| 1 Aff stitches | Rp 30,000 | Visit Domestic | | visit-domestic |
| 1 Stitches/1 wound suturing/1 hecting | Rp 75,000 | Visit Domestic | | visit-domestic |
| ABBOCATH 22 | Rp 108,000 | ALKES, Visit Domestic | | alkes|visit-domestic |
| ABBOCATH 24 | Rp 108,000 | ALKES, Visit Domestic | | alkes|visit-domestic |
| ACIFAR 400 MG TAB | Rp 10,076 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| ACITRAL SYR 120 ML | Rp 183,306 | INTERBAT, SYRUP, Visit Domestic | | interbat|syrup|visit-domestic |
| ACITRAL TAB ISI 10 | Rp 0 | INTERBAT, TABLET, Visit Domestic | | interbat|tablet|visit-domestic |
| AED + pad | Rp 5,000,000 | Visit Domestic | | visit-domestic |
| ALCO PLUS DMP SYR | Rp 216,837 | INTERBAT, SYRUP, Visit Domestic | | interbat|syrup|visit-domestic |
| ALLORIS TAB | Rp 0 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| ALOFAR 100MG TAB | Rp 2,957 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| AMBEVEN TAB | Rp 7,241 | ADAPOTEK, Kapsul, Visit Domestic | | adapotek|kapsul|visit-domestic |
| ANADEX SYR | Rp 175,418 | INTERBAT, SYRUP, Visit Domestic | | interbat|syrup|visit-domestic |
| ANALSIK TAB | Rp 0 | SANBE, TAB, Visit Domestic | | sanbe|tab|visit-domestic |
| ANTI HCV (RAPID) | Rp 790,000 | Visit Domestic | | visit-domestic |
| ANTI HCV TOTAL KUANTITATIF | Rp 965,000 | Visit Domestic | | visit-domestic |
| ANTIGEN | Rp 95,000 | Visit Domestic | | visit-domestic |
| APD COVER ALL | Rp 445,500 | ALKES, Visit Domestic | | alkes|visit-domestic |
| APIALYS SYR | Rp 181,711 | LAPI, SYRUP, Visit Domestic | | lapi|syrup|visit-domestic |
| APTT | Rp 380,000 | Visit Domestic | | visit-domestic |
| ARMSLING | Rp 270,000 | ALKES, Visit Domestic | | alkes|visit-domestic |
| ASPILET 80 MG TAB | Rp 3,167 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| ASTHAROL TAB | Rp 6,674 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| ATROPIN INJ | Rp 44,550 | ADAPOTEK, INFUS, INJEKSI, Visit Domestic | | adapotek|infus|injeksi|visit-domestic |
| AVIGAN TAB | Rp 46,407 | DEXA, TABLET, Visit Domestic | | dexa|tablet|visit-domestic |
| AZOMAX SYR | Rp 0 | DEXA, SYRUP, Visit Domestic | | dexa|syrup|visit-domestic |
| BACTIGRAS | Rp 121,500 | ALKES, Visit Domestic | | alkes|visit-domestic |
| BAQUINOR TAB | Rp 51,589 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| BECOM ZET TAB | Rp 11,976 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| BETA HCG | Rp 1,140,000 | Visit Domestic | | visit-domestic |
| BETADINE | Rp 20,250 | ADAPOTEK, SYRUP, Visit Domestic | | adapotek|syrup|visit-domestic |
| biaya tambahan Escort /km >5km | Rp 125,000 | Visit Domestic | | visit-domestic |
| BIDAI SPALK | Rp 0 | ALKES, Visit Domestic | | alkes|visit-domestic |
| BILIRUBIN DIREK | Rp 140,000 | Visit Domestic | | visit-domestic |
| BILIRUBIN TOTAL | Rp 140,000 | Visit Domestic | | visit-domestic |
