Laporan Pemakaian Dan Lembar Permintaan Obat (Lplpo) : Box at 50 Tablet

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
KODE PUSKESMAS : 0 0 0 0 0 0 0 0 0 0 PEMAKAIAN BULAN : Desember

PUSKESMAS : DEDAI PERMINTAAN BULAN : Januari
KECAMATAN : DEDAI
KAB / KOTA : SINTANG Tahun 2019
PROPINSI : KALIMANTAN BARAT
PENERIMAAN
PERMINTAAN
PERSEDIAAN
PEMAKAIAN
STOK AWAL
SISA STOK
STOK OPT
K
ALFABET
NOMOR
O
NAMA OBAT KEMASAN SATUAN HARGA JUMLAH HARGA JUMLAH KET
D
E
1 A A297-17DAK Acyclovir Tablet 200 mg Box @ 50 Tablet Tablet - - - Rp 259.00 Rp - - - Rp 259.00 Rp - -
2 A A298-17DAK Acyclovir Tablet 400 mg Box @ 50 Tablet Tablet - - - Rp 415.00 Rp - - - Rp 415.00 Rp - -
3 A A241-16DAK AESCULAP BLADES NO.10 BOX BOX - - - Rp 345,000.00 Rp - - - Rp 345,000.00 Rp - -
8 A A246-16DAK AESCULAP BLADES NO.24 BOX BOX - - Rp 345,000.00 Rp - - - Rp 345,000.00 Rp - -
9 A A271-16BUF Albendazole tab 400mg Botol Tablet - - - Rp 344.00 Rp - - - Rp 344.00 Rp - -
10 A A299-17DAK Alkazyme Sachet 25 mg Pack Pack - - - Rp 801,000.00 Rp - - - Rp 801,000.00 Rp - -
11 A A037.14NKAT Alkohol 70 % 300 ml btl 300 ml botol 7 - 7 Rp 13,000.00 Rp 91,000.00 7 - Rp 13,000.00 Rp - 8
12 A A300-17DAK Alkohol 70% 1000 ml Botol Botol 10 - 10 Rp 25,550.00 Rp 255,500.00 3 7 Rp 25,550.00 Rp 178,850.00 3
13 A A301-17DAK Alkohol 70% 300 ml Botol Botol 8 - 8 Rp 12,400.00 Rp 99,200.00 8 - Rp 12,400.00 Rp - 9
14 A A302-17DAK Alkohol Swab ONEMED Box Box 4 - 4 Rp 13,000.00 Rp 52,000.00 3 1 Rp 13,000.00 Rp 13,000.00 3
15 A A303-17DAK Allopurinol 100 mg Tablet Box @ 100 Tablet Tablet 2,900 2,000 4,900 Rp 117.00 Rp 573,300.00 2,500 2,400 Rp 117.00 Rp 280,800.00 2,750
16 A A257-17BUFF Allupurinol 100 mg Kotak @ 100 tab Tablet - - - Rp 199.00 Rp - - - Rp 199.00 Rp - -
17 A A304-17DAK Alopurinol Tablet 300 mg Box @ 100 Tablet Tablet 750 - 750 Rp 225.00 Rp 168,750.00 750 - Rp 225.00 Rp - 825
18 A A134-16DAK Alprazolam tablet/kapsul/kaplet 0,5 mg ktk 100 tab tablet - - - Rp 144.00 Rp - - - Rp 144.00 Rp - -
19 A A305-17DAK ALT (GPT) FS Sedang - PROLINE KIT KIT - - - Rp 1,246,090.00 Rp - - - Rp 1,246,090.00 Rp - -
20 A A109-16DAK Ambroxol sirup 15 mg/ml botol botol 60 ml 185 150 335 Rp 3,226.00 Rp 1,080,710.00 209 126 Rp 3,226.00 Rp 406,476.00 230
21 A A115-16DAK Ambroxol tablet Kotak @ 100 tab Tablet - - - Rp 101.20 Rp - - - Rp 101.20 Rp - -
22 A A306-17DAK Aminophylline Injeksi 24 mg/ml Box @ 24 Ampul Ampul 30 - 30 Rp 3,080.00 Rp 92,400.00 - 30 Rp 3,080.00 Rp 92,400.00 -
23 A A216-16DAK Amitriptilin tablet salut 25 mg Tablet tablet - - - Rp 165.00 Rp - - - Rp 165.00 Rp - -
24 A A307-17DAK Amlodipin Tablet 10 mg Kotak @ 30 Tablet Tablet 3,640 2,100 5,740 Rp 107.00 Rp 614,180.00 3,330 2,410 Rp 107.00 Rp 257,870.00 3,663
25 A A308-17DAK Amlodipine Tablet 5 mg Box @ 30 Tablet Tablet 2,290 1,500 3,790 Rp 91.00 Rp 344,890.00 2,290 1,500 Rp 91.00 Rp 136,500.00 2,519
26 A A309-17DAK Amoksisilin Kaplet 500 mg Box @ 100 Kaplet Kaplet 700 - 700 Rp 191.00 Rp 133,700.00 700 - Rp 191.00 Rp - 770
27 A A310-17DAK Amoksisilin Sirup Forte 250 mg/ 5 ml Box @ 50 Botol Botol 92 - 92 Rp 3,797.00 Rp 349,324.00 - 92 Rp 3,797.00 Rp 349,324.00 -
28 A A221-16DAK Amoksisilin sirup kering 125 mg/5 ml btl 60 ml botol 100 - 100 Rp 2,200.00 Rp 220,000.00 11 89 Rp 2,200.00 Rp 195,800.00 12
29 A A108-16DAK Amoxicilin 500 mg tab Kotak @ 100 tab Tablet 2,500 2,000 4,500 Rp 370.00 Rp 1,665,000.00 1,700 2,800 Rp 370.00 Rp 1,036,000.00 1,870
30 A A312-17DAK Amoxicillin 250 mg Kapsul Box @ 100 Tablet Tablet 1,200 - 1,200 Rp 191.00 Rp 229,200.00 1,200 - Rp 191.00 Rp - 1,320
31 A A225-16DAK Antasida DOEN I Kapsul ktk 100 tab tablet 15,900 - 15,900 Rp 64.00 Rp 1,017,600.00 6,800 9,100 Rp 64.00 Rp 582,400.00 7,480
32 A A313-17DAK Antasida DOEN I Tablet Kunyah 0 Tablet - - - Rp 59.00 Rp - - - Rp 59.00 Rp - -
33 A A226-16DAK Antasida DOEN II Sirup botol 60 ML botol 185 150 335 Rp 2,106.00 Rp 705,510.00 185 150 Rp 2,106.00 Rp 315,900.00 204
34 A A315-17DAK Anti-A Monoclonal Golongan Darah (Vial 10 ml) LORNE LABORATORIES Vial Vial - - - Rp 68,200.00 Rp - - - Rp 68,200.00 Rp - -
35 A A316-17DAK Anti-A,B Monoclonal Golongan Darah (Vial 10 ml) LORNE LABORATORIES Vial Vial - - - Rp 92,510.00 Rp - - - Rp 92,510.00 Rp - -
36 A A317-17DAK Anti-B Monoclonal Golongan Darah (Vial 10 ml) LORNE LABORATORIES Vial Vial - - - Rp 68,200.00 Rp - - - Rp 68,200.00 Rp - -
37 A A318-17DAK Antibakteri DOEN (Bacitracin Polymyxin B) Salep Kulit Kotak @ 25 Tube Tube 283 100 383 Rp 3,365.00 Rp 1,288,795.00 143 240 Rp 3,365.00 Rp 807,600.00 157
38 A A319-17DAK Anti-D Duoclone Golongan Darah (Vial 10 ml) LORNE LABORATORIES Vial Vial - - - Rp 114,070.00 Rp - - - Rp 114,070.00 Rp - -
39 A A227-16DAK Aqua Pro injecsi steril OTSU AMPUL ampul 50 50 100 Rp 2,750.00 Rp 275,000.00 50 50 Rp 2,750.00 Rp 137,500.00 55
40 A A025.14NKAT Aquadestilata steril 500 ml btl 500 ml botol - - - Rp 19,770.00 Rp - - - Rp 19,770.00 Rp - -
41 A A249-17PRO Artesunate inj 250 mg ktk 5 amp ampul - - - Rp 42,900.00 Rp - - - Rp 42,900.00 Rp - -
42 A A320-17DAK Asam Ascorbat 50 mg Box @ 100 Tablet Box 4,100 1,500 5,600 Rp 120.00 Rp 672,000.00 2,700 2,900 Rp 120.00 Rp 348,000.00 2,970
43 A A321-17DAK Asam Asetil Salisilat 80 mg (Asetosal) Kotak @ 100 Tablet Tablet 200 - 200 Rp 94.00 Rp 18,800.00 200 - Rp 94.00 Rp - 220
44 A A322-17DAK Asam Mefenamat Kaplet 500mg 0 Kaplet 5,700 5,000 10,700 Rp 102.00 Rp 1,091,400.00 6,600 4,100 Rp 102.00 Rp 418,200.00 7,260
45 A A326-17BUF Asam Mefenamat Kaplet 500mg Box @ 100 Tablet Tablet - - - Rp 113.00 Rp - - - Rp 113.00 Rp - -
46 A A002EKAT15 Asam Traneksamat injecsi 50 mg/ml ktk 10 ampul @ 5 ml ampul 40 - 40 Rp 3,200.00 Rp 128,000.00 25 15 Rp 3,200.00 Rp 48,000.00 28
47 A A323-17DAK AST (GOT) FS Sedang - PROLINE KIT KIT - - - Rp 1,246,090.00 Rp - - - Rp 1,246,090.00 Rp - -
48 A A113-16BUF Atropin injeksi Kotak @ 30 amp Ampul - - - Rp 1,353.00 Rp - - - Rp 1,353.00 Rp - -

