Bulan: Januari 2022: No. Nama Obat Satuan Harga PBF

LPLPO OBAT GUDANG FARMASI
RSUD PADANG PANJANG
BULAN : JANUARI 2022

KELUAR Retur/ Bayar
No. NAMA OBAT SATUAN S.AWAL MASUK PERSEDIAAN TOTAL SISA HARGA PBF
UTAMA D.IGD D.OK COVID R.Ampr Exp Bon
1 A.B.U Vial 5 5 5 5 - Rp 517,132 Indofarma 1

2 A.T.S 1500 ui Ampul - - - - Rp 130,999 Indofarma 2
3 Abillify discmelt Tablet - - - - Rp 19,500 Merapi 3
4 Acarbose 100 mg Tablet - - - - Rp 876 AAM 4
5 Acarbose 50 mg Tablet 1,400 1,000 2,400 1,400 1,400 1,000 Rp 600 AAM 5
6 Acetylsistein 200 mg Tablet - - - - Rp 605 P.Padang 6
7 Acyclovir 200 mg Tablet 500 500 - 500 Rp 565 K.Farma 7

8 Acyclovir 400 mg Tablet 950 950 500 500 450 Rp 426 Rajawali 8
9 Acyclovir 400 mg Tablet 500 500 - 500 Rp 429 Rajawali 9
10 Acyclovir 5% cream Tube 15 15 5 5 10 Rp 3,391 K.Farma 10
11 Adalat Oros 30 mg Tablet 3,990 3,990 30 30 3,960 Rp 3,986 P.Padang 11

12 Akilen ear drop Botol 120 50 170 40 2 42 128 Rp 35,000 BSP 12
13 Allopurinol 100 mg Tablet - - - - Rp 105 Merapi 13
14 Allopurinol 100 mg Tablet 22,700 22,700 5,000 100 5,100 17,600 Rp 87 Enseval 14
15 Allopurinol 300 mg Tablet 1,000 1,000 - 1,000 Rp 200 Enseval 15
16 Alpentin 100 mg Tablet - - - - Rp 1,095 AAM 16
17 Alprazolam 0.5 mg Tablet 7,800 7,800 2,000 2,000 5,800 Rp 78 Merapi 17
18 Ambroxol 15 mg/5 ml Botol 240 240 50 10 4 64 176 Rp 3,264 Indofarma 18
19 Ambroxol 30 mg Tablet 3,400 3,400 1,000 300 1,300 2,100 Rp 231 Indofarma 19
20 Ambroxol 30 mg Tablet 5,000 5,000 - 5,000 Rp 246 Indofarma 20
21 Aminofusin Hepar Botol 13 13 - 13 Rp 79,500 Enseval 21
22 Aminofusin Pead inf Botol - - - - Rp 56,784 Enseval 22
23 Aminofusin Pead inf Botol 3 3 3 3 - RSAM 23
24 Aminosteril infan 6% Botol 3 3 - 3 Rp 39,000 APL
25 Aminosteril infan 10% Botol - - - - Rp 58,905 APL 24
26 Aminophylin 24 mg/ml Amp 14 14 - 14 Rp 7,017 APL 25
27 Aminophylin 24 mg/ml Amp - - - - Yarsi 26
28 Aminophylin 24 mg/ml Amp 60 60 30 30 30 Rp 2,704 K.Farma 27
29 Aminophyllin 200 mg Tablet - - - - Rp 96 K.Farma 28
30 Amiodaron 50 mg/ ml Amp 60 60 48 12 60 - Rp 8,700 APL
31 Amiodaron 50 mg/ ml Amp 10 10 10 10 - Rp 6,118 APL
32 Amiparen infus Botol 48 48 - 48 Rp 96,650 Merapi
33 Amitriptilin 25 mg Tablet 200 200 200 200 - Rp 175 P.Padang
34 Amlodipin 10 mg Tablet 68,400 68,400 15,000 200 15,200 53,200 Rp 72 Merapi

35 Amlodipin 5 mg Tablet 59,700 59,700 - 59,700 Rp 53 Tempo
36 Amoxicillin 500 mg Tablet 12,700 12,700 1,200 400 1,600 11,100 Rp 261 Enseval
37 Amoxicillin dry syr Botol - - - - Rp 2,783 Indofarma
38 Amoxicillin drop Botol 140 140 - 140 Rp 13,500 TSJ
39 Amoxicillin 1 gr Vial - - - - Rp 9,450 Rajawali
40 Ampicilin 1 gr Vial 20 20 20 20 - Rp 8,649 P.Padang
41 Ampicilin 1 gr Vial - - - - Rp 10,395 K.Farma
42 Ampicilin 1 gr Vial 200 200 50 70 120 80 Rp 8,988 TSJ
43 Anemolat 1 mg Tablet - - - - Rp 165 Rajawali

44 Anemolat 1 mg Tablet 3,600 3,600 3,600 3,600 - Rp 220 K.Farma
45 Antasida Botol 50 50 20 4 24 26 Rp 1,725 Indofarma
46 Antihemorroid supp Supp 930 930 200 20 20 240 690 Rp 3,250 K.Farma
47 Apidra Solastar Pen 180 180 - 180 Rp 89,500 APL
48 Aqua pro injeksi / Otsu-WI Botol 3,470 3,470 480 480 240 1,200 2,270 Rp 2,625 Merapi
49 Aripiprazole 10 mg Tablet 100 100 100 100 - Rp 19,500 AAM

50 Arixtra 2,5 mg Ampul 140 140 10 10 130 Rp 225,290 AAM
51 Arkine 2 mg Tablet - - - - Rp 762 Sapta Sari
52 Artesunate Ampul - - - - Pinjaman
53 Asam Folat 1 mg Tablet 6,400 6,400 3,000 3,000 3,400 Rp 58 K.Farma
54 Asam Mefenamat 500 mg Tablet 32,200 32,200 600 100 700 31,500 Rp 111 Enseval
55 Asam Tranexamat 250 mg/5 ml Ampul 430 430 30 10 40 390 Rp 1,813 AAM
56 Asam Tranexamat 500 mg Tablet 4,000 4,000 200 200 3,800 Rp 1,683 TSJ
57 Asam Tranexamat 500 mg/5 ml Ampul 1,920 1,920 150 80 230 1,690 Rp 2,088 AAM
58 Asam Valproat 250 mg/5 ml Botol 300 300 100 100 200 Rp 12,123 AAM
59 Ascorbic Acid 200 mg Ampul - - - - Rp 5,772 APL
60 Ascorbic Acid 200 mg Ampul 105 105 30 30 60 45 Rp 8,800 Merapi
61 Ascorbic Acid 1000 mg Ampul - - - - Rp 17,600 Merapi
62 Asering infus Botol 520 520 40 100 40 180 340 Rp 9,680 Merapi
63 Aspilets 80 mg Tablet 10,900 10,900 100 100 10,800 Rp 611 K.Farma
64 Atorvastatin 20 mg Tablet - - - - Rp 1,265 K.Farma
65 Atorvastatin 20 mg Tablet - 3,000 3,000 1,500 30 1,530 1,470 Rp 467 AAM
66 Atracurium 50 mg Ampul - - - - Rp 14,235 APL
67 Atracurium 25 mg Ampul - - - - Rp 11,737 Indofarma
68 Atracurium 25 mg Ampul 25 25 25 25 - Rp 8,978 APL
69 Atropin Sulfat 0,25 mg/ml Ampul 500 500 100 100 400 Rp 1,718 APL
70 Avamys Nasal Spray Box 100 100 15 15 85 Rp 115,400 APL
71 Azitromicin 500 mg Tablet 2,760 2,760 400 40 440 2,320 Rp 1,300 K.Farma
72 Bactesyn 1,5 g Ampul 150 150 20 45 65 85 Rp 20,010 Enseval
73 Bamgetol Tablet - - - - Rp 1,287 Merapi
74 Bedak Kocok Anak 100 ml Botol 45 45 - 45 Rp 7,898 Panay
75 Bedak Kocok Dewasa 100 ml Botol - - - - Rp 20,020 APM
76 Bedak Kocok Dewasa 200 ml Botol 87 87 20 20 67 Rp 21,461 Panay
77 Berotec MDI Box 298 298 168 16 184 114 Rp 86,930 APL
78 Berotec MDI Box - - - - RSAM
79 Betahistin 6 mg Tablet 19,400 19,400 5,000 500 5,500 13,900 Rp 88 AAM

