APT UMUMDAFTAR OBATTanggal Pemeriksaan : ___30 APRIL 2015______________________Nama Pemeriksa : ____MUTIARA REZKY NST______________________KodeNamaQtyHargaJumlahEJ01001Acifar 400 (07-18)25586,00$14,650EJ01240Acyclovir 400 mg Tab573,180.0EJ01002Acyclovir 5% Cream3.000,000.0EJ01003Afolat Tab (05-19)65138,00$8,970EU01004Afomix Tab (10-17)506.050,00$302,500EU01005Agrezol Tab (06-16)2247.018,00$1,572,032EU01009Alinamin F (04-16)5214.972,60$778,575EU01010Alkohol 70%4.477,000.0DU01159Alkohol 70% 1 ltr24.500,000.0DU01501ALL 110 (05-15)552.800,00$264,000EJ01006Allupurinol 100 mg (03-19)90165,00$14,850EJ01008Alprazolam 1 mg945,000.0EJ01219Ambroxol Syr3.298,000.0EJ01218Ambroxol Tab (12-18)93330,00$30,690EU01016Aminofluid Inf114.950,000.0EJ01009Aminophylin Inj (06-18)343.240,14$110,165EJ01212Amitripthylin indofarma (12-18)100150,00$15,000EJ01010Amitriptyllin Tab Yarindo (JKN)180,000.0EJ01236Amlodipin 5 mg (11-18)1191.151,99$137,087EU01019Amoxan Drop (02-17)822.403,67$179,229EU01020Anadium Tab (06-17)2617.260,00$1,894,860EU01021Anafen Syr (01-17)617.325,00$103,950EJ01173Antacida Syr (JKN)3.616,670.0EJ01228Antasida Doen Tab30,350.0EU01023Apitra Inj (02-16)8177.236,00$1,417,888EU01024Aprovel 150 (02-16)2611.772,00$306,072EU01025Aquabidest (05-17)723.256,00$234,432EU01028Arimed Tab (10-16)407.150,00$286,000EU01029Arixtra Inj (01-17)14522.500,00$7,315,000EJ01012Arkavit C (11-17)125450,00$56,250EU01030Arkine (05-15)20385,00$7,700EU01031Artem Inj (02-17)1533.124,00$496,860EJ01250Asam Mefenamat Tab197,180.0EJ01224Asam Traneksamat Tab (JKN) (02-17)851.045,00$88,825EJ01013Asam Tranexamat Inj (03-18)3911.000,00$429,000EJ01014Aspilet (01-17)40630,00$25,200EU01032Astamax6.292,000.0EU01034Atracurium Inj87.664,500.0EJ01015Atropin Sulfat Inj2.731,000.0EU01035ATS (05-15)23139.150,00$3,200,450EJ01017Batugin Elixir20.500,000.0EU01037Benocetam 3 gr Inj (11-17)1045.980,00$459,800EU01040Bernoflox Tab (11-17)912.100,00$108,900EU01499Betadin Kumur49.500,00$38,000EJ01238Betahistin Tab (12-17)80953,33$76,266EJ01018Betamethason Cr2.100,000.0EJ01019Bic. Natric220,000.0EU01044Biocurliv (08-16)1306.050,00$786,500EU01045Biodasin 300 (10-17)3006.897,00$2,069,100EU01046Bionemi (12-18)1201.210,00$145,200EU01047Bisolvon (01-18)1440.765,00$570,710EJ01020Bisoprolol 5 mg (05-16)1241.842,22$228,435DU01502BMT Platinum (01-17)6127.570,00$765,420DU01503BMT Regular (03-16)743.255,00$302,785EU01048Bondi ED6.655,000.0DU01013Botol susu3616.000,00$576,000EU01050Bralin Inj 500 mg (12-16)1363.525,00$825,825EJ01239Bronchitin Syr4.633,330.0EJ01223Bronchosal Tab (JKN) (11-19)79188,43$14,886EJ01023Bupivacain Inj58.666,670.0EU01054Burnazin Cr (10-15)644.165,00$264,990EU01055Buscotica Inj (03-16)3618.483,00$665,388EU01056Ca-Glukonas11.480,000.0EU01057Calnic13.025,00$3,025EU01058Calsiro Tab (08-16)2143.267,00$699,138EJ01026Calsium Laktat42,000.0EJ01211Captopril 12,5 mg89,940.0EJ01027Captopril 25 mg (05-18)9137,41$1,237EJ01029Carpiaton 25 mg (09-16)88554,50$48,796EU01059Catapres (09-17)1549.500,00$742,500EJ01032Cefadroxil 500 mg (02-19)1461.008,00$147,168EJ01034Cefezet Tab100,000.0EJ01035Cefixim 100 mg2.014,710.0EJ01036Cefixim 200 mg32.533,00$7,599EJ01237Cefixime Syr30.250,000.0EJ01037Cefotaxim I gr4.625,000.0EJ01038Ceftriaxon 1 gr (09-17)535.833,33$309,166EU01065Cendo Augentonic (11-16)826.166,00$209,328EU01066Cendo Berry (12-15)1533.638,50$556,691EU01067Cendo Carpin 2%21.326,000.0EU01068Cendo Catarlent (06-17)422.000,00$88,000EU01070Cendo Cenfress (01-18)226.143,33$52,287EU01071Cendo Conver 2%21.462,000.0EU01073Cendo Floxa30.896,500.0EU01075Cendo Hervis EO (03-17)544.468,00$222,340EU01076Cendo Homatro (12-15)832,175.00$257,400EU01077Cendo Lfx (09-16)963,750.00$573,750EU01078Cendo Lyteers (01-18)3321.175,00$698,775EU01079Cendo Mydriatil (09-17)732.312,00$226,184EU01080Cendo Natacten (09-16)145.787,00$45,787EU01081Cendo Pantocain 2% (09-17)817.325,00$138,600EU01082Cendo Poligran (05-16)821.175,00$169,400EU01083Cendo Poligran EO (06-16)422.385,00$89,540EU01084Cendo Polydex (07-17)2829.150,00$816,200EU01085Cendo Protagen A (02-17)2037.661,00$753,220EU01086Cendo Rephitel (06-16)544.468,00$222,340EU01087Cendo Timol 0,25% (07-17)1021.423,00$214,230EU01089Cendo Tobroson (01-16)926.923,00$242,307EU01091Cendo Tropine (11-16)1018.603,00$186,030EU01092Cendo Vernacel (06-17)225.289,00$50,578EU01093Cendo Vitolenta (07-17)629.282,00$175,692EU01094Cendo Xytrol (07-17)2926.812,00$777,548EU01095Cendo Xytrol EO (01-17)431.006,00$124,024EU01096Cephaflox Inj (10-16)15217.800,00$3,267,000EU01097Cernevit (10-15)6163.350,00$980,100EJ01039Cetrizine Tab (12-16)165313,50$51,728EU01099Chepamed Inj (10-15)348.400,00$145,200EU01102Ciflos tab (05-16)314.520,00$43,560EJ01040Ciproflaxacin 500 mg (11-16)100440,00$44,000EJ01041Citicolin Inj (02-16)1526.400,00$396,000EJ01042Citicolin Tab (11-19)606.799,83$407,990EU01107Clast (01-18)1722.002,00$344,344EJ01044Clindamycin 300 mg923,000.0EJ01045Clopidogrel Tab Dexa (JKN) (06-16)726.300,00$453,600EJ01046Codein Tab507,860.0EU01110Codipront Kap2008.525,00$1,705,000DU01024Collacure465.300,000.0DU01025Colostomi bag14.584,000.0EJ01048Cotrimoxazol100198,00$19,800EJ01050Curcuma tab6424.684,00$1,579,776EU01116Cycloproginova3109.934,00$329,802EU01118Cygest Supp 4007824.200,00$1,887,600EU01119Cygest Supp 200313.310,00$39,930EU01120Cymafort581.150,00$66,700EU01121D-40% (03-18)284.356,00$121,968EU01498D5%+1/2 NS OTSU0,000.0EJ01051Dexa Inj (05-18)412.402,27$98,493EJ01052Dexamethason 0,5 Tab120,000.0EU01123Dextrose 10% (09-19)386.435,50$244,549EU01125Dextrose 5% + 1/4 NS (01-17)2317.475,67$401,940EU01126Dextrose 5% 100 (03-16)80,000.0EU01127Dextrose 5% 500 (10-19)95.579,00$50,211EU01490Dextrose 5%+1/2 NS WIDA11.850,000.0EJ01054Diazepam 2 mg325,000.0EJ01055Diazol Inf8.000,000.0EU01129Digezym22.178,00$4,356EU01131Dome Drop (07-15)433.275,00$133,100EU01132Dome Syr (02-16)525.300,00$126,500EU01133Dome Tab13.146,00$3,146EJ01235Dopamin Injeksi (09-17)1544.545,00$668,175EU01136Dorbigot (05-17)1862.504,50$465,837EJ01056Doxicyclin 100 mg (09-18)80290,00$23,200EU01137Dulcolax0,000.0EU01138Dulcolax 10 mg1713.058,00$221,986EU01139Duvadilan Inj (06-17)3031.148,33$934,450EU01140Duvadilan Tab55.500,00$27,500EU01141Efomed Tab2541.210,00$307,340EU01143Elanos Tab293.630,00$105,270EU01145Endometryl514.092,00$208,692EU01479Engerix B6100.000,00$600,000EJ01059Epedrin inj2855.000,00$1,540,000EU01146Erycoat 500 tab144.782,00$66,948EJ01230Erythromycin Syr 200 mg/5 ml109.500,00$95,000EU01149Estin Drop749.133,33$343,933EJ01064Etafenin Tab155165,00$25,575DU01041Extension Tube2035.000,00$700,000EU01152Ezygard Forte416.159,83$252,553EU01153Ezygard Syr261.710,00$123,420EU01154Farelax Inj84.700,000.0EJ01071Fargoxin 0,25 mg (05-17)100495,00$49,500EJ01072Farmalat 10 mg (02-17)100327,50$32,750EJ01075Farsorbid 5140175,00$24,500EU01158Fenatic Tab605,000.0EU01160Fentanyl Inj744.767,00$313,369EU01495Ferriz FM Tablet290933,33$270,666EU01161Ferriz Syr430.855,00$123,420EU01162Fibramed 3001319.559,00$1,252,229EU01165Flamed Tab513.630,00$185,130EU01166Flexotide6021.054,00$1,263,240EJ01231Flunarizine Tab1500,000.0EU01168Forasma 2,5 mg1001.155,00$115,500DU01043Formalin Cair100040.000,00$40,000,000EU01172Frego 5 Mg (06-15)185.082,00$91,476EU01174Fuladic Cream (06-16)2249.610,00$1,091,420EJ01208Furosemide 40 mg Tab (12-18)21102,00$2,142EJ01080Furosemide Inj152.729,33$40,940EU01175Futrolit Inf (07-17)1063.802,00$638,020EU01176Galepsi Tab6610.648,00$702,768EU01178Gastrolan Cap12.100,000.0EU01179Gastrul Tab111.495,00$11,495EJ01082Genoint tts Mata7.000,000.0EJ01227Gentamicin Tetes Mata3.315,630.0EJ01083Gentamycin Cream981,480.0EJ01084Gentamycin Inj293.692,20$107,074EU01181Gitaramin5861.372,80$804,461EU01183Glisodin46.655,00$26,620EJ01088Glucosamin Tab2801.500,00$420,000EU01185Govazol Tab1175.625,00$831,875EU01186Gracef14205.700,00$2,879,800EU01188Gracivask 5 mg5.445,000.0EU01189Grafalax Syr948.308,33$434,775DU01169H2O2100010,00$10,000EJ01092HCT78400,00$31,200EU01191Hepamax Tab427.623,00$320,166EU01192Heptamyl147.865,00$110,110EJ01096Hufadon Tab49360,00$17,640EJ01097Hyocine Inj7.600,000.0EU01194Hytrin 1 Mg319.016,00$279,496EU01195Idesar Plus2706.861,00$1,852,470EU01473Illiadin 0.65% Tts Hidung113.500,00$13,500EU01199Inciclav Tab4012.403,00$496,120EU01477Infanrix Hexa495.000,000.0EU01489Infanrix Hib450.000,000.0EU01200Infelon Tab306.800,00$204,000EU01474Infix Syr771.500,00$500,500EJ01098INH 300177,620.0EJ01246INH CIBA 300320,000.0EU01202Inhitril 10 mg Tablet1305.445,00$707,850EU01203Inhitril 5 mg1743.391,00$590,034EU01205Interhistin71682,00$48,422EU01207Isoric 3001123.388,00$379,456EJ01099Itranidasal296,000.0EU01208Kaen 3B5918.271,00$1,077,989EU01209Kaen MG 3718.792,00$131,544EU01496Kalmeco Cap802.046,00$163,680EU01210Kalnex Inj3413.310,00$452,540EU01211Kaltrofen Supp1508.873,33$1,331,000EU01212Kanamycin 1 gr179.862,00$167,654EJ01100Kaotin Syr0,000.0EU01213KCl124.356,00$52,272EU01214Keto G7.502,000.0EJ01220Ketorolac inj Bernofarm5324.000,00$1,272,000EJ01206Ketorolac inj hexapharm5.033,330.0EU01486Kina Tab80980,10$78,408EJ01243Kloroquin Tab100,000.0DU01060Kondom cateter2.650,000.0DU01061Kondom Sutra0,000.0EU01218KSR2553.299,67$841,416EU01220KTM INJ 1 CC2002.002,00$400,400EU01222Kutoin Inj4790.448,00$4,251,056EU00540L-Bio320,000.0EU01223Lacbon1631.490,67$242,979EU01225Lactamor403.993,00$159,720DU01505Lactogen 180 mg1522.455,00$336,825EU01228Laktasi Tab1316.500,00$214,500EU01229Lanakeloid E (09-16)758.300,00$408,100EJ01207Lansoprazol Hexapharm375,830.0EJ01107Laxama Tab100263,00$26,300EU01232Lefos Inf 750 mg14317.625,00$4,446,750EU01233Lefos Tab7337.510,00$2,738,230EU01234Leomoxyl Cap213.267,00$68,607EJ01108Lerzin Syr240,000.0EU01236Letonal 100 mg13.933,00$3,933EJ01109Levofloxacin 500 mg30925,00$27,750EU01239Levonic Inf19199.650,00$3,793,350EJ01111Lidocain Inj782.026,97$158,104EU01241Lynoral511.618,00$82,518EU01242Manitol575.755,00$378,775EU01245Mebo0,000.0EU01248Medigrel Tab1412.650,00$177,100EU01249Meiact Tab2921.175,00$614,075EJ01117Meloxicam 15 mg58797,13$46,234EJ01118Meloxicam 7,5 mg33691,90$22,833EU01250Meropenem Inj 1 gr5227.333,33$1,136,667EJ01121Metformin Tab200,000.0EU01253Methylon Inj0,000.0EJ01122Methylprednisolon Inj630.000,00$180,000EJ01123Methylprednisolon Tab440,370.0EU01255Metilat Tab22.420,00$4,840EJ01126Metronidazole Tab 50080264,00$21,120EU01260Meylon2011.979,00$239,580EU01261MgSO4 20%63.964,00$23,784EU01262MgSO4 40%297.819,50$226,766EU01264Midazolam Inj22.361,000.0EU01266Moretic Drop222.990,00$45,980EJ01129Myomergin2014.950,00$994,950EJ01130Na diklofenac Tab44217,84$9,585EU01268Nacl 100 cc1412.221,00$171,094EU01271NaCl 500cc Wida445.772,67$253,997EU01272NaCL Sanbe3014.811,50$444,345DU01507Nan Ha5161.899,00$809,495EU01275Neo Gynoxa8613.860,00$1,191,960EU01276Neo K2813.552,00$379,456EU01277Nerva Plus42.178,00$8,712EU01278Neurobion Inj68.200,00$49,200EJ01131Neurodex Tab366235,00$86,010EU01280Nichomedson 4 mg2812.082,50$585,183DU01509NL 3310,000.0EU01281Nobor1593.993,00$634,887EU01282Noflam Tab134.840,00$62,920EU01284Nonflamin Cap464.491,00$206,586EU01285Norages839.406,67$780,754EU01286Norages syr424.200,00$96,800EU01287Norestil Tab14.194,00$4,194EJ01135Novadium Tab100193,50$19,350DU01081Novofine