| BILIRUBIN TOTAL DIREK INDIREK | Rp 280,000 | Visit Domestic | | visit-domestic |
| Blood pressure check | | Visit Domestic | | visit-domestic |
| BORRAGINOL S SUPP | Rp 76,950 | ADAPOTEK, SYRUP, Visit Domestic | | adapotek|syrup|visit-domestic |
| BT | Rp 105,000 | Visit Domestic | | visit-domestic |
| BUFECT FORTE SUSP | Rp 0 | SANBE, SYRUP, Visit Domestic | | sanbe|syrup|visit-domestic |
| BUN | Rp 115,000 | Visit Domestic | | visit-domestic |
| BURNAZIN CREAM 53 GR | Rp 294,307 | ADAPOTEK, CREAM, Visit Domestic | | adapotek|cream|visit-domestic |
| CALADINE LOTION 60 ML | Rp 73,560 | ADAPOTEK, LOTION, Visit Domestic | | adapotek|lotion|visit-domestic |
| CALCIUM | Rp 230,000 | Visit Domestic | | visit-domestic |
| CANDIDA, TRICOMONAS, GRAM GO | Rp 580,000 | Visit Domestic | | visit-domestic |
| CEFAT 500 MG TAB | Rp 38,570 | Kapsul, SANBE, Visit Domestic | | kapsul|sanbe|visit-domestic |
| CEFAT DS | Rp 0 | SANBE, SYRUP, Visit Domestic | | sanbe|syrup|visit-domestic |
| CEFSPAN 100 MG CAPS | Rp 53,833 | KALBE, Kapsul, Visit Domestic | | kalbe|kapsul|visit-domestic |
| CENDO EYEFRESH MINIDOSE | Rp 26,831 | ADAPOTEK, SYRUP, Visit Domestic | | adapotek|syrup|visit-domestic |
| CENDO XITROL MINIDOSE | Rp 28,249 | ADAPOTEK, SYRUP, Visit Domestic | | adapotek|syrup|visit-domestic |
| CERINI SYR | Rp 0 | SANBE, SYRUP, Visit Domestic | | sanbe|syrup|visit-domestic |
| CERNEVIT 750 MG INJ | Rp 750,000 | INFUS, INJEKSI, KALBE, Visit Domestic | | infus|injeksi|kalbe|visit-domestic |
| CHLORIDA | Rp 280,000 | Visit Domestic | | visit-domestic |
| CHOLESTEROL | Rp 105,000 | Visit Domestic | | visit-domestic |
| Cholesterol Test + Doctor fee | Rp 80,000 | Visit Domestic | | visit-domestic |
| CLANEKSI 500 MG TAB | Rp 64,525 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| CLANEKSI DS | Rp 251,856 | SANBE, SYRUP, Visit Domestic | | sanbe|syrup|visit-domestic |
| CLOPIDOGREL TAB | Rp 33,413 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| COLLAR NECK | Rp 1,093,500 | ALKES, Visit Domestic | | alkes|visit-domestic |
| CORTAMIN TAB | Rp 17,545 | INTERBAT, TABLET, Visit Domestic | | interbat|tablet|visit-domestic |
| CORTAMINE SYR | Rp 238,994 | INTERBAT, SYRUP, Visit Domestic | | interbat|syrup|visit-domestic |
| CORTIDEX INJ | Rp 35,612 | INFUS, INJEKSI, SANBE, Visit Domestic | | infus|injeksi|sanbe|visit-domestic |
| CREATININ | Rp 115,000 | Visit Domestic | | visit-domestic |
| CT | Rp 105,000 | Visit Domestic | | visit-domestic |
| D 40% OTSU | Rp 91,125 | ADAPOTEK, INFUS, INJEKSI, Visit Domestic | | adapotek|infus|injeksi|visit-domestic |
| D 5% SANBE | Rp 114,619 | INFUS, INJEKSI, SANBE, Visit Domestic | | infus|injeksi|sanbe|visit-domestic |
| D-DIMER | Rp 1,490,000 | Visit Domestic | | visit-domestic |
| DEMACOLIN TAB | Rp 2,957 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| DERMAFIX PLESTER INFUS | Rp 0 | ALKES, Visit Domestic | | alkes|visit-domestic |