80 Betametason 0.1% cream Tube 75 75 - 75 Rp 1,520 K.Farma
81 Bfluid Botol 390 390 20 30 50 340 Rp 76,300 Merapi
82 Bisacodyl 5 mg Tablet - - - - Rp 327 AMS
83 Bisacodyl 5 mg Tablet 600 600 - 600 Rp 216 K.Farma
84 Bisoprolol 5 mg Tablet 30,300 30,300 2,700 2,700 27,600 Rp 137 AAM
85 Bisoprolol 5 mg Tablet - - - - GFK
86 Bisoprolol 2,5 mg Tablet 35,000 35,000 31,000 200 31,200 3,800 Rp 129 AAM
87 Bisoprolol 2,5 mg Tablet - - - - Rp 275 Enseval
88 Bricasma 0,5 mg/ml Vial 15 15 15 15 - Rp 12,558 APL
89 Brilinta 90 mg Tablet 1,120 1,120 - 1,120 Rp 8,404 APL
90 Bucain spinal 0,5 mg Ampul 55 200 255 55 55 200 Rp 48,400 UDC
91 C. Asternof 5 ml Botol - - - - Rp 21,483 P.Valent
92 C. Asternof 0,6 ml Strip 100 100 - 100 Rp 20,972 P.Valent
93 C. Augentonic 0.6 ml Strip 100 100 - 100 Rp 22,122 P.Valent
94 C. Carpin 2% 0,6 ml Strip 60 60 - 60 Rp 18,030 P.Valent
95 C. Catarlen 0,6 ml Strip 97 97 - 97 Rp 20,460 P.Valent
96 C. Cendrid 0,6 ml Strip - - - - Rp 17,007 P.Valent
97 C. Cenfresh 0,6 ml Strip 440 440 180 180 260 Rp 23,529 P.Valent
98 C. Conver 0,6 ml Strip 60 60 60 60 - Rp 16,496 P.Valent
99 C. Efrisel 5 ml Botol - - - - Rp 15,601 P.Valent
100 C. Efrisel 5 ml Botol 40 40 - 40 Rp 14,900 P.Valent
101 C. Efrisel 0,6 ml Strip - - - - Rp 15,600 P.Valent
102 C. Fenicol 1% 3,5 g Tube - - - - Rp - P.Valent
103 C. Floxa 0,6 ml Strip 140 140 - 140 Rp 27,364 P.Valent
104 C. Gentamicin 3,5 g Tube 110 110 - 110 Rp 37,212 P.Valent
105 C. Gentamicin 3,5 g Tube - - - - Rp 37,210 P.Valent
106 C.Gentamicin 5 ml Botol - - - - Rp 29,026 P.Valent
107 C.Gentamicin 5 ml Botol 20 20 - 20 Rp 22,300 P.Valent
108 C. Hervis 3,5 g Tube 20 20 - 20 Rp 37,594 P.Valent
109 C. Hervis 3,5 g Tube 30 30 - 30 Rp 37,595 P.Valent
110 C. Homatro 2% 5 ml Botol 10 10 - 10 Rp 36,316 P.Valent
111 C. Homatro 2% 5 ml Botol 10 10 5 5 5 Rp 36,317 P.Valent
112 C. LFX 0,6 ml Strip 115 115 - 115 Rp 70,587 P.Valent
113 C. LFX ed 5 ml Botol - - - - Rp 68,557 K.Farma
114 C. Lyteers 15 ml Botol 130 130 - 130 Rp 23,018 P.Valent
115 C. Lyteers 0,6 ml Strip - - - - Rp 20,117 P.Valent
116 C. Lyteers 0,6 ml Strip 197 197 57 57 140 Rp 19,693 P.Valent
117 C. Mycetin 3,5 g Tube 67 67 25 25 42 Rp 13,043 P.Valent
118 C. Mydriatil 1% 5 ml Botol - - - - Rp 39,971 P.Valent
119 C. Mydriatil 0.5% Botol 35 35 - 35 Rp 29,538 P.Valent
120 C. Noncort 0,6 ml Strip 100 100 60 60 40 Rp 43,221 P.Valent
121 C. Pantocain 0,5% 5 ml Botol - - - - Rp 12,404 P.Valent
122 C. Pantocain 2% 0,6 ml Strip - - - - Rp 16,112 P.Valent
123 C. Pantocain 2% 5 ml Botol 53 53 - 53 Rp 13,555 P.Valent
124 C. Polidex 0,6 ml Strip 257 257 100 5 105 152 Rp 27,110 P.Valent
125 C. Polipred 0,6 ml Strip 5 5 - 5 Rp 17,775 P.Valent
126 C. Polygrant 0.6 ml Strip 40 40 - 40 Rp 17,903 P.Valent
127 C. Polygrant 3,5 g Tube 100 100 - 100 Rp 18,925 K.Farma
128 C. Protagenta 0,6 ml Strip 276 276 66 66 210 Rp 36,700 P.Valent
129 C. Siloxan 5 ml botol 300 300 - 300 Rp 53,963 P.Valent
130 C. Timol 0.5% 0,6 ml Strip 198 198 60 60 138 Rp 26,342 P.Valent
131 C. Tobro 0,6 ml Strip 60 60 - 60 Rp 19,565 P.Valent
132 C. Tobroson 0,6 ml Strip 69 69 - 69 Rp 29,667 P.Valent
133 C. Tropin 0,5% 5 ml botol - - - - Rp 12,756 P.Valent
134 C. Tropin 0,5% 0,6 ml Strip 135 135 - 135 Rp 15,729 P.Valent
135 C. Vasacon 0.6 ml strip 100 100 60 60 40 Rp 14,194 P.Valent
136 C. Vasacon 15 ml Botol - - - - Rp 16,981 P.Valent
137 C. Vernacel 0,6 ml Strip 165 165 - 165 Rp 21,227 P.Valent
138 C. Vitrolenta 0,6 ml Strip - - - - Rp 29,912 P.Valent
139 C. Vitrolenta 5 ml Botol 100 100 - 100 Rp 33,503 P.Valent
140 C. Vosama 0,6 ml Strip 20 20 - 20 Rp 18,030 P.Valent
141 C. Xitrol 3,5 g Tube - - - - Rp 37,489 P.Valent
142 C. Xitrol 5 ml Botol 5 5 - 5 Rp 27,877 P.Valent
143 Ca. Gluconas 10% 10 ml Ampul - 48 48 - 48 Rp 5,723 APL
144 Calcium polystyrene sachet 560 560 20 20 540 Rp 5,639 MPI
145 Calsium laktat 500 mg Tablet 10,600 10,600 3,000 3,000 7,600 Rp 63 Merapi
146 Calsium laktat 500 mg Tablet 30,000 30,000 - 30,000 Rp 60 Merapi
147 Candesartan 16 mg Tablet 35,220 35,220 12,240 12,240 22,980 Rp 319 AAM
148 Candesartan 8 mg Tablet 45,210 45,210 10,800 90 10,890 34,320 Rp 212 AAM
149 Captopril 12,5 mg Tablet - - - - Rp 64 K.Farma
150 Captopril 25 mg Tablet 7,600 7,600 100 100 7,500 Rp 75 K.Farma
151 Carbamazepin 200 mg Tablet 9,300 9,300 5,000 5,000 4,300 Rp 198 Merapi
152 Carbo gliserin Botol - - - - Rp 2,730 APM
153 Carmed urea 10 % Tube 94 94 20 20 74 Rp 28,710 AMS
154 Carvedilol 6,25 mg Tablet 4,900 4,900 3,000 3,000 1,900 Rp 1,309 K.Farma
155 Cefadroxyl 500 mg Tablet 5,100 5,100 200 200 4,900 Rp 580 Enseval
156 Cefadroxyl 125 mg/5 ml Botol 260 260 50 10 60 200 Rp 4,340 K.Farma
157 Cefazolin 1 gr Vial - - - - Rp 6,323 AAM
158 Cefepime 1 gr Vial - - - - Rp 45,045 Indofarma
159 Cefixime 100 mg Tablet 11,700 11,700 10,900 500 300 11,700 - Rp 387 Enseval
160 Cefixime 100 mg/5 ml Botol 115 115 25 5 5 35 80 Rp 4,947 AAM
161 Cefoperazone 1 gr Vial 164 164 24 10 34 130 Rp 7,888 AAM
162 Cefotaxim 1 g Vial 90 90 90 90 - Rp 2,850 Enseval
163 Ceftazidime 1 g Vial 100 100 - 100 Rp 6,597 AAM
164 Ceftriaxon 1 g inj Vial 2,202 2,202 600 200 800 1,402 Rp 2,850 Enseval
165 Cetadop 40 mg/ml Amp - - - - Rp 6,160 APL
166 Cetirizin 10 mg Tablet - 1,000 1,000 1,000 1,000 - GFK
167 Cetirizin 10 mg Tablet - 40,000 40,000 8,000 200 100 8,300 31,700 Rp 50 Merapi
168 Cetirizin 5 mg/5 ml Botol 25 50 75 20 15 35 40 Rp 2,153 Merapi
169 Chloramphenicl 250 mg Tablet - - - - GFK
170 Chloroquin 150 mg Tablet - - - - Rp 1,506 K.Farma
171 Cilostazol 100 mg Tablet 3,000 3,000 500 500 2,500 Rp 5,852 TSJ
172 Ciprofloxacin 500 mg Tablet 1,500 1,500 - 1,500 Rp 250 Enseval

