No Nama Obat Kemasan No.

Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
1 2 4 5 6 ###

2 Abbocath No 14 Pcs 58203KY 38,610.00 - - 50.00 - - - 8.33

1 Abbocath No 16 G Pcs 151109A 8,074.00 - - - - - - -
2 Abbocath No 20 G Pcs 160109SD 8,421.00 - - 400.00 - 50.00 - 75.00
3 Abbocath No 20 G Pcs 151110SA 8,421.00 - - - - - - -
4 Abbocath No 20 G Pcs 141020SA 8,421.00 - - - 50.00 - - 8.33
50 buah /
3 Abbocath No. 24 G 160519SB 421,050.00 - - 6.00 1.00 1.40 2.00 1.73
kotak
7 Acarbose Tab 100 mg ( Box/100 ) - -
6 Acarbose Tab 50 mg ( Box/100 ) - -
4 Acyclovir 200 mg Ktk / 100 tab KC2116J 24,500.00 - - - - - - -
1 Acyclovir Cream 5% tube 1503008 2,860.00 - - 10.00 15.00 - - 25.00 4.17
64 Acyclovir Cream 5% Tube 1702016 3,445.00 55.00 20.00 - - - 180.00 255.00 42.50
104 Al,at suntik 1 ml BOX @ 100 PCS pcs 0 500 870 228.33
106 Al,at suntik 2,5 ml BOX @ 100 PCS pcs 0 0 0 -
107 Al,at suntik 2,5 ml BOX @ 100 PCS pcs 0 0 900 150.00
105 Al,at suntik 5 ml BOX @ 100 PCS pcs 0 500 0 83.33
108 Al,at suntik 5 ml BOX @ 100 PCS pcs 400 0 100 83.33
2 Alat Suntik 2.5 cc Ktk/100 pcs 13022021 320,650.00 4.00 3.00 4.00 9.00 - 3.00 3.83
112 Alat suntik 3 ml Box @ 100 Pcs Pcs 0 100 300 66.67
113 Alat suntik 3 ml Box @ 100 Pcs Pcs 0 0 700 116.67
114 Alat suntik 3 ml Box @ 100 Pcs Pcs 0 0 700 116.67
118 Alat suntik 3 ml Box @ 100 Pcs Pcs 0 10 300 51.67
119 Alat suntik 3 ml Box @ 100 Pcs Pcs 500 1350 0 308.33
3 Alat Suntik 5 cc Ktk/100 pcs 1304201 308,550.00 1.00 6.00 6.00 - 8.00 - 3.50
5 Alat suntik 50 ml Pcs 16F0382003 15,750.00 10.00 - 5.00 5.00 - - 3.33
6 Alat Suntik Sekali Pakai 0,5 ml Pcs 1608401 1,325.00 - - - 50.00 50.00 - 16.67
7 Alat suntik Sekali pakai 1 ml Pcs 1601201 802.00 600.00 - 200.00 350.00 34.00 - 197.33
8 Alat suntik Sekali Pakai 10 ml Pcs 1305201 1,143.00 - 10.00 - 50.00 - 300.00 60.00
9 Alat suntik Sekali pakai 3 ml Pcs 1703201 842.00 1,250.00 1,100.00 900.00 890.00 300.00 - 740.00
10 Alat Suntik Sekali Pakai 5 ml Ktk / 100 bh 130401R 8,800.00 - - 9.00 - - - 1.50
91 Albendazol 400 mg Tablet Kunyah Tab I161484B 308.00 - - - - - - -
11 Albendazol susp 200 mg/5 ml Botol 1703011 4,426.00 - - - - - - -
12 Albendazol tab 400 mg Tab I161483B 308.00 - - - - - 100.00 100.00 16.67
13 Albumin Kit 200000 2,290,200.00 - - 1.00 - - - 1.00 0.17
14 Alinamin tab 5 mg Ktk / 100 tab 11114958 50,500.00 - - - - - - -
4 Alkohol Swab Ktk/100 pcs E52347 18,920.00 - - - - - - -
111 Alkohol Swab 2% Kotak @ 100 Sheet Tablet 0 0 21 3.50
15 Alopurinol tab 100 mg Tab T11051AF 95.00 5,600.00 8,000.00 4,000.00 8,300.00 3,500.00 3,300.00 32,700.00 5,450.00
16 Alprazolam tab 1 mg tablet 170012 184.00 200.00 200.00 200.00 330.00 100.00 70.00 1,100.00 183.33
17 ALT/GPT SL Kit 282800 1,805,650.00 - - 1.00 - - - 0.17
18 Aluminium cotton PCS 150092 533,500.00 - - - - - - -
19 Ambroxol 30mg Tab 24702707 247.50 11,100.00 20,000.00 10,500.00 8,300.00 5,800.00 2,900.00 58,600.00 9,766.67
20 Ambroxol Syr Botol 160971844 8,580.00 385.00 35.00 - - - - 420.00 70.00
45 Aminofluid-L 500ml - -
21 Aminophillin injeksi 24 mg/ml - 10 ml Ktk / 30 amp 15IF031 120,390.00 3.00 - - - - - 3.00 0.50
22 Amiodarone HCl tablet 200 Tablet TB1291 1,298.00 - - - - - - -
23 Amiodarone inj 150mg/3 ml Ampul IJ0023 13,200.00 - - - - - - -

57 Amiodarone IV Generik ( F ) - -

24 Amitriptilin HCl tablet 25 mg Ktk / 100 tab 1407011 9,198.20 5.00 5.00 6.00 3.00 1.00 - 20.00 3.33

33 Amlodipin 5 mg Tab 20G121 91.00 - - - 2,150.00 250.00 900.00 3,300.00 550.00

25 Amlodipin tab 10 mg Tab PK098021 163.00 3,750.00 3,840.00 1,650.00 90.00 - - 9,330.00 1,555.00
26 Amlodipin tab 5 mg tablet 71700020 105.00 4,350.00 6,360.00 4,050.00 3,750.00 5,780.00 3,390.00 27,680.00 4,613.33
27 Amoksisilin sir forte 250 mg/5 ml Botol 5610010 4,147.00 - - - - - - -
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
28 Amoksisilin sir kering 125 mg/5 ml Botol 0504005AG 2,200.00 515.00 500.00 150.00 520.00 530.00 600.00 2,815.00 469.17
29 Amoksisilin tab 250 mg Tab 17030851 207.00 500.00 2,500.00 1,500.00 2,000.00 1,300.00 500.00 8,300.00 1,383.33
30 Amoksisilin tab 500 mg Tab HB018026 233.00 8,300.00 3,900.00 - - - - 12,200.00 2,033.33
65 Amoxicillin 500 mg Tab HJ018439 191.00 600.00 4,000.00 9,200.00 15,800.00 - 900.00 30,500.00 5,083.33
31 Ampicilin Sirker Btl 60ml 17030197 6,160.00 - 100.00 100.00 22.00 10.00 - 232.00 38.67
32 Ampisilin Serb Inj 1000 mg/ml Vial 95436011 11,484.00 - 20.00 - 10.00 - 30.00 60.00 10.00
109 Antalgin 500 mg 10 Strip @ 10 Tablet Tablet 0 900 500 1,400.00 233.33
33 Antalgin tab 500mg Botol/1000 tab 14100101 132,000.00 2.00 3.00 2.00 4.00 4.00 2.00 17.00 2.83
66 Antasida Doen Tab 172170 59.00 10,500.00 8,700.00 7,900.00 9,000.00 8,600.00 4,800.00 49,500.00 8,250.00

34 Antasida, kombinasi : aluminium hidroksida 200 mg + magnesium hidroksida 200 mg Botol S05010AG 2,106.00 305.00 300.00 - 270.00 445.00 300.00 1,620.00 270.00

35 Antifungi salep, kombinasi : asam benzoat 6%+ asam salisilat 3% Tube 17SC043A 4,782.00 50.00 30.00 - - - - 80.00 13.33

Antihemoroid, kombinasi: bismut subgalat 150 mg + heksaklorofen 2,5 mg + lidokain lidokain