Needle3.600,000.0EU01289Nufaclind 300316.970,00$216,070EU01291Nufagrabion GM1.942,670.0EU01292Nufalev Tab6028.103,00$1,686,180EU01293Nufamicron Tab1381.863,00$257,094EU01294Nufanibrox syr1020.196,00$201,960EU01295Nufaprazol Cap8012.606,67$1,008,534EU01297Nufolic50,000.0EU01298Nulacta Plus15.566,00$5,566EU01300Nulox Forte2755,00$1,510EU01301Nutriflam619.620,00$586,820EU01302Nyndia Drop138.720,00$38,720EU01303Ofertil Tab213.310,00$26,620EJ01138Omelegar Tab100190,00$19,000EU01304Ondane Inj 4 mg3630.603,00$1,101,708EU01306Ondansentron 8 mg Inj138.000,00$104,000EJ01141Ondansetron Inj 4 mg323.833,33$122,667EU01308Opox Tab401.210,00$48,400EU01484Osfit DHA1243.593,33$445,573EU01310Otsu Salim 32414.548,00$349,152EU01311Ottopain Ear Drop537.208,00$186,040EJ01145Oxytocin Inj3672.259,17$829,115EU01312Pamol 125 mg297.912,00$229,448EU01313Pamol 250 mg1311.374,00$147,862EU01316Pantoprazole Inj3988.000,00$3,432,000EU01318Panzol Inj150.150,000.0EU01319Paracetamol Inf1359.725,00$776,425EJ01147Paracetamol Tab133114,00$15,162EU01320Paramol Inf666.550,00$399,300EU01321Pehacain199.350,00$177,650EU01322Penfri Spray488.935,00$355,740EU01324Petidin Inj5714.102,65$803,851EJ01151Phenobarbital300,000.0EU01326Piracetam Inj 3 gr522.579,00$112,895EJ01153Pirazinamid 500245,330.0EJ01156Pospargin Tab30550,00$16,500DU01510Pre Nan469.916,00$279,664EU01329Preschol 10 mg1306.171,00$802,230EU01482Prestrenol Tab305,500.00$165,000EU01331Proanes2175.241,93$1,580,081EU01332Procefa Inj9151.250,00$1,361,250EU01333Procur Plus1146.413,00$731,082EU01334Profat Syr59.436,670.0EU01335Profertil Tab10014.410,00$1,441,000EU01336Profim Cap17.902,500.0EU01338Progina Care 100 ml124.200,00$24,200EU01340Prohelic25.011,11$10,022EU01342Prolecin Tab7029.645,00$2,075,150EU01347Promuxol Drop531.350,00$156,750EJ01159Propanolol 10 mg7690,00$6,840EU01350Propect Tab431.071,50$46,075EU01352Propepsa 100 ml1051.150,00$511,500EU01497Proris Supp 125 mg112,000.00$12,000EU01353Proste Kap2663.146,00$836,836EU01468Proster Tab29610.450,00$3,093,200EU01354Prostigmin1519.051,00$285,765EJ01160PTU (05-19)85915,00$77,775EU01358Quamiprox Forte (02-18)2512.333,00$308,325EU01359Ranicare Syr (08-16)546.806,67$234,033EJ01213Ranitidin inj bernofarm (09-17)1101.696,28$186,591EJ01163Ranitidin tab (11-17)48264,00$12,672EU01361Renalof (19912.099,00$2,407,701EJ01167Rifampisin 450 Hexapharrm (JKN)1.383,330.0EU01364Rifamtibi 450 mg (01-18)74.325,75$30,280EU01365Rifamtibi 600 mg (01-17)635.948,00$374,724EU01471Rimactazid 300/450 kap8.514,000.0EU01366Ring As (08-15)1019.263,00$192,630EJ01241RL BRAUN (11-17)154.799,67$71,995EU01368RL Sanbe21.981,670.0EU01369RL Wida (12-19)735.709,00$416,757EU00376RL Wida Cairan0,000.0EU01371Ronazol Syr42.350,000.0EU01372Ropain Inj (05-17)8932.670,00$2,907,630EU01480Rotarix300.000,000.0EU01373RS (Ringer Solution's)1811.896,50$214,137EJ01217Salbutamol 2 mg70168,75$11,813EJ01172Samcobion200210,00$42,000EU01376Sanazet1931.307,00$252,251EU01377Sanbe Hest (04-16)21208.362,00$4,375,602EU01378Sanmol Drop (11-17)815.482,50$123,860EU01379Sanmol Syr (12-19)1610.912,00$174,592EU01380Sanmol tab1290,00$290EU01475Santa E Tab (10-16)753.586,00$268,950EU01381Santibi Plus (07-19)285610,50$173,993EU01382Selkom C22.118,00$4,236EU01383Sensikol (07-16)1165.198,00$602,968EU01384Serbuk VK104.950,00$49,500EU01385Sibital Inj29.922,00$19,844EJ01175Simvastatin (12-16)16513,00$8,208EU01387Sirbo Cream (07-17)193.170,00$93,170EJ01178Sotatic Inj (05-18)294.133,33$119,867EJ01179Spasminal Tab (02-19)183475,00$86,925EU01389Stesolid 10 mg Inj (07-19)1013.970,00$139,700EU01390Stesolid 5 mg Supp (11-15)826.136,00$209,088EU01392Stobled Tab48.168,00$32,672EJ01181Streptomycin Inj (06-19)505,500.00$275,000EU01393Sulcolon27.260,00$14,520EU01394Suldox12.218,00$2,218EJ01242Sulfadoxin Tab2.650,000.0EU01396Supramox Drop (07-17)123.595,00$23,595EU01481Synflorix1550.000,00$550,000EU01398Taxime 20026.050,00$12,100EU01399Teranol Inj (01-17)2039.325,00$786,500EU01400Teranol Tab (08-16)1205.687,00$682,440EU01401Termicef Inj53193.233,33$10,241,366EU01403Terral (Isofluran) 1 ml2506,984.00$1,746,000EU01406Theobron (06-15)1091.089,00$118,701DU01139Three way7.040,000.0EU01408Tiaryt (11-17)704.598,00$321,860EJ01183Tibigon tab (02-17)304$638$193,952EU01410Tisolon 4 mg (10-17)2073.086,00$638,802EU01413Tonotan Tab (01-17)3173.270,00$1,036,590EJ01229Tramadol Capsul (01-18)55750,00$41,250EJ01184Tramadol Inj7.682,200.0EU01415Tranec Inj12.705,000.0EU01416Tranec Tab (11-18)12.860,00$2,860EU01418Tribestan15.125,000.0EU01419Tridex (11-16)321.357,00$64,071EU01500Trimoxsul Syr (01-17)221.835,00$43,670EJ01185Trodet Tab (06-17)90430,00$38,700EU01422Tronadex Inj (06-15)230.250,00$60,500EU01427Urispas (09-18)794.774,00$377,146EU01428Ursolic Cap (07-17)769.801,00$744,876EU01429Valamin Inf (02-17)1273.697,50$884,370EU01430Valisanbe Inj (12-15)1913.685,00$260,015EU01432Vascon Inj121.000,000.0EU01433Vasgard 10 mg (01-16)1788.712,00$1,550,736EU01436Venosmil Gel1147.125,00$147,125EU01437Ventolin Expect (04-16)1649.610,00$793,760EU01438Ventolin Nebule (09-17)809.093,33$727,466EU01439Ventolin Syr (10-16)447.190,00$188,760EU01442Vioquin Tab (11-17)513.310,00$66,550EJ01192Vit B133,500.0EJ01193Vit B645,330.0EJ01194Vit C 100 mg (09-16)986.413,00$628,474EJ01195Vit C Tab (01-18)5232,00$1,664EJ01196Vit K Injeksi (JKN)4.070,000.0EJ01197Vita Curcumaris Syr4.400,000.0EJ01198Vitazym Tab (03-16)159550,00$87,450EU01449Vomecho Tab (05-17)1653.465,00$571,725EU01450Vomil B 6 (11-15)352.738,00$95,830EU01451Voxin Tab (06-17)6431.460,00$2,013,440EU01453Vroxyl Forte Syr (11-16)960.500,00$544,500EU01454Vroxyl Syr (11-16)645.375,00$272,250EU01455Widahest (05-18)5181.911,00$909,555EU01456Xidane Tab (07-15)1507.260,00$1,089,000EU01457Zanic Syr25.006,670.0EJ01234Zinc Syr0,000.0EJ01232Zinc Tab673,490.0EU01461Zine Syr (01-16)642.350,00$254,100EU01462Zinkid Syr (01-16)200,000.0EU01464Zistic Tab233.275,00$66,550Unalium tab151Trombhopob gel6Viccilin inj6EU01466Zolagel Cream (05-17)1028.875,00$288,750TOTAL$216,606,351Diketahui Oleh:Sibuhuan, 4 April 2015Dr.H Musbar M.KesSatria Ningsih, SAADirekturKa Unit Pengadaan Farmasi

APT JKNDAFTAR OBATTanggal Pemeriksaan : _________________________Nama Pemeriksa : __________________________KodeNamaQtyHargaJumlahEJ01001Acifar 40056586,00$32,816EJ01002Acyclovir 5% Cream13.000,00$3,000EJ01003Afolat Tab5138,00$690EJ01004Albendazol Tab14403,00$5,642EJ01005Allopurinol 300 mg124292,00$36,208EJ01006Allupurinol 100 mg67165,00$11,055EJ01007Alprazolam 0,5 mg189632,00$119,448EJ01008Alprazolam 1 mg94945,00$88,830EJ01219Ambroxol Syr283.298,00$92,344EJ01218Ambroxol Tab5330,00$1,650EJ01009Aminophylin Inj263.240,14$84,244EJ01225Aminophyllin Tab170,000.0EJ01212Amitripthylin indofarma195150,00$29,250EJ01236Amlodipin 5 mg2361.151,99$271,870EJ01173Antacida Syr (JKN)323.616,67$115,733EJ01228Antasida Doen Tab73930,35$22,429EU01025Aquabidest783.256,00$253,968EJ01012Arkavit C206450,00$92,700EJ01250Asam Mefenamat Tab470197,18$92,675EJ01224Asam Traneksamat Tab (JKN)981.045,00$102,410EJ01013Asam Tranexamat Inj3711.000,00$407,000EJ01014Aspilet215630,00$135,450EJ01015Atropin Sulfat Inj1292.731,00$352,299EJ01016Axofen Syr34.200,00$12,600EJ01017Batugin Elixir20.500,000.0EJ01238Betahistin Tab15953,33$14,300EJ01018Betamethason Cr282.100,00$58,800EJ01019Bic. Natric315220,00$69,300EJ01020Bisoprolol 5 mg101.842,22$18,422EJ01216Bledstop Inj428.000,00$336,000EJ01239Bronchitin Syr84.633,33$37,067EJ01223Bronchosal Tab (JKN)390188,43$73,488EJ01023Bupivacain Inj11058.666,67$6,453,334EJ01024Butasal 4 mg135,000.0EJ01026Calsium Laktat99042,00$41,580EJ01211Captopril 12,5 mg10389,94$9,264EJ01027Captopril 25 mg167137,41$22,947EJ01029Carpiaton 25 mg162554,50$89,829EJ01031Cazetin Drop220.500,00$41,000EJ01226Cefadroxil 125 mg Syr107.000,00$70,000EJ01032Cefadroxil 500 mg2151.008,00$216,720EJ01034Cefezet Tab161100,00$16,100EJ01035Cefixim 100 mg3132.014,71$630,604EJ01237Cefixime Syr30.250,000.0EJ01037Cefotaxim I gr174.625,00$78,625EJ01038Ceftriaxon 1 gr605.833,33$350,000EJ01248Cetrizine Drop1126.125,00$287,375EJ01039Cetrizine Tab313,500.0EJ01247Chloramphenicol Cap0,000.0EJ01040Ciproflaxacin 500 mg97440,00$42,680EJ01041Citicolin Inj3226.400,00$844,800EJ01042Citicolin Tab2226.799,83$1,509,562EJ01043Clindamycin 150 mg50530,00$26,500EJ01044Clindamycin 300 mg163923,00$150,449EJ01045Clopidogrel Tab Dexa (JKN)386.300,00$239,400EJ01046Codein Tab101507,86$51,294EJ01047Compyrantel 250 mg890,000.0EJ01048Cotrimoxazol110198,00$21,780EJ01050Curcuma tab55124.684,00$13,600,884EU01498D5%+1/2 NS OTSU0,000.0EJ01051Dexa Inj562.402,27$134,527EJ01052Dexamethason 0,5 Tab120,000.0EJ01053Dextrometorpan200,000.0EU01123Dextrose 10%6.435,500.0EU01127Dextrose 5% 5005.579,000.0EU01490Dextrose 5%+1/2 NS WIDA11.850,000.0EJ01054Diazepam 2 mg325,000.0EJ01055Diazol Inf158.000,00$120,000EJ01209Domperidon 10 mg indofarma403,520.0EJ01235Dopamin Injeksi2344.545,00$1,024,535EJ01056Doxicyclin 100 mg131290,00$37,990EJ01057Duramycin Tab 500 mg40105,00$4,200EJ01058Epedrin225,000.0EJ01059Epedrin inj55.000,000.0EJ01060Epinephrin Inj223.500,00$77,000EJ01061Erlamol Syr2.900,000.0EJ01062Erlamycetin Tts Mata7.000,000.0EJ01063Erlamycetin Tts Telinga53.500,00$17,500EJ01230Erythromycin Syr 200 mg/5 ml109.500,00$95,000EJ01064Etafenin Tab165,000.0EJ01066Etagemycetin Syr34.500,00$13,500EJ01067Etamoxul Tab175,000.0EJ01070Famacrol Forte39275,00$10,725EJ01071Fargoxin 0,25 mg190495,00$94,050EJ01072Farmalat 10 mg56327,50$18,340EJ01073Farmoten 12,5 mg170,000.0EJ01075Farsorbid 5171175,00$29,925EJ01076Fasidol Drop88.250,00$66,000EJ01078Flagsol Syr44.750,00$19,000EJ01079Flasicox tab2002.400,00$480,000EJ01231Flunarizine Tab1500,000.0EJ01208Furosemide 40 mg Tab47102,00$4,794EJ01080Furosemide Inj1362.729,33$371,189EJ01082Genoint tts Mata17.000,00$7,000EJ01227Gentamicin Tetes Mata243.315,63$79,575EJ01083Gentamycin Cream19981,48$18,648EJ01084Gentamycin Inj753.692,20$276,915EJ01085Gitri Syr3.400,000.0EJ01088Glucosamin Tab4141.500,00$621,000Tanggal Pemeriksaan : _________________________Nama Pemeriksa : __________________________EJ01089Gludefatic Tab250,000.0EJ01092HCT62400,00$24,800EJ01094Helixime Syr324.000,00$72,000EJ01095Hidrocortison Salep40,000.0EJ01096Hufadon Tab169360,00$60,840EJ01097Hyocine Inj367.600,00$273,600DJ01026Hypafix Kotak 10 cm x 5 m3112.500,00$337,500EJ01254Ibuprofen Tab600,000.0DJ01009Infusset Micro Gea563.500,00$196,000DJ01010Infusset Macro Gea583.000,00$174,000EJ01098INH 300483177,62$85,790EJ01246INH CIBA 3000,000.0EU01208Kaen 3B18.271,000.0EU01211Kaltrofen Supp8.873,330.0EJ01100Kaotin Syr53500$17,500DJ01030Kasa Gulung0,000.0DU01059Kasa Hidrofil Biru183.492,00$62,856DU01175Kertas EKG390.000,00$270,000EJ01220Ketorolac inj Bernofarm10424.000,00$2,496,000EJ01206Ketorolac inj hexapharm5.033,330.0EU01486Kina Tab80980,10$78,408EJ01243Kloroquin Tab50100,00$5,000DU01062Laminaria M13107.000,00$1,391,000EJ01207Lansoprazol Hexapharm375,830.0EJ01107Laxama Tab475263,00$124,925EJ01108Lerzin Syr240,000.0EJ01109Levofloxacin 500 mg195925,00$180,375EJ01111Lidocain Inj782.026,97$158,104EJ01115Lostacef 250 mg Syr20,000.0EJ01117Meloxicam 15 mg307797,13$244,719EJ01118Meloxicam 7,5 mg306691,90$211,721EJ01119Meropenem Inj0,000.0EJ01120Mersibion