| DIAGIT TAB | Rp 13,924 | INTERBAT, TABLET, Visit Domestic | | interbat|tablet|visit-domestic |
| DIGENTA CREAM | Rp 326,700 | CREAM, INTERBAT, Visit Domestic | | cream|interbat|visit-domestic |
| DL 5 DIFF | Rp 230,000 | Visit Domestic | | visit-domestic |
| DOCTOR FEE 08.00 – 22.00 | Rp 300,000 | Visit Domestic | | visit-domestic |
| DOCTOR FEE 22.00 – 08.00 | Rp 400,000 | Visit Domestic | | visit-domestic |
| DRESSING + DOCTOR FEE Large Dressing | Rp 300,000 | Visit Domestic | | visit-domestic |
| DRESSING + DOCTOR FEE Medium Dressing | Rp 250,000 | Visit Domestic | | visit-domestic |
| DRESSING + DOCTOR FEE Small Dressing | Rp 150,000 | Visit Domestic | | visit-domestic |
| DULCOLAX 10TAB | Rp 7,987 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| EAR SPOOLING/EYE IRIGATION + DOCTOR FEE 1 ear/eye | Rp 200,000 | Visit Domestic | | visit-domestic |
| EAR SPOOLING/EYE IRIGATION + DOCTOR FEE 2 ear/eye | Rp 300,000 | Visit Domestic | | visit-domestic |
| EKG | Rp 200,000 | Visit Domestic | | visit-domestic |
| ELASTIC BANDAGE/TENSOCREPE 10 CM | Rp 540,000 | ALKES, Visit Domestic | | alkes|visit-domestic |
| ELASTIC BANDAGE/TENSOCREPE 7,5 CM | Rp 452,250 | ALKES, Visit Domestic | | alkes|visit-domestic |
| ELASTOMULL HAFT | Rp 371,250 | ALKES, Visit Domestic | | alkes|visit-domestic |
| EPEXOL FDS | Rp 161,947 | SANBE, SYRUP, Visit Domestic | | sanbe|syrup|visit-domestic |
| EPINEPHRINE INJ | Rp 87,075 | ADAPOTEK, INFUS, INJEKSI, Visit Domestic | | adapotek|infus|injeksi|visit-domestic |
| EPISAN SUSP 200 ML | Rp 305,648 | SANBE, SYRUP, Visit Domestic | | sanbe|syrup|visit-domestic |
| EPRINOC TAB | Rp 19,562 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| Escort 2-5 km dgn perawat | Rp 750,000 | Visit Domestic | | visit-domestic |
| Escort 2-5 km dgn perawat + dokter | Rp 850,000 | Visit Domestic | | visit-domestic |
| Escort dekat <2km dgn perawat | Rp 500,000 | Visit Domestic | | visit-domestic |
| Escort rujukan | Rp 400,000 | Visit Domestic | | visit-domestic |
| Exploration/nail extraction/abscess incision/ tampon | Rp 250,000 | Visit Domestic | | visit-domestic |
| EZOL 20 MG TAB | Rp 47,520 | KALBE, TABLET, Visit Domestic | | kalbe|tablet|visit-domestic |
| EZOL 40 MG TAB | Rp 57,024 | KALBE, TABLET, Visit Domestic | | kalbe|tablet|visit-domestic |
| EZOMEB 40 MG INJ | Rp 513,216 | INFUS, INJEKSI, KALBE, Visit Domestic | | infus|injeksi|kalbe|visit-domestic |
| FARGETIK TAB | Rp 3,159 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| FARMOTEN TAB | Rp 3,698 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| FARSIFEN 400 MG TAB | Rp 4,455 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| FASIDOL PLUS TAB | Rp 0 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| FASORBID TAB | Rp 1,539 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| FECES LENGKAP | Rp 640,000 | Visit Domestic | | visit-domestic |
