

434 METRONIDAZOLE Tab 500 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Metronidazole Tablet 500 mg Tablet 32,813.00 328.13 5.00 311.72 31,172.35
100

435 METRONIDAZOLE Tab 500 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Metronidazole Tablet 500 mg Tablet 24,000.00 240.00 30.00 168.00 16,800.00
100

436 ANTASIDA DOEN Syr 60 ml (DM) DEXA MEDICA PT. Anugrah Argon Medica Mg(OH) +Al (OH) Suspensi 60 ml Botol 3,500.00 3,500.00 0.00 3,500.00 3,500.00
1

437 ANTASIDA Syr (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Mg(OH) +Al (OH) Suspensi 60 ml Botol 8,913.00 8,913.00 15.00 7,576.05 7,576.05
1

438 ANTASIDA Tab 200 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Mg(OH) +Al (OH) Tablet 200 mg Tablet 34,239.00 342.39 7.50 316.71 31,671.08
100

439 ANTASIDA Tab 200 mg (MA) MOLEX AYUS PT. Mensa Bina Sukses Mg(OH) +Al (OH) Tablet 200 mg Tablet 14,727.00 147.27 22.50 114.13 11,413.43
100
PT. Penta Valent
PROMEDRAHARDJO FARMASI INDUSTRI
440 ANTASIDA DOEN Tab 200 mg (PM) PT. Millenium Pharmacon International Tbk Mg(OH) +Al (OH) Tablet 200 mg Tablet 18,000.00 180.00 33.00 120.60 12,060.00
OGB 100
PT. Merapi Utama Pharma
441 MISOPROSTOL Tab 200 mcg (PN) FAHRENHEIT PT. Kebayoran Farma Misoprostol Tablet 200 mcg Tablet 150,000.00 5,000.00 25.00 3,750.00 112,500.00
30

442 MISOPROSTOL Tab 200 mcg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Misoprostol Tablet 200 mcg Tablet 150,000.00 5,000.00 35.00 3,250.00 97,500.00
30

443 MOMETASONE Cream 0,1% 10 g (NP) NOVELL PT. Antarmitra Sembada Mometasone Furoate Krim 0.1% 10 g Tube 20,000.00 20,000.00 35.00 13,000.00 13,000.00
1

444 MOMETASONE FUROATE Cream 10 g (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Mometasone Furoate Krim 0.1% 10 g Tube 20,250.00 20,250.00 30.00 14,175.00 14,175.00
1

445 MOMETASONE Cream 0,1% 5 g (NP) NOVELL PT. Antarmitra Sembada Mometasone Furoate Krim 0.1% 5 g Tube 12,500.00 12,500.00 35.00 8,125.00 8,125.00
1

446 MOXIFLOXACIN Infus 400 mg/250 ml (DV) DARYA VARIA PT. Anugerah Pharmindo Lestari Moxifloxacin Infus 400 mg/250 ml Botol 120,000.00 120,000.00 25.00 90,000.00 90,000.00
1

447 MOXIFLOXACIN HCL 400 mg/ 250 ml Infus BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Moxifloxacin Infus 400 mg/250 ml Botol 300,000.00 300,000.00 48.00 156,000.00 156,000.00
1

448 MOXIFLOXACIN HCL Kaps 400 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Moxifloxacin Kapsul 400 mg Kapsul 182,280.00 18,228.00 37.50 11,392.50 113,925.00
10

449 MOXIFLOXACIN Tab 400 mg (PN) FAHRENHEIT PT. Kebayoran Farma Moxifloxacin Tablet 400 mg Tablet 250,000.00 25,000.00 50.00 12,500.00 125,000.00
10

450 MOXIFLOXACIN HCl Tetes Mata 5 mg/ml (FE) FERRON PAR PHARMACEUTICALS PT. Anugrah Argon Medica Moxifloxacin Tetes mata 5 mg/ml Botol 65,000.00 65,000.00 31.70 44,395.00 44,395.00
1

451 ACETYLCYSTEINE Infus 200 mg/ml (YN) YARINDO PT. Kebayoran Farma ,PT PARIT PADANG N-Acetylcysteine Infus 200 mg/ml Vial 199,000.00 199,000.00 16.00 167,160.00 167,160.00
1

452 ACETYLCYSTEINE Kaps 200 mg (NP) NOVELL PT. Antarmitra Sembada N-Acetylcysteine Kapsul 200 mg Kapsul 100,000.00 1,000.00 55.00 450.00 45,000.00
100

453 ACETYLCYSTEIN Kaps 200 mg (PN) FAHRENHEIT PT. Kebayoran Farma, PT.Parit Padang N-Acetylcysteine Kapsul 200 MG Kapsul 100,000.00 1,000.00 50.00 500.00 50,000.00
100

454 N-ACETYLCYSTEINE Kaps 200 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional N-Acetylcysteine Kapsul 200 mg Kapsul 100,000.00 1,000.00 27.50 725.00 72,500.00
100

455 NICARDIPINE Inj 10 mg/10 ml (PN) FAHRENHEIT PT. Kebayoran Farma Nicardipine Injeksi 10 mg / 10 ml Ampul 260,000.00 130,000.00 81.50 24,050.00 48,100.00
2

456 NIFEDIPIN Tab 10 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Nifedipin Tablet 10 mg Tablet 20,016.00 200.16 2.50 195.16 19,515.60
100
NOREPINEPHRINE BITARTRATE MONOHYDRATE Inj 1 mg / ml
457 NOVELL PT. Antarmitra Sembada Norephineprine Injeksi 4 mg / 4 ml Ampul 63,000.00 12,600.00 5.00 11,970.00 59,850.00
(NP) 5

458 NOREPHINEPHRINE BITARTATE Inj 4 mg/4 ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Norephineprine Injeksi 4 mg / 4 ml Ampul 600,000.00 60,000.00 69.00 18,600.00 186,000.00
10

459 NYSTATIN Drops 100.000 IU/ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Nystatin Drops 100.000 UI / ml Botol 220,000.00 22,000.00 35.00 14,300.00 143,000.00
10

460 NYSTATIN Drops 100.000 IU/ml (NP) NOVELL PT. Antarmitra Sembada Nystatin Drops 100.000IU/ml Botol 20,000.00 20,000.00 27.50 14,500.00 14,500.00
1