Inj214.840,00$101,640EJ01121Metformin Tab90200,00$18,000EJ01122Methylprednisolon Inj1730.000,00$510,000EJ01123Methylprednisolon Tab694440,37$305,617EJ01125Metronidazole Inf Hexapharm0,000.0EJ01126Metronidazole Tab 500334264,00$88,176EU01261MgSO4 20%63.964,00$23,784EU01262MgSO4 40%247.819,50$187,668EJ01244Miconazole Cream63.000,00$18,000EJ01128Micoticum Tab (JKN)198617$122,166EJ01129Myomergin2014.950,00$994,950EJ01130Na diklofenac Tab35217,84$7,624EU01271NaCl 500cc Wida5.772,670.0EU01476Nebacetin Powder/Tabur0,000.0EU01276Neo K13.552,000.0EJ01131Neurodex Tab285235,00$66,975EJ01134Nofabiotik 500 mg280,000.0Tanggal Pemeriksaan : _________________________Nama Pemeriksa : __________________________EU01285Norages9.406,670.0EJ01135Novadium Tab252193,50$48,762EJ01136Novaflox Tab485,000.0DU01081Novofine Needle73.600,00$25,200EJ01137Omedom Tab207,500.0EJ01138Omelegar Tab332190,00$63,080EU01306Ondansentron 8 mg Inj8.000,000.0EJ01141Ondansetron Inj 4 mg1063.833,33$406,333EJ01142Ondansetron Tab 4 mg0,000.0EJ01253Oralit10600$6,000EU01310Otsu Salim 32414.548,00$349,152EJ01144Ottoryl 25 mg0,000.0EJ01145Oxytocin Inj3672.259,17$829,115EJ01146Pallerskin Tab324160,00$51,840EU01312Pamol 125 mg367.912,00$284,832EJ01245Paracetamol Syr2.706,000.0EJ01147Paracetamol Tab500114,00$57,000EJ01148Pharmafix Cap0,000.0EJ01150Pharmamox Tab245592,00$145,040EJ01151Phenobarbital194300,00$58,200EJ01152Phylocin Tab 250 mg80475,00$38,000EJ01252Piracetam Tab 400 mg0,000.0EJ01153Pirazinamid 500719245,33$176,392DU01090Poly Cateter No.167.088,330.0DU01091Poly Cateter No.187.000,000.0DU01094Poly Cateter No.818.150,000.0DU01096Poly Cathther 147.000,000.0EJ01156Pospargin Tab90550,00$49,500EJ01157Prednison Tab9530,000.0EJ01158Primaquin Tab70100,00$7,000EJ01159Propanolol 10 mg26890,00$24,120EU01468Proster Tab10.450,000.0EJ01160PTU85915,00$77,775EJ01161Pyrantel Pamoat 125 mg920,000.0EJ01213Ranitidin inj bernofarm1001.696,28$169,628EJ01163Ranitidin tab100264,00$26,400EJ01164Rhemacox 15 mg0,000.0EJ01165Rhemafar0,000.0EJ01167Rifampisin 450 Hexapharrm (JKN)1611.383,33$222,716EJ01168Rindopain Tab1113,414.00$378,954EJ01241RL BRAUN (11-17)134.799,67$62,396EU01369RL Wida5.709,000.0EJ01169Rosidon Syr53,700.00$18,500EJ01217Salbutamol 2 mg157168,75$26,494EJ01172Samcobion107210,00$22,470EJ01175Simvastatin264513,00$135,432EJ01178Sotatic Inj544.133,33$223,200EJ01179Spasminal Tab339475,00$161,025Tanggal Pemeriksaan : _________________________Nama Pemeriksa : __________________________EJ01181Streptomycin Inj625500$341,000EJ01242Sulfadoxin Tab382.650,00$100,700EJ01183Tibigon tab560638$357,280EJ01229Tramadol Capsul170750,00$127,500EJ01184Tramadol Inj7.682,200.0EJ01185Trodet Tab69430,00$29,670EU01438Ventolin Nebule9.093,330.0EJ01188Viccilin 1 gr85500$44,000EJ01191Vit B Komplex45066,10$29,745EJ01192Vit B116433,50$5,494EJ01193Vit B665645,33$29,736EJ01194Vit C 100 mg746.413,00$474,562EJ01195Vit C Tab100032,00$32,000EJ01196Vit K Injeksi (JKN)4.070,000.0EJ01251Vit K Tab65150,00$9,750EJ01197Vita Curcumaris Syr334.400,00$145,200EJ01198Vitazym Tab200550,00$110,000EJ01201Zelona Tab0,000.0EJ01234Zinc Syr0,000.0EJ01232Zinc Tab219673,49$147,494Azithromycin Tab80$9,000$720,000Flamigra Tab250$300$75,0000.00.0TOTAL$47,221,253Diketahui Oleh:Sibuhuan, 4 April 2015Dr.H Musbar M.KesSatria Ningsih, SAADirekturKa Unit Pengadaan Farmasi

GUDANG DAFTAR OBATTanggal Pemeriksaan : _________________________Nama Pemeriksa : __________________________KodeNamaQtyHargaJumlahEJ01240Acyclovir 400 mg Tab250573,18$143,295EJ01003Afolat Tab1000138,00$138,000EU01004Afomix Tab6.050,000.0EU01009Alinamin F14.972,600.0DJ01015Alkohol 70% 1 ltr600023$138,000EJ01006Allupurinol 100 mg165,000.0EJ01008Alprazolam 1 mg1300945,00$1,228,500EJ01219Ambroxol Syr1213.298,00$399,058EJ01218Ambroxol Tab1200330,00$396,000EJ01009Aminophylin Inj723.240,14$233,290EJ01225Aminophyllin Tab170,000.0EJ01212Amitripthylin indofarma1500150,00$225,000EJ01236Amlodipin 5 mg4001.151,99$460,796EU01019Amoxan Drop22.403,670.0EU01021Anafen Syr17.325,000.0EJ01173Antacida Syr (JKN)1003.616,67$361,667EJ01228Antasida Doen Tab100030,35$30,350EJ01011Aptor500630$315,000EU01025Aquabidest2403.256,00$781,440EU01026Aquabidest 1000 ml50003.256,00$16,280,000EJ01250Asam Mefenamat Tab1200197,18$236,616EJ01224Asam Traneksamat Tab (JKN)24001.045,00$2,508,000EJ01013Asam Tranexamat Inj10011.000,00$1,100,000EJ01014Aspilet200630,00$126,000DU01007Assucry 33678.333,34$2,820,000DU00008Assucryl 116879,000.00$13,272,000DU01009Assucryl 215670.998,34$11,075,741EU01034Atracurium Inj87.664,500.0EJ01015Atropin Sulfat Inj1002.731,00$273,100DJ01016Betadin 5 liter5000154$770,000EU01499Betadin Kumur9.500,000.0EJ01238Betahistin Tab500953,33$476,665EJ01018Betamethason Cr502.100,00$105,000EU01045Biodasin 3002506.897,00$1,724,250EU01046Bionemi5001.210,00$605,000EJ01020Bisoprolol 5 mg1.842,220.0DU01012Blood Bag45.320,000.0DU01502BMT Platinum127.570,000.0DU01503BMT Regular43.255,000.0DU01013Botol susu16.000,000.0EU01050Bralin Inj 500 mg5063.525,00$3,176,250EJ01239Bronchitin Syr4.633,330.0EJ01223Bronchosal Tab (JKN)2200188,43$414,546EJ01023Bupivacain Inj58.666,670.0EJ01026Calsium Laktat200042,00$84,000EJ01211Captopril 12,5 mg160089,94$143,904EJ01027Captopril 25 mg4100137,41$563,381EJ01029Carpiaton 25 mg200554,50$110,900DJ01017Cat gut Plain 10,000.0EU01059Catapres2049.500,00$990,000DU01016Catgut Chromic 2/0 sachet0,000.0DJ01019Catgut Chromic 3/00,000.0DU01018Catgut Chromic 3/0 Sachet38.367,000.0DJ01021Catgut cromic 20,000.0DJ01050Catgut Plain 3/00,000.0EJ01032Cefadroxil 500 mg31001.008,00$3,124,800EU01063Cefdim Inj199.650,000.0EJ01035Cefixim 100 mg30702.014,71$6,185,160EJ01237Cefixime Syr730.250,00$211,750EJ01038Ceftriaxon 1 gr1025.833,33$595,000EU01078Cendo Lyteers21.175,000.0EU01079Cendo Mydriatil32.312,000.0EU01084Cendo Polydex29.150,000.0EU01087Cendo Timol 0,25%21.423,000.0EU01094Cendo Xytrol26.812,000.0DU01023Cerflast Cavity 100 x 150 mm88.000,000.0EJ01248Cetrizine Drop26.125,000.0EJ01039Cetrizine Tab313,500.0EJ01040Ciproflaxacin 500 mg3200440,00$1,408,000EJ01041Citicolin Inj14026.400,00$3,696,000EJ01042Citicolin Tab6.799,830.0EJ01044Clindamycin 300 mg923,000.0EJ01045Clopidogrel Tab Dexa (JKN)6006.300,00$3,780,000EJ01046Codein Tab1300507,86$660,218DU01025Colostomi bag14.584,000.0EJ01050Curcuma tab440024.684,00$108,609,600EU01116Cycloproginova109.934,000.0EU01498D5%+1/2 NS OTSU0,000.0EJ01051Dexa Inj5002.402,27$1,201,135EU01123Dextrose 10%406.435,50$257,420EU01125Dextrose 5% + 1/4 NS17.475,670.0EU01127Dextrose 5% 500605.579,00$334,740EU01490Dextrose 5%+1/2 NS WIDA11.850,000.0EJ01055Diazol Inf1508.000,00$1,200,000EJ01209Domperidon 10 mg indofarma3500403,52$1,412,320EJ01056Doxicyclin 100 mg800290,00$232,000EJ01057Duramycin Tab 500 mg200105,00$21,000EU01139Duvadilan Inj31.148,330.0EU01140Duvadilan Tab1005.500,00$550,000DU01029Electroda 3M4.549,330.0DU01035Endotracheal Tube no.440.000,000.0DU01036Endotracheal Tube no.4,540.000,000.0DU01037Endotracheal Tube no.540.000,000.0DU01038Endotracheal Tube no.640.000,000.0EJ01060Epinephrin Inj3.500,000.0EJ01230Erythromycin Syr 200 mg/5 ml149.500,00$133,000EU01149Estin Drop49.133,330.0EJ01064Etafenin Tab600165,00$99,000DU01041Extension Tube35.000,000.0EJ01071Fargoxin 0,25 mg495,000.0EJ01072Farmalat 10 mg600327,50$196,500EJ01073Farmoten 12,5 mg300170,00$51,000EJ01075Farsorbid 5175,000.0DJ01024Film USG 4 Dimensi 100x148mm0,000.0EJ01079Flasicox tab2002.400,00$480,000EJ01208Furosemide 40 mg Tab2100102,00$214,200EJ01080Furosemide Inj1752.729,33$477,633EJ01249Gabapentin 300 mg3607.766,67$2,796,001EU01176Galepsi Tab24010.648,00$2,555,520EJ01227Gentamicin Tetes Mata3.315,630.0EJ01083Gentamycin Cream981,480.0EJ01084Gentamycin Inj3.692,200.0EU01181Gitaramin1.372,800.0EJ01088Glucosamin Tab4001.500,00$600,000DU01048Gudel Dewasa28.025,000.0DU01052Handscoen 7,510.461,000.0DJ01008Handscoon Maxter3.850,000.0DU01053Handscoon Panjang15.894,330.0DU01054Handscoon Steril no 711.183,000.0DU01055Handscuen 7.5 Non steril451,670.0EJ01092HCT400,000.0EJ01094Helixime Syr24.000,000.0EJ01096Hufadon Tab3400360,00$1,224,000EJ00095Hufadon Tab (Tablet) -JKN200,000.0DJ01026Hypafix Kotak 10 cm x 5 m112.500,000.0EU01474Infix Syr1471.500,00$1,001,000DU01056Infusion Set Makro10.100,000.0DU01057Infusion Set Mikro13.750,000.0DJ01009Infusset Micro Gea3.500,000.0DJ01010Infusset Macro Gea3.000,000.0EJ01098INH 300177,620.0EJ01246INH CIBA 3000,000.0DJ01032K-Y Jelly0,000.0EU01496Kalmeco Cap2.046,000.0EU01210Kalnex Inj4013.310,00$532,400EU01211Kaltrofen Supp8.873,330.0DJ01028Kapas 500 gr0,000.0DJ01030Kasa Gulung0,000.0DU01059Kasa Hidrofil Biru3.492,000.0EJ01220Ketorolac inj Bernofarm9024.000,00$2,160,000EJ01206Ketorolac inj hexapharm5.033,330.0EU01486Kina Tab980,100.0EU01218KSR1003.299,67$329,967EU01223Lacbon3001.490,67$447,201EJ01207Lansoprazol Hexapharm375,830.0EJ01107Laxama Tab263,000.0EJ01108Lerzin Syr0,000.0EJ01109Levofloxacin 500 mg1650925,00$1,526,250EU01239Levonic Inf40199.650,00$7,986,000EJ01111Lidocain Inj1002.026,97$202,697DJ01033Lomatule 10cm x 10cm14.300,000.0DU01064Masker550,000.0EJ01117Meloxicam 15 mg1400797,13$1,115,982EJ01118Meloxicam 7,5 mg450691,90$311,355EU01250Meropenem Inj 1 gr15227.333,33$3,410,000DU01521Mersilk 3/0 Ronded27.000,000.0EJ01121Metformin Tab3300200,00$660,000EJ01122Methylprednisolon Inj5130.000,00$1,530,000EJ01123Methylprednisolon Tab2100440,37$924,777EU01256Metronidazole inf5022.000,00$1,100,000EJ01126Metronidazole Tab 5003500264,00$924,000EJ01129Myomergin4.950,000.0EJ01130Na diklofenac Tab217,840.0EU01271NaCl 500cc Wida2805.772,67$1,616,348EU01272NaCL Sanbe14.811,500.0DU01067Nasal oksigen cannula (dewasa)10.000,000.0DU01068Nasal oksigen cannula (pth/Anak)10.000,000.0DU01069Needle No 23350,000.0DU01070Needle No 27385,000.0EU01276Neo K13.552,000.0EJ01131Neurodex Tab6600235,00$1,551,000DU01076NGT No.1414.000,000.0DU01077NGT No.1614.000,000.0DU01078NGT No.1814.166,670.0EU01280Nichomedson 4 mg4002.082,50$833,000EU01285Norages9.406,670.0EJ01135Novadium Tab900193,50$174,150EU01291Nufagrabion GM1.942,670.0EU01293Nufamicron Tab2001.863,00$372,600EU01294Nufanibrox syr20.196,000.0EJ01138Omelegar Tab700190,00$133,000EU01306Ondansentron 8 mg Inj808.000,00$640,000EJ01141Ondansetron Inj 4 mg2003.833,33$766,666DU01082Onescrub 5 L0,000.0EU01484Osfit DHA3.593,330.0EJ01145Oxytocin Inj2.259,170.0EJ01146Pallerskin Tab160,000.0EU01312Pamol 125 mg7.912,000.0EU01316Pantoprazole Inj88.000,000.0EU01318Panzol Inj280150.150,00$42,042,000EU01319Paracetamol Inf59.725,000.0EJ01147Paracetamol Tab500114,00$57,000EJ01150Pharmamox Tab592,000.0EJ01152Phylocin Tab 250 mg200475,00$95,000EJ01153Pirazinamid 5002000245,33$490,660EJ01156Pospargin Tab400550,00$220,000EJ01158Primaquin Tab100,000.0EU01331Proanes75.241,930.0EU01332Procefa Inj20151.250,00$3,025,000EU01333Procur Plus3506.413,00$2,244,550EU01342Prolecin Tab39029.645,00$11,561,550EJ01159Propanolol 10 mg130090,00$117,000EU01352Propepsa 100 ml51.150,000.0EU01497Proris Supp 125 mg0,000.0EU01468Proster Tab10.450,000.0EJ01160PTU1300915,00$1,189,500EJ01213Ranitidin inj bernofarm2001.696,28$339,256EJ01214Ranitidin inj hexapharm2.246,670.0EJ01163Ranitidin tab8400264,00$2,217,600EU01364Rifamtibi 450 mg4.325,750.0EJ01241RL