49 A A324-17DAK Atropin Injeksi 0,25 mg/ml Box @ 100 Ampul Ampul 200 - 200 Rp 1,540.00 Rp 308,000.00 - 200 Rp 1,540.00 Rp 308,000.00 -
50 A A325-17DAK Attapulgit 0 Tablet 1,450 500 1,950 Rp 600.00 Rp 1,170,000.00 600 1,350 Rp 600.00 Rp 810,000.00 660
51 B B207-16PRO BCG Kotak @ 50 vial Vial - - - Rp 50,460.00 Rp - - - Rp 50,460.00 Rp - -
52 B B219-17DAK Becton Dickinson (BD) Tube EDTA plh 13x75 3.0 blblce lav Box @ 100 Piece Box - - - Rp 169,092.00 Rp - - - Rp 169,092.00 Rp - -
53 B B220-17DAK Bedak Salicyl Serbuk 2% Kotak 50 gr Kotak 54 10 64 Rp 1,071.00 Rp 68,544.00 26 38 Rp 1,071.00 Rp 40,698.00 29
54 B B221-17DAK Betametason Krim Box @ 25 Tube Tube 203 100 303 Rp 1,450.00 Rp 439,350.00 165 138 Rp 1,450.00 Rp 200,100.00 182
55 B B222-17DAK BILIRUBIN DIRECT FS Kecil - PROLINE KIT KIT - - - Rp 631,080.00 Rp - - - Rp 631,080.00 Rp - -
56 B B223-17DAK BILIRUBIN TOTAL FS Kecil - PROLINE KIT KIT - - - Rp 601,930.00 Rp - - - Rp 601,930.00 Rp - -
57 B B204.14NKAT Blood Lancet ktk 100 pcs pcs - - - Rp 300.00 Rp - - - Rp 300.00 Rp - -
58 B B229-17PRO Blood Lancet Box Box - - - Rp 35,135.00 Rp - - - Rp 35,135.00 Rp - -
59 B B224-17DAK Blood Lancet 26G OM Box Box - - - Rp 18,207.50 Rp - - - Rp 18,207.50 Rp - -
60 B B228-17PRO Blood Slide Box Box - - - Rp 18,509.00 Rp - - - Rp 18,509.00 Rp - -
61 B B206-16DAK Blood Transfusion Set Pcs Pcs - - - Rp 4,482.00 Rp - - - Rp 4,482.00 Rp - -
62 B B225-17DAK Blood Transfusion Set NIPRO SHANGHALAMSINO MEDICAL DEVICE Piece Piece - - - Rp 13,420.00 Rp - - - Rp 13,420.00 Rp - -
63 B B226-17DAK BOX MOTOR FIBREGLASS DINAS KESEHATAN KABUPATEN SINTANG Unit Unit - - - Rp - Rp - - - Rp - Rp - -
64 B B227-17DAK Box Objeck Glass Grey and Orange '50 Box Box - - - Rp 47,145.84 Rp - - - Rp 47,145.84 Rp - -
65 C C210-17PRO Calci Glukonas inj 1 gr Ktk 24 amp ampul - - - Rp 9,955.00 Rp - - - Rp 9,955.00 Rp - -
66 C C338-17DAK Calcii Gluconas (Calsium Gluconate) Injeksi 10% Box @ 24 Ampul Ampul 10 - 10 Rp 9,955.00 Rp 99,550.00 - 10 Rp 9,955.00 Rp 99,550.00 -
67 C C211-17PRO Campak Kotak @ 10 vial Vial - - - Rp 25,641.00 Rp - - - Rp 25,641.00 Rp - -
68 C C340-17DAK Captopril 25 mg Tablet Box @ 100 Tablet Tablet 2,150 1,000 3,150 Rp 86.00 Rp 270,900.00 1,650 1,500 Rp 86.00 Rp 129,000.00 1,815
69 C C307-16DAK Carbamazepine 200mg Kotak @ 100 Tab Tablet 810 - 810 Rp 306.00 Rp 247,860.00 120 690 Rp 306.00 Rp 211,140.00 132
70 C C202-16DAK Cat Gud Chormic 2/0 + jarum 1/2 Gt 35 mm ktk 20 pcs Kotak 4 - 4 Rp 166,830.00 Rp 667,320.00 - 4 Rp 166,830.00 Rp 667,320.00 -
71 C C101BAKHP15 Cat gut plain 2/0 + jarum 1/2 GT 35 mm Kotak @ 24 pcs KTK 5 - 5 Rp 172,190.00 Rp 860,950.00 4 1 Rp 172,190.00 Rp 172,190.00 4
72 C C341-17DAK Catgut Chromic 2/0 + 1/2 GT 35 mm OM Box @ 24 Piece Box - - - Rp 167,500.00 Rp - - - Rp 167,500.00 Rp - -
73 C C342-17DAK Catgut Chromic 3/0 + 1/2 GT 35 mm OM Box @ 24 Piece Box - - - Rp 167,500.00 Rp - - - Rp 167,500.00 Rp - -
74 C C343-17DAK Catgut Plain 2/0 + 1/2 GT 35 mm OM Box @ 24 Piece Box - - - Rp 167,500.00 Rp - - - Rp 167,500.00 Rp - -
75 C C314-17BUF Cefadroxil 500 mg Kotak @ 100 tab Tablet 500 500 1,000 Rp 557.00 Rp 557,000.00 200 800 Rp 557.00 Rp 445,600.00 220
76 C C344-17DAK Cetirizine Syrup Box @ 60 Botol Botol 180 150 330 Rp 3,300.00 Rp 1,089,000.00 167 163 Rp 3,300.00 Rp 537,900.00 184
77 C C345-17DAK Chlorpromazine 5 mg/ml Injeksi Box @ 30 Ampul Ampul - - - Rp 1,672.00 Rp - - - Rp 1,672.00 Rp - -
78 C C346-17DAK CHOLESTEROL FS Besar - PROLINE KIT KIT - - - Rp 3,737,370.00 Rp - - - Rp 3,737,370.00 Rp - -
79 C C347-17DAK Clindamycin Kapsul 300 mg Box @ 50 Kapsul Kapsul - - - Rp 589.00 Rp - - - Rp 589.00 Rp - -
80 C C303-16DAK Clorpromazine 100 mg Tablet Kotak @ 100 Tab Tablet - - - Rp 179.00 Rp - - - Rp 179.00 Rp - -
81 C C102-16DAK Clorpromazine 25 mg Tablet Tablet Tablet - - - Rp 170.00 Rp - - - Rp 170.00 Rp - -
82 C C103-16DAK Clorpromazine injeksi 25mg/mL ampul ampul - - - Rp 1,980.00 Rp - - - Rp 1,980.00 Rp - -
83 C C304-16DAK Clozapine Kotak @ 100 Tab Tablet 215 - 215 Rp 1,550.00 Rp 333,250.00 215 - Rp 1,550.00 Rp - 237
84 C C306-16DAK Clozapine Kotak @ 100 Tab Tablet - - - Rp 1,550.00 Rp - - - Rp 1,550.00 Rp - -
85 C C210-16DAK Colortusin Syrup Botol 60mL Botol - - - Rp 3,533.00 Rp - - - Rp 3,533.00 Rp - -
86 C C209-16DAK Colortusin Tablet kotak 100 tab tablet - - - Rp 286.67 Rp - - - Rp 286.67 Rp - -
87 C C348-17DAK Combi Screen 11 Sys Plus Botol Botol - - - Rp 261,621.67 Rp - - - Rp 261,621.67 Rp - -
88 C C111-16KAT COMBIVENT UDV BOX @20 BTL botol - - - Rp 4,995.00 Rp - - - Rp 4,995.00 Rp - -
89 C C349-17DAK Cover Glass 20 x 20 Pack Pack - - - Rp 157,179.69 Rp - - - Rp 157,179.69 Rp - -
90 C C308-16DAK Cover Glass 20x20 mm pak pak - - - Rp 156,550.94 Rp - - - Rp 156,550.94 Rp - -
91 C C350-17DAK CREATININE FS Sedang - PROLINE KIT KIT - - - Rp 937,430.00 Rp - - - Rp 937,430.00 Rp - -
92 C C208-16DAK CTM 4 mg tablet kotak 100 tab tablet 6,400 3,000 9,400 Rp 45.00 Rp 423,000.00 8,000 1,400 Rp 45.00 Rp 63,000.00 8,800
93 C C351-17DAK Curmunos 60 ml syr Kotak @ 24 Botol Botol - - - Rp 57,200.00 Rp - - - Rp 57,200.00 Rp - -
94 D D308-17BUF DEC Tab Box Tablet - - - Rp 135.00 Rp - - - Rp 135.00 Rp - -
95 D D320-17DAK Deksametason 0,5 mg Tablet Box @ 100 Tablet Tablet 2,000 2,000 4,000 Rp 45.00 Rp 180,000.00 2,800 1,200 Rp 45.00 Rp 54,000.00 3,080
96 D D203-16DAK Deksamethason injeksi 5mg/mL Kotak @ 100 amp Ampul 12 - 12 Rp 1,745.00 Rp 20,940.00 12 - Rp 1,745.00 Rp - 13
97 D D321-17DAK Dengue Ag.NS1 Rapid Test Device Box @ 25 Test Box - - - Rp 2,700,000.00 Rp - - - Rp 2,700,000.00 Rp - -
98 D D322-17DAK Dexamethasone Injeksi 5 mg/ml Box @ 100 Ampul Ampul 100 50 150 Rp 1,822.00 Rp 273,300.00 100 50 Rp 1,822.00 Rp 91,100.00 110
99 D D323-17DAK DHA Gold Capsul 0 Botol - - - Rp 465,714.00 Rp - - - Rp 465,714.00 Rp - -
100 D D324-17DAK Diamicron MR (Glikazide) 60 mg Tablet Box @ 30 Tablet Tablet 530 - 530 Rp 2,992.00 Rp 1,585,760.00 - 530 Rp 2,992.00 Rp 1,585,760.00 -
101 D D010-16DAK Diazepam Injeksi 5mg/mL Kotak @ 5 ampul ampul - - - Rp 27,588.00 Rp - - - Rp 27,588.00 Rp - -
102 D D302-16DAK Diazepam Larutan Rektal 5mg/2,5ml tube tube - - - Rp 12,749.00 Rp - - - Rp 12,749.00 Rp - -
103 D D104 Diazepam tab 2 mg botol 100 tab Tablet 494 - 494 Rp 39.00 Rp 19,266.00 - 494 Rp 39.00 Rp 19,266.00 -
104 D D105-16DAK Diazepam tab 5 mg ktk 10 x 10 tab Tablet 7 - 7 Rp 143.89 Rp 1,007.23 7 - Rp 143.89 Rp - 8
105 D D325-17DAK Diazepam Tablet 5 mg 0 Tablet 500 - 500 Rp 105.00 Rp 52,500.00 103 397 Rp 105.00 Rp 41,685.00 113
106 D D326-17DAK Difenhidramin Injeksi 10 mg/ml Ampul Ampul - - - Rp 1,222.00 Rp - - - Rp 1,222.00 Rp - -
107 D D327-17DAK Digoksin 0,25 mg Tablet Box @ 100 Tablet Tablet 120 - 120 Rp 109.00 Rp 13,080.00 20 100 Rp 109.00 Rp 10,900.00 22
108 D D328-17DAK Disposafe Safety Box 5 lt Coklat OM Piece Piece - - - Rp 19,644.10 Rp - - - Rp 19,644.10 Rp - -
109 D D329-17DAK DOMETIC MEDICAL COLD CHAIN-TCW 3000 SDD-GENERATOR 2-KAP 156 L 42000000-AKS-000035212 Unit Unit - - - Rp 206,762,888.00 Rp - - - Rp 206,762,888.00 Rp - -
110 D D334-17BUF Domperidon 10 mg Box @ 100 Tablet Tablet 800 - 800 Rp 120.00 Rp 96,000.00 200 600 Rp 120.00 Rp 72,000.00 220
111 D D221-17BUF Domperidon Syrup Botol Botol 100 - 100 Rp 3,400.00 Rp 340,000.00 - 100 Rp 3,400.00 Rp 340,000.00 -
112 D D335-17BUF Domperidon Syrup Box @ 50 Botol Botol 50 - 50 Rp 3,490.00 Rp 174,500.00 36 14 Rp 3,490.00 Rp 48,860.00 40
113 D D330-17DAK Domperidone (Miradon) Syrup Box @ 50 Botol Botol - - - Rp 17,050.00 Rp - - - Rp 17,050.00 Rp - -
114 D D331-17DAK Domperidone 10 mg Kaplet Box @ 100 Kaplet Kaplet - - - Rp 110.00 Rp - - - Rp 110.00 Rp - -
115 D D214-17PRO DPTHBhib/pentabio Kotak @ 10 vial Vial - - - Rp 63,930.00 Rp - - - Rp 63,930.00 Rp - -
116 D D220-17PRO DT Kotak @ 10 vial Vial - - - Rp 15,550.00 Rp - - - Rp 15,550.00 Rp - -
117 D D332-17DAK Dulcolax Supp ADULT Bisakodil Suppositoria 10 mg Box @ 50 Suppositoria Suppositoria 30 10 40 Rp 5,800.00 Rp 232,000.00 15 25 Rp 5,800.00 Rp 145,000.00 17
118 D D215-16KAT Dulcolax Supp Infant 5mg kotak @6pcs pcs 13 - 13 Rp 5,670.00 Rp 73,710.00 7 6 Rp 5,670.00 Rp 34,020.00 8
119 D D333-17DAK Dulcolax Supp INFANT Bisakodil Suppositoria 5 mg Box @ 6 Suppositoria Suppositoria - - - Rp 5,800.00 Rp - - - Rp 5,800.00 Rp - -
120 E E218-17DAK Epinephrine (Adrenaline) Injeksi 0,1% Box @ 100 Ampul Ampul 75 - 75 Rp 1,848.00 Rp 138,600.00 - 75 Rp 1,848.00 Rp 138,600.00 -
121 E E219-17DAK Eritromisin Tablet 500 mg Box @ 100 Tablet Tablet 900 - 900 Rp 766.00 Rp 689,400.00 - 900 Rp 766.00 Rp 689,400.00 -
122 E E220-17DAK Erythromycin Sirup Kering Box @ 100 Botol Botol 55 - 55 Rp 6,461.00 Rp 355,355.00 - 55 Rp 6,461.00 Rp 355,355.00 -
123 E E203.14KAT Etanol 70% cairan btl 100 ml botol - - - Rp 2,625.00 Rp - - - Rp 2,625.00 Rp - -
124 E E205-16DAK Etil Clorida Semprot btl 100 ml botol - - - Rp 110,000.00 Rp - - - Rp 110,000.00 Rp - -
125 E E208-17PRO Euthyrox 100 mg Kotak @ 100 tab tablet - - - Rp 944.00 Rp - - - Rp 944.00 Rp - -
126 E E221-17DAK Examination Glove (L) HALONI JANE PROTOS Box @ 50 Pasang Box - 10 10 Rp 42,200.00 Rp 422,000.00 10 - Rp 42,200.00 Rp - 11
127 E E222-17DAK Examination Glove (M) HALONI JANE PROTOS Box @ 50 Pasang Box - - - Rp 42,200.00 Rp - - - Rp 42,200.00 Rp - -
128 E E223-17DAK Examination Glove (S) HALONI JANE PROTOS Box @ 50 Pasang Box - 5 5 Rp 42,200.00 Rp 211,000.00 5 - Rp 42,200.00 Rp - 6
129 F F235-17DAK Farbion 500 Injeksi 3 ml Box @ 5 Ampul Ampul 95 50 145 Rp 5,170.00 Rp 749,650.00 92 53 Rp 5,170.00 Rp 274,010.00 101
130 F F200-16DAK Farbion Injecsi ktk 5 Amp ampul - - - Rp 5,172.00 Rp - - - Rp 5,172.00 Rp - -
131 F F236-17DAK Farmadol 50 ml Botol Botol 67 - 67 Rp 38,500.00 Rp 2,579,500.00 10 57 Rp 38,500.00 Rp 2,194,500.00 11
132 F F237-17DAK Fartison Injeksi vial 100 mg Box @ 1 Vial Vial - - - Rp 99,000.00 Rp - - - Rp 99,000.00 Rp - -
133 F F238-17DAK FDC Kategori I Paket Paket - - - Rp 430,538.00 Rp - - - Rp 430,538.00 Rp - -
134 F F239-17DAK FDC Kategori II Paket Paket - - - Rp 1,435,178.00 Rp - - - Rp 1,435,178.00 Rp - -
135 F F105.14NKAT Fenobarbital 30 mg Tablet ktk 100 tab tablet - - - Rp 69.00 Rp - - - Rp 69.00 Rp - -
136 F F240-17DAK Fenobarbital Injeksi 50 mg Box @ 30 Ampul Ampul 30 - 30 Rp 1,925.00 Rp 57,750.00 - 30 Rp 1,925.00 Rp 57,750.00 -
137 F F008.15PRO Fenobarbital Injeksi i.m.50 mg/ml Kotak ampul - - - Rp 2,178.00 Rp - - - Rp 2,178.00 Rp - -
138 F F011-16DAK Fitomenadion (Vit.K) inj 10 mg/ ml kotak 30 ampul @ 1 ml ampul - - - Rp 11,000.00 Rp - - - Rp 11,000.00 Rp - -
139 F F241-17DAK Fitomenadion Tablet 10 mg Box @ 100 Tablet Tablet 900 - 900 Rp 790.00 Rp 711,000.00 300 600 Rp 790.00 Rp 474,000.00 330
140 F F208BAKHP15 Foley Catheter 2 way Ped no 10 ktk pcs 10 - 10 Rp 38,550.00 Rp 385,500.00 - 10 Rp 38,550.00 Rp 385,500.00 -
141 F F209.14NKAT Foley Catheter 2 way Ped no 6 ktk pcs 6 - 6 Rp 47,632.50 Rp 285,795.00 - 6 Rp 47,632.50 Rp 285,795.00 -
142 F F209BAKHP15 Foley Catheter 2 way Ped no 6 ktk pcs - - - Rp 46,902.50 Rp - - - Rp 46,902.50 Rp - -
143 F F210BAKHP15 Foley Catheter 2 way Ped no 8 ktk pcs 10 - 10 Rp 38,550.00 Rp 385,500.00 - 10 Rp 38,550.00 Rp 385,500.00 -
144 F F109BAKHP15 Foley Catheter 2 way no 14 ktk pcs - - - Rp 10,280.00 Rp - - - Rp 10,280.00 Rp - -
145 F F110BAKHP15 Foley Catheter 2 way no 18 ktk pcs - - - Rp 10,280.00 Rp - - - Rp 10,280.00 Rp - -
146 F F242-17DAK Folley Catheter 2 Way 14 FRESCO Piece Piece 10 - 10 Rp 9,821.00 Rp 98,210.00 - 10 Rp 9,821.00 Rp 98,210.00 -
147 F F243-17DAK Folley Catheter 2 Way 18 FRESCO Piece Piece - - - Rp 9,821.00 Rp - - - Rp 9,821.00 Rp - -
148 F F244-17DAK Folley Catheter 2 Way 20 FRESCO Piece Piece 18 - 18 Rp 9,821.00 Rp 176,778.00 - 18 Rp 9,821.00 Rp 176,778.00 -
149 F F245-17DAK Folley Catheter 3-5 ml/cc - 10 fr REMEDI Kotak @ 10 Piece Piece - - - Rp 12,480.00 Rp - - - Rp 12,480.00 Rp - -
152 F F248-17DAK Folley Catheter No. 14 Box @ 10 Piece Piece - - - Rp 9,065.10 Rp - - - Rp 9,065.10 Rp - -
156 F F215-16DAK Fridep 50mg Kotak @ 30 tab Tablet - - - Rp 2,840.00 Rp - - - Rp 2,840.00 Rp - -
157 F F252-17DAK Furosemide 40 mg Box @ 100 Tablet Tablet 900 400 1,300 Rp 187.73 Rp 244,049.00 650 650 Rp 187.73 Rp 122,024.50 715
158 F F106-16DAK Furosemide tab 40 mg ktk 10 x 10 tab Tablet - - - Rp 181.73 Rp - - - Rp 181.73 Rp - -
159 G G310-17DAK GAMMA GT FS Kecil - PROLINE KIT KIT - - - Rp 890,460.00 Rp - - - Rp 890,460.00 Rp - -
160 G G311-17DAK Garam Oralit I Serbuk Box @ 100 Sachet Sachet 36 - 36 Rp 273.00 Rp 9,828.00 - 36 Rp 273.00 Rp 9,828.00 -
161 G G318-17BUF Garam Oralit I Serbuk Box @ 100 Sachet Sachet - - - Rp 273.00 Rp - - - Rp 273.00 Rp - -
162 G G302-16DAK GC Fuji IX kotak kotak - - - Rp 1,292,500.00 Rp - - - Rp 1,292,500.00 Rp - -
163 G G312-17DAK GC Fuji LX Piece Piece - - - Rp 1,292,500.00 Rp - - - Rp 1,292,500.00 Rp - -
164 G G303-16DAK GC Fuji VII Pink kotak kotak - - - Rp 1,134,375.00 Rp - - - Rp 1,134,375.00 Rp - -
165 G G313-17DAK GC Fuji VII Pink Piece Piece - - - Rp 1,134,375.00 Rp - - - Rp 1,134,375.00 Rp - -
166 G G203.14KAT Gemfibrozil cap.300 mg ktk 120 tab tablet 720 - 720 Rp 318.00 Rp 228,960.00 - 720 Rp 318.00 Rp 228,960.00 -
167 G G104.14KAT Gentamisin Tetes Mata 0,3 % btl 5ml botol - - - Rp 3,513.00 Rp - - - Rp 3,513.00 Rp - -
168 G G216-17PRO Gentamycin 40 mg ktk 5 amp ampul - - - Rp 3,739.00 Rp - - - Rp 3,739.00 Rp - -
169 G G317-17PRO Giemsa Botol Botol - 2 2 Rp 493,115.00 Rp 986,230.00 2 - Rp 493,115.00 Rp - 2
170 G G209-16DAK Glibenklamida tablet 5 mg ktk 100 tab tablet 1,100 - 1,100 Rp 92.40 Rp 101,640.00 500 600 Rp 92.40 Rp 55,440.00 550
171 G G215-16DAK Glimepirid 2mg kotak 5x10 tab tablet 800 500 1,300 Rp 880.00 Rp 1,144,000.00 600 700 Rp 880.00 Rp 616,000.00 660
172 G G314-17DAK Glimepiride Tablet 1 mg Box @ 50 Tablet Box - - - Rp 194.00 Rp - - - Rp 194.00 Rp - -
173 G G315-17DAK Gliseryl Guaiakolat 0 Tablet - - - Rp 107.00 Rp - - - Rp 107.00 Rp - -
174 G G319-17BUF Gliseryl Guaiakolat Box @ 100 Tablet Tablet - - - Rp 129.00 Rp - - - Rp 129.00 Rp - -
175 G G316-17DAK GLUCOSE HEXOKINASE FS Sedang - PROLINE KIT KIT - - - Rp 1,659,800.00 Rp - - - Rp 1,659,800.00 Rp - -
176 G G106.14KAT Glukosa Infus 10 % btl 500 ml botol 40 - 40 Rp 6,270.00 Rp 250,800.00 - 40 Rp 6,270.00 Rp 250,800.00 -
177 G G107.14KAT Glukosa Infus 5 % btl 500 ml botol - - - Rp 5,720.00 Rp - - - Rp 5,720.00 Rp - -
178 G G107 Glukosa Larutan Infus 5 % steril botol botol 500 ml - - - Rp 5,844.00 Rp - - - Rp 5,844.00 Rp - -
179 H H200-16DAK Haloperidol tab 0,5 mg Tablet tablet 850 - 850 Rp 64.00 Rp 54,400.00 155 695 Rp 64.00 Rp 44,480.00 171
180 H H201-16DAK Haloperidol tab 1,5 mg ktk 100 tab Tablet 410 - 410 Rp 74.00 Rp 30,340.00 240 170 Rp 74.00 Rp 12,580.00 264
181 H H201KAT15 Haloperidol tab 1,5 mg ktk 100 tab Tablet - - - Rp 76.00 Rp - - - Rp 76.00 Rp - -
182 H H217-17DAK Haloperidol Tablet 5 mg 0 Tablet 1,000 - 1,000 Rp 74.00 Rp 74,000.00 30 970 Rp 74.00 Rp 71,780.00 33
183 H H203.14NKAT hanscoen Steril Uk. 7,5 psg psg 30 - 30 Rp 12,000.00 Rp 360,000.00 15 15 Rp 12,000.00 Rp 180,000.00 17
184 H H204-16KAT Hanscoen Panjang Steril( Gynecologi)7,5 inc psg psg 40 - 40 Rp 19,400.00 Rp 776,000.00 - 40 Rp 19,400.00 Rp 776,000.00 -
185 H H109-16KAT HB Sahli kotak kotak - - - Rp 61,875.00 Rp - - - Rp 61,875.00 Rp - -
186 H H218-17DAK HB Sahli Set Set - - - Rp 61,800.00 Rp - - - Rp 61,800.00 Rp - -
187 H H102-17PRO HB uniject/HB0 Kotak @ 100 uniject Uniject - - - Rp 19,096.00 Rp - - - Rp 19,096.00 Rp - -
188 H H219-17DAK HDL-C IMMUNO FS Besar - PROLINE KIT KIT - - - Rp 5,887,210.00 Rp - - - Rp 5,887,210.00 Rp - -
189 H H223-17DAK Hemafort Box @ 100 Kapsul Kapsul 1,000 1,000 2,000 Rp 834.90 Rp 1,669,800.00 1,000 1,000 Rp 834.90 Rp 834,900.00 1,100
190 H H220-17DAK Hidroklortiazide 25 mg Tablet Box @ 100 Tablet Tablet 50 - 50 Rp 171.00 Rp 8,550.00 - 50 Rp 171.00 Rp 8,550.00 -
191 H H221-17DAK Hidrokortison Krim Box @ 24 Tube Tube 52 - 52 Rp 2,838.00 Rp 147,576.00 27 25 Rp 2,838.00 Rp 70,950.00 30
192 H H209-16DAK Horvita Kotak @100tab Tablet 1,000 1,000 2,000 Rp 678.84 Rp 1,357,680.00 1,500 500 Rp 678.84 Rp 339,420.00 1,650
193 H H222-17DAK Human Syphilis RPR test Kit Kit - - - Rp 551,670.00 Rp - - - Rp 551,670.00 Rp - -
194 I I228-17DAK Ibuprofen 200 mg Box @ 100 Tablet Tablet 1,500 1,500 3,000 Rp 108.00 Rp 324,000.00 1,600 1,400 Rp 108.00 Rp 151,200.00 1,760
195 I I229-17DAK Ibuprofen 400 mg Kotak @ 100 Tablet Tablet 2,500 1,500 4,000 Rp 113.00 Rp 452,000.00 2,900 1,100 Rp 113.00 Rp 124,300.00 3,190
196 I I239-17PRO Immersion Oil Botol Botol - - - Rp 836,595.00 Rp - - - Rp 836,595.00 Rp - -
197 I I205-16DAK Infus set anak AXIMED pcs pcs 201 - 201 Rp 6,171.00 Rp 1,240,371.00 5 196 Rp 6,171.00 Rp 1,209,516.00 6
198 I I230-17DAK Infus Set Anak STERA Piece Piece - - - Rp 4,550.00 Rp - - - Rp 4,550.00 Rp - -
199 I I204-16DAK Infus set Dewasa AXIMED pcs pcs 82 - 82 Rp 5,808.00 Rp 476,256.00 62 20 Rp 5,808.00 Rp 116,160.00 68
200 I I231-17DAK Infus Set Dewasa STERA Piece Piece 100 100 200 Rp 4,160.00 Rp 832,000.00 80 120 Rp 4,160.00 Rp 499,200.00 88
201 I I218-17PRO Insektisida Gokilath S 50 EC 1 Liter Box @ 12 Botol Botol - - - Rp 523,435.00 Rp - - - Rp 523,435.00 Rp - -
202 I I232-17DAK Iodine Povidon 30 ml 10% OM Botol Botol 21 20 41 Rp 3,625.00 Rp 148,625.00 20 21 Rp 3,625.00 Rp 76,125.00 22
203 I I233-17DAK Iodine Povidon 60 ml 10% OM Botol Botol - - - Rp 4,800.00 Rp - - - Rp 4,800.00 Rp - -
204 I I215-17PRO IPV Kotak @ 50 vial Vial - - - Rp 137,610.00 Rp - - - Rp 137,610.00 Rp - -
205 I I240-17BUF Isosorbid dinitrat tab sublingual 5 mg Box @ 100 Tablet Tablet - - - Rp 93.00 Rp - - - Rp 93.00 Rp - -
206 I I109-16DAK Iv Cateter no. 22 G INTROCAN kotak Pcs - - - Rp 10,062.50 Rp - - - Rp 10,062.50 Rp - -
207 I I110-16DAK Iv Cateter no. 24 G INTROCAN kotak Pcs 91 50 141 Rp 10,062.50 Rp 1,418,812.50 53 88 Rp 10,062.50 Rp 885,500.00 58
208 I I108-16DAK Iv Cateter no.20G INTROCAN kotak Pcs 100 - 100 Rp 10,062.50 Rp 1,006,250.00 53 47 Rp 10,062.50 Rp 472,937.50 58
209 I I108.14NKAT IV Catether no 20 G x 32 mm ktk 50 buah pcs - - - Rp 4,959.00 Rp - - - Rp 4,959.00 Rp - -
210 I I111BKAHP15 IV Catether Terumo 26 G x 32 mm pcs pcs 133 100 233 Rp 21,065.00 Rp 4,908,145.00 100 133 Rp 21,065.00 Rp 2,801,645.00 110
211 I I234-17DAK IV Catheter 22G Canula FRESCO Piece Piece - - - Rp 4,760.60 Rp - - - Rp 4,760.60 Rp - -
212 I I235-17DAK IV Catheter WP No. 18G AXIMED Box @ 50 Piece Piece 149 50 199 Rp 8,610.00 Rp 1,713,390.00 52 147 Rp 8,610.00 Rp 1,265,670.00 57
213 I I236-17DAK IV Catheter WP No. 24G AXIMED Box @ 50 Piece Piece - - - Rp 8,437.31 Rp - - - Rp 8,437.31 Rp - -
214 I I237-17DAK IV-CATH WP, with wing & port no. 20 AXIMED Piece Piece - - - Rp 8,610.00 Rp - - - Rp 8,610.00 Rp - -
215 I I238-17DAK IV-CATH WP, with wing & port no. 26 AXIMED Piece Piece - - - Rp 10,086.00 Rp - - - Rp 10,086.00 Rp - -
216 K K301-16DAK KA-EN 3A BAG BAG - 20 20 Rp 10,050.00 Rp 201,000.00 - 20 Rp 10,050.00 Rp 201,000.00 -