173 Citaz 100 mg Tablet - - - - Rp 6,501 Enseval
174 Citicolin 250 mg/ml amp 385 385 300 75 375 10 Rp 4,700 Enseval
175 Citicolin 250 mg/ml amp - - - - Rp 8,250 Rajawali
176 Citicolin 500 mg/ml amp 50 50 - 50 Rp 12,000 Enseval
177 Citicolin 500 mg Tablet 3,400 3,400 2,000 2,000 1,400 Rp 2,750 Enseval
178 Clindamicin 150 mg Tablet 5,000 5,000 - 5,000 Rp 677 AMS
179 Clindamycin 300 mg Tablet - - - - Yarsi
180 Clobazam 10 mg Tablet 1,100 1,100 1,100 1,100 - Rp 384 AAM

181 Clobazam 10 mg Tablet 5,000 5,000 - 5,000 Rp 776 AAM
182 Clonidine 0,15 mg Tablet 900 5,500 6,400 900 900 5,500 Rp 146 K.Farma
183 Clopidogrel 75 mg Tablet 63,330 63,330 17,280 150 60 17,490 45,840 Rp 575 K.Farma
184 Clopidogrel 75 mg Tablet - - - - Rp 1,200 AAM
185 Clorpromazine/CPZ 100 mg tab 500 500 300 300 200 Rp 433 K.Farma
186 Clozapin 100 mg Tablet 2,200 2,200 - 2,200 Rp 1,197 AAM
187 Clozapin 25 mg Tablet 4,000 4,000 1,000 1,000 3,000 Rp 473 AAM
188 Co-Amoxyclav 625 mg Tablet 840 840 - 840 Rp 4,158 AAM
189 Codein 10 mg Tablet 4,500 4,500 500 200 700 3,800 Rp 600 K.Farma
190 Colcitine 0,5 mg Tablet 390 390 60 60 330 Rp 2,414 APL
191 Colcitine 0,5 mg Tablet 1,650 1,650 - 1,650 Rp 649 APL
192 Comafusin hepar Botol 12 12 6 6 6 Rp 79,129 Enseval
193 Combivent UDV Ampul 580 580 300 200 80 580 - Rp 3,500 APL
194 Cotrimoksazole 480 mg Tablet 3,500 3,500 - 3,500 Rp 365 TSJ
195 Cotrimoxasazol syr 60 ml botol 67 67 - 67 Rp 2,190 Merapi
196 CTM/Chlorpheniramini maleat 4 mg Tablet - - - - Rp 25 K.Farma
197 Curcuma Tablet - - - - Rp 416 P.Padang
198 Curcuma blister Tablet 12,840 12,840 6,000 240 240 6,480 6,360 Rp 876 P.Padang
199 D 10% otsu Botol 80 80 20 20 40 40 Rp 7,200 Merapi
200 D 40%, Otsu Ampul 178 178 12 12 166 Rp 7,000 Merapi
201 D 5 % Otsu Botol 380 380 20 20 40 340 Rp 6,627 Merapi
202 Daryatul Pcs - - - - Rp 9,666 APL
203 Decafil 150 mg Tablet - - - - Rp 152 K.Farma
204 Depakote 250 mg Tablet - - - - Rp 1,200 APL
205 Desferal Vial - - - - Rp 119,756 AAM
206 Desoximethason cream Tube 264 264 72 72 192 Rp 9,000 AAM
207 Desrem/ remsedivir Ampul 100 100 - 100 Rp 440,000 IGM
208 Dexametason 0.5 mg Tablet 200 200 100 100 100 Rp 136 K.Farma
209 Dexametason 0.5 mg Tablet 2,000 2,000 - 2,000 Rp 163 K.Farma
210 Dexametason 0,5 mg/ml Ampul 170 170 90 50 140 30 Rp 1,152 Sapta Sari
211 DHD frimal Tablet - - - - GFK

212 Dialifer inj Ampul - - - - Rp 31,020 AMS
213 Diazepam 2 mg Tablet - - - - Rp 137 K.Farma
214 Diazepam 2 mg Tablet 3,700 3,700 2,000 100 100 2,200 1,500 Rp 70 P.Padang
215 Diazepam 5 mg Tablet 2,400 2,400 100 100 2,300 Rp 114 Merapi
216 Diazepam 5 mg/ ml Ampul 100 100 10 20 10 40 60 Rp 1,545 K.Farma
217 Diflucan 50 mg Tablet - - - - Rp 5,900 AAM
218 Digoxin 0.25 mg Tablet 4,000 4,000 3,000 3,000 1,000 Rp 124 P.Padang
219 Diltiazem 30 mg Tablet 10,000 10,000 2,000 2,000 8,000 Rp 135 AAM
220 Diphenhydramine 10 mg/ ml Vial - 30 30 - 30 Rp 825 K.Farma
221 Dipsamol inh Box - - - - Rp 25,245 P.Padang
222 Divalprex sodium 250 mg Tablet 12,000 12,000 4,000 4,000 8,000 Rp 990 AMS
223 Diviti PFS 2,5 mg Ampul - - - - Rp 256,355 AAM
224 Dobutamin 50 mg Ampul 50 50 - 50 Rp 8,497 AAM
225 Domperidon Syrup 60 ml Botol - - - - Rp 2,359 Indofarma
226 Domperidon 10 mg Tablet 3,000 3,000 500 200 100 800 2,200 Rp 73 Merapi
227 Donepezil 5 mg Tablet 1,200 1,200 600 600 600 Rp 1,600 IGM
228 Dopamed 250 mg Tablet 700 700 200 200 500 Rp 1,014 AAM
229 Dopamin 250 mg/5 ml Ampul 105 105 - 105 Rp 3,397 K.Farma
230 Dorner Tablet 900 1,500 2,400 1,800 1,800 600 Rp 4,900 APL
231 Doxicyclin 100 mg Tablet 500 500 500 500 - Rp 289 AAM
232 Dulcolac 5 mg supp Supp 24 24 - 24 Rp 5,085 APL
233 Dulcolax 10 mg supp Supp 200 200 50 50 150 Rp 4,325 APL
234 Dulcolax 10 mg Tablet - - - - Rp 1,508 APL
235 Dumin rectal 125 mg/2.5 ml Tube 160 160 20 85 105 55 Rp 15,355 AAM
236 Eas Pfrimer inf Botol - - - - Rp 53,000 Enseval