BRAUN4.799,670.0EU01369RL Wida3205.709,00$1,826,880EU01372Ropain Inj8032.670,00$2,613,600EU01373RS (Ringer Solution's)11.896,500.0EJ01217Salbutamol 2 mg2200168,75$371,250EJ01172Samcobion5200210,00$1,092,000EU01378Sanmol Drop115.482,50$15,483EU01379Sanmol Syr10.912,000.0EU01475Santa E Tab3003.586,00$1,075,800EU01381Santibi Plus610,500.0EJ01175Simvastatin513,000.0EJ01178Sotatic Inj11004.133,33$4,546,663EJ01179Spasminal Tab2600475,00$1,235,000DU01114Spinocain 2528.385,670.0DJ01011Spuit 3 Cc One Med590,000.0DU01118Spuit 1 cc2.533,330.0DU01120Spuit 10 cc2.558,000.0DJ01012Spuit 10 Cc One Med1.383,330.0DU01122Spuit 3 cc1.400,000.0DU01123Spuit 5 cc2.075,000.0DU01125Suction Catheter no 108.800,000.0DU01126Suction Catheter no 127.350,000.0DU01128Suction Catheter no 88.816,670.0DU00158Suction Cathether 1611.640,000.0DU01522Suction Cathether 148.075,000.0EJ01182Sultrimmix Tab500190$95,000DU01131Syringe Catheter Tip 50 ml23.925,000.0DU01132Syringe Without Needle Tip 50 ml13.750,000.0EU01402Termifen Inj392.040,000.0DU01139Three way7.040,000.0EJ01183Tibigon tab1000638$638,000DU01140Topi Operasi1.200,000.0EJ01229Tramadol Capsul1500750,00$1,125,000EJ01184Tramadol Inj7.682,200.0DJ01014Transfusi Set Gea5.000,000.0DU01141Transfusion Set23.100,000.0EU01500Trimoxsul Syr21.835,000.0EJ01185Trodet Tab1200430,00$516,000EU01421Trombophob Gel51.975,000.0DU01143Umbilical39.015,000.0DU01144Under Pad5.590,000.0DU01147Urine bag4.135,000.0EU01438Ventolin Nebule9.093,330.0DU01151Vicryl 1101.659,000.0DU01153Vicryl 3 - 00,000.0EJ01192Vit B1100033,50$33,500EJ01193Vit B6100045,33$45,330EJ01194Vit C 100 mg2006.413,00$1,282,600EJ01195Vit C Tab100032,00$32,000EJ01251Vit K Tab150,000.0EJ01197Vita Curcumaris Syr4.400,000.0EJ01198Vitazym Tab5300550,00$2,915,000EU01449Vomecho Tab5003.465,00$1,732,500EU01450Vomil B 62.738,000.0EU01453Vroxyl Forte Syr1060.500,00$605,000EU01454Vroxyl Syr1045.375,00$453,750EU01455Widahest181.911,000.0EJ01202Zenicardo 10 mg792,000.0EJ01232Zinc Tab1900673,49$1,279,631Ethambutol 500 Tab1000$500$500,000Camidon Inj10$3,500$35,000Viccilin Inj80$5,500$440,000Ibuprofen Tab900$134$120,600Bisolvon Injeksi50$37,059$1,852,950Azithromycin Tab20$9,000$180,000Scopamin Injeksi50$6,500$325,000Simvastatin0.0Estalex Tab500$870$435,000Tetracyclin Tab1000$300$300,000Flamigra Tab1750$300$525,000Stesolid Injeksi50$11,440$572,000Alprazolam 0,5 mg1800$632$1,137,600Rifampisin 4504000$1,400$5,600,0000.0TOTAL$268,581,841Mengetahui,Tanda Tangan Pemeriksa(__________________)(___________________________)

BHP JKNDAFTAR BAHPTanggal Pemeriksaan : _________________________Nama Pemeriksa : __________________________KodeNamaQtyHargaJumlahDJ01001Abocat No. 18 x 1 Gea (08-18)703.850,00$269,500DJ01002Abocat No. 20 x 1 Gea3.850,000.0DJ01003Abocat No. 22 x 1 Gea485.036,67$241,760DJ01004Abocat No. 24 x 1 Gea (06-18)353.950,00$138,250DJ01005Abocath No 14x 1 Gea (06-18)344.700,00$159,800DJ01006Abocath No 16x 1 Gea (05-16)454.700,00$211,500DJ01007Abocath No 26x 1 Gea (05-17)165.866,67$93,867DJ01011Spuit 3 Cc One Med (08-19)39590,00$23,010DJ01012Spuit 10 Cc One Med (01-18)921.383,33$127,266DJ01013Spuit 5 Cc One Med750,000.0DJ01014Transfusi Set Gea (11-18)365.000,00$180,000Infusset macro gea583000$174,000Infusset micra gea563500$196,000DU01007Assucry 33678.333,34$2,820,000DU01008Assucryl 166.000,000.0DU01009Assucryl 24670.998,34$3,265,924TOTAL$7,900,877Mengetahui,Tanda Tangan Pemeriksa(__________________)(_________________________)

BHP UMUMDAFTAR OBATTanggal Pemeriksaan : _________________________Nama Pemeriksa : __________________________KodeNamaQtyHargaJumlahDU01001Abocat No. 16 x 2239.650,00$221,950DU01002Abocat No. 18 x 1678.900,00$596,300DU01003Abocat No. 20 x 168.900,00$53,400DU01004Abocat No. 22 x 15313.646,67$723,274DU01005Abocat No. 24 x 1312.460,00$37,380DU01006Abocath 260,000.0EU01010Alkohol 70%24.477,00$8,954DU01159Alkohol 70% 1 ltr900024.500,00$220,500,000DU01007Assucry 378.333,340.0DU01008Assucryl 16066.000,00$3,960,000DU01009Assucryl 2370.998,34$212,995DU01010Bardia Foley Cathether 18468.000,00$272,000EJ01017Batugin Elixir20.500,000.0DU01160Betadin 5 liter5000154,00$770,000DU01012Blood Bag945.320,00$407,880DJ01019Catgut Chromic 3/00,000.0DU01018Catgut Chromic 3/0 Sachet38.367,000.0DJ01050Catgut Plain 3/00,000.0DU01021Cerflast AFL 50 x 501052.250,00$522,500DU01022Cerflast Cavity 100 x 100577.000,00$385,000DU01023Cerflast Cavity 100 x 150 mm388.000,00$264,000DU01024Collacure3465.300,00$1,395,900DU01025Colostomi bag1714.584,00$247,928DU01026Curafor4435.750,00$1,573,000DU01027Curapor 7*5504.730,00$236,500DU01029Electroda 3M1074.549,33$486,778DU01030Endotracheal Tube 3,0140.000,00$40,000DU01033Endotracheal Tube no 6,5340.000,00$120,000DU01034Endotracheal Tube no.3,5240.000,00$80,000DU01035Endotracheal Tube no.4440.000,00$160,000DU01036Endotracheal Tube no.4,5840.000,00$320,000DU01039Endotracheal Tube no.7240.000,00$80,000DU01040Endotracheal Tube no.7,5240.000,00$80,000DU01041Extension Tube2035.000,00$700,000DU01168Film USG 4 Dimensi 100x148mm0,000.0DU01042Flow Regulator extension tube144.000,00$44,000DU01043Formalin Cair100040.000,00$40,000,000DU01044Gelang bayi biru42750,00$31,500DU01045Gelang bayi pink51750,00$38,250DU01047Gudel Anak136.500,00$36,500DU01048Gudel Dewasa128.025,00$28,025DU01049Gypsona 3 Inchi627.801,50$166,809DU01050Gypsona 4 inchi750.000,00$350,000Tanggal Pemeriksaan : _________________________Nama Pemeriksa : __________________________DU01051Gypsona 6 inchi1250.500,00$606,000DU01169H2O2100010,00$10,000DU01052Handscoen 7,52110.461,00$219,681DU00060Handscoen 7.50,000.0DU01053Handscoon Panjang215.894,33$31,789DU01054Handscoon Steril no 73111.183,00$346,673DU01055Handscuen 7.5 Non steril29451,67$13,098DU01170Hypafix Kotak 10 cm x 5 m361.875,00$185,625DU01056Infusion Set Makro7010.100,00$707,000DU01057Infusion Set Mikro6313.750,00$866,250DU01171Jelly USG1250123.522,10$154,402,625DU01176K-Y Jelly752.000,00$364,000DJ01030Kasa Gulung0,000.0DU01059Kasa Hidrofil Biru3.492,000.0DU01175Kertas EKG90.000,000.0DU01062Laminaria M13107.000,00$1,391,000DU01063Leukodur334.496,00$103,488DJ01033Lomatule 10cm x 10cm7714.300,00$1,101,100DU01064Masker61550,00$33,550DU01065Mesh2288.500,00$577,000DU01068Nasal oksigen cannula (pth/Anak)10.000,000.0DU01069Needle No 23738350,00$258,300DU01070Needle No 271048385,00$403,480DU01071NGT 61212.600,00$151,200DU01072NGT No. 10313.860,00$41,580DU01073NGT No. 12414.000,00$56,000DU01074NGT No. 512.500,000.0DU01075NGT No. 8512.000,00$60,000DU01076NGT No.14614.000,00$84,000DU01077NGT No.16114.000,00$14,000DU01078NGT No.18214.166,67$28,333DU01079NGT No.3,5312.500,00$37,500DU01081Novofine Needle73.600,00$25,200DU01084Pisau Besturi no 111842.023,50$372,324DU01085Pisau Besturi no 152122.827,00$599,324DU00112Pisau Besturi no 221020,000.0DU01087Pisau Besturi no 231113.003,00$333,333DJ01046Plester 7,5 cm x 4,5 m542.000,00$210,000DU01088Poly Cateter No.10518.150,00$90,750DU01089Poly Cateter No.1267.000,00$42,000DU00117Poly Cateter No.1610,000.0DU01091Poly Cateter No.1817.000,00$7,000DU01092Poly Cateter No.20206.333,33$126,667DU01093Poly Cateter No.6718.000,00$126,000DU01094Poly Cateter No.8618.150,00$108,900Tanggal Pemeriksaan : _________________________Nama Pemeriksa : __________________________DU01095Poly Cathether Bardex 893.500,000.0DU01096Poly Cathther 1437.000,00$21,000DU01097Prolen 3/011125.528,00$1,380,808DU01098Prolen 4/0983.206,00$748,854DU01099Prolene 2/012100.050,00$1,200,600DU01100Prolene 5/040145.567,00$5,822,680DU01101Prolene 6/01175.900,00$834,900DU01104Safil 4/0 70 cm94.810,000.0DU01109Silkam 2/0 Sachet681.615,000.0DU01111Sofban 3 Inchi118.539,00$18,539DU01112Sofban 4"838.133,00$305,064DU01113Sofban 6 Inchi693.996,00$563,976DU01114Spinocain 252528.385,67$709,642DU01116Spinocain 274318.650,00$801,950DU01118Spuit 1 cc662.533,33$167,200DU01119Spuit 1 Cc Insulin2.420,000.0DU01120Spuit 10 cc632.558,00$161,154DU01121Spuit 20 Cc166.600,00$105,600DU01122Spuit 3 cc781.400,00$109,200DU01123Spuit 5 cc402.075,00$83,000DU01126Suction Catheter no 1247.350,00$29,400DU01128Suction Catheter no 868.816,67$52,900DU01131Syringe Catheter Tip 50 ml1523.925,00$358,875DU01132Syringe Without Needle Tip 50 ml3913.750,00$536,250DU01134Tensocrape 4"866.975,00$535,800DU01135Tensocref 3 Inchi455.644,00$222,576DU01136Tensocref 6 Inchi587.077,00$435,385DU01137Termometer digital112.000,00$12,000DU01139Three way167.040,00$112,640DU01141Transfusion Set3123.100,00$716,100DU01143Umbilical5539.015,00$2,145,825DU01144Under Pad5.590,000.0DU01145Urinal Lk25.500,00$11,000DU01146Urinal P15.500,00$5,500DU01147Urine bag234.135,00$95,105DU01148Verban 12 Cm85500,00$42,500DU01149Verban 15 Cm100500,00$50,000DU01153Vicryl 3 - 00,000.0DU01154Vicryl 4 - 012148.934,00$1,787,208DU01155Vicryl 5 - 012131,539.00$1,578,468kondom cathether55,000.00$25,000kondom sutra233,000.00$69,000Suction Catheter no 1657,350.00$36,750Suction Catheter no 1477,350.00$51,450Suction Catheter no 1027,350.00$14,700Silkam 2/0 black16,300.00$6,300Silkam 2 black16,300.00$6,300Endotracheal Tube no.5340,000.00$120,000Catgut Plain 175$1,453,000$108,975,000Bardex Poly Cathether 819$8,000$152,0000.0TOTAL$570,503,791Mengetahui,Tanda Tangan Pemeriksa(__________________)(___________________________)

BHP GUDANG DAFTAR OBATTanggal Pemeriksaan : _________________________Nama Pemeriksa : __________________________KodeNamaQtyHargaJumlahDU01002Abocat No. 18 x 16008.900,00$5,340,000DJ01001Abocat No. 18 x 1 Gea3503.850,00$1,347,500DU01003Abocat No. 20 x 15008.900,00$4,450,000DJ01002Abocat No. 20 x 1 Gea2503.850,00$962,500DU01004Abocat No. 22 x 135013.646,67$4,776,335DJ01003Abocat No. 22 x 1 Gea505.036,67$251,834DU01005Abocat No. 24 x 125012.460,00$3,115,000DJ01004Abocat No. 24 x 1 Gea1003.950,00$395,000DJ01007Abocath No 26x 1 Gea5.866,670.0DU01007Assucry 378.333,340.0DU00008Assucryl 10,000.0DU01009Assucryl 270.998,340.0DJ01016Betadin 5 liter50000,000.0DU01012Blood Bag8045.320,00$3,625,600DU01013Botol susu16.000,000.0DJ01017Cat gut Plain 10,000.0DU01016Catgut Chromic 2/0 sachet240,000.0DJ01019Catgut Chromic 3/00,000.0DU01018Catgut Chromic 3/0 Sachet38.367,000.0DJ01021Catgut cromic 20,000.0DJ01050Catgut Plain 3/00,000.0DU01023Cerflast Cavity 100 x 150 mm1088.000,00$880,000DU01029Electroda 3M4.549,330.0DU01035Endotracheal Tube no.440.000,000.0DU01036Endotracheal Tube no.4,540.000,000.0DU01037Endotracheal Tube no.540.000,000.0DU01038Endotracheal Tube no.640.000,000.0DU01041Extension Tube35.000,000.0DJ01024Film USG 4 Dimensi 100x148mm60,000.0DU01048Gudel Dewasa28.025,000.0DU01052Handscoen 7,532010.461,00$3,347,520DJ01008Handscoon Maxter3.850,000.0DU01053Handscoon Panjang1515.894,33$238,415DU01054Handscoon Steril no 720011.183,00$2,236,600DU01055Handscuen 7.5 Non steril400451,67$180,668DJ01026Hypafix Kotak 10 cm x 5 m112.500,000.0DU01056Infusion Set Makro35010.100,00$3,535,000DU01057Infusion Set Mikro15013.750,00$2,062,500DJ01009Infusset Micro Gea503.500,00$175,000DJ01010Infusset Macro Gea2503.000,00$750,000DJ01032K-Y Jelly50,000.0DJ01028Kapas 500 gr15000,000.0DJ01030Kasa Gulung50200,000.0DU01059Kasa Hidrofil Biru723.492,00$251,424DJ01033Lomatule 10cm x 10cm14.300,000.0DU01064Masker100550,00$55,000DU01067Nasal oksigen cannula (dewasa)310.000,00$30,000DU01068Nasal oksigen cannula (pth/Anak)310.000,00$30,000DU01069Needle No 23350,000.0DU01070Needle No 27385,000.0DU01076NGT No.1414.000,000.0DU01077NGT No.1614.000,000.0DU01078NGT No.1814.166,670.0DU01082Onescrub 5 L50006270.00$31,350,000DU01084Pisau Besturi no 112.023,500.0DU01085Pisau Besturi no 152.827,000.0DU00112Pisau Besturi no 221005.405,00$540,500DJ01046Plester 7,5 cm x 4,5 m42.000,000.0DU00117Poly Cateter No.161310,000.0DU01091Poly Cateter No.18307.000,00$210,000DU01092Poly Cateter No.206.333,330.0DJ01011Spuit 3 Cc One Med590,000.0DU01118Spuit 1 cc1002.533,33$253,333DU01120Spuit 10 cc8002.558,00$2,046,400DJ01012Spuit 10 Cc One Med1.383,330.0DU01122Spuit 3 cc10001.400,00$1,400,000DU01123Spuit 5 cc3002.075,00$622,500DU01125Suction Catheter no 108.800,000.0DU01126Suction Catheter no 127.350,000.0DU01128Suction Catheter no 88.816,670.0DU00158Suction Cathether 1611.640,000.0DU01522Suction Cathether 148.075,000.0DU01131Syringe Catheter Tip 50 ml2023.925,00$478,500DU01132Syringe Without Needle Tip 50 ml8013.750,00$1,100,000DU01139Three way7.040,000.0DU01140Topi Operasi1.200,000.0DJ01014Transfusi Set Gea505.000,00$250,000DU01141Transfusion Set20023.100,00$4,620,000DU01143Umbilical39.015,000.0DU01144Under Pad105.590,00$55,900DU01147Urine bag704.135,00$289,450DU01151Vicryl 1101.659,000.0DU01153Vicryl 3 - 00,000.0Spinocain 2510028.385,67$2,838,567Spinocain 262528.385,67$709,642Film 35x35100$15,000$1,500,0009,000Film 30x40300$14,000$4,200,00014,000Film 24x30100$9,000$900,00015,0000.00.00.0TOTAL$91,400,687Mengetahui,Tanda Tangan Pemeriksa(__________________)(___________________________)

