LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ((LPLPO)

DINAS KESEHATAN KABUPATEN PEGUNUNGAN BINTANG

PUSKESMAS : BORME
LAPORAN BULAN : MARET

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN KET
1 2-4 KOMBINASI SALEP SALEP 72 0 72 22 50 0
2 ACYCLOVIR TABLET 200 MG TABLET 0 0 0 0 0
3 ACYCLOVIR TABLET 400 MG TABLET 1000 1000 0 1000 0
4 ADALAT OROS TABLET PELEPASAN LAMBAT 20 MG/NIFEDIPIN TABLET 0 0 0 0 0 0
5 ALBENDAZOLE TABLET 400 MG(BOTOL, 200 TABLET) TABLET 600 2400 3000 100 2900 0
6 ALKOHOL 70 % CAIRAN OBAT LUAR 70 %(BOTOL CAIRAN OBAT L
LAIN-LAIN 2 0 2 1 1 3
7 ALKOHOL SWAB (BOX, 50 PIECES) 500 0 500 0 500 0
8 ALLOPURINOL TABLET 100 MG TABLET 0 2000 2000 100 1900 0
9 ALPARA TABLET (15 STR a 10) TABLET 0 1800 1800 150 1650 0
10 ALPHAMOL DROPS 100 mg/ml(BOTOL 15 ML) DROPS 0 80 80 10 70 0
11 AMBROXOL TABLET 30 MG TABLET 0 1000 1000 100 900 0
12 AMINOPHYLLINE CAIRAN INJEKSI 24 MG/ML(30 AMPUL @ 10 ML) CAIRAN INJEKSI 0 30 30 0 30 0
13 AMLODIPINE TABLET 10 MG(DUS, 5 STRIP @ 10 TABLET) TABLET 700 0 700 0 700 0
14 AMOXICILLIN CAPTABS 500 MG(DUS, 10 STRIP @ 10 KAPLET) CAPTABS 300 5000 5300 800 4500 0
15 AMOXICILLIN SIRUP KERING 125 MG/5 ML(DUS, BOTOL @ 60 ML) SIRUP KERING 0 120 120 0 120 0
16 AMOXIL DROPS 125 MG/1,25 ML/AMOKSISILIN DROP DROPS 0 0 0 0 0 0
17 AMPICILLIN SERBUK INJEKSI 1 G/VIAL SERBUK INJEKSI 0 20 20 0 20 0
18 ANAKONIDIN SIRUP (DUS, BOTOL @ 60 ML) SIRUP 0 144 144 10 134 0
19 ANTASIDA DOEN SUSPENSI (DUS, BOTOL @ 60 ML) SUSPENSI 0 100 100 0 100 0
20 ANTASIDA DOEN TABLET TABLET 0 3000 3000 100 2900 0
21 ANTIHEMOROID SUPPOSITORIA SUPPOSITORIA 0 0 0 0 0 0
22 ANTISEPTIC HAND RUB LIQUID 500 ML/SABUN ANTIBAKTERI LIQUID 0 3 3 1 2 2
23 AQUA BIDEST STERIL CAIRAN INJEKSI CAIRAN INJEKSI 20 13 33 0 33 0
24 ARTESUNATE INJECTION 60 MG\/ML(BOX, 60 MG @8 VIAL) INJECTION 16 8 24 0 24 0
25 ASAM ASKORBAT Tablet 50 MG Mg(ASAM ASKORBAT (VIT C) 50 MGTablet 0 0 0 0 0 0
26 ASAM MEFENAMAT CAPTABS 500 MG(DUS, 10 STRIP @ 10 KAPLET)CAPTABS 0 2000 2000 500 1500 0
27 ASAM TRANEKSAMAT CAIRAN INJEKSI 250 MG CAIRAN INJEKSI 0 0 0 0 0 0
28 AUTOCHECK 3 in 1 Multi / EASY TOUCH PAKET 0 0 0 0 0 0
29 BACITRACIN - POLYMYXIN B SALEP (DUS, 25 TUBE @ 5 GRAM) SALEP 30 25 55 0 55 0
30 BEDAK SALYCYL SERBUK OBAT LUAR 2% SERBUK OBAT L 6 30 36 0 36 0
31 BENZATIN BENZIL PENISILIN INJEKSI 2.4 UI/Ml INJEKSI 0 20 20 0 20 0
32 BETAMETASON CREAM 0,1 %(DUS, 25 TUBE @ 5 GRAM) CREAM 0 0 0 0 0 0
33 BIOPLACENTON GEL 15 G(DUS, 1 TUBE @ 15 G) GEL 0 0 0 0 0 0
34 BLOOD LANCET() KOTAK 100 PCS 100 500 600 0 600 0
35 BUSCOPAN TABLET SALUT GULA 10 MG TABLET SALUT 0 0 0 0 0 0
36 CALCIUM LACTATE TABLET 500 MG(DUS, 10 BLISTER @ 10 TABLET) TABLET 300 1000 1300 600 700 0
37 CAPTOPRIL TABLET 25 MG(DUS, 10 STRIP @ 10 TABLET) TABLET
LAIN-LAIN 1000 1000 2000 100 1900 0
38 CAT GUT CHROMIC 3/0 BENANG BEDAH/ HR 40 MM 20 2 22 2 20 0
39 CAT-GUT CHROMIC 3 HR.20 MM PCS 20 24 44 2 40 0
40 CAT GUT PLAIN 3 - 0 HR 26() PCS 0 0 0 0 0 0
41 CEFADROKSIL Sirop/Sirop Kering 480 Mg Sirop/Sirop Ker 0 50 50 0 50 0
42 CEFADROXIL CAPSUL 500 MG(DUS, 10 STRIP @ 10 CAPSUL) CAPSUL 300 0 300 100 200 0
43 CEFIXIME CAPSUL 100 MG(DUS, 3 STRIP @ 10 KAPSUL) CAPSUL 1170 0 1170 150 1020 0
44 CEFOTAXIME SERBUK INJEKSI 1000 MG(DUS, 2 VIAL @ 1000 MG) SERBUK INJEKSI 0 30 30 0 30 0
45 CEFTRIAXONE SERBUK INJEKSI 1 G(DUS, 2 VIAL @ 1000 G) SERBUK INJEKSI 0 30 30 0 30 0
46 CENDO XITROL TETES MATA (Catch cover,5 btl pls @ 0,3 ml) TETES MATA 0 100 100 0 100 0
47 CHLORAMEX CAPSUL 500 MG(DUS, 10 STRIP @ 10 KAPSUL) CAPSUL 0 500 500 0 500 0
48 CHLORAMPHENICOL SALEP MATA 1%(TUBE @ 3,5 G) SALEP MATA 0 24 24 0 24 0
49 CHLORPHENIRAMIN MALEAT / CTM TABLET 0 5000 5000 300 4700 0
50 CHLORPROMAZINE CAIRAN INJEKSI 25 MG/ML(30 AMPUL a 1 ML) CAIRAN INJEKSI 0 0 0 0 0 0
51 CIDEX OPA Desinfectant / ODEX BOTOL 0 0 0 0 0 0
52 COMBIVENT UDV CAIRAN INHALER (DUS, 20 VIAL @ 2,5 ML) CAIRAN INHALE 0 20 20 0 20 0
53 COTRIMOKSAZOLE SUSPENSI 200 MG + 40 MG(BOTOL @ 60 ML) SUSPENSI 0 50 50 0 50 0
54 COTRIMOKSAZOLE TABLET 400 MG + 80 MG TABLET 0 0 0 0 0 0
55 COUNTERPAIN CREAM (TUBE 15 GRAM) CREAM 0 10 10 2 8 0
56 CURCUMA SHARPY SiRUP Sirop/Sirop Ker 0 100 100 15 85 0
57 Cuticell Classic PLASTER 10 x 10 cm() PLASTER 0 25 25 5 20 0
58 CYANOCOBALAMIN CAIRAN INJEKSI (DUS, 100 AMPUL @ 1 ML) CAIRAN INJEKSI 0 100 100 0 100 0
59 DEXAMETHASON CAIRAN INJEKSI 5 MG/ML(5 AMPUL A 3 ML) CAIRAN INJEKSI 0 50 50 0 50 0
60 DEXAMETHASONE TABLET 0,5 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 0 4000 4000 100 3900 0
61 DIAZEPAM CAIRAN INJEKSI 5 MG\/ML(DUS, 100 AMPUL @ 2 ML) CAIRAN INJEKSI 0 10 10 0 10 0
62 DIAZEPAM TABLET 5 MG(BOTOL PLASTIK @ 100 TABLET) TABLET 100 200 300 0 300 0
63 DIETHYLCARBAMAZINE TABLET 100 MG(DUS, 10 STRIP @ 10 TABLETTABLET 1500 5000 6500 0 6500 0
64 DIFENHIDRAMINA HCL CAIRAN INJEKSI 10 mg/ml(100 AMP a 1) CAIRAN INJEKSI 0 30 30 0 0 0
 65 DIGOXIN TABLET 0.25 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 0 0 0 0 0 0
66 DOMPERIDON SUSPENSI 5 MG/5 ML(DUS, BOTOL 60 ML) SUSPENSI 1400 0 1400 0 1400 0
67 DOMPERIDON TABLET 10 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 900 1000 1900 100 1800 0
68 DOXYCYCLINE CAPSUL 100 MG(DUS, 10 STRIP @ 10 CAPSUL) CAPSUL 0 1000 1000 100 900 0
69 DULCOLAX TABLET SALUT ENTERIK 5 MG TABLET SALUT 0 4 4 0 4 0
70 ENTROSTOP TABLET (DUS, 20 BLISTER @ 12 TABLET) TABLET 0 90 90 0 90 0
71 EPHEDRIN HCL CAIRAN INJEKSI 50 MG/ML(DUS, 10 AMPUL @ 1 ML)CAIRAN
CAIRAN INJEKSI
INJEKSI 0 0 0 0 0 0
72 EPINEFRIN CAIRAN INJEKSI 1 MG\/ML(BOX, 30 AMPUL) 0 0 0 0 0 0
73 ERLAMYCETIN EAR Tetes Telinga (ERLAMYCETIN EAR DROP) Tetes Telinga 0 0 0 0 0 0
74 ERYTHROMYCIN CAPSUL 250 MG (BASE)(DUS, 10 STRIP @10 KAPSULCAPSUL 0 3000 3000 100 2900 0
75 ETHYL CHLORIDA LAIN-LAIN 100 Ml(ETHYL CHLORIDA SPRAY 100 MLLAIN-LAIN 1 0 1 0 1 0
76 FEEDING TUBE NO 3,5 35 CM TERUMO() PCS 0 0 0 0 0 0
77 FEEDING TUBE NO 5 120 CM TERUMO() PCS
LAIN-LAIN 0 0 0 0 0 0
78 FOLLEY CATHETER 2 WAY NO. 16 LAIN-LAIN -(BOX, 10 PIECES) LAIN-LAIN 10 0 10 0 10 0
79 FOLLEY CATHETER 2 WAY NO. 18 LAIN-LAIN -(BOX, 10 PIECES) 10 20 30 0 30 0
80 FOLLEY CATHETER 2 WAY NO. 20(BOX, 10 PIECES) CATHETER 10 20 30 5 25 0
81 FUROSEMIDA TABLET 40 MG(DUS,10 STRIP @10 TABLET) TABLET 300 100 400 100 300 0
82 FUROSEMIDE CAIRAN INJEKSI 10 MG/ML(DUS, 25 AMPUL @ 2 ML) CAIRAN INJEKSI 0 10 10 0 10 0
83 GENOINT TETES MATA 0,3 %(DUS, BOTOL PLASTIK @ 5 ML) TETES MATA 0 0 0 0 0 0
84 GENTAMISIN SALEP 0,1 %(DUS,10 TUBE @ 5 GRAM) SALEP 60 24 84 60 24 42
85 GLIBENCLAMIDE CAPTABS 5 MG(DUS, 10 BLISTER @ 10 KAPTAB) CAPTABS
INFUS 1600 0 1600 0 1600 0
86 GLUKOSA INFUS 10 %(BOTOL PLASTIK @ 500 ML) 50 0 50 0 50 0
87 GLYCERIL GUAIACOLATE TABLET 100 MG/ GUAEFENESIN TABLET 0 3000 3000 200 2800 0
88 GRISEOFULVIN TABLET 125 MG(DUS,10 STR @ 10 TAB) TABLET 500 2000 2500 200 2300 0
89 HANSAPLAST() ROLL
LARUTAN / CAIRAN 0 10 10 2 8 0
90 HIDROGEN PEROKSIDA (H202) 1 3 4 1 3 0
91 HIDROKLOROTIAZIDA (HCT) TABLET 25 MG TABLET 0 0 0 0 0 0
92 HIDROKORTISON CREAM 2,5%(Ktk) CREAM 48 48 96 40 56 0
93 HUMAN HEXAGON RDT SYPHILIS KIT 0 0 0 0 0 0
94 HUMAN Sypilis Screen / RPR SYPILIS TEST 0 0 0 0 0 0
95 HYDROCHLORTIAZIDE Tablet 25 Mg(HYDROCHLORTIAZIDE 25 MG) Tablet 400 0 400 0 400 0
96 HYDROCORTISONE CREAM 2.5 %(DUS, 24 TUBE @ 5 G) CREAM 0 0 0 0 0 0
97 HYPAFIX 10 CM X 5 M() ROLL 0 5 5 1 4 0