461 NYSTATIN Tab Salut 500000 IU (PR) PHAPROS PT. Rajawali Nusindo Nystatin Tablet Salut 500000 IU Tablet 97,500.00 975.00 10.00 877.50 87,750.00
100

462 OFLOXACIN Infus 200 mg/ml (DM) DEXA MEDICA PT. Anugrah Argon Medica Ofloxacin Infus 200 mg/ml Botol 55,000.00 55,000.00 20.00 44,000.00 44,000.00
1

463 OFLOXACIN Tab 200 mg (NP) NOVELL PT. Antarmitra Sembada Ofloxacin Tablet 200 mg Tablet 26,823.00 536.46 25.00 402.35 20,117.25
50

464 OFLOXACIN Tab 400 mg (NP) NOVELL PT. Antarmitra Sembada Ofloxacin Tablet 400 mg Tablet 39,682.00 793.64 25.00 595.23 29,761.50
50
Tablet Salut
465 OFLOXACIN FILM COATED Tab 200 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Ofloxacin 200 mg Tablet 76,700.00 767.00 10.00 690.30 69,030.00
Selaput 100
 Halaman 10 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

466 OLOPATADINE HCl Tetes Mata 1 mg/ml (FE) FERRON PAR PHARMACEUTICALS PT. Anugrah Argon Medica Olopatadine Tetes mata 1 mg/ml Botol 60,000.00 60,000.00 33.80 39,720.00 39,720.00
1

467 OMEPRAZOLE Inj 40 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Omeprazole Injeksi 40 mg Vial 680,000.00 68,000.00 87.00 8,840.00 88,400.00
10

468 OMEPRAZOLE Inj 40 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Omeprazole Injeksi 40 mg Vial 80,000.00 80,000.00 90.00 8,000.00 8,000.00
1

469 OMEPRAZOLE Inj (DV) DARYA VARIA PT. Anugerah Pharmindo Lestari Omeprazole Injeksi 40 mg Vial 107,890.00 10,789.00 17.00 8,954.87 89,548.70
10

470 OMEPRAZOLE Kaps 20 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Omeprazole Kapsul 20 mg Tablet 74,240.00 371.20 51.00 181.89 36,377.60
200

471 OMEPRAZOLE Kaps 20 mg (NP) NOVELL PT. Antarmitra Sembada Omeprazole Kapsul 20 mg Tablet 11,136.00 371.20 30.00 259.84 7,795.20
30

472 OMEPRAZOLE Kap 20 Mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Omeprazole Kapsul 20 mg Kapsul 37,120.00 371.20 25.00 278.40 27,840.00
100

473 ONDANSETRON Inj 4 mg /2 ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ondansetron Injeksi 4 mg / 2 ml Ampul 50,000.00 5,000.00 80.00 1,000.00 10,000.00
10

474 ONDANSETRON Inj 4 mg/2 mL (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Ondansetron Injeksi 4 mg / 2 ml Ampul 29,000.00 2,900.00 52.00 1,392.00 13,920.00
10

475 ONDANCETRON Inj 4 mg/2ml (IT) INTERBAT PT. Mensa Bina Sukses, PT. Enseval Megatrading Ondansetron Injeksi 4 mg / 2 ml Ampul 50,000.00 5,000.00 70.00 1,500.00 15,000.00
10

476 ONDANSETRON Inj 8 mg / 4 ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Ondansetron Injeksi 8 mg / 4 ml Ampul 36,000.00 7,200.00 50.00 3,600.00 18,000.00
5

477 ONDANSETRON Inj 8 mg/4 ml (QL) QUANTUM LABS PT. ANUGERAH PHARMINDO LESTARI Ondansetron Injeksi 8 mg / 4 ml Ampul 72,728.00 7,272.80 50.00 3,636.40 36,364.00
10

478 ONDANSETRON Tab 4 mg (LS) LANDSON PT. Mensa Bina Sukses Ondansetron Tablet 4 mg Tablet 45,000.00 1,500.00 76.00 360.00 10,800.00
30

479 ONDANSETRON Tab 8 mg (LS) LANDSON PT. Mensa Bina Sukses Ondansetron Tablet 4 mg Tablet 75,000.00 2,500.00 83.00 425.00 12,750.00
30

480 ONDANSETRON Tab 4 mg (NP) NOVELL PT. Antarmitra Sembada Ondansetron Tablet 4 mg Tablet 16,800.00 1,400.00 62.50 525.00 6,300.00
12

481 ONDANSETRON Tab 8 mg (NP) NOVELL PT. Antarmitra Sembada Ondansetron Tablet 8 mg Tablet 27,600.00 2,300.00 62.50 862.50 10,350.00
12

482 ONDANCETRON Tab 8 mg (IT) INTERBAT PT. Mensa Bina Sukses, PT. Enseval Megatrading Ondansetron Tablet 8 mg Tablet 350,000.00 3,500.00 70.00 1,050.00 105,000.00
100

483 ONDANSETRON Tab 8 mg (IF) INDOFARMA PT. Indofarma Global Medika Ondansetron Tablet 8 mg Tablet 27,600.00 2,300.00 45.00 1,265.00 15,180.00
12

484 OXALIPLATIN Inj 100 mg (FE) FERRON PAR PHARMACEUTICALS PT. Anugrah Argon Medica Oxaliplatin Injeksi 100 mg/ml Vial 565,000.00 565,000.00 21.96 440,926.00 440,926.00
1

485 OXALIPLATIN Inj 50 mg (FE) FERRON PAR PHARMACEUTICALS PT. Anugrah Argon Medica Oxaliplatin Injeksi 50 mg/ml Vial 285,000.00 285,000.00 22.65 220,447.50 220,447.50
1

486 OKSITETRASIKLIN Cream 3% (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Oxytetracycline HCL Krim Salep Kulit 3.0% Tube 1,881.00 1,881.00 10.00 1,692.90 1,692.90
1

487 OKSITETRASIKLIN Eye Oint 1% (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Oxytetracycline HCL Salep Mata 1.0% Tube 3,182.00 3,182.00 0.00 3,182.00 3,182.00 YA
1

488 PANTOPRAZOLE Inj 40 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Pantopazole Injeksi 40 mg Vial 800,000.00 80,000.00 85.20 11,840.00 118,400.00
10