217 K K302-16DAK KA-EN 3B BAG BAG - 20 20 Rp 10,050.00 Rp 201,000.00 - 20 Rp 10,050.00 Rp 201,000.00 -
218 K K330-17DAK Kalsium Laktat 500 mg Kotak @ 100 Tablet Tablet 2,000 2,000 4,000 Rp 57.00 Rp 228,000.00 600 3,400 Rp 57.00 Rp 193,800.00 660
219 K K331-17DAK Kapas Pembalut 250 gr ONEMED Roll Roll 19 10 29 Rp 16,250.00 Rp 471,250.00 12 17 Rp 16,250.00 Rp 276,250.00 13
220 K K103KAT15 Kaptopril tablet 50 mg ktk 100 tab Tablet 300 - 300 Rp 141.00 Rp 42,300.00 - 300 Rp 141.00 Rp 42,300.00 -
221 K K332-17DAK Kaptopril Tablet Scored 12,5 mg Box @ 100 Tablet Tablet 2,450 - 2,450 Rp 67.00 Rp 164,150.00 300 2,150 Rp 67.00 Rp 144,050.00 330
222 K K333-17DAK Karbogliserin TT 10% Botol Botol 35 - 35 Rp 2,500.00 Rp 87,500.00 3 32 Rp 2,500.00 Rp 80,000.00 3
223 K K310-17BUF Kasa Elastis 4x5 cm Piece Pieces - - - Rp 334.00 Rp - - - Rp 334.00 Rp - -
224 K K334-17DAK Kasa Hidrofil 40 x 80 cm ONEMED Roll Roll 5 - 5 Rp 136,500.00 Rp 682,500.00 2 3 Rp 136,500.00 Rp 409,500.00 2
225 K K335-17DAK Kasa Hidrofil Steril 16 x 16 cm ONEMED Box @ 16 Piece Box 72 30 102 Rp 10,400.00 Rp 1,060,800.00 65 37 Rp 10,400.00 Rp 384,800.00 72
226 K K336-17DAK Kasa Pembalut Elastis 7,5 cm x 4,55 cm Roll Roll 2 - 2 Rp 28,914.00 Rp 57,828.00 - 2 Rp 28,914.00 Rp 57,828.00 -
227 K K337-17DAK Kasa Pembalut Hidrofil uk. 4 m x 10 cm ONEMED Roll Roll 100 - 100 Rp 1,950.00 Rp 195,000.00 90 10 Rp 1,950.00 Rp 19,500.00 99
228 K K338-17DAK Kasa Pembalut Hidrofil uk. 4 m x 5 cm ONEMED Roll Roll 240 100 340 Rp 975.00 Rp 331,500.00 100 240 Rp 975.00 Rp 234,000.00 110
229 K K126 Kasa Pembalut hirofil uk. 4 m x 10 cm pack 50 rool pack 85 50 135 Rp 634.80 Rp 85,698.00 - 135 Rp 634.80 Rp 85,698.00 -
230 K K226-16DAK Kawat OSE pcs pcs - - - Rp 27,500.00 Rp - - - Rp 27,500.00 Rp - -
231 K K339-17DAK Ketoconazole cream Tube 10 g Tube 92 50 142 Rp 2,790.00 Rp 396,180.00 74 68 Rp 2,790.00 Rp 189,720.00 81
232 K K340-17DAK Ketokonazole Tab 200 mg Box @ 50 Tablet Tablet 850 500 1,350 Rp 297.00 Rp 400,950.00 950 400 Rp 297.00 Rp 118,800.00 1,045
233 K K227-16DAK Ketoprofen 50mg/2mL Kotak @ 5 ampul ampul - - - Rp 5,649.80 Rp - - - Rp 5,649.80 Rp - -
234 K K305-16DAK Ketorolax Injeksi 30mg/mL ampul ampul - - - Rp 1,383.00 Rp - - - Rp 1,383.00 Rp - -
235 K K219-16DAK Kloramfenicol suspensi 125 mg/ml btl 60 ml botol 6 - 6 Rp 4,000.00 Rp 24,000.00 - 6 Rp 4,000.00 Rp 24,000.00 -
236 K K033 Kloramfenikol kapsul 250 mg Botol @250 tab Kapsul 220 - 220 Rp 254.10 Rp 55,902.00 120 100 Rp 254.10 Rp 25,410.00 132
237 K K341-17DAK Kloramfenikol Suspensi Box @ 50 Botol Botol 72 - 72 Rp 4,982.00 Rp 358,704.00 - 72 Rp 4,982.00 Rp 358,704.00 -
238 K K307-16DAK Kloramfenikol Tetes Mata 10mg/mL Botol 10mL Botol - - - Rp 6,380.00 Rp - - - Rp 6,380.00 Rp - -
239 K K308-16DAK Kloramfenikol Tetes Telinga 10mg/mL Botol 10mL Botol 42 - 42 Rp 7,150.00 Rp 300,300.00 25 17 Rp 7,150.00 Rp 121,550.00 28
240 K K111 Klorampenikol kapsul 250 mg ktk 12 x 10 kaps Kapsul - - - Rp 264.00 Rp - - - Rp 264.00 Rp - -
241 K K342-17DAK Klorfeniramina Maleat (CTM) Tablet 4 mg Box @ 200 Tablet Tablet - - - Rp 39.00 Rp - - - Rp 39.00 Rp - -
242 K K221.14KAT Kombinasi tetes mata 2,5 mg/ml btl 15 ml botol - - - Rp 15,750.00 Rp - - - Rp 15,750.00 Rp - -
243 K K343-17DAK Kotrimoksazol DOEN I (Dewasa) Kotak @ 100 Tablet Tablet 2,100 500 2,600 Rp 131.00 Rp 340,600.00 600 2,000 Rp 131.00 Rp 262,000.00 660
244 K K344-17DAK Kotrimoksazol Suspensi Box @ 50 Botol Botol 190 - 190 Rp 2,462.00 Rp 467,780.00 - 190 Rp 2,462.00 Rp 467,780.00 -
245 K K303-16BUF Kotrimoksazol Syrup btl 60 ml botol 35 - 35 Rp 2,298.00 Rp 80,430.00 5 30 Rp 2,298.00 Rp 68,940.00 6
246 K K345-17DAK Kuinin Tablet 200 mg Box @ 60 Tablet Tablet 56 - 56 Rp 737.00 Rp 41,272.00 6 50 Rp 737.00 Rp 36,850.00 7
247 L L258-17PRO Laboratorium Kit Paket Paket - - - Rp 901,274.00 Rp - - - Rp 901,274.00 Rp - -
248 L L105.14NKAT lancet + Pen set set - - - Rp 45,000.00 Rp - - - Rp 45,000.00 Rp - -
249 L L240-17DAK Lancet + Pen ONEMED Piece Piece - - - Rp 22,640.08 Rp - - - Rp 22,640.08 Rp - -
250 L L201-16DAK Lanzoprazol 30 mg tablet ktk 20 TAB tablet - - - Rp 341.00 Rp - - - Rp 341.00 Rp - -
251 L L241-17DAK Larutan Benedict 100 ml Botol Botol - - - Rp 41,050.00 Rp - - - Rp 41,050.00 Rp - -
252 L L001-16KAT Larutan Benedict 100mL Botol 100 ml Botol - - - Rp 41,250.00 Rp - - - Rp 41,250.00 Rp - -
253 L L002-16KAT Larutan EDTA Botol 100 ml Botol - - - Rp 151,250.00 Rp - - - Rp 151,250.00 Rp - -
254 L L242-17DAK Larutan EDTA 100 ml Botol Botol - - - Rp 150,000.00 Rp - - - Rp 150,000.00 Rp - -
255 L L243-17DAK Larutan Eosin 2% 100 ml Botol Botol - - - Rp 355,500.00 Rp - - - Rp 355,500.00 Rp - -
256 L L003-16KAT Larutan Eosin 2% 100mL Botol 100 ml Botol - - - Rp 357,500.00 Rp - - - Rp 357,500.00 Rp - -
257 L L244-17DAK Larutan Giemsa 100 ml Botol Botol - 2 2 Rp 719,000.00 Rp 1,438,000.00 2 - Rp 719,000.00 Rp - 2
258 L L106-16KAT Larutan Giemsa Stain btl 100 ml botol - 2 2 Rp 719,812.50 Rp 1,439,625.00 2 - Rp 719,812.50 Rp - 2
259 L L205-16KAT Larutan HCL 0,1 % btl 100 ml botol - - - Rp 41,250.00 Rp - - - Rp 41,250.00 Rp - -
260 L L245-17DAK Larutan HCl 0,1% 100 ml Botol Botol - 1 1 Rp 48,500.00 Rp 48,500.00 1 - Rp 48,500.00 Rp - 1
261 L L206-16KAT Larutan KOH 0,1 % 100mL btl 100 ml botol - - - Rp 42,625.00 Rp - - - Rp 42,625.00 Rp - -
262 L L246-17DAK Larutan KOH 0,1% 100 ml Botol Botol - - - Rp 41,880.00 Rp - - - Rp 41,880.00 Rp - -
263 L L006-16KAT Larutan Lugholy Botol 100 ml Botol - - - Rp 94,875.00 Rp - - - Rp 94,875.00 Rp - -
264 L L247-17DAK Larutan Lugoly 100 ml Botol Botol - - - Rp 94,000.00 Rp - - - Rp 94,000.00 Rp - -
265 L L024-16KAT Larutan Metilen blue botol 100 ml Botol - - - Rp 94,875.00 Rp - - - Rp 94,875.00 Rp - -
266 L L248-17DAK Larutan Metilen Blue Botol Botol - - - Rp 94,000.00 Rp - - - Rp 94,000.00 Rp - -
267 L L207-16KAT Larutan NACL 0,86 % btl 100 ml botol - 1 1 Rp 31,625.00 Rp 31,625.00 1 - Rp 31,625.00 Rp - 1
268 L L249-17DAK Larutan NaCl 0,86% 100 ml Botol Botol - 1 1 Rp 31,220.00 Rp 31,220.00 1 - Rp 31,220.00 Rp - 1
269 L L025-16KAT Larutan Rees Hecker botol 100 ml Botol - - - Rp 94,875.00 Rp - - - Rp 94,875.00 Rp - -
270 L L250-17DAK Larutan Res Eker Botol Botol - - - Rp 94,000.00 Rp - - - Rp 94,000.00 Rp - -
271 L L009-16KAT Larutan Turk Botol 100 ml Botol - - - Rp 48,125.00 Rp - - - Rp 48,125.00 Rp - -
272 L L251-17DAK Larutan Turk Botol Botol - - - Rp 47,850.00 Rp - - - Rp 47,850.00 Rp - -