bhp gudangDAFTAR BHP GUDANGKodeNamaQtyHargaJumlahDU01002Abocat No. 18 x 16008.900,00$5,340,000DJ01001Abocat No. 18 x 1 Gea3503.850,00$1,347,500DU01003Abocat No. 20 x 15008.900,00$4,450,000DJ01002Abocat No. 20 x 1 Gea2503.850,00$962,500DU01004Abocat No. 22 x 135013.646,67$4,776,335DJ01003Abocat No. 22 x 1 Gea505.036,67$251,834DU01005Abocat No. 24 x 125012.460,00$3,115,000DJ01004Abocat No. 24 x 1 Gea1003.950,00$395,000DJ01007Abocath No 26x 1 Gea5.866,670.0DU01007Assucry 378.333,340.0DU00008Assucryl 10,000.0DU01009Assucryl 270.998,340.0DJ01016Betadin 5 liter0,000.0DU01012Blood Bag8045.320,00$3,625,600DU01013Botol susu16.000,000.0DJ01017Cat gut Plain 10,000.0DU01016Catgut Chromic 2/0 sachet240,000.0DJ01019Catgut Chromic 3/00,000.0DU01018Catgut Chromic 3/0 Sachet38.367,000.0DJ01021Catgut cromic 20,000.0DJ01050Catgut Plain 3/00,000.0DU01023Cerflast Cavity 100 x 150 mm1088.000,00$880,000DU01029Electroda 3M4.549,330.0DU01035Endotracheal Tube no.440.000,000.0DU01036Endotracheal Tube no.4,540.000,000.0DU01037Endotracheal Tube no.540.000,000.0DU01038Endotracheal Tube no.640.000,000.0DU01041Extension Tube35.000,000.0DJ01024Film USG 4 Dimensi 100x148mm60,000.0DU01048Gudel Dewasa28.025,000.0DU01052Handscoen 7,532010.461,00$3,347,520DJ01008Handscoon Maxter3.850,000.0DU01053Handscoon Panjang1515.894,33$238,415DU01054Handscoon Steril no 720011.183,00$2,236,600DU01055Handscuen 7.5 Non steril400451,67$180,668DJ01026Hypafix Kotak 10 cm x 5 m112.500,000.0DU01056Infusion Set Makro35010.100,00$3,535,000DU01057Infusion Set Mikro15013.750,00$2,062,500DJ01009Infusset Micro Gea503.500,00$175,000DJ01010Infusset Macro Gea2503.000,00$750,000DJ01032K-Y Jelly50,000.0DJ01028Kapas 500 gr15000,000.0DJ01030Kasa Gulung50200,000.0DU01059Kasa Hidrofil Biru723.492,00$251,424DJ01033Lomatule 10cm x 10cm14.300,000.0DU01064Masker100550,00$55,000DU01067Nasal oksigen cannula (dewasa)310.000,00$30,000DU01068Nasal oksigen cannula (pth/Anak)310.000,00$30,000DU01069Needle No 23350,000.0DU01070Needle No 27385,000.0DU01076NGT No.1414.000,000.0DU01077NGT No.1614.000,000.0DU01078NGT No.1814.166,670.0DU01082Onescrub 5 L50006270.00$31,350,000DU01084Pisau Besturi no 112.023,500.0DU01085Pisau Besturi no 152.827,000.0DU00112Pisau Besturi no 221005.405,00$540,500DJ01046Plester 7,5 cm x 4,5 m42.000,000.0DU00117Poly Cateter No.161310,000.0DU01091Poly Cateter No.18307.000,00$210,000DU01092Poly Cateter No.206.333,330.0DJ01011Spuit 3 Cc One Med590,000.0DU01118Spuit 1 cc1002.533,33$253,333DU01120Spuit 10 cc8002.558,00$2,046,400DJ01012Spuit 10 Cc One Med1.383,330.0DU01122Spuit 3 cc10001.400,00$1,400,000DU01123Spuit 5 cc3002.075,00$622,500DU01125Suction Catheter no 108.800,000.0DU01126Suction Catheter no 127.350,000.0DU01128Suction Catheter no 88.816,670.0DU00158Suction Cathether 1611.640,000.0DU01522Suction Cathether 148.075,000.0DU01131Syringe Catheter Tip 50 ml2023.925,00$478,500DU01132Syringe Without Needle Tip 50 ml8013.750,00$1,100,000DU01139Three way7.040,000.0DU01140Topi Operasi1.200,000.0DJ01014Transfusi Set Gea505.000,00$250,000DU01141Transfusion Set20023.100,00$4,620,000DU01143Umbilical39.015,000.0DU01144Under Pad105.590,00$55,900DU01147Urine bag704.135,00$289,450DU01151Vicryl 1101.659,000.0DU01153Vicryl 3 - 00,000.0DU01155Spinocain 2510028.385,67$2,838,567DU01157Spinocain 262528.385,67$709,642DU01159Film 35x35100$15,000$1,500,0009,000DU01161Film 30x40300$14,000$4,200,00014,000DU01163Film 24x30100$9,000$900,00015,0000.00.00.0TOTAL$91,400,687Diketahui Oleh:Sibuhuan, 4 April 2015Dr.H Musbar M.KesSatria Ningsih, SAADirekturKa Unit Pengadaan Farmasi

bhp uDAFTAR BHP APOTEK UMUMKodeNamaQtyHargaJumlahDU01001Abocat No. 16 x 2239.650,00$221,950DU01002Abocat No. 18 x 1678.900,00$596,300DU01003Abocat No. 20 x 168.900,00$53,400DU01004Abocat No. 22 x 15313.646,67$723,274DU01005Abocat No. 24 x 1312.460,00$37,380DU01006Abocath 260,000.0EU01010Alkohol 70%24.477,00$8,954DU01159Alkohol 70% 1 ltr900024.500,00$220,500,000DU01007Assucry 378.333,340.0DU01008Assucryl 16066.000,00$3,960,000DU01009Assucryl 2370.998,34$212,995DU01010Bardia Foley Cathether 18468.000,00$272,000EJ01017Batugin Elixir20.500,000.0DU01160Betadin 5 liter5000154,00$770,000DU01012Blood Bag945.320,00$407,880DJ01019Catgut Chromic 3/00,000.0DU01018Catgut Chromic 3/0 Sachet38.367,000.0DJ01050Catgut Plain 3/00,000.0DU01021Cerflast AFL 50 x 501052.250,00$522,500DU01022Cerflast Cavity 100 x 100577.000,00$385,000DU01023Cerflast Cavity 100 x 150 mm388.000,00$264,000DU01024Collacure3465.300,00$1,395,900DU01025Colostomi bag1714.584,00$247,928DU01026Curafor4435.750,00$1,573,000DU01027Curapor 7*5504.730,00$236,500DU01029Electroda 3M1074.549,33$486,778DU01030Endotracheal Tube 3,0140.000,00$40,000DU01033Endotracheal Tube no 6,5340.000,00$120,000DU01034Endotracheal Tube no.3,5240.000,00$80,000DU01035Endotracheal Tube no.4440.000,00$160,000DU01036Endotracheal Tube no.4,5840.000,00$320,000DU01039Endotracheal Tube no.7240.000,00$80,000DU01040Endotracheal Tube no.7,5240.000,00$80,000DU01041Extension Tube2035.000,00$700,000DU01168Film USG 4 Dimensi 100x148mm0,000.0DU01042Flow Regulator extension tube144.000,00$44,000DU01043Formalin Cair100040.000,00$40,000,000DU01044Gelang bayi biru42750,00$31,500DU01045Gelang bayi pink51750,00$38,250DU01047Gudel Anak136.500,00$36,500DU01048Gudel Dewasa128.025,00$28,025DU01049Gypsona 3 Inchi627.801,50$166,809DU01050Gypsona 4 inchi750.000,00$350,000DU01051Gypsona 6 inchi1250.500,00$606,000DU01169H2O2100010,00$10,000DU01052Handscoen 7,52110.461,00$219,681DU00060Handscoen 7.50,000.0DU01053Handscoon Panjang215.894,33$31,789DU01054Handscoon Steril no 73111.183,00$346,673DU01055Handscuen 7.5 Non steril29451,67$13,098DU01170Hypafix Kotak 10 cm x 5 m361.875,00$185,625DU01056Infusion Set Makro7010.100,00$707,000DU01057Infusion Set Mikro6313.750,00$866,250DU01171Jelly USG1250123.522,10$154,402,625DU01176K-Y Jelly752.000,00$364,000DJ01030Kasa Gulung0,000.0DU01059Kasa Hidrofil Biru3.492,000.0DU01175Kertas EKG90.000,000.0DU01062Laminaria M13107.000,00$1,391,000DU01063Leukodur334.496,00$103,488DJ01033Lomatule 10cm x 10cm7714.300,00$1,101,100DU01064Masker61550,00$33,550DU01065Mesh2288.500,00$577,000DU01068Nasal oksigen cannula (pth/Anak)10.000,000.0DU01069Needle No 23738350,00$258,300DU01070Needle No 271048385,00$403,480DU01071NGT 61212.600,00$151,200DU01072NGT No. 10313.860,00$41,580DU01073NGT No. 12414.000,00$56,000DU01074NGT No. 512.500,000.0DU01075NGT No. 8512.000,00$60,000DU01076NGT No.14614.000,00$84,000DU01077NGT No.16114.000,00$14,000DU01078NGT No.18214.166,67$28,333DU01079NGT No.3,5312.500,00$37,500DU01081Novofine Needle73.600,00$25,200DU01084Pisau Besturi no 111842.023,50$372,324DU01085Pisau Besturi no 152122.827,00$599,324DU00112Pisau Besturi no 221020,000.0DU01087Pisau Besturi no 231113.003,00$333,333DJ01046Plester 7,5 cm x 4,5 m542.000,00$210,000DU01088Poly Cateter No.10518.150,00$90,750DU01089Poly Cateter No.1267.000,00$42,000DU00117Poly Cateter No.1610,000.0DU01091Poly Cateter No.1817.000,00$7,000DU01092Poly Cateter No.20206.333,33$126,667DU01093Poly Cateter No.6718.000,00$126,000DU01094Poly Cateter No.8618.150,00$108,900DU01095Poly Cathether Bardex 893.500,000.0DU01096Poly Cathther 1437.000,00$21,000DU01097Prolen 3/011125.528,00$1,380,808DU01098Prolen 4/0983.206,00$748,854DU01099Prolene 2/012100.050,00$1,200,600DU01100Prolene 5/040145.567,00$5,822,680DU01101Prolene 6/01175.900,00$834,900DU01104Safil 4/0 70 cm94.810,000.0DU01109Silkam 2/0 Sachet681.615,000.0DU01111Sofban 3 Inchi118.539,00$18,539DU01112Sofban 4"838.133,00$305,064DU01113Sofban 6 Inchi693.996,00$563,976DU01114Spinocain 252528.385,67$709,642DU01116Spinocain 274318.650,00$801,950DU01118Spuit 1 cc662.533,33$167,200DU01119Spuit 1 Cc Insulin2.420,000.0DU01120Spuit 10 cc632.558,00$161,154DU01121Spuit 20 Cc166.600,00$105,600DU01122Spuit 3 cc781.400,00$109,200DU01123Spuit 5 cc402.075,00$83,000DU01126Suction Catheter no 1247.350,00$29,400DU01128Suction Catheter no 868.816,67$52,900DU01131Syringe Catheter Tip 50 ml1523.925,00$358,875DU01132Syringe Without Needle Tip 50 ml3913.750,00$536,250DU01134Tensocrape 4"866.975,00$535,800DU01135Tensocref 3 Inchi455.644,00$222,576DU01136Tensocref 6 Inchi587.077,00$435,385DU01137Termometer digital112.000,00$12,000DU01139Three way167.040,00$112,640DU01141Transfusion Set3123.100,00$716,100DU01143Umbilical5539.015,00$2,145,825DU01144Under Pad5.590,000.0DU01145Urinal Lk25.500,00$11,000DU01146Urinal P15.500,00$5,500DU01147Urine bag234.135,00$95,105DU01148Verban 12 Cm85500,00$42,500DU01149Verban 15 Cm100500,00$50,000DU01153Vicryl 3 - 00,000.0DU01154Vicryl 4 - 012148.934,00$1,787,208DU01155Vicryl 5 - 012131,539.00$1,578,468DU01156kondom cathether55,000.00$25,000DU01157kondom sutra233,000.00$69,000DU01158Suction Catheter no 1657,350.00$36,750DU01159Suction Catheter no 1477,350.00$51,450DU01160Suction Catheter no 1027,350.00$14,700DU01161Silkam 2/0 black16,300.00$6,300DU01162Silkam 2 black16,300.00$6,300DU01163Endotracheal Tube no.5340,000.00$120,000DU01164Catgut Plain 175$1,453,000$108,975,000DU01165Bardex Poly Cathether 819$8,000$152,000DU01166Endotracheal Tube no.64$40,000$160,0000.0TOTAL$570,663,791Diketahui Oleh:Sibuhuan, 4 April 2015Dr.H Musbar M.KesSatria Ningsih, SAADirekturKa Unit Pengadaan Farmasi