489 PANTOPRAZOLE SODIUM Inj 40 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Pantopazole Injeksi 40 mg Vial 55,000.00 55,000.00 78.36 11,902.00 11,902.00
1

490 PANTOPRAZOL Tab Salut 20 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Pantopazole Tablet 20 mg Tablet 195,000.00 6,500.00 10.00 5,850.00 175,500.00
30

491 PANTOPRAZOLE Tab 40 mg (NP) NOVELL PT. Antarmitra Sembada Pantopazole Tablet 40 mg Tablet 80,000.00 8,000.00 40.00 4,800.00 48,000.00
10

492 PANTOPRAZOLE E.C Tab 40 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Pantopazole Tablet 40 mg Tablet 240,000.00 8,000.00 20.00 6,400.00 192,000.00
30

493 PARACETAMOL ENEMA 125 mg/2,5 ml (NP) Paracetamol enama 125 mg/2,5 ml enema 45,000.00 9,000.00 20.00 7,200.00 36,000.00
NOVELL PT. Antarmitra Sembada 5

494 PARACETAMOL Infus 1 g/100 ml (DV) DARYA VARIA PT. Anugerah Pharmindo Lestari Paracetamol Infus 1 g / 100 ml Botol 10,900.00 10,900.00 5.00 10,355.00 10,355.00
1

495 PARACETAMOL Infus 1 g /100 ml (PR) PHAPROS PT. Rajawali Nusindo Paracetamol Infus 1 g / 100 ml Botol 22,000.00 22,000.00 50.00 11,000.00 11,000.00
1

496 PARACETAMOL Infus 1000 mg / 100 ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Paracetamol Infus 1 g / 100 ml Flexy bag 35,000.00 35,000.00 68.00 11,200.00 11,200.00
1

497 PARACETAMOL Syr 120 mg/5 ml (TP) TEMPO RX FARMA PT. Tempo Paracetamol Sirup 120 mg / 5 ml Botol Err:522 Err:522 0.00 Err:522 Err:522
1

498 PARACETAMOL Tab 500 mg (ID) IMFARMIND INDUSTRI PT. Indofarma Global Medika Paracetamol Tablet 500 mg Tablet 22,311.00 223.11 42.50 128.29 12,828.82
100

499 PARACETAMOL Tab 500 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Paracetamol Tablet 500 mg Tablet 24,953.00 249.53 12.50 218.34 21,833.88
100
PT. Penta Valent
PROMEDRAHARDJO FARMASI INDUSTRI
500 PARACETAMOL Tab 500 mg (PM) PT. Millenium Pharmacon International Tbk Paracetamol Tablet 500 mg Tablet 17,000.00 170.00 8.00 156.40 15,640.00
OGB 100
PT. Merapi Utama Pharma
501 PARACETAMOL Syr 120 mg/5 ml (MM) PT MEPROFARM MPI dan Penta Valen Paracetamol Sirup 120 mg / 5 ml Botol 3,500.00 3,500.00 15.00 2,975.00 2,975.00
1

502 PEMETRIN Krim (CB) COMBIPHAR PT. Anugerah Pharmindo Lestari Permetrin Krim 10gr Tube 16,670.00 16,670.00 25.00 12,502.50 12,502.50
1

503 NA. PHENYTOIN Inj 50 mg/ml (PR) PHAPROS PT. Rajawali Nusindo Phenytoin Injeksi 50 mg / ml Ampul 30,000.00 3,000.00 25.00 2,250.00 22,500.00
10

504 PHENYTOIN SODIUM Inj 50 mg/ml (MM) PT MEPROFARM MPI dan Penta Valen Phenytoin Injeksi 50 mg/ml Ampul 60,900.00 12,180.00 55.00 5,481.00 27,405.00
5

505 PHYTOMENADIONE Inj 10 mg/ml (PR) PHAPROS PT. Rajawali Nusindo Phytomenadione Injeksi 10 mg/ml Ampul 130,500.00 4,350.00 10.00 3,915.00 117,450.00
30

506 PHYTOMENADIONE Inj 2 mg/ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Phytomenadione Injeksi 2 mg / ml Ampul 30,000.00 6,000.00 53.00 2,820.00 14,100.00
5

507 PHYTOMENADIONE Inj 2 mg/ml (PR) PHAPROS PT. Rajawali Nusindo Phytomenadione Injeksi 2 mg / ml Ampul 120,000.00 4,000.00 10.00 3,600.00 108,000.00
30

508 PIOGLITAZONE Tab 15 mg (LS) LANDSON PT. Mensa Bina Sukses Pioglitazone Tablet 15 mg Tablet 90,000.00 3,000.00 41.00 1,770.00 53,100.00
30

509 PIOGLITAZONE Tab 15 mg (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Pioglitazone Tablet 15 mg Tablet 100,000.00 3,333.33 45.00 1,833.33 55,000.00
30

510 PIOGLITAZONE Tab 30 mg (LS) LANDSON PT. Mensa Bina Sukses Pioglitazone Tablet 30 mg Tablet 120,000.00 4,000.00 32.00 2,720.00 81,600.00
30

511 PIOGLITAZONE Tab 30 mg (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Pioglitazone Tablet 30 mg Tablet 150,000.00 5,000.00 45.00 2,750.00 82,500.00
30

512 PIRACETAM Inj 1 g/5 ml (QL) QUANTUM LABS PT. ANUGERAH PHARMINDO LESTARI Piracetam Injeksi 1 g / 5 mL Ampul 60,000.00 6,000.00 62.00 2,280.00 22,800.00
10

513 PIRACETAM Inj 1 g/5 mL (NP) NOVELL PT. Antarmitra Sembada Piracetam Injeksi 1 g / 5 mL Ampul 72,000.00 6,000.00 30.00 4,200.00 50,400.00
12

514 PIRACETAM Inj 3 g/15 ml (QL) QUANTUM LABS PT. ANUGERAH PHARMINDO LESTARI Piracetam Injeksi 3 g / 15 ml Ampul 190,000.00 19,000.00 65.00 6,650.00 66,500.00
10

515 PIRACETAM Inj 3 g/15 ml (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Piracetam Injeksi 3 g / 15 ml Ampul 40,000.00 10,000.00 10.00 9,000.00 36,000.00
4

