DAFTAR HARGA PRODUK INFUSAN BASIC SOLUTION SANBE DOUBLE PORT NO 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
NAMA PRODUK
KEMASAN
INFUSAN RL INFUSAN D5 INFUSAN NS INFUSAN D5+1/2NS INFUSAN D5+1/4NS INFUSAN R+D INFUMAL 10% INFUSAN RING AS TRIDEX 27A TRIDEX 27B TRIDEX 100 HYDROMAL TRIDEX PLAIN INFUSAN NS 100ML INFUSAN NS 250ML INFUSAN D5 100ML INFUSAN D5 250ML FUTROLIT INFUS INFUSAN D10 INFUSAN D5+NS INFUSAN D2,5+1/2NS SANBE WATER FOR IRRIGATION SANBE WATER FOR IRRIGATION
Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 100 cc Softbag 250 cc Softbag 100 cc Softbag 250 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 1000 cc Softbag 2000 cc
HARGA (Rp) HNA 17,800 18,150 17,350 18,550 18,350 18,650 84,400 20,000 19,500 19,500 21,250 66,000 18,100 15,450 15,300 16,200 16,100 52,950 18,100 16,850 16,250 16,650 25,950
HARGA (RP) HNA+PPN 19,580 19,965 19,085 20,405 20,185 20,515 92,840 22,000 21,450 21,450 23,375 72,600 19,910 16,995 16,830 17,820 17,710 58,245 19,910 18,535 17,875 18,315 28,545
DAFTAR HARGA PRODUK INFUS BASIC SOLUTION SANBE SINGLE PORT NO 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
NAMA PRODUK INFUSAN RL INFUSAN D5 INFUSAN NS INFUSAN D5+1/2NS INFUSAN D5+1/4NS INFUSAN R+D INFUMAL 10% INFUSAN RING AS INFUSAN M20 INFUCAP RL INFUCAP NS INFUCAP RING AS INFUCAP D5 INFUCAP D5+1/4 NS INFUCAP D5+1/2 NS INFUCAP R+D CAPTOSA 10%
KEMASAN Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc Softbag 500 cc
HARGA (Rp) HNA 16,300 16,750 15,850 16,950 16,850 17,100 82,900 18,550 76,800 16,300 15,850 18,550 16,750 16,850 16,950 17,100 82,900
HARGA (RP) HNA+PPN 17,930 18,425 17,435 18,645 18,535 18,810 91,190 20,405 84,480 17,930 17,435 20,405 18,425 18,535 18,645 18,810 91,190
DAFTAR HARGA PRODUK INFUS ASAM AMINO DAN NUTRISI NO
NAMA PRODUK
1 AMITEN 2 RENOSAN 3 LIVAMIN 4 PRECOPAR 5 BENUTRION VE 6 VALAMIN INFUS
KEMASAN Botol Gelas 200 ml Botol Gelas 500 ml Botol Gelas 500 ml Botol Gelas 500 ml Botol Gelas 250 ml Botol Gelas 500 ml
HARGA (Rp) HNA 88,300 228,200 192,350 193,850 100,700 65,350
HARGA (RP) HNA+PPN 97,130 251,020 211,585 213,235 110,770 71,885
DAFTAR HARGA PRODUK (OTHERS) NO
NAMA PRODUK
1 INFUSAN NS IRIGASI 2 PROANES 1% (MCT/LCT) 3 SANBE HEST 130 4 SANBE HEST 200 5 ENERTON 500 6 ASENTAT 7 BICARLIS 8 Lipomed 20% (MCT/LCT) 9 Lipomed 20% (MCT/LCT) 10 Lipomed 20% (MCT/LCT) * proanes 1 ampul : 73.100
KEMASAN Softbag 1000 ml Box 5 Ampul @20ml Softbag 500 ml Softbag 500 ml Softbag 500 ml Jerigen 5 L Jerigen 5 L Botol Gelas 100 ml Botol Gelas 250 ml Botol Gelas 500 ml
HARGA (Rp) HNA 23,250 365,500 190,050 178,250 71,300 74,000 57,400 115,600 210,150 287,000
HARGA (RP) HNA+PPN 25,575 402,050 209,055 196,075 78,430 81,400 63,140 127,160 231,165 315,700
SANBE DOUBLE PORT ITEM YANG MASUK BPJS I DO I DO I DO -