BHP JDAFTAR BHP APOTEK JKNKodeNamaQtyHargaJumlahDJ01001Abocat No. 18 x 1 Gea (08-18)703.850,00$269,500DJ01002Abocat No. 20 x 1 Gea3.850,000.0DJ01003Abocat No. 22 x 1 Gea485.036,67$241,760DJ01004Abocat No. 24 x 1 Gea (06-18)353.950,00$138,250DJ01005Abocath No 14x 1 Gea (06-18)344.700,00$159,800DJ01006Abocath No 16x 1 Gea (05-16)454.700,00$211,500DJ01007Abocath No 26x 1 Gea (05-17)165.866,67$93,867DJ01011Spuit 3 Cc One Med (08-19)39590,00$23,010DJ01012Spuit 10 Cc One Med (01-18)921.383,33$127,266DJ01013Spuit 5 Cc One Med750,000.0DJ01014Transfusi Set Gea (11-18)365.000,00$180,000DJ01015Infusset macro gea583000$174,000DJ01016Infusset micra gea563500$196,000DU01007Assucry 33678.333,34$2,820,000DU01008Assucryl 166.000,000.0DU01009Assucryl 24670.998,34$3,265,924TOTAL$7,900,877Diketahui Oleh:Sibuhuan, 4 April 2015Dr.H Musbar M.KesSatria Ningsih, SAADirekturKa Unit Pengadaan Farmasi

GUDAFTAR OBAT DI GUDANG FARMASIKodeNamaQtyHargaJumlahEJ01240Acyclovir 400 mg Tab250573,18$143,295EJ01003Afolat Tab1000138,00$138,000EU01004Afomix Tab6.050,000.0EU01009Alinamin F14.972,600.0DJ01015Alkohol 70% 1 ltr600023$138,000EJ01006Allupurinol 100 mg165,000.0EJ01008Alprazolam 1 mg1300945,00$1,228,500EJ01219Ambroxol Syr1213.298,00$399,058EJ01218Ambroxol Tab1200330,00$396,000EJ01009Aminophylin Inj723.240,14$233,290EJ01225Aminophyllin Tab170,000.0EJ01212Amitripthylin indofarma1500150,00$225,000EJ01236Amlodipin 5 mg4001.151,99$460,796EU01019Amoxan Drop22.403,670.0EU01021Anafen Syr17.325,000.0EJ01173Antacida Syr (JKN)1003.616,67$361,667EJ01228Antasida Doen Tab100030,35$30,350EJ01011Aptor500630$315,000EU01025Aquabidest2403.256,00$781,440EU01026Aquabidest 1000 ml50003.256,00$16,280,000EJ01250Asam Mefenamat Tab1200197,18$236,616EJ01224Asam Traneksamat Tab (JKN)24001.045,00$2,508,000EJ01013Asam Tranexamat Inj10011.000,00$1,100,000EJ01014Aspilet200630,00$126,000DU01007Assucry 33678.333,34$2,820,000DU00008Assucryl 116879,000.00$13,272,000DU01009Assucryl 215670.998,34$11,075,741EU01034Atracurium Inj87.664,500.0EJ01015Atropin Sulfat Inj1002.731,00$273,100DJ01016Betadin 5 liter5000154$770,000EU01499Betadin Kumur9.500,000.0EJ01238Betahistin Tab953,330.0EJ01018Betamethason Cr502.100,00$105,000EU01045Biodasin 3002506.897,00$1,724,250EU01046Bionemi5001.210,00$605,000EJ01020Bisoprolol 5 mg1.842,220.0DU01012Blood Bag45.320,000.0DU01502BMT Platinum127.570,000.0DU01503BMT Regular43.255,000.0DU01013Botol susu16.000,000.0EU01050Bralin Inj 500 mg5063.525,00$3,176,250EJ01239Bronchitin Syr4.633,330.0EJ01223Bronchosal Tab (JKN)2200188,43$414,546EJ01023Bupivacain Inj58.666,670.0EJ01026Calsium Laktat200042,00$84,000EJ01211Captopril 12,5 mg160089,94$143,904EJ01027Captopril 25 mg4100137,41$563,381EJ01029Carpiaton 25 mg200554,50$110,900DJ01017Cat gut Plain 10,000.0EU01059Catapres2049.500,00$990,000DU01016Catgut Chromic 2/0 sachet0,000.0DJ01019Catgut Chromic 3/00,000.0DU01018Catgut Chromic 3/0 Sachet38.367,000.0DJ01021Catgut cromic 20,000.0DJ01050Catgut Plain 3/00,000.0EJ01032Cefadroxil 500 mg31001.008,00$3,124,800EU01063Cefdim Inj199.650,000.0EJ01035Cefixim 100 mg30702.014,71$6,185,160EJ01237Cefixime Syr730.250,00$211,750EJ01038Ceftriaxon 1 gr705.833,33$408,333EU01078Cendo Lyteers21.175,000.0EU01079Cendo Mydriatil32.312,000.0EU01084Cendo Polydex29.150,000.0EU01087Cendo Timol 0,25%21.423,000.0EU01094Cendo Xytrol26.812,000.0DU01023Cerflast Cavity 100 x 150 mm88.000,000.0EJ01248Cetrizine Drop26.125,000.0EJ01039Cetrizine Tab313,500.0EJ01040Ciproflaxacin 500 mg3200440,00$1,408,000EJ01041Citicolin Inj14026.400,00$3,696,000EJ01042Citicolin Tab6.799,830.0EJ01044Clindamycin 300 mg923,000.0EJ01045Clopidogrel Tab Dexa (JKN)6006.300,00$3,780,000EJ01046Codein Tab1300507,86$660,218DU01025Colostomi bag14.584,000.0EJ01050Curcuma tab440024.684,00$108,609,600EU01116Cycloproginova109.934,000.0EU01498D5%+1/2 NS OTSU0,000.0EJ01051Dexa Inj5002.402,27$1,201,135EU01123Dextrose 10%406.435,50$257,420EU01125Dextrose 5% + 1/4 NS17.475,670.0EU01127Dextrose 5% 500605.579,00$334,740EU01490Dextrose 5%+1/2 NS WIDA11.850,000.0EJ01055Diazol Inf1508.000,00$1,200,000EJ01209Domperidon 10 mg indofarma3500403,52$1,412,320EJ01056Doxicyclin 100 mg800290,00$232,000EJ01057Duramycin Tab 500 mg200105,00$21,000EU01139Duvadilan Inj31.148,330.0EU01140Duvadilan Tab1005.500,00$550,000DU01029Electroda 3M4.549,330.0DU01035Endotracheal Tube no.440.000,000.0DU01036Endotracheal Tube no.4,540.000,000.0DU01037Endotracheal Tube no.540.000,000.0DU01038Endotracheal Tube no.640.000,000.0EJ01060Epinephrin Inj3.500,000.0EJ01230Erythromycin Syr 200 mg/5 ml149.500,00$133,000EU01149Estin Drop49.133,330.0EJ01064Etafenin Tab600165,00$99,000DU01041Extension Tube35.000,000.0EJ01071Fargoxin 0,25 mg495,000.0EJ01072Farmalat 10 mg600327,50$196,500EJ01073Farmoten 12,5 mg300170,00$51,000EJ01075Farsorbid 5175,000.0DJ01024Film USG 4 Dimensi 100x148mm0,000.0EJ01079Flasicox tab2002.400,00$480,000EJ01208Furosemide 40 mg Tab2100102,00$214,200EJ01080Furosemide Inj1752.729,33$477,633EJ01249Gabapentin 300 mg3607.766,67$2,796,001EU01176Galepsi Tab24010.648,00$2,555,520EJ01227Gentamicin Tetes Mata3.315,630.0EJ01083Gentamycin Cream981,480.0EJ01084Gentamycin Inj3.692,200.0EU01181Gitaramin1.372,800.0EJ01088Glucosamin Tab4001.500,00$600,000DU01048Gudel Dewasa28.025,000.0DU01052Handscoen 7,510.461,000.0DJ01008Handscoon Maxter3.850,000.0DU01053Handscoon Panjang15.894,330.0DU01054Handscoon Steril no 711.183,000.0DU01055Handscuen 7.5 Non steril451,670.0EJ01092HCT400,000.0EJ01094Helixime Syr24.000,000.0EJ01096Hufadon Tab3400360,00$1,224,000EJ00095Hufadon Tab (Tablet) -JKN200,000.0DJ01026Hypafix Kotak 10 cm x 5 m112.500,000.0EU01474Infix Syr1471.500,00$1,001,000DU01056Infusion Set Makro10.100,000.0DU01057Infusion Set Mikro13.750,000.0DJ01009Infusset Micro Gea3.500,000.0DJ01010Infusset Macro Gea3.000,000.0EJ01098INH 300177,620.0EJ01246INH CIBA 3000,000.0DJ01032K-Y Jelly0,000.0EU01496Kalmeco Cap2.046,000.0EU01210Kalnex Inj4013.310,00$532,400EU01211Kaltrofen Supp8.873,330.0DJ01028Kapas 500 gr0,000.0DJ01030Kasa Gulung0,000.0DU01059Kasa Hidrofil Biru3.492,000.0EJ01220Ketorolac inj Bernofarm9024.000,00$2,160,000EJ01206Ketorolac inj hexapharm5.033,330.0EU01486Kina Tab980,100.0EU01218KSR1003.299,67$329,967EU01223Lacbon3001.490,67$447,201EJ01207Lansoprazol Hexapharm375,830.0EJ01107Laxama Tab263,000.0EJ01108Lerzin Syr0,000.0EJ01109Levofloxacin 500 mg1650925,00$1,526,250EU01239Levonic Inf40199.650,00$7,986,000EJ01111Lidocain Inj1002.026,97$202,697DJ01033Lomatule 10cm x 10cm14.300,000.0DU01064Masker550,000.0EJ01117Meloxicam 15 mg1400797,13$1,115,982EJ01118Meloxicam 7,5 mg450691,90$311,355EU01250Meropenem Inj 1 gr15227.333,33$3,410,000DU01521Mersilk 3/0 Ronded27.000,000.0EJ01121Metformin Tab3300200,00$660,000EJ01122Methylprednisolon Inj5130.000,00$1,530,000EJ01123Methylprednisolon Tab2100440,37$924,777EU01256Metronidazole inf5022.000,00$1,100,000EJ01126Metronidazole Tab 5003500264,00$924,000EJ01129Myomergin4.950,000.0EJ01130Na diklofenac Tab217,840.0EU01271NaCl 500cc Wida2805.772,67$1,616,348EU01272NaCL Sanbe14.811,500.0DU01067Nasal oksigen cannula (dewasa)10.000,000.0DU01068Nasal oksigen cannula (pth/Anak)10.000,000.0DU01069Needle No 23350,000.0DU01070Needle No 27385,000.0EU01276Neo K13.552,000.0EJ01131Neurodex Tab6600235,00$1,551,000DU01076NGT No.1414.000,000.0DU01077NGT No.1614.000,000.0DU01078NGT No.1814.166,670.0EU01280Nichomedson 4 mg4002.082,50$833,000EU01285Norages9.406,670.0EJ01135Novadium Tab900193,50$174,150EU01291Nufagrabion GM1.942,670.0EU01293Nufamicron Tab2001.863,00$372,600EU01294Nufanibrox syr20.196,000.0EJ01138Omelegar Tab700190,00$133,000EU01306Ondansentron 8 mg Inj808.000,00$640,000EJ01141Ondansetron Inj 4 mg2003.833,33$766,666DU01082Onescrub 5 L0,000.0EU01484Osfit DHA3.593,330.0EJ01145Oxytocin Inj2.259,170.0EJ01146Pallerskin Tab160,000.0EU01312Pamol 125 mg7.912,000.0EU01316Pantoprazole Inj88.000,000.0EU01318Panzol Inj280150.150,00$42,042,000EU01319Paracetamol Inf59.725,000.0EJ01147Paracetamol Tab500114,00$57,000EJ01150Pharmamox Tab592,000.0EJ01152Phylocin Tab 250 mg200475,00$95,000EJ01153Pirazinamid 5002000245,33$490,660EJ01156Pospargin Tab400550,00$220,000EJ01158Primaquin Tab100,000.0EU01331Proanes75.241,930.0EU01332Procefa Inj20151.250,00$3,025,000EU01333Procur Plus3506.413,00$2,244,550EU01342Prolecin Tab39029.645,00$11,561,550EJ01159Propanolol 10 mg130090,00$117,000EU01352Propepsa 100 ml51.150,000.0EU01497Proris Supp 125 mg0,000.0EU01468Proster Tab10.450,000.0EJ01160PTU1300915,00$1,189,500EJ01213Ranitidin inj bernofarm2001.696,28$339,256EJ01214Ranitidin inj hexapharm2.246,670.0EJ01163Ranitidin tab8400264,00$2,217,600EU01364Rifamtibi 450 mg4.325,750.0EJ01241RL BRAUN4.799,670.0EU01369RL Wida3205.709,00$1,826,880EU01372Ropain Inj8032.670,00$2,613,600EU01373RS (Ringer Solution's)11.896,500.0EJ01217Salbutamol 2 mg2200168,75$371,250EJ01172Samcobion5200210,00$1,092,000EU01378Sanmol Drop15.482,500.0EU01379Sanmol Syr10.912,000.0EU01475Santa E Tab3003.586,00$1,075,800EU01381Santibi Plus610,500.0EJ01175Simvastatin513,000.0EJ01178Sotatic Inj11004.133,33$4,546,663EJ01179Spasminal Tab2600475,00$1,235,000DU01114Spinocain 2528.385,670.0DJ01011Spuit 3 Cc One Med590,000.0DU01118Spuit 1 cc2.533,330.0DU01120Spuit 10 cc2.558,000.0DJ01012Spuit 10 Cc One Med1.383,330.0DU01122Spuit 3 cc1.400,000.0DU01123Spuit 5 cc2.075,000.0DU01125Suction Catheter no 108.800,000.0DU01126Suction Catheter no 127.350,000.0DU01128Suction Catheter no 88.816,670.0DU00158Suction Cathether 1611.640,000.0DU01522Suction Cathether 148.075,000.0EJ01182Sultrimmix Tab500190$95,000DU01131Syringe Catheter Tip 50 ml23.925,000.0DU01132Syringe Without Needle Tip 50 ml13.750,000.0EU01402Termifen Inj392.040,000.0DU01139Three way7.040,000.0EJ01183Tibigon tab1000638$638,000DU01140Topi Operasi1.200,000.0EJ01229Tramadol Capsul1500750,00$1,125,000EJ01184Tramadol Inj7.682,200.0DJ01014Transfusi Set Gea5.000,000.0DU01141Transfusion Set23.100,000.0EU01500Trimoxsul Syr21.835,000.0EJ01185Trodet Tab1200430,00$516,000EU01421Trombophob Gel51.975,000.0DU01143Umbilical39.015,000.0DU01144Under Pad5.590,000.0DU01147Urine bag4.135,000.0EU01438Ventolin Nebule9.093,330.0DU01151Vicryl 1101.659,000.0DU01153Vicryl 3 - 00,000.0EJ01192Vit B1100033,50$33,500EJ01193Vit B6100045,33$45,330EJ01194Vit C 100 mg1006.413,00$641,300EJ01195Vit C Tab100032,00$32,000EJ01251Vit K Tab150,000.0EJ01197Vita Curcumaris Syr4.400,000.0EJ01198Vitazym Tab600550,00$330,000EU01449Vomecho Tab5003.465,00$1,732,500EU01450Vomil B 62.738,000.0EU01453Vroxyl Forte Syr1060.500,00$605,000EU01454Vroxyl Syr1045.375,00$453,750EU01455Widahest181.911,000.0EJ01202Zenicardo 10 mg792,000.0EJ01232Zinc Tab1900673,49$1,279,631EJ01262Ethambutol 500 Tab1000$500$500,000EJ01292Camidon Inj10$3,500$35,000EJ01322Viccilin Inj80$5,500$440,000EJ01352Ibuprofen Tab900$134$120,600EJ01382Bisolvon Injeksi50$37,059$1,852,950EJ01412Azithromycin Tab20$9,000$180,000EJ01442Scopamin Injeksi50$6,500$325,000EJ01472Simvastatin0.0EJ01502Estalex Tab500$870$435,000EJ01532Tetracyclin Tab1000$300$300,000EJ01562Flamigra Tab1750$300$525,000EJ01592Stesolid Injeksi50$11,440$572,000EJ01622Alprazolam 0,5 mg1800$632$1,137,600EJ01652Rifampisin 4504000$1,400$5,600,0000.0TOTAL$265,153,392Diketahui Oleh:Sibuhuan, 4 April 2015Dr.H Musbar M.KesSatria Ningsih, SAADirekturKa Unit Pengadaan Farmasi