273 L L252-17DAK Larutan Xilol Botol Botol - - - Rp 143,000.00 Rp - - - Rp 143,000.00 Rp - -
274 L L010-16KAT Larutan Xylol Botol 100 ml Botol - - - Rp 144,375.00 Rp - - - Rp 144,375.00 Rp - -
275 L L222-17PRO Larvasida BTI 30 ml Box @ 24 Botol Botol - - - Rp 15,295.00 Rp - - - Rp 15,295.00 Rp - -
276 L L253-17DAK LDL-C SELECT FS Kecil - PROLINE KIT KIT - - - Rp 6,700,660.00 Rp - - - Rp 6,700,660.00 Rp - -
277 L L254-17DAK Lexapram Sirup Box @ 50 Botol Botol - - - Rp 2,950.00 Rp - - - Rp 2,950.00 Rp - -
278 L L255-17DAK Lidocaine Injeksi 2% (HCl) Box @ 100 Ampul Ampul 99 - 99 Rp 1,280.00 Rp 126,720.00 - 99 Rp 1,280.00 Rp 126,720.00 -
279 L L103-16DAK Lidokain injeksi 2 % ( HCL ) + Epineprin Ampul ampul 31 - 31 Rp 2,122.00 Rp 65,782.00 31 - Rp 2,122.00 Rp - 34
280 L L104-16DAK Lidokain Injeksi 2% Vial Vial - - - Rp 875.00 Rp - - - Rp 875.00 Rp - -
281 L L256-17DAK Loratadine Kaplet 10 mg Box @ 100 Kaplet Kaplet 350 1,000 1,350 Rp 134.00 Rp 180,900.00 550 800 Rp 134.00 Rp 107,200.00 605
282 L L257-17DAK Lysol 1 Liter Botol Botol - 10 10 Rp 53,300.00 Rp 533,000.00 10 - Rp 53,300.00 Rp - 11
283 M M014.14NKAT Magnetsium sulfat 40 % injecsi ktk 10 vial vial 11 - 11 Rp 6,044.00 Rp 66,484.00 - 11 Rp 6,044.00 Rp 66,484.00 -
284 M M233-17DAK Malaria HRP2/pLDH (Pf/PAN) Combo Cassete 25 Test/Dus Box @ 25 Test Box - - - Rp 452,000.00 Rp - - - Rp 452,000.00 Rp - -
285 M M211-16DAK Masflu Tablet kotak @100 tab tablet - - - Rp 350.00 Rp - - - Rp 350.00 Rp - -
286 M M218-17DAK Masker Jilbab OM box box - 10 10 Rp 22,000.00 Rp 220,000.00 10 - Rp 22,000.00 Rp - 11
287 M M234-17DAK Medeco Syringe 0,05 ml ADS Kotak @ 100 Blister Blister - - - Rp 2,120.00 Rp - - - Rp 2,120.00 Rp - -
288 M M235-17DAK Medeco Syringe 0,5 ml ADS Kotak @ 100 Blister Blister - - - Rp 1,700.00 Rp - - - Rp 1,700.00 Rp - -
289 M M209-16KAT Medico Spuit 0.05cc Pcs Pcs 80 - 80 Rp 2,238.51 Rp 179,080.80 - 80 Rp 2,238.51 Rp 179,080.80 -
290 M M210-16KAT Medico Spuit 0.5cc Pcs Pcs - - - Rp 1,785.78 Rp - - - Rp 1,785.78 Rp - -
291 M M236-17DAK Metformin HCl Tablet/Kapsul/Kaplet 500 mg Kaplet @ 100 mg Kaplet 2,550 1,000 3,550 Rp 103.00 Rp 365,650.00 1,900 1,650 Rp 103.00 Rp 169,950.00 2,090
292 M M237-17DAK Methilprednisolon 4 mg Tablet Box @ 100 Tablet Tablet - - - Rp 165.00 Rp - - - Rp 165.00 Rp - -
293 M M238-17DAK Methylprednisolone Injeksi 125 mg/ml Box @ 1 Vial Vial - - - Rp 12,801.00 Rp - - - Rp 12,801.00 Rp - -
294 M M027-16DAK Metilergometrin Maleat 0,125 mg Tablet Salut Kotak @ 100 tab Tablet 500 500 1,000 Rp 270.60 Rp 270,600.00 400 600 Rp 270.60 Rp 162,360.00 440
295 M M239-17DAK Metilergometrin Maleat inj 0,2 mg/ml Box @ 100 Ampul Ampul - - - Rp 3,278.00 Rp - - - Rp 3,278.00 Rp - -
296 M M212-16DAK Metilprednisolon Injeksi 125mg/mL Ampul Ampul - - - Rp 14,750.00 Rp - - - Rp 14,750.00 Rp - -
297 M M204-16DAK Metilprednisolon tablet 4 mg ktk 100 tab tablet 2,000 2,000 4,000 Rp 209.00 Rp 836,000.00 2,200 1,800 Rp 209.00 Rp 376,200.00 2,420
298 M M240-17DAK Metoklopramide 10 mg Tablet Box @ 100 Tablet Tablet 600 - 600 Rp 93.00 Rp 55,800.00 400 200 Rp 93.00 Rp 18,600.00 440
299 M M105-16DAK Metoklopramide tab 10 mg Kotak @ 100 tab Tablet - - - Rp 100.00 Rp - - - Rp 100.00 Rp - -
300 M M205-16DAK Metronidazol infus btl 100 ml botol 48 48 96 Rp 22,000.00 Rp 2,112,000.00 48 48 Rp 22,000.00 Rp 1,056,000.00 53
301 M M241-17DAK Metronidazol Infus 5 mg/ml Botol 100 cc Botol - - - Rp 9,680.00 Rp - - - Rp 9,680.00 Rp - -
302 M M206.14KAT Metronidazol supositoria 500 mg ktk 10 tab tablet - - - Rp 3,655.00 Rp - - - Rp 3,655.00 Rp - -
303 M M242-17DAK Metronidazole 500 mg Kotak @ 100 Tablet Tablet 500 500 1,000 Rp 115.00 Rp 115,000.00 - 1,000 Rp 115.00 Rp 115,000.00 -
304 M M243-17DAK Metronidazole Syr 125 mg Kotak @ 50 Botol Botol 10 - 10 Rp 3,800.00 Rp 38,000.00 - 10 Rp 3,800.00 Rp 38,000.00 -
305 M M244-17DAK MgSO4 20 Injeksi Ampul Ampul 20 20 40 Rp 3,200.00 Rp 128,000.00 20 20 Rp 3,200.00 Rp 64,000.00 22
306 M M245-17DAK MgSO4 40 Injeksi Ampul Ampul - - - Rp 3,650.00 Rp - - - Rp 3,650.00 Rp - -
307 M M215-17PRO Mineral mix Kotak @ 40 sach sach - - - Rp 2,727.00 Rp - - - Rp 2,727.00 Rp - -
308 M M246-17DAK Mirasic 500 mg Box @ 100 Tablet Tablet - - - Rp 495.00 Rp - - - Rp 495.00 Rp - -
309 M M214-16DAK Multivitamin Anak + DHA Botol 60 mL Botol 179 72 251 Rp 9,450.00 Rp 2,371,950.00 119 132 Rp 9,450.00 Rp 1,247,400.00 131
310 N N221-17DAK Natrium Diklofenak Tablet 25 mg Box @ 50 Tablet Tablet 2,300 1,500 3,800 Rp 150.00 Rp 570,000.00 2,800 1,000 Rp 150.00 Rp 150,000.00 3,080
311 N N222-17DAK Natrium Diklofenak Tablet 50 mg Box @ 50 Tablet Tablet 2,500 1,500 4,000 Rp 135.00 Rp 540,000.00 3,100 900 Rp 135.00 Rp 121,500.00 3,410
312 N N100KAT15 Natrium Klorida (NaCl) Infus 0,9 % btl 500 ml botol 143 60 203 Rp 5,170.00 Rp 1,049,510.00 62 141 Rp 5,170.00 Rp 728,970.00 68
313 N N223-17DAK Natrium Phenytoin 50 mg/ml Injeksi Box @ 100 Ampul Ampul 24 - 24 Rp 6,231.00 Rp 149,544.00 - 24 Rp 6,231.00 Rp 149,544.00 -
314 N N207BKAHP15 NGT , Terumo Tube 16 FR pcs pcs - - - Rp 10,010.00 Rp - - - Rp 10,010.00 Rp - -
315 N N204BKAHP15 NGT , Terumo Tube 5 FR pcs pcs - - - Rp 8,841.00 Rp - - - Rp 8,841.00 Rp - -
316 N N207-16DAK NGT No 16 AXIMED pcs pcs 5 - 5 Rp 8,917.00 Rp 44,585.00 3 2 Rp 8,917.00 Rp 17,834.00 3
317 N N105.14NKAT NGT No 18 pcs pcs - - - Rp 21,000.00 Rp - - - Rp 21,000.00 Rp - -
318 N N106-16DAK NGT no.20 AXIMED pcs Pcs - - - Rp 8,917.70 Rp - - - Rp 8,917.70 Rp - -
319 N N224-17DAK Nifedipin 10 mg Box @ 100 Tablet Tablet 400 - 400 Rp 110.00 Rp 44,000.00 400 - Rp 110.00 Rp - 440
320 N N209-16DAK Nifedipin tablet/kapsul 10 mg 10 tablet salut ktk 100 tab tablet 500 500 1,000 Rp 123.00 Rp 123,000.00 400 600 Rp 123.00 Rp 73,800.00 440
321 N N212-16DAK Nistatin Suspensi 100.000 ui/mL Botol 12 mL Botol - - - Rp 24,200.00 Rp - - - Rp 24,200.00 Rp - -
322 N N225-17DAK Non Contact Infrared Thermofinder, FS 300 Unit Unit - - - Rp 360,000.00 Rp - - - Rp 360,000.00 Rp - -
323 N N226-17DAK Nystatin Vaginal Tablet 100.000 IU Box @ 100 Tablet Tablet 370 - 370 Rp 627.00 Rp 231,990.00 - 370 Rp 627.00 Rp 231,990.00 -
324 N N227-17DAK Nystatin Vaginal Tablet 500.000 IU Box @ 100 Tablet Tablet - - - Rp 881.00 Rp - - - Rp 881.00 Rp - -
325 O O220-17PRO OAM Box @ 9 Tablet Cure - - - Rp 43,288.00 Rp - - - Rp 43,288.00 Rp - -
326 O O216-17BUF OAT FDC Anak Paket Paket - - - Rp - Rp - - - Rp - Rp - -
327 O O215-17BUF OAT FDC Kat. I Paket Paket - - - Rp 359,985.00 Rp - - - Rp 359,985.00 Rp - -
328 O O015-16DAK Obat Batuk Hitam ( OBH ) Cairan botol 100 ml Botol 133 72 205 Rp 8,000.00 Rp 1,640,000.00 95 110 Rp 8,000.00 Rp 880,000.00 105
329 O O222-17DAK Obat FDC Anak Paket Paket - - - Rp 257,125.00 Rp - - - Rp 257,125.00 Rp - -
330 O O004-16DAK Object Glass 7101 Kotak 72 Pcs Kotak - - - Rp 21,904.15 Rp - - - Rp 21,904.15 Rp - -
331 O O223-17DAK Object Glass 7101 OM (Box Isi 72) Box Box - - - Rp 22,005.15 Rp - - - Rp 22,005.15 Rp - -
332 O O224-17DAK Omeprazole Kapsul 20 mg Box @ 30 Kapsul Kapsul 1,500 1,500 3,000 Rp 148.00 Rp 444,000.00 1,770 1,230 Rp 148.00 Rp 182,040.00 1,947
333 O O213-16DAK Onemed Tes Kehamilan Pcs Pcs - - - Rp 1,958.40 Rp - - - Rp 1,958.40 Rp - -
334 O O211-16DAK Oxytocin ampul ampul 73 50 123 Rp 1,900.00 Rp 233,700.00 59 64 Rp 1,900.00 Rp 121,600.00 65
335 O O225-17DAK Oxytocin Injeksi 10 IU Box @ 100 Ampul Ampul - - - Rp 1,900.00 Rp - - - Rp 1,900.00 Rp - -
336 P P203-16DAK Parasetamol sirup 60ml btl 60 ml botol 184 100 284 Rp 1,119.00 Rp 317,796.00 170 114 Rp 1,119.00 Rp 127,566.00 187
337 P P237-17DAK Parasetamol Tablet 500 mg Kotak @ 100 Tablet Tablet 12,600 8,300 20,900 Rp 51.00 Rp 1,065,900.00 11,900 9,000 Rp 51.00 Rp 459,000.00 13,090
338 P P254-17DAK Pehavral Tablet Box @ 100 Tablet Tablet 1,000 1,000 2,000 Rp 935.00 Rp 1,870,000.00 1,000 1,000 Rp 935.00 Rp 935,000.00 1,100
339 P P248-17DAK Phenoxymetil Penisillin 250 mg Tablet Box @ 100 Tablet Tablet 400 - 400 Rp 403.00 Rp 161,200.00 - 400 Rp 403.00 Rp 161,200.00 -
340 P P230-17BUF Phytomenadion 10 mg/Vit.K Kotak @ 100 tab Tablet - - - Rp 796.00 Rp - - - Rp 796.00 Rp - -
341 P P206-16DAK Piracetam 3 gr/15mL injeksi ktk 4 amp ampul - - - Rp 11,000.00 Rp - - - Rp 11,000.00 Rp - -
342 P P249-17DAK Pirantel Syr 125 mg Box @ 50 Botol Botol 12 - 12 Rp 10,835.00 Rp 130,020.00 5 7 Rp 10,835.00 Rp 75,845.00 6
343 P P116-16DAK Piridoxin B6 10 mg tablet botol 100 tab Tablet - - - Rp 52.00 Rp - - - Rp 52.00 Rp - -
344 P P239-17DAK Plester 5 x 5 m Roll Roll 12 10 22 Rp 30,888.00 Rp 679,536.00 10 12 Rp 30,888.00 Rp 370,656.00 11
345 P P250-17DAK Plester 5 x 5 m Roll Roll - - - Rp 30,888.00 Rp - - - Rp 30,888.00 Rp - -
346 P P211.14KAT Polikresulen cairan Ktk 10 Botol @ 10ml botol - - - Rp 18,635.00 Rp - - - Rp 18,635.00 Rp - -
347 P P232-17PRO Polio Oral /BOPV Kotak @ 10 vial Vial - - - Rp 18,370.00 Rp - - - Rp 18,370.00 Rp - -
348 P P117 Postinur tablet tab Tablet - - - Rp 9,695.00 Rp - - - Rp 9,695.00 Rp - -
349 P P117.14NKAT Postinur tablet ktk 2 tab kotak - - - Rp 9,690.00 Rp - - - Rp 9,690.00 Rp - -
350 P P251-17DAK Prednison Tablet 5 mg Box @ 100 Tablet Tablet 900 500 1,400 Rp 85.00 Rp 119,000.00 700 700 Rp 85.00 Rp 59,500.00 770
351 P P217-16DAK Primakuin 15 mg Tablet Tablet tablet 180 - 180 Rp 258.00 Rp 46,440.00 - 180 Rp 258.00 Rp 46,440.00 -
352 P P252-17DAK Primaquine 15 mg Tablet Box @ 100 Tablet Tablet - - - Rp 258.00 Rp - - - Rp 258.00 Rp - -
353 P P253-17DAK Prohem Injeksi 1 ml Box @ 5 Ampul Ampul 101 50 151 Rp 11,000.00 Rp 1,661,000.00 - 151 Rp 11,000.00 Rp 1,661,000.00 -
354 P P228-17PRO Prokain Benzil Penicilin3 jt KTK 30 vial vial - - - Rp 9,908.00 Rp - - - Rp 9,908.00 Rp - -
355 P P222.14KAT Providon Iodida larutan 10 % btl 300ml botol - 24 - Rp 15,386.00 Rp - - - Rp 15,386.00 Rp - -
356 P P223.14KAT Providon Iodida larutan 10 % btl 30 ml botol - - - Rp 2,344.00 Rp - - - Rp 2,344.00 Rp - -