516 PIRACETAM Inj 3 g/15 ml (DM) DEXA MEDICA PT. Anugrah Argon Medica Piracetam Injeksi 3 g / 15 ml Ampul 62,200.00 15,550.00 30.00 10,885.00 43,540.00
4

517 PIRACETAM Kapl 1200 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Piracetam Tablet 1200 mg Tablet 100,000.00 1,000.00 40.00 600.00 60,000.00
100
 Halaman 11 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

518 PIRACETAM Tab 1200 mg (NP) NOVELL PT. Antarmitra Sembada Piracetam Tablet 1200 mg Tablet 117,600.00 1,176.00 30.00 823.20 82,320.00
100

519 PIRACETAM Kapl 400 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Piracetam Tablet 400 mg Tablet 49,200.00 492.00 40.00 295.20 29,520.00
100

520 PIRACETAM Kapl 800 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Piracetam Tablet 800 mg Tablet 65,000.00 650.00 40.00 390.00 39,000.00
100

521 PIRACETAM Tab 800 mg (NP) NOVELL PT. Antarmitra Sembada Piracetam Tablet 800 mg Tablet 43,800.00 730.00 20.00 584.00 35,040.00
60

522 PIROXICAM Tab 10 mg (GF) GRAHA FARMA PT. Indofarma Global Medika Piroxicam Tablet 10 mg Tablet 10,494.55 104.95 10.00 94.45 9,445.09
100
PT. Penta Valent
PROMEDRAHARDJO FARMASI INDUSTRI
523 PIROXICAM Tab 10 mg (PM) PT. Millenium Pharmacon International Tbk Piroxicam Tablet 10 mg Tablet 15,000.00 150.00 27.00 109.50 10,950.00
OGB 100
PT. Merapi Utama Pharma
524 PIROXICAM Tab 20 mg (GF) GRAHA FARMA PT. Indofarma Global Medika Piroxicam Tablet 20 mg Tablet 13,550.55 135.51 10.00 121.95 12,195.49
100

525 PIROXICAM Tab 20 mg (PN) FAHRENHEIT PT. Kebayoran Farma Piroxicam Tablet 20 mg Tablet 18,000.00 180.00 10.00 162.00 16,200.00
100
Potassium chloride 1,5 g; Sodium chloride 4,5
526 WIDA KN-2 WIDATRA BHAKTI PT. Merapi Utama Pharma Cairan Infus Plabot Err:522 Err:522 25.00 Err:522 Err:522
g 20
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
527 POTASSIUM CHLORIDA Infus 7,46% (SR) SATORIA Potassium Chloride 1865 mg WFI ad 25 ml Cairan Infus 7.46% Ampul 351,600.00 2,930.00 0.00 2,930.00 351,600.00 YA
Perusahaan Perdagangan Indonesia 120

528 IODINE POVIDON Soln 10% 60 ml (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Povidone Iodine Larutan 10.0% Botol 3,864.00 3,864.00 0.00 3,864.00 3,864.00 YA
1

529 IODINE POVIDON Soln 10% 300 ml (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Povidone Iodine Larutan 10.0% Botol 15,636.00 15,636.00 20.00 12,508.80 12,508.80
1

530 IODINE POVIDONE Soln 10% 1000 ml (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Povidone Iodine Larutan 10.0% Botol 33,382.00 33,382.00 0.00 33,382.00 33,382.00 YA
1

531 PRAVASTATIN Tab 20 mg (NP) NOVELL PT. Antarmitra Sembada Pravastatin 20 mg Tablet 20 mg Tablet 127,500.00 2,550.00 21.60 1,999.20 99,960.00
50

532 PREDNISON Tab 5 mg ERELA PENTA VALENT, BAHARADAH SAKTI/SELARAS KUSUMA Prednisone Tablet 5 mg Tablet 19,102.00 191.02 13.62 165.00 16,500.31
100

533 PREGABALIN Kaps 150 mg (NP) NOVELL PT. Antarmitra Sembada Pregabalin Kapsul 150 mg Kapsul 107,800.00 7,700.00 45.00 4,235.00 59,290.00
14

534 PREGABALIN Kaps 150 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Pregabalin Kapsul 150 mg Kapsul 75,992.00 5,428.00 17.50 4,478.10 62,693.40
14

535 PREGABALIN Kaps 150 mg (IP) IKAPHARMINDO PUTRAMAS PT. Distriversa Buanamas Pregabalin Kapsul 150 mg Kapsul 240,000.00 8,000.00 40.00 4,800.00 144,000.00
30

536 PREGABALIN Kaps 50 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Pregabalin Kapsul 50 mg Kapsul 50,000.00 3,571.43 15.00 3,035.71 42,500.00
14

537 PREGABALIN Kaps 50 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Pregabalin Kapsul 50 mg Kapsul 59,192.00 4,228.00 17.50 3,488.10 48,833.40
14

538 PREGABALIN Kaps 75 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Pregabalin Kapsul 75 mg Kapsul 60,000.00 4,285.71 60.00 1,714.29 24,000.00
14

539 PREGABALIN Kaps 75 mg (IP) IKAPHARMINDO PUTRAMAS PT. Distriversa Buanamas Pregabalin Kapsul 75 mg Kapsul 120,000.00 4,000.00 40.00 2,400.00 72,000.00
30

540 PREGABALIN Kaps 75 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Pregabalin Kapsul 75 mg Kapsul 45,192.00 3,228.00 17.50 2,663.10 37,283.40
14
PROCATEROL HYDROCHLORIDE HEMIHYDRATE Syr 0.025
541 PT MEPROFARM MPI dan Penta Valen Procaterol hydrochloride hemihydrate Sirup 0,025 mg/5 ml Botol 20,000.00 20,000.00 30.00 14,000.00 14,000.00
mg/5 ml (MM) 1

542 PROPRANOLOL Tab 40 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Propranolol Tablet 40 mg Tablet 12,650.00 126.50 5.00 120.18 12,017.50
100

543 PROPYLTHIOURACIL Tab 100 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Propylthiouracil Tablet 100 mg Tablet 45,126.00 451.26 22.44 350.00 35,000.00 YA
100