36 Supp F71307W 3,502.00 40.00 10.00 - 10.00 - - 60.00 10.00
10 mg+ seng oksida 120 mg + sup ad 2 g
37 Antimigren Tab JIS1366B 224.40 200.00 - - - - - 200.00 33.33
110 Antimigren Ergotamin Tatrat 1 mg + cafein 50 mg Btl @ !00 Tablet Tablet 0 1500 600 2,100.00 350.00
67 Aqua Pro Injeksi Vial 95316003 6,350.00 38.00 10.00 - - 7,000.00 - 7,048.00 1,174.67
30 Arixtra INJ 2,5 mg/0,5 ml ( Box/10 ) - -
38 Arm Sling Pcs 25,740.00 - - - - 5.00 - 0.83
39 Artemether inj 80 mg/ml Ampul 20150712 25,490.00 - - - - - - -
40 Artesunat serb inj 60 mg/ml (i.v./i.m.) Vial LA160923 42,900.00 - - 120.00 - - - 120.00 20.00
5 Artesunate 4 injection vial LA160518 26,316.00 - - 120.00 - 2.00 - 122.00 20.33
41 Asam asetilsalisilat (asetosal) tab 80 mg Tab 161933 123.00 2,300.00 2,000.00 1,700.00 2,200.00 1,500.00 1,500.00 11,200.00 1,866.67
42 Asam askorbat (vitamin C) tab 250 mg Tab H160953B 139.00 5,500.00 6,100.00 400.00 - - - 12,000.00 2,000.00
43 Asam askorbat (vitamin C) tab 50 mg Tab I16045B 120.00 1,000.00 - - - - - 1,000.00 166.67
44 Asam Folat 1 mg Tab 34473 279.40 4,000.00 1,500.00 1,100.00 600.00 500.00 - 7,700.00 1,283.33
45 Asam folat tab 0,4 mg Tab T04014AG 68.00 500.00 - - 500.00 200.00 1,800.00 3,000.00 500.00
46 Asam Mefenamat kaplet 500 mg Ktk / 100 kap 406065 12,683.00 114.00 140.00 90.00 160.00 - - 504.00 84.00
47 Asam Mefenamat kaplet 500 mg Ktk / 100 kap 509463 10,500.00 - - - - 110.00 58.00 168.00 28.00
48 Asam Valpoic (DEPAKENE) Syr Botol 74619XP 41,800.00 - - - - - 8.00 8.00 1.33
49 Asering Larutan Infus Botol 47E86A 9,275.00 160.00 - - - - - 160.00 26.67
32 Asiklofir 400 mg Tab 06304012 415.00 100.00 - - - - 1,150.00 1,250.00 208.33
50 Aspar-K 300 mg Ktk / 100 tab EB715 258,500.00 - - - - - - -
51 Atapulgit 600 mg (NEW ANTIDES) Tab MG0401 173.00 1,900.00 1,000.00 2,000.00 3,600.00 300.00 - 8,800.00 1,466.67
52 Atenolol tab 50 mg Tab TE1521 330.00 - - - - - - -
28 Atorvastatin Calsium Tab 20 mg ( Box/30) - -
53 Atosvastatin 20 mg Tab TD1941 2,625.33 180.00 450.00 30.00 - - - 660.00 110.00
54 Atropin Inj 0,25 mg Ampul 97KJ0079 1,672.00 - - - - 10.00 20.00 30.00 5.00
55 Atrovent 0,025% Larutan 20 ml Botol 15102155 98,000.00 - - - - - 2.00 2.00 0.33
6 ATS 1500 IU Ampul 4700717 126,500.00 - - - - - - -
56 Attapulgite (AKITA) Tab 70408 1,532.30 500.00 1,700.00 - - 1,500.00 2,200.00 5,900.00 983.33
57 Azithromisin tab 500mg tablet C70532J 1,900.00 100.00 200.00 - - - - 300.00 50.00
58 Bahan tambahan GIC (Fuji IX) Pak 170411 482,240.00 - - - - 1.00 - 0.17
59 Bahan tambahan sementara ( Caviton ) Pot 150092 211,640.00 - - - - - - -
60 Bedak salisil serb 2% Botol A80EGA0050 1,066.00 200.00 80.00 50.00 350.00 150.00 60.00 890.00 148.33
56 Beraprost Sodium (Dorner) Tab 20 mg 30's- jkn ( F ) - -
61 Berotec 0,1% Sol 50 ml btl/50 ml 14040465 117,500.00 - - - - - - -
62 Berotec 0,1% Sol 50 ml btl/50 ml 15030572 117,500.00 - 10.00 - - - - 10.00 1.67
63 Betahistine tab 6 mg Tablet 161612 170.00 - 90.00 - - - - 90.00 15.00
115 Betamethason Crem 0,1 % Box 25 Tube @ 5 gram Tube 0 0 0 -
116 Betamethason Crem 0,1 % Box 25 Tube @ 5 gram Tube 0 0 190 190.00 31.67
117 Betamethason Crem 0,1 % Box 25 Tube @ 5 gram Tube 0 100 0 100.00 16.67
64 Bilirubin Direct Kit 161700 1,442,100.00 - - 1.00 - - - 1.00 0.17
65 Bilirubin Total Kit 303100 1,926,650.00 - - 1.00 - - - 1.00 0.17
7 Biomeriux Vkia Pcs I005735560 19,912.00 25.00 - - - - - 25.00 4.17
66 Bisakodil 5 mg Tab 70307 1,411.66 1,400.00 850.00 700.00 350.00 100.00 100.00 3,500.00 583.33
67 Bisakodil sup 10 mg Botol 15040822 5,800.00 - - - - - - -
68 Bisakodil sup 10 mg Botol 15030528 5,800.00 - 10.00 - - - - 10.00 1.67
69 Bisakodil sup 5 mg Botol 15020300 5,670.00 - - - - - - -
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
70 Bisolvon 10 mg/5ml Btl 50 ml 17040477 86,680.00 4.00 - 1.00 1.00 - 2.00 8.00 1.33
4 Bisoprolol 5 mg 600.00 600.00 100.00
103 Blood Lancet Ktk 35,135.00 9.00 - - - - - 1.50
100 Blood Slide Ktk 18,509.00 43.00 - - - - - 7.17
71 Blood Tranfusi Set Pcs 07061785 3,600.00 100.00 300.00 - - 100.00 - 83.33
72 Blue Tip Bks FY1609069 83,160.00 - - 5.00 - - - 0.83
73 Blue Tip Ktng 1000 pcs 161145 72,600.00 - - - - - - -
74 Bonding 6 - Bond Botol N868432 1,475,650.00 - - - - 1.00 - 0.17
75 Bonding Gigi Btl - 230,710.00 - - - - - - -
76 Box Slide Objec Glass Kotak 19,800.00 5.00 - - - - - 5.00 0.83
77 Bromhexin 8 mg (Hustab P) Tab 95029005 344.66 50.00 90.00 - - - - 140.00 23.33
78 Bromhexin HCL Syr (MIRAVON) Btl 60 ml F60681 22,000.00 2.00 - - - - - 2.00 0.33
79 Bromocriptin (CRISPA) Tablet SK2144 8,500.00 - - - - - - -
80 Bucain inj 5 mg/ml 5 ampul/kotak PIG90843 274,642.50 - 3.00 - - - - 3.00 0.50
81 Budenoside Nebulez PCS IF7547A 106,000.00 - - - - - - -
82 Bur Diamaond FG Set Set E03001 329,120.00 - - - - - - -
83 Buret Infus Micro Pcs M270LA 56,628.00 - - - - - - -
84 Burnazin (Silver Suilfadiazine) Tube 0435AM 74,690.00 2.00 2.00 - - - - 4.00 0.67
85 Burnicer ( Medesy ) 477,32 Pcs ZEE1160194 356,290.00 - - - - - - -
86 Ca Gluconas 10 % Ktk / 24 amp 14F0559 187,200.00 - - - - - - -
8 Ca Glukonas Inj Ktk/24 amp 14F0559 10,425.00 - - - - - - -
87 Cairan Developer ( Automatik Processing ) 5 liter Galon 00429 1,212,200.00 - - - - - - -
88 Cairan Fixer ( Automatik Processing ) 5 liter & 600 ml ( A&B ) Galon 3421 1,212,200.00 - - - - - - -
89 Cairan fixer (Automatic Processing) Galon/5 liter 3044 826,850.00 - - - - - - -
38 Cairan infus Glucose 10 % - -
37 Cairan infus Glucose 5% - -
36 Cairan infus Ringer Lactat - -
35 Cairan infus Sodium Chlorida 0,9 % ( NACL 0,9 % ) - -
49 Calcii Gluconas ( Calcium Gluconate ) inj 30.00 30.00 5.00
9 Candesartan 8 mg ( Box/30'S ) 300.00 300.00 50.00
130 Captopril 25 mg 10 Strip 10 Tablet Tablet 0 9500 4100 13,600.00 2,266.67
68 Cat Gut 3/0 DS 24 (Plain) Pcs 1601701 40,985.00 12.00 48.00 24.00 - 2.00 12.00 16.33
30 Cat gut chromic 2/0HR 37 24.00 4.00
29 Cat gut chromic 3/0 HR 37 24.00 4.00
90 Cat Gut Chromic No.0, Taper, HR-45 mm Buah 160701 44,555.00 - - - - - - -
42 Cat gut chromic SMI 3/0 HR 30 MM 24.00 4.00
91 Cat Gut Plain No. 3/0, Taper, HR-37 mm Pcs 170401 36,985.00 48.00 - - - - - 8.00
92 Cat Gut Plain No.0, Taper, HR-37 mm Pcs 160401 36,345.00 - - - - - - -
93 Cat Gut Plain No.4/0, Taper, HR-26 mm Buah 170101 34,115.00 - - - - - - -
94 Cateter No. 10 Folley Two Way Pcs 57H15 22,630.00 - - - - - - -
95 Cateter No. 12 Folley Two Way PCS 209H16 21,700.00 - - - - - - -
96 Cateter No. 14 Folley Two Way Pcs 21H15 21,700.00 - - - - - - -
97 Cateter No. 16 Folley Three Way Pcs 4106996 51,165.00 - - - - - - -
98 Cateter No. 16 Folley Two Way Pcs 240H16 21,700.00 - - - 100.00 10.00 - 18.33
99 Cateter No. 18 Folley Two Way pcs 2091116 21,700.00 - - - - - - -
100 Cateter No. 8 Folley Two Way pcs 57H15 22,630.00 - - - - - - -
101 Cateter Umbilical No. 5 pcs 951214 80,300.00 - - - - - - -
102 Cateter Umbilical No. 6 pcs 369R13 80,300.00 - - - - - - -
103 Cavicur (Ekstrak Curcuma) Tab 752015 1,155.00 800.00 400.00 400.00 - - - 1,600.00 266.67
104 Caviplex Tab 1452022 1,397.00 1,300.00 500.00 1,500.00 1,000.00 1,500.00 2,500.00 8,300.00 1,383.33
69 Cefadroxil 500 mg Kapsul HJ038226 455.00 3,800.00 2,900.00 2,700.00 500.00 144.00 - 10,044.00 1,674.00
105 Cendo Cenfresh Strip MD 7C60905 30,690.00 1.00 - 2.00 1.00 - - 4.00 0.67
106 Cendo Cover 2% Strip MD 7CV60802 21,560.00 - - - - - - -
107 Cendo Eyefresh Strip MD 7EH60815 30,910.00 3.00 - 2.00 2.00 - 2.00 9.00 1.50
108 Cendo Genta 0,3% Strip MD 7G560703 21,120.00 - - - - - - -
109 Cendo Glaoplus Strip MD 7GP60816 128,150.00 - - - - - - -
110 Cendo P-pred Strip MD 7PP60808 53,240.00 - - - - - - -
111 Cepezet 100 (Klorpromazin 100 mg) Tab 170016 1,072.50 - 800.00 300.00 - 800.00 200.00 2,100.00 350.00
112 Certofix 4 F Pcs 17D21A8551 907,500.00 - - - - - - -
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
113 Certofix 5 F Pcs 17C13A8551 907,500.00 - - - - - - -
70 Cetirizin 10 mg Kapsul 06807010 115.00 4,200.00 3,250.00 1,300.00 400.00 100.00 2,300.00 11,550.00 1,925.00