357 P P224.14KAT Providon Iodida larutan 10 % btl 1000 ml botol - - - Rp 40,202.00 Rp - - - Rp 40,202.00 Rp - -
358 P P226-17PRO Pyrimethamin 25mg Kotak @ 100 tab Tablet - - - Rp - Rp - - - Rp - Rp - -
359 Q Q226-17PRO Quinin inj 250mg ktk 100 amp ampul - - - Rp 6,820.00 Rp - - - Rp 6,820.00 Rp - -
360 R R008-16DAK Rak Tabung Reaksi Multipurpose pcs Pcs - - - Rp 94,000.00 Rp - - - Rp 94,000.00 Rp - -
361 R R219-17DAK Rak Tabung Reaksi Multipurpose Piece Piece - - - Rp 94,736.25 Rp - - - Rp 94,736.25 Rp - -
362 R R209-16DAK Ramabion kotak 10x10 tab Tablet - - - Rp 246.67 Rp - - - Rp 246.67 Rp - -
363 R R210-17DAK Ranitidin Injeksi 25 mg /ml Box @ 10 Ampul Ampul 64 - 64 Rp 1,677.00 Rp 107,328.00 64 - Rp 1,677.00 Rp - 70
364 R R220-17DAK Ranitidin Injeksi 25 mg /ml Box @ 10 Ampul Ampul - - - Rp 1,677.00 Rp - - - Rp 1,677.00 Rp - -
365 R R202-16DAK Ranitidine 150 mg tablet ktk 100 tab tablet - - - Rp 119.00 Rp - - - Rp 119.00 Rp - -
366 R R221-17DAK Ranitidine Kaplet 150 mg Box @ 100 Tablet Tablet - - - Rp 110.00 Rp - - - Rp 110.00 Rp - -
367 R R214-17PRO RDT DBD Combo Box @ 25 Test Box - - - Rp 115,236.00 Rp - - - Rp 115,236.00 Rp - -
368 R R212-17PRO RDT IgG / IgM Box @ 25 Test Box - - - Rp 37,500.00 Rp - - - Rp 37,500.00 Rp - -
369 R R114-16KAT Resperidon tablet 2 mg ktk 50 tab Tablet 200 - 200 Rp 495.00 Rp 99,000.00 - 200 Rp 495.00 Rp 99,000.00 -
370 R R105.15PRO Retinol ( Vitamin A ) 100.000 IU kaps botol @ 50 kaps kapsul - - - Rp 268.00 Rp - - - Rp 268.00 Rp - -
371 R R106-16DAK Retinol ( Vitamin A ) 200.000 IU kaps botol @ 50 kaps kapsul - - - Rp 374.00 Rp - - - Rp 374.00 Rp - -
372 R R222-17DAK Retinol (Vitamin A) 200.000 IU Botol @ 50 Kapsul Kapsul - - - Rp 585.00 Rp - - - Rp 585.00 Rp - -
373 R R223-17DAK Retinol 100.000 UI Botol @ 50 Kapsul Kapsul - - - Rp 327.00 Rp - - - Rp 327.00 Rp - -
374 R R211-17DAK Ringer Laktat Box @ 20 Botol Botol 247 - 247 Rp 7,150.00 Rp 1,766,050.00 247 - Rp 7,150.00 Rp - 272
375 R R224-17DAK Ringer Laktat Kotak @ 20 Botol Botol - 200 200 Rp 7,150.00 Rp 1,430,000.00 85 115 Rp 7,150.00 Rp 822,250.00 94
376 R R225-17BUF Ringer Laktat Box @ 20 Botol Botol - - - Rp 7,150.00 Rp - - - Rp 7,150.00 Rp - -
377 S S409-17PRO safety bok pcs Pieces - - - Rp - Rp - - - Rp - Rp - -
378 S S201-16DAK Safety Box Pcs Pcs - - - Rp 19,565.35 Rp - - - Rp 19,565.35 Rp - -
379 S S418-17BUF Salbutamol 2 mg tablet tablet - - - Rp 68.00 Rp - - - Rp 68.00 Rp - -
380 S S440-17DAK Salbutamol 2 mg Tablet Box @ 100 Tablet Tablet 2,300 1,000 3,300 Rp 82.00 Rp 270,600.00 1,800 1,500 Rp 82.00 Rp 123,000.00 1,980
381 S S441-17DAK Salep 2-4, Kombinasi : Asam Salisilat 2% + Belerang endap 4% Box @ 24 Pot Pot 66 24 90 Rp 2,907.00 Rp 261,630.00 27 63 Rp 2,907.00 Rp 183,141.00 30
382 S S442-17DAK Salmonella Paratyphi AH Widal Test (Vial 5 ml) LORNE LABORATORIES Vial Vial - - - Rp 66,660.00 Rp - - - Rp 66,660.00 Rp - -
383 S S443-17DAK Salmonella Paratyphi AO Widal Test (Vial 5 ml) LORNE LABORATORIES Vial Vial - - - Rp 66,660.00 Rp - - - Rp 66,660.00 Rp - -
384 S S444-17DAK Salmonella Paratyphi BH Widal Test (Vial 5 ml) LORNE LABORATORIES Vial Vial - - - Rp 66,660.00 Rp - - - Rp 66,660.00 Rp - -
385 S S445-17DAK Salmonella Paratyphi BO Widal Test (Vial 5 ml) LORNE LABORATORIES Vial Vial - - - Rp 66,660.00 Rp - - - Rp 66,660.00 Rp - -
386 S S446-17DAK Salmonella Paratyphi CH Widal Test (Vial 5 ml) LORNE LABORATORIES Vial Vial - - - Rp 66,660.00 Rp - - - Rp 66,660.00 Rp - -
387 S S447-17DAK Salmonella Paratyphi CO Widal Test (Vial 5 ml) LORNE LABORATORIES Vial Vial - - - Rp 66,660.00 Rp - - - Rp 66,660.00 Rp - -
388 S S448-17DAK Salmonella Typhi H Widal Test (Vial 5 ml) LORNE LABORATORIES Vial Vial - - - Rp 66,660.00 Rp - - - Rp 66,660.00 Rp - -
389 S S449-17DAK Salmonella Typhi O Widal Test (Vial 5 ml) LORNE LABORATORIES Vial Vial - - - Rp 66,660.00 Rp - - - Rp 66,660.00 Rp - -
390 S S450-17DAK Samconal 500 mg Box @ 100 Tablet Tablet - - - Rp 435.60 Rp - - - Rp 435.60 Rp - -
391 S S451-17DAK Sefadroksil Kapsul 500 mg Kotak @ 100 Kapsul Kapsul - - - Rp 455.00 Rp - - - Rp 455.00 Rp - -
392 S S205-16DAK Sefadroksil sir kering 250 mg/5 mL btl 60 ml botol 1 - 1 Rp 5,910.00 Rp 5,910.00 1 - Rp 5,910.00 Rp - 1
393 S S452-17DAK Sefadroksil sirup kering 125 mg/ 5 ml Box @ 50 Botol Botol 58 - 58 Rp 4,133.00 Rp 239,714.00 5 53 Rp 4,133.00 Rp 219,049.00 6
394 S S208-16DAK Sefotaksim injeksi 1 g ktk 10 Vial vial 69 20 89 Rp 5,884.00 Rp 523,676.00 20 69 Rp 5,884.00 Rp 405,996.00 22
395 S S209-16DAK Seftriakson serbuk injeksi 1 g/vial ktk 2 Vial vial 89 20 109 Rp 11,000.00 Rp 1,199,000.00 20 89 Rp 11,000.00 Rp 979,000.00 22
396 S S301-16BUF Semen Seng Fosfat Serbuk sachet sachet - - - Rp 130,000.00 Rp - - - Rp 130,000.00 Rp - -
397 S S453-17DAK Serum Anti Bisa Ular Injeksi 0 Vial 2 2 4 Rp 1,220,000.00 Rp 4,880,000.00 4 - Rp 1,220,000.00 Rp - 4
398 S S107-16DAK Sianocobalamin ( Vitamin B12 ) injeksi Ampul ampul - - - Rp 1,226.00 Rp - - - Rp 1,226.00 Rp - -
399 S S023-16DAK Sianokobalamin (vit.B12) 50 mcg Tablet Botol 1000 tablet Tablet - - - Rp 14.19 Rp - - - Rp 14.19 Rp - -
400 S S454-17DAK Sianokobalamin (Vitamin B12) Injeksi 500 mcg Box @ 100 Ampul Ampul 100 - 100 Rp 1,117.00 Rp 111,700.00 100 - Rp 1,117.00 Rp - 110
401 S S455-17DAK Silk 3/0 + Jarum 1/2 GT 35 mm ONEMED Box @ 36 Piece Box 11 5 16 Rp 143,000.00 Rp 2,288,000.00 5 11 Rp 143,000.00 Rp 1,573,000.00 6
402 S S215-16DAK Simvastatin scored tablet 10 mg ktk 30 tab tablet - - - Rp 135.00 Rp - - - Rp 135.00 Rp - -
403 S S456-17DAK Simvastatin Tablet 10 mg 0 Tablet - 900 900 Rp 113.00 Rp 101,700.00 - 900 Rp 113.00 Rp 101,700.00 -
404 S S419-17DAK Siprofloksasin 500mg Box @ 100 Tablet Tablet 100 - 100 Rp 254.00 Rp 25,400.00 100 - Rp 254.00 Rp - 110
405 S S471-17PRO Slide Box Buah Buah - - - Rp 41,342.00 Rp - - - Rp 41,342.00 Rp - -
406 S S407-17PRO Spuit 0,05 CC Kotak @ 100 pcs Pieces - - - Rp 1,995.00 Rp - - - Rp 1,995.00 Rp - -
407 S S406-17PRO Spuit 0,5 CC Kotak @ 100 pcs Pieces - - - Rp 3,085.00 Rp - - - Rp 3,085.00 Rp - -
408 S S408-17PRO Spuit 5 CC Kotak @ 100 pcs Pieces - - - Rp 3,974.00 Rp - - - Rp 3,974.00 Rp - -
409 S S458-17DAK Sterile Scalpel Blade 10 F 3 HDL Box Box - - - Rp 325,000.00 Rp - - - Rp 325,000.00 Rp - -
411 S S460-17DAK Sterile Scalpel Blade 18 Box Box - - - Rp 325,000.00 Rp - - - Rp 325,000.00 Rp - -
415 S S403-16DAK Streptomisin serbuk Injeksi 1000 mg/vial Vial Vial - - - Rp 5,750.00 Rp - - - Rp 5,750.00 Rp - -
416 S S464-17DAK Sulfadiazine Silver Krim 1% Tube Tube 14 - 14 Rp 20,700.00 Rp 289,800.00 10 4 Rp 20,700.00 Rp 82,800.00 11
417 S S465-17DAK Surgical Glove Sterile Gynecolog - 7,5 (Elbow Length) REMEDI Pasang Pasang 40 - 40 Rp 20,358.00 Rp 814,320.00 - 40 Rp 20,358.00 Rp 814,320.00 -
418 S S466-17DAK Surgical Glove Sterile with powder - 7,5 REMEDI Pasang Pasang - - - Rp 5,499.00 Rp - - - Rp 5,499.00 Rp - -
419 S S467-17DAK Surgical Mask Earloop ONEMED Box Box - - - Rp 28,600.00 Rp - - - Rp 28,600.00 Rp - -
420 S S468-17DAK Syringe 1 cc Box @ 100 Piece Box 6 - 6 Rp 102,090.00 Rp 612,540.00 6 - Rp 102,090.00 Rp - 7
421 S S469-17DAK Syringe 5 cc Box @ 100 Piece Box - - - Rp 114,144.00 Rp - - - Rp 114,144.00 Rp - -
422 S S470-17DAK Syringe Disposable With Needle 3 cc TERUMO Box @ 100 Piece Piece 300 300 600 Rp 818.00 Rp 490,800.00 300 300 Rp 818.00 Rp 245,400.00 330
423 T T322-17DAK Tablet Tambah Darah Box @ 30 Tablet Tablet - - - Rp 410.00 Rp - - - Rp 410.00 Rp - -
424 T T323-17DAK Tabung Oksigen Besar 6 m3 + Trolley + Regulator Set Set - - - Rp 5,600,000.00 Rp - - - Rp 5,600,000.00 Rp - -
425 T T324-17DAK Tabung Oksigen Kecil 1 m3 + Trolley + Regulator Set Set - - - Rp 3,200,000.00 Rp - - - Rp 3,200,000.00 Rp - -
426 T T303-17PRO TD Kotak @ 10 vial Vial - - - Rp 14,710.00 Rp - - - Rp 14,710.00 Rp - -
427 T T217-16DAK Termometer Digital Cooler Thermometer pcs pcs - - - Rp 128,238.00 Rp - - - Rp 128,238.00 Rp - -
428 T T001EKAT15 Terumo Disp Syringe With Needle 1 cc Tuberculin Ktk 100 pcs pcs - 300 300 Rp 1,540.00 Rp 462,000.00 - 300 Rp 1,540.00 Rp 462,000.00 -
429 T T002EKAT15 Terumo Disp Syringe With Needle 10 cc Tuberculin Ktk 100 pcs pcs 760 - 760 Rp 1,790.00 Rp 1,360,400.00 - 760 Rp 1,790.00 Rp 1,360,400.00 -
430 T T004-16KAT Terumo Disp Syringe With Needle 3 cc Tuberculin Ktk 100 pcs pcs 147 - 147 Rp 4,600.00 Rp 676,200.00 147 - Rp 4,600.00 Rp - 162
431 T T003EKAT15 Terumo Disp Syringe With Needle 5 cc Tuberculin Ktk 100 pcs pcs 396 300 696 Rp 1,348.00 Rp 938,208.00 330 366 Rp 1,348.00 Rp 493,368.00 363
432 T T202.14NKAT Tes KIT Borag Pag 50 tes Pag 50 tes - - - Rp 200,000.00 Rp - - - Rp 200,000.00 Rp - -
433 T T325-17DAK Test Kit Borax Set Set - - - Rp 652,500.00 Rp - - - Rp 652,500.00 Rp - -
434 T T326-17DAK Test Kit Formalin Set Set - - - Rp 652,500.00 Rp - - - Rp 652,500.00 Rp - -
435 T T327-17DAK Test Kit Sakarin Set Set - - - Rp 1,055,500.00 Rp - - - Rp 1,055,500.00 Rp - -
436 T T328-17DAK Test Rhodamin B Set Set - - - Rp 772,000.00 Rp - - - Rp 772,000.00 Rp - -
437 T T329-17DAK Tetagam P. Preffilled Syringe 1 ml Ampul Ampul - - - Rp 170,000.00 Rp - - - Rp 170,000.00 Rp - -
438 T T009.14KAT Tetrakain HCl tetes mata 0,5% btl 5ml botol - - - Rp 11,500.00 Rp - - - Rp 11,500.00 Rp - -
439 T T330-17DAK Tetrasiklin Kapsul 250 mg Box @ 100 Kapsul Kapsul - - - Rp 181.00 Rp - - - Rp 181.00 Rp - -
440 T T331-17DAK Thermometer Higro Tanpa Kabel Roll Roll - - - Rp 100,000.00 Rp - - - Rp 100,000.00 Rp - -
441 T T216-16DAK Thermometer Suhu R pcs pcs - - - Rp 17,688.00 Rp - - - Rp 17,688.00 Rp - -
442 T T309-17BUF Thiamfenicol syr/ Diodicol botol 60ml botol - - - Rp 9,900.00 Rp - - - Rp 9,900.00 Rp - -
443 T T332-17DAK Thiamin (Vit. B1) Tablet Box @ 100 Tablet Tablet 100 - 100 Rp 87.00 Rp 8,700.00 100 - Rp 87.00 Rp - 110
444 T T333-17DAK TOTAL PROTEIN FS Kecil - PROLINE KIT KIT - - - Rp 400,630.00 Rp - - - Rp 400,630.00 Rp - -
445 T T104EKAT15 Tramadol injeksi 50 mg/ml ktk 10 ampul ampul - - - Rp 2,680.00 Rp - - - Rp 2,680.00 Rp - -
446 T T213.14KAT Trifluoperazin tablet 5 mg Kotak @ 100 Tablet Tablet - - - Rp 445.00 Rp - - - Rp 445.00 Rp - -
447 T T334-17DAK TRIGLYCERIDES FS Besar - PROLINE KIT KIT - - - Rp 6,219,850.00 Rp - - - Rp 6,219,850.00 Rp - -
448 T T102-16DAK Triheksipenidil 2 mg tab Kotak @ 100 tab Tablet 60 - 60 Rp 97.00 Rp 5,820.00 60 - Rp 97.00 Rp - 66
449 T T335-17DAK TRUCAL U CALIBRATOR UNIVERSAL KIT KIT - - - Rp 1,545,730.00 Rp - - - Rp 1,545,730.00 Rp - -
450 T T336-17DAK TRULAB N KONTOR NORMAL - PROLINE KIT KIT - - - Rp 2,216,620.00 Rp - - - Rp 2,216,620.00 Rp - -
451 U U200-16DAK Underpad ( Ukuran 60 x 90 cm) Steril Pcs Pcs - - - Rp 9,494.52 Rp - - - Rp 9,494.52 Rp - -
452 U U206-17DAK Underpad (Soft Pad 60*90) Pack Pack 5 - 5 Rp 52,030.00 Rp 260,150.00 5 - Rp 52,030.00 Rp - 6
453 U U207-17DAK UREA FS Sedang - PROLINE KIT KIT - - - Rp 1,342,230.00 Rp - - - Rp 1,342,230.00 Rp - -
454 U U208-17DAK URIC ACID FS TBHBA - PROLINE KIT KIT - - - Rp 1,702,260.00 Rp - - - Rp 1,702,260.00 Rp - -
455 U U209-17DAK Urine Bag Standart Steril 2 lt ONEMED Piece Piece 44 - 44 Rp 7,550.40 Rp 332,217.60 - 44 Rp 7,550.40 Rp 332,217.60 -
456 U U101-16DAK Urine bag steril pcs Pcs - - - Rp 3,735.00 Rp - - - Rp 3,735.00 Rp - -
457 U U210-17DAK USG Gel 250 ml Blue Tutup Ulir Botol Botol 1 - 1 Rp 16,359.20 Rp 16,359.20 - 1 Rp 16,359.20 Rp 16,359.20 -
458 V V410-17PRO Vaksin Carrer pcs Pieces - - - Rp - Rp - - - Rp - Rp - -
459 V V201-17DAK Valdimex Injeksi 5 mg Box @ 5 Ampul Ampul - - - Rp 12,100.00 Rp - - - Rp 12,100.00 Rp - -
460 V V411-17PRO VAR Kotak @ 1 Vial Vial - - - Rp 78,500.00 Rp - - - Rp 78,500.00 Rp - -
461 V V101-16DAK Ventolin Nebulizer kotak 20 ampul ampul - - - Rp 4,000.00 Rp - - - Rp 4,000.00 Rp - -
462 V V100-16DAK Vitamin B Complek Tab botol 100 tab Tablet - - - Rp 49.00 Rp - - - Rp 49.00 Rp - -
463 V V202-17DAK Vitamin B Komplek Tablet Box @ 100 Tablet Box 5,400 - 5,400 Rp 132.00 Rp 712,800.00 4,400 1,000 Rp 132.00 Rp 132,000.00 4,840
464 V V203-17DAK Vitamin B6 Tablet Box @ 100 Tablet Box 1,300 - 1,300 Rp 136.00 Rp 176,800.00 200 1,100 Rp 136.00 Rp 149,600.00 220
465 W W002-16DAK Wing Needle 23G kotak 100pcs pcs 100 - 100 Rp 1,743.00 Rp 174,300.00 - 100 Rp 1,743.00 Rp 174,300.00 -
466 X X003-17DAK Xylocaine (Lidocaine) 10% Spray Botol Botol - - - Rp 170,400.00 Rp - - - Rp 170,400.00 Rp - -
467 X X004-17DAK Xylocaine (Lidocaine) 2% Jelly 10 Tube Syringe Syringe - - - Rp 40,000.00 Rp - - - Rp 40,000.00 Rp - -
468 Z Z306-17DAK Zinc Sirup 20mg/5ml Box @ 50 Botol Botol - - - Rp 4,959.00 Rp - - - Rp 4,959.00 Rp - -
469 Z Z303-17PRO Zinc tablet Kotak @ 100 tab Tablet 500 - 500 Rp 592.00 Rp 296,000.00 - 500 Rp 592.00 Rp 296,000.00 -
470 Z Z307-17DAK Zinc Tablet Dispersible 20 mg Tablet @ 100 mg Tablet 1,270 - 1,270 Rp 586.00 Rp 744,220.00 - 1,270 Rp 586.00 Rp 744,220.00 -
471 Z Z302-16DAK Zinpro Drop botol 15mL botol 158 - 158 Rp 11,700.00 Rp 1,848,600.00 40 118 Rp 11,700.00 Rp 1,380,600.00 44
472 A A327-18DAK Alkohol swab Kotak @ 200 Pieces Kotak - - - Rp 37,100.00 Rp - - - Rp 37,100.00 Rp - -
473 A A328-18DAK Abate 25kg Drum Drum - - - Rp 2,655,400.00 Rp - - - Rp 2,655,400.00 Rp - -
474 A A329-18DAK Atropin injeksi 0,25mg/mL Kotak @ 100 Ampul Ampul - - - Rp 1,815.00 Rp - - - Rp 1,815.00 Rp - -
475 A A330-18DAK AESCULAP BLADES NO.10 Kotak Kotak - - - Rp 325,000.00 Rp - - - Rp 325,000.00 Rp - -
481 A A336-18DAK Albendazole 0 Tablet - - - Rp 216.00 Rp - - - Rp 216.00 Rp - -
482 A A337-18DAK Alkohol 70 % 300 ml Kotak @ 24 Botol Botol - - - Rp 10,400.00 Rp - - - Rp 10,400.00 Rp - -
483 A A338-18DAK Alkohol 70% 1 Liter Kotak @ 12 Botol Botol - - - Rp 27,000.00 Rp - - - Rp 27,000.00 Rp - -
484 A A339-18DAK Alprazolam 0.5 mg tab Kotak @ 100 Tablet Tablet - - - Rp 88.00 Rp - - - Rp 88.00 Rp - -
485 A A340-18DAK Aluporinol tablet 100 mg Kotak @ 100 Tablet Tablet - - - Rp 99.00 Rp - - - Rp 99.00 Rp - -
486 A A341-18DAK Alupurinol tablet 300 mg Kotak @ 30 Tablet Tablet 3,480 2,100 5,580 Rp 216.00 Rp 1,205,280.00 2,880 2,700 Rp 216.00 Rp 583,200.00 3,168
487 A A342-18DAK Aminofilin injeksi 24 mg/ml Kotak @ 30 Ampul Ampul - - - Rp 2,878.00 Rp - - - Rp 2,878.00 Rp - -
488 A A343-18DAK Amitriptilin tablet salut 25 mg Kotak @ 100 Tablet Tablet 120 - 120 Rp 168.00 Rp 20,160.00 5 115 Rp 168.00 Rp 19,320.00 6
489 A A344-18DAK Amlodipin tablet 10mg 0 Tablet - - - Rp 95.00 Rp - - - Rp 95.00 Rp - -
490 A A345-18DAK Amlodipin tablet 5 mg 0 Tablet - - - Rp 75.00 Rp - - - Rp 75.00 Rp - -
491 A A346-18DAK Ammonia Reagent Set 0 Set - - - Rp 4,050,000.00 Rp - - - Rp 4,050,000.00 Rp - -
492 A A347-18DAK Amoxicilin 250 mg Kapsul Kotak @ 100 Tablet Tablet 8,000 1,000 9,000 Rp 196.00 Rp 1,764,000.00 1,700 7,300 Rp 196.00 Rp 1,430,800.00 1,870
493 A A348-18DAK Amoxicilin sirup forte 250mg 0 Botol - - - Rp 3,604.00 Rp - - - Rp 3,604.00 Rp - -
494 A A349-18DAK Amoxicilin sirup kering 125 mg/5 ml 0 Botol - - - Rp 1,919.00 Rp - - - Rp 1,919.00 Rp - -
495 A A350-18DAK Antasida DOEN 200 mg tablet Kotak @ 100 Tablet Tablet 2,000 - 2,000 Rp 56.00 Rp 112,000.00 - 2,000 Rp 56.00 Rp 112,000.00 -
496 A A351-18DAK Antasida DOEN II Sirup 0 Botol - - - Rp 2,098.00 Rp - - - Rp 2,098.00 Rp - -

497 A A352-18DAK ANTI A GOL DARAH Vial Vial - - - Rp 81,836.36 Rp - - - Rp 81,836.36 Rp - -
498 A A353-18DAK ANTI AB GOL DARAH Vial Vial - - - Rp 106,146.36 Rp - - - Rp 106,146.36 Rp - -
499 A A354-18DAK ANTI B GOL DARAH Vial Vial - - - Rp 81,836.36 Rp - - - Rp 81,836.36 Rp - -
500 A A355-18DAK Anti bacteri DOEN (Bacitrasin) 0 Tube - - - Rp 3,490.00 Rp - - - Rp 3,490.00 Rp - -
501 A A356-18DAK ANTI D GOL DARAH Vial Vial - - - Rp 127,706.36 Rp - - - Rp 127,706.36 Rp - -
502 A A357-18DAK Anti HBS 0 Box - - - Rp 997,500.00 Rp - - - Rp 997,500.00 Rp - -
503 A A358-18DAK Antifungi Salep 0 Tube 28 - 28 Rp 5,170.00 Rp 144,760.00 - 28 Rp 5,170.00 Rp 144,760.00 -
504 A A359-18DAK Aqua Pro injecsi steril 25 ml Kotak @ 120 Ampul Ampul - - - Rp 2,860.00 Rp - - - Rp 2,860.00 Rp - -
505 A A360-18DAK Aquadestilata steril 1000 ml Kotak @ 10 Botol Botol - 10 10 Rp 12,100.00 Rp 121,000.00 10 - Rp 12,100.00 Rp - 11
506 A A361-18DAK Asam Asetil Salisilat 80mg (Asetosal) Kotak @ 100 Tablet Tablet 2,000 - 2,000 Rp 99.00 Rp 198,000.00 1,800 200 Rp 99.00 Rp 19,800.00 1,980
507 A A362-18DAK Asam Askorbat (Vitamin C) tablet 50 mg Kotak @ 100 Tablet Tablet - - - Rp 120.00 Rp - - - Rp 120.00 Rp - -
508 A A363-18DAK Asam Folat 1mg Kotak @ 100 Tablet Tablet 1,350 - 1,350 Rp 81.00 Rp 109,350.00 - 1,350 Rp 81.00 Rp 109,350.00 -
509 A A364-18DAK Asam Mefenamat 500 mg tab Kotak @ 100 Tablet Tablet - - - Rp 103.00 Rp - - - Rp 103.00 Rp - -
510 A A365-18DAK Asam Traneksamat injecsi 50 mg/ml Kotak @ 10 Ampul Ampul 25 - 25 Rp 1,813.00 Rp 45,325.00 - 25 Rp 1,813.00 Rp 45,325.00 -
511 A A366-18DAK Asam Urat Reagent 0 Box - - - Rp 2,134,000.00 Rp - - - Rp 2,134,000.00 Rp - -
512 A A367-18DAK Asering Wida Bes Kotak @ 20 Botol Botol 40 - 40 Rp 9,646.00 Rp 385,840.00 5 35 Rp 9,646.00 Rp 337,610.00 6
513 A A368-18DAK Asiklovir tablet 400 mg Kotak @ 50 Tablet Tablet 500 500 1,000 Rp 425.00 Rp 425,000.00 50 950 Rp 425.00 Rp 403,750.00 55
514 A A369-18DAK ASTO 0 Box - - - Rp 1,108,500.00 Rp - - - Rp 1,108,500.00 Rp - -
515 A A370-18DAK Atapulgit tablet 600 mg Kotak @ 100 Tablet Tablet - - - Rp 149.00 Rp - - - Rp 149.00 Rp - -
516 A A371-18DAK 3D Normal 0 Kit - - - Rp 616,000.00 Rp - - - Rp 616,000.00 Rp - -
517 B B230-18DAK BIOSAT 1,5 Ampul Ampul - - - Rp - Rp - - - Rp - Rp - -
518 B B231-18DAK BECTON DICKINSON (BD) Tube edta plh 13X75 3.0 blblce lav 0 Box/ 101 - - - Rp 169,092.00 Rp - - - Rp 169,092.00 Rp - -
519 B B232-18DAK BECTON DICKINSON (BD) Tube pln plh 13X75 4.0 plbl rd 0 Box/ 100 - - - Rp 159,390.00 Rp - - - Rp 159,390.00 Rp - -
520 B B233-18DAK Betametason krim 0.1% 0 0 - - - Rp 1,373.00 Rp - - - Rp 1,373.00 Rp - -
521 B B234-18DAK Blood Lancet Kotak @ 30 Pieces Kotak - - - Rp 29,645.00 Rp - - - Rp 29,645.00 Rp - -
522 B B235-18DAK Blood Transfusion Set 0 Set - - - Rp 4,537.00 Rp - - - Rp 4,537.00 Rp - -
523 B B236-18DAK Blue tips Pack/ 1000' Pack/ 1000' - - - Rp 239,600.00 Rp - - - Rp 239,600.00 Rp - -
524 C C352-18DAK Combivent Kotak @ 20 Vial Vial - - - Rp 4,550.00 Rp - - - Rp 4,550.00 Rp - -