| FERITIN | Rp 525,000 | Visit Domestic | | visit-domestic |
| FLAMAR 50MG TAB | Rp 10,409 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| FLAMAR GEL | Rp 95,799 | GEL, SANBE, Visit Domestic | | gel|sanbe|visit-domestic |
| FLOXIGRA TAB | Rp 5,026 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| FOLLEY CATHETER | Rp 145,125 | ALKES, Visit Domestic | | alkes|visit-domestic |
| FORUMEN EAR DROPS | Rp 145,695 | SANBE, SYRUP, Visit Domestic | | sanbe|syrup|visit-domestic |
| FOSFOR | Rp 245,000 | Visit Domestic | | visit-domestic |
| GD2PP | Rp 70,000 | Visit Domestic | | visit-domestic |
| GDP | Rp 70,000 | Visit Domestic | | visit-domestic |
| GDS | Rp 70,000 | Visit Domestic | | visit-domestic |
| GENOINT SALEP MATA | Rp 46,373 | ADAPOTEK, SALEP, Visit Domestic | | adapotek|salep|visit-domestic |
| GGT | Rp 195,000 | Visit Domestic | | visit-domestic |
| GITAS INJ 20 MG AMP | Rp 159,266 | INFUS, INJEKSI, INTERBAT, Visit Domestic | | infus|injeksi|interbat|visit-domestic |
| GITAS PLUS TAB | Rp 29,700 | INTERBAT, TABLET, Visit Domestic | | interbat|tablet|visit-domestic |
| GLICOS 500 MG TAB | Rp 2,471 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| Gluco test | Rp 70,000 | Visit Domestic | | visit-domestic |
| GO | Rp 200,000 | Visit Domestic | | visit-domestic |
| GUANISTREP SYR | Rp 67,360 | ADAPOTEK, SYRUP, Visit Domestic | | adapotek|syrup|visit-domestic |
| HBA1C | Rp 350,000 | Visit Domestic | | visit-domestic |
| HBS AG (RAPID) | Rp 270,000 | Visit Domestic | | visit-domestic |
| HBS AG KUANTITATIF | Rp 875,000 | Visit Domestic | | visit-domestic |
| HDL | Rp 135,000 | Visit Domestic | | visit-domestic |
| HISTIGO TAB | Rp 7,533 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| HYPAFIX | Rp 170,100 | ADAPOTEK, Visit Domestic | | adapotek|visit-domestic |
| IGG CLAMIDIA | Rp 1,575,000 | Visit Domestic | | visit-domestic |
| IGG HSV 1 | Rp 790,000 | Visit Domestic | | visit-domestic |
| IGG HSV 2 | Rp 700,000 | Visit Domestic | | visit-domestic |
| IGG IGM ANTI DENGUE | Rp 875,000 | Visit Domestic | | visit-domestic |
| IGM (TUBEX) | Rp 265,000 | Visit Domestic | | visit-domestic |
| IGM CLAMIDIA | Rp 1,575,000 | Visit Domestic | | visit-domestic |
| IGM HSV 1 | Rp 790,000 | Visit Domestic | | visit-domestic |
| IGM HSV 2 | Rp 700,000 | Visit Domestic | | visit-domestic |
| INERSON SALEP | Rp 295,053 | INTERBAT, SALEP, Visit Domestic | | interbat|salep|visit-domestic |
| INFUS NACL 0,9 % 250ML 500 ML SANBE | Rp 109,488 | INFUS, INJEKSI, SANBE, Visit Domestic | | infus|injeksi|sanbe|visit-domestic |
| INFUS RL 500 ML SANBE | Rp 112,051 | INFUS, INJEKSI, SANBE, Visit Domestic | | infus|injeksi|sanbe|visit-domestic |
| INFUS SET MAKRO TERUMO | Rp 101,250 | ALKES, Visit Domestic | | alkes|visit-domestic |
| INFUS SET MIKRO TERUMO | Rp 0 | ALKES, Visit Domestic | | alkes|visit-domestic |