98 IBUPROFEN SUSPENSI 100 MG/5 ML(DUS, BOTOL @ 60 ML) SUSPENSI 0 24 24 0 24 0
99 IBUPROFEN TABLET 400 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 0 2000 2000 100 1900 0
100 ICHTIOL SALEP 30 %(POT 12) SALEP 0 32 32 5 27 0
101 IL TEST Referril HDL Colesterol/ STIK KOLESTEROL STRIP 0 0 0 0 0 0
102 IMBOOST Suspensi 60 Ml(IMBOOST SYR 60ML) Suspensi 0 0 0 0 0 0
103 IMBOOST Tablet 1 Mg(IMBOOST TABLET SALUT SELAPUT) Tablet 0 150 150 0 150 0
104 INFUS SET ADULT TERUMO KIT SET(Kotak @ 50) PCS 0 50 50 0 50 0
105 INFUS SET PEDIATRIC TERUMO() PCS 0 50 50 0 50 0
106 INSTO REGULAR TETES MATA (DUS, BOTOL PLASTIK @ 10 ML) TETES MATA 0 0 0 0 0 0
107 IV CATHETER NO 18 SHORT TERUMO() PCS 0 20 20 2 18 0
108 IV CATHETER NO 20 SHORT TERUMO() PCS 0 20 20 0 20 0
109 IV CATHETER NO 22 TERUMO() PCS 0 20 20 0 20 0
110 IV CATHETER NO 24 TERUMO() PCS 0 20 20 0 20 0
111 IV CATHETER NO 26 TERUMO() PCS 0 5 5 0 5 0
112 JMS Umbilical Cord Clamp PCS
LAIN-LAIN 0 0 0 0 0 0
113 KAPAS 250 G LAIN-LAIN\n -() 0 5 5 0 5 0
114 KAPAS ONEMED 500(KAPAS ONEMED 500 GRAM) ROLL
LAIN-LAIN 0 24 24 4 18 0
115 KASA HIDROFIL DRC LAIN-LAIN 36 X 80 CM(ROL) LAIN-LAIN 1 3 4 1 4 0
116 KASA HIDROFIL DRC LAIN-LAIN 4 M X 10 CM() 1 1 2 1 1 2
117 KASA STERIL ALAT KESEHATAN 16 X 16(KASA STERIL 16 X 16 CN) ALAT KESEHAT 20 50 70 20 50 0
118 KERTAS PUYER() KOTAK 100 PCS 100 800 900 100 800 0
119 KETOCONAZOL TABLET 200 MG(Dus, 5 strip a 10 tablet) TABLET 250 1100 1350 100 1250 0
120 KETOCONAZOLE CREAM 2 %(DUS, TUBE @ 10 G) CREAM 25 0 25 10 15 0
121 KETOROLAC CAIRAN INJEKSI 10 MG/ML(DUS, 6 AMPUL @ 1 ML) CAIRAN INJEKSI 0 20 20 0 20 0
122 LACTO-B LAIN-LAIN Mcg(LACTO-B) LAIN-LAIN 0 3 3 0 3 0
123 LEUKOPLAST PLASTER 4,5 CM X 5 CM() PLASTER 0 5 5 2 3 0
124 LIDOCAIN CAIRAN INJEKSI 2 %(DUS, 100 AMPUL @ 2 ML) CAIRAN
CAIRAN INJEKSI
INJEKSI 50 100 150 50 100 0
125 LIDOKAIN 2% HCL + EPINEPHRINE 1 : 80.000 / ANASTETIK GIGI 20 0 20 10 10 10
126 LOPERAMID HCL TABLET 2 MG(10 STR a 10) TABLET 0 500 500 0 500 0
127 LYSOL LIQUID 1 L() LIQUID 1 3 4 1 4 0
128 MAGNESIUM SULFATE CAIRAN INJEKSI 20 %(10 VIAL a 25 ML) CAIRAN INJEKSI 0 18 18 2 16 0
129 MASKER (MASKER TALI) PAIR 150 200 350 200 150 100
130 MEDI-TEST Glucose/ STIK GLUKOSA STRIP 0 0 0 0 0 0
131 METFORMIN TABLET 500 MG() TABLET 1000 500 1500 0 1500 0
132 METHYL PREDNISOLON Tablet 4 MG MG Tablet 0 500 500 0 500 0
133 METHYLERGOMETRINE CAIRAN INJEKSI 0.2 MG/ML CAIRAN INJEKSI 0 0 0 0 0 0
134 METHYLERGOMETRINE TABLET SALUT SELAPUT 0,125 MG TABLET SALUT 0 500 500 0 500 0
135 METILEN BLUE BOTOL 1 1 2 0 2 0
136 METRONIDAZOL INFUS 5 MG/ML INFUS 0 15 15 0 15 0
137 MINERAL MIX SERBUK 8 G(DUS, 40 SACHET @ 8 G) SERBUK 0 0 0 0 0 0
138 MOLAGIT TABLET (DUS, 15 STRIP @ 10 TABLET) TABLET 700 750 1450 150 1300 0
139 MOLAZOL TABLET 500 MG(DUS,10 STRIP @ 10 TABLET) TABLET 0 2000 2000 100 1900 0
140 NATRIUM DIKLOFENAK TABLET SALUT ENTERIK 50 MG(5 STRIP a 10 INFUS
TABLET SALUT 0 500 500 100 400 0
141 NATRIUM KLORIDA INFUS 0,9 %(DUS, BOTOL PLASTIK PE @ 500 ML) 60 0 60 5 55 0
142 NESCO MultiCheck / EASY TOUCH PAKET 0 0 0 0 0
143 NYSTATIN TABLET SALUT GULA 500.000 IU(BOTOL 100 TABLET) TABLET SALUT 0 300 300 0 300 0
144 NYSTATIN TABLET VAGINAL 100.000 IU(10 STRIP a 10 TABLET) TABLET VAGINA 600 0 600 0 600 0
145 OBAT FDC Tablet 1 Ml(OBAT FDC ANAK) Tablet 0 0 0 0 0 0
146 OBH SYRUP 60 ML(BOTOL, 60 ML) SYRUP 0 0 0 0 0 0
147 OKSITOSIN INJEKSI 1 Ml(OKSITOSIN INJ 10 IU/ML) INJEKSI 0 0 0 0 0 0
148 OMEPRAZOLE CAPSUL 20 MG CAPSUL 990 1500 2490 150 2340 0
149 ONDANSETRON CAIRAN INJEKSI 2 MG/ML(DUS, 5 AMPUL @ 2 ML) CAIRAN INJEKSI 0 30 30 0 30 0
150 ONDANSETRON TABLET SALUT SELAPUT 4 MG TABLET SALUT
LARUTAN / CAIRAN 0 900 900 0 900 0
151 ONEMED ASEPTAN / ODEX 0 0 0 0 0 0
152 ONEMED Disposable Syringe 1 ml() PCS 0 0 0 0 0 0
153 ONEMED Disposable Syringe 3 ml() PCS 0 0 0 0 0
154 ONEMED Disposable Syringe 5 ml() PCS 0 0 0 0 0
155 ONEMED Hb Meter/ HB SAHLI PCS 0 0 0 0 0
156 ONEMED Surgical Blade() KOTAK 100 PCS 0 0 0 0 0 0
157 ORALIT SERBUK (DUS. 100 SACHET @ 4,129 G) SERBUK 0 400 400 0 400 0
158 OTSU - WI CAIRAN INJEKSI (DUS, 120 AMPUL PE @ 25 ML) CAIRAN INJEKSI 0 0 0 0 0
159 OXYTETRACYCLINE SALEP 3 %(TUBE a 3.5 GRAM) SALEP 0 0 0 0 0
160 OXYTETRACYCLINE SALEP MATA 1%(DUS, 25 TUBE @ 3.5 GRAM) SALEP MATA 0 75 75 10 65 0
161 OXYTOCIN CAIRAN INJEKSI 10 MCG/ML(10 AMP a 1) CAIRAN INJEKSI 0 0 0 0 0
162 PARACETAMOL INFUS 10 MG/ML(DUS, 1 VIAL @ 100 ML) INFUS 0 10 10 0 10 0
163 PARACETAMOL SIRUP 120 MG/5 ML(BOTOL @ 60 ML) SIRUP
TETES TELINGA 0 100 100 15 85 0
164 PHENOL GLYCEROL TETES TELINGA 10%() 0 0 0 0 0
165 PHYTOMENADIONE CAIRAN INJEKSI 2 MG/ML CAIRAN INJEKSI 0 60 60 0 60 0
166 PHYTOMENADIONE TABLET SALUT GULA 10 MG TABLET SALUT 0 500 500 0 500 0
167 PIROXICAM TABLET 10 MG TABLET
LAIN-LAIN 300 1300 1600 400 1200 0
168 PLASTIK OBAT LAIN-LAIN 5 CM X 8 CM(100 PIECES) LAIN-LAIN 0 2000 2000 100 1900 0
169 POT SPUTUM LAIN-LAIN\n -() LARUTAN / CAIRAN 0 25 25 0 25 0
170 POVIDONE IODINE LARUTAN 300 ML 0 5 5 1 4 0
171 PREDNISON TABLET 5 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 0 1000 1000 200 800 0
172 PRIMAQUINE TABLET 15 MG(Ktk100) TABLET
CAIRAN INJEKSI 20 0 20 HILANG 0 30
173 PROKAIN BENZIL PENISILIN CAIRAN INJEKSI 3.000.000 IU(KOTAK, 30 0 5 5 0 5 0
174 PYRANTEL SUSPENSI 125 MG/5 ML(BOTOL 60 ML) SUSPENSI 0 0 0 0 0 0
175 PYRANTEL TABLET 125 MG(DUS, 25 STRIP @ 4 TABLET) TABLET 0 1000 1000 50 950 0
176 PYRIDOXINE TABLET 10 MG(BOTOL PLASTIK @ 1000 TABLET) TABLET 0 0 0 0 0
177 QUININE TABLET SALUT SELAPUT 222 MG(BOTOL PLASTIK 1000 TABTABLET SALUT 0 0 0 0 0 0
178 RANITIDIN CAIRAN INJEKSI 25 MG/ML(DUS, 5 AMPUL @ 2 ML) CAIRAN INJEKSI 0 100 100 0 100 0
179 RANITIDINE TABLET SALUT SELAPUT 150 MG TABLET SALUT 1100 0 1100 200 900 0
180 RDT CARESTART MALARIA TEST / RDT MALARIA TEST
LARUTAN / CAIRAN 0 50 50 1 49 0
181 REAGEN ZIEHL NEELSEN LARUTAN 0 0 0 0 0
182 REAGENT KIMIA KLINIK ASAM URAT TEST -() TEST 0 0 0 0 0 0
183 RETAPHYL CAPTABS PELEPASAN LAMBAT 250 MG CAPTABS
CAIRAN OBAT LUAR 0 0 0 0 0 0
184 RIVANOL (ONEMED) CAIRAN OBAT LUAR 300 ML() LAIN-LAIN 0 5 5 1 4 0
185 SAFEED FEEDING TUBE LAIN-LAIN 8 FR (100 CM)() LAIN-LAIN 0 0 0 0 0 0
186 SAFEED FEEDING TUBE LAIN-LAIN 8 FR (40 CM)() LAIN-LAIN 0 0 0 0 0 0
187 SAFETY BOX LAIN-LAIN\n -() 5 5 10 0 10 0
188 SALBUTAMOL TABLET 4 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 600 1000 1600 300 1300 0
189 SARUNG TANGAN (SARUNG TANGAN MAXTER SIZE S) PAIR/PASANG 0 200 200 200 200
190 SARUNG TANGAN (SARUNG TANGAN MAXTER SIZE M) PAIR/PASANG 0 200 200 100 100 100
191 SARUNG TANGAN (SARUNG TANGAN MAXTER SIZE L) PAIR/PASANG 0 200 200 0 200 0
192 SARUNG TANGAN MEDIGRIP NO 7,5() PAIR/PASANG 0 0 0 0 0 0
193 SARUNG TANGAN STERIL N0 6,5 MEDICDENT() PAIR/PASANG 0 30 30 2 28 0
194 SARUNG TANGAN STERIL N0 8 MEDICDENT() PAIR/PASANG 0 30 30 0 30 0
195 SCABIMITE CREAM 5 %(DUS,TUBE @ 10 G) CREAM 0 10 10 2 8 0
196 SIMVASTATIN TABLET SALUT SELAPUT 10 MG TABLET SALUT
LAIN-LAIN 390 300 690 30 660 0
197 SMI SILK BLACK 3\/0 LAIN-LAIN DS 24 MM() 0 0 0 0 0 0
198 SOFT PAD (SOFT PAD 60X90) PCS 0 200 200 50 150 0
199 SPUIT 10 CC BD() PCS 0 200 200 10 190 0
200 SULFADIAZINE SILVER CREAM 10 MG(TUBE, NETTO 35 G) CREAM
LAIN-LAIN 0 5 5 1 4 0
201 SURGICAL MASK-3 PLY PLUS EARLOOP LAIN-LAIN -(BOX, 50 LEMBAR 0 200 200 0 200 0
202 TABLET TAMBAH DARAH TABLET SALUT SELAPUT (SACHET 30 TABLETABLET SALUT 0 2880 2880 360 2520 0