525 C C353-18DAK Combi Screen 11 Sys Plus Botol Botol - - - Rp 281,272.73 Rp - - - Rp 281,272.73 Rp - -
526 C C354-18DAK Carbamazepine 200mg Kotak @ 100 Tablet Tablet - - - Rp 234.00 Rp - - - Rp 234.00 Rp - -
527 C C355-18DAK Cat Gud Chormic 2/0 + jarum 1/2 Gt 35 mm Kotak @ 24 Pieces Kotak - - - Rp 159,000.00 Rp - - - Rp 159,000.00 Rp - -
528 C C356-18DAK Cat Gud Chormic 3/0 + jarum 1/2 Gt 35 mm Kotak @ 24 Pieces Kotak - - - Rp 108,500.00 Rp - - - Rp 108,500.00 Rp - -
529 C C357-18DAK Cat gut plain 2/0 + jarum 1/2 GT 35 mm Kotak @ 24 Pieces Kotak - - - Rp 159,000.00 Rp - - - Rp 159,000.00 Rp - -
530 C C358-18DAK Cefixim syrup 100mg/5mL 0 0 66 - 66 Rp 5,710.00 Rp 376,860.00 - 66 Rp 5,710.00 Rp 376,860.00 -
531 C C359-18DAK Cetrizin kaps 0 0 1,450 1,000 2,450 Rp 97.00 Rp 237,650.00 1,280 1,170 Rp 97.00 Rp 113,490.00 1,408
532 C C360-18DAK Cetrizin sirup 5 mg / ml 0 0 - - - Rp 2,993.00 Rp - - - Rp 2,993.00 Rp - -
533 C C361-18DAK Chloride Reagent Set 0 Set - - - Rp 2,500,000.00 Rp - - - Rp 2,500,000.00 Rp - -
534 C C362-18DAK Cholesterol Reagent 0 Box - - - Rp 770,000.00 Rp - - - Rp 770,000.00 Rp - -
535 C C363-18DAK Clorpromazine 100 mg Tablet Kotak @ 100 Tablet Tablet 900 - 900 Rp 170.00 Rp 153,000.00 183 717 Rp 170.00 Rp 121,890.00 201
536 C C364-18DAK Clorpromazine injeksi 25mg/mL 0 0 - - - Rp 1,435.00 Rp - - - Rp 1,435.00 Rp - -
537 C C365-18DAK Cover Glass 20x20 mm 0 pack - - - Rp 145,000.00 Rp - - - Rp 145,000.00 Rp - -
538 C C366-18DAK C-Reaktif Protein Tes Kit ( latex ) 0 Kit - - - Rp 1,108,500.00 Rp - - - Rp 1,108,500.00 Rp - -
539 C C367-18DAK Creatinin Reagent 0 Box - - - Rp 660,000.00 Rp - - - Rp 660,000.00 Rp - -
540 C C368-18DAK CTM 4 mg tablet Kotak @ 100 Tablet Tablet - - - Rp 24.00 Rp - - - Rp 24.00 Rp - -
541 C C369-18DAK Cyanide Reagent Set 0 Set - - - Rp 2,980,000.00 Rp - - - Rp 2,980,000.00 Rp - -
542 C C370-18DAK Cynovv (Lar. Kimia Fogging) Kotak @ 20 Botol Botol - - - Rp 360,000.00 Rp - - - Rp 360,000.00 Rp - -
543 D D353-18DAK Dekglass 18x18 0 Bh - - - Rp 62,000.00 Rp - - - Rp 62,000.00 Rp - -
544 D D354-18DAK Deksamethason 0.5mg tab Kotak @ 100 Tablet Tablet - - - Rp 34.00 Rp - - - Rp 34.00 Rp - -
545 D D355-18DAK Deksamethason injeksi 5mg/mL 0 0 - - - Rp 1,210.00 Rp - - - Rp 1,210.00 Rp - -
546 D D356-18DAK Dengue Rapid Test Device NS1 Kotak @ 25 Casette Kotak - - - Rp 2,200,000.00 Rp - - - Rp 2,200,000.00 Rp - -
547 D D357-18DAK Diatro Cleaner 0 1L - - - Rp 1,771,000.00 Rp - - - Rp 1,771,000.00 Rp - -
548 D D358-18DAK Diatro Diluent 0 kit - - - Rp 2,618,000.00 Rp - - - Rp 2,618,000.00 Rp - -
549 D D359-18DAK Diazepam Injeksi 5mg/mL 0 0 - - - Rp 1,913.00 Rp - - - Rp 1,913.00 Rp - -
550 D D360-18DAK Diazepam tab 2 mg Kotak @ 100 Tablet Tablet - - - Rp 86.00 Rp - - - Rp 86.00 Rp - -
551 D D361-18DAK Diazepam tab 5 mg Kotak @ 100 Tablet Tablet - - - Rp 109.00 Rp - - - Rp 109.00 Rp - -
552 D D362-18DAK Digoksin tablet Kotak @ 100 Tablet Tablet - - - Rp 104.00 Rp - - - Rp 104.00 Rp - -
553 D D363-18DAK Diltiazem HCl tablet 30 mg 0 0 - - - Rp 136.00 Rp - - - Rp 136.00 Rp - -
554 D D364-18DAK Diphenhydramine Injeksi kotak @ 30 Ampul Ampul - - - Rp 1,262.00 Rp - - - Rp 1,262.00 Rp - -
555 D D365-18DAK Doksisiklin 100mg Kotak @ 100 Kapsul Kapsul 700 - 700 Rp 264.00 Rp 184,800.00 - 700 Rp 264.00 Rp 184,800.00 -
556 D D366-18DAK Domperidon suspensi/sirup 5 mg/5 ml Kotak @ 50 Botol Botol - - - Rp 2,862.00 Rp - - - Rp 2,862.00 Rp - -
557 D D367-18DAK Domperidone tablet 10MG Kotak @ 100 Tablet Tablet - - - Rp 90.00 Rp - - - Rp 90.00 Rp - -
558 D D368-18DAK Dulcolax Supp 10mg 0 0 - - - Rp 5,900.00 Rp - - - Rp 5,900.00 Rp - -
559 D D369-18DAK Dulcolax Supp Infant 5mg 0 0 - - - Rp 6,000.00 Rp - - - Rp 6,000.00 Rp - -
560 E E224-18DAK Examination Glove S Kotak @ 100 Pieces Kotak - - - Rp 90,322.58 Rp - - - Rp 90,322.58 Rp - -
561 E E225-18DAK Examination Glove L Kotak @ 100 Pieces Kotak - - - Rp 89,655.17 Rp - - - Rp 89,655.17 Rp - -
562 E E226-18DAK Examination Glove M Kotak @ 100 Pieces Kotak - - - Rp 53,256.00 Rp - - - Rp 53,256.00 Rp - -
563 E E227-18DAK Efinefrin ( Adrenalin)0,1% Injeksi sebagai HCL Kotak @ 100 Ampul Ampul - - - Rp 1,518.00 Rp - - - Rp 1,518.00 Rp - -
564 E E228-18DAK Elastis Perban 7,5cmx 4,55c Pieces Pieces - - - Rp 27,830.00 Rp - - - Rp 27,830.00 Rp - -
565 E E229-18DAK Elitrol 1 Normal 0 Vial - - - Rp 770,000.00 Rp - - - Rp 770,000.00 Rp - -
566 E E230-18DAK Ergotamin + Kafein 0 0 - - - Rp 199.00 Rp - - - Rp 199.00 Rp - -
567 E E231-18DAK Eritromicin 500 Mg Tablet Kotak @ 100 Tablet Tablet 1,500 - 1,500 Rp 781.00 Rp 1,171,500.00 - 1,500 Rp 781.00 Rp 1,171,500.00 -
568 E E232-18DAK Eritromisin 250mg Tablet Kotak @ 100 Tablet Tablet - - - Rp 636.00 Rp - - - Rp 636.00 Rp - -
569 E E233-18DAK Eritromisin sirup kering 200 mg/ 5 ml 0 0 - - - Rp 6,390.00 Rp - - - Rp 6,390.00 Rp - -
570 F F253-18DAK Fenitoin Injeksi 50mg/mL 0 0 40 40 80 Rp 4,121.00 Rp 329,680.00 - 80 Rp 4,121.00 Rp 329,680.00 -
571 F F254-18DAK Fenobarbital 30mg Tab Kotak @ 100 Tablet Tablet - - - Rp 197.00 Rp - - - Rp 197.00 Rp - -
572 F F255-18DAK Fenobarbital Injeksi i.m.50 mg/ml 0 0 - - - Rp 2,135.00 Rp - - - Rp 2,135.00 Rp - -
573 F F256-18DAK Fitominadion ( Vit K 1) tablet salut gula 10mg 0 0 1,000 - 1,000 Rp 818.00 Rp 818,000.00 - 1,000 Rp 818.00 Rp 818,000.00 -
574 F F257-18DAK Frescoplast 2,5cm x 4,5cm 0 roll - - - Rp 10,259.00 Rp - - - Rp 10,259.00 Rp - -
575 F F258-18DAK Frescoplast 5cm x 4,5cm 0 roll - - - Rp 18,968.00 Rp - - - Rp 18,968.00 Rp - -
576 F F259-18DAK Furosemide tab 40 mg Kotak @ 100 Tablet Tablet - - - Rp 79.00 Rp - - - Rp 79.00 Rp - -
577 F F260-18DAK Furusemide injeksi IV/IM/10 /ml Kotak @ 25 Ampul Ampul - - - Rp 1,555.00 Rp - - - Rp 1,555.00 Rp - -
578 G G320-18DAK Glukosa 10% Kotak @ 20 Botol Botol - - - Rp 7,500.00 Rp - - - Rp 7,500.00 Rp - -
579 G G321-18DAK Glukosa 5% Kotak @ 20 Botol Botol 38 - 38 Rp 6,900.00 Rp 262,200.00 10 28 Rp 6,900.00 Rp 193,200.00 11
580 G G322-18DAK Gentamicin Salep Mata 0,3% Kotak @ 24 Tube Tube 148 - 148 Rp 3,075.00 Rp 455,100.00 5 143 Rp 3,075.00 Rp 439,725.00 6
581 G G323-18DAK Gentamisin Tetes Mata 0,3 % Kotak @ 24 Botol Botol - - - Rp 4,885.00 Rp - - - Rp 4,885.00 Rp - -
582 G G324-18DAK Gentamycin 40 mg inj 0 0 10 - 10 Rp 4,036.00 Rp 40,360.00 - 10 Rp 4,036.00 Rp 40,360.00 -
583 G G325-18DAK Glibenklamida tablet 5 mg Kotak @ 100 Tablet Tablet - - - Rp 137.00 Rp - - - Rp 137.00 Rp - -
584 G G326-18DAK Gliklazid tab 60 mg 0 0 - - - Rp 3,014.00 Rp - - - Rp 3,014.00 Rp - -
585 G G327-18DAK Glimepirid 2mg 0 0 - - - Rp 207.00 Rp - - - Rp 207.00 Rp - -
586 G G328-18DAK Glukosa Reagent 0 Box - - - Rp 506,000.00 Rp - - - Rp 506,000.00 Rp - -
587 G G329-18DAK Griseovulvin 500 Mg tablet Kotak @ 100 Tablet Tablet 210 - 210 Rp 975.00 Rp 204,750.00 100 110 Rp 975.00 Rp 107,250.00 110
588 G G330-18DAK Griseufulvin tab 125 mg Kotak @ 100 Tablet Tablet - - - Rp 223.00 Rp - - - Rp 223.00 Rp - -
589 H H227-18DAK Handsrub semprot 500ml Botol Botol - - - Rp 98,000.00 Rp - - - Rp 98,000.00 Rp - -
590 H H228-18DAK Handsrub 5L Ken Ken 5L - - - Rp 630,000.00 Rp - - - Rp 630,000.00 Rp - -
591 H H229-18DAK HbsAg Rapid Test Kotak @ 25 Strip Strip - - - Rp 10,947.00 Rp - - - Rp 10,947.00 Rp - -
592 H H230-18DAK Haloperidol tab 0,5 mg Kotak @ 100 Tablet Tablet - - - Rp 55.00 Rp - - - Rp 55.00 Rp - -
593 H H231-18DAK Haloperidol tab 1,5 mg Kotak @ 100 Tablet Tablet - - Rp 59.00 Rp - - - Rp 59.00 Rp - -
594 H H232-18DAK Haloperidol tablet 5 mg Kotak @ 100 Tablet Tablet - - - Rp 56.00 Rp - - - Rp 56.00 Rp - -
595 H H233-18DAK Handsaplast 0 Box - - - Rp 40,000.00 Rp - - - Rp 40,000.00 Rp - -
596 H H234-18DAK Hanscoen Steril Uk. 7,5 Kotak @ 40 Psg Psg - - - Rp 6,732.00 Rp - - - Rp 6,732.00 Rp - -
597 H H235-18DAK Hanscoen Panjang Steril( Gynecologi)7,5 inc 0 Pcs - - - Rp 19,800.00 Rp - - - Rp 19,800.00 Rp - -
598 H H236-18DAK HCT 25 mg Kotak @ 100 Tablet Tablet - - - Rp 178.00 Rp - - - Rp 178.00 Rp - -
599 H H237-18DAK HDL Cholesterol Reagent 0 Box - - - Rp 1,540,000.00 Rp - - - Rp 1,540,000.00 Rp - -
600 H H238-18DAK Hidrokortison krim 2.5% 0 0 - - - Rp 2,533.00 Rp - - - Rp 2,533.00 Rp - -
601 H H239-18DAK Handsoon L Kotak @ 50 Psg Kotak - - - Rp 90,300.11 Rp - - - Rp 90,300.11 Rp - -
602 H H240-18DAK Hanscoon S Kotak @ 50 Psg Kotak - - - Rp 90,300.11 Rp - - - Rp 90,300.11 Rp - -
603 I I241-18DAK Ibuprofen 200 mg Kotak @ 100 Tablet Tablet - - - Rp 112.00 Rp - - - Rp 112.00 Rp - -
604 I I242-18DAK Ibuprofen 400mg Kotak @ 100 Tablet Tablet - - - Rp 127.00 Rp - - - Rp 127.00 Rp - -
605 I I243-18DAK Ibuprofen sirup 100 mg/5 ml 0 0 330 50 380 Rp 2,520.00 Rp 957,600.00 80 300 Rp 2,520.00 Rp 756,000.00 88
606 I I244-18DAK Immersion Oil 0 Box - - - Rp 1,915,000.00 Rp - - - Rp 1,915,000.00 Rp - -
607 I I245-18DAK ISONIAZID (INH) 100mg Kotak @ 100 Tablet Tablet - - - Rp 79.00 Rp - - - Rp 79.00 Rp - -
608 I I246-18DAK Isosorbid dinitrat tab sublingual 5 mg Kotak @ 100 Tablet Tablet 200 - 200 Rp 89.00 Rp 17,800.00 - 200 Rp 89.00 Rp 17,800.00 -
609 I I247-18DAK Iv Cateter no. 20 G Kotak @ 50 Pieces Pieces - - - Rp 7,700.00 Rp - - - Rp 7,700.00 Rp - -
610 I I248-18DAK Iv Cateter no. 22 G Kotak @ 50 Pieces Pieces - - - Rp 7,700.00 Rp - - - Rp 7,700.00 Rp - -
611 K K346-18DAK Ketorolax Injeksi 30mg/mL Kotak @ 100 Ampul Ampul - - - Rp 1,045.00 Rp - - - Rp 1,045.00 Rp - -
612 K K347-18DAK Kapas Pembalut 250 gr Roll roll - - - Rp 28,117.00 Rp - - - Rp 28,117.00 Rp - -
613 K K348-18DAK Kasa hidrofil steril 16 x 16 cm Kotak @ 16 Pads Kotak - - - Rp 8,400.00 Rp - - - Rp 8,400.00 Rp - -
614 K K349-18DAK Kalsium Laktat 500 mg Tablet Kotak @ 100 Tablet Tablet 2,400 - 2,400 Rp 59.00 Rp 141,600.00 2,400 - Rp 59.00 Rp - 2,640
615 K K350-18DAK Kaptopril 25 mg tab Kotak @ 100 Tablet Tablet - - - Rp 80.00 Rp - - - Rp 80.00 Rp - -
616 K K351-18DAK Kaptopril tablet 50 mg Kotak @ 100 Tablet Tablet - - - Rp 143.00 Rp - - - Rp 143.00 Rp - -
617 K K352-18DAK Karbogliserol Tetes Telinga Kotak @ 24 Botol Botol - - - Rp 2,590.00 Rp - - - Rp 2,590.00 Rp - -
618 K K353-18DAK kasa hidrofil steril 40 x 80 cm 0 roll - - - Rp 117,000.00 Rp - - - Rp 117,000.00 Rp - -
619 K K354-18DAK Kasa Pembalut hirofil uk. 4 m x 10 cm 0 roll - - - Rp 1,750.00 Rp - - - Rp 1,750.00 Rp - -
620 K K355-18DAK Kasa Pembalut hirofil uk. 4 m x 5 cm 0 roll - - - Rp 900.00 Rp - - - Rp 900.00 Rp - -
621 K K356-18DAK Ketokonazole 200 mg tab Kotak @ 50 Tablet Tablet - - - Rp 286.00 Rp - - - Rp 286.00 Rp - -
622 K K357-18DAK ketokonazole cream 0 0 - - - Rp 2,577.00 Rp - - - Rp 2,577.00 Rp - -
623 K K358-18DAK Kina tablet 222mg 0 0 - - - Rp 801.00 Rp - - - Rp 801.00 Rp - -
624 K K359-18DAK Kloramfenikol kapsul 250 mg Kotak @ 100 Kapsul Kapsul 2,000 - 2,000 Rp 329.00 Rp 658,000.00 - 2,000 Rp 329.00 Rp 658,000.00 -
625 K K360-18DAK Kloramfenikol salep mata 0 0 - - - Rp 1,925.00 Rp - - - Rp 1,925.00 Rp - -
626 K K361-18DAK kodein 10mg 0 0 6 - 6 Rp 657.00 Rp 3,942.00 - 6 Rp 657.00 Rp 3,942.00 -
627 K K362-18DAK Kombinasi Tablet salut Besi (II) sulfat 7H2O 200 mg Asam Folat Kotak @ 30 Tablet Tablet - - - Rp 409.00 Rp - - - Rp 409.00 Rp - -
628 K K363-18DAK Kontrol Reagen 0 Set - - - Rp 1,260,500.00 Rp - - - Rp 1,260,500.00 Rp - -
629 K K364-18DAK Kontrol Reagen 0 Set - - - Rp 6,900,000.00 Rp - - - Rp 6,900,000.00 Rp - -
630 K K365-18DAK Kotrimoksazol DOEN I (Dewasa) Kotak @ 100 Tablet Tablet - - - Rp 125.00 Rp - - - Rp 125.00 Rp - -
631 K K366-18DAK Kotrimoksazol Suspensi 240mg/mL Kotak @ 100 Botol Botol - - - Rp 2,052.00 Rp - - - Rp 2,052.00 Rp - -
632 L L259-18DAK Leukoplast 7,5 CM x 4,55 CM 0 Roll - - - Rp 35,532.00 Rp - - - Rp 35,532.00 Rp - -
633 L L260-18DAK Lidocain Gel 0 0 - - - Rp 41,600.00 Rp - - - Rp 41,600.00 Rp - -
634 L L261-18DAK Lidokain injeksi 2 % ( HCL ) + Epineprin 0 0 270 - 270 Rp 1,317.00 Rp 355,590.00 127 143 Rp 1,317.00 Rp 188,331.00 140
635 L L262-18DAK Lidokain Injeksi 2% Kotak @ 100 Ampul Ampul - - - Rp 1,315.00 Rp - - - Rp 1,315.00 Rp - -
636 L L263-18DAK Lisol 0 Btl 1L - - - Rp 50,666.00 Rp - - - Rp 50,666.00 Rp - -