544 PYRAZINAMID Tab 500 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Pyrazinamide Tablet 500 mg Tablet 37,625.00 376.25 7.50 348.03 34,803.13
100
PT. Penta Valent
PROMEDRAHARDJO FARMASI INDUSTRI
545 PYRAZINAMIDE Tab 500 mg (PM) PT. Millenium Pharmacon International Tbk Pyrazinamide Tablet 500 mg Tablet 65,000.00 650.00 35.00 422.50 42,250.00
OGB 100
PT. Merapi Utama Pharma
546 QUETIAPINE FUMARATE Tab 100 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Quetiapine fumarate Tablet 100 mg Tablet 553,680.00 9,228.00 39.26 5,605.09 336,305.23
60

547 QUETIAPINE FUMARATE Tab 200 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Quetiapine fumarate Tablet 200 mg Tablet 637,680.00 10,628.00 15.00 9,033.80 542,028.00
60

548 QUETIAPINE FUMARATE Tab 25 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Quetiapine fumarate Tablet 25 mg Tablet 463,680.00 7,728.00 15.00 6,568.80 394,128.00
60

549 QUETIAPINE FUMARATE XR Tab 200 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Quetiapine Fumarate XR Tablet 200 mg Tablet 149,280.00 14,928.00 18.50 12,166.32 121,663.20
10

550 RAMIPRIL Tab 2,5 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Ramipril Tablet 2,5 mg Tablet 29,091.00 290.91 25.00 218.18 21,818.18 YA
100

551 RAMIPRIL Tab 5 mg (NP) NOVELL PT. Antarmitra Sembada Ramipril Tablet 5 mg Tablet 57,727.00 577.27 45.00 317.50 31,749.85
100

552 RANITIDINE Inj 25 mg/ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Ranitidin HCl Injeksi 50 mg / 2 ml Ampul 640,000.00 6,400.00 83.50 1,056.00 105,600.00
100

553 RANITIDINE HCI Inj 50 mg/2 ml (MM) PT MEPROFARM MPI dan Penta Valen Ranitidin HCl Injeksi 50 mg / 2 ml Ampul 13,700.00 1,370.00 20.00 1,096.00 10,960.00
10

554 RANITIDINE Inj 25 mg/ml (MT) MERSIFARMA PT. Merapi Utama Pharma Ranitidin HCl Injeksi 50 mg / 2 ml Ampul 12,000.00 1,200.00 5.00 1,140.00 11,400.00
10

555 RANITIDINE Tab 150 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Ranitidin HCl Tablet 150 mg Tablet 20,000.00 200.00 50.00 100.00 10,000.00
100

556 RANITIDINE Tab 150 mg (IF) INDOFARMA PT. Indofarma Global Medika Ranitidin HCl Tablet 150 mg Tablet 27,500.00 275.00 15.00 233.75 23,375.00
100

557 RANITIDIN Tab 150 mg (PR) PHAPROS PT. Rajawali Nusindo Ranitidin HCl Tablet 150 mg Tablet 23,000.00 230.00 20.00 184.00 18,400.00
100

558 REBAMIPIDE Tab 100 mg (IT) INTERBAT PT. Mensa Bina Sukses, PT. Enseval Megatrading rebamipide Tablet 100 mg Tablet 200,000.00 2,000.00 55.00 900.00 90,000.00
100

559 RIFAMPICIN Kapl 600 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Rifampicin Kaplet 600 mg Kaplet 270,000.00 2,700.00 38.00 1,674.00 167,400.00
100

560 RIFAMPICIN Tab 450 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Rifampicin Tablet 450 mg Tablet 84,909.00 849.09 0.00 849.09 84,909.00 YA
100

561 RISPERIDONE Tab 2 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Risperidone Tablet 2 mg Tablet 107,955.00 2,159.10 55.00 971.59 48,579.75
50

562 RISPERIDONE Tab 2 mg (MT) MERSIFARMA PT. Merapi Utama Pharma Risperidone Tablet 2 mg Tablet 116,591.00 2,331.82 47.50 1,224.21 61,210.28
50

563 ROCURONIUM Inj 10 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Rocuronium Bromide Injeksi 10 mg / ml Ampul 700,000.00 70,000.00 64.91 24,566.36 245,663.64 YA
10

564 ROCURONIUM BROMIDE Inj 50 mg/5 ml (NP) NOVELL PT. Antarmitra Sembada Rocuronium Bromide Injeksi 10 mg / ml Vial 864,000.00 72,000.00 30.00 50,400.00 604,800.00
12

565 ROCURONIUM BROMIDE Inj 50 mg/5 ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Rocuronium Bromide Injeksi 10 mg / ml Ampul 70,000.00 70,000.00 25.00 52,500.00 52,500.00
1

566 ROSUVASTATIN CAL Tab 10 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Rosuvastatin Tablet 10 mg Tablet 200,520.00 2,228.00 70.00 668.40 60,156.00
90

567 ROSUVASTATIN CA Tab 10 mg (NP) NOVELL PT. Antarmitra Sembada Rosuvastatin Tablet 10 mg Tablet 60,000.00 3,000.00 45.00 1,650.00 33,000.00
20

568 ROSUVASTATIN Tab 20 mg (IT) INTERBAT PT. Mensa Bina Sukses, PT. Enseval Megatrading Rosuvastatin Tablet 20 mg Tablet 450,000.00 4,500.00 55.00 2,025.00 202,500.00
100
 Halaman 12 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

569 ROSUVASTATIN Tab 20 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Rosuvastatin Tablet 20 mg Tablet 120,000.00 4,000.00 45.00 2,200.00 66,000.00
30

570 ROSUVASTATIN Tab 20 mg (PN) FAHRENHEIT PT. Kebayoran Farma, PT.Parit Padang Rosuvastatin Tablet 20 MG Tablet 120,000.00 4,000.00 35.00 2,600.00 78,000.00
30

571 ROSUVASTATIN CAL Tab 40 mg (AM) AMAROX PHARMA GLOBAL PT PARIT PADANG GLOBAL Rosuvastatin Tablet 40 mg Tablet 776,520.00 8,628.00 25.00 6,471.00 582,390.00
90
Inhalasi
572 SALBUTAMOL Inhalasi (PN) FAHRENHEIT PT. Kebayoran Farma Salbutamol 2,5mg/2,5ml Ampul 80,000.00 8,000.00 32.50 5,400.00 54,000.00
Nebulazer 10

573 SALBUTAMOL Syr 2 mg /5 ml (ID) IMFARMIND INDUSTRI PT. Indofarma Global Medika Salbutamol Sirup 2 mg/5 ml Botol 14,062.00 14,062.00 71.00 4,077.98 4,077.98
1