114 Chisel Panjang 954 Pcs 601299 595,760.00 - - - - - - -
115 CHKM Botol 1121705 97,680.00 - - - - - 1.00 0.17
71 Chlorpheniramin Maleat 4 mg Tab 20304710 39.00 10,600.00 8,000.00 1,400.00 4,000.00 1,950.00 8,500.00 34,450.00 5,741.67
116 Cholesterol PAP Kit 260000 2,048,200.00 - - 2.00 - - - 0.33
117 Cilostazol 100 mg (STAZOL) Tab TPN29645 13,064.33 - - - - - - -
118 Cimetidin 200 mg Tab RA2666 163.90 100.00 - - - - - 100.00 16.67
36 Cimetidin 200 mg Tab J60182 248.00 - - - - - - -
31 Ciprofloxacine Infus IV 100.00 100.00 16.67
119 Citicolin 500 mg Tab 215019 10,021.00 150.00 - - - - - 150.00 25.00
120 Clast tab Ktk / 100 tab 13171 220,000.00 - - - - - - -
42 Clindamisin 300 mg - -
10 Clopidogrel Tab 75 mg ( Box/100 ) - -
26 Concor 2 mg JKN ( Box/100 ) 500.00 500.00 83.33
27 Concor 2 mg JKN ( Box/100 ) - -
133 Cotrimoksazole Dewasa 10 Strip @ 10 Tablet Tablet 0 0 5300 5,300.00 883.33
121 Creatinine Kit 242400 1,514,700.00 - - 1.00 - - - 0.17
122 Crescent Knife pcs 201406 176,000.00 - - - - - - -
123 Crescent Knife pcs 201305 230,000.00 - - - - - - -
124 Cresoformalin PCS 106,700.00 - - - - - - -
139 Cut gut Plain 2/0 D5 24 8 Box @ 12` Pcs Pcs 0 0 0 -
125 Cutgut Chromic No.2/0 Taper Point CG811 Pcs DGL2142ZX 107,250.00 62.00 - - - - - 10.33
126 Cuticell 10 cm x 10 cm Pcs 638158 5,448.00 10.00 2.00 - - - 5.00 2.83
1 Cuticell Clasicc 10 cm x 10 cm - -
127 Cyproheptadin 4 mg (GRAPERIDE) Tab XC345A 302.50 - - - - - - -
128 Deksametason inj 5 mg/ml (i.v./i.m.) vial PIC34546 1,745.00 50.00 50.00 120.00 - - 50.00 270.00 45.00
129 Dentin Condisioner ( GC ) 25 g Botol 1704181 435,380.00 - - - - 1.00 - 0.17
130 Depakane Syr botol/ 120ml 54651XP 198,000.00 - 10.00 17.00 11.00 - - 38.00 6.33
131 Dermafix-t 5 x 7 cm Pcs 11032016 1,792.00 - - - 50.00 - - 8.33
40 Dexametason 0,5 mg Tab 00717F0510 45.00 3,400.00 - - - - - 3,400.00 566.67
41 Dexametason 0,5 mg Tab 00717G0440 45.00 6,000.00 11,000.00 11,000.00 9,300.00 - - 37,300.00 6,216.67
132 Diazepam lar rektal 10 mg/2,5 ml Botol U23691704 18,458.00 - - - - - - -
133 Diazepam lar rektal 5 mg/2,5 ml Botol U23681701 12,749.00 - - - - - - -
134 Digoksin tab 0,25 mg Tab A7809EU 108.00 300.00 - - - - - 300.00 50.00
135 Digoksin tab 0,25 mg Tab A7809EU 108.00 - - - - - 200.00 200.00 33.33
37 Digoxin 0,25 mg Tab A7817GT 108.00 - - - 800.00 - - 800.00 133.33
136 Diltiazem 30 mg Ktk/100 tab D130511B 12,600.00 - - - - - - -
137 Diltiazem 30 mg Ktk/100 tab D1404188 13,700.00 6.00 - - - - 5.00 11.00 1.83
8 Diltiazem 30 mg Tab D130511B 126.00 500.00 - - - - - 500.00 83.33
9 Diltiazem 30 mg Tab D140418B 126.00 - - - - - - -
138 Diltiazem tab 30 mg Tab K160619B 128.00 - - 300.00 200.00 300.00 - 800.00 133.33
139 Dimenhidrinat 50 mg (OMEDRINAT) Tab 417349 264.00 1,200.00 600.00 700.00 800.00 1,400.00 - 4,700.00 783.33
140 Dipenhidramin HCl injeksi 10 mg Ktk / 30 amp 141G004 13,768.70 6.00 7.00 3.00 2.00 - - 18.00 3.00
141 Dipenhidramin HCl injeksi 10 mg Ktk / 30 amp 15IC019 11,070.00 - 4.00 - - - - 4.00 0.67
2 Discofix 3 -Way Stopcock 30.00 5.00
142 Dobutamin Inj (INDOP) Vial TC0823 215,600.00 - - - - 20.00 - 20.00 3.33
143 Doksazosin tab 1 mg Tablet 729-82001 3,480.00 - - - - - - -
144 Doksazosin tab 2 mg Tablet 529-82001 5,480.00 - - - - - - -
145 Doksisiklin kaps 100 mg Kaps 1704013 309.00 - 500.00 - 600.00 700.00 200.00 2,000.00 333.33
38 Domperidon 10 mg Tab 47K0394 187.00 3,400.00 4,000.00 600.00 - - - 8,000.00 1,333.33
39 Domperidon 5 mg/ 5 ml Botol 150814186 3,410.00 5.00 - - - - - 5.00 0.83
11 Donperidon Tab 10 mg ( Box/ 100 ) 1,700.00 1,700.00 283.33
50 Dopamin (Catadop) inj 200 mg - -
146 Dopamin inj 40mg/ml Ampul 97LA0019 7,480.00 - - - - - - -
121 Dphenhydramine injeksi 10 mg /ml 30 Ampul @ 1 ml Ampul 0 0 150 150.00 25.00
147 Dulcolax 10 mg/suppo dewasa / Stolax Ktk / 6 supp 15091975 82,225.00 5.00 2.00 - - - - 7.00 1.17
148 Dumin rektal tube 125 mg/2,5 ml 5 tube/kotak T239714 77,436.70 2.00 - - - - - 2.00 0.33
149 Dupaston Tab 353179 11,665.50 - - - - - - -
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
150 E.T.T No.5 UnCuffed PCS 365H16 19,390.00 - - - - - - -
151 EDTA Gel Pcs 612/16 372,680.00 - - - - 1.00 - 0.17
152 EDTA Powder 25 g Botol 121,660.00 - - - - - 2.00 0.33
153 Efedrin 25 mg Tab C160182B 62.92 - - - - - - -
154 Efedrin inj 50 mg/ml Ampul 97LA0025 10,989.00 - 30.00 - - - - 30.00 5.00
155 Ekskavator Pcs AE1150764 360,250.00 - - - - - - -
156 Elastis Verband 6 inci Roll 0 543,101.90 - - - - - 3.00 0.50
157 Elektrode EKG Pcs 7162X 7,150.00 150.00 - 100.00 - - - 41.67
51 Epinephrine Inj 1 mg - -
72 Epineprin Inj Ampul 97LA0058 1,848.00 50.00 135.00 70.00 30.00 12,400.00 160.00 12,845.00 2,140.83
158 Eritromisin sir 200 mg/5 ml Botol AK92038 7,039.00 30.00 60.00 20.00 20.00 - 30.00 160.00 26.67
9 Erythromycin 500 mg tablet Tablet T 2253 AF 766.00 - - 300.00 - - 200.00 500.00 83.33
159 Etching Pcs 953,920.00 - - - - - 1.00 0.17
160 Etil Klorida Spry Btl 170346 139,590.00 4.00 - - 1.00 - - 0.83
73 Etil Klorida Spry Btl 170443 166,980.00 1.00 2.00 2.00 1.00 3.00 14.00 3.83
161 ETT No.2,5 F Pcs 16GG40 112,970.00 - - - - - - -
162 ETT No.3 F Pcs 15HE34 64,350.00 - - - - - - -
163 ETT No.3,5 F Pcs 16FG25 64,350.00 - - - - - - -
164 ETT No.4 F Pcs 15BG08 64,350.00 - - - - - - -
165 ETT No.4,5 F Pcs 14LG02 64,350.00 - - - - - - -
166 ETT No.5 F Pcs 15DE18 64,350.00 - - - - - - -
167 Eugenol Botol D70735W 20,815.00 2.00 2.00 - - - - 4.00 0.67
168 Farbion Inj Ampul TG0293 13,068.00 100.00 30.00 - - - - 130.00 21.67
169 Farelax Vial 78,980.00 - - - - - - -
10 FDC Kategori II paket 95471002-3 1,379,984.00 - - 1.00 - 500.00 - 501.00 83.50
170 Fenobarbital inj Ktk/30 amp 75803001 56,700.00 - - - - - - -
171 Fenobarbital 30 mg btl/100 tab 1309004 5,800.00 1.00 - - - - - 1.00 0.17
65 Fenobarbital inj 30 mg/ml - -
66 Fenobarbital inj 30 mg/ml - -
11 Fenobarbital inj 50mg/ml Ktk/30 amp 658030041 56,700.00 - - - - - - -
172 Fenobarbital injeksi Ktk / 30 Amp 75803002 56,700.00 - - - 1.00 - - 1.00 0.17
12 Fenobarbital tab 30 mg Ktk/100 tab 1309004 6,400.00 - - - - - - -
173 Fenoterol HBr cairan ih 0,1% botol 14101863 125,750.00 - - - - - - -
174 Fenoterol HBr cairan ih 0,1% botol 14040465 125,750.00 - - - - - - -
175 Fenoterol HBr cairan ih 0,1% botol 15081859 125,750.00 - - - - - - -
176 Fentanil inj 0,05 mg/ml - 2ml vial 6019 40,000.00 - - - - - - -
177 Fentanyl 0,05mg/2mg Ampul 6019 53,460.00 - - - - - - -
1 Film Rongent 35x35 100 set / kotak 41218 4,887,960.00 - 1.00 - - - 1.00 0.33
178 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m) Vial 6478017 4,083.00 150.00 60.00 55.00 25.00 - 5.00 295.00 49.17
179 Flufenazin inj i.m 25 mg/ml ampul 57,500.00 5.00 105.00 70.00 - - 35.00 215.00 35.83
180 Flukonazol kaps 150 mg kapsul ME3000J 20,700.00 20.00 - - 80.00 - - 100.00 16.67
181 Fluoksetin 20 mg Tab 225.00 - - - - - - -
182 Flusinolon asetonid krim 0,025% tube 70104 2,512.00 - 5.00 - - - - 5.00 0.83
183 Fondaparinux Sodium (ARIXTRA) Fls 64554B 265,833.00 - - - - - - -
184 Formalin Cair 10 Liter Galon 727,760.00 - - - - - - -
63 Fresofol 11 MCT/LCT 5 Ampul/ Box 30.00 30.00 5.00
185 Furosemid 10 mg/ml Ampul ILI7E077 2,274.80 150.00 200.00 - - - 50.00 400.00 66.67
186 Furosemid 40 mg Tab A0431GU 198.00 2,500.00 2,300.00 1,400.00 - - - 6,200.00 1,033.33
25
187 Furosemid inj 1506066 48,000.00 - - - - - - -
ampul/kotak
13 Furosemida 40 mg Tablet 1703003 209.00 - - 1,500.00 1,500.00 3.00 400.00 3,403.00 567.17
12 Furosemide Injeksi 10 mg ( Box/ 25 Ampul ) - -
188 Fursultiamin Inj (FURAMIN) Ampul F7B754 20,636.00 - - - - - - -
13 Gabapentin Kap 300 mg ( Box/30 ) 450.00 450.00 75.00
Garam oralit kombinasi : natrium klorida 0,52 g + kalium klorida 0,30 g + trinatrium sitrat 0,58
189 Sachet 0631367 CC 274.00 - - - - - - -
g + glukosa anhidrat 2,7 g
Garam oralit kombinasi : natrium klorida 0,52 g + kalium klorida 0,30 g + trinatrium sitrat 0,58
92 sachet 95373176 274.00 - - 1,000.00 - - 800.00 1,800.00 300.00
g + glukosa anhidrat 2,7 g