637 M M250-18DAK Metronidazol infus 0 Botol - - - Rp 8,250.00 Rp - - - Rp 8,250.00 Rp - -
638 M M251-18DAK Magnesium SO4 Injeksi 20% Kotak @ 120 Ampul Ampul - - - Rp 3,328.00 Rp - - - Rp 3,328.00 Rp - -
639 M M252-18DAK Metlergometrin maleat inj 0,2mg/mL Kotak @ 100 Ampul Ampul - - - Rp 3,399.00 Rp - - - Rp 3,399.00 Rp - -
640 M M253-18DAK Magnetsium sulfat 40 % injecsi Kotak @ 120 Ampul Ampul - - - Rp 3,796.00 Rp - - - Rp 3,796.00 Rp - -
641 M M254-18DAK Malaria rapid test Kotak @ 25 Test Kotak - - - Rp 452,750.00 Rp - - - Rp 452,750.00 Rp - -
642 M M255-18DAK Manganese Reagent Set 0 Set - - - Rp 2,000,000.00 Rp - - - Rp 2,000,000.00 Rp - -
643 M M256-18DAK Masker 0 Box - - - Rp 18,500.00 Rp - - - Rp 18,500.00 Rp - -
644 M M257-18DAK Metformin 850mg Kotak @ 100 Tablet Tablet - - - Rp 167.00 Rp - - - Rp 167.00 Rp - -
645 M M258-18DAK Metilergometrin Maleat 0,125 mg Tablet Salut Kotak @ 100 Tablet Tablet 100 - 100 Rp 243.00 Rp 24,300.00 100 - Rp 243.00 Rp - 110
646 M M259-18DAK Metilergometrin Maleat Injeksi 0 0 - - - Rp 3,399.00 Rp - - - Rp 3,399.00 Rp - -
647 M M260-18DAK Metilprednisolon Injeksi 125mg/mL 0 0 - - - Rp 11,449.00 Rp - - - Rp 11,449.00 Rp - -
648 M M261-18DAK Metilprednisolon tablet 16 mg Kotak @ 100 Tablet Tablet 1,000 1,000 2,000 Rp 548.00 Rp 1,096,000.00 900 1,100 Rp 548.00 Rp 602,800.00 990
649 M M262-18DAK Metoklopramide sirup 5mg/ml 0 0 235 50 285 Rp 2,700.00 Rp 769,500.00 90 195 Rp 2,700.00 Rp 526,500.00 99
650 M M263-18DAK Metoklopramide tab 10 mg 0 0 1,000 - 1,000 Rp 83.00 Rp 83,000.00 - 1,000 Rp 83.00 Rp 83,000.00 -
651 M M264-18DAK Metronidazol suspensi 125mg/5mL 0 0 - - - Rp 3,950.00 Rp - - - Rp 3,950.00 Rp - -
652 M M265-18DAK Metronidazol tablet 250 mg Kotak @ 100 Tablet Tablet - - - Rp 93.00 Rp - - - Rp 93.00 Rp - -
653 M M266-18DAK Metronidazole 500mg tab Kotak @ 100 Tablet Tablet - - - Rp 127.00 Rp - - - Rp 127.00 Rp - -
654 M M267-18DAK Miconazol cream 0 0 33 - 33 Rp 3,926.00 Rp 129,558.00 - 33 Rp 3,926.00 Rp 129,558.00 -
655 M M268-18DAK Microscope slide 0 Pack - - - Rp 17,446.00 Rp - - - Rp 17,446.00 Rp - -
656 M M269-18DAK Mikropipet 100-1000µl Unit Unit - - - Rp 3,927,313.00 Rp - - - Rp 3,927,313.00 Rp - -
657 N N228-18DAK NaCl Kotak @ 20 Botol Botol - - - Rp 6,410.00 Rp - - - Rp 6,410.00 Rp - -
658 N N229-18DAK Nistatin Tab Vagina 100.000 IU/g Kotak @ 100 Tablet Tablet - - Rp 645.00 Rp - - - Rp 645.00 Rp - -
659 N N230-18DAK Nasal oxygen canula 0 piece 7 - 7 Rp 6,730.00 Rp 47,110.00 - 7 Rp 6,730.00 Rp 47,110.00 -
660 N N231-18DAK Natrium Diklofenak tablet 25 mg Kotak @ 50 Tablet Tablet - - - Rp 142.00 Rp - - - Rp 142.00 Rp - -
661 N N232-18DAK Natrium Diklofenak tablet 50 mg Kotak @ 50 Tablet Tablet - - - Rp 136.00 Rp - - - Rp 136.00 Rp - -
662 N N233-18DAK NGT No 14 Kotak @ 100 Pieces Pieces - - - Rp 9,045.00 Rp - - - Rp 9,045.00 Rp - -
663 N N234-18DAK NGT No 16 0 Piece - - - Rp 38,728.00 Rp - - - Rp 38,728.00 Rp - -
664 N N235-18DAK NGT No 18 0 Piece - - - Rp 38,733.00 Rp - - - Rp 38,733.00 Rp - -

665 N N236-18DAK NGT no.20 Kotak @ 100 Pieces Pieces - - - Rp 8,870.00 Rp - - - Rp 8,870.00 Rp - -
666 N N237-18DAK Nifedipin tablet/kapsul 10 mg 10 tablet salut Kotak @ 100 Tablet Tablet - - - Rp 107.00 Rp - - - Rp 107.00 Rp - -
667 N N238-18DAK Nistatin 500.000 iu/g Tablet Vagina 0 0 - - - Rp 910.00 Rp - - - Rp 910.00 Rp - -
668 N N239-18DAK NARKOBA TEST Kotak @ 25 Test Kotak - - - Rp 2,557,500.00 Rp - - - Rp 2,557,500.00 Rp - -
669 O O226-18DAK Oxytocin INJ Kotak @ 100 Ampul Ampul - - - Rp 1,232.00 Rp - - - Rp 1,232.00 Rp - -
670 O O227-18DAK OAT FDC KAT II 0 0 - - - Rp 1,492,579.00 Rp - - - Rp 1,492,579.00 Rp - -
671 O O228-18DAK OAT/FDC Kategori Anak 0 0 - - - Rp 267,397.00 Rp - - - Rp 267,397.00 Rp - -
672 O O229-18DAK OAT/FDC Kategori I 0 0 - - - Rp 447,747.00 Rp - - - Rp 447,747.00 Rp - -
673 O O230-18DAK Object Glass 7101 0 box - - - Rp 20,000.00 Rp - - - Rp 20,000.00 Rp - -
674 O O231-18DAK Oksitetrasiklin salep mata 0 0 95 25 120 Rp 2,600.00 Rp 312,000.00 55 65 Rp 2,600.00 Rp 169,000.00 61
675 O O232-18DAK Omeprazol kapsul/kaplet 20 mg 0 0 - - - Rp 138.00 Rp - - - Rp 138.00 Rp - -
676 O O233-18DAK Ondansentron Injeksi Kotak @ 5 Ampul Ampul 110 50 160 Rp 1,198.00 Rp 191,680.00 110 50 Rp 1,198.00 Rp 59,900.00 121
677 P P257-18DAK Paracetamol tablet 500 mg Kotak @ 100 Tablet Tablet - - - Rp 60.00 Rp - - - Rp 60.00 Rp - -
678 P P258-18DAK Parasetamol drop 15mL 0 0 40 - 40 Rp 7,646.00 Rp 305,840.00 - 40 Rp 7,646.00 Rp 305,840.00 -
679 P P259-18DAK Parasetamol sirup 60ml 0 0 - - - Rp 1,160.00 Rp - - - Rp 1,160.00 Rp - -
680 P P260-18DAK Perak sulfadiazin krim 1% Tube Tube - - - Rp 20,700.00 Rp - - - Rp 20,700.00 Rp - -
681 P P261-18DAK Pirantel sirup 125mg 0 0 50 - 50 Rp 11,050.00 Rp 552,500.00 - 50 Rp 11,050.00 Rp 552,500.00 -
682 P P262-18DAK Pirantel tablet score (base) 125 mg 0 0 1,960 - 1,960 Rp 331.00 Rp 648,760.00 100 1,860 Rp 331.00 Rp 615,660.00 110
683 P P263-18DAK Piridoxin B6 10 mg tablet Kotak @ 100 Tablet Tablet - - - Rp 141.00 Rp - - - Rp 141.00 Rp - -
684 P P264-18DAK Plester 5x5 cm Kotak @ 48 Roll Roll 9 - 9 Rp 37,440.00 Rp 336,960.00 2 7 Rp 37,440.00 Rp 262,080.00 2
685 P P265-18DAK Pot Sputum 0 Botol - - - Rp 3,060.00 Rp - - - Rp 3,060.00 Rp - -
686 P P266-18DAK Pot Urine 0 Botol - - - Rp 2,651.00 Rp - - - Rp 2,651.00 Rp - -
687 P P267-18DAK Povidon Iodida larutan 10 % 300ml 0 botol 3 - 3 Rp 21,750.00 Rp 65,250.00 2 1 Rp 21,750.00 Rp 21,750.00 2
688 P P268-18DAK Povidon Iodida larutan 10 % 30ml 0 botol - - - Rp 3,566.00 Rp - - Rp 3,566.00 Rp - -
689 P P269-18DAK Prednison Tablet 5 mg Kotak @ 100 Tablet Tablet - - - Rp 74.00 Rp - - - Rp 74.00 Rp - -
690 P P270-18DAK Proline ALAT (GPT) FS (IFCC mod.) Kemasan Umum - Sedang Kit Kit - - - Rp 1,236,340.00 Rp - - - Rp 1,236,340.00 Rp - -
691 P P271-18DAK Proline Albumin FS 102209910025 Kemasan Umum - Sedang Kit Kit - - - Rp 896,330.00 Rp - - - Rp 896,330.00 Rp - -
692 P P272-18DAK Proline ASAT (GOT) FS (IFCC mod.) Kemasan Umum - Sedang kit kit - - - Rp 1,236,340.00 Rp - - - Rp 1,236,340.00 Rp - -
693 P P273-18DAK Proline Bilirubin Auto Direct FS Kemasan Umum - Kecil Kit Kit - - - Rp 618,472.86 Rp - - - Rp 618,472.86 Rp - -
694 P P274-18DAK Proline Bilirubin Auto Total FS Kemasan Umum - Kecil Kit Kit - - - Rp 605,052.86 Rp - - - Rp 605,052.86 Rp - -
695 P P275-18DAK Proline Cholesterol FS 10' Kemasan Umum - Besar Kit Kit - - - Rp 3,727,620.00 Rp - - - Rp 3,727,620.00 Rp - -
696 P P276-18DAK Proline Creatinine Kemasan Umum - Sedang Kit Kit - - - Rp 927,680.00 Rp - - - Rp 927,680.00 Rp - -
697 P P277-18DAK Proline Gamma-GT FS (Szasz mod./IFCC stand.) Kemasan Umum - Kecil Kit Kit - - - Rp 877,852.86 Rp - - - Rp 877,852.86 Rp - -
698 P P278-18DAK Proline Glucose Hexokinase Kemasan Umum - Sedang Kit Kit - - - Rp 1,650,050.00 Rp - - - Rp 1,650,050.00 Rp - -
699 P P279-18DAK Proline HDL-C Immuno Kemasan Respons910 - Besar Kit Kit - - - Rp 5,884,126.67 Rp - - - Rp 5,884,126.67 Rp - -
700 P P280-18DAK Proline LDL-C Select Kemasan Respons910 - Kecil Kit Kit - - - Rp 6,690,910.00 Rp - - - Rp 6,690,910.00 Rp - -
701 P P281-18DAK Proline Total ProteinKemasan Umum - Kecil Kit Kit - - - Rp 397,546.67 Rp - - - Rp 397,546.67 Rp - -
702 P P282-18DAK Proline Triglycerides Kemasan Umum - Besar Kit Kit - - - Rp 6,212,600.00 Rp - - - Rp 6,212,600.00 Rp - -
703 P P283-18DAK Proline TruCal U Kalibrator Universal Kit Kit - - - Rp 1,533,122.86 Rp - - - Rp 1,533,122.86 Rp - -
704 P P284-18DAK Proline TruLab N Kontrol Normal Kit Kit - - - Rp 2,204,012.86 Rp - - - Rp 2,204,012.86 Rp - -
705 P P285-18DAK Proline Urea FS Kemasan Umum - Sedang Kit Kit - - - Rp 1,332,480.00 Rp - - - Rp 1,332,480.00 Rp - -
706 P P286-18DAK Proline Uric Acid FSKemasan Umum - Sedang Kit Kit - - - Rp 1,692,510.00 Rp - - - Rp 1,692,510.00 Rp - -
707 P P287-18DAK Propanolol tab 10 mg 0 0 2,500 - 2,500 Rp 59.00 Rp 147,500.00 1,000 1,500 Rp 59.00 Rp 88,500.00 1,100
708 R R226-18DAK RL Kotak @ 20 Botol Botol - - - Rp 7,150.00 Rp - - - Rp 7,150.00 Rp - -
709 R R227-18DAK Ranitidin injeksi 25 mg/2 ml 0 0 - - - Rp 1,155.00 Rp - - - Rp 1,155.00 Rp - -
710 R R228-18DAK Reagen Drew 0 Set - - - Rp 6,700,000.00 Rp - - - Rp 6,700,000.00 Rp - -
711 R R229-18DAK Reagen Sysmex : Cellpack (PK-30L) 0 Galon - - - Rp 2,351,500.00 Rp - - - Rp 2,351,500.00 Rp - -
712 R R230-18DAK Reagen Sysmex : Stromatolyser 4DL (FFD-200A) 0 Galon - - - Rp 8,292,000.00 Rp - - - Rp 8,292,000.00 Rp - -
713 R R231-18DAK Reagen Sysmex : Stromatolyser 4DS (FFS-800A) 0 Botol - - - Rp 3,455,500.00 Rp - - - Rp 3,455,500.00 Rp - -
714 R R232-18DAK Reagen Sysmex : Sulfolyser (SLS-210A) 0 Botol - - - Rp 905,000.00 Rp - - - Rp 905,000.00 Rp - -
715 R R233-18DAK Retinol ( Vitamin A ) 100.000 IU kaps 0 0 - - - Rp 331.00 Rp - - - Rp 331.00 Rp - -
716 R R234-18DAK Retinol ( Vitamin A ) 200.000 IU kaps 0 0 - - - Rp 596.00 Rp - - - Rp 596.00 Rp - -
717 R R235-18DAK Rhematoid Factor Tes Kit (latex) 0 Box - - - Rp 1,108,500.00 Rp - - - Rp 1,108,500.00 Rp - -
718 R R236-18DAK Rivanol 300ml 0 botol 49 24 73 Rp 3,500.00 Rp 255,500.00 25 48 Rp 3,500.00 Rp 168,000.00 28
719 S S472-18DAK Spuit Syringe With Needle 3 cc Tuberculin Kotak @ 100 Pieces Pieces - - - Rp 1,138.00 Rp - - - Rp 1,138.00 Rp - -
720 S S473-18DAK Safety Box 0 dus - - - Rp 18,307.00 Rp - - - Rp 18,307.00 Rp - -

721 S S474-18DAK Salbutamol 2 mg tab Kotak @ 100 Tablet Tablet - - - Rp 64.00 Rp - - - Rp 64.00 Rp - -
722 S S475-18DAK Salbutamol 4 mg tab Kotak @ 100 Tablet Tablet 250 - 250 Rp 77.00 Rp 19,250.00 - 250 Rp 77.00 Rp 19,250.00 -
723 S S476-18DAK Salep 2-4 0 0 - - - Rp 3,017.00 Rp - - - Rp 3,017.00 Rp - -
724 S S477-18DAK Sefadroksil sir kering 125mg/5 mL Kotak @ 50 Botol Botol - - - Rp 4,086.00 Rp - - - Rp 4,086.00 Rp - -
725 S S478-18DAK Sefadroksil sir kering 250mg/5 mL 0 0 100 - 100 Rp 5,460.00 Rp 546,000.00 4 96 Rp 5,460.00 Rp 524,160.00 4
726 S S479-18DAK Sefadroxil kapsul 500 mg Kotak @ 100 Tablet Tablet - - - Rp 492.00 Rp - - - Rp 492.00 Rp - -
727 S S480-18DAK Sefotaksim injeksi 1 g 0 0 - - - Rp 4,410.00 Rp - - - Rp 4,410.00 Rp - -
728 S S481-18DAK Seftriakson serbuk injeksi 1 g/vial 0 0 - - - Rp 4,822.00 Rp - - - Rp 4,822.00 Rp - -
729 S S482-18DAK Serum Anti Bisa Ular (ABU) injecsi Vial Vial - - - Rp 479,996.00 Rp - - - Rp 479,996.00 Rp - -
730 S S483-18DAK Spuit Syringe With Needle 1 cc Tuberculin Kotak @ 100 Pieces Kotak - - - Rp 101,000.00 Rp - - - Rp 101,000.00 Rp - -
731 S S484-18DAK Spuit Syringe With Needle 5 cc Tuberculin Kotak @ 100 Pieces Kotak - - - Rp 112,800.00 Rp - - - Rp 112,800.00 Rp - -
732 S S485-18DAK Serum anti Tetanus Biosat Ampul Ampul - - - Rp 130,999.00 Rp - - - Rp 130,999.00 Rp - -
733 S S486-18DAK SGOT Reagent 0 Box - - - Rp 902,000.00 Rp - - - Rp 902,000.00 Rp - -
734 S S487-18DAK SGPT Reagent 0 Box - - - Rp 902,000.00 Rp - - - Rp 902,000.00 Rp - -
735 S S488-18DAK Sianocobalamin ( Vitamin B12 ) injeksi Kotak @ 100 Ampul Ampul - - - Rp 1,087.00 Rp - - - Rp 1,087.00 Rp - -
736 S S489-18DAK Sianokobalamin (vit.B12) 50 mcg Tablet Kotak @ 100 Tablet Tablet 4,000 1,500 5,500 Rp 49.00 Rp 269,500.00 1,600 3,900 Rp 49.00 Rp 191,100.00 1,760
737 S S490-18DAK Silk 3/0 + jarum 1/2 Gt 35 mm 0 box - - - Rp 129,000.00 Rp - - - Rp 129,000.00 Rp - -
738 S S491-18DAK Simvastatin 20mg 0 0 1,500 250 1,750 Rp 225.00 Rp 393,750.00 720 1,030 Rp 225.00 Rp 231,750.00 792
739 S S492-18DAK Simvastatin scored tablet 10 mg Kotak @ 30 Tablet Tablet - - - Rp 110.00 Rp - - - Rp 110.00 Rp - -
740 S S493-18DAK Siprofloxazine tab 500 mg tab Kotak @ 100 Tablet Tablet - - - Rp 281.00 Rp - - - Rp 281.00 Rp - -
741 S S494-18DAK SMI CATGUT CHROMIC SMI 2/0 HR 26 MM 0 sachet - - - Rp 33,630.00 Rp - - - Rp 33,630.00 Rp - -
742 S S495-18DAK SMI CATGUT CHROMIC SMI 3/0HR 26 MM 0 sachet - - - Rp 33,630.00 Rp - - - Rp 33,630.00 Rp - -
743 S S496-18DAK SMI CATGUT PLAIN SMI 2/0 HR 26 MM Kotak @ 12 Sachet sachet - - - Rp 35,130.00 Rp - - - Rp 35,130.00 Rp - -
744 S S497-18DAK SMI silk black 3/0 HR 26 MM 0 sach - - - Rp 20,530.00 Rp - - - Rp 20,530.00 Rp - -
745 S S498-18DAK Smoke analyzer 0 Pcs - - - Rp 9,379,987.50 Rp - - - Rp 9,379,987.50 Rp - -
746 S S499-18DAK Spuit 0.05cc Kotak @ 100 Pieces Pieces - - - Rp 1,609.80 Rp - - - Rp 1,609.80 Rp - -
747 S S500-18DAK Spuit 0.5cc Kotak @ 100 Pieces Pieces - - - Rp 1,479.45 Rp - - - Rp 1,479.45 Rp - -
748 S S501-18DAK Sukralfat syr 0 0 95 50 145 Rp 7,338.00 Rp 1,064,010.00 58 87 Rp 7,338.00 Rp 638,406.00 64