| Injection fee | Rp 75,000 | Visit Domestic | | visit-domestic |
| INTERZINC SYR | Rp 194,906 | INTERBAT, SYRUP, Visit Domestic | | interbat|syrup|visit-domestic |
| INTERZOL CREAM | Rp 149,109 | CREAM, INTERBAT, Visit Domestic | | cream|interbat|visit-domestic |
| INTRIZIN TAB | Rp 31,766 | INTERBAT, TABLET, Visit Domestic | | interbat|tablet|visit-domestic |
| IVFD insertion fee | Rp 100,000 | Visit Domestic | | visit-domestic |
| KALIUM | Rp 280,000 | Visit Domestic | | visit-domestic |
| KASA STERIL | Rp 60,750 | ALKES, Visit Domestic | | alkes|visit-domestic |
| Kateter urin insertion fee | Rp 150,000 | Visit Domestic | | visit-domestic |
| KENALOG CREAM 5 GR | Rp 266,838 | ADAPOTEK, CREAM, Visit Domestic | | adapotek|cream|visit-domestic |
| KN95 MASK | Rp 135,000 | ALKES, Visit Domestic | | alkes|visit-domestic |
| KULTUR DARAH MANUAL | Rp 770,000 | Visit Domestic | | visit-domestic |
| KULTUR FECES MANUAL | Rp 735,000 | Visit Domestic | | visit-domestic |
| KULTUR URINE MANUAL | Rp 930,000 | Visit Domestic | | visit-domestic |
| L-ACYS 200 MG CAPS | Rp 16,706 | Kapsul, LAPI, Visit Domestic | | kapsul|lapi|visit-domestic |
| LACOSIB 60 MG TAB | Rp 27,845 | LAPI, TABLET, Visit Domestic | | lapi|tablet|visit-domestic |
| LAPRAZ TAB | Rp 45,544 | Kapsul, SANBE, Visit Domestic | | kapsul|sanbe|visit-domestic |
| LDL | Rp 205,000 | Visit Domestic | | visit-domestic |
| LED | Rp 100,000 | Visit Domestic | | visit-domestic |
| LESPAIN CREAM | Rp 41,436 | ADAPOTEK, CREAM, Visit Domestic | | adapotek|cream|visit-domestic |
| LEVOCIN TAB | Rp 105,209 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| LIDOCAINE 2% INJ | Rp 10,125 | ADAPOTEK, INFUS, INJEKSI, Visit Domestic | | adapotek|infus|injeksi|visit-domestic |
| LOKEV CAPS | Rp 6,926 | ADAPOTEK, Kapsul, Visit Domestic | | adapotek|kapsul|visit-domestic |
| LOSTACEF 500 MG CAPS | Rp 12,960 | ADAPOTEK, Kapsul, Visit Domestic | | adapotek|kapsul|visit-domestic |
| MAGNESIUM | Rp 265,000 | Visit Domestic | | visit-domestic |
| MALARIA TEST MIKROSKOPIK | Rp 280,000 | Visit Domestic | | visit-domestic |
| MEFINAL 500MG TAB | Rp 7,614 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| MEGATIC 50 MG TAB | Rp 3,633 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| MICROPORE SURGICAL TAPE 0,5 | Rp 94,500 | ALKES, Visit Domestic | | alkes|visit-domestic |
| MUCOHEXIN TAB | Rp 2,880 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| NAMA BARANG | | Pabrikan, Sediaan, Visit Domestic | | pabrikan|sediaan|visit-domestic |
| NARKOTEST AMPH, MORFIN, THC | Rp 765,000 | Visit Domestic | | visit-domestic |
| NATRIUM | Rp 280,000 | Visit Domestic | | visit-domestic |
| NEBACETIN POWDER 5 GR | Rp 114,048 | ADAPOTEK, POWDER, Visit Domestic | | adapotek|powder|visit-domestic |
| Nebulizer | Rp 250,000 | Visit Domestic | | visit-domestic |