190 GC Tooth Mosse ( Rsa Buah ) Pcs 1705125 311,630.00 - - - - 1.00 - 0.17
24 Gelafusal Infusion 500 mg 20.00 20.00 3.33
25 Gelafusal Infusion 500 mg - -
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
191 Gemfibrozil 300 mg Kaps Kapsul 6441007 436.00 600.00 300.00 - - - - 900.00 150.00
14 Gene X-Pert MTB/RIF50 (Cartridge) Pcs 1000064128 190,690.00 - - 50.00 - 900.00 - 950.00 158.33
60 Gentamicin Inj Ampul BF160076 3,549.00 - - 10.00 30.00 - 25.00 65.00 10.83
192 Gentamisin SK Tube J60049T 2,200.00 335.00 125.00 - - - - 460.00 76.67
193 Gentamycin inj 40mg/1 ml ampul BF16G120 3,545.00 - - - - - - -
194 Gentamycin salep Mata 0,3% tube 1652013 2,950.00 50.00 - - - - - 50.00 8.33
122 Gentamysin Salep Kulit 0,1 % Box @ 25 Tube Tube 0 105 95 200.00 33.33
195 Gipsona 4 inch Roll 650 49,574.00 5.00 - - - - - 0.83
196 Gipsona 6 inch Roll 701 65,008.00 5.00 - - - - - 0.83
197 Glibenklamid 5 mg Tab 1607067 429.00 3,200.00 3,100.00 1,000.00 500.00 200.00 100.00 8,100.00 1,350.00
42 Glibenklamid 5 mg Tab 1511091 211.00 1,000.00 - - 1,000.00 700.00 1,500.00 4,200.00 700.00
61 Glicazid (Diamicron mr) 60 mg Tab 30's- jkn 150.00 150.00 25.00
198 Gliklazid 80 mg Tab 4860083 1,822.70 60.00 - - - - 60.00 120.00 20.00
199 Glimepirid tab 2 mg Tab A70042J 296.00 - 50.00 - - - - 50.00 8.33
14 Glimepiride Tab 2mg ( Box /100 ) 1,500.00 1,500.00 250.00
15 Glimepiride Tab 2mg ( Box /100 ) - -
16 Glimepiride Tab 2mg ( Box /100 ) - -
200 Glimepiride tab 4 mg 50 tablet/kotak 1606244 16,500.00 36.00 65.00 - 5.00 10.00 - 116.00 19.33
29 Gliquidone 30 mg Tab - -
201 Gliserin lar 50% botol 17LC001 6,600.00 - - - - - - -
202 Glucose PAP Kit 290000 1,442,100.00 - - 2.00 - - - 0.33
15 Glukosa 5% infus Btl 500 ml 230504 5,579.00 - - - - - - -
74 Glukosa Infus 10 % Btl 231003 4,100.00 180.00 - - - - - 180.00 30.00
75 Glukosa Infus 10 % Btl 250804 5,985.00 - - - - - 120.00 120.00 20.00
76 Glukosa Infus 10 % Btl 240906 5,985.00 - - - - - - -
16 Glukosa infus 10% botol 231003 4,100.00 - - - - - - -
203 Glukosa larutan infus 10 % steril Btl / 500 ml 240906 5,985.00 - - 40.00 - - - 40.00 6.67
10 Glukosa Larutan Infus 10% steril Botol 220509 6,013.00 - - - - - - -
204 Glukosa larutan infus 5 % steril Btl / 500 ml 220508 5,180.18 25.00 - - - - - 25.00 4.17
205 Glukosa larutan infus 5 % steril Btl / 500 ml 230902 5,579.00 - 40.00 10.00 60.00 50.00 - 160.00 26.67
206 Glukosa larutan infus 5 % steril Btl / 500 ml 240918 3,815.90 - 80.00 100.00 205.00 60.00 320.00 765.00 127.50
207 Golongan darah anti A Botol 700250A 95,370.00 1.00 - - 2.00 3.00 1.00 1.17
208 Golongan darah anti AB Botol 720442B 84,150.00 - - - - - - -
209 Golongan darah anti B Botol 7102714 79,200.00 1.00 - - 2.00 3.00 1.00 1.17
210 Golongan darah anti D Botol 730309A 105,050.00 6.00 - - 2.00 3.00 1.00 2.00
211 Grafclor Tab XA138G 319.00 3,100.00 100.00 400.00 - - - 3,600.00 600.00
212 Guedel Uk. Dewasa No. 3 Pcs 1705020768 38,610.00 - - 25.00 - - - 4.17
213 Halogen Lamp Pcs - 3,575,000.00 - - 1.00 - - - 0.17
17 Haloperidol 1.5 mg tablet 1408013 72.00 100.00 - - - - - 100.00 16.67
214 Haloperidol Inj (LODOMER) Ampul 460078 13,832.50 - 36.00 6.00 - - - 42.00 7.00
215 Haloperidol inj 5 mg/ml (i.m.) (Haldol Decanoas) ampul 6009 97,500.00 - 5.00 - - - - 5.00 0.83
216 Haloperidol tab 0,5 mg Tab 1611004 64.00 - - - - - - -
217 Haloperidol tab 2 mg Tab 160326 115.00 - - - - - 300.00 300.00 50.00
218 Haloperidol tab 5 mg Tab 170119 98.00 - 300.00 200.00 - - - 500.00 83.33
219 Haloperidol tablet 1,5 mg Ktk / 100 tab 1505017 7,200.00 - 10.00 7.00 - - 3.00 20.00 3.33
220 Handscoon Non Steril M pcs 1704003171 840.00 4,700.00 5,000.00 1,100.00 1,000.00 800.00 1,300.00 2,316.67
221 Handscoon Steril Ukuran 7 Pasang 1607108105 9,667.00 200.00 - - - - - 33.33
222 Handscoon Steril Ukuran 7.5 Pasang 1606101505 9,667.00 250.00 10.00 630.00 5.00 10.00 150.83
223 Handscoon Steril Ukuran 6 Pasang 1508110405 9,667.00 - 30.00 - 410.00 200.00 120.00 126.67
224 Handscoon Steril Ukuran 6,5 Pasang 1701100905 9,667.00 - 50.00 - - - - 8.33
225 Hemospon Pcs 179471 137,060.00 - - - - 60.00 - 10.00
226 Hidroklorotiazid tab 25 mg Tab K60347B 171.00 200.00 300.00 - - 500.00 800.00 1,800.00 300.00
227 Hidrokortison krim 2,5% Tube K61344T 2,712.00 122.00 128.00 120.00 236.00 50.00 99.00 755.00 125.83
18 Hidrokortisone 2.5% tube H508545T 2,868.00 - - - 75.00 600.00 - 675.00 112.50
21 Hydrex surgical scrup 500 ml 100.00 16.67
19 Hydroclortiaide tab 25 mg tablet J60037B 171.00 - - - - 21.00 - 21.00 3.50
228 Hyoscine-N-butylbromida20 mg Ampul 7D0389 29,854.00 - - - - - - -
229 I.V. Chateter No.22 Pcs 160729SD 8,355.00 - - - - - 230.00 38.33
230 I.V. Chateter No.22 Pcs 160828SE 8,355.00 - - 100.00 - 150.20 - 41.70
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
231 I.V. Chateter No.24 Pcs 160912SB 8,355.00 - - - - - 40.00 6.67
232 Ibuprofen tab 400 mg Tab BC911939 133.00 100.00 - - - - - 100.00 16.67
124 Ibupropen 200 mg Tab Tablet 0 1000 4700 5,700.00 950.00
125 Ibupropen 400 mg 10 Strip @ 10 Tablet Tablet 0 500 0 500.00 83.33
77 Infuset Anak Pcs 20141122A 3,658.00 30.00 50.00 75.00 78.00 - - 38.83
233 Infuset Dewasa Pcs 160914531 9,070.00 60.00 50.00 75.00 255.00 85.00 25.00 91.67
6 Intrafix Safeset IS 280.00 46.67
7 Intrafix Safeset IS - -
234 Isofluran Inhalasi 250 ml (TERRELL) Inhalan N0406F14 339,895.00 - - - - - - -
235 Isofluran Inhalasi 250 ml (TERRELL) Inhalan N0406F14 339,895.00 - - - - - - -
236 Isoniazid tab 100 mg Tab 1610054 82.00 100.00 200.00 200.00 - - - 500.00 83.33
237 Isoniazid tab 300 mg Tab C70162B 177.00 100.00 200.00 600.00 - - - 900.00 150.00
238 Isosorbid dinitrat inj 10 mg/10 ml vial IH1343 31,345.00 10.00 - - 10.00 - - 20.00 3.33
239 Isosorbid dinitrat tab 5 mg Tab A2331FU 93.00 2,200.00 1,900.00 1,200.00 300.00 1,500.00 500.00 7,600.00 1,266.67
240 Isotic Adretor 0,5%/ Timolol tetes mata botol/ 5ml ND1621 9,996.00 - - - - - - -
241 Isoxsuprine HCL (Hystolan) Tab 48C0446 6,344.80 - - - - 50.00 - 50.00 8.33
134 IV Catheter No. 20 G Pcs Pcs 0 0 100 16.67
135 IV Catheter No. 20 G Pcs Pcs 0 0 0 -
123 IV Catheter No. 20 G @ 50 Pcs Pcs 0 0 0 -
242 Jelly USG 50 ml Onemed Botol 16061788 15,730.00 5.00 - - - - - 0.83
243 Kaca Mulut Pcs ,- 53,350.00 - - - - - - -
244 Kalium aspartat tab 300 mg tablet 030127 690.00 - - - - - - -
58 Kalsium Glukonas Ampul 14F0280 7,800.00 - - - - - - -
120 Kalsium Laktat 500 mg 10 Blister @ 10 Tablet Tablet 0 2500 5300 7,800.00 1,300.00
245 Kandesartan tab 16 mg tablet EAC252 6,225.00 90.00 30.00 - - - - 120.00 20.00
246 Kantong Darah 350 ml pcs 160301007 106,700.00 50.00 180.00 - - - - 230.00 38.33
247 Kantong Obat uk. 10 x 7 Kotak 9,020.00 40.00 60.00 - 20.00 - - 20.00
248 Kantong Obat uk. 13 x 8,7 Kotak 14,300.00 40.00 60.00 - 20.00 4.00 20.00 24.00
249 Kantong Obat uk. 15 x 10 Kotak 16,500.00 40.00 60.00 - 20.00 12.00 20.00 25.33
250 Kanul Nasa Anak Pcs 01071588 24,310.00 - - - - - - -
251 Kanul Nasa Bayi Pcs 07111388 28,600.00 - - - - - - -
252 Kapas 250 g Bks - 20,900.00 - 2.00 5.00 2.00 1.00 - 10.00 1.67
20 Kapas Berlemak 500 gram Bungkus 0 13,800.00 2.00 5.00 - - - - 7.00 1.17
7 Kaptopril 12,5 mg Tab 1408027 70.81 - - - - - 500.00 500.00 83.33
34 Kaptopril 12,5 mg Tab 201027 86.00 - - - - 2,400.00 - 2,400.00 400.00
253 Kaptopril tab 12,5 mg Tab 6323002 69.00 - 500.00 9,000.00 9,500.00 5,000.00 7,000.00 31,000.00 5,166.67
254 Kaptopril tab 50 mg Tab 1604017 143.00 - - - - - - -
255 Kaptopril tablet 12,5 mg Ktk / 100 tab 1408027 7,080.70 55.00 73.00 - - - - 128.00 21.33
256 Kaptopril tablet 25 mg Ktk / 100 tab HGI957 7,200.00 75.00 151.00 600.00 129.00 20.00 - 975.00 162.50
257 Karbamazepin 200 mg Tab 170280 1,456.40 - - - 500.00 1,800.00 - 2,300.00 383.33
258 Karbamazepin Tab 200 mg Tablet 171048 306.00 600.00 800.00 1,000.00 1,300.00 - - 3,700.00 616.67
259 Kasa Kompres 16 x 16 16 pad/ktk 50515 8,690.50 25.00 30.00 20.00 5.00 - - 13.33
260 Kasa Kompres 40 x 40 steril Pcs 1,600.00 20.00 400.00 100.00 30.00 100.00 50.00 116.67
78 Kasa Pembalut 2 m x 80 cm Roll 03011788 8,085.00 20.00 60.00 50.00 - - 45.00 29.17
21 Kasa Pembalut Hidrofil 4 yardx5cm Rol 006090615 932.00 - - 2.00 - - 20.00 3.67
261 Kasa Pembalut Hidrofil 40 m x 80 cm roll 0000A 126,000.00 - - - - - - -
262 Kasa Pembalut Hidrofil 4m x 10 cm Rol 022288mx 1,800.00 10.00 - - - 20.00 10.00 6.67
263 Kasa Pembalut Hidrofil 4m x 10 cm Roll 072188 MX 1,800.00 - 20.00 30.00 20.00 20.00 70.00 26.67
264 Kasa Pembalut Hidrofil 4m x 15 cm Roll 012188 MX 2,520.00 50.00 150.00 50.00 30.00 - - 46.67
265 Kasa Pembalut Hidrofil 4m x 5 cm Roll 021688 MX 900.00 - - 20.00 10.00 - - 5.00
266 Kasa Pembalut Hidropil 4x15 cm elastis pcs 12188 4,950.00 - - - - - 60.00 10.00
267 Kasa Steril 4 m x 3 cm lembar - 880.44 110.00 30.00 60.00 - 20.00 14.00 39.00
268 Kertas EKG Gulung panjang Uk.21cm pcs 318545767 73,920.00 - 2.00 1.00 - - - 0.50
269 Kertas EKG Gulung panjang Uk.5,3cm pcs 45665666 116,820.00 - - - - - - -
270 Kertas Puyer Rim 29,150.00 50.00 15.00 10.00 - 6.00 - 13.50
271 Ketokonazol 200 mg Tab 170908103 726.00 1,600.00 1,300.00 - - - - 2,900.00 483.33
126 Ketokonazole 200 mg5 Strip @ 10 Tablet Tablet 0 1300 700 2,000.00 333.33
272 Ketokonazole cream tube 06489008 2,606.00 5.00 - - - - - 5.00 0.83
127 Ketokonazole Crem 10 Gram Tube 0 110 5 115.00 19.17
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
273 Ketoprofen 100 mg Tab KTKTPB72105 17,010.40 100.00 - - - 100.00 - 200.00 33.33
274 Ketorolac inj 30 mg/ml Ampul 95459093 1,383.00 - 150.00 - - 120.00 72.00 342.00 57.00
275 Ketosteril Tab 95FA001 11,027.50 - - - - - - -
276 Klindamisin 150 mg Kapsul 06437004 682.00 1,100.00 100.00 - - - - 1,200.00 200.00
35 Klindamisin 150 mg Kapsul 1705010 806.00 100.00 300.00 400.00 500.00 - - 1,300.00 216.67
277 Klomifen sitrat 50 mg (BIESIFEN) Tab TC2585 23,166.00 40.00 - - - 24.00 - 64.00 10.67
278 Klonidin HCl inj 150 mcg/ml Ampul 528303B 32,600.00 - - - - - - -
279 Klonidin tab 0,15 mg Tab E160456B 139.00 - 100.00 - - - - 100.00 16.67
280 Klopidogrel 75 Ktk /30 tab 0 70036 63,000.00 10.00 19.00 13.00 - - - 42.00 7.00
281 Klopidogrel tab 75g tablet 030027 2,100.00 - - - - 300.00 - 300.00 50.00
282 Kloramfenicol Syr botol GG2234 4,000.00 30.00 - - - - - 30.00 5.00
283 Kloramfenikol 125 mg/5ml Btl 60 ml 70802 14,410.00 - - - - - - -
284 Kloramfenikol kaps 500 mg (CHLORAMEX) Kaps U2388116 1,155.00 500.00 - 500.00 100.00 - 500.00 1,600.00 266.67
285 Kloramfenikol kaps 500 mg (CHLORAMEX) Kaps U2388116 1,155.00 - - - - - - -
286 Kloramfenikol salep mata 1% Tube E70972W 1,850.00 10.00 89.00 - 23.00 20.00 20.00 162.00 27.00
287 Kloramfenikol SK 2%(BUFACETIN) Tube I0207708 3,409.00 25.00 - - - - - 25.00 4.17
288 Kloramfenikol TM (Reco) Btl 10 ml 0090817010 18,150.00 50.00 - 5.00 - - - 55.00 9.17
289 Kloramfenikol TT (Reco) Btl 0520817002 12,100.00 20.00 - - - - - 20.00 3.33
290 Klorfenol Kamfer Menthol ( CHKM ) Btl / 10 ml 22115 53,130.00 - - - - - - -
291 Klorpromazin HCl tab 100 mg Btl/100 tab E140544B 21,844.90 - - - - - - -
292 Klorpromazin inj 5 mg/ml (i.m.) Ampul 95330001 1,483.00 - 10.00 - - - - 10.00 1.67
293 Klorpromazin tab sal 25 mg Tab sal 06328001 170.00 100.00 - 500.00 - - - 600.00 100.00
294 Kodein tab 10 mg Tab HG1214J 630.00 - - - 100.00 - - 100.00 16.67
295 Kolkisin 0,5 mg Tablet (RECOLFAR) Tablet II0981 4,065.00 - 150.00 150.00 - - - 300.00 50.00
296 Kombinasi: ipratropium Br 0,5 mg+ salbutamol 2,5 mg nebules Botol 7984001 4,995.00 10.00 - - - - - 10.00 1.67
297 Kompolak Syr Btl 60 ml 70307 13,200.00 10.00 - 3.00 - 11.00 - 24.00 4.00
298 Komposit A2 Anterior Pcs N874602 498,300.00 - - - - 1.00 - 0.17
299 Komposit A2 Fosterior Pcs N874602 498,300.00 - - - - - - -
300 Komposit A3 Anterior Pcs N879632 498,300.00 - - - - 1.00 - 0.17
301 Komposit A3 Fosterior Pcs N879632 498,300.00 - - - - - - -