203 TERA-F CAPTABS 100 UI/Ml(TERA-FKAPLET) CAPTABS 0 0 0 0 0 0
204 TES KEHAMILAN (ONEMED) STRIP -(BOX, 50 STRIP) STRIP 20 50 70 25 45 0
205 TETRACYCLINE CAPSUL 500 MG(DUS, 10 STRIP @ 10 KAPSUL) CAPSUL 0 1000 1000 100 900 0
206 THIAMIN TABLET 50 MG(BOX, 10 STRIPS @10 TABLET) TABLET 0 0 0 0 0 0
207 TRIHEXYPHENIDYL TABLET 100 MG(10 STRIP a 10 TABLET) TABLET 0 0 0 0 0 0
208 UNI BABY COUGH Sirop/Sirop Kering 60 Ml(uni baby cough sirup 60Sirop/Sirop Ker 0 72 72 2 70 0
209 UNIFLEX PLASTER 15 CM X 4,5 M(BOX, 10 PACK @6 ROLL) PLASTER 0 0 0 0 0 0
210 URINE BAG TERUMO() PCS 0 10 10 0 10 0
211 VERBAN ELASTIS ALAT KESEHATAN NO(VERBAN ELASTIS 4) ALAT KESEHAT 0 0 0 0 0 0
212 VITAMIN A CAPSUL LUNAK 200.000 IU(Botol pls 50 kap) CAPSUL LUNAK 0 200 200 0 200 0
213 VITAMIN B COMPLEX TABLET (DUS, 10 STRIP @ 10 TABLET) TABLET 0 5000 5000 400 4600 0
214 VITAMIN B6 TABLET 10 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 1400 1500 2900 500 2400 0
215 WHITEFIELD SALEP SALEP (POT 30) SALEP 0 0 0 0 0 0
216 WIDA D10 INFUS 10 %(BOTOL PLASTIK @ 500 ML) INFUS 50 0 50 0 50 0
217 WIDA D5 INFUS 5 %(BOTOL PLASTIK PE @ 500 ML) INFUS 40 0 40 4 46 0
218 WIDA RL INFUS (BOTOL PLASTIK PE @ 500 ML) INFUS
INFUS 60 0 60 0 0
219 WIDA WI UNICAP INFUS 1000 ML(BOTOL, 1000 ML) 0 0 0 0 0
220 ZINC SULFATE SYRUP 20 MG(BOTOL 60 ML) SYRUP 300 0 300 100 200
221 LUMPANG NO. 8 PAKET 1 0 1 1 0 1
222 LUMPANG NO.10 PAKET 0 0 0 0 0 0
223 LUMPANG NO.16 PAKET 0 0 0 0 0 1
224 RDT HIV 1 / SD HIV -1 TEST 0 25 25 0 25 0
225 RDT HIV 2 TEST 0 0 0 0 0 0
226 RDT HIV 3 TEST 0 0 0 0 0
227 LARUTAN HCl 0,1 N BOTOL 1 1 2 1 1 1
228 VITAMIN B1 TABLET 0 3000 3000 300 2700 0
229 ZINK SULFAT SIRUP 5 ML SIRUP 0 24 24 0 24 0
300 SPUIT 0,5 ML 0 700 700 0 700 0
301 SPUIT 3 ML 0 200 200 0 200 0
302 SPUIT 5 ML 0 200 200 0 200 0
303 VITAMIN C TABLET 1500 5000 6500 500 6000 0
304 ZINK TABLET 300 500 800 200 700 0
305 PARACETAMOL TABLET TABLET 0 3000 3000 400 2600 0

MENGETAHUI : KEPALA PUSKESMAS YANG MEMBUAT :

KEPALA DINAS KESEHATAN

JEREMIAS TAPYOR, SKM. ___________________ ____________________

NIP. 19720102 201104 2 002
No Kode Obat Nama Obat Sediaan Harga Sumber Dana
1 DRG000000082 2-4 KOMBINASI SALEP (POT 30 GRAM) SALEP 3,280.00 DAK 2018
5 DRG000000600 ACYCLOVIR TABLET 200 MG(DUS, 5 STRIP @ 10 TABLET) TABLET 465.00 DAK 2018
6 DRG000000609 ACYCLOVIR TABLET 400 MG(DUS, 5 STRIP @ 10 TABLET) TABLET 496.00 DAK 2019
7 DRG000000657 ADALAT OROS TABLET PELEPASAN LAMBAT 20 MG(DUS, 3 BLISTER TABLET PELEPASAN L 3,575.00 DAK 2019
8 DRG000046951 ALBENDAZOLE TABLET 400 MG(BOTOL, 200 TABLET) TABLET 271.14 Lain-lain 2018
9 DRG000046951 ALBENDAZOLE TABLET 400 MG(BOTOL, 200 TABLET) TABLET 271.25 Lain-lain 2018
10 DRG000000988 ALBENDAZOLE TABLET 400 MG(DUS, 5 STRIP @ 6 TABLET (INPRES))TABLET 358.00 DAK 2018
11 DRG000001200 ALKOHOL 70 % CAIRAN OBAT LUAR 70 %(BOTOL PLASTIK 1000 ML)CAIRAN OBAT LUAR 38,750.00 DAK 2018
12 DRG000001160 ALKOHOL CAIRAN OBAT LUAR 70 %(BOTOL @ 1 LITER) CAIRAN OBAT LUAR
LAIN-LAIN 150,000.00 Lain-lain 2018
13 MDVx041973 ALKOHOL SWAB LAIN-LAIN\n -(BOX, 50 PIECES) 15,000.00 DAK 2018
14 DRG000001267 ALLOPURINOL TABLET 100 MG(DUS, 10 BLISTER @ 10 TABLET) TABLET 117.00 DAK 2018
15 DRG000001267 ALLOPURINOL TABLET 100 MG(DUS, 10 BLISTER @ 10 TABLET) TABLET 117.00 Lain-lain 2019
16 DRG000001270 ALLOPURINOL TABLET 100 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 124.00 DAK 2019
17 DRG000001397 ALPARA TABLET (15 STR a 10) TABLET 970.00 DAK 2018
18 DRG000001420 ALPHAMOL DROPS 100 mg/ml(BOTOL 15 ML) DROPS 14,300.00 DAK 2019
19 DRG000001420 ALPHAMOL DROPS 100 mg/ml(BOTOL 15 ML) DROPS 14,300.00 DAK 2019
20 DRG000001420 ALPHAMOL DROPS 100 mg/ml(BOTOL 15 ML) DROPS 14,300.00 DAK 2019
21 DRG000001574 AMBROXOL TABLET 30 MG(DUS, 10 BLISTER @ 10 TABLET) TABLET 381.00 DAK 2018
22 DRG000001574 AMBROXOL TABLET 30 MG(DUS, 10 BLISTER @ 10 TABLET) TABLET 380.00 DAK 2019
23 DRG000001699 AMINOPHYLLIN CAIRAN INJEKSI 25 mg/ml(DUS, 30 AMPUL @ 10 MCAIRAN INJEKSI 3,280.00 DAK 2019
24 DRG000001702 AMINOPHYLLIN TABLET 200 MG(BOTOL A 100 TABLET) TABLET 259.78 DAK 2018
25 DRG000001702 AMINOPHYLLIN TABLET 200 MG(BOTOL A 100 TABLET) TABLET 110.00 Lain-lain 2019
26 DRG000001708 AMINOPHYLLINE CAIRAN INJEKSI 24 MG/ML(30 AMPUL @ 10 ML) CAIRAN INJEKSI 3,280.00 DAK 2018
27 DRG000001706 AMINOPHYLLINE CAIRAN INJEKSI 24 MG/ML(DUS, 24 AMPUL @ 10 CAIRAN INJEKSI 6,878.54 DAK 2018
28 DRG000001787 AMLODIPINE TABLET 10 MG(DUS, 3 BLISTER @ 10 TABLET) TABLET 99.00 DAK 2018
29 DRG000001784 AMLODIPINE TABLET 10 MG(DUS, 3 STRIP @ 10 TABLET) TABLET 110.00 DAK 2018
30 DRG000001793 AMLODIPINE TABLET 10 MG(DUS, 5 STRIP @ 10 TABLET) TABLET 99.00 DAK 2019
31 DRG000001899 AMOKSISILIN SIRUP KERING 125 MG/5 ML(BOTOL 60 ML) SIRUP KERING 1,974.00 Lain-lain 2019
32 DRG000001942 AMOXICILLIN CAPTABS 500 MG(DUS, 10 STRIP @ 10 KAPLET) CAPTABS 248.00 DAK 2018
33 DRG000001942 AMOXICILLIN CAPTABS 500 MG(DUS, 10 STRIP @ 10 KAPLET) CAPTABS 263.00 DAK 2019
34 DRG000001942 AMOXICILLIN CAPTABS 500 MG(DUS, 10 STRIP @ 10 KAPLET) CAPTABS 263.00 DAK 2019
35 DRG000001942 AMOXICILLIN CAPTABS 500 MG(DUS, 10 STRIP @ 10 KAPLET) CAPTABS 263.00 DAK 2019
36 DRG000001972 AMOXICILLIN SIRUP KERING 125 MG/5 ML(DUS, BOTOL @ 60 ML) SIRUP KERING 4,100.00 DAK 2019
37 DRG000002128 AMOXIL DROPS 125 MG/1,25 ML(Dus,botol 10 ml) DROPS 35,002.00 DAK 2019
38 DRG000002238 AMPICILLIN SERBUK INJEKSI 1 G/VIAL(DUS, 10 VIAL @ 1 G) SERBUK INJEKSI 10,296.00 DAK 2019
39 DRG000002238 AMPICILLIN SERBUK INJEKSI 1 G/VIAL(DUS, 10 VIAL @ 1 G) SERBUK INJEKSI 10,296.00 DAK 2018
40 DRG000002238 AMPICILLIN SERBUK INJEKSI 1 G/VIAL(DUS, 10 VIAL @ 1 G) SERBUK INJEKSI 10,296.00 DAK 2019
41 DRG000002496 ANAKONIDIN SIRUP (DUS, BOTOL @ 60 ML) SIRUP 34,800.00 DAK 2019
42 DRG000002496 ANAKONIDIN SIRUP (DUS, BOTOL @ 60 ML) SIRUP 34,860.00 DAK 2018
43 DRG000002884 ANTASIDA DOEN SUSPENSI (DUS, BOTOL @ 60 ML) SUSPENSI 2,408.00 DAK 2019
44 DRG000002933 ANTASIDA DOEN TABLET (BOTOL 1000 TABLET) TABLET 66.00 DAK 2019
45 DRG000002891 ANTASIDA DOEN TABLET KUNYAH (DUS, 10 STRIP @ 10 TABLET) TABLET KUNYAH 62.00 DAK 2018
46 DRG000003002 ANTIHEMOROID SUPPOSITORIA SUPPOSITORIA 2 GRAM(STRIP a 10SUPPOSITORIA 3,806.00 DAK 2018
47 DRG000003002 ANTIHEMOROID SUPPOSITORIA SUPPOSITORIA 2 GRAM(STRIP a 10SUPPOSITORIA 4,576.66 DAK 2018
48 DRG000003002 ANTIHEMOROID SUPPOSITORIA SUPPOSITORIA 2 GRAM(STRIP a 10SUPPOSITORIA 3,959.00 DAK 2019
49 DRG000003002 ANTIHEMOROID SUPPOSITORIA SUPPOSITORIA 2 GRAM(STRIP a 10SUPPOSITORIA 3,959.00 DAK 2018
50 MDVx042102 ANTISEPTIC HAND RUB LIQUID 500 ML() LIQUID 34,100.00 DAK 2019
51 DRG000003158 AQUA BIDEST STERIL CAIRAN INJEKSI (Dus, 25 VIAL a 20) CAIRAN INJEKSI 2,860.00 DAK 2018
52 DRG000003166 AQUA PRO INJECTION CAIRAN INJEKSI (AMPUL @ 5 ML) CAIRAN INJEKSI 2,750.00 DAK 2018
53 DRG000046794 ARTESUNATE INJECTION 60 MG\/ML(BOX, 60 MG @8 VIAL) INJECTION 48,750.00 Lain-lain 2019
54 DRG000046794 ARTESUNATE INJECTION 60 MG\/ML(BOX, 60 MG @8 VIAL) INJECTION 48,750.00 Lain-lain 2019
55 DRG000003567 ASAM ASKORBAT Tablet 50 MG Mg(ASAM ASKORBAT (VIT C) 50 MGTablet 131.00 DAK 2019
56 DRG000003567 ASAM ASKORBAT Tablet 50 MG Mg(ASAM ASKORBAT (VIT C) 50 MGTablet 131.00 DAK 2019
57 DRG000003565 ASAM ASKORBAT Tablet 50 Mg(ASAM ASKORBAT (VIT C) 50 MG) Tablet 131.00 DAK 2018