237 Efedrin 50 mg/ ml Ampul - - - - Rp 8,569 APL
238 Efedrin 50 mg/ ml Ampul 20 20 20 20 - Rp 6,486 APL
239 Efedrin 25 mg Tablet - - - - Rp 158 K.Farma
240 Eferison 50 mg Tablet 39,700 39,700 10,000 100 200 10,300 29,400 Rp 983 Merapi
241 Engerix B 10 mcg Box - - - - Rp 67,100 APL
242 Epinephrine 0,1% Ampul 150 150 30 30 60 90 Rp 2,772 Rajawali
243 Epodion 2000 iu Ampul 30 30 20 20 10 Rp 57,000 UDC
244 Ergotamine Coffein Tablet 3,900 3,900 1,000 1,000 2,900 Rp 217 K.Farma
245 Erlamycetine eo Tube 16 16 - 16 Penggantian
246 Erlamycetine ed Botol - - - - Rp 4,234 P.Valent
247 Erphafillin 200 mg Tablet 19,700 19,700 2,000 300 900 3,200 16,500 Rp 153 Sapta Sari
248 Erphahexin Tablet - - - - Rp 95 Sapta Sari
249 Ermethasone 0,5 mg Tablet - - - - Rp 73 Sapta Sari
250 Erythromycin 250 mg Tablet - - - - Rp 576 Sapta Sari
251 Erythromycin 500 mg Tablet 800 800 - 800 Rp 1,040 Kebayoran
252 Erythromycin 500 mg Tablet 500 500 - 500 Rp 785 Rajawali
253 Erythromycin 200 mg/ 5 ml Botol 10 10 - 10 Rp 6,785 K.Farma
254 Etadium 2 mg Tablet 500 500 - 500 Rp 183 APM
255 Etambutol 500 mg Tablet 1,400 1,400 500 500 900 Rp 447 Dosniroha
256 Eugenol 10 ml Botol - - - - GFK
257 Euthyrox 100 mcg Tablet - - - - Rp 1,072 AAM
258 Euthyrox 50 mcg Tablet - - - - Rp 719 AAM
259 Extrace 200 mg Ampul - - - - Rp 7,865 APL
260 Ezelin insulin Box - - - - Rp 85,000 Enseval
261 Fargoxin 0,25 mg Tablet - - - - Rp 12 Kebayoran

262 Fargoxin 0,25 mg/ml Ampul - - - - Rp 25,300 P.Padang
264 Farmavon 2 mg/ml Ampul 340 340 30 30 310 Rp 37,752 P.Padang
265 Fartison 100 mg Vial 6 6 - 6 Rp 99,275 P.Padang
266 Farsix Ampul - - - - Rp 3,674 P.Padang
267 Fasorbid 10 mg Tablet - - - - Rp 189 Kebayoran
269 Fasorbit 1 mg/ml Vial - - - - Rp 51,975 P.Padang
270 Fenobarbital 30 mg Tablet 4,400 4,400 1,000 100 1,100 3,300 Rp 182 K.Farma
271 Fenobarbital 50 mg/ml Ampul 30 30 - 30 Rp 1,700 K.Farma

272 Fentanyl 0.5 mg/ml Ampul 50 50 50 50 - Rp 28,274 K.Farma
273 Fetik Supp 570 570 100 50 150 20 320 250 Rp 10,890 Enseval
274 Fibrion 1500000 IU Tablet - - - - Rp 3,400,000 AAM
275 Flamergi eye drop Botol - - - - Rp 20,570 BSP
276 Flamicort 10 mg/ ml Vial 50 50 20 20 30 Rp 110,000 AAM
277 Flixotide Nebules 2 ml Ampul 130 130 50 30 30 110 20 Rp 14,738 APL
278 Fluconazol 150 mg Tablet 100 100 100 100 - Rp 18,800 K.Farma
279 Fluimucil granule sachet 8,490 8,490 3,000 600 390 3,990 4,500 Rp 3,230 APL
280 Flunarizin 5 mg Tablet 9,520 9,520 1,840 200 2,040 7,480 Rp 894 P.Valent/MPI
281 Fluoxetine 20 mg Tablet 4,980 4,980 - 4,980 Rp 387 AAM
282 Fonylin 60 mg Tablet 3,300 3,300 - 3,300 Rp 3,300 AAM
283 Fortanes inj 15 mg/3ml Ampul - - - - Rp 18,700 Enseval
284 Framycetine sulfate Pcs 70 70 20 50 70 - Rp 10,175 APL
285 Fresofol 1% Ampul 100 100 50 50 50 Rp 11,000 APL
286 Fucilex cream Tube 51 51 30 30 21 Rp 7,150 MBS
287 Furosemid 40 mg Tablet 51,200 51,200 14,400 14,400 36,800 Rp 145 K.Farma
288 Furosemid 10 mg/ ml Ampul - - - - Rp 923 AAM
289 Fusycom cr Tube 100 100 - 100 Rp 19,096 APL