749 S S502-18DAK Sypillis test 0 Kit - - - Rp 540,670.00 Rp - - - Rp 540,670.00 Rp - -
750 T T339-18DAK Tabung Hematokrit Heparin 0 Tube - - - Rp 145,000.00 Rp - - - Rp 145,000.00 Rp - -
751 T T340-18DAK Tabung Serologi 12x75 0 Pack - - - Rp 910,000.00 Rp - - - Rp 910,000.00 Rp - -
752 T T341-18DAK Tetagham 0 0 - - - Rp 176,800.00 Rp - - - Rp 176,800.00 Rp - -
753 T T342-18DAK Tetrasiklin capsul 500 mg Kotak @ 100 Tablet Tablet 1,310 - 1,310 Rp 310.00 Rp 406,100.00 - 1,310 Rp 310.00 Rp 406,100.00 -
754 T T343-18DAK Thiamin (Vit. B1) tab 0 0 4,000 2,000 6,000 Rp 88.00 Rp 528,000.00 1,020 4,980 Rp 88.00 Rp 438,240.00 1,122
755 T T101-16DAK Tramadol kapsul ktk 5 x 10 Tablet 1,200 - 1,200 Rp 329.68 Rp 395,616.00 50 1,150 Rp 329.68 Rp 379,132.00 55
756 T T345-18DAK Trigliserida Reagent 0 Box - - - Rp 1,012,000.00 Rp - - - Rp 1,012,000.00 Rp - -
757 T T346-18DAK Triheksipenidil Kotak @ 100 Tablet Tablet - - - Rp 95.00 Rp - - - Rp 95.00 Rp - -
758 U U212-18DAK Underpad ( Ukuran 60 x 90 cm) Steril Pack @ 10 Pieces Pcs - - - Rp 9,000.00 Rp - - - Rp 9,000.00 Rp - -
759 U U213-18DAK Underpad ( Ukuran 60 x 90 cm) Steril Pack @ 10 Pieces Pcs 5 - 5 Rp 9,000.00 Rp 45,000.00 1 4 Rp 9,000.00 Rp 36,000.00 1
760 U U214-18DAK Ureum Reagent 0 Kit - - - Rp 1,364,000.00 Rp - - - Rp 1,364,000.00 Rp - -
761 U U215-18DAK Urine Bag Standart Steril 2 lt 0 Pcs - - - Rp 5,290.00 Rp - - - Rp 5,290.00 Rp - -
762 U U216-18DAK USG Jell 0 Btl 250ml - - - Rp 14,500.00 Rp - - - Rp 14,500.00 Rp - -
763 V V204-18DAK Vitamin B Complek Tab Kotak @ 100 Tablet Tablet - - - Rp 135.00 Rp - - - Rp 135.00 Rp - -
764 W W003-18DAK WIDAL TES H Vial Vial - - - Rp 80,296.36 Rp - - - Rp 80,296.36 Rp - -
765 W W004-18DAK WIDAL TES O Vial Vial - - - Rp 80,296.36 Rp - - - Rp 80,296.36 Rp - -
766 W W005-18DAK WIDAL TES AO Vial Vial - - - Rp 80,296.36 Rp - - - Rp 80,296.36 Rp - -
767 W W006-18DAK WIDAL TES BO Vial Vial - - - Rp 80,296.36 Rp - - - Rp 80,296.36 Rp - -
768 W W007-18DAK WIDAL TES CO Vial Vial - - - Rp 80,296.36 Rp - - - Rp 80,296.36 Rp - -
769 W W008-18DAK WIDAL TES AH Vial Vial - - - Rp 80,296.36 Rp - - - Rp 80,296.36 Rp - -
770 W W009-18DAK WIDAL TES BH Vial Vial - - - Rp 80,296.36 Rp - - - Rp 80,296.36 Rp - -
771 W W010-18DAK WIDAL TES CH Vial Vial - - - Rp 80,296.36 Rp - - - Rp 80,296.36 Rp - -
772 Y Y001-18DAK Yellow tips Pack/ 200' Pack/ 200' - - - Rp 188,200.00 Rp - - - Rp 188,200.00 Rp - -
773 Z Z308-18DAK Zinc tablet dispersible20 mg Kotak @ 100 Tablet Tablet - - - Rp 604.00 Rp - - - Rp 604.00 Rp - -
774 Z Z309-18DAK Zirkum kids sirup Botol Botol - - - Rp 3,285.00 Rp - - - Rp 3,285.00 Rp - -
775 N N237 Nasal oxygen canula anak piece pieces 10 - 10 Rp 6,733.33 Rp 67,333.30 - 10 Rp 6,733.33 Rp 67,333.30 -
776 T T309-17BUF Thiamfenicol tab kotak tablet - - - Rp 984.00 Rp - - - Rp 984.00 Rp - -

777 P P107 Propiltiuarasil 100 tab kotak tablet 100 - 100 Rp 297.00 Rp 29,700.00 - 100 Rp 297.00 Rp 29,700.00 -
778 F F262-18dak Flucadex kotak kotak - - - Rp 62,810.00 Rp - - Rp 62,810.00 Rp - -
779 T T215-16DAK Tabung reaski 15 x 75 kotak pieces - 100 100 Rp 8,400.00 Rp 840,000.00 100 - Rp 297.00 Rp - -
780 D D359-18DAK Diazepam Injeksi 5mg/mL kotak ampul 12 - 12 Rp 1,913.00 Rp 22,956.00 5 7 Rp 1,913.00 Rp 13,391.00 -
779 K K367-18DAK Kloramfenikol 125mg / sirup kotak @72 botol botol 72 - 72 Rp 16,500.00 Rp 1,188,000.00 - 72 Rp 297.00 Rp 21,384.00 -
778 G G331-18DAK Garam Oralit (Ramolit) kotak kotak 50 - 50 Rp 17,500.00 Rp 875,000.00 - 50 Rp 62,810.00 Rp 3,140,500.00 -
778 P P289-18DAK Piracetam 800mg tab kotak tablet 300 300 600 Rp 803.00 Rp 481,800.00 - 600 Rp 62,810.00 Rp 37,686,000.00 -
778 P P288-18DAK Prohem inj kotak @5 ampul ampul - - - Rp 11,000.00 Rp - - - Rp 62,810.00 Rp - -
781 L L211-16DAK Loperamid tablet 2 mg tablet kotak 1,750 - 1,750 Rp 550.00 Rp 962,500.00 - 1,750 Rp 550.00 Rp 962,500.00 -
778 S S420-17DAK Sulfadiazine Silver Krim 1% box Tube - 5 5 Rp 18,818.00 Rp 94,090.00 - 5 Rp 18,818.00 Rp 94,090.00 -
782 P M220-17DAK Miniaspi 80 mg ( Acetosal) Box @10 x 10 tablet tablet 1,000 - 1,000 Rp 85.45 Rp 85,450.00 - 1,000 Rp 85.45 Rp 85,450.00 -
782 G G333-19DAK GUAFANESIN kotak @100 TABLET tablet 4,300 - 4,300 Rp 107.00 Rp 460,100.00 1,600 2,700 Rp 107.00 Rp 288,900.00 1,760
JUMLAH Rp 111,557,080.90
UMUM JKN JUMLAH RESEP MONITORING R/

GENERIK
JUMLAH KUNJUNGAN RESEP
Mengetahui/Menyetujui Yang Menyerahkan Yang Meminta Yang Menerima
A.n. Kepala Dinas Kesehatan kabupaten Sintang Penanggung Jawab Gudang Farmasi Pimpinan Puskesmas Petugas Puskesmas
KABID YANKES
Rachmat Aseng, S.Sos, M.Si Iin Riana,S.Ssi,Apt Ismail, A.Md,Kep Riyana Purnamasari, A.Md, Far
Pembina Penata Tk I Penata Tk I NIP. -
NIP. 19650406 198703 1 009 NIP. 19790204 201101 2 004 NIP. 19690404198911 1 001 0

Laporan Pemakaian Dan Lembar Permintaan Obat (Lplpo) : Box at 50 Tablet

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Laporan Pemakaian Dan Lembar Permintaan Obat (Lplpo) : Box at 50 Tablet

Uploaded by

Copyright:

Available Formats

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

KODE PUSKESMAS : 0 0 0 0 0 0 0 0 0 0 PEMAKAIAN BULAN : Desember

1 A A297-17DAK Acyclovir Tablet 200 mg Box @ 50 Tablet Tablet - - - Rp 259.00 Rp - - - Rp 259.00 Rp - -

2 A A298-17DAK Acyclovir Tablet 400 mg Box @ 50 Tablet Tablet - - - Rp 415.00 Rp - - - Rp 415.00 Rp - -

3 A A241-16DAK AESCULAP BLADES NO.10 BOX BOX - - - Rp 345,000.00 Rp - - - Rp 345,000.00 Rp - -

4 A A242-16DAK AESCULAP BLADES NO.15 BOX BOX - - - Rp 345,000.00 Rp - - - Rp 345,000.00 Rp - -

5 A A243-16DAK AESCULAP BLADES NO.18 BOX BOX - - - Rp 345,000.00 Rp - - - Rp 345,000.00 Rp - -

6 A A244-16DAK AESCULAP BLADES NO.20 BOX BOX - - - Rp 345,000.00 Rp - - - Rp 345,000.00 Rp - -

7 A A245-16DAK AESCULAP BLADES NO.22 BOX BOX - - - Rp 345,000.00 Rp - - - Rp 345,000.00 Rp - -

8 A A246-16DAK AESCULAP BLADES NO.24 BOX BOX - - Rp 345,000.00 Rp - - - Rp 345,000.00 Rp - -

9 A A271-16BUF Albendazole tab 400mg Botol Tablet - - - Rp 344.00 Rp - - - Rp 344.00 Rp - -

10 A A299-17DAK Alkazyme Sachet 25 mg Pack Pack - - - Rp 801,000.00 Rp - - - Rp 801,000.00 Rp - -

11 A A037.14NKAT Alkohol 70 % 300 ml btl 300 ml botol 7 - 7 Rp 13,000.00 Rp 91,000.00 7 - Rp 13,000.00 Rp - 8

13 A A301-17DAK Alkohol 70% 300 ml Botol Botol 8 - 8 Rp 12,400.00 Rp 99,200.00 8 - Rp 12,400.00 Rp - 9

16 A A257-17BUFF Allupurinol 100 mg Kotak @ 100 tab Tablet - - - Rp 199.00 Rp - - - Rp 199.00 Rp - -

19 A A305-17DAK ALT (GPT) FS Sedang - PROLINE KIT KIT - - - Rp 1,246,090.00 Rp - - - Rp 1,246,090.00 Rp - -

23 A A216-16DAK Amitriptilin tablet salut 25 mg Tablet tablet - - - Rp 165.00 Rp - - - Rp 165.00 Rp - -

32 A A313-17DAK Antasida DOEN I Tablet Kunyah 0 Tablet - - - Rp 59.00 Rp - - - Rp 59.00 Rp - -

40 A A025.14NKAT Aquadestilata steril 500 ml btl 500 ml botol - - - Rp 19,770.00 Rp - - - Rp 19,770.00 Rp - -

41 A A249-17PRO Artesunate inj 250 mg ktk 5 amp ampul - - - Rp 42,900.00 Rp - - - Rp 42,900.00 Rp - -

47 A A323-17DAK AST (GOT) FS Sedang - PROLINE KIT KIT - - - Rp 1,246,090.00 Rp - - - Rp 1,246,090.00 Rp - -

48 A A113-16BUF Atropin injeksi Kotak @ 30 amp Ampul - - - Rp 1,353.00 Rp - - - Rp 1,353.00 Rp - -

51 B B207-16PRO BCG Kotak @ 50 vial Vial - - - Rp 50,460.00 Rp - - - Rp 50,460.00 Rp - -

55 B B222-17DAK BILIRUBIN DIRECT FS Kecil - PROLINE KIT KIT - - - Rp 631,080.00 Rp - - - Rp 631,080.00 Rp - -

56 B B223-17DAK BILIRUBIN TOTAL FS Kecil - PROLINE KIT KIT - - - Rp 601,930.00 Rp - - - Rp 601,930.00 Rp - -

57 B B204.14NKAT Blood Lancet ktk 100 pcs pcs - - - Rp 300.00 Rp - - - Rp 300.00 Rp - -

58 B B229-17PRO Blood Lancet Box Box - - - Rp 35,135.00 Rp - - - Rp 35,135.00 Rp - -

59 B B224-17DAK Blood Lancet 26G OM Box Box - - - Rp 18,207.50 Rp - - - Rp 18,207.50 Rp - -

60 B B228-17PRO Blood Slide Box Box - - - Rp 18,509.00 Rp - - - Rp 18,509.00 Rp - -

61 B B206-16DAK Blood Transfusion Set Pcs Pcs - - - Rp 4,482.00 Rp - - - Rp 4,482.00 Rp - -

65 C C210-17PRO Calci Glukonas inj 1 gr Ktk 24 amp ampul - - - Rp 9,955.00 Rp - - - Rp 9,955.00 Rp - -

67 C C211-17PRO Campak Kotak @ 10 vial Vial - - - Rp 25,641.00 Rp - - - Rp 25,641.00 Rp - -

78 C C346-17DAK CHOLESTEROL FS Besar - PROLINE KIT KIT - - - Rp 3,737,370.00 Rp - - - Rp 3,737,370.00 Rp - -

79 C C347-17DAK Clindamycin Kapsul 300 mg Box @ 50 Kapsul Kapsul - - - Rp 589.00 Rp - - - Rp 589.00 Rp - -

81 C C102-16DAK Clorpromazine 25 mg Tablet Tablet Tablet - - - Rp 170.00 Rp - - - Rp 170.00 Rp - -

82 C C103-16DAK Clorpromazine injeksi 25mg/mL ampul ampul - - - Rp 1,980.00 Rp - - - Rp 1,980.00 Rp - -

84 C C306-16DAK Clozapine Kotak @ 100 Tab Tablet - - - Rp 1,550.00 Rp - - - Rp 1,550.00 Rp - -

85 C C210-16DAK Colortusin Syrup Botol 60mL Botol - - - Rp 3,533.00 Rp - - - Rp 3,533.00 Rp - -

86 C C209-16DAK Colortusin Tablet kotak 100 tab tablet - - - Rp 286.67 Rp - - - Rp 286.67 Rp - -

87 C C348-17DAK Combi Screen 11 Sys Plus Botol Botol - - - Rp 261,621.67 Rp - - - Rp 261,621.67 Rp - -

88 C C111-16KAT COMBIVENT UDV BOX @20 BTL botol - - - Rp 4,995.00 Rp - - - Rp 4,995.00 Rp - -

89 C C349-17DAK Cover Glass 20 x 20 Pack Pack - - - Rp 157,179.69 Rp - - - Rp 157,179.69 Rp - -

90 C C308-16DAK Cover Glass 20x20 mm pak pak - - - Rp 156,550.94 Rp - - - Rp 156,550.94 Rp - -

91 C C350-17DAK CREATININE FS Sedang - PROLINE KIT KIT - - - Rp 937,430.00 Rp - - - Rp 937,430.00 Rp - -

93 C C351-17DAK Curmunos 60 ml syr Kotak @ 24 Botol Botol - - - Rp 57,200.00 Rp - - - Rp 57,200.00 Rp - -

94 D D308-17BUF DEC Tab Box Tablet - - - Rp 135.00 Rp - - - Rp 135.00 Rp - -

99 D D323-17DAK DHA Gold Capsul 0 Botol - - - Rp 465,714.00 Rp - - - Rp 465,714.00 Rp - -

106 D D326-17DAK Difenhidramin Injeksi 10 mg/ml Ampul Ampul - - - Rp 1,222.00 Rp - - - Rp 1,222.00 Rp - -

115 D D214-17PRO DPTHBhib/pentabio Kotak @ 10 vial Vial - - - Rp 63,930.00 Rp - - - Rp 63,930.00 Rp - -

116 D D220-17PRO DT Kotak @ 10 vial Vial - - - Rp 15,550.00 Rp - - - Rp 15,550.00 Rp - -

130 F F200-16DAK Farbion Injecsi ktk 5 Amp ampul - - - Rp 5,172.00 Rp - - - Rp 5,172.00 Rp - -

131 F F236-17DAK Farmadol 50 ml Botol Botol 67 - 67 Rp 38,500.00 Rp 2,579,500.00 10 57 Rp 38,500.00 Rp 2,194,500.00 11

134 F F239-17DAK FDC Kategori II Paket Paket - - - Rp 1,435,178.00 Rp - - - Rp 1,435,178.00 Rp - -

144 F F109BAKHP15 Foley Catheter 2 way no 14 ktk pcs - - - Rp 10,280.00 Rp - - - Rp 10,280.00 Rp - -

145 F F110BAKHP15 Foley Catheter 2 way no 18 ktk pcs - - - Rp 10,280.00 Rp - - - Rp 10,280.00 Rp - -

156 F F215-16DAK Fridep 50mg Kotak @ 30 tab Tablet - - - Rp 2,840.00 Rp - - - Rp 2,840.00 Rp - -

158 F F106-16DAK Furosemide tab 40 mg ktk 10 x 10 tab Tablet - - - Rp 181.73 Rp - - - Rp 181.73 Rp - -

159 G G310-17DAK GAMMA GT FS Kecil - PROLINE KIT KIT - - - Rp 890,460.00 Rp - - - Rp 890,460.00 Rp - -

162 G G302-16DAK GC Fuji IX kotak kotak - - - Rp 1,292,500.00 Rp - - - Rp 1,292,500.00 Rp - -

163 G G312-17DAK GC Fuji LX Piece Piece - - - Rp 1,292,500.00 Rp - - - Rp 1,292,500.00 Rp - -

164 G G303-16DAK GC Fuji VII Pink kotak kotak - - - Rp 1,134,375.00 Rp - - - Rp 1,134,375.00 Rp - -

165 G G313-17DAK GC Fuji VII Pink Piece Piece - - - Rp 1,134,375.00 Rp - - - Rp 1,134,375.00 Rp - -