AP UDAFTAR OBAT APOTEK UMUMKodeNamaQtyHargaJumlahEJ01001Acifar 400 (07-18)25586,00$14,650EJ01240Acyclovir 400 mg Tab573,180.0EJ01002Acyclovir 5% Cream3.000,000.0EJ01003Afolat Tab (05-19)65138,00$8,970EU01004Afomix Tab (10-17)506.050,00$302,500EU01005Agrezol Tab (06-16)2247.018,00$1,572,032EU01009Alinamin F (04-16)5214.972,60$778,575EU01010Alkohol 70%4.477,000.0DU01159Alkohol 70% 1 ltr24.500,000.0DU01501ALL 110 (05-15)552.800,00$264,000EJ01006Allupurinol 100 mg (03-19)90165,00$14,850EJ01008Alprazolam 1 mg945,000.0EJ01219Ambroxol Syr3.298,000.0EJ01218Ambroxol Tab (12-18)93330,00$30,690EU01016Aminofluid Inf114.950,000.0EJ01009Aminophylin Inj (06-18)343.240,14$110,165EJ01212Amitripthylin indofarma (12-18)100150,00$15,000EJ01010Amitriptyllin Tab Yarindo (JKN)180,000.0EJ01236Amlodipin 5 mg (11-18)1191.151,99$137,087EU01019Amoxan Drop (02-17)822.403,67$179,229EU01020Anadium Tab (06-17)2617.260,00$1,894,860EU01021Anafen Syr (01-17)617.325,00$103,950EJ01173Antacida Syr (JKN)3.616,670.0EJ01228Antasida Doen Tab30,350.0EU01023Apitra Inj (02-16)8177.236,00$1,417,888EU01024Aprovel 150 (02-16)2611.772,00$306,072EU01025Aquabidest (05-17)723.256,00$234,432EU01028Arimed Tab (10-16)407.150,00$286,000EU01029Arixtra Inj (01-17)14522.500,00$7,315,000EJ01012Arkavit C (11-17)125450,00$56,250EU01030Arkine (05-15)20385,00$7,700EU01031Artem Inj (02-17)1533.124,00$496,860EJ01250Asam Mefenamat Tab197,180.0EJ01224Asam Traneksamat Tab (JKN) (02-17)851.045,00$88,825EJ01013Asam Tranexamat Inj (03-18)3911.000,00$429,000EJ01014Aspilet (01-17)40630,00$25,200EU01032Astamax6.292,000.0EU01034Atracurium Inj87.664,500.0EJ01015Atropin Sulfat Inj2.731,000.0EU01035ATS (05-15)23139.150,00$3,200,450EJ01017Batugin Elixir20.500,000.0EU01037Benocetam 3 gr Inj (11-17)1045.980,00$459,800EU01040Bernoflox Tab (11-17)912.100,00$108,900EU01499Betadin Kumur9.500,000.0EJ01238Betahistin Tab (12-17)80953,33$76,266EJ01018Betamethason Cr2.100,000.0EJ01019Bic. Natric220,000.0EU01044Biocurliv (08-16)1306.050,00$786,500EU01045Biodasin 300 (10-17)3006.897,00$2,069,100EU01046Bionemi (12-18)1201.210,00$145,200EU01047Bisolvon (01-18)1440.765,00$570,710EJ01020Bisoprolol 5 mg (05-16)1241.842,22$228,435DU01502BMT Platinum (01-17)6127.570,00$765,420DU01503BMT Regular (03-16)743.255,00$302,785EU01048Bondi ED6.655,000.0DU01013Botol susu3616.000,00$576,000EU01050Bralin Inj 500 mg (12-16)1363.525,00$825,825EJ01239Bronchitin Syr4.633,330.0EJ01223Bronchosal Tab (JKN) (11-19)79188,43$14,886EJ01023Bupivacain Inj58.666,670.0EU01054Burnazin Cr (10-15)644.165,00$264,990EU01055Buscotica Inj (03-16)3618.483,00$665,388EU01056Ca-Glukonas11.480,000.0EU01057Calnic13.025,00$3,025EU01058Calsiro Tab (08-16)2143.267,00$699,138EJ01026Calsium Laktat42,000.0EJ01211Captopril 12,5 mg89,940.0EJ01027Captopril 25 mg (05-18)9137,41$1,237EJ01029Carpiaton 25 mg (09-16)88554,50$48,796EU01059Catapres (09-17)1549.500,00$742,500EJ01032Cefadroxil 500 mg (02-19)1461.008,00$147,168EJ01034Cefezet Tab100,000.0EJ01035Cefixim 100 mg2.014,710.0EJ01036Cefixim 200 mg32.533,00$7,599EJ01237Cefixime Syr30.250,000.0EJ01037Cefotaxim I gr4.625,000.0EJ01038Ceftriaxon 1 gr (09-17)535.833,33$309,166EU01065Cendo Augentonic (11-16)826.166,00$209,328EU01066Cendo Berry (12-15)1533.638,50$556,691EU01067Cendo Carpin 2%21.326,000.0EU01068Cendo Catarlent (06-17)422.000,00$88,000EU01070Cendo Cenfress (01-18)226.143,33$52,287EU01071Cendo Conver 2%21.462,000.0EU01073Cendo Floxa30.896,500.0EU01075Cendo Hervis EO (03-17)544.468,00$222,340EU01076Cendo Homatro (12-15)832,175.00$257,400EU01077Cendo Lfx (09-16)963,750.00$573,750EU01078Cendo Lyteers (01-18)3321.175,00$698,775EU01079Cendo Mydriatil (09-17)732.312,00$226,184EU01080Cendo Natacten (09-16)145.787,00$45,787EU01081Cendo Pantocain 2% (09-17)817.325,00$138,600EU01082Cendo Poligran (05-16)821.175,00$169,400EU01083Cendo Poligran EO (06-16)422.385,00$89,540EU01084Cendo Polydex (07-17)2829.150,00$816,200EU01085Cendo Protagen A (02-17)2037.661,00$753,220EU01086Cendo Rephitel (06-16)544.468,00$222,340EU01087Cendo Timol 0,25% (07-17)1021.423,00$214,230EU01089Cendo Tobroson (01-16)926.923,00$242,307EU01091Cendo Tropine (11-16)1018.603,00$186,030EU01092Cendo Vernacel (06-17)225.289,00$50,578EU01093Cendo Vitolenta (07-17)629.282,00$175,692EU01094Cendo Xytrol (07-17)2926.812,00$777,548EU01095Cendo Xytrol EO (01-17)431.006,00$124,024EU01096Cephaflox Inj (10-16)15217.800,00$3,267,000EU01097Cernevit (10-15)6163.350,00$980,100EJ01039Cetrizine Tab (12-16)165313,50$51,728EU01099Chepamed Inj (10-15)348.400,00$145,200EU01102Ciflos tab (05-16)314.520,00$43,560EJ01040Ciproflaxacin 500 mg (11-16)100440,00$44,000EJ01041Citicolin Inj (02-16)1526.400,00$396,000EJ01042Citicolin Tab (11-19)606.799,83$407,990EU01107Clast (01-18)1722.002,00$344,344EJ01044Clindamycin 300 mg923,000.0EJ01045Clopidogrel Tab Dexa (JKN) (06-16)726.300,00$453,600EJ01046Codein Tab507,860.0EU01110Codipront Kap2008.525,00$1,705,000DU01024Collacure465.300,000.0DU01025Colostomi bag14.584,000.0EJ01048Cotrimoxazol100198,00$19,800EJ01050Curcuma tab6424.684,00$1,579,776EU01116Cycloproginova3109.934,00$329,802EU01118Cygest Supp 4007824.200,00$1,887,600EU01119Cygest Supp 200313.310,00$39,930EU01120Cymafort581.150,00$66,700EU01121D-40% (03-18)284.356,00$121,968EU01498D5%+1/2 NS OTSU0,000.0EJ01051Dexa Inj (05-18)412.402,27$98,493EJ01052Dexamethason 0,5 Tab120,000.0EU01123Dextrose 10% (09-19)386.435,50$244,549EU01125Dextrose 5% + 1/4 NS (01-17)2317.475,67$401,940EU01126Dextrose 5% 100 (03-16)80,000.0EU01127Dextrose 5% 500 (10-19)95.579,00$50,211EU01490Dextrose 5%+1/2 NS WIDA11.850,000.0EJ01054Diazepam 2 mg325,000.0EJ01055Diazol Inf8.000,000.0EU01129Digezym22.178,00$4,356EU01131Dome Drop (07-15)433.275,00$133,100EU01132Dome Syr (02-16)525.300,00$126,500EU01133Dome Tab3.146,000.0EJ01235Dopamin Injeksi (09-17)1544.545,00$668,175EU01136Dorbigot (05-17)1862.504,50$465,837EJ01056Doxicyclin 100 mg (09-18)80290,00$23,200EU01137Dulcolax0,000.0EU01138Dulcolax 10 mg1713.058,00$221,986EU01139Duvadilan Inj (06-17)3031.148,33$934,450EU01140Duvadilan Tab55.500,00$27,500EU01141Efomed Tab2541.210,00$307,340EU01143Elanos Tab293.630,00$105,270EU01145Endometryl514.092,00$208,692EU01479Engerix B6100.000,00$600,000EJ01059Epedrin inj2855.000,00$1,540,000EU01146Erycoat 500 tab144.782,00$66,948EJ01230Erythromycin Syr 200 mg/5 ml109.500,00$95,000EU01149Estin Drop749.133,33$343,933EJ01064Etafenin Tab155165,00$25,575DU01041Extension Tube2035.000,00$700,000EU01152Ezygard Forte416.159,83$252,553EU01153Ezygard Syr261.710,00$123,420EU01154Farelax Inj84.700,000.0EJ01071Fargoxin 0,25 mg (05-17)100495,00$49,500EJ01072Farmalat 10 mg (02-17)100327,50$32,750EJ01075Farsorbid 5140175,00$24,500EU01158Fenatic Tab605,000.0EU01160Fentanyl Inj744.767,00$313,369EU01495Ferriz FM Tablet290933,33$270,666EU01161Ferriz Syr230.855,00$61,710EU01162Fibramed 3001319.559,00$1,252,229EU01165Flamed Tab513.630,00$185,130EU01166Flexotide6021.054,00$1,263,240EJ01231Flunarizine Tab1500,000.0EU01168Forasma 2,5 mg1001.155,00$115,500DU01043Formalin Cair100040.000,00$40,000,000EU01172Frego 5 Mg (06-15)185.082,00$91,476EU01174Fuladic Cream (06-16)2249.610,00$1,091,420EJ01208Furosemide 40 mg Tab (12-18)21102,00$2,142EJ01080Furosemide Inj152.729,33$40,940EU01175Futrolit Inf (07-17)1063.802,00$638,020EU01176Galepsi Tab6610.648,00$702,768EU01178Gastrolan Cap12.100,000.0EU01179Gastrul Tab111.495,00$11,495EJ01082Genoint tts Mata7.000,000.0EJ01227Gentamicin Tetes Mata3.315,630.0EJ01083Gentamycin Cream20981,48$19,630EJ01084Gentamycin Inj293.692,20$107,074EU01181Gitaramin5861.372,80$804,461EU01183Glisodin46.655,00$26,620EJ01088Glucosamin Tab2801.500,00$420,000EU01185Govazol Tab1175.625,00$831,875EU01186Gracef14205.700,00$2,879,800EU01188Gracivask 5 mg5.445,000.0EU01189Grafalax Syr948.308,33$434,775DU01169H2O2100010,00$10,000EJ01092HCT78400,00$31,200EU01191Hepamax Tab427.623,00$320,166EU01192Heptamyl147.865,00$110,110EJ01096Hufadon Tab49360,00$17,640EJ01097Hyocine Inj7.600,000.0EU01194Hytrin 1 Mg319.016,00$279,496EU01195Idesar Plus2706.861,00$1,852,470EU01473Illiadin 0.65% Tts Hidung113.500,00$13,500EU01199Inciclav Tab4012.403,00$496,120EU01477Infanrix Hexa495.000,000.0EU01489Infanrix Hib450.000,000.0EU01200Infelon Tab306.800,00$204,000EU01474Infix Syr771.500,00$500,500EJ01098INH 300177,620.0EJ01246INH CIBA 300320,000.0EU01202Inhitril 10 mg Tablet1305.445,00$707,850EU01203Inhitril 5 mg1743.391,00$590,034EU01205Interhistin71682,00$48,422EU01207Isoric 3001123.388,00$379,456EJ01099Itranidasal296,000.0EU01208Kaen 3B5918.271,00$1,077,989EU01209Kaen MG 3718.792,00$131,544EU01496Kalmeco Cap802.046,00$163,680EU01210Kalnex Inj3413.310,00$452,540EU01211Kaltrofen Supp1508.873,33$1,331,000EU01212Kanamycin 1 gr179.862,00$167,654EJ01100Kaotin Syr0,000.0EU01213KCl124.356,00$52,272EU01214Keto G7.502,000.0EJ01220Ketorolac inj Bernofarm5324.000,00$1,272,000EJ01206Ketorolac inj hexapharm5.033,330.0EU01486Kina Tab80980,10$78,408EJ01243Kloroquin Tab100,000.0DU01060Kondom cateter2.650,000.0DU01061Kondom Sutra0,000.0EU01218KSR2553.299,67$841,416EU01220KTM INJ 1 CC2002.002,00$400,400EU01222Kutoin Inj4790.448,00$4,251,056EU00540L-Bio320,000.0EU01223Lacbon1631.490,67$242,979EU01225Lactamor403.993,00$159,720DU01505Lactogen 180 mg1522.455,00$336,825EU01228Laktasi Tab1316.500,00$214,500EU01229Lanakeloid E (09-16)758.300,00$408,100EJ01207Lansoprazol Hexapharm375,830.0EJ01107Laxama Tab100263,00$26,300EU01232Lefos Inf 750 mg14317.625,00$4,446,750EU01233Lefos Tab7337.510,00$2,738,230EU01234Leomoxyl Cap213.267,00$68,607EJ01108Lerzin Syr240,000.0EU01236Letonal 100 mg13.933,00$3,933EJ01109Levofloxacin 500 mg30925,00$27,750EU01239Levonic Inf19199.650,00$3,793,350EJ01111Lidocain Inj782.026,97$158,104EU01241Lynoral511.618,00$82,518EU01242Manitol75.755,000.0EU01245Mebo0,000.0EU01248Medigrel Tab1412.650,00$177,100EU01249Meiact Tab2921.175,00$614,075EJ01117Meloxicam 15 mg58797,13$46,234EJ01118Meloxicam 7,5 mg33691,90$22,833EU01250Meropenem Inj 1 gr5227.333,33$1,136,667EJ01121Metformin Tab200,000.0EU01253Methylon Inj0,000.0EJ01122Methylprednisolon Inj630.000,00$180,000EJ01123Methylprednisolon Tab440,370.0EU01255Metilat Tab22.420,00$4,840EJ01126Metronidazole Tab 50080264,00$21,120EU01260Meylon2011.979,00$239,580EU01261MgSO4 20%63.964,00$23,784EU01262MgSO4 40%297.819,50$226,766EU01264Midazolam Inj22.361,000.0EU01266Moretic Drop222.990,00$45,980EJ01129Myomergin2014.950,00$994,950EJ01130Na diklofenac Tab44217,84$9,585EU01268Nacl 100 cc1412.221,00$171,094EU01271NaCl 500cc Wida445.772,67$253,997EU01272NaCL Sanbe3014.811,50$444,345DU01507Nan Ha5161.899,00$809,495EU01275Neo Gynoxa8613.860,00$1,191,960EU01276Neo K2813.552,00$379,456EU01277Nerva Plus42.178,00$8,712EU01278Neurobion Inj68.200,00$49,200EJ01131Neurodex Tab366235,00$86,010EU01280Nichomedson 4 mg2812.082,50$585,183DU01509NL 3310,000.0EU01281Nobor1593.993,00$634,887EU01282Noflam Tab134.840,00$62,920EU01284Nonflamin Cap464.491,00$206,586EU01285Norages839.406,67$780,754EU01286Norages syr424.200,00$96,800EU01287Norestil Tab14.194,00$4,194EJ01135Novadium Tab100193,50$19,350DU01081Novofine Needle3.600,000.0EU01289Nufaclind 300316.970,00$216,070EU01291Nufagrabion GM1.942,670.0EU01292Nufalev Tab6028.103,00$1,686,180EU01293Nufamicron Tab1381.863,00$257,094EU01294Nufanibrox syr1020.196,00$201,960EU01295Nufaprazol Cap8012.606,67$1,008,534EU01297Nufolic50,000.0EU01298Nulacta