58 DRG000003579 ASAM MEFENAMAT CAPTABS 500 MG(DUS, 10 STRIP @ 10 KAPLET)CAPTABS 113.00 DAK 2018
 59 DRG000003577 ASAM MEFENAMAT CAPTABS 500 MG(DUS, 10 STRIP @ 10 KAPLET)CAPTABS 580.00 DAK 2019
60 DRG000003577 ASAM MEFENAMAT CAPTABS 500 MG(DUS, 10 STRIP @ 10 KAPLET)CAPTABS 113.00 Lain-lain 2019
61 DRG000003655 ASAM TRANEKSAMAT CAIRAN INJEKSI 250 MG(DUS,5 AMPUL @ 5 CAIRAN INJEKSI 2,376.00 DAK 2019
62 DRG000003648 ASAM TRANEKSAMAT CAIRAN INJEKSI 50 MG/ ML(DUS, 10 AMPUL CAIRAN INJEKSI 3,740.00 DAK 2018
63 DRG000046708 Atropin Sulfat INJECTION 0,25 mg\/ml(Kotak) INJECTION 2,900.00 DAK 2018
64 MDVx041180 AUTOCHECK 3 in 1 Multi - Monitoring System (Total cholesterol, Blood glucose, uric acid)( 575,000.00 DAK 2018
65 DRG000004233 BACITRACIN - POLYMYXIN B SALEP (DUS, 25 TUBE @ 5 GRAM) SALEP 6,500.00 DAK 2019
66 DRG000004233 BACITRACIN - POLYMYXIN B SALEP (DUS, 25 TUBE @ 5 GRAM) SALEP 3,794.00 DAK 2018
67 DRG000004624 BEDAK SALICYL SERBUK OBAT LUAR 2 %(BOTOL PLASTIK 80 GRAM) SERBUK OBAT LUAR 19,850.00 DAK 2018
68 DRG46605 BEDAK SALYCYL SERBUK OBAT LUAR 2%(BOTOL PLASTIK 50 GRAM) SERBUK OBAT LUAR 7,006.00 DAK 2019
69 DRG000004832 BENZATIN BENZIL PENISILIN INJEKSI 2.4 UI/Ml(Benzil Penisilin Phapro
INJEKSI 34,000.00 DAK 2018
70 DRG000004833 BENZATIN PENISILIN G INJEKSI 20 Ml(BENZATIN BENZIN PENISILIN SE INJEKSI 13,375.00 DAK 2018
71 DRG000005108 BETAMETASON CREAM 0,1 %(DUS, 25 TUBE @ 5 GRAM) CREAM 1,520.00 DAK 2018
72 DRG000005403 BIO ATP TABLET SALUT SELAPUT (Dus, 5 strip @ 6 tab sal sel) TABLET SALUT SELAPU 2,497.00 DAK 2018
73 DRG000005594 BIOPLACENTON GEL 15 G(DUS, 1 TUBE @ 15 G) GEL 28,600.00 DAK 2019
74 DRG000005594 BIOPLACENTON GEL 15 G(DUS, 1 TUBE @ 15 G) GEL 28,550.00 DAK 2018
75 MDVx002305 BLOOD LANCET() 21,849.00 DAK 2018
76 DRG000006421 BUSCOPAN TABLET SALUT GULA 10 MG(DUS, 10 STRIP @ 10 TABLETABLET SALUT GULA 7,470.00 DAK 2019
77 DRG000006615 CALCIUM LACTATE TABLET 500 MG(DUS, 10 BLISTER @ 10 TABLET)TABLET 65.00 DAK 2018
78 DRG000006615 CALCIUM LACTATE TABLET 500 MG(DUS, 10 BLISTER @ 10 TABLET)TABLET 69.00 DAK 2019
79 DRG000006907 CAPTOPRIL TABLET 12,5 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 79.00 DAK 2019
80 DRG000006914 CAPTOPRIL TABLET 25 MG(DUS, 10 STRIP @ 10 TABLET) TABLET
LAIN-LAIN 165.00 DAK 2018
81 MDVx042550 CAT GUT CHROMIC 3/0 BENANG BEDAH LAIN-LAIN -(KOTAK, 24 PIE 36,038.00 DAK 2019
82 MDVx001334 CAT GUT PLAIN 3 - 0 HR 26() 34,986.00 DAK 2018
83 MDVx003958 CATGUT PLAIN 3/0 W102() 42,065.00 DAK 2018
84 DRG000007257 CEFADROKSIL Sirop/Sirop Kering 480 Mg(CEFADROXIL SIROP KERINSirop/Sirop Kering 6,215.00 DAK 2019
85 DRG000007263 CEFADROXIL CAPSUL 500 MG(DUS, 10 STRIP @ 10 CAPSUL) CAPSUL 497.00 DAK 2018
86 DRG000007425 CEFIXIME CAPSUL 100 MG(DUS, 3 STRIP @ 10 KAPSUL) CAPSUL 1,004.00 DAK 2018
87 DRG000007510 CEFOTAXIME SERBUK INJEKSI 1 G(DUS, 2 VIAL @ 1 GRAM) SERBUK INJEKSI 7,700.00 DAK 2018
88 DRG000007504 CEFOTAXIME SERBUK INJEKSI 1000 MG(DUS, 2 VIAL @ 1000 MG) SERBUK INJEKSI 5,020.00 DAK 2019
89 DRG000007598 CEFTRIAXONE SERBUK INJEKSI 1 G(DUS, 2 VIAL @ 1000 G) SERBUK INJEKSI 5,488.00 DAK 2019
90 DRG000007598 CEFTRIAXONE SERBUK INJEKSI 1 G(DUS, 2 VIAL @ 1000 G) SERBUK INJEKSI 50,500.00 DAK 2018
91 DRG000007850 CENDO XITROL TETES MATA (Catch cover,5 btl pls @ 0,3 ml) TETES MATA 26,813.00 DAK 2019
92 DRG000008282 CHLORAMEX CAPSUL 500 MG(DUS, 10 STRIP @ 10 KAPSUL) CAPSUL 1,363.00 DAK 2018
93 DRG000008316 CHLORAMPHENICOL SALEP MATA 1%(TUBE @ 3,5 G) SALEP MATA 2,305.00 DAK 2019
94 DRG000008320 CHLORAMPHENICOL TETES TELINGA 3 %(BOTOL PLASTIK 5 ML) TETES TELINGA 12,300.00 DAK 2018
95 DRG000008524 CHLORPHENIRAMIN MALEAT TABLET 4 MG() TABLET 47.00 DAK 2018
96 DRG000008524 CHLORPHENIRAMIN MALEAT TABLET 4 MG() TABLET 25.00 DAK 2018
97 DRG000008528 CHLORPHENIRAMINE TABLET 4 MG(10 STRIP @ 10 TABLET) TABLET 27.00 DAK 2019
98 DRG000008607 CHLORPROMAZINE CAIRAN INJEKSI 25 MG/ML(30 AMPUL a 1 ML) CAIRAN INJEKSI 1,100.00 Lain-lain 2019
99 MDVx017486 CIDEX OPA Desinfectant Solution() 136,400.00 DAK 2019
100 DRG000009236 CLINDAMYCIN CAPSUL 300 MG(DUS, 5 BLISTER @ 10 KAPSUL) CAPSUL 612.00 DAK 2018
101 DRG000009656 COMBIVENT UDV CAIRAN INHALER (DUS, 10 VIAL @ 2,5 ML) CAIRAN INHALER 4,550.00 DAK 2019
102 DRG000009657 COMBIVENT UDV CAIRAN INHALER (DUS, 20 VIAL @ 2,5 ML) CAIRAN INHALER 4,550.00 DAK 2019
103 MDVx033983 CORE HBsAg() 9,850.00 Lain-lain 2019
104 DRG000010131 COTRIMOKSAZOLE SUSPENSI 200 MG + 40 MG(BOTOL @ 60 ML) SUSPENSI 2,410.00 DAK 2019
105 DRG000010131 COTRIMOKSAZOLE SUSPENSI 200 MG + 40 MG(BOTOL @ 60 ML) SUSPENSI 2,258.00 DAK 2018
106 DRG000010176 COTRIMOKSAZOLE TABLET 400 MG + 80 MG(DUS, 10 STR @ 10 TABTABLET 146.00 DAK 2019
107 DRG000010286 COUNTERPAIN CREAM (TUBE 15 GRAM) CREAM 38,550.00 DAK 2018
108 DRG000010286 COUNTERPAIN CREAM (TUBE 15 GRAM) CREAM 38,000.00 DAK 2019
109 DRG000010483 CURCUMA PLUS Sirop/Sirop Kering 60 Ml(CURPLUS DHA + EPA ST Sirop/Sirop Kering 34,860.00 DAK 2018
110 DRG000010493 CURCUMA SHARPY Sirop/Sirop Kering 60 Ml(CURCUMA SHARPY B Sirop/Sirop Kering 34,800.00 DAK 2019
111 MDVx041880 Cuticell Classic PLASTER 10 x 10 cm() PLASTER 5,520.00 DAK 2019
112 DRG000010547 CYANOCOBALAMIN CAIRAN INJEKSI (DUS, 100 AMPUL @ 1 ML) CAIRAN INJEKSI 1,425.00 DAK 2019
113 DRG000011240 DEKSAMETHASON Infus 5 mg/ml Mg/Ml(DEKSAMETHASON) Infus 1,450.00 Lain-lain 2019
114 DRG000011635 DEXAMETHASON CAIRAN INJEKSI 5 MG/ML(5 AMPUL A 3 ML) CAIRAN INJEKSI 1,450.00 DAK 2019
115 DRG000011635 DEXAMETHASON CAIRAN INJEKSI 5 MG/ML(5 AMPUL A 3 ML) CAIRAN INJEKSI 1,450.00 Lain-lain 2019
116 DRG000011633 DEXAMETHASON TABLET 0.5 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 36.00 Lain-lain 2019
117 DRG000011633 DEXAMETHASON TABLET 0.5 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 36.00 DAK 2018
118 DRG000011654 DEXAMETHASONE TABLET 0,5 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 60.00 DAK 2019
119 DRG46580 DHP FRIMAL (DIHYDROARTEMISININ PIPERAQUINE) TABLET (KOTAKTABLET 2,140.00 Lain-lain 2019
120 DRG46580 DHP FRIMAL (DIHYDROARTEMISININ PIPERAQUINE) TABLET (KOTAKTABLET 194.40 Lain-lain 2019
121 DRG46580 DHP FRIMAL (DIHYDROARTEMISININ PIPERAQUINE) TABLET (KOTAKTABLET 2,140.00 Lain-lain 2019
122 DRG000012215 DIAZEPAM CAIRAN INJEKSI 5 MG\/ML(DUS, 100 AMPUL @ 2 ML) CAIRAN INJEKSI 2,250.00 Lain-lain 2019
123 DRG000012208 DIAZEPAM LARUTAN / CAIRAN 5 MG / 2,5 ML(DUS, 4 TUBE @ 2,5 MLARUTAN / CAIRAN 2,250.00 DAK 2019
124 DRG000012203 DIAZEPAM TABLET 5 MG(BOTOL PLASTIK @ 100 TABLET) TABLET 120.00 DAK 2018
125 DRG000012285 DIETHYLCARBAMAZINE TABLET 100 MG(DUS, 10 STRIP @ 10 TABLETABLET 0.00 Lain-lain 2019
126 DRG000012285 DIETHYLCARBAMAZINE TABLET 100 MG(DUS, 10 STRIP @ 10 TABLETABLET 197.00 Lain-lain 2019
127 DRG000012293 DIFENHIDRAMIN CAIRAN INJEKSI 10 mg/ml(100 AMP a 1) CAIRAN INJEKSI 1,469.00 DAK 2018
128 DRG000012294 DIFENHIDRAMINA HCL CAIRAN INJEKSI 10 mg/ml(100 AMP a 1) CAIRAN INJEKSI 1,372.00 DAK 2019
129 DRG000012294 DIFENHIDRAMINA HCL CAIRAN INJEKSI 10 mg/ml(100 AMP a 1) CAIRAN INJEKSI 1,372.00 DAK 2018
130 DRG000012294 DIFENHIDRAMINA HCL CAIRAN INJEKSI 10 mg/ml(100 AMP a 1) CAIRAN INJEKSI 1,372.00 DAK 2019
131 DRG000012326 DIGOXIN TABLET 0.25 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 327.88 DAK 2018
132 DRG000012326 DIGOXIN TABLET 0.25 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 104.00 DAK 2019