| NEURALGIN RX TAB | Rp 4,277 | KALBE, TABLET, Visit Domestic | | kalbe|tablet|visit-domestic |
| NEUROBAT FORTE INJ | Rp 70,166 | INFUS, INJEKSI, INTERBAT, Visit Domestic | | infus|injeksi|interbat|visit-domestic |
| NEUROSANBE 5000 | Rp 14,572 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| NEUTROSKIN INJ (COLAGEN) | Rp 0 | ADAPOTEK, INFUS, INJEKSI, Visit Domestic | | adapotek|infus|injeksi|visit-domestic |
| NISAGON CREAM 5 GR | Rp 59,940 | ADAPOTEK, CREAM, Visit Domestic | | adapotek|cream|visit-domestic |
| NS1 ANTIGEN | Rp 790,000 | Visit Domestic | | visit-domestic |
| Observation/1 hours | Rp 100,000 | Visit Domestic | | visit-domestic |
| ODANOSTIN 4 MG TAB | Rp 15,471 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| OMEPRAZOLE 40 MG INJEKSI VIAL | Rp 0 | ADAPOTEK, INFUS, INJEKSI, Visit Domestic | | adapotek|infus|injeksi|visit-domestic |
| ONDANSETRON 8MG INJ AMP | Rp 40,095 | ADAPOTEK, INFUS, INJEKSI, Visit Domestic | | adapotek|infus|injeksi|visit-domestic |
| OPSITE WATERPROOF BANDAGE | Rp 195,750 | ALKES, Visit Domestic | | alkes|visit-domestic |
| OTOPAIN EAR DROPS | Rp 278,438 | INTERBAT, SYRUP, Visit Domestic | | interbat|syrup|visit-domestic |
| OXYFLOW NASAL CANULE | Rp 168,750 | ALKES, Visit Domestic | | alkes|visit-domestic |
| OXYGEN MASK | Rp 202,500 | ALKES, Visit Domestic | | alkes|visit-domestic |
| Oxygenation/10 minutes + Doctor fee | Rp 150,000 | Visit Domestic | | visit-domestic |
| PAMOL ORAL DROP | Rp 220,431 | INTERBAT, SYRUP, Visit Domestic | | interbat|syrup|visit-domestic |
| PAMOL SUPP 250 MG | Rp 111,375 | INTERBAT, SYRUP, Visit Domestic | | interbat|syrup|visit-domestic |
| PAMOL SYR | Rp 0 | INTERBAT, SYRUP, Visit Domestic | | interbat|syrup|visit-domestic |
| PANTOCAINE EYE DROP 5 ML | Rp 133,650 | ADAPOTEK, SYRUP, Visit Domestic | | adapotek|syrup|visit-domestic |
| PCR | Rp 350,000 | Visit Domestic | | visit-domestic |
| PHAROLIT | Rp 7,695 | ADAPOTEK, SYRUP, Visit Domestic | | adapotek|syrup|visit-domestic |
| PISAU CUKUR | Rp 0 | ALKES, Visit Domestic | | alkes|visit-domestic |
| PISAU MESS | Rp 23,625 | ALKES, Visit Domestic | | alkes|visit-domestic |
| PLASMINEX TAB | Rp 15,455 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| POSTINOR 2 | Rp 55,688 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| PP TEST | Rp 220,000 | Visit Domestic | | visit-domestic |
| PROBIOKID | Rp 0 | SANBE, SYRUP, Visit Domestic | | sanbe|syrup|visit-domestic |
| PROLENE BENANG | Rp 311,850 | ALKES, Visit Domestic | | alkes|visit-domestic |
| PROVE D3 1000IU | Rp 14,256 | KALBE, TABLET, Visit Domestic | | kalbe|tablet|visit-domestic |
| PROVE VIT INJ | Rp 456,192 | INFUS, INJEKSI, KALBE, Visit Domestic | | infus|injeksi|kalbe|visit-domestic |
| PSA | Rp 875,000 | Visit Domestic | | visit-domestic |
| PT | Rp 525,000 | Visit Domestic | | visit-domestic |
| PULMICORT NEBULES 0.5 ML AMP | Rp 0 | ADAPOTEK, NEBUL, Visit Domestic | | adapotek|nebul|visit-domestic |