302 Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 400 mg+ trimetoprim 80 mg Tab 1609163 158.00 500.00 - - - - - 500.00 83.33

303 Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 800 mg+ trimetoprim 160 mg tablet TPE29046 344.00 200.00 500.00 1,000.00 - 1,000.00 - 2,700.00 450.00

Kotrimoksazol (dewasa) kombinasi tiap 5 ml suspensi : sulfametoksazol 200 mg +

304 Botol 505002AG 2,225.00 75.00 150.00 100.00 50.00 50.00 250.00 675.00 112.50
trimetoprim 40 mg
98 Laboratorium Kit Paket 901,274.00 11.00 - - - - - 1.83
305 Lacto B Ssch IN01R02 6,985.00 200.00 140.00 80.00 60.00 100.00 - 580.00 96.67
32 Lansoprazol (Prosogan) inj 30 mg @ 1 20.00 20.00 3.33
306 Lansoprazol 30 mg Kapsul 17070G6 2,827.00 80.00 40.00 - - - - 120.00 20.00
34 Lansoprazole 30 mg Kapsul 700.00 700.00 116.67
307 Larutan Alkohol 70% btl/ 100ml 141180203 2,575.00 262.00 180.00 25.00 130.00 76.00 265.00 156.33
308 Larutan Anisol 100 ml Botol 315,260.00 - - - - - - -
309 Larutan asam asetat 6% 100 ml Botol 46,530.00 - - - - - - -
310 Larutan asam Sulfo Salisilat 100 ml Botol 109,450.00 - - - - - - -
311 Larutan benedict 100 ml Botol 167,530.00 - - - - - - -
312 Larutan Bennedict Btl/100 ml BND100 149,600.00 - 1.00 - 1.00 - - 0.33
313 Larutan carbol fuchin 100 ml Botol 73,150.00 - - - 1.00 - - 0.17
101 Larutan Giemsa Btl 493,115.00 17.00 - - - - - 2.83
314 Larutan Giemsastain 100 ml Botol 385,000.00 - - 5.00 1.00 - 2.00 1.33
315 Larutan H2O2 3 % 350 ml Botol 33,000.00 6.00 - - - 1.00 - 1.17
316 Larutan HCL 0,1 N 100 ml Botol 52,800.00 11.00 - 1.00 - - 1.00 2.17
317 Larutan Hemoglobin 500 ml Botol 298,760.00 - - - 1.00 - - 0.17
102 Larutan Imersion oil Btl 836,595.00 11.00 - - - - - 1.83
318 Larutan Imersion oil 30 ml Botol 424,600.00 - - - 1.00 - - 0.17
41 Larutan KA EN3A 100.00 100.00 16.67
46 Larutan KA EN3B 100.00 100.00 16.67
319 Larutan mengandung Elektrolit (Kalium Klorida) Botol 83C47A 3,099.00 - - - - - - -
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat 2.24 gr, KCL 0.75 gr
320 Botol 47D84A 10,050.00 - 20.00 20.00 - - - 40.00 6.67
Dekstrosa 27 gr) (KA EN 3A)
321 Larutan Methanol 100 ml Botol 58,300.00 - 10.00 - 1.00 - 2.00 2.17
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
322 Larutan Methylene blue 0,25%" 100 ml/botol ZN3100 78,650.00 - - - - - - -
323 Larutan Metilen Blue 0,25% 100 ml Botol 43,450.00 - - - 1.00 - - 0.17
324 Larutan Na Citrat 3,8% Botol/250 ml NACT250 93,500.00 - - - 1.00 - - 0.17
325 Larutan Na. Sitrat 3,8% 100 ml Botol 34,100.00 - - - - - - -
326 Larutan Nacl 0,9 ( salin 0,9 % )% 250 ml Botol 34,100.00 - - - - - - -
327 Larutan NaCl 0.9% Botol 470502 6,410.00 665.00 520.00 100.00 661.00 300.00 334.00 2,580.00 430.00
328 Larutan Ringer Laktat Botol 370503 7,150.00 125.00 60.00 40.00 1,040.00 290.00 680.00 2,235.00 372.50
329 Larutan turk 100 ml Botol 34,100.00 - - 2.00 - - - 0.33
330 Levofloksasin tab 500 mg tablet TSC15346 525.00 - - - - - - -
79 Lidocain comb Inj Ampul 16IK040 1,360.00 540.00 390.00 90.00 30.00 10.00 350.00 1,410.00 235.00
331 Linkomisin kapsul 500 mg ktk/60 kapsul 85438015 55,000.00 - - - - - - -
1 Lisinopril Tablet 10 mg ( Box/ 100 ) 500.00 500.00 83.33
2 Lisinopril Tablet 10 mg ( Box/ 100 ) - -
3 Lisinopril Tablet 10 mg ( Box/ 100 ) - -
332 Liver Prime Kapsul DY7B001 9,273.00 - - - - - - -
43 Loratadin 10 mg Tab 1707103 383.00 800.00 1,600.00 1,100.00 100.00 300.00 150.00 4,050.00 675.00
333 M-30 CFL Lyse 500 ml Btl 2017061901 1,518,000.00 - - - - 2.00 1.00 0.50
334 M-30 D Diluet 5.5 L Btl 2016120503 497,200.00 - - - - 8.00 2.00 1.67
335 M-53 Diluet 20 L Galon 2017021902 1,375,000.00 - - 2.00 - - - 0.33
336 Magnesium sulfat inj 20% vial 86C47A 3,200.00 - 10.00 - - - - 10.00 1.67
337 Magnesium sulfat inj 40% vial 99L46A 3,650.00 - - - - - - -
338 Masker (Surgical face Mask 3 ply Year Loop) Box 3M2016 30,294.00 - - - 1.00 - - 0.17
22 Masker ear loop 56.00 9.33
80 Masker Ear loop Pcs 02051586 330.00 1,200.00 700.00 50.00 3,250.00 380.00 4,150.00 1,621.67
339 Masker N95 Pcs R17074 27,200.00 - - - - - - -
81 Masker N-95 Pcs 7,400.00 - - - - 1,200.00 - 200.00
340 Masker Nebulizer Anak (8906) Pcs NOP103116 41,899.00 - - 50.00 - - - 8.33
341 Masker Nebulizer Anak (8906) Pcs NOP121216 34,320.00 - - - - - - -
342 Masker Oksigen Dewasa Set 1111588 16,262.40 5.00 - - - - - 0.83
343 Masker Oksigen Dewasa Pcs 440346 36,300.00 9.00 - - - - - 1.50
344 Masker Oksigen Dewasa (non rebreathing) Pcs 1703020258 18,997.00 - - 5.00 - - - 0.83
23 Masker tie on - -
345 Mata bur Higt Speed Pcs E03001 329,120.00 - - - - - - -
346 Mata bur Low Speed Pcs D03001 356,400.00 - - - - - - -
347 Mata bur tulang dental speed Pcs FG52247 661,540.00 - - - - - - -
348 Mebendazol tab 500 mg (WERMOX) Tab 7H4361 8,800.00 - - - - - - -
349 Mebhydrolin 50 mg (KETERGI) Tab 7A6015 1,205.60 - - - - - - -
350 Mediamer B6 Tab DY7A058 4,252.60 100.00 - - - - - 100.00 16.67
351 Medroksi progesteron asetat tab 10 mg ( PROVERA ) tablet 139EC 2,522.00 - - - - - - -
352 Mekobalamin 500 mg Tab EAE204 1,266.10 - - - - - - -
82 Meloxicam 15 mg Tab 1707151 1,377.00 400.00 150.00 300.00 400.00 - 400.00 1,650.00 275.00
353 Mesh ukuran 5cm x 7.5cm Ktk/12 pcs 3866071 2,875,000.00 - - - - - - -
45 Metformi 500 mg Tab 0712271 103.00 7,300.00 6,000.00 6,100.00 4,600.00 - 6,000.00 30,000.00 5,000.00
33 Methit Prednisolon 4 mg Tablet - -
54 Methyl Ergometrine Mal Inj 0,2 mg /100 's ( F ) - -
354 Methylergometrin 0,125 mg Tab LE285IJ 199.10 500.00 1,000.00 600.00 500.00 1,200.00 - 3,800.00 633.33
83 Methylergometrin Inj Ampul 97LC0052 3,278.00 - - - - 350.00 100.00 450.00 75.00
17 Methylprednisolone 16 mg 400.00 400.00 66.67
18 Methylprednisolone 16 mg 100.00 100.00 16.67
355 metildopa tab sal 250mg (DOPAMET) Tablet U2344103 1,001.00 300.00 300.00 - - - - 600.00 100.00
61 Metilergometrin inj Ampul 97KG0113 26,800.00 - - 20.00 - - 20.00 40.00 6.67
356 Metilergometrin inj 0,2 mg/ml Ampul 97LA0054 2,684.00 55.00 40.00 40.00 - - - 135.00 22.50
357 Metilprednisolon inj 125 mg/2 ml vial 6463037 14,750.00 100.00 - - - 10.00 - 110.00 18.33
358 Metilprednisolon inj 500 mg/8 ml vial 95450018 74,719.00 20.00 - - - - - 20.00 3.33
359 Metronidazol 250 mg tab BE91274 98.00 - - - - - - -
136 Metronidazol 250 mg 10 Strip @ 10 Tablet Tablet 0 0 1100 1,100.00 183.33
137 Metronidazol 250 mg 10 Strip @ 10 Tablet Tablet 0 0 1000 1,000.00 166.67
360 Metronidazol Inf 5 mg/ml Btl 100 ml 270751 50,600.00 - - - - 72.00 - 72.00 12.00
361 Metronidazol ovula 500 mg supp B70144W 4,715.00 - - - - - - -
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
362 Metronidazol tab 250 mg Tab BD91272 98.00 200.00 200.00 300.00 100.00 - - 800.00 133.33
363 Metronidazol tab 500 mg Tab AK91263 140.00 2,100.00 1,000.00 1,000.00 2,000.00 - 500.00 6,600.00 1,100.00
364 Metronidazol tablet 500 mg Ktk / 100 tab DG1091 15,700.00 - - - - - - -
58 Metronidazole Generik 500 mg/100 ml ( F ) - -
84 Metylprednisolon 4 mg Tab ZG126 165.00 2,900.00 1,600.00 400.00 - - 700.00 5,600.00 933.33
44 Meylon 8,4 % 25 ml - -
47 MGSO4 20 % - -
48 MGSO4 40 % - -
59 MGSO4 40 % Ampul 74H43 2,629.00 - - - - - - -
365 MH-30 P Probe Cleaser 17 ml Btl 20170725201 69,300.00 - - - - - - -
366 MH-53 Clenser Btl 2117071801 628,100.00 - - 1.00 - - - 0.17
367 MH-53 Leo (I) Lyse Btl 2017081101 2,623,500.00 - - 1.00 - - - 0.17
368 MH-53 Leo (II) Lyse Btl 2017060301 2,130,700.00 - - 1.00 - - - 0.17
369 MH-53 LH Lyse Btl 2017031201 2,095,500.00 - - 1.00 - - - 0.17
370 MH-53 Probe Clenser Btl 2017031101 275,000.00 - - 1.00 - - - 0.17
11 Micropore 1 Inch - -
371 Mikonazol krim 2% Tube 070683W 3,737.00 160.00 242.00 110.00 200.00 70.00 41.00 823.00 137.17