290 Gabapentin 100 mg Tablet 23,200 23,200 12,600 50 100 12,750 10,450 Rp 1,025 APL
291 Garam ingris sac/30gr 698 698 - 698 Rp 2,040 Bratako
292 Gelafusal infus Botol 30 30 10 10 20 Rp 145,015 AAM
293 Gelofusin inf botol - - - - Rp 145,015 Dosniroha
294 Gemfibrozil 300 mg Tablet 2,000 2,000 1,900 100 2,000 - Rp 462 K.Farma
295 Gemfibrozil 300 mg Tablet - 6,000 6,000 - 6,000 Rp 315 K.Farma
296 Gentalex cream Tube 24 24 24 24 - Rp 2,350 Kebayoran
297 Gentamicin 40 mg/ ml Ampul - - - - Rp 5,060 Indofarma
298 Gentamicin sulfate 0,1% Tube 500 500 50 40 90 410 Rp 2,849 K.Farma
299 Gentian Violet Botol 43 43 - 43 Rp 1,760 APM
300 Glaucon 100 mg Tablet 1,680 1,680 - 1,680 Rp 3,887 P.Valent
301 Glauseta Tablet - - - - Rp 3,793 BSP
302 Glibenklamide 5 mg Tablet - - - - Rp 58 Indofarma
303 Gliclazide 80 mg Tablet 1,000 1,000 - 1,000 Rp 235 Tempo
304 Gliclazide 80 mg Tablet 5,000 5,000 - 5,000 Rp 199 AAM
305 Glimepiride 1 mg Tablet - - - - Rp 220 P.Valent
306 Glimepiride 2 mg Tablet 14,900 14,900 5,000 100 100 5,200 9,700 Rp 123 Enseval
307 Gliquidon 30 mg Tablet 14,000 14,000 4,000 100 4,100 9,900 Rp 1,000 AAM
308 Glucosamin Tablet 10,000 10,000 2,100 2,100 7,900 Rp 1,198 Merapi/DNR
309 Glucosamin Tablet 2,900 2,900 2,900 2,900 - Rp 1,106 Merapi
310 Griseovulfin 125 mg Tablet 300 300 100 100 200 Rp 326 K.Farma
311 Hepatitis B rekom Ampul - - - - Rp 52,052 Rajawali
312 Haloperidol 0,5 mg Tablet 8,000 8,000 - 8,000 Rp 55 P.Padang
313 Haloperidol 1,5 mg Tablet 8,000 8,000 1,000 1,000 7,000 Rp 59 P.Padang
314 Haloperidol 5 mg Tablet 2,000 2,000 - 2,000 Rp 54 Merapi
315 Hemapo 3000 ui Ampul 204 204 50 50 154 Rp 80,000 Enseval
316 Heparin sodium 5000 iu Vial 90 90 10 10 80 Rp 46,635 P.Padang
317 Herbesser CD inj Vial 10 10 - 10 Rp 163,700 AAM
318 Herbesser CD 100 mg Tablet 5,900 5,900 4,000 4,000 1,900 Rp 4,750 AAM
319 Hexymer 2 mg Tablet - - - - Rp 385 UDC
320 Hidroklortiazid 25 mg Tablet 2,000 2,000 - 2,000 Rp 148 K.Farma
321 Hidrokortison 2.5% salep Tube 121 121 6 6 115 Rp 2,475 K.Farma
322 Holimox dry syrup Botol - - - - Rp 3,783 Sapta Sari
323 Humalog kwikpen Pen - - - - Rp 87,000 Tempo
324 Humalog Mix 25 Pen 350 350 200 200 150 Rp 112,000 APL
326 Human Albumin 20% 50 ml Botol 6 6 3 3 3 Rp 445,000 AAM
327 Hydroxychloroquin Tablet 150 150 - 150 Rp 2,585 MBS
328 Hyocine-N-Butylbromide 20 mg/ ml Ampul 30 30 60 30 30 30 Rp 5,778 APL
329 Hyocine-N-Butylbromide 10 mg Tablet 1,000 1,000 - 1,000 Rp 1,050 Rajawali
330 Hytroz 1 mg Tablet - - - - Rp 688 AAM
332 Hytroz 2 mg Tablet - - - - Rp 5,363 AAM
333 Ibuprofen 100 mg/5 ml Botol - - - - Rp 2,776 Indofarma
334 Ibupropen 400 Mg Tablet 10,700 10,700 3,000 200 3,200 7,500 Rp 366 Kebayoran
335 Ibupropen 200 Mg Tablet - - - - Rp 108 Sapta Sari
336 Iliadin spray 0,05% Pcs 10 20 30 10 10 20 Rp 38,819 APL
337 Iliadin drop 0,025% Pcs 8 8 8 8 - Rp 36,817 APL
338 INH 100 mg Tablet 3,900 3,900 3,000 3,000 900 Rp 75 K.Farma
339 INH 300 mg Tablet - 5,000 5,000 2,000 2,000 3,000 Rp 150 K.Farma
340 Inviclot 5000 iu Vial - - - - Rp 46,631 P.Padang
341 Iron sucrose Ampul 50 50 20 20 30 Rp 27,500 AMS
342 ISDN 1 mg/ ml Ampul 10 10 10 10 - Rp 17,500 AMS
343 Isoflurance 250 ml Botol - - - - Rp 400,000 P.Padang
344 Isosorbid Dinitrat/ISDN 5 mg Tablet 3,400 3,400 - 3,400 Rp 88 P.Padang
345 Ivanes 100 mg/10 ml Vial - - - - Rp 48,600 K.Farma
346 Ka EN 1B Botol 200 200 40 40 80 120 Rp 10,350 Merapi
347 Ka EN MG3 Botol 80 80 - 80 Rp 10,750 Merapi
348 Kalitake 20 mg Tablet - - - - Rp 4,998 MPI
349 Kaltrofen Supp - - - - Rp 11,500 Enseval
350 Kanamycin 1 g Vial 50 50 - 50 Rp 17,074 K.Farma
351 KCl 7.4 % Otsu Ampul 116 116 10 12 22 94 Rp 3,472 Merapi
352 KCl Serbuk Pot 1 kg - - - - Rp 93,500 Bratako
353 Kendaron 200 mg Tablet 570 570 300 30 330 240 Rp 1,027 APL
354 Ketamin 100 mg/ ml Ampul 20 20 - 20 Rp 14,788 AAM
355 Ketokonazol 200 mg Tablet 1,900 1,900 200 200 1,700 Rp 260 Enseval
356 Ketokonazol Cream 2% 10gr Tube 20 20 20 20 - Rp 2,399 K.Farma
357 Ketoprofen 100 mg Tablet 1,300 1,300 1,300 1,300 - Rp 726 P.Padang
358 Ketoprofen 100 mg Tablet 2,000 2,000 700 200 900 1,100 Rp 1,080 AMS
359 Ketoprofen 50 mg Tablet 1,000 1,000 - 1,000 Rp 563 AMS
360 Ketorolac 30 mg inj Ampul 1,210 1,210 200 100 200 60 560 650 Rp 880 AAM
361 Ketorolac 30 mg inj Ampul 30 30 - 30 Rp 6,014 AMS
362 Ketorolac tablet Tablet - - - - Rp 1,894 AMS

363 Kidmin inf Botol 180 180 - 180 Rp 54,620 Merapi
364 Kompolax Botol - - - - Rp 5,555 Indofarma
365 KSR 600 mg Tablet 2,800 2,800 1,000 100 100 1,200 1,600 Rp 1,842 AAM
366 KTM Vial - - - - Rp 116,035 MPI
367 Lacto B sachet 200 200 120 80 200 - Rp 6,230 P.Valent
368 Laktulosa 60 ml Botol 14 14 - 14 Rp 27,225 Indofarma

369 Lanolin gram 1,000 1,000 - 1,000 Rp 605 Bratako
370 Lansoprazol 30 mg Tablet 7,750 7,750 7,750 7,750 - Rp 278 Enseval
371 Lansoprazol 30 mg Tablet 6,000 20,000 26,000 6,000 6,000 20,000 Rp 608 P.Valent
372 Lansoprazol Vial 90 90 50 20 10 80 10 Rp 93,704 P.Padang
373 Lantus solostar Pen 295 295 100 5 105 190 Rp 89,000 APL
374 Laxadin 30 ml Botol 267 267 100 10 110 157 Rp 24,310 AMS
375 Lasix Ampul 310 310 200 45 65 310 - Rp 18,576 APL
376 Lasix Ampul 170 170 110 25 135 35 Rp 20,640 APL
377 L Bio sachet - - - - Rp 5,775 P.Valent

378 L Cisin Tablet - - - - Rp 2,728 P.Valent
379 Levofloxacin 500 mg Tablet 8,000 8,000 500 100 600 7,400 Rp 544 Enseval
380 Levofloxacin Inf 500 mg Botol 268 268 12 6 18 250 Rp 8,713 AAM
381 Levofloxacin Inf 750 mg Botol 8 8 8 8 - Rp 85,014 AAM
382 Levopar Tablet 5,000 5,000 3,000 3,000 2,000 Rp 904 K.Farma
383 Levosif syr Botol 236 236 10 10 20 216 Rp 36,960 AAM
384 Levothyroxine 100 mcg Tablet 5,970 5,970 1,500 1,500 4,470 Rp 890 AMS
385 Lexavon syrup Botol 120 120 60 40 5 105 15 Rp 4,250 Kebayoran
386 Lidocain compositum Ampul 360 360 - 360 Rp 1,286 K.Farma