| RANITIDINE HCL 25 MG INJ AMP | Rp 13,365 | ADAPOTEK, INFUS, INJEKSI, Visit Domestic | | adapotek|infus|injeksi|visit-domestic |
| RATIVOL 30 MG INJ | Rp 173,829 | INFUS, INJEKSI, SANBE, Visit Domestic | | infus|injeksi|sanbe|visit-domestic |
| RECODRYL 15 MG INJ VIAL | Rp 35,551 | ADAPOTEK, INFUS, INJEKSI, Visit Domestic | | adapotek|infus|injeksi|visit-domestic |
| Rent whell chair (kursi roda)/day | Rp 200,000 | Visit Domestic | | visit-domestic |
| Resusitasi Jantung Paru/CPR /10 mnt | Rp 100,000 | Visit Domestic | | visit-domestic |
| RHINOS SR CAPS | Rp 0 | DEXA, Kapsul, Visit Domestic | | dexa|kapsul|visit-domestic |
| RHREMAFAR 4 MG TAB | Rp 6,561 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| SALTICIN CREAM | Rp 164,280 | CREAM, INTERBAT, Visit Domestic | | cream|interbat|visit-domestic |
| SANADRYL DMP 120ML | Rp 0 | SANBE, SYRUP, Visit Domestic | | sanbe|syrup|visit-domestic |
| SANEXON 16 MG | Rp 37,689 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| SANEXON 8 MG | Rp 0 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| SANKORBIN INJ | Rp 169,019 | INFUS, INJEKSI, SANBE, Visit Domestic | | infus|injeksi|sanbe|visit-domestic |
| SANMOL INF | Rp 290,348 | INFUS, INJEKSI, SANBE, Visit Domestic | | infus|injeksi|sanbe|visit-domestic |
| SANMOL TAB | Rp 1,713 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| SCABIMITE CREAM 10 GR (PERMETHERINE) | Rp 150,356 | ADAPOTEK, CREAM, Visit Domestic | | adapotek|cream|visit-domestic |
| SELVIM 10 MG TAB | Rp 4,658 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| SEREMIG 10 MG TAB | Rp 10,328 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| SGOT | Rp 125,000 | Visit Domestic | | visit-domestic |
| SGPT | Rp 125,000 | Visit Domestic | | visit-domestic |
| SI | Rp 350,000 | Visit Domestic | | visit-domestic |
| SINCRONIK TAB | Rp 0 | KALBE, TABLET, Visit Domestic | | kalbe|tablet|visit-domestic |
| SOFRATULLE | Rp 0 | ALKES, Visit Domestic | | alkes|visit-domestic |
| Spalk | Rp 150,000 | Visit Domestic | | visit-domestic |
| SPUIT 1 CC ONE MED | Rp 5,805 | ALKES, Visit Domestic | | alkes|visit-domestic |
| SPUIT 10 CC ONE MED | Rp 8,573 | ALKES, Visit Domestic | | alkes|visit-domestic |
| SPUIT 3 CC ONE MED | Rp 5,468 | ALKES, Visit Domestic | | alkes|visit-domestic |
| SPUIT 5 CC ONE MED | Rp 5,805 | ALKES, Visit Domestic | | alkes|visit-domestic |
| STARMUNO KIDS SYR | Rp 0 | KALBE, SYRUP, Visit Domestic | | kalbe|syrup|visit-domestic |
| STARMUNO TAB | Rp 33,650 | KALBE, TABLET, Visit Domestic | | kalbe|tablet|visit-domestic |
| STERI STRIP | Rp 0 | ALKES, Visit Domestic | | alkes|visit-domestic |
| STESOLID 5 MG/2,5 ML SUPP | Rp 169,425 | ADAPOTEK, SYRUP, Visit Domestic | | adapotek|syrup|visit-domestic |
| SYNBIO CAPS | Rp 20,652 | KALBE, Kapsul, Visit Domestic | | kalbe|kapsul|visit-domestic |