DISKON 10% 10% 10% 10% 10% 10% 10% 10% 10% 10% 10% 31.82% 10% 10% 10% 35.75% 35.63% 10% 10% 10% 10% 10% 10%
HARGA +PPN 17,622 17,969 17,177 18,365 18,167 18,464 83,556 19,800 19,305 19,305 21,038 49,499 17,919 15,296 15,147 11,449 11,400 52,421 17,919 16,682 16,088 16,484 25,691
ANBE SINGLE PORT ITEM YANG MASUK BPJS -
DISKON 10% 10% 10% 10% 10% 10% 10% 10% 10% 10% 10% 10% 10% 10% 10% 10% 10%
HARGA +PPN 16,137 16,583 15,692 16,781 16,682 16,929 82,071 18,365 76,032 16,137 15,692 18,365 16,583 16,682 16,781 16,929 82,071
DAN NUTRISI ITEM YANG MASUK BPJS -
DISKON 10% 10% 10% 10% 10% 10%
HARGA +PPN 87,417 225,918 190,427 191,912 99,693 64,697
S) ITEM YANG MASUK BPJS I DO -
DISKON 10% 10% 10% 10% 10% 10% 10% 10% 26.84% 10%
HARGA +PPN 23,018 361,845 188,150 176,468 70,587 73,260 56,826 114,444 169,120 284,130
DAFTAR HNA & HET PRODUK ONKOLOGI BRANDED NO
NAMA PRODUK
Gentanosan 200 Injeksi Romisan 40 mg Injeksi Romisan 100 mg Injeksi Rubisandin 10 mg Injeksi Sandobicin 10 mg Injeksi Sandobicin 50 mg Injeksi Santotaxel 30 mg Injeksi Santotaxel 100 mg Injeksi Sanroxa 50 mg Injeksi Sanotrexat 50 mg Injeksi
KEMASAN Box 1 vial @ o,5 ml + 1 vial solvent @ 1,5 ml Box 1 vial @ o,5 ml + 1 vial solvent @ 1,5 ml Box 1 vial @ 200mg Box 1 vial @ 2 ml Box 1 vial @ 5 ml Box 1 vial @ 5 ml Box 1 vial @ 5 ml Box 1 vial @ 25 ml Box 1 vial @ 5 ml Box 1 vial @ 16,7 ml Box 1 vial @ 10 ml Box 1 vial @ 2ml
GENERIK NO NAMA PRODUK 1 Docetaxel 20 mg Injeksi 2 Docetaxel 80 mg Injeksi 3 Doxorubicin Hcl 10 mg Injeksi 4 Doxorubicin Hcl 50 mg Injeksi 5 Epirubicin HCl 10 mg Injeksi 6 Gemcitabine 200 Injeksi 7 Gemcitabine 1000 Injeksi 8 Irinotecan HCl 40 mg Injeksi 9 Irinotecan HCl 100 mg Injeksi 10 Oxaliplatin 50 mg Injeksi 11 Paclitaxel 30 mg Injeksi 12 Paclitaxel 100 mg Injeksi 13 Methotrexate 50 mg Injeksi
KEMASAN Box 1 vial @ o,5 ml Box 1 vial @ o,5 ml Box 1 vial @ 5 ml Box 1 vial @ 25 ml Box 1 vial @ 5 ml Box 1 vial @ 200 mg Box 1 vial @ 1000 mg Box 1 vial @ 2 ml Box 1 vial @ 5 ml Box 1 vial @ 10 ml Box 1 vial @ 5 ml Box 1 vial @ 16,7 ml Box 1 vial @ 2 ml
1 Doxetasan Injeksi 20 mg 2 Doxetasan Injeksi 80 mg 3 4 5 6 7 8 9 10 11 12
HNA
HNA+PPN
1,854,450
2,039,895
5,408,700
5,949,570
695,450 927,250 1,912,350 255,000 169,300 695,550 999,100 2,595,050 1,970,400 66,300
764,995 1,019,975 2,103,585 280,500 186,230 765,105 1,099,010 2,854,555 2,167,440 72,930
HNA 1,390,850 3,466,550 73,050 278,450 173,900 478,150 1,694,350 732,350 1,778,500 1,501,500 522,750 1,313,300 44,200
HNA+PPN 1,529,935 3,813,205 80,355 306,295 191,290 525,965 1,863,785 805,585 1,956,350 1,651,650 575,025 1,444,630 48,620
Nama Generik Docetaxel Docetaxel Gemcitabine Irrinotecan Irrinotecan Epirubicin Hcl Doxorubicin Hc Doxorubicin Hc Paclitaxel Paclitaxel Oxaliplatin Methotrexate
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