574 SALBUTAMOL Tab 2 mg (ID) IMFARMIND INDUSTRI PT. Indofarma Global Medika Salbutamol Tablet 2 mg Tablet 13,273.00 132.73 45.00 73.00 7,300.15
100

575 SALBUTAMOL Tab 2 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Salbutamol Tablet 2 mg Tablet 10,298.00 102.98 20.00 82.38 8,238.40
100

576 SALBUTAMOL Tab 2 mg (GF) GRAHA FARMA PT. Indofarma Global Medika Salbutamol Tablet 2 mg Tablet 9,319.09 93.19 10.00 83.87 8,387.18
100

577 SALBUTAMOL Tab 4 mg (ID) IMFARMIND INDUSTRI PT. Indofarma Global Medika Salbutamol Tablet 4 mg Tablet 15,636.00 156.36 41.00 92.25 9,225.24
100

578 SALBUTAMOL Tab 4 mg (PN) FAHRENHEIT PT. Kebayoran Farma Salbutamol Tablet 4 mg Tablet 11,000.00 110.00 12.50 96.25 9,625.00
100

579 SALBUTAMOL Tab 4 mg (GF) GRAHA FARMA PT. Indofarma Global Medika Salbutamol Tablet 4 mg Tablet 12,852.00 128.52 10.00 115.67 11,566.80
100

580 SALBUTAMOL Tab 4 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Salbutamol Tablet 4 mg Tablet 12,953.00 129.53 10.00 116.58 11,657.70
100

581 SERTRALINE Tab 50 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Sertraline HCl Tablet 50 mg Tablet 195,000.00 6,500.00 55.00 2,925.00 87,750.00
30

582 SEVOFLURANE Sol 250 ml (MT) MERSIFARMA PT. Merapi Utama Pharma Sevoflurane Cairan Inhalasi 250ml Botol 994,892.00 994,892.00 15.00 845,658.20 845,658.20
1

583 SEVOFLURANE Sol 250 ml (NP) NOVELL PT. Antarmitra Sembada Sevoflurane Cairan Inhalasi 250ml Vial 1,560,000.00 1,560,000.00 30.00 1,092,000.00 1,092,000.00
1

584 SILDENAFIL CITRATE Tab 100 mg (NP) Sildenafil Citrate tablet 100 mg Tablet 175,000.00 43,750.00 55.00 19,687.50 78,750.00
NOVELL PT. Antarmitra Sembada 4

585 SILDENAFIL CITRATE Tab 50 mg (NP) Sildenafil Citrate tablet 50 mg Tablet 112,000.00 28,000.00 55.00 12,600.00 50,400.00
NOVELL PT. Antarmitra Sembada 4

586 SIMVASTATIN Kapl 10 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Simvastatin Kaplet 10 mg Tablet 55,963.00 559.63 82.00 100.73 10,073.34
100

587 SIMVASTATIN Kapl 20 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Simvastatin Kaplet 20 mg Tablet 111,928.00 1,119.28 80.00 223.86 22,385.60
100

588 SIMVASTATIN Tab 10 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Simvastatin Tablet 10 mg Tablet 27,000.00 270.00 65.00 94.50 9,450.00
100

589 SIMVASTATIN Tab 10 mg (PN) FAHRENHEIT PT. Kebayoran Farma Simvastatin Tablet 10 mg Tablet 13,991.00 466.37 65.00 163.23 4,896.85
30

590 SIMVASTATIN Tab 20 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Simvastatin Tablet 20 mg Tablet 93,333.00 933.33 85.00 140.00 13,999.95
100

591 SIMVASTATIN Tab 20 mg (TP) TEMPO RX FARMA PT. Tempo Simvastatin Tablet 20 mg Tablet Err:522 Err:522 0.00 Err:522 Err:522
500
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
592 NATRIUM KLORIDA Infus 0,9% 100 ml (SR) SATORIA Sodium Chloride WFI ad 100 ml Cairan Infus 0.9% 100 ml Botol 223,600.00 5,590.00 0.00 5,590.00 223,600.00 YA
Perusahaan Perdagangan Indonesia 40
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
593 NATRIUM KLORIDA Infus 0,9% 25 ml (SR) SATORIA Sodium Chloride WFI ad 25 ml Cairan Infus 0.9% 25 ml Ampul 381,818.18 3,181.82 5.00 3,022.73 362,727.27
Perusahaan Perdagangan Indonesia 120
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
594 NATRIUM KLORIDA Infus 0,9% 250 ml (SR) SATORIA Sodium Chloride WFI ad 250 ml Cairan Infus 0.9% 250 ml Botol 251,127.27 6,278.18 0.00 6,278.18 251,127.27 YA
Perusahaan Perdagangan Indonesia 40
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
595 NATRIUM KLORIDA Infus 0,9% 500 ml (SR) SATORIA Sodium Chloride WFI ad 500 ml Cairan Infus 0.9% 500 ml Botol 123,640.00 6,182.00 0.00 6,182.00 123,640.00 YA
Perusahaan Perdagangan Indonesia 20

596 NATRIUM KLORIDA Infus 0,9% 500 ml (WB) WIDATRA BHAKTI PT. Merapi Utama Pharma Sodium Chloride Cairan Infus 0.9% 500 ml Plabot Err:522 Err:522 0.00 Err:522 Err:522 YA
20

597 SODIUM CHLORIDE Infus 0,9% 500 ml (MH) EMJEBE PT. Kimia Farma Trading & Distribution Sodium Chloride Cairan Infus 0.9% 500 ml Botol Err:522 Err:522 7.00 Err:522 Err:522 Ya
Sodium Chloride 3,4g, Potassium Chloride 20
0,15g, Magnesium Chloride Hexahydrate 0,10g,
598 WIDA BES WIDATRA BHAKTI PT. Merapi Utama Pharma Cairan Infus Plabot Err:522 Err:522 30.00 Err:522 Err:522
Calcium chloride dihydrate 0,185g, Sodium 20
acetate
Sodiumtrihydrate 1,635g,
chloride 4,5 Malic acid
g; Potassium 0,335g0,75
chloride
599 WIDA KN-1 WIDATRA BHAKTI PT. Merapi Utama Pharma Cairan Infus Plabot Err:522 Err:522 25.00 Err:522 Err:522
g 20