| TETAGAM INJ | Rp 556,875 | ADAPOTEK, INFUS, INJEKSI, Visit Domestic | | adapotek|infus|injeksi|visit-domestic |
| TG | Rp 115,000 | Visit Domestic | | visit-domestic |
| THROMBOPHOB GEL | Rp 229,713 | ADAPOTEK, GEL, Visit Domestic | | adapotek|gel|visit-domestic |
| TIBC | Rp 350,000 | Visit Domestic | | visit-domestic |
| TOMIT TAB | Rp 0 | INTERBAT, TABLET, Visit Domestic | | interbat|tablet|visit-domestic |
| TOPCORT CREAM | Rp 128,304 | CREAM, SANBE, Visit Domestic | | cream|sanbe|visit-domestic |
| TORASIC FC TAB 10 MG | Rp 24,948 | KALBE, TABLET, Visit Domestic | | kalbe|tablet|visit-domestic |
| TPHA | Rp 340,000 | Visit Domestic | | visit-domestic |
| TRADYL CAPS | Rp 0 | INTERBAT, Kapsul, Visit Domestic | | interbat|kapsul|visit-domestic |
| TRICHODAZOL TAB | Rp 9,469 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| TRIFED TAB | Rp 15,038 | INTERBAT, TABLET, Visit Domestic | | interbat|tablet|visit-domestic |
| TROVENSIS TAB 8 MG | Rp 50,325 | SANBE, TABLET, Visit Domestic | | sanbe|tablet|visit-domestic |
| UL | Rp 115,000 | Visit Domestic | | visit-domestic |
| UNDERPAD | Rp 30,375 | ALKES, Visit Domestic | | alkes|visit-domestic |
| UREUM | Rp 115,000 | Visit Domestic | | visit-domestic |
| URIC ACID | Rp 115,000 | Visit Domestic | | visit-domestic |
| Uric Acid test + Doctor fee | Rp 100,000 | Visit Domestic | | visit-domestic |
| URIN BAG | Rp 54,000 | ALKES, Visit Domestic | | alkes|visit-domestic |
| URINTER CAPS | Rp 0 | INTERBAT, Kapsul, Visit Domestic | | interbat|kapsul|visit-domestic |
| VAGISTIN SUPP | Rp 80,976 | ADAPOTEK, SUPP, Visit Domestic | | adapotek|supp|visit-domestic |
| VENTOLIN NEBULES 2.5 MG AMP | Rp 59,328 | ADAPOTEK, NEBUL, Visit Domestic | | adapotek|nebul|visit-domestic |
| VERBAN | Rp 57,375 | ALKES, Visit Domestic | | alkes|visit-domestic |
| VERORAB INJ | Rp 950,000 | ADAPOTEK, INFUS, INJEKSI, Visit Domestic | | adapotek|infus|injeksi|visit-domestic |
| VICRYL BENANG | Rp 506,250 | ALKES, Visit Domestic | | alkes|visit-domestic |
| VOMCERAN 8 MG INJ | Rp 0 | INFUS, INJEKSI, KALBE, Visit Domestic | | infus|injeksi|kalbe|visit-domestic |
| VOSEDON SUSP | Rp 165,941 | SANBE, SYRUP, Visit Domestic | | sanbe|syrup|visit-domestic |
| VRDL | Rp 230,000 | Visit Domestic | | visit-domestic |
| WATERPROOF BANDAGE 15,5X8,5 | Rp 0 | ALKES, Visit Domestic | | alkes|visit-domestic |
| WATERPROOF BANDAGE 9,5X8,5 | Rp 0 | ALKES, Visit Domestic | | alkes|visit-domestic |
| WIDAL | Rp 310,000 | Visit Domestic | | visit-domestic |
| WING NEEDLE TERUMO | Rp 87,750 | ALKES, Visit Domestic | | alkes|visit-domestic |
| ZEVASK 10 MG TAB | Rp 6,885 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| ZEVASK 5 MG TAB | Rp 4,155 | ADAPOTEK, TABLET, Visit Domestic | | adapotek|tablet|visit-domestic |
| ZYCIN 500 MG TAB | Rp 175,046 | INTERBAT, TABLET, Visit Domestic | | interbat|tablet|visit-domestic |