22 Mineral Mix Sachet sachet 1609062 2,726.90 - - - - - - -
93 Mineral Mix Sachet sachet 1707017 2,805.00 - - - - - - -
372 Morfin Inj Vial DG0742J 11,583.00 - - - - - - -
373 Multi Calibrator Kit CA0002 2,070,750.00 - - 1.00 - - - 0.17
374 Multiclean solution Btl 1,817,750.00 - - 1.00 - - - 0.17
375 N.G.T No. 12 ( Levin Tube ) Buah 160824B 15,373.00 - 5.00 - - - - 0.83
376 N.G.T No. 14 ( Levin Tube ) Buah 160831B 15,373.00 - 5.00 - - - - 0.83
377 N.G.T No. 16 ( Levin Tube ) Buah 161029B 15,373.00 - - - - - - -
378 N.G.T No.3,5 ( Feeding Tube ) Buah 141022B 17,366.00 - 5.00 - - - - 0.83
379 N.G.T No.8 ( Feeding Tube ) Buah 160607B 17,366.00 - - - 1.00 - - 0.17
380 Nald Hecting No.10 Type Cutting ( D ) pcs 15,400.00 - - - - - - -
381 Nald Hecting No.10 Type Taper ( O ) pcs 15,400.00 - - - - - - -
382 Nald Hecting No.13 Type Cutting ( D ) pcs 15,400.00 - - - - - - -
383 Nald Hecting No.13 Type Taper( O ) pcs 1134 15,400.00 - - - - - - -
384 Nald Hecting No.8 Type Taper ( O ) pcs 1134 15,400.00 - - - - - - -
385 Nalokson inj 0,4 mg/ml ampul TB0093 79,000.00 - - - - - - -
386 Natrium Bicarbonat tab 500 mg Btl/1000 tab 292606141 10,725.00 - - - 2.00 - - 2.00 0.33
46 Natrium Diklofenat 25 mg Tab 06364021 150.00 3,500.00 900.00 - - 9,100.00 3,050.00 16,550.00 2,758.33
387 Needle Terumo 23 G Kotak 170415B 146,300.00 7.00 14.00 4.00 2.00 6.00 3.00 6.00
388 Needle Terumo 24 G Kotak 1607270 146,300.00 8.00 13.00 5.00 8.00 4.00 2.00 6.67
389 Needle Terumo 25 G Kotak 170311E 146,300.00 11.00 7.00 4.00 9.00 8.20 6.00 7.53
390 Neflon No. 26 Box 7138150 2,904,688.00 1.00 1.00 - - - - 0.33
391 Neflon No.24 Box 6323463 2,220,075.00 1.00 1.00 - - - - 0.33
392 Neocenta Gell Tube 702008 17,710.00 50.00 25.00 3.00 2.00 5.00 - 85.00 14.17
393 Nephrolit Kapsul 221010 1,017.50 100.00 - - - - - 100.00 16.67
394 NGT Levin no.12 pcs 20160725 10,148.00 - - - - - - -
395 NGT Levin no.14 pcs 20160725 10,148.00 - - - - - - -
396 NGT No.6 Pcs 161110541 37,180.00 2.00 - - - - - 0.33
59 Nicardifine Hcl Inj ( GeneriK ) ( F ) 10.00 10.00 1.67
128 Nipedipine Tablet 10mg 10 Strip @ 10 Tablet Tablet 800 1000 2400 4,200.00 700.00
397 Nistatin Susp 100.000 UI/ml Btl 12 ml 70209 40,260.00 7.00 1.00 - - - - 8.00 1.33
398 Nistatin tab vaginal 100.000 UI Tab 6372004 602.00 300.00 100.00 - 200.00 - - 600.00 100.00
399 Nistatin tab vaginal 500.000 UI Tablet 95371010 857.00 200.00 100.00 - 200.00 - - 500.00 83.33
55 Norefinephrine Bitartrate Inj /5's ( F ) 10.00 10.00 1.67
400 Norethisteron 5 mg (REGUMEN) Tab TB2359 11,872.66 90.00 - - - - - 90.00 15.00
401 Norethisteron 5 mg (REGUMEN) Tab TC2588 4,257.00 - - - - 90.00 - 90.00 15.00
402 Normal Control Serum Kit QC0001 2,363,900.00 - - 1.00 - - - 0.17
403 NovoMix 30 100 U/ml Pcs FR74721 110,000.00 20.00 - - - - - 20.00 3.33
404 Nuralgin RX Tab KTNLGD73891 746.90 400.00 - - - - - 400.00 66.67
405 Nurse Cup Kotak 1061688 38,399.00 - 3.00 - - - - 0.50
406 Nutralix Tab 70807 915.20 1,800.00 500.00 1,000.00 100.00 - - 3,400.00 566.67
48 Nystatin 100000 IU Tab 6372008 627.00 - - - - - - -
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
47 Nystatin 500000 IU Tab 95371010 881.00 - - - - 5,750.00 - 5,750.00 958.33
23 Nystatin tab vag 100.000 UI tablet 95372010 602.00 - - - - - - -
24 Nystatin tab vag 100.000 UI tablet 85372010 504.00 - - - - - - -
25 Nystatin tab vag 500.000 UI tablet 85371003 672.00 - - - - - - -
57 OAT ANAK Paket 06493002 247,234.00 2.00 4.00 1.00 - - - 7.00 1.17
56 OAT FDC KATEGORI I Paket 1707002 247,243.00 16.00 5.00 3.00 - 800.00 - 824.00 137.33
49 OBH sirup 100 ml Botol 2607012 6,930.00 85.00 5.00 - - - - 90.00 15.00
407 OBH Syr Btl 60 ml GR01S11 8,800.00 15.00 - - - - - 15.00 2.50
408 Obimin AF Tab 17004306 1,928.66 - - - - - - -
409 Ofloksasin tab 200 mg tablet 1610007 400.00 - - 400.00 - - - 400.00 66.67
410 Oksigen IH (gas dalam tabung) Tabung 7091788 6,075,080.00 - - - - - - -
64 Oksimetazolin tts hidung (Iliadin) drop ( F ) - -
411 Oksitetrasiklin SK 3% Tube E71058W 4,244.16 174.00 125.00 125.00 10.00 - 6.00 440.00 73.33
412 Oksitetrasiklin SM 1% Tube G71572W 4,248.75 170.00 125.00 120.00 75.00 - - 490.00 81.67
62 Oksitosin inj Ampul 97K10062 1,900.00 - - - - 30.00 - 30.00 5.00
413 Oksitosin inj 10 UI/ml Ampul 97LD0016 1,900.00 30.00 - 10.00 - - - 40.00 6.67
414 Omeprazol 20 mg Kapsul 17082053 674.66 4,950.00 5,400.00 2,550.00 1,350.00 - - 14,250.00 2,375.00
20 Omeprazole Injecion 40 mg ( Box/10 vl) - -
19 Omeprazole Injeksion 40 mg ( Box/10 vL ) 100.00 100.00 16.67
131 Omeprazole Kapsul 20 mg 3 Strip @ 10 Kapsul Capsules 0 2550 4080 6,630.00 1,105.00
415 Ondansentron 8 mg Tab 1611003 5,459.66 48.00 - - - - - 48.00 8.00
416 Ondansentron Inj 4 mg Ampul 97KK0054 1,650.00 100.00 300.00 120.00 - - 50.00 570.00 95.00
417 Ondansetron 4mg 30 tab/box A8102FS 37,830.00 - - - - - - -
5 Ondansetron IV/IM 4 mg OGB DEXA ( BOX/ 5 Ampul ) - -
418 Ondansetron tab 4 mg tablet 1607004 542.00 360.00 600.00 - - 120.00 - 1,080.00 180.00
419 Ossein Hydroxyapatite 200 mg Tab 48E0413 1,831.50 120.00 - - - - - 120.00 20.00
43 Otsu Water Inj.25 Ml 206.00 206.00 34.33
52 Oxytocin inj 10 IU - -
85 Oxytoxcin Inj Ampul 97LG0065 1,900.00 - - - - 800.00 100.00 900.00 150.00
420 Pan Amin G Larutan Infus Botol SB82J46B 45,950.00 - - - - - - -
421 Papaverin Inj 40 mg/ml Ampul GR01511 955.90 - - - - - - -
422 Papaverin tab 40 mg ktk / 100 tab H131071B 18,457.00 - - - - - - -
423 Papaverin tab 40 mg ktk / 100 tab FB0771 12,500.00 4.00 2.00 - - - - 6.00 1.00
424 Parasetamo 120 mg/5ml Btl 31703708 7,370.00 585.00 600.00 220.00 980.00 360.00 390.00 3,135.00 522.50
54 Parasetamol 500 mg Tab 172141 51.00 27,600.00 18,200.00 18,500.00 24,000.00 - 14,700.00 103,000.00 17,166.67
425 Parasetamol inf 1000 mg/100ml Btl 100 ml GI0626736 47,850.00 20.00 20.00 - 10.00 - - 50.00 8.33
426 Parasetamol tts 60 mg/0,6 ml Botol 1612102 5,980.00 45.00 - 10.00 - - 5.00 60.00 10.00
427 Permetrin (SCABIMITE) Salap Tube CO83E1709 11,050.00 25.00 - - - 10.00 10.00 45.00 7.50
428 Petidin 50 mg/ml Ampul KE2531J 14,575.00 - - - - - - -
86 Phytomenadion injeksi 10mg/ml ampul 95478028 4,250.00 - - - - 0 - -
429 Pincet Dental Pcs 2EE1160153 444,840.00 - - - - - - -
430 Piracetam 1200 mg Tab 48A0086 2,378.20 - - - - - 100.00 100.00 16.67
431 Piracetam 400 mg Tab 48D0047 1,689.60 200.00 - - 100.00 - 100.00 400.00 66.67
432 Pirantel 125 mg/5ml (KONVERMEX) Btl 5 ml JUN17A06 18,370.00 25.00 - - - - - 25.00 4.17
433 Pirazinamid tab 500 mg Tab 1608190 248.00 200.00 - - - - - 200.00 33.33
434 Piroksikam 10 mg Tab 10916L0020 236.50 2,500.00 100.00 - - - - 2,600.00 433.33
435 Piroksikam 20 mg Tab A6025GU 264.00 3,000.00 1,200.00 600.00 - - - 4,800.00 800.00
51 Piroxikam 20 mg Tab E70607 B 294.00 1,200.00 1,300.00 840.00 - - - 3,340.00 556.67
140 Plain Cutgut 3/0 Pcs 0 96 0 16.00
44 Plester 5 cm x 4,5 m Roll 50818248 28,600.00 - - - - - - -
50 Plester 5 cm x 5 m (PARAFIX) Roll 10B17 29,700.00 6.00 4.00 2.00 - - - 2.00
436 Plester 7,5 cm x 5 m pcs 7610314 30,800.00 20.00 15.00 27.00 15.00 12.00 - 14.83
26 Polikrrusulen lar 30 mg (Albothl) Btl EG0841 17,993.00 - - - - - - -
33 Polypropylen 2/0 DS 24 MM 24.00 4.00
34 Polypropylen 3/0 DS 30 MM 24.00 4.00
35 Polypropylen 6/0 DS 10 MM 24.00 4.00
36 Polypropylen Mesh 15x15 5.00 0.83
437 Polypropylene No. 1 Reverse Cutting DS-24 mm Buah 170506 32,285.00 - - - - - - -
438 Povidon Iodida 10 % Btl / 300 ml F48505 14,771.00 2.00 - - - - - 0.33
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
439 Povidon Iodin 10% 300ml Btl 2081788 35,750.00 88.00 60.00 8.00 49.00 4.00 - 34.83
129 Povidon Iodine 10 % Botol 30 ml Botol 0 50 95 24.17