387 Lidocain Ampul 500 500 100 100 200 300 Rp 891 K.Farma
388 Lidocain Ampul 100 100 100 100 - Rp 1,221 Rajawali
389 Lincomycin 500 mg Tablet - - - - Rp 1,701 K.Farma
390 Lodomer drop Botol - - - - Rp 20,915 Merapi
391 Loperamid 2 mg Tablet - - - - Rp 187 APM
392 Loratadin 10 mg Tablet 1,000 1,000 1,000 1,000 - Rp 111 Enseval
393 Lorazepam 2 mg Tablet 1,500 1,500 - 1,500 Rp 615 Merapi
394 Lovenox 0,4 Ampul 94 94 20 20 74 Rp 90,660 APL
395 Lovenox 0,6 Ampul 488 488 60 20 80 408 Rp 125,325 APL
396 Luteron Tablet - - - - Rp 1,499 Merapi
397 Manitol 20%, 250 ml Botol 20 20 20 20 - Rp 28,275 Merapi
398 Manitol 20%, 250 ml Botol 80 80 5 5 75 Rp 24,350 Merapi
399 Mantoux test Ampul - - - - Rp 733,851 Rajawali
400 Mecobalamin 500 mg Tablet 28,100 28,100 15,000 15,000 13,100 Rp 501 P.Valent
401 Mecobalamin inj Ampul 126 126 - 126 Rp 6,600 P.Valent
402 Meloxicam 15 mg Tablet 3,500 3,500 500 50 550 2,950 Rp 385 Enseval
403 Meloxicam 7,5 mg Tablet 26,050 26,050 6,600 6,600 19,450 Rp 231 MBS
404 Meprovent nebu Ampul 1,000 1,000 100 100 900 Rp 3,677 K.Farma
405 Meropenem 1 gr Vial 238 238 110 20 130 108 Rp 27,435 Enseval
406 Merlopam 0,5 mg Box 5,000 5,000 - 5,000 Rp 379 Merapi
407 Merlopam 2 mg Tablet - - - - Rp 1,380 Merapi
408 Mestinon Tablet 1,350 1,350 - 1,350 Rp 7,850 APL
409 Metformin 500 mg Tablet 22,200 22,200 4,000 4,000 18,200 Rp 77 Enseval
410 Methoclorpramid 5 mg Tablet 200 200 100 100 100 Rp 121 K.Farma
411 Methoclorpramid 10 mg/2 ml Ampul - - - - Rp 4,158 TSJ
412 Methylergometrin 10 mg/ml Ampul 200 200 100 100 100 Rp 3,273 AMS
413 Methylergometrin 10 mg/ml Ampul 400 400 - 400 Rp 1,023 AAM
414 Methylergometrin 0,125 mg Tablet 100 100 - 100 Rp 270 K.Farma
415 Methylergometrin 0,125 mg Tablet 5,000 5,000 - 5,000 Rp 236 K.Farma
416 Methylprednisolone 8 mg Tablet - - - - Rp 309 Dosniroha
417 Metilprednisolon 125 mg Ampul 295 295 60 50 70 180 115 Rp 10,912 K.Farma
418 Metilprednisolon 16 mg Tablet 500 500 500 500 - Rp 558 AAM
419 Metilprednisolon 4 mg Tablet 16,400 16,400 3,000 200 300 3,500 12,900 Rp 102 Enseval
420 Metronidazol 500 mg Tablet - - - - Rp 282 K.Farma
421 Metronidazol 500 mg Tablet 300 300 200 100 300 - Rp 251 P.Padang
422 Metronidazol 500 mg Tablet 4,800 4,800 1,000 1,000 3,800 Rp 137 Rajawali
423 Metronidazol infus Botol 292 292 144 24 24 192 100 Rp 5,885 K.Farma
424 Metronidazol 125 mg/5 ml Botol 84 84 - 84 Rp 3,950 K.Farma
425 Meylon Ampul 5 5 5 5 - Rp 6,448 Merapi
426 Meylon Ampul 32 32 5 5 27 Rp 6,750 Merapi
427 Mg SO4 40% Ampul 71 71 - 71 Rp 4,290 Merapi
428 Miconazol cream Tube 247 247 48 48 199 Rp 1,900 K.Farma
429 Microgynon Tablet - - - - Rp 628 P.Padang
430 Midazolam 1 mg/ml Ampul 80 80 50 50 30 Rp 4,444 APL
431 Midazolam 5 mg/ml Ampul - - - - Rp 23,661 APL
432 Miloz 5 mg/5ml Ampul - - - - Rp 4,489 AMS
433 Miniaspi 80 mg Tablet 1,600 1,600 1,600 1,600 - Rp 105 Merapi
434 Miniaspi 80 mg Tablet 5,100 5,100 3,400 3,400 1,700 Rp 89 Merapi
435 Misoprostol Tablet 900 900 300 30 330 570 Rp 3,850 P.Valent
436 Mometason cr 5 gr Tube - - - - Rp 8,162 AMS
437 Mometason cr 5 gr Tube - - - - Rp 9,875 Penta Valent
438 Mometason cr 10 gr Tube 290 290 - 290 Rp 5,743 AAM
439 Morfin 10 mg Tablet 420 420 60 60 360 Rp 1,199 K.Farma
440 N-Ace Ampul - - - - Rp 10,000 P.Padang
441 Na Cl 0.9%, 500 ml Botol 3,752 3,752 1,160 200 60 60 1,480 2,272 Rp 6,900 Merapi
442 Na Cl 3 %, Otsu Botol 360 360 40 40 320 Rp 30,335 Merapi
443 Na. Diclofenac 25 mg Tablet 19,100 19,100 8,400 250 8,650 10,450 Rp 115 K.Farma
444 Na. Diclofenac 50 mg Tablet - - - - Rp 108 K.Farma
445 Nacl 0,9 % 100 ml Botol 270 270 20 20 250 Rp 6,764 Merapi
446 Nairet 0,5 mg/ ml Ampul - 100 100 - 100 Rp 17,160 MBS
447 Nasacort Box - - - - Rp 111,999 APL
448 Natrium Bicarbonat Tablet 8,900 8,900 6,000 100 6,100 2,800 Rp 57 T. Gugun
449 Natrium Bicarbonat Tablet 20,000 20,000 - 20,000 Rp 69 T. Gugun
450 Neostigmine Ampul 10 5 15 15 15 - Rp 7,050 APL

451 Nerilon Cream 15 g Tube 305 305 80 80 225 Rp 27,363 Enseval
452 Neurodex Tablet - - - - Rp 560 AAM

454 New antides Tablet - - - - Rp 145 Indofarma
455 New antides Tablet - - - - GFK
456 New diatab Tablet - - - - Rp 529 APL
457 Nicardipine HCL 10 mg Ampul 170 170 50 10 60 110 Rp 7,872 AAM
458 Nifedipine 10 mg Tablet 1,000 1,000 - 1,000 Rp 220 K.Farma
459 Niflec Powder sachet - 10 10 - 10 Rp 123,500 Merapi
460 Nitral 500 mg Tablet 15,000 15,000 8,400 30 8,430 6,570 Rp 1,415 AAM
461 Nitrokaf retard Tablet 24,900 24,900 12,000 12,000 12,900 Rp 1,640 K.Farma
462 Nitrokaf retard F Tablet 6,000 6,000 - 6,000 Rp 2,530 K.Farma
463 Nokoba Ampul - - - - Rp 72,600 P.Padang
464 Nopres 20 mg Tablet - - - - Rp 676 AAM
465 Norephineprin 1 mg/ ml Ampul 10 10 10 10 - Rp 23,490 APL
466 Norephineprin 1 mg/ ml Ampul 400 400 100 10 110 290 Rp 6,298 AAM
467 Norestil 5 mg Tablet - 900 900 600 600 300 Rp 2,420 Penta Valent
468 Notisil 2 mg Tablet - - - - Rp 759 AMS
469 Notrixum 25 mg/ 2,5 ml Ampul - - - - Rp 13,390 Indofarma
470 Novomix 30 Pen Pen - - - - Rp 106,000 AAM
471 Novorapid flexpen Pen 810 810 300 25 325 485 Rp 89,500 AAM
472 NTG Ampul 150 150 10 10 140 Rp 64,350 AAM
473 Nyndia drop Botol - - - - Rp 24,750 MPI
474 Nystatin drop Botol 85 85 10 10 75 Rp 11,750 MPI
475 Nystatin ovula 100.000 IU Tablet 100 100 - 100 Rp 630 k.Farma
476 OBH Botol - - - - GFK
477 Obucort swinghaler Box - - - - Rp 106,000 Merapi
478 Octalbin 25 % 100 ml Botol 14 14 2 2 12 Rp 1,590,001 Enseval
479 Octalbin 20 % 100 ml Botol 25 25 - 25 Rp 905,000 Enseval
480 Ofloxacin 400 mg Tablet 400 400 - 400 Rp 647 Indofarma
481 Olanzapine 10 mg Tablet 1,200 1,200 - 1,200 Rp 4,000 AAM
482 Olanzapine 5 mg Tablet 1,740 1,740 300 300 1,440 Rp 713 AAM
483 Omegavit Tablet - - - - Rp 200 APM
484 Omeprazol 20 mg Tablet 6,090 6,090 - 6,090 Rp 129 Enseval
485 Omeprazol 20 mg Tablet 4,260 4,260 3,000 120 3,120 1,140 Rp 396 P.Padang
486 Omeprazole 40 mg Vial 2,650 2,650 280 200 20 60 560 2,090 Rp 5,346 K.Farma
487 Omeprazole 40 mg Vial - - - - Rp 6,999 Merapi
488 Ondansetron 4 mg Tablet 600 600 600 600 - Rp 385 P.Padang
489 Ondansetron 4 mg Tablet 1,410 1,410 150 60 210 1,200 Rp 270 MPI
490 Ondansetron 4 mg/2ml Ampul 1,735 1,735 200 275 100 575 1,160 Rp 873 AAM
491 Oralit sachet 400 400 200 100 300 100 Rp 274 K.Farma
492 Oralit sachet 500 500 - 500 Rp 869 K.Farma
493 Orphen 4 mg Tablet 1,000 1,000 600 400 1,000 - Rp 60 Sapta Sari
494 Oseltamivir 75 mg Tablet - - - - GFK
495 Osteocal Tablet 9,144 9,144 6,480 6,480 2,664 Rp 500 Kebayoran
496 Osteocal Tablet 20,016 20,016 - 20,016 Rp 540 Kebayoran
497 Oxytocin Ampul 40 40 - 40 Rp 1,199 APL
498 Oxytocin Ampul 400 400 100 100 300 Rp 1,126 APL
499 Pan Amin G Inf Botol 14 14 - 14 Rp 51,460 Merapi
500 Paracetamol 500 mg Tablet 38,800 38,800 19,200 2,000 500 21,700 17,100 Rp 216 T. Gugun
501 Paracetamol Drop Botol 47 47 20 20 27 Rp 6,981 Indofarma
502 Paracetamol infus Botol 35 35 8 24 3 35 - Rp 11,990 k.Farma