133 DRG000012629 DOKSISIKLIN Capsul 100 Mg(DOKSISIKLIN KAPSUL 100 MG) Capsul 550.00 DAK 2018
134 DRG000012720 DOMPERIDON SUSPENSI 5 MG/5 ML(DUS, BOTOL 60 ML) SUSPENSI 3,051.00 DAK 2019
135 DRG000012720 DOMPERIDON SUSPENSI 5 MG/5 ML(DUS, BOTOL 60 ML) SUSPENSI 3,051.00 DAK 2018
136 DRG000012719 DOMPERIDON TABLET 10 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 96.00 DAK 2019
137 DRG000012719 DOMPERIDON TABLET 10 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 90.00 DAK 2018
138 DRG000012885 DOXYCYCLINE CAPSUL 100 MG(DUS, 10 STRIP @ 10 CAPSUL) CAPSUL 264.00 DAK 2018
139 DRG000012964 DULCOLAX TABLET SALUT ENTERIK 5 MG(DUS, 10 AMPLOP @ 3 BLITABLET SALUT ENTERI 1,360.00 Lain-lain 2018
140 MDVx042134 EASYTOUCH BLOOD GLUCOSE STRIP -() STRIP 8,500.00 DAK 2018
141 MDVx042137 EASYTOUCH TOTAL CHOLESTEROL STRIP -() STRIP 20,000.00 DAK 2018
142 MDVx041951 EMERSI OIL 100 ML(BOTOL, 100 ML) OIL 756,000.00 Lain-lain 2018
143 DRG000013766 ENTROSTOP TABLET (DUS, 20 BLISTER @ 12 TABLET) TABLET 4,800.00 DAK 2019
144 DRG000013770 ENTROSTOP TABLET (DUS, 6 BLISTER @ 12 TABLET) TABLET 4,490.00 DAK 2018
145 DRG000013808 EPHEDRIN HCL CAIRAN INJEKSI 50 MG/ML(DUS, 10 AMPUL @ 1 MLCAIRAN
CAIRAN INJEKSI
INJEKSI 9,900.00 DAK 2019
146 DRG000047156 EPINEFRIN CAIRAN INJEKSI 1 MG\/ML(BOX, 30 AMPUL) 2,486.00 Lain-lain 2019
147 DRG000014042 ERLAMYCETIN EAR Tetes Telinga (ERLAMYCETIN EAR DROP) Tetes Telinga 13,800.00 DAK 2019
148 DRG000014225 ERYTHROMYCIN CAPSUL 250 MG (BASE)(DUS, 10 STRIP @10 KAPSUCAPSUL 740.00 DAK 2019
149 DRG000014225 ERYTHROMYCIN CAPSUL 250 MG (BASE)(DUS, 10 STRIP @10 KAPSUCAPSUL 740.00 DAK 2019
150 DRG000014225 ERYTHROMYCIN CAPSUL 250 MG (BASE)(DUS, 10 STRIP @10 KAPSUCAPSUL 740.00 DAK 2019
151 DRG000014225 ERYTHROMYCIN CAPSUL 250 MG (BASE)(DUS, 10 STRIP @10 KAPSUCAPSUL 740.00 DAK 2019
152 DRG000014234 ERYTHROMYCIN CAPSUL 500 MG(DUS, 10 STRIP @ 10 CAPSUL) CAPSUL 829.00 Lain-lain 2019
153 DRG000014635 ETHYL CHLORIDA LAIN-LAIN 100 Ml(ETHYL CHLORIDA SPRAY 100 MLAIN-LAIN 394,000.00 DAK 2019
154 DRG000046822 FDC KAT. I PACKING KOMBINASI(Paket) PACKING 519,342.00 Lain-lain 2019
155 DRG000047263 FDC KATEGORI I TABLET RHZE (150\/75\/400\/275) MG + RH(150\ TABLET 486,685.00 Lain-lain 2019
156 MDVx001947 FEEDING TUBE NO 3,5 35 CM TERUMO() 7,524.00 DAK 2019
157 MDVx001948 FEEDING TUBE NO 5 100 CM TERUMO() 15,664.00 DAK 2019
158 MDVx011404 FEEDING TUBE NO 5 120 CM TERUMO() 15,664.00 DAK 2019
159 DRG000046829 FITOMENADION ( VIT. K ) INJECTION 10 MG\/ML(Ktk) INJECTION 4,595.00 DAK 2018
160 DRG000015955 FLUCADEX CAPTABS (10 CATCH COVER a 1 STRIP a 10 CAPTABS) CAPTABS
LAIN-LAIN 970.00 DAK 2019
161 MDVx041926 FOLLEY CATHETER 2 WAY NO. 16 LAIN-LAIN -(BOX, 10 PIECES) LAIN-LAIN 21,446.00 DAK 2018
162 MDVx041926 FOLLEY CATHETER 2 WAY NO. 16 LAIN-LAIN -(BOX, 10 PIECES) LAIN-LAIN 21,446.00 DAK 2018
163 MDVx041927 FOLLEY CATHETER 2 WAY NO. 18 LAIN-LAIN -(BOX, 10 PIECES) LAIN-LAIN 21,446.00 DAK 2018
164 MDVx041927 FOLLEY CATHETER 2 WAY NO. 18 LAIN-LAIN -(BOX, 10 PIECES) 21,450.00 DAK 2018
165 MDVx042036 FOLLEY CATHETER 2 WAY NO. 20(BOX, 10 PIECES) CATHETER 21,450.00 DAK 2018
166 MDVx042036 FOLLEY CATHETER 2 WAY NO. 20(BOX, 10 PIECES) CATHETER 21,446.00 DAK 2018
167 DRG000016683 FUROSEMIDA TABLET 40 MG(DUS,10 STRIP @10 TABLET) TABLET 94.00 DAK 2019
168 DRG000016683 FUROSEMIDA TABLET 40 MG(DUS,10 STRIP @10 TABLET) TABLET 94.00 DAK 2019
169 DRG000016686 FUROSEMIDE CAIRAN INJEKSI 10 MG/ML(DUS, 25 AMPUL @ 2 ML) CAIRAN INJEKSI 1,850.00 DAK 2019
170 DRG000016698 FUROSEMIDE TABLET 40 MG(20 STRIP a 10 TABLET) TABLET 88.00 DAK 2018
171 DRG000016688 FUROSEMIDE TABLET 40 MG(DUS, 10 STRIP @ 10 TABLET) TABLET
SERBUK 97.00 DAK 2018
172 DRG000046801 GARAM ORALIT I SERBUK KOMBINASI(KOTAK, 100 SACHET) SERBUK 257.00 Lain-lain 2019
173 DRG000046801 GARAM ORALIT I SERBUK KOMBINASI(KOTAK, 100 SACHET) SERBUK 2,960.00 Lain-lain 2019
174 DRG000046801 GARAM ORALIT I SERBUK KOMBINASI(KOTAK, 100 SACHET) 296.00 Lain-lain 2019
175 DRG000017128 GENOINT TETES MATA 0,3 %(DUS, BOTOL PLASTIK @ 5 ML) TETES MATA 17,600.00 DAK 2019
176 DRG000017201 GENTAMISIN SALEP 0,1 %(DUS,10 TUBE @ 5 GRAM) SALEP 6,550.00 DAK 2018
177 DRG000017209 GENTAMYCIN 80 CAIRAN INJEKSI 80 MG\/ML(5 AMP a 2) CAIRAN INJEKSI 4,387.00 DAK 2018
178 DRG000017228 GENTIAN VIOLET CAIRAN OBAT LUAR 1%(BOTOL 10) CAIRAN OBAT LUAR 1,181.25 DAK 2018
 LARUTAN / CAIRAN
179 DRG000047033 GIEMSA LARUTAN \/ CAIRAN\n 100 ML() 444,000.00 Lain-lain 2018
180 DRG000017383 GLIBENCLAMIDE CAPTABS 5 MG(DUS, 10 BLISTER @ 10 KAPTAB) CAPTABS 149.00 DAK 2018
181 DRG000017398 GLIBENKLAMIDA Tablet 100 TABLET Mg(GLIBENKLAMIDA) Tablet
INFUS 182.00 DAK 2018
182 DRG000017683 GLUKOSA INFUS 10 %(BOTOL PLASTIK @ 500 ML) INFUS 7,500.00 DAK 2018
183 DRG000017683 GLUKOSA INFUS 10 %(BOTOL PLASTIK @ 500 ML) INFUS 7,500.00 DAK 2018
184 DRG000017682 GLUKOSA INFUS 5 %(BOTOL PLASTIK PE @ 500 ML) INFUS 6,900.00 DAK 2018
185 DRG000017682 GLUKOSA INFUS 5 %(BOTOL PLASTIK PE @ 500 ML) 6,900.00 DAK 2018
186 DRG000017765 GLYCERIL GUAIACOLATE TABLET 100 MG(BOTOL PLASTIK @ 100 TATABLET 324.00 DAK 2018
187 DRG000018088 GRISEOFULVIN TABLET 125 MG(DUS, 10 BLISTER @ 10 TABLET) TABLET 238.00 DAK 2018
188 DRG000018090 GRISEOFULVIN TABLET 125 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 239.00 DAK 2018
189 DRG000018109 GRISEOFULVIN TABLET 125 MG(DUS,10 STR @ 10 TAB) TABLET 254.00 DAK 2019
190 MDVx002014 HANSAPLAST() LARUTAN / CAIRAN 26,244.00 DAK 2018
191 MDVx042679 HIDROGEN PEROKSIDA (H202) LARUTAN / CAIRAN 3%(BOTOL 100 LARUTAN / CAIRAN 5,208.00 DAK 2019
192 MDVx042562 HIDROGEN PEROKSIDA (H2O2) LARUTAN \/ CAIRAN 1000 ML(BOTO 44,000.00 DAK 2018
193 DRG000047271 HIDROKLOROTIAZIDA (HCT) TABLET 25 MG(KOTAK, 100 TABLET) TABLET 194.00 DAK 2018
194 DRG000046832 HIDROKORTISON CREAM 2,5%(Ktk) CREAM 2,846.00 DAK 2018
195 MDVx042392 HUMAN HEXAGON RDT SYPHILIS KIT -(20 TESTS) KIT 12,132.00 Lain-lain 2019
196 MDVx035624 HUMAN Sypilis Screen ELISA() 4,700.00 Lain-lain 2019
197 DRG000019253 HYDROCHLORTIAZIDE Tablet 25 Mg(HYDROCHLORTIAZIDE 25 MG) Tablet 194.00 DAK 2019
198 DRG000019253 HYDROCHLORTIAZIDE Tablet 25 Mg(HYDROCHLORTIAZIDE 25 MG) Tablet 194.00 DAK 2019
199 DRG000019261 HYDROCORTISONE CREAM 2.5 %(DUS, 24 TUBE @ 5 G) CREAM 2,846.00 DAK 2019
200 MDVx002241 HYPAFIX 10 CM X 5 M() 237,300.00 DAK 2018
201 MDVx002241 HYPAFIX 10 CM X 5 M() 90,000.00 DAK 2019
202 DRG000019430 IBUPROFEN SUSPENSI 100 MG/5 ML(DUS, BOTOL @ 60 ML) SUSPENSI 5,944.00 DAK 2019
203 DRG000019430 IBUPROFEN SUSPENSI 100 MG/5 ML(DUS, BOTOL @ 60 ML) SUSPENSI 5,944.00 DAK 2019
204 DRG000019434 IBUPROFEN TABLET 400 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 640.00 DAK 2019
205 DRG000019490 ICHTIOL SALEP 30 %(POT 12) SALEP 7,845.83 DAK 2018
206 MDVx034294 IL TEST Referril HDL Colesterol() 8,600.00 DAK 2019
207 DRG000019712 IMBOOST Suspensi 60 Ml(IMBOOST SYR 60ML) Suspensi 77,000.00 DAK 2019
208 DRG000019714 IMBOOST Tablet 1 Mg(IMBOOST TABLET SALUT SELAPUT) Tablet 13,100.00 DAK 2019
209 MDVx041586 INDO REAGEN Pewarna Ziehl Neelsen() 266,410.00 Lain-lain 2019
210 MDVx002086 INFUS SET ADULT TERUMO KIT SET(Kotak @ 50) 4,800.00 DAK 2018
211 MDVx002084 INFUS SET PEDIATRIC TERUMO() 5,250.00 DAK 2018
212 DRG000020125 INSTO REGULAR TETES MATA (DUS, BOTOL PLASTIK @ 10 ML) TETES MATA 17,710.00 DAK 2019