440 Prednison Tab 64683 136.84 9,000.00 6,000.00 5,000.00 6,000.00 6,000.00 3,000.00 35,000.00 5,833.33
441 Primakuin tab 15 mg Tab 06386005 258.00 2,000.00 500.00 - - - 300.00 2,800.00 466.67
442 Profofol (FRESOFOL 1%) Ampul 16KL5804 11,649.00 - - - 5.00 - - 5.00 0.83
5 Prontosan Sol BT 350 ml 20.00 20.00 3.33
3 Prontosan Wound BT 30 ml 10.00 10.00 1.67
4 Prontosan Wound BT 30 ml 40.00 40.00 6.67
87 Propanolol 10 mg Tab 1709072 59.00 100.00 300.00 300.00 400.00 - 100.00 1,200.00 200.00
443 Propiltiourasil tablet 100 mg Btl / 100 tab 1305004 27,700.00 - - - - - - -
444 Propiltiourasil tablet 100 mg Btl / 100 tab 1407002 29,927.00 - - - 8.00 - - 8.00 1.33
53 Prostigmin inj 0,5 mg/Box 5 Amp ( F ) - -
445 Pulp Fiil Kit Pak 98115 211,750.00 - - - - - - -
446 Quinine 222 mg Tab A70025B 737.00 - - - - - - -
90 Rabipur (Vaksin Rabies) Vial N1G961M 164,030.00 3.00 - - - - - 3.00 0.50
21 Ramipril Tab 5mg ( Box/100 ) - -
52 Ranitidin 150 mg Tab 48E4146 109.00 8,200.00 5,900.00 7,600.00 1,500.00 - 2,600.00 25,800.00 4,300.00
10
447 Ranitidin injeksi 25 mg/ml J10356402 64,166.30 - - - - - - -
ampul/kotak
448 Ranitidine inj 50mg/2ml Ampul N10356616 1,600.00 650.00 1,020.00 20.00 120.00 20.00 - 1,830.00 305.00
449 Rapid Test 1 Pcs GJ17020191 52,800.00 - - 300.00 - - - 50.00
450 Rapid Test 2 Pcs GJ17020191 52,800.00 - - 200.00 - - - 33.33
451 Rapid Test 3 Pcs GJ17020191 52,800.00 - - - - - - -
452 RDT Dengue device Kotak 1702056 1,734,700.00 - - - - - 2.00 0.33
453 RDT HBsAg strip Kotak 1707112 1,595,000.00 3.00 8.00 - 1.00 - - 2.00
454 RDT HCV device Kotak 1702052 3,414,400.00 1.00 8.00 - 4.00 2.00 - 2.50
455 RDT HIV device Kotak 1704281 3,201,000.00 2.00 6.00 - 1.00 1.00 - 1.67
456 RDT Malaria 25 pcs/ kotak MAL 42023 1,375,687.50 - 1.00 - - - - 0.17
457 RDT Malaria device Kotak 1,595,000.00 - 1.00 - - 1.00 - 0.33
458 RDT Spyilis device Kotak 2,774,200.00 2.00 5.00 - - - - 1.17
459 Reading Cuvettes Pack 14P1083700 9,693,750.00 - - 1.00 - - - 0.17
460 Reading Plate With 80 Cuvetts Pack - 4,241,050.00 - - 1.00 - - - 0.17
461 Reagen Albumin Set 755,370.00 - - - - - - -
462 Reagen Bilirubin Ktk 1510303a 598,000.00 - - - - - - -
463 Reagen BIlirubin Set 1510303A 454,300.00 - - - - - - -
464 Reagen Bilirubin Total Set 1510303A 454,300.00 - - - - - - -
465 Reagen Cholesterol Set 15531 832,260.00 - - - - - - -
466 Reagen Cholesterol 2 x 50 ml Set 15531 499,400.00 - - - - - - -
467 Reagen Creatinin Set 7006 883,300.00 - - - - - - -
468 Reagen GGT Set 7006 565,400.00 - - - - - - -
469 Reagen Glukosa Set 15478 1,263,350.00 - - - - - - -
470 Reagen GPT- ALT 2x50 ml Set 15343 1,263,350.00 - - - - - - -
471 Reagen Hematologi Set 41016 1,263,350.00 1.00 - - 1.00 1.00 - 0.50
472 Reagen LDL Cholesterol Set 15475 4,546,300.00 - - - - - - -
473 Reagen Multistik ( Stik Urine 10 ) Set URS7070076 116,600.00 - - - - - - -
474 Reagen Protein Total Set A7506 629,200.00 - - - - - - -
475 Reagen SGOT Set 7003 709,500.00 - - - - - - -
476 Reagen SGPT Set 7003 709,500.00 - - - - - - -
477 Reagen Trigleserida Set 15475 1,355,200.00 - - - - - - -
478 Reagen Urea Set 15459 953,920.00 - - - - - - -
479 Reagen Urea UV 2 x 50 ml Set 7008 576,180.00 - - - - - - -
480 Reagen Uric Acid Set 15452 783,200.00 - - - - - - -
481 Reagen Uric Acid 2 x 50 ml Set 15452 576,180.00 - - - - - - -
27 Reagen ZN Kit 890516 276,600.00 6.00 5.00 - - - - 1.83
482 Rifampisin kaps 300 mg Kaps 1605002 785.00 100.00 - - - - - 100.00 16.67
483 Rine Solution (EW CVT) Kit 190000 3,332,450.00 - - 3.00 - - - 0.50
484 Rine Solution (EW PRB) Kit 180000 3,332,450.00 - - 1.00 - - - 0.17
485 Risperidone tab 2 mg ktk/50 tab 1606192 24,750.00 - 5.00 8.00 - - - 13.00 2.17
486 Rivanol Botol M1071688 3,750.00 2.00 10.00 5.00 10.00 - 3.00 30.00 5.00
487 Roculax(Rocuronium Bromida 50 mg/5ml) Vial KARCXA73002 96,910.00 10.00 - - - - - 10.00 1.67
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
488 Salbutamol sir 2 mg/5 ml Botol 1812038 5,463.00 - 25.00 - - - - 25.00 4.17
489 Salbutamol tab 2 mg Tab A8225DU 68.00 6,800.00 3,000.00 4,500.00 7,500.00 4,000.00 2,800.00 28,600.00 4,766.67
490 Salbutamol tab 4 mg Tab L60475B 84.00 500.00 500.00 - 1,000.00 - - 2,000.00 333.33
491 Salep 2-4, kombinasi : asam salisilat 2 %+ belerang endap 4 % Tube 17SC053C 2,797.00 121.00 24.00 - 74.00 58.00 70.00 347.00 57.83
492 Sample Cups 3 ml (Plastic) Pack 16P1000900 227,288.00 - - 1.00 - - - 0.17
95 Sarung Tangan L Pcs 477.00 - 100.00 1,200.00 3,300.00 1,800.00 2,100.00 1,416.67
94 Sarung Tangan M Pcs 476.00 - - 1,500.00 6,400.00 - 300.00 1,366.67
493 Scabimite Tube F1710 102,080.00 - - - - - - -
494 Scopma Tab 70403 3,644.30 200.00 200.00 - - - - 400.00 66.67
28 SD 1/2 HIV Pcs 03AMB015A 21,815.00 100.00 - - - - - 16.67
495 Sefadroxil sirker 125mg/5ml botol 70306 4,746.00 140.00 55.00 25.00 90.00 - 23.00 333.00 55.50
496 Sefaleksin kaps 500 mg kapsul 60109 717.00 100.00 - - - - - 100.00 16.67
497 Sefiksim sir 100 mg/5 ml botol HE358037 7,690.00 - - - - - 5.00 5.00 0.83
498 Sefixime 100mg kaps kapsul PJ048064 649.00 150.00 - - - - - 150.00 25.00
499 Sefotaksim 1 gram Vial 48D0220 11,770.00 20.00 20.00 20.00 - - - 60.00 10.00
500 Seftriakson 1 gram Vial 223849 12,430.00 120.00 90.00 - - - - 210.00 35.00
501 Selang Extention 150 cm Pcs ET152EL22 53,339.00 - - 5.00 5.00 - - 1.67
502 Selang Nebulizer set Disposible ( Anak ) pcs 11081488 33,000.00 - 1.00 5.00 - - - 1.00
503 Selang Nebulizer set Disposible ( Dewasa ) pcs 411688 33,000.00 - 1.00 5.00 - - 12.00 3.00
504 Semen Fuji 1-1-1 Pak 1702231 1,484,230.00 - - - - - - -
505 Serlang/ kanul Oksigen Dewasa Pcs NCA170192AX 12,155.00 - - 250.00 - - - 41.67
506 Serlang/ kanul Oksigen Dewasa Pcs NCA170992AX 12,155.00 250.00 - - - - - 41.67
89 Serum Anti Bisa Ular (ABU 1) Vial 4200917 462,000.00 3.00 2.00 - - 1,500.00 2.00 251.17
507 Set Epidural G18 x 3 1/4 Ktk/10 pcs 3M3258F06 346,500.00 - - - - - - -
508 Set Epidural G18 x 3 1/4 Ktk/10 pcs 14G06G8F06 3,277,500.00 - - - - - - -
509 Setirizin sir 5 mg/5 ml. Botol 1610169 7,756.00 65.00 50.00 - - 80.00 - 195.00 32.50
510 Sianocobalamin tab 50mcg Ktk/100 tab F130797B 19,800.00 41.00 60.00 50.00 - - - 151.00 25.17
511 Sianokobalamin (vitamin B12) injeksi ampul 17IC014 1,226.00 - - - 50.00 100.00 - 150.00 25.00
512 Sianokobalamin Injeksi Ktk/100ampul 15IG010 11,310.00 1.00 3.00 - 1.00 - - 5.00 0.83
138 Silk ( Benang Bedah Sutera ) No. 3/0 Dengan Jarum Bedah Box 0 0 7 1.17
513 Silk Black ( Silkam ) No.2/0 Reverse Cutting DS-24 mm pcs 161204 24,545.00 36.00 - - - - - 6.00
514 Silk Black ( Silkam ) No.4/0 Reverse Cutting DS-16 mm Pcs 170102 24,725.00 - 12.00 - - - - 2.00
43 Silk black 2/0 HR 26 24.00 4.00
37 Silk Black 3/0 HR 26 24.00 4.00
515 Silk black 4/0 DS 19 mm cutting pcs 150501 17,013.00 - - - - 24.00 - 4.00
53 Simvastatin 10 mg Tab 171610 113.00 600.00 - - 930.00 7,000.00 - 8,530.00 1,421.67
516 Simvastatin tab sal 10 mg Tablet 19J203 135.00 2,100.00 3,300.00 3,600.00 2,910.00 300.00 - 12,210.00 2,035.00
517 Simvastatin tab sal 20 mg Tab sal L60524B 252.00 2,300.00 1,000.00 1,400.00 3,000.00 3,850.00 2,200.00 13,750.00 2,291.67
518 Siprofloksasin tab scored 500 mg Tab 170318108 298.00 2,200.00 2,600.00 1,500.00 3,200.00 2,000.00 800.00 12,300.00 2,050.00
519 Slide Objec Glass Kotak 15,400.00 55.00 15.00 4.00 - - - 12.33
99 Slides Box Pcs 41,342.00 19.00 - - - - - 3.17
63 Slides/ Glas Objec Ktk - 7.00 5.00 - - - 2.00
26 Smiths medical jelco 16 G 25.00 4.17
27 Smiths medical jelco 18 G - -
28 Smitths medical hotline warming set- disp/30 pcs - -
520 Soft ClothOnLiner 10 x 10 (Hypafix) Roll 5110621933 118,251.00 - 1.00 - - 2.00 - 0.50