600 SPIROLACTON Tab 100 mg (PR) PHAPROS PT. Rajawali Nusindo Spironolactone Tablet 100 mg Tablet 80,000.00 800.00 20.00 640.00 64,000.00
100

601 SPIRONOLACTONE Tab 100 mg (OT) OTTO OGB PT. Mensa Bina Sukses Spironolactone Tablet 100 mg Tablet 140,000.00 1,400.00 5.00 1,330.00 133,000.00
100

602 SPIRONOLACTONE Tab 25 mg (OT) OTTO OGB PT. Mensa Bina Sukses Spironolactone Tablet 25 mg Tablet 40,000.00 400.00 3.50 386.00 38,600.00
100

603 SUKRALFAT Syr 500 mg/5 ml (CB) COMBIPHAR PT. Anugerah Pharmindo Lestari Sucralfate Sirup 500 mg / 5 ml Botol 13,335.00 13,335.00 27.50 9,667.88 9,667.88
1

604 SUCRALFATE Syr 500 mg/5 ml (NP) NOVELL PT. Antarmitra Sembada Sucralfate Sirup 500 mg / 5 ml Botol 66,000.00 66,000.00 25.00 49,500.00 49,500.00
1

605 SUCRALFATE Tab 500 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Sucralfate Tablet 500 mg Tablet 78,540.00 785.40 74.30 201.82 20,181.82 YA
100

606 SUCRALFATE Tab 500 mg (CB) COMBIPHAR PT. Anugerah Pharmindo Lestari sucralfate Tablet 500mg Tablet 60,300.00 1,005.00 25.00 753.75 45,225.00
60

607 COTRIMOXAZOLE Syr 240 mg/5 ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Sulfamethoxazole Trimethoprim Sirup 240 mg / 5 ml Botol 6,000.00 6,000.00 40.00 3,600.00 3,600.00
1

608 COTRIMOXAZOLE Susp 240 mg/5 ml (IF) INDOFARMA PT. Indofarma Global Medika Sulfamethoxazole Trimethoprim Sirup 240 mg / 5 ml Botol 4,945.00 4,945.00 20.00 3,956.00 3,956.00
1

609 COTRIMOXAZOL Syr 240 mg/5 ml (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Sulfamethoxazole Trimethoprim Sirup 240 mg/5 ml Botol 5,994.00 5,994.00 20.00 4,795.20 4,795.20
1
PT. Penta Valent
PROMEDRAHARDJO FARMASI INDUSTRI
610 COTRIMOXAZOLE Tab 400 mg/80 mg (PM) PT. Millenium Pharmacon International Tbk Sulfamethoxazole Trimethoprim Tablet 480 mg Tablet 30,000.00 300.00 27.00 219.00 21,900.00
OGB 100
PT. Merapi Utama Pharma
611 COTRIMOXAZOLE Tab 480 mg (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Sulfamethoxazole Trimethoprim Tablet 480 mg Tablet 40,000.00 400.00 40.00 240.00 24,000.00
100

612 TAMSULOSIN Tab 0,4 mg (NP) Tamsulosin Tablet 0,4 mg Tablet 132,000.00 4,400.00 10.00 3,960.00 118,800.00
NOVELL PT. Antarmitra Sembada 30

613 TELMISARTAN Tab 80 mg (NP) Telmisartan Tablet 80 mg Tablet 100,000.00 5,000.00 25.00 3,750.00 75,000.00
NOVELL PT. Antarmitra Sembada 20

614 THIAMPENICOL Syr 125 mg/5 ml (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Thiampenicol Sirup 125 mg / 5 ml Botol 20,000.00 20,000.00 35.00 13,000.00 13,000.00
1

615 THIOPENTAL SODIUM Inj 0.5 g (BE) BERNO GENERIK PT. Parit Padang Globa,Anugerah Pharma Lestari, Tri Sapta Jaya Thiopental sodium Injeksi 0,5 g Ampul 680,000.00 68,000.00 20.00 54,400.00 544,000.00
10

616 TIZANIDINE Tab 2 mg Tizanidine tablet 2 mg tablet 66,000.00 2,200.00 35.00 1,430.00 42,900.00
NOVELL PT. Antarmitra Sembada 30

617 TRAMADOL Inj 100 mg/2 ml (MT) MERSIFARMA PT. Merapi Utama Pharma Tramadol Injeksi 100 mg/2 ml Ampul 12,000.00 2,400.00 0.00 2,400.00 12,000.00
5

618 TRAMADOL Inj 100 mg/2 ml (MB) MAHAKAM BETA FARMA PT. Daya Muda Agung Tramadol Injeksi 100 mg/2 ml Ampul 50,000.00 5,000.00 40.00 3,000.00 30,000.00
10

619 TRAMADOL Inj 100 mg/2 ml (NP) NOVELL PT. Antarmitra Sembada Tramadol Injeksi 100 mg/2 ml Ampul 29,100.00 5,820.00 37.00 3,666.60 18,333.00
5

620 TRAMADOL Kaps 50 mg (MT) MERSIFARMA PT. Merapi Utama Pharma Tramadol Kapsul 50 mg Kapsul 16,000.00 320.00 30.00 224.00 11,200.00
50
 Halaman 13 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan

621 TRAMADOL Kaps 50 mg( GF) GRAHA FARMA PT. Indofarma Global Medika Tramadol Kapsul 50 mg Kapsul 21,925.23 438.50 10.00 394.65 19,732.70
50

622 TRIAMCINOLONE ACETONIDE IA/ID 1 mg/ ml (NP) NOVELL PT. Antarmitra Sembada Triamcinolon Injeksi 10 mg / mL Vial 45,000.00 45,000.00 10.00 40,500.00 40,500.00
1

623 TRIAMCINOLONE Tab 4 mg (NP) NOVELL PT. Antarmitra Sembada Triamcinolon Tablet 4 mg Tablet 72,450.00 724.50 40.00 434.70 43,470.00
100

624 URSODEOXYCHOLIC ACID Kapl 250 mg (DM) DEXA MEDICA PT. Anugrah Argon Medica Ursodeoxycholic Acid Kaplet 250 mg Kaplet 168,000.00 5,600.00 60.00 2,240.00 67,200.00
30