213 DRG000020125 INSTO REGULAR TETES MATA (DUS, BOTOL PLASTIK @ 10 ML) TETES MATA 17,710.00 DAK 2019
214 DRG000020125 INSTO REGULAR TETES MATA (DUS, BOTOL PLASTIK @ 10 ML) TETES MATA 17,710.00 DAK 2019
215 DRG000020125 INSTO REGULAR TETES MATA (DUS, BOTOL PLASTIK @ 10 ML) TETES MATA 17,710.00 DAK 2019
216 DRG000020429 IODINE POVIDON CAIRAN OBAT LUAR 10 %(BOTOL 300 ML) CAIRAN OBAT LUAR 60,125.00 Lain-lain 2018
217 MDVx002088 IV CATHETER NO 18 SHORT TERUMO() 15,785.00 DAK 2019
218 MDVx001125 IV CATHETER NO 20 SHORT TERUMO() 8,355.00 Lain-lain 2019
219 MDVx001125 IV CATHETER NO 20 SHORT TERUMO() 15,785.00 DAK 2019
220 MDVx001129 IV CATHETER NO 22 TERUMO() 8,355.00 Lain-lain 2019
221 MDVx001129 IV CATHETER NO 22 TERUMO() 15,785.00 DAK 2019
222 MDVx001136 IV CATHETER NO 24 TERUMO() 8,355.00 Lain-lain 2019
223 MDVx001136 IV CATHETER NO 24 TERUMO() 16,390.00 DAK 2019
224 MDVx042566 IV CATHETER NO. 18 (ABBOCATH 18)(KOTAK, 50 SET/PIECES) CATHETER 8,355.00 Lain-lain 2019
225 MDVx042566 IV CATHETER NO. 18 (ABBOCATH 18)(KOTAK, 50 SET\/PIECES) CATHETER 9,060.00 DAK 2018
226 MDVx042568 IV CATHETER NO. 20 (ABBOCATH 20)(KOTAK, 50 SET\/PIECES) CATHETER 9,060.00 DAK 2018
227 MDVx017609 JMS Umbilical Cord Clamp() 1,950.00 DAK 2019
228 DRG000021048 KAEN 3B Infus 500 Ml(KAEN 3B LARUTAN INFUS 500ML) Infus 10,285.00 DAK 2018
229 DRG000047300 KALSIUM LAKTAT TABLET 500 MG(KOTAK 100 TABLET) TABLET
LAIN-LAIN 73.00 DAK 2018
230 MDVx041990 KAPAS 250 G LAIN-LAIN\n -() 32,000.00 DAK 2018
231 DRG000021384 KAPAS ONEMED 500(KAPAS ONEMED 500 GRAM) LAIN-LAIN 40,920.00 DAK 2019
232 MDVx042464 KASA HIDROFIL DRC LAIN-LAIN 36 X 80 CM(ROL) LAIN-LAIN 15,300.00 DAK 2018
233 MDVx042332 KASA HIDROFIL DRC LAIN-LAIN 4 M X 10 CM() LAIN-LAIN 2,250.00 DAK 2019
234 MDVx042718 KASA PEMBALUT HIDROFIL LAIN-LAIN 4 X 10 CM() 2,767.20 DAK 2018
235 DRG000021449 KASA STERIL ALAT KESEHATAN 16 X 16(KASA STERIL 16 X 16 CN) ALAT KESEHATAN 9,875.00 DAK 2018
236 MDVx002021 KERTAS PUYER() 55.00 DAK 2018
237 MDVx002021 KERTAS PUYER() 55,000.00 DAK 2019
238 DRG000021664 KETOCONAZOL TABLET 200 MG(Dus, 5 strip a 10 tablet) TABLET 305.00 DAK 2018
239 DRG000021673 KETOCONAZOLE CREAM 2 %(DUS, TUBE @ 10 G) CREAM 2,893.00 DAK 2019
240 DRG000021673 KETOCONAZOLE CREAM 2 %(DUS, TUBE @ 10 G) CREAM 2,893.00 DAK 2019
241 DRG000021673 KETOCONAZOLE CREAM 2 %(DUS, TUBE @ 10 G) CREAM 2,893.00 DAK 2018
242 DRG000021673 KETOCONAZOLE CREAM 2 %(DUS, TUBE @ 10 G) CREAM 2,893.00 DAK 2019
243 DRG000046868 KETOKONAZOLE TABLET 200 MG(DUS, 50 TABLET) TABLET 325.00 DAK 2019
244 DRG000021731 KETOROLAC CAIRAN INJEKSI 10 MG/ML(DUS, 6 AMPUL @ 1 ML) CAIRAN INJEKSI 1,309.00 DAK 2019
245 DRG000022494 LACTO-B LAIN-LAIN Mcg(LACTO-B) LAIN-LAIN 17,000.00 DAK 2019
246 DRG000022839 LARUTAN NATRIUM CHLORIDA INFUS 0,9 %(BOTOL PLASTIK A 500 INFUS 6,410.00 DAK 2018
247 DRG000047112 LEUKOPLAST PLASTER 4,5 CM X 5 CM() PLASTER 12,675.00 DAK 2019
248 DRG000023407 LIDOCAIN CAIRAN INJEKSI 2 %(DUS, 100 AMPUL @ 2 ML) CAIRAN
CAIRAN INJEKSI
INJEKSI 1,533.00 DAK 2019
249 DRG000047275 LIDOKAIN 2% HCL + EPHINEFRINE 1 : 80.000 CAIRAN INJEKSI 2 ML CAIRAN INJEKSI 1,440.00 DAK 2018
250 DRG000047275 LIDOKAIN 2% HCL + EPHINEFRINE 1 : 80.000 CAIRAN INJEKSI 2 ML CAIRAN INJEKSI 2,424.00 Lain-lain 2019
251 DRG000047276 LIDOKAIN 2% HCL + EPINEPHRINE 1 : 80.000 CAIRAN INJEKSI 2 ML 1,537.00 DAK 2019
252 DRG000023879 LOPERAMID HCL TABLET 2 MG(10 STR a 10) TABLET 334.00 DAK 2019
253 DRG000047101 LYSOL LIQUID 1 L() LIQUID 63,550.00 DAK 2019
254 DRG000047101 LYSOL LIQUID 1 L() LIQUID 63,550.00 DAK 2019
255 DRG000047101 LYSOL LIQUID 1 L() LIQUID 63,550.00 DAK 2018
256 DRG000047101 LYSOL LIQUID 1 L() LIQUID 63,550.00 DAK 2019
257 DRG000024327 MAGNESIUM SULFATE CAIRAN INJEKSI 20 %(10 VIAL a 25 ML) CAIRAN INJEKSI 3,328.00 DAK 2018
258 DRG000024473 MASKER (MASKER KARET) 24,750.00 DAK 2018
259 DRG000024474 MASKER (MASKER TALI) 1,368.00 DAK 2018
260 DRG46583 MDT (Multi Drug Therapy) MB DEWASA TABLET RIFAMPICIN 300 MTABLET 30,595.00 Lain-lain 2019
261 MDVx033769 MEDI-TEST Glucose() 8,600.00 DAK 2019
262 DRG000046806 METFORMIN TABLET 500 MG() TABLET 128.00 DAK 2019
263 DRG000025486 METFORMIN TABLET SALUT SELAPUT 500 MG(DUS, 10 STRIP @ 10 TABLET SALUT SELAPU 119.00 DAK 2018
264 DRG000025554 METHYL PREDNISOLON Tablet 4 MG Mg(METHYL PREDNISOLON 4 Tablet 153.00 DAK 2019
265 DRG000025554 METHYL PREDNISOLON Tablet 4 MG Mg(METHYL PREDNISOLON 4 Tablet LARUTAN / CAIRAN 900.00 DAK 2018
266 DRG000046766 METHYLEN BLUE 100ML LARUTAN \/ CAIRAN\n 0,1%(Botol 100ML) 135,050.00 Lain-lain 2018
267 DRG000025567 METHYLERGOMETRINE CAIRAN INJEKSI 0.2 MG/ML(DUS, 100 AMPUCAIRAN INJEKSI 3,696.00 DAK 2019
268 DRG000025567 METHYLERGOMETRINE CAIRAN INJEKSI 0.2 MG/ML(DUS, 100 AMPUCAIRAN INJEKSI 3,564.00 Lain-lain 2019
269 DRG000025563 METHYLERGOMETRINE TABLET SALUT SELAPUT 0,125 MG(DUS, 10 TSABLET SALUT SELAPU 282.00 DAK 2019
270 DRG000025563 METHYLERGOMETRINE TABLET SALUT SELAPUT 0,125 MG(DUS, 10 TSABLET SALUT SELAPU 282.00 DAK 2019
271 DRG000025581 METHYLPREDNISOLONE CAPTABS 4 MG(DUS, 10 STRIP @ 10 KAPLECAPTABS 143.00 DAK 2018
272 MDVx012323 METILEN BLUE PA() TABLET SALUT GULA 79,812.60 DAK 2019
273 DRG000046807 METILERGOMETRIN MALEAT TABLET SALUT GULA 0,125 MG() 264.00 DAK 2018
274 DRG000025750 METRONIDAZOL INFUS 5 MG/ML(DUS, BOTOL @ 100 ML) INFUS 8,250.00 DAK 2019
275 DRG000025750 METRONIDAZOL INFUS 5 MG/ML(DUS, BOTOL @ 100 ML) INFUS 8,250.00 DAK 2019
276 DRG000025750 METRONIDAZOL INFUS 5 MG/ML(DUS, BOTOL @ 100 ML) INFUS 8,250.00 DAK 2019
277 DRG000025750 METRONIDAZOL INFUS 5 MG/ML(DUS, BOTOL @ 100 ML) INFUS 8,250.00 DAK 2019
278 DRG000025758 METRONIDAZOL TABLET 500 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 361.79 Lain-lain 2019
279 DRG000026103 MINERAL MIX SERBUK 8 G(DUS, 40 SACHET @ 8 G) SERBUK 2,920.00 Lain-lain 2019
280 DRG000026103 MINERAL MIX SERBUK 8 G(DUS, 40 SACHET @ 8 G) SERBUK 2,920.00 Lain-lain 2019
281 DRG000026695 MOLAGIT TABLET (DUS, 15 STRIP @ 10 TABLET) TABLET 950.00 DAK 2018
282 DRG000026695 MOLAGIT TABLET (DUS, 15 STRIP @ 10 TABLET) TABLET 950.00 DAK 2019
283 DRG000026708 MOLAZOL TABLET 500 MG(DUS,10 STRIP @ 10 TABLET) TABLET 220.00 DAK 2019
284 DRG000026708 MOLAZOL TABLET 500 MG(DUS,10 STRIP @ 10 TABLET) TABLET 220.00 DAK 2019
285 DRG000026708 MOLAZOL TABLET 500 MG(DUS,10 STRIP @ 10 TABLET) TABLET 220.00 DAK 2019
286 DRG000026708 MOLAZOL TABLET 500 MG(DUS,10 STRIP @ 10 TABLET) TABLET 220.00 DAK 2019
287 DRG000026708 MOLAZOL TABLET 500 MG(DUS,10 STRIP @ 10 TABLET) TABLET 220.00 DAK 2019
288 DRG000027447 NATRIUM DIKLOFENAK TABLET SALUT ENTERIK 50 MG(5 STRIP a 10TABLET SALUT ENTERI 164.00 DAK 2019
289 DRG000027447 NATRIUM DIKLOFENAK TABLET SALUT ENTERIK 50 MG(5 STRIP a 10TABLET INFUS SALUT ENTERI 154.00 DAK 2018
290 DRG000027475 NATRIUM KLORIDA INFUS 0,9 %(DUS, BOTOL PLASTIK PE @ 500 MLINFUS 6,840.00 DAK 2019
291 DRG000027475 NATRIUM KLORIDA INFUS 0,9 %(DUS, BOTOL PLASTIK PE @ 500 ML 6,840.00 DAK 2019
292 MDVx036698 NESCO MultiCheck Glucose / Cholesterol / Uric Acid Multi Function Monitoring System() 575,000.00 DAK 2018
293 DRG000029086 NOVATRIM FORTE CAPTABS (DUS, 10 STRIP @ 10 KAPLET) CAPTABS 1,108.21 DAK 2018
294 DRG000029469 NYSTATIN TABLET SALUT GULA 500.000 IU(BOTOL 100 TABLET) TABLET SALUT GULA 990.00 DAK 2018