521 Soft ClothOnLiner 5cmx10m (Hypafix) Roll 6072221920 66,283.00 - - - - - - -
522 Softband (Padding) 3 inci Roll - 37,852.10 - - - - - - -
523 Softband (Padding) 4 inci Roll - 28,801.30 - - - - - - -
524 Softband (Padding) 6 inci Roll - 24,843.50 - - - - - - -
525 Sonde Pcs ZEE1151144 160,050.00 - - - - - - -
526 Spasminal Tab HTSPLA74010 1,097.80 600.00 100.00 100.00 100.00 - - 900.00 150.00
6 Spasminal (spasmal) Tab KY3A050 834.90 - 1,200.00 2,800.00 1,600.00 - 400.00 6,000.00 1,000.00
527 Spironolakton tab 25 mg tab 7E 0516 314.00 400.00 400.00 500.00 - - - 1,300.00 216.67
528 Spuit 1 cc Pcs 170710D 2,002.00 - - - - - - -
44 Spuit 1 CC (Tuberculin) - -
45 Spuit 10 CC - -
46 Spuit 10 CC - -
529 Spuit 20 cc Pcs 170724B 18,161.00 55.00 - - - - - 55.00 9.17
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
47 Spuit 20 CC - -
48 Spuit 3 CC - -
49 Spuit 3 CC - -
50 Spuit 5 CC - -
530 Stab Knife pcs 201308 145,475.00 - - - - - - -
531 Stik Asam urat Strip Kotak U17059078 77,550.00 - - - - - - -
532 Stik Cholesterol Strip Kotak C17072085 140,800.00 5.00 - - - - - 0.83
533 Stik Glukosa Strip Kotak 617125084 79,530.00 - - - - - - -
534 Stik Hb Strip Kotak HB317405A4H 146,300.00 - - - - - - -
535 Stik Tes Narkoba 3 Parameter Kotak D1705043 509,300.00 - - 2.00 - - - 0.33
536 Stik Trigliselida Strip Kotak 141161215B 1,455,080.00 - - - - - - -
537 Stik Urine 10 Parameter 100 pcs/kotak 20160829 227,700.00 2.00 - - - - - 0.33
538 Streptomisin serb inj 1000 mg/ml Vial 95395017 5,750.00 - - - - - - -
539 Suction / Saliva ejector Pcs 87,450.00 - - - - - - -
540 Suction Cateter Bayi No. 10 FR - 52 cm Pcs 105S15 7,400.00 - - - - - - -
541 Suction Catheter No. 10 Pcs SC160405 6,006.00 - - - - - - -
542 Suction Catheter No. 6 Pcs SCI50206 6,006.00 - - - - - 3.00 0.50
543 Suction Catheter No. 8 Pcs SC170603 6,006.00 - - - - - - -
544 Sukralfat 500 mg (ULSAFATE) Tablet A11139 373.00 60.00 - - - - - 60.00 10.00
60 SULFADIAZINE SILVER ( F ) - -
545 Supralysin Syr Btl 60 ml E7H434 46,860.00 30.00 10.00 - - - - 40.00 6.67
546 Surgical Blade/Pisau Operasi No.24" 100 pcs/kotak 4506252989 315,000.00 - 2.00 - - - - 0.33
31 Surgicryl 1 HR 36 48.00 8.00
38 Surgicryl 1 HR 40 MM 24.00 4.00
39 Surgicryl 2/0 DS 30 24.00 4.00
24 Surgicryl 2/0 HR 26 24.00 4.00
32 Surgicryl 2/0 HR 36 24.00 4.00
25 Surgicryl 3/0 HR 26 24.00 4.00
41 Surgicryl PGA 0 HR 30 24.00 4.00
40 Surgicryl PGA 2 HS 36 24.00 4.00
547 Systemic Solution Btl 1B0000 3,575,000.00 - - 1.00 - - - 0.17
14 T. PEDIATRIC SOLUTION Adm Set TK*A200LK 110.00 18.33
12 T. Terufusion Blood ADM Set- TB * U800L - -
13 T. Terufusion Blood ADM Set- TB * U800L - -
29 Tablet Tambah Darah Tablet O6818102 43.00 - 2,100.00 - - - - 2,100.00 350.00
548 Tabung EDTA Pcs 170320 145,200.00 - - - - - - -
549 Tabung reaksi pcs - 7,232.00 - - - - - - -
550 Tabung Reaksi 3 cm Tutup Merah Box 1604015 209,000.00 - - 1.00 - - - 0.17
551 Tabung Reaksi 3 cm Tutup Ungu Box 1607709 209,000.00 - - 1.00 - - - 0.17
552 Tegaderm 9 cm x 35 cm Pcs 201905AU 28,168.08 25.00 - - - - - 4.17
22 Terasozin (Hytroz) 1mg Tab ( Box /100 ) - -
553 Terazosin HCL (HYTRIN) Tablet 6065680 975.00 - - - - - - -
19 Terume Safeed Feeding Tube 3,5 ( 35CM ) - -
20 Terume Safeed Feeding Tube 5 FR ( 100CM) - -
15 Terumo Surflo IV Cath SR+OX1451C3 ( Abbocat no.14 ) - -
16 Terumo Surflo IV Cath SR+OX2032C3 ( ABBOCAT no. 20 ) 100.00 16.67
17 Terumo Surflo IV Cath SR+OX2225C3 ( ABBOCAT NO.22 ) - -
18 Terumo Surflo IV Cath SR+OX2419C3 ( Abbocat no, 24 ) - -
554 Tetrasiklin kaps 250 mg Kaps 1611049 174.00 500.00 500.00 - - - - 1,000.00 166.67
555 Thiamfenikol 125 mg/ml (DIONICOL) Btl 60 ml 70408 30,140.00 - - - - - - -
5 Thiamfenikol 500 mg Kapsul 65401001 811.44 - - - - - - -
556 Thiamin HCl tablet 50 mg Ktk/100 tab 1212017 23,849.10 8.00 - - - - - 8.00 1.33
132 Thiamine 50 mg ( Vitamin B1 ) 10 Strip@ 10 Tablet Tablet 0 1000 3100 4,100.00 683.33
557 Threeway Cock Treck Pcs 29,601.00 - - - 5.00 - - 0.83
558 Timolol tts mata 0,5% (ISOTIC ADRETOR) botol TE0292 12,425.00 - - - - - - -
559 Timolol tts mata 0,5% (ISOTIC ADRETOR) botol TE0292 12,425.00 - - - - - - -
560 TKF botol/ 10 ml 35315 56,925.00 - 1.00 - - - - 0.17
561 Tramadol 50 mg (TRAMOFAI) Tab 70402 1,313.40 200.00 550.00 - 900.00 1,110.00 300.00 3,060.00 510.00
30 Tramadol 50mg injeksi ampul 460114 1,984.00 25.00 - - - 3,000.00 - 3,025.00 504.17
No Nama Obat Kemasan No.Batch Harga FEB MAR APRIL MEI JUN JUL JML RATA2
562 Tramadol inj 50 mg/ml vial 460136 1,984.00 25.00 100.00 - 100.00 200.00 - 425.00 70.83
563 Tramadol inj 50 mg/ml Ampul 470012 1,984.00 - - - - - - -
564 Triglicerides Kit 230000 3,017,300.00 - - 1.00 - - - 0.17
565 Triheksifenidil tab 2 mg Tab 161413 97.00 100.00 1,000.00 1,100.00 - 1,000.00 200.00 3,400.00 566.67
8 Trnexmic Acid Injeksi 10 % 500 mg/5 ml ( Box / 10 Ampul ) 40.00 40.00 6.67
566 Umbilical Catheter N0.6 Pcs 150416PQ 78,650.00 - - - - - - -
567 Umblical Cort (kleim Tali Pusat) Ktk 1031688 78,000.00 - - - - - - -
568 Urdafalk 250 mg kapsul Ktk / 30 kaps VY6B001 344,301.10 - - - - - - -
569 Urea CP Kit 303000 2,048,200.00 - - 1.00 - - - 0.17
570 Uric Acid CP Kit 262600 2,290,200.00 - - 2.00 - - - 0.33
571 Urine Bag Pcs 24111688 3,600.00 50.00 110.00 40.00 20.00 - - 36.67
572 Urispas Tab 1607006 7,483.66 30.00 - 30.00 - - 90.00 150.00 25.00
573 Vaculainer Plain dengan Tutup Kotak 170518 145,200.00 1.00 - - - 2.00 - 0.50
23 Valsartan Tablet 80 mg ( Box /30 ) 510.00 510.00 85.00
8 Vasofix safety G 20 50.00 8.33
9 Vasofix safety G 22 50.00 8.33
10 Vasofix safety G 24 50.00 8.33
574 Verorab Vial NIJ331M 233,860.00 2.00 - - - - - 2.00 0.33
575 Vevirapin 200 mg Tab IG1862J 3,773.00 - - - - - - -
96 Vitamin A 100,000 IU Tab 066155W 327.00 - - 200.00 200.00 1,300.00 800.00 2,500.00 416.67
97 Vitamin A 200,000 IU Tab 046076W 519.00 - - 1,000.00 1,500.00 - 8,350.00 10,850.00 1,808.33
88 Vitamin B 6 10 mg Tab G71209B 136.00 1,600.00 400.00 1,000.00 2,700.00 200.00 - 5,900.00 983.33
576 Vitamin B Comlpex Tab 21507704 49.00 8,300.00 9,700.00 7,000.00 4,000.00 7,000.00 7,700.00 43,700.00 7,283.33
55 Vitamin C 250 mg Tab 1416029379 124.00 200.00 - 2,000.00 3,000.00 14,000.00 - 19,200.00 3,200.00
577 Vitazim Tab KTVTZB73536 1,028.50 - - - - - - -
40 WDN3TE-WIDA D5 1/ ANS/TM ( cairan infus Dex 1/4 NS) 100.00 100.00 16.67
500
578 White Tip - 207,000.00 - - - - - - -
pcs/Plastik
579 White Tip pcs 83,600.00 - - - - - - -
39 WIDA - WI 1000 ml air untuk irigasi 40.00 40.00 6.67
580 Widal /Salmonella Typhi H Vial 22132 114,400.00 - - - - - - -
581 Widal/Salmonella Typhi H Vial/5 ml 290415A 101,200.00 - - 3.00 - 2.00 - 0.83
582 Widal/Salmonella Typhi O Vial/5 ml 282035B 101,200.00 - - - - 2.00 - 0.33
583 Widal/Salmonella Typhi O Vial 22334 114,400.00 - - 3.00 - - - 0.50
584 Wing Needle 24 G pcs 4016258386 43,750.00 - - - - - - -
585 X- Ray Ukuran 18 x 24 Kotak 45740 1,434,070.00 - - - - - - -
586 X- Ray Ukuran 24 x 30 Kotak 43421 1,792,560.00 - 3.00 - - - - 0.50
587 X- Ray Ukuran 30 x 40 Kotak 43271 2,240,700.00 - 3.00 - - - 1.00 0.67
588 X- Ray Ukuran 35 x 35 Kotak 42370 2,422,090.00 - - - - - - -
62 Xylocaine 21 Jelly 10 Tube ( F ) 11.00 11.00 1.83
589 Zinc sir 10 mg/ml Botol 1706005 15,729.00 109.00 20.00 - 90.00 20.00 - 239.00 39.83
590 Zinc tab disp 20 mg Tab 1508107 592.00 200.00 - - - - - 200.00 33.33
591 Zinc tab disp 20 mg Tab 1604009 592.00 800.00 - - - - - 800.00 133.33
592 Zinc tab disp 20 mg Tab 1601001 592.00 600.00 200.00 - - - - 800.00 133.33
593 Zinc tab disp 20 mg Tab 1611037 592.00 500.00 1,800.00 1,500.00 300.00 1,500.00 2,000.00 7,600.00 1,266.67
31 Zink disp tablet tablet 1505082 474.00 - 500.00 - - - - 500.00 83.33