503 Paracetamol infus Botol 300 300 80 20 100 200 Rp 8,880 Enseval
504 Paracetamol 120 mg/5 ml Botol 417 417 100 100 200 217 Rp 1,160 Merapi
505 Pehacain Ampul 100 100 60 60 40 Rp 3,113 Rajawali
506 Perdiphin Ampul - - - - Rp 135,000 APL
507 Permethrin salep Tube 200 200 - 200 Rp 6,578 APL
508 Pethidin 50 mg/ml Ampul - - - - Rp 19,481 K.Farma
509 Phenitoin 100 mg Tablet 16,100 16,100 4,800 4,800 11,300 Rp 484 Kebayoran
510 Phenitoin 50 mg/ml Ampul - - - - Rp 3,924 Rajawali/KF
511 Phenitoin (Na) 50 mg/ml Ampul 100 100 10 10 90 Rp 2,596 K.Farma
512 Phenol glyserol tetes telinga 10 % Botol 48 48 - 48 Rp 2,764 Rajawali
513 Phental 100 mg/ml Ampul - - - - Rp 9,240 APL
514 Phytomenadion 10 mg/5 ml Ampul - 150 150 90 30 30 150 - Rp 5,025 K.Farma
515 Phytomenadion 10 mg/5 ml Ampul - - - - Rp 3,600 Rajawali
516 Phytomenadion (vit K1) 2mg Ampul - - - - Rp 3,867 Rajawali
517 Phytomenadion 10 mg Tablet 2,300 2,300 500 200 700 1,600 Rp 781 Rajawali
518 Piracetam 1200 mg Tablet - - - - Rp 877 APL
519 Piracetam 400 mg Tablet 300 300 - 300 Rp 331 AAM
520 Piracetam 800 mg Tablet - - - - Rp 590 AAM
521 Piracetam inj 1 g Ampul - - - - Rp 3,300 Enseval
522 Piracetam inj 3 gram Ampul - - - - Rp 9,350 Enseval
524 Pirazinamide 500 mg Tablet - 1,000 1,000 500 500 500 Rp 401 K.Farma
525 PK Kristal Pot - - - - Rp 5,115 APM
526 Plavix 75 mg Tablet - - - - Rp 27,200 APL
528 Pramifrol 0,375 mg Tablet 4,440 4,440 - 4,440 Rp 3,050 P.Padang

529 Pramipexole 0,125 mg Tablet 300 300 - 300 Rp 1,400 AAM
530 Pramifrol 0,75 mg Tablet - - - - Rp 5,406 P.Padang
531 Prednison 5 mg Tablet 1,500 1,500 - 1,500 Rp 162 K.Farma
532 Primaquin Tablet - - - - Pinj GFK
533 Pronalges Supp - - - - Rp 8,382 AAM
534 Propanolol 10 mg Tablet 11,900 11,900 - 11,900 Rp 88 AAM
535 Propanolol 10 mg Tablet 2,000 2,000 2,000 2,000 - Rp 59 K.Farma
536 Propofol Ampul 100 100 - 100 Rp 9,889 AMS
537 Propyltiouracyl 100 mg Tablet 7,000 7,000 2,000 2,000 5,000 Rp 405 AAM
538 Proris Supp - - - - Rp 5,041
539 Protofen Supp - - - - Rp 1,998 K.Farma
540 Prove D3 1000 iu Tablet 3,600 3,600 - 3,600 Rp 2,200 Enseval
541 Pulmicort 0,5 Ampul - - - - Rp 14,131 APL
542 Pyrantel 125 mg Tablet 200 200 - 200 Rp 692 K.Farma

543 Quinin sulfat Tablet - - - - GFK
544 Ramipril 2,5 mg Tablet 13,300 13,300 - 13,300 Rp 240 AAM

545 Ramipril 5 mg Tablet 14,300 14,300 - 14,300 Rp 146 AAM
546 Ramipril 5 mg Tablet - - - - Yarsi
547 Ramipril 10 mg Tablet 6,600 6,600 - 6,600 Rp 710 AMS
548 Ranitidin 150 mg Tablet 61,200 61,200 16,400 1,500 200 18,100 43,100 Rp 85 AAM
549 Ranitidin 50 mg/ 2 ml Ampul 75 75 25 25 50 Rp 858 K.Farma
550 Recofol N Ampul - - - - Rp 78,375 K.Farma

551 Renogen 2000 IU Ampul 44 44 44 44 - Rp 57,000 APL
552 Retaphyl SR 300 mg Tablet 8,800 8,800 2,000 100 2,100 6,700 Rp 1,170 K.Farma
553 Retinol 100,000 UI Tablet - - - - Rp 324 K.Farma
554 Retinol 200,000 UI, Tablet - - - - Rp - GFK
555 Revatio 20 mg Tablet 180 360 540 360 360 180 Rp 36,000 AAM
556 Rifampisin 300 mg Tablet - - - - Rp 786 Indofarma
557 Rifampisin 450 mg Tablet 3,900 3,900 1,000 1,000 2,900 Rp 934 K.Farma
558 Rifampisin 600 mg Tablet 2,000 2,000 - 2,000 Rp 1,182 K.Farma
560 Ringer Lactat inf Botol 2,640 2,640 780 400 20 240 1,440 1,200 Rp 7,703 Merapi
561 Risperidon 1 mg Tablet - - - - Rp 228 AAM
562 Risperidon 2 mg Tablet 34,300 34,300 2,000 2,000 32,300 Rp 123 AAM
564 Ryzodeg flex touch Ampul 100 100 30 30 70 Rp 112,000 AAM
565 S L / Laktosa serbuk Pot - - - - Rp 231,000 Bratako
566 Sagestam 40 mg/ 2 ml Ampul 720 720 50 50 670 Rp 8,571 BSP
567 Salbutamol 2 mg Tablet 13,000 13,000 5,000 200 100 5,300 7,700 Rp 79 K.Farma
568 Salbutamol 1 mg/ml Ampul 220 220 50 20 70 150 Rp 4,900 AAM
569 Salofalk 250 mg Tablet 1,000 1,000 - 1,000 Rp 4,675 K.Farma
570 Sammoxin 125 mg/ 5 ml Botol 395 395 20 20 375 Rp 3,700 T.Gugun
571 Scabimite cream 10 gr tube - - - - Rp 11,825 UDC
572 Scobutrin 10 mg Tablet 700 700 500 500 200 Rp 2,118 MBS
573 Sedacum Ampul - - - - Rp 27,500 AAM
574 Seretide Diskus 100 mg Box 100 100 30 1 31 69 Rp 111,850 APL
575 Seretide Diskus 250 mg Box 105 105 30 30 75 Rp 125,716 APL
576 Seretide diskus 500 mg Box 9 30 39 9 9 30 Rp 137,492 APL
577 Sertralin 50 mg Tablet 4,100 4,100 - 4,100 Rp 1,345 K.Farma
578 Sevoflurane 250 ml Botol - - - - Rp 899,000 AMS