295 DRG000029467 NYSTATIN TABLET SALUT GULA 500.000 IU(BOTOL 100) TABLET SALUT GULA 1,056.00 DAK 2019
296 DRG000029468 NYSTATIN TABLET VAGINAL 100.000 IU(10 STRIP a 10 TABLET) TABLET VAGINAL 747.00 DAK 2019
297 DRG000029468 NYSTATIN TABLET VAGINAL 100.000 IU(10 STRIP a 10 TABLET) TABLET VAGINAL 700.00 DAK 2018
298 DRG000029573 OBAT BATUK HITAM SIRUP (DUS, BOTOL PLASTIK @ 100 ML) SIRUP 22,400.00 DAK 2018
299 DRG000029730 OBAT FDC Tablet 1 Ml(OBAT FDC ANAK) Tablet 290,650.00 Lain-lain 2019
300 DRG000029730 OBAT FDC Tablet 1 Ml(OBAT FDC ANAK) Tablet 310,153.00 Lain-lain 2019
301 DRG000029730 OBAT FDC Tablet 1 Ml(OBAT FDC ANAK) Tablet 310,153.00 Lain-lain 2019
302 DRG000029730 OBAT FDC Tablet 1 Ml(OBAT FDC ANAK) Tablet 232,518.00 Lain-lain 2019
303 DRG000029730 OBAT FDC Tablet 1 Ml(OBAT FDC ANAK) Tablet 310,153.00 Lain-lain 2019
304 DRG000029731 OBAT FDC Tablet 1 Ml(OBAT FDC KATEGORI 1) Tablet 486,685.00 Lain-lain 2019
305 DRG000029732 OBAT FDC Tablet 1 Ml(OBAT FDC KATEGORI 2) Tablet 1,622,369.00 Lain-lain 2019
306 DRG000046898 OBH SYRUP 60 ML(BOTOL, 60 ML) SYRUP 22,000.00 DAK 2019
307 DRG000030151 OKSITOSIN INJEKSI 1 Ml(OKSITOSIN INJ 10 IU/ML) INJEKSI 1,900.00 Lain-lain 2019
308 DRG000030253 OMEPRAZOLE CAPSUL 20 MG(DUS, 3 STRIP @ 10 KAPSUL) CAPSUL 157.00 DAK 2019
309 DRG000030247 OMEPRAZOLE CAPSUL 20 MG(DUS, 5 STRIP @ 10 KAPSUL) CAPSUL 147.00 DAK 2018
310 DRG000030399 ONDANSENTRON 4 Mg(ONDANSENTRON 4 MG) 569.00 DAK 2018
311 DRG000030409 ONDANSETRON CAIRAN INJEKSI 2 MG/ML(DUS, 5 AMPUL @ 2 ML) CAIRAN INJEKSI 1,354.00 DAK 2019
312 DRG000030419 ONDANSETRON TABLET SALUT SELAPUT 4 MG(DUS, 3 STRIP @ 10 TTABLET SALUT SELAPU 440.00 DAK 2019
313 DRG000030419 ONDANSETRON TABLET SALUT SELAPUT 4 MG(DUS, 3 STRIP @ 10 TTABLET
LARUTAN SALUT SELAPU
/ CAIRAN 440.00 DAK 2019
314 DRG000046745 ONEMED ASEPTAN LARUTAN / CAIRAN 500 ML(BOTOL 500 ML) 34,100.00 DAK 2019
315 MDVx027777 ONEMED Disposable Syringe 1 ml() 975.00 DAK 2019
316 MDVx027781 ONEMED Disposable Syringe 3 ml() 1,168.50 DAK 2019
317 MDVx027780 ONEMED Disposable Syringe 5 ml() 1,452.00 DAK 2019
318 MDVx041685 ONEMED Hb Meter() 132,000.00 DAK 2019
319 MDVx026064 ONEMED Surgical Blade() 85,000.00 DAK 2018
320 MDVx026796 ONEMED Ultrasonic Gel() 19,505.20 DAK 2018
321 DRG000030662 ORALIT SERBUK (DUS. 100 SACHET @ 4,129 G) SERBUK 800.00 DAK 2019
322 DRG000031057 OTSU - WI CAIRAN INJEKSI (DUS, 120 AMPUL PE @ 25 ML) CAIRAN INJEKSI 2,860.00 DAK 2019
323 DRG000031214 OXYTETRACYCLINE SALEP 3 %(DUS, 25 TUBE @ 5 GRAM) SALEP 4,950.00 DAK 2018
324 DRG000031213 OXYTETRACYCLINE SALEP 3 %(TUBE a 3.5 GRAM) SALEP 2,412.00 DAK 2019
325 DRG000031213 OXYTETRACYCLINE SALEP 3 %(TUBE a 3.5 GRAM) SALEP 2,412.00 DAK 2019
326 DRG000031217 OXYTETRACYCLINE SALEP MATA 1%(DUS, 25 TUBE @ 3.5 GRAM) SALEP MATA 2,600.00 DAK 2018
327 DRG000031217 OXYTETRACYCLINE SALEP MATA 1%(DUS, 25 TUBE @ 3.5 GRAM) SALEP MATA 2,774.00 DAK 2019
328 DRG000031234 OXYTOCIN CAIRAN INJEKSI 10 MCG/ML(10 AMP a 1) CAIRAN INJEKSI 1,837.00 DAK 2019
329 DRG000031235 OXYTOCIN S CAIRAN INJEKSI 10 iu/ml(DUS, 100 AMPUL @ 1 ML) CAIRAN INJEKSI 1,900.00 Lain-lain 2019
330 DRG000031805 PARACETAMOL 500 MG TABLET 500 MG(DUS, 10 STRIP @ 10 TABLETABLET 66.00 DAK 2018
331 DRG000031575 PARACETAMOL CAPTABS 500 MG(DUS,10 STRIP @ 10 KAPLET) CAPTABS 362.97 Lain-lain 2019
332 DRG000031585 PARACETAMOL DROPS 100 MG/ML(DUS, BOTOL @ 15 ML) DROPS 8,311.00 DAK 2018
333 DRG000031586 PARACETAMOL INFUS 1 G/ 100 ML(DUS, 1 BOTOL INFUS KACA @ 1INFUS 85,000.00 DAK 2018
334 DRG000031588 PARACETAMOL INFUS 10 MG/ML(DUS, 1 VIAL @ 100 ML) INFUS 11,990.00 DAK 2019
335 DRG000031592 PARACETAMOL SIRUP 120 MG/5 ML(BOTOL @ 60 ML) SIRUP 3,355.00 DAK 2019
336 DRG000031925 PARASETAMOL SIRUP 120 MG/5 ML(BOTOL A 60 ML) SIRUP
TETES TELINGA 1,269.00 DAK 2018
337 DRG000047113 PHENOL GLYCEROL TETES TELINGA 10%() 9,300.00 DAK 2019
338 DRG000032665 PHYTOMENADIONE CAIRAN INJEKSI 2 MG/ML(DUS, 30 AMPUL @ 1CAIRAN INJEKSI 4,595.00 DAK 2019
339 DRG000032665 PHYTOMENADIONE CAIRAN INJEKSI 2 MG\/ML(DUS, 30 AMPUL @ CAIRAN INJEKSI 4,438.00 DAK 2018
340 DRG000032666 PHYTOMENADIONE TABLET SALUT GULA 10 MG(BOTOL 100 TABLETTABLET SALUT GULA 950.00 DAK 2019
341 DRG000032666 PHYTOMENADIONE TABLET SALUT GULA 10 MG(BOTOL 100 TABLETTABLET SALUT GULA 890.00 DAK 2018
342 DRG000032997 PIROXICAM TABLET 10 MG(DUS, 10 STRIP @ 10 TABLET) TABLET
LAIN-LAIN 185.00 DAK 2018
343 MDVx042199 PLASTIK OBAT LAIN-LAIN 5 CM X 8 CM(100 PIECES) LAIN-LAIN 24,000.00 DAK 2019
344 MDVx042200 PLASTIK OBAT LAIN-LAIN\n 7 CM X 10 CM(100 PIECES) LAIN-LAIN 6,300.00 Lain-lain 2018
345 MDVx042200 PLASTIK OBAT LAIN-LAIN\n 7 CM X 10 CM(100 PIECES) LAIN-LAIN 500.00 DAK 2018
346 MDVx042053 POT SPUTUM LAIN-LAIN\n -() CAIRAN OBAT LUAR 569.00 Lain-lain 2019
347 DRG000046839 Povidon Iodida 10% CAIRAN OBAT LUAR\n 300 ml() LARUTAN / CAIRAN 27,900.00 DAK 2018
348 DRG000047096 POVIDONE IODINE LARUTAN / CAIRAN PVP IODINE 10% 300 ML(BO 27,900.00 DAK 2019
349 DRG000033668 PREDNISON TABLET 5 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 297.00 DAK 2018
350 DRG000033668 PREDNISON TABLET 5 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 297.00 DAK 2018
351 DRG000033668 PREDNISON TABLET 5 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 86.00 DAK 2019
352 DRG000033668 PREDNISON TABLET 5 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 81.00 DAK 2018
353 DRG000033901 PRIMAKUIN Tablet 15 Mg(PRIMAKUIN TABLET 15 MG) Tablet 224.00 Lain-lain 2019
354 DRG000033901 PRIMAKUIN Tablet 15 Mg(PRIMAKUIN TABLET 15 MG) Tablet 550.00 DAK 2018
355 DRG000033915 PRIMAQUINE TABLET 15 MG(10 BLISTER A 10 TABLET) TABLET 253.00 Lain-lain 2019
356 DRG000046783 PRIMAQUINE TABLET 15 MG(Ktk100) TABLET
CAIRAN INJEKSI 386.39 DAK 2019
357 DRG000047296 PROKAIN BENZIL PENISILIN CAIRAN INJEKSI 3.000.000 IU\/VIAL(KOT 21,250.00 DAK 2018
358 DRG000034967 PYRANTEL SUSPENSI 125 MG/5 ML(BOTOL 60 ML) SUSPENSI 12,698.00 DAK 2019
359 DRG000034967 PYRANTEL SUSPENSI 125 MG/5 ML(BOTOL 60 ML) SUSPENSI 11,900.00 DAK 2018
360 DRG000034967 PYRANTEL SUSPENSI 125 MG/5 ML(BOTOL 60 ML) SUSPENSI 12,698.00 DAK 2019
361 DRG000034967 PYRANTEL SUSPENSI 125 MG/5 ML(BOTOL 60 ML) SUSPENSI 750.00 DAK 2019
362 DRG000034963 PYRANTEL TABLET 125 MG(DUS, 25 STRIP @ 4 TABLET) TABLET 361.00 DAK 2018
363 DRG000034963 PYRANTEL TABLET 125 MG(DUS, 25 STRIP @ 4 TABLET) TABLET 334.00 DAK 2018
364 DRG000035043 PYRIDOXINE TABLET 10 MG(BOTOL PLASTIK @ 1000 TABLET) TABLET 164.00 DAK 2019
365 DRG000035185 QUININE TABLET SALUT SELAPUT 222 MG(BOTOL PLASTIK 1000 TABTABLET SALUT SELAPU 838.00 DAK 2018
366 DRG000035287 RAMAFLU TABLET (25 CATCH COVER a 4 TABLET) TABLET 970.00 DAK 2018
367 DRG000035401 RANITIDIN CAIRAN INJEKSI 25 MG/ML(DUS, 10 AMPUL @ 2ML) CAIRAN INJEKSI 10,500.00 DAK 2018
368 DRG000035398 RANITIDIN CAIRAN INJEKSI 25 MG/ML(DUS, 5 AMPUL @ 2 ML) CAIRAN INJEKSI 1,573.00 DAK 2019
369 DRG000035404 RANITIDINE TABLET SALUT SELAPUT 150 MG(DUS, 10 STRIP @ 10 TTABLET SALUT SELAPU 350.00 DAK 2018
370 MDVx042175 RDT CARESTART MALARIA TEST -(BOX, 25 PIECES) TEST 14,934.00 Lain-lain 2019
371 MDVx042175 RDT CARESTART MALARIA TEST -(BOX, 25 PIECES) TEST
LARUTAN / CAIRAN 17,999.00 Lain-lain 2019
372 DRG000047186 REAGEN ZIEHL NEELSEN LARUTAN \/ CAIRAN 100 ML() 266,410.00 Lain-lain 2019
373 MDVx042429 REAGENT KIMIA KLINIK ASAM URAT TEST -() TEST 8,500.00 DAK 2018