Plus15.566,00$5,566EU01300Nulox Forte2755,00$1,510EU01301Nutriflam619.620,00$586,820EU01302Nyndia Drop138.720,00$38,720EU01303Ofertil Tab213.310,00$26,620EJ01138Omelegar Tab100190,00$19,000EU01304Ondane Inj 4 mg3630.603,00$1,101,708EU01306Ondansentron 8 mg Inj138.000,00$104,000EJ01141Ondansetron Inj 4 mg323.833,33$122,667EU01308Opox Tab401.210,00$48,400EU01484Osfit DHA1243.593,33$445,573EU01310Otsu Salim 3414.548,00$58,192EU01311Ottopain Ear Drop537.208,00$186,040EJ01145Oxytocin Inj3672.259,17$829,115EU01312Pamol 125 mg297.912,00$229,448EU01313Pamol 250 mg1311.374,00$147,862EU01316Pantoprazole Inj3988.000,00$3,432,000EU01318Panzol Inj150.150,000.0EU01319Paracetamol Inf1359.725,00$776,425EJ01147Paracetamol Tab133114,00$15,162EU01320Paramol Inf666.550,00$399,300EU01321Pehacain199.350,00$177,650EU01322Penfri Spray488.935,00$355,740EU01324Petidin Inj5714.102,65$803,851EJ01151Phenobarbital300,000.0EU01326Piracetam Inj 3 gr522.579,00$112,895EJ01153Pirazinamid 500245,330.0EJ01156Pospargin Tab30550,00$16,500DU01510Pre Nan469.916,00$279,664EU01329Preschol 10 mg1306.171,00$802,230EU01482Prestrenol Tab305,500.00$165,000EU01331Proanes2175.241,93$1,580,081EU01332Procefa Inj9151.250,00$1,361,250EU01333Procur Plus1146.413,00$731,082EU01334Profat Syr59.436,670.0EU01335Profertil Tab10014.410,00$1,441,000EU01336Profim Cap17.902,500.0EU01338Progina Care 100 ml124.200,00$24,200EU01340Prohelic25.011,11$10,022EU01342Prolecin Tab7029.645,00$2,075,150EU01347Promuxol Drop531.350,00$156,750EJ01159Propanolol 10 mg7690,00$6,840EU01350Propect Tab431.071,50$46,075EU01352Propepsa 100 ml1051.150,00$511,500EU01497Proris Supp 125 mg112,000.00$12,000EU01353Proste Kap2663.146,00$836,836EU01468Proster Tab29610.450,00$3,093,200EU01354Prostigmin1519.051,00$285,765EJ01160PTU (05-19)85915,00$77,775EU01358Quamiprox Forte (02-18)2512.333,00$308,325EU01359Ranicare Syr (08-16)546.806,67$234,033EJ01213Ranitidin inj bernofarm (09-17)1101.696,28$186,591EJ01163Ranitidin tab (11-17)48264,00$12,672EU01361Renalof (19912.099,00$2,407,701EJ01167Rifampisin 450 Hexapharrm (JKN)1.383,330.0EU01364Rifamtibi 450 mg (01-18)74.325,75$30,280EU01365Rifamtibi 600 mg (01-17)635.948,00$374,724EU01471Rimactazid 300/450 kap8.514,000.0EU01366Ring As (08-15)1019.263,00$192,630EJ01241RL BRAUN (11-17)154.799,67$71,995EU01368RL Sanbe21.981,670.0EU01369RL Wida (12-19)735.709,00$416,757EU00376RL Wida Cairan0,000.0EU01371Ronazol Syr42.350,000.0EU01372Ropain Inj (05-17)8932.670,00$2,907,630EU01480Rotarix300.000,000.0EU01373RS (Ringer Solution's)1811.896,50$214,137EJ01217Salbutamol 2 mg70168,75$11,813EJ01172Samcobion200210,00$42,000EU01376Sanazet1931.307,00$252,251EU01377Sanbe Hest (04-16)21208.362,00$4,375,602EU01378Sanmol Drop (11-17)815.482,50$123,860EU01379Sanmol Syr (12-19)1610.912,00$174,592EU01380Sanmol tab1290,00$290EU01475Santa E Tab (10-16)753.586,00$268,950EU01381Santibi Plus (07-19)285610,50$173,993EU01382Selkom C22.118,00$4,236EU01383Sensikol (07-16)1165.198,00$602,968EU01384Serbuk VK104.950,00$49,500EU01385Sibital Inj29.922,00$19,844EJ01175Simvastatin (12-16)16513,00$8,208EU01387Sirbo Cream (07-17)193.170,00$93,170EJ01178Sotatic Inj (05-18)294.133,33$119,867EJ01179Spasminal Tab (02-19)183475,00$86,925EU01389Stesolid 10 mg Inj (07-19)1013.970,00$139,700EU01390Stesolid 5 mg Supp (11-15)826.136,00$209,088EU01392Stobled Tab48.168,00$32,672EJ01181Streptomycin Inj (06-19)505,500.00$275,000EU01393Sulcolon27.260,00$14,520EU01394Suldox12.218,00$2,218EJ01242Sulfadoxin Tab2.650,000.0EU01396Supramox Drop (07-17)123.595,00$23,595EU01481Synflorix1550.000,00$550,000EU01398Taxime 20026.050,00$12,100EU01399Teranol Inj (01-17)2039.325,00$786,500EU01400Teranol Tab (08-16)1205.687,00$682,440EU01401Termicef Inj193.233,330.0EU01403Terral (Isofluran) 1 ml2506,984.00$1,746,000EU01406Theobron (06-15)1091.089,00$118,701DU01139Three way7.040,000.0EU01408Tiaryt (11-17)704.598,00$321,860EJ01183Tibigon tab (02-17)304$638$193,952EU01410Tisolon 4 mg (10-17)2073.086,00$638,802EU01413Tonotan Tab (01-17)3173.270,00$1,036,590EJ01229Tramadol Capsul (01-18)55750,00$41,250EJ01184Tramadol Inj7.682,200.0EU01415Tranec Inj12.705,000.0EU01416Tranec Tab (11-18)12.860,00$2,860EU01418Tribestan15.125,000.0EU01419Tridex (11-16)321.357,00$64,071EU01500Trimoxsul Syr (01-17)221.835,00$43,670EJ01185Trodet Tab (06-17)90430,00$38,700EU01422Tronadex Inj (06-15)230.250,00$60,500EU01427Urispas (09-18)794.774,00$377,146EU01428Ursolic Cap (07-17)769.801,00$744,876EU01429Valamin Inf (02-17)1273.697,50$884,370EU01430Valisanbe Inj (12-15)1913.685,00$260,015EU01432Vascon Inj121.000,000.0EU01433Vasgard 10 mg (01-16)1788.712,00$1,550,736EU01436Venosmil Gel1147.125,00$147,125EU01437Ventolin Expect (04-16)1649.610,00$793,760EU01438Ventolin Nebule (09-17)809.093,33$727,466EU01439Ventolin Syr (10-16)447.190,00$188,760EU01442Vioquin Tab (11-17)513.310,00$66,550EJ01192Vit B133,500.0EJ01193Vit B645,330.0EJ01194Vit C 100 mg (09-16)986.413,00$628,474EJ01195Vit C Tab (01-18)5232,00$1,664EJ01196Vit K Injeksi (JKN)4.070,000.0EJ01197Vita Curcumaris Syr4.400,000.0EJ01198Vitazym Tab (03-16)159550,00$87,450EU01449Vomecho Tab (05-17)1653.465,00$571,725EU01450Vomil B 6 (11-15)352.738,00$95,830EU01451Voxin Tab (06-17)6431.460,00$2,013,440EU01453Vroxyl Forte Syr (11-16)960.500,00$544,500EU01454Vroxyl Syr (11-16)645.375,00$272,250EU01455Widahest (05-18)5181.911,00$909,555EU01456Xidane Tab (07-15)1507.260,00$1,089,000EU01457Zanic Syr25.006,670.0EJ01234Zinc Syr0,000.0EJ01232Zinc Tab673,490.0EU01461Zine Syr (01-16)642.350,00$254,100EU01462Zinkid Syr (01-16)200,000.0EU01464Zistic Tab233.275,00$66,550EU01466Zolagel Cream (05-17)1028.875,00$288,750TOTAL$205,612,023Diketahui Oleh:Sibuhuan, 4 April 2015Dr.H Musbar M.KesSatria Ningsih, SAADirekturKa Unit Pengadaan Farmasi

AP JDAFTAR OBAT APOTEK BPJSKodeNamaQtyHargaJumlahEJ01001Acifar 40056586,00$32,816EJ01002Acyclovir 5% Cream13.000,00$3,000EJ01003Afolat Tab5138,00$690EJ01004Albendazol Tab14403,00$5,642EJ01005Allopurinol 300 mg124292,00$36,208EJ01006Allupurinol 100 mg67165,00$11,055EJ01007Alprazolam 0,5 mg189632,00$119,448EJ01008Alprazolam 1 mg94945,00$88,830EJ01219Ambroxol Syr283.298,00$92,344EJ01218Ambroxol Tab5330,00$1,650EJ01009Aminophylin Inj263.240,14$84,244EJ01225Aminophyllin Tab170,000.0EJ01212Amitripthylin indofarma195150,00$29,250EJ01236Amlodipin 5 mg2361.151,99$271,870EJ01173Antacida Syr (JKN)323.616,67$115,733EJ01228Antasida Doen Tab73930,35$22,429EU01025Aquabidest783.256,00$253,968EJ01012Arkavit C206450,00$92,700EJ01250Asam Mefenamat Tab470197,18$92,675EJ01224Asam Traneksamat Tab (JKN)981.045,00$102,410EJ01013Asam Tranexamat Inj3711.000,00$407,000EJ01014Aspilet215630,00$135,450EJ01015Atropin Sulfat Inj1292.731,00$352,299EJ01016Axofen Syr34.200,00$12,600EJ01017Batugin Elixir20.500,000.0EJ01238Betahistin Tab15953,33$14,300EJ01018Betamethason Cr282.100,00$58,800EJ01019Bic. Natric315220,00$69,300EJ01020Bisoprolol 5 mg101.842,22$18,422EJ01216Bledstop Inj428.000,00$336,000EJ01239Bronchitin Syr84.633,33$37,067EJ01223Bronchosal Tab (JKN)390188,43$73,488EJ01023Bupivacain Inj11058.666,67$6,453,334EJ01024Butasal 4 mg135,000.0EJ01026Calsium Laktat99042,00$41,580EJ01211Captopril 12,5 mg10389,94$9,264EJ01027Captopril 25 mg167137,41$22,947EJ01029Carpiaton 25 mg162554,50$89,829EJ01031Cazetin Drop220.500,00$41,000EJ01226Cefadroxil 125 mg Syr107.000,00$70,000EJ01032Cefadroxil 500 mg2151.008,00$216,720EJ01034Cefezet Tab161100,00$16,100EJ01035Cefixim 100 mg3132.014,71$630,604EJ01237Cefixime Syr30.250,000.0EJ01037Cefotaxim I gr174.625,00$78,625EJ01038Ceftriaxon 1 gr605.833,33$350,000EJ01248Cetrizine Drop1126.125,00$287,375EJ01039Cetrizine Tab313,500.0EJ01247Chloramphenicol Cap0,000.0EJ01040Ciproflaxacin 500 mg97440,00$42,680EJ01041Citicolin Inj3226.400,00$844,800EJ01042Citicolin Tab2226.799,83$1,509,562EJ01043Clindamycin 150 mg50530,00$26,500EJ01044Clindamycin 300 mg163923,00$150,449EJ01045Clopidogrel Tab Dexa (JKN)386.300,00$239,400EJ01046Codein Tab101507,86$51,294EJ01047Compyrantel 250 mg890,000.0EJ01048Cotrimoxazol110198,00$21,780EJ01050Curcuma tab55124.684,00$13,600,884EU01498D5%+1/2 NS OTSU0,000.0EJ01051Dexa Inj562.402,27$134,527EJ01052Dexamethason 0,5 Tab120,000.0EJ01053Dextrometorpan200,000.0EU01123Dextrose 10%6.435,500.0EU01127Dextrose 5% 5005.579,000.0EU01490Dextrose 5%+1/2 NS WIDA11.850,000.0EJ01054Diazepam 2 mg325,000.0EJ01055Diazol Inf158.000,00$120,000EJ01209Domperidon 10 mg indofarma403,520.0EJ01235Dopamin Injeksi2344.545,00$1,024,535EJ01056Doxicyclin 100 mg131290,00$37,990EJ01057Duramycin Tab 500 mg40105,00$4,200EJ01058Epedrin225,000.0EJ01059Epedrin inj55.000,000.0EJ01060Epinephrin Inj223.500,00$77,000EJ01061Erlamol Syr2.900,000.0EJ01062Erlamycetin Tts Mata7.000,000.0EJ01063Erlamycetin Tts Telinga53.500,00$17,500EJ01230Erythromycin Syr 200 mg/5 ml109.500,00$95,000EJ01064Etafenin Tab165,000.0EJ01066Etagemycetin Syr34.500,00$13,500EJ01067Etamoxul Tab175,000.0EJ01070Famacrol Forte39275,00$10,725EJ01071Fargoxin 0,25 mg190495,00$94,050EJ01072Farmalat 10 mg56327,50$18,340EJ01073Farmoten 12,5 mg170,000.0EJ01075Farsorbid 5171175,00$29,925EJ01076Fasidol Drop88.250,00$66,000EJ01078Flagsol Syr44.750,00$19,000EJ01079Flasicox tab2002.400,00$480,000EJ01231Flunarizine Tab1500,000.0EJ01208Furosemide 40 mg Tab47102,00$4,794EJ01080Furosemide Inj1362.729,33$371,189EJ01082Genoint tts Mata17.000,00$7,000EJ01227Gentamicin Tetes Mata243.315,63$79,575EJ01083Gentamycin Cream19981,48$18,648EJ01084Gentamycin Inj753.692,20$276,915EJ01085Gitri Syr3.400,000.0EJ01088Glucosamin Tab4141.500,00$621,000EJ01089Gludefatic Tab250,000.0EJ01092HCT62400,00$24,800EJ01094Helixime Syr324.000,00$72,000EJ01095Hidrocortison Salep40,000.0EJ01096Hufadon Tab169360,00$60,840EJ01097Hyocine Inj367.600,00$273,600DJ01026Hypafix Kotak 10 cm x 5 m3112.500,00$337,500EJ01254Ibuprofen Tab600,000.0DJ01009Infusset Micro Gea563.500,00$196,000DJ01010Infusset Macro Gea583.000,00$174,000EJ01098INH 300483177,62$85,790EJ01246INH CIBA 3000,000.0EU01208Kaen 3B18.271,000.0EU01211Kaltrofen Supp8.873,330.0EJ01100Kaotin Syr53500$17,500DJ01030Kasa Gulung0,000.0DU01059Kasa Hidrofil Biru183.492,00$62,856DU01175Kertas EKG390.000,00$270,000EJ01220Ketorolac inj Bernofarm10424.000,00$2,496,000EJ01206Ketorolac inj hexapharm5.033,330.0EU01486Kina Tab80980,10$78,408EJ01243Kloroquin Tab50100,00$5,000DU01062Laminaria M13107.000,00$1,391,000EJ01207Lansoprazol Hexapharm375,830.0EJ01107Laxama Tab475263,00$124,925EJ01108Lerzin Syr240,000.0EJ01109Levofloxacin 500 mg195925,00$180,375EJ01111Lidocain Inj782.026,97$158,104EJ01115Lostacef 250 mg Syr20,000.0EJ01117Meloxicam 15 mg307797,13$244,719EJ01118Meloxicam 7,5 mg306691,90$211,721EJ01119Meropenem Inj0,000.0EJ01120Mersibion Inj214.840,00$101,640EJ01121Metformin Tab90200,00$18,000EJ01122Methylprednisolon Inj1730.000,00$510,000EJ01123Methylprednisolon Tab694440,37$305,617EJ01125Metronidazole Inf Hexapharm0,000.0EJ01126Metronidazole Tab 500334264,00$88,176EU01261MgSO4 20%63.964,00$23,784EU01262MgSO4 40%247.819,50$187,668EJ01244Miconazole Cream63.000,00$18,000EJ01128Micoticum Tab (JKN)198617$122,166EJ01129Myomergin2014.950,00$994,950EJ01130Na diklofenac Tab35217,84$7,624EU01271NaCl 500cc Wida5.772,670.0EU01476Nebacetin Powder/Tabur0,000.0