625 URSODEOXYCHOLIC ACID Tab 250 mg (NP) NOVELL PT. Antarmitra Sembada Ursodeoxycholic Acid Tablet 250 mg Tablet 126,000.00 4,200.00 40.00 2,520.00 75,600.00
30

626 VALACYCLOVIR Kapl 500 mg (IN) INFION PT. United Dico Citas, PT. Merapi Utama Pharma Valacyclovir Kaplet 500 mg Kaplet 250,000.00 8,333.33 35.00 5,416.67 162,500.00
30

627 VALACICLOVIR Tab 500 mg (NP) Valacyclovir tablet 500 mg tablet 300,000.00 6,000.00 20.00 4,800.00 240,000.00
NOVELL PT. Antarmitra Sembada 50

628 VALSARTAN Filco Tab 160 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Valsartan Tablet 160 mg Tablet 165,000.00 5,500.00 70.00 1,650.00 49,500.00
30

629 VALSARTAN Tab 160 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Valsartan Tablet 160 mg Tablet 130,000.00 6,500.00 50.00 3,250.00 65,000.00
20

630 VALSARTAN Filco Tab 80 mg (HJ) HEXPHARM JAYA OGB PT. Enseval Putera Megatrading Valsartan Tablet 80 mg Tablet 120,000.00 4,000.00 75.00 1,000.00 30,000.00
30

631 VALSARTAN Tab 80 mg (NB) NULAB PHARMACEUTICAL INDONESIA OGB PT. Millennium Pharmacon Internasional Valsartan Tablet 80 mg Tablet 120,000.00 4,000.00 50.00 2,000.00 60,000.00
30

632 VANCOMYCIN Inj 0,5 g (PN) FAHRENHEIT PT. Kebayoran Farma Vancomycin Injeksi 0,5 g Vial 400,000.00 200,000.00 15.00 170,000.00 340,000.00
2

633 PYRIDOXINE (VIT B6) Tab 10 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Vit. B6 Tablet 10 mg Tablet 6,455.00 64.55 0.00 64.55 6,455.00 YA
100

634 VITAMIN B6 Tab 25 mg (ID) IMFARMIND INDUSTRI PT. Indofarma Global Medika Vit. B6 Tablet 25 mg Tablet 47,850.00 478.50 50.00 239.25 23,925.00
100

635 VITAMIN B1 Tab 100 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution VITAMIN B1 Tablet 100 mg Tablet 23,700.00 237.00 15.00 201.45 20,145.00
100

636 VITAMIN B12 Tab 0.05 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Vitamin B12 Tablet 0.05 mg Tablet 3,909.00 39.09 0.00 39.09 3,909.00 YA
100
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
637 WATER FOR INJECTION Sol 100 ml (SR) SATORIA Water For Injection WFI ad 100 ml Cairan Infus 100 ml Botol 208,000.00 5,200.00 0.00 5,200.00 208,000.00 YA
Perusahaan Perdagangan Indonesia 40
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
638 WATER FOR INJECTION Sol 25 ml (SR) SATORIA Water For Injection - Cairan Infus 25 ml Ampul 289,090.91 2,409.09 0.00 2,409.09 289,090.91 YA
Perusahaan Perdagangan Indonesia 120
PT. Kimia Farma Trading & Distribution, PT. United Dico Citas, PT.
639 WATER FOR INJECTION Sol 250 ml (SR) SATORIA Water For Injection - Cairan Infus 250 ml Botol 212,800.00 5,320.00 0.00 5,320.00 212,800.00 YA
Perusahaan Perdagangan Indonesia 40

640 WATER FOR INJECTION 500 ml (IP) IKAPHARMINDO PUTRAMAS PT. Distriversa Buanamas Water For Injection Larutan 500 ML Botol 25,000.00 25,000.00 35.00 16,250.00 16,250.00
1

641 ZINC SULFATE MONOHYDRATE Drops 10 mg/ml (MM) PT MEPROFARM MPI dan Penta Valen Zinc Sulfate Monohydrate Drops 10mg/ml Botol 7,130.00 7,130.00 25.00 5,347.50 5,347.50
1

642 ZINC SULFATE MONOHYDRATE Drops 10 mg/ml (CB) COMBIPHAR PT. Anugerah Pharmindo Lestari Zinc Sulfate Monohydrate Drops 10mg/ml Botol 9,000.00 9,000.00 25.00 6,750.00 6,750.00
1

643 ZINC SULFATE MONOHYDRATE Syr 20 mg/ 5 ml (ID) IMFARMIND INDUSTRI PT. Indofarma Global Medika Zinc Sulfate Monohydrate Sirup 20 mg/5 ml Botol 16,275.00 16,275.00 80.00 3,255.00 3,255.00
1

644 ZINK DISPERSIBEL Tab 20 mg (KF) KIMIA FARMA PT. Kimia Farma Trading & Distribution Zinc Sulfate Monohydrate Tablet 20 mg Tablet 23,000.00 230.00 0.00 230.00 23,000.00 YA
100

645 ZINC Tab Disp 20 mg (IF) INDOFARMA PT. Indofarma Global Medika Zinc Sulfate Monohydrate Tablet 20 mg Tablet 61,315.00 613.15 50.00 306.58 30,657.50
100

646 ZINC SULFATE MONOHYDRATE Tab 20 mg (MM) PT MEPROFARM MPI dan Penta Valen Zinc sulfate monohydrate Tablet 20 mg Tablet 55,000.00 550.00 30.00 385.00 38,500.00
100

647 ZINC SULFATE Syr 20 mg/5 ml (MM) PT MEPROFARM MPI dan Penta Valen Zinc sulfate monohydrate Sirup 20 mg/5 ml Tablet 8,000.00 8,000.00 55.00 3,600.00 3,600.00
1

Note :

Khusus Produk OGB Dexa Medica dan Satoria mengikuti harga per re
 Halaman 14 dari 14

DAFTAR OBAT GENERIK LOGO SISIPAN

SATUAN TERKECIL Harga Beli Per

NO NAMA OBAT PABRIK PBF Zat aktif utama Zat Aktif Lainnya Sediaan ISI PERKEMASAN DOSIS
(KEMASAN)
HNA PER KEMASAN HNA/SATUAN Discount Harga Beli Satuan E- CATALOG
Kemasan