374 MDVx042429 REAGENT KIMIA KLINIK ASAM URAT TEST -() TEST 8,509.00 DAK 2019
375 DRG000036036 RETAPHYL CAPTABS PELEPASAN LAMBAT 250 MG(DUS, 10 STRIP @CAPTABS PELEPASAN 1,404.00 DAK 2019
376 DRG000036036 RETAPHYL CAPTABS PELEPASAN LAMBAT 250 MG(DUS, 10 STRIP @CAPTABS PELEPASAN 1,404.00 DAK 2019
377 DRG000036036 RETAPHYL CAPTABS PELEPASAN LAMBAT 250 MG(DUS, 10 STRIP @CAPTABS PELEPASAN 1,404.00 DAK 2019
378 DRG000036036 RETAPHYL CAPTABS PELEPASAN LAMBAT 250 MG(DUS, 10 STRIP @CAPTABS
INFUS PELEPASAN 1,404.00 DAK 2019
379 DRG000036603 RINGER LAKTAT INFUS 500 ML(BOTOL PLASTIK PE @ 500 ML) CAIRAN OBAT LUAR 7,150.00 DAK 2018
380 DRG000047003 RIVANOL (ONEMED) CAIRAN OBAT LUAR 300 ML() 4,650.00 DAK 2019
381 DRG000036719 RIVANOL CAIRAN OBAT LUAR 0.1 %(BOTOL 300 ML) CAIRAN OBAT LUAR 4,650.00 DAK 2018
382 DRG000036722 RIVANOL CAIRAN OBAT LUAR 1%(BOTOL @ 300 ML) CAIRAN OBAT LUAR
LAIN-LAIN 8,510.00 Lain-lain 2018
383 MDVx042284 SAFEED FEEDING TUBE LAIN-LAIN 8 FR (100 CM)() LAIN-LAIN 15,664.00 DAK 2019
384 MDVx042285 SAFEED FEEDING TUBE LAIN-LAIN 8 FR (40 CM)() LAIN-LAIN 15,664.00 DAK 2019
385 MDVx042128 SAFETY BOX LAIN-LAIN\n -() 23,573.00 DAK 2018
386 DRG000037224 SALBUTAMOL TABLET 4 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 81.00 DAK 2018
387 DRG000037711 SARUNG TANGAN (SARUNG TANGAN MAXTER SIZE L) 1,677.24 DAK 2018
388 DRG000037712 SARUNG TANGAN (SARUNG TANGAN MAXTER SIZE M) 1,677.24 DAK 2018
389 DRG000037713 SARUNG TANGAN (SARUNG TANGAN MAXTER SIZE S) 1,677.24 DAK 2018
390 DRG000037713 SARUNG TANGAN (SARUNG TANGAN MAXTER SIZE S) 1,842.24 DAK 2019
391 MDVx001473 SARUNG TANGAN MEDIGRIP NO 7,5() 9,573.00 DAK 2019
392 MDVx001473 SARUNG TANGAN MEDIGRIP NO 7,5() 8,833.00 DAK 2018
393 MDVx002389 SARUNG TANGAN STERIL N0 6,5 MEDICDENT() 8,883.00 DAK 2018
394 MDVx002389 SARUNG TANGAN STERIL N0 6,5 MEDICDENT() 9,248.00 DAK 2019
395 MDVx002396 SARUNG TANGAN STERIL N0 8 MEDICDENT() 8,883.00 DAK 2018
396 MDVx002396 SARUNG TANGAN STERIL N0 8 MEDICDENT() 9,448.00 DAK 2019
397 DRG000037725 SCABIMITE CREAM 5 %(DUS,TUBE @ 10 G) CREAM 62,350.00 DAK 2018
398 DRG000037725 SCABIMITE CREAM 5 %(DUS,TUBE @ 10 G) CREAM 71,496.00 DAK 2019
399 MDVx037907 SD HIV 1/2 ELISA 3.0() 11,975.00 Lain-lain 2019
400 DRG000038643 SIMVASTATIN CAPTABS SALUT SELAPUT 20 MG(DUS, 3 STRIP @ 10 CAPTABS SALUT SELA 252.00 DAK 2018
401 DRG000038645 SIMVASTATIN TABLET SALUT SELAPUT 10 MG(DUS, 3 STRIP @ 10 T TABLET SALUT SELAPU 110.00 DAK 2018
402 DRG000038645 SIMVASTATIN TABLET SALUT SELAPUT 10 MG(DUS, 3 STRIP @ 10 T TABLET SALUT SELAPU
LAIN-LAIN 117.00 DAK 2019
403 MDVx042369 SMI SILK BLACK 3\/0 LAIN-LAIN DS 24 MM() LAIN-LAIN 22,725.00 DAK 2018
404 MDVx042369 SMI SILK BLACK 3\/0 LAIN-LAIN DS 24 MM() 24,378.00 DAK 2018
405 DRG000038917 SODIUM BICARBONATE TABLET 500 MG(BOTOL 1000 TABLET) TABLET 22,308.00 DAK 2018
406 DRG000038964 SOFT PAD (SOFT PAD 60X90) 6,243.60 DAK 2018
407 DRG000039235 SPECTREM TABLET 400 MG + 80 MG(10 BLISTER a 10 TABLET) TABLET 1,703.26 DAK 2018
408 DRG000039345 SPUIT (SPUIT 5CC ONEMED) 983.00 DAK 2018
409 MDVx001723 SPUIT 1 CC INSULIN 100 BD() 682.50 DAK 2018
410 MDVx001728 SPUIT 10 CC BD() 1,948.05 Lain-lain 2018
411 MDVx001791 SPUIT 3 CC TERUMO() 1,168.50 DAK 2018
412 MDVx001793 SPUIT 5 CC TERUMO() 1,452.00 DAK 2018
413 DRG000047225 SULFADIAZINE SILVER CREAM 10 MG(TUBE, NETTO 35 G) CREAM 20,700.00 DAK 2019
414 DRG000047225 SULFADIAZINE SILVER CREAM 10 MG(TUBE, NETTO 35 G) CREAM
LAIN-LAIN 20,700.00 DAK 2019
415 MDVx042268 SURGICAL MASK-3 PLY PLUS EARLOOP LAIN-LAIN -(BOX, 50 LEMBAR 24,750.00 DAK 2019
416 DRG000040321 TABLET TAMBAH DARAH TABLET SALUT SELAPUT (SACHET 30 TABL TABLET SALUT SELAPU 448.00 Lain-lain 2019
417 DRG000040321 TABLET TAMBAH DARAH TABLET SALUT SELAPUT (SACHET 30 TABL TABLET SALUT SELAPU 13,440.00 Lain-lain 2019
418 DRG000040893 TERA-F CAPTABS 100 UI/Ml(TERA-FKAPLET) CAPTABS 970.00 DAK 2019
 419 MDVx041966 TES KEHAMILAN (ONEMED) STRIP -(BOX, 50 STRIP) STRIP 2,908.50 DAK 2019
420 DRG000040999 TES KEHAMILAN 1(TES KEHAMILAN ONE MED) 3,000.00 DAK 2018
421 DRG000041002 TEST KEHAMILAN (TEST KEHAMILAN 3++ OM) 2,908.50 DAK 2018
422 DRG000041068 TETRACYCLINE CAPSUL 500 MG(DUS, 10 STRIP @ 10 KAPSUL) CAPSUL 371.00 DAK 2019
423 DRG000041068 TETRACYCLINE CAPSUL 500 MG(DUS, 10 STRIP @ 10 KAPSUL) CAPSUL 371.00 DAK 2019
424 DRG000041068 TETRACYCLINE CAPSUL 500 MG(DUS, 10 STRIP @ 10 KAPSUL) CAPSUL 371.00 DAK 2019
425 DRG000047182 THIAMIN TABLET 50 MG(BOX, 10 STRIPS @10 TABLET) TABLET 96.00 DAK 2018
426 DRG000047182 THIAMIN TABLET 50 MG(BOX, 10 STRIPS @10 TABLET) TABLET 102.00 DAK 2019
427 DRG000041259 THIAMINE TABLET 100 MG(BOTOL a 1000 TABLET) TABLET 86.67 DAK 2018
428 DRG000042269 TRIFACORT TABLET 5 mg(BOTOL PLASTIK 1000 TABLET) TABLET 297.00 DAK 2018
429 DRG000042326 TRIHEXYPHENIDYL TABLET 100 MG(10 STRIP a 10 TABLET) TABLET
LARUTAN / CAIRAN 80.00 Lain-lain 2019
430 MDVx041964 TURK LARUTAN \/ CAIRAN\n 100 ML() 52,910.00 Lain-lain 2018
431 DRG000043010 UNI BABY COUGH Sirop/Sirop Kering 60 Ml(uni baby cough sirup 60Sirop/Sirop Kering 14,800.00 DAK 2019
432 DRG000043010 UNI BABY COUGH Sirop/Sirop Kering 60 Ml(uni baby cough sirup 60Sirop/Sirop Kering 14,940.00 DAK 2018
433 MDVx042366 UNIFLEX PLASTER 15 CM X 4,5 M(BOX, 10 PACK @6 ROLL) PLASTER 33,700.00 DAK 2019
434 MDVx000660 URINE BAG TERUMO() 39,855.00 DAK 2019
435 DRG000043722 VERBAN ELASTIS ALAT KESEHATAN NO(VERBAN ELASTIS 4) ALAT KESEHATAN 48,300.00 Lain-lain 2018
436 DRG000043722 VERBAN ELASTIS ALAT KESEHATAN NO(VERBAN ELASTIS 4) ALAT KESEHATAN 29,668.50 DAK 2018
437 DRG000044394 VITAMIN A CAPSUL LUNAK 100.000 IU(BOTOL PLASTIK @ 50 KAPSUCAPSUL LUNAK 287.00 Lain-lain 2019
438 DRG000044394 VITAMIN A CAPSUL LUNAK 100.000 IU(BOTOL PLASTIK @ 50 KAPSUCAPSUL LUNAK 355.00 DAK 2018
439 DRG000044405 VITAMIN A CAPSUL LUNAK 200.000 IU(Botol pls 50 kap) CAPSUL LUNAK 634.00 Lain-lain 2019
440 DRG000044426 VITAMIN B COMPLEX TABLET (DUS, 10 STRIP @ 10 TABLET) TABLET 102.00 DAK 2019
441 DRG000044426 VITAMIN B COMPLEX TABLET (DUS, 10 STRIP @ 10 TABLET) TABLET 96.00 DAK 2018
442 DRG000044426 VITAMIN B COMPLEX TABLET (DUS, 10 STRIP @ 10 TABLET) TABLET 102.00 DAK 2019
443 DRG000044426 VITAMIN B COMPLEX TABLET (DUS, 10 STRIP @ 10 TABLET) TABLET 102.00 DAK 2019
444 DRG000044426 VITAMIN B COMPLEX TABLET (DUS, 10 STRIP @ 10 TABLET) TABLET 102.00 DAK 2019
445 DRG000044727 VITAMIN B6 TABLET 10 MG(DUS, 10 STRIP @ 10 TABLET) TABLET 154.00 DAK 2018
446 DRG000045213 WHITEFIELD SALEP SALEP (POT 30) SALEP 5,620.00 DAK 2018
447 DRG000045247 WIDA D10 INFUS 10 %(BOTOL PLASTIK @ 500 ML) INFUS 8,003.00 DAK 2019
448 DRG000045249 WIDA D5 INFUS 5 %(BOTOL PLASTIK PE @ 500 ML) INFUS 7,363.00 DAK 2019
449 DRG000045274 WIDA RL INFUS (BOTOL PLASTIK PE @ 500 ML) INFUS
INFUS 7,630.00 DAK 2019
450 DRG000047098 WIDA WI UNICAP INFUS 1000 ML(BOTOL, 1000 ML) 13,375.00 DAK 2019
451 DRG000047244 ZINC SULFATE SYRUP 20 MG(BOTOL 60 ML) SYRUP 3,925.00 DAK 2019
452 DRG000046201 ZINC TABLET DISPERSIBLE 20 MG(DUS, 10 BLISTER @ 10 TABLET DI TABLET DISPERSIBLE 658.00 DAK 2018

Yang menerima

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Stok awal Penerimaan Persediaan Pemakaian Sisa Stok Ket
PEGUNUNGAN BINTANG, 20-02-2020
Yang menyerahkan/memeriksa

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