DAFTAR HARGA OBAT INJ 2015 NO 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54
HARGA
NAMA OBAT ALBUMIN BEHRING 20% 100 ML ALBUMIN BEHRING 20% 100 ML (BPJS) AMINOFUSIN HEPAR ANBACIM INJ ANBACIM INJ (BPJS) BACTRAS INJ BIOXON INJ BENUTRION INF CAPSINAT INJ CERNEVIT INJ CEFOMAX INJ CEFOPERAZONE + SULBACTAM INJ CEPRAZ INJ CEFTIZOXIME INJ CEFTAZIDIME INJ CEFXON INJ CEFOBACTAM INJ CINAM INJ DYNASTAT INJ FLOXACAP INF GELOFUSIN INF GELAFUSAL INF LACEDIM INJ LAPIXIME INJ LAMESON 125 INJ LIVAMIN INF MEROBAT 1 GR INJ MEROBAT 0,5 GR INJ MEROSAN 1 GR INJ MEROSAN 0,5 GR INJ METRONIDAZOLE INF MEROPENEM 1 GR INJ MEROPENEM 0,5 GR INJ MIKASIN 250 INJ MAXILAN INJ NOVORAPID PEN OXTERCID INJ OTTOZOL INJ PANTOPUMP INJ PUMPICEL INJ PUMPITOR INJ ROCER INJ RYCEF INJ SNMC INJ SANSULIN R INJ SANSULIN PEN SANMOL INF SANEXON INJ STARXON INJ TAXEGRAM 1 GR INJ TAXEGRAM 0,5 GR INJ TERFACEF INJ TOPAZOL INJ TRILAC INJ
UMUM Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp
2,125,200 1,034,999 269,445 105,197 78,172 273,240 280,830 149,067 116,641 218,592 159,390 197,340 197,340 151,800 51,915 265,650 276,503 196,201 157,454 350,870 278,760 250,470 300,564 197,340 127,512 284,852 652,740 351,902 739,873 378,968 75,900 182,160 303,600 144,210 409,860 120,259 101,136 208,725 208,725 203,336 206,144 189,750 241,362 144,210 175,708 358,840 83,793 125,690 289,938 196,125 99,960 289,938 209,484 143,451
55 56
VENOFER INJ ZIDIFEC INJ
Rp Rp
279,312 358,096
2015 HARGA JAMINAN Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp
2,337,720 1,138,499 286,389 115,717 58,990 300,564 308,912 163,974 122,805 240,451 175,329 217,074 ### 166,980 57,107 317,262 304,154 215,821 173,200 385,957 306,635 275,517 330,620 217,074 140,263 313,337 718,014 387,093 812,860 416,865 83,490 200,376 333,960 158,631 450,846 132,065 111,250 229,597 ### 223,758 226,759 208,725 265,498 158,631 193,279 394,724 92,172 138,259 318,931 215,738 109,956 318,931 230,432 157,796
Rp Rp
307,243 393,905
DAFTAR HARGA VAKSIN 2016 HARGA UMUM JAMINAN
NAMA VAKSIN ACT HIB ATS ABU BCG / VIAL CAMPAK / VIAL EUVAX PAED EUVAX ADULT HAVRIX HB UNINJECT POLIO PPD / MANTOUX TES / CC (5 ORG) PPD / MANTOUX TES / VIAL PEDIACEL PENTABIO ROTARIX SYNFLORIX / IPD THYPHIM VI TRIMOVAX TRIPACEL TT / VIAL TT / CC COOPER T NOVA T IMPLANON ANDALAN IUD VERORAB
Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp
289,292 175,824 815,925 237,187 165,082 76,810 110,206 333,960 80,454 81,593 201,894 1,211,364 623,413 209,028 311,190 599,610 166,562 160,385 401,152 116,041 27,600 136,620 311,675 506,460 296,010 201,628
Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp
318,222 193,406 897,518 260,906 181,591 84,491 121,227 367,356 88,499 89,752 222,083 1,332,500 685,755 229,931 342,309 659,571 183,218 176,424 441,268 127,646 30,360 150,282 315,515 557,105 325,611 211,230
6 KETERANGAN HIBERIK TETANUS ANTI BISA ULAR HEP B HEP B HEP A HEP B TB PARU DPT + POLIO + HIB HB, DPT, HIB ROTAVIRUS PNEUMOCOCUS TYPUS MMR DPT Tidak Panas TETANUS KB 5 TH KB 3 TH KB 3 TH RABIES