579 Sevoflurane 250 ml Botol - - - - Rp 898,904 P.Padang
580 Sibital 200 mg/2 ml Ampul 60 60 10 10 50 Rp 9,801 Sapta Sari
581 Sikzonoate 25 mg/ml Ampul 5 5 - 5 Rp 63,812 Merapi
582 Simarc 2 mg Tablet - - - - Rp 889 P.Padang
583 Simvastatin 10 mg Tablet 19,540 19,540 - 19,540 Rp 68 Enseval
584 Simvastatin 20 mg Tablet 59,800 59,800 20,000 20,000 39,800 Rp 150 K.Farma
585 Sistenol Tablet 290 290 10 10 280 Rp 1,870 AAM
586 Soft U Derm 40 gr Tube - - - - Rp 29,700 UDC
588 Solpenox 125 mg/5 ml Botol - - - - Rp 3,600 Sapta Sari
589 Sourjon 250 ml Botol - - - - Rp 1,146,879 P.Padang
591 Spiriva 2,5 mcg respimat Box 30 30 - 30 Rp 445,000 Tempo
592 Spironolacton 25 mg Tablet 64,300 64,300 17,500 200 100 17,800 46,500 Rp 200 AAM
593 Spironolacton 100 mg Tablet 1,000 500 1,500 1,000 1,000 500 Rp 530 AAM
594 Stalevo 100 mg Tablet 3,810 3,810 2,700 2,700 1,110 Rp 8,800 AAM
595 Stesolid 5 mg/ ml Ampul - - - - Rp 12,584 AAM
596 Stesolid rectal 10 mg supp 10 10 10 10 - Rp 19,192 AAM
597 Stesolid rectal 5 mg supp 5 5 5 5 - Rp 13,203 AAM

598 Sucralfat Botol 608 608 450 100 35 585 23 Rp 8,206 APL
599 Sucralfat 500 mg Tablet 9,400 9,400 500 500 8,900 Rp 222 AAM
600 Sulfadiazine silver oint 10 mg Tube 8 10 18 8 5 13 5 Rp 18,557 K.Farma
601 Sulfadoxine Pyremetamin Tablet - - - - Rp 544 K.Farma
602 Suprafenid 100 mg supp - - - - Rp 2,380 K.Farma

603 Suprasma inhaler box 100 100 3 3 97 Rp 22,000 AAM
604 Symbicort inh 160 Botol 40 40 20 20 20 Rp 150,704 APL
605 Symbicort inh 80 Botol - - - - Rp 110,500 APL
606 Tablet tambah darah(ferro fumarat) Tablet 4,700 4,700 1,020 60 1,080 3,620 Rp 238 K.Farma
607 Tamsulosin 0,4 mg Tablet - - - - Rp 4,356 AMS
608 Tarivid otic Botol - - - - Rp 35,000 Enseval
609 Terazosin 2 mg Tablet 9,000 9,000 1,000 1,000 8,000 Rp 980 AAM
610 Terrell 250 ml Botol - - - - Rp 400,049 P.Padang
611 Tetagam P Syringe Box 130 130 44 44 86 Rp 146,800 AAM
612 Thiamfenicol 500 mg Tablet 400 400 100 100 300 Rp 1,056 TSJ
613 Thiamfenicol 125 mg/5 ml Botol 79 79 8 5 13 66 Rp 16,500 TSJ
614 Thyrozol 10 mg Tablet - 500 500 500 500 - Rp 1,325 AAM
615 Tramadol 100 mg Ampul - 50 50 50 50 - Rp 4,161 Penta Valent
616 Treatson 0,125 mg Tablet - - - - Rp 2,200 AAM

617 Trifluoferazin 5 mg Tablet 3,700 3,700 - 3,700 Rp 302 Merapi
618 Trihexipenidil 2 mg Tablet 16,900 16,900 6,000 6,000 10,900 Rp 63 Merapi
619 Triofusin Inf Botol 18 18 - 18 Rp 53,890 Enseval
621 Urinter 500 mg Tablet 500 500 300 100 400 100 Rp 3,630 Enseval
622 Urinter 500 mg Tablet 1,900 1,900 - 1,900 Rp 4,235 Enseval
623 Ursode oxycholic acid 250 mg Tablet 300 300 300 300 - Rp 2,268 AAM
624 Ursode oxycholic acid 250 mg Tablet 1,500 1,500 1,200 60 1,260 240 Rp 1,679 AAM
625 Vaselin gram - - - - Rp 121 Bratako
626 V - Blok 6,25 mg Tablet - - - - Rp 1,748 Enseval
627 V - Blok 25 mg Tablet 1,710 1,710 300 300 1,410 Rp 1,210 Enseval
628 Venofundin Botol - - - - Rp 52,250 Dosniroha
629 Ventolin Inhaler Box - - - - Rp 66,938 APL
630 Ventolin Nebulizer UDV Ampul - - - - Rp 4,000 APL
631 Verapamil 80 mg Tablet 1,600 1,600 800 800 800 Rp 455 K.Farma
632 Viccilin - SX Vial - - - - Rp 37,500 Merapi
633 Vitamin B. 1/ Thiamin HCL 100 mg Tablet - - - - Rp 86 K.Farma
634 Vitamin B. 1/ Thiamin HCL 50 mg Tablet 14,600 14,600 100 100 14,500 Rp 192 K.Farma
635 Vitamin B. 6/ Pyridoxin 10 mg Tablet 6,900 6,900 1,000 1,000 5,900 Rp 71 K.Farma
636 Vitamin C /Asam Askorbat 50 mg Tablet 11,100 11,100 3,000 3,000 8,100 Rp 43 K.Farma
637 Vitamin C /Asam Askorbat 250 mg Tablet - - - - Rp 123 Indofarma
638 Vitamin B.Complex Tablet 30,000 30,000 16,000 500 16,500 13,500 Rp 68 T.Gugun
639 Vitamin B.Complex Tablet 30,000 30,000 - 30,000 Rp 121 K.Farma
640 Voluven 6% 500 ml Botol 3 3 3 3 - Rp 21,780 APL ed 01/22

641 Warfarin 2 mg Tablet 9,000 9,000 1,000 100 1,100 7,900 Rp 669 AMS
642 Wibrom 8 mg Tablet 3,500 3,500 1,000 600 1,600 1,900 Rp 107 Sapta Sari
643 Widahes inf Botol - - - - Rp 57,608 Merapi
644 Wida KN-1 Botol - - - - Rp 11,562 Merapi
645 Wida KN-2 Botol 8 8 8 8 - Rp 11,562 Merapi ed 01/22
646 Xarelto Tablet - - - - Rp 25,717 P.Padang
647 Xylocain gel Tube - - - - Rp 44,391 AAM
648 Xylocain spray Botol - - - - Rp 189,107 AAM
649 Zinat tab 250 mg Tablet - - - - Rp 5,940 APL
650 Zinat tab 500 mg Tablet 100 100 - 100 Rp 4,725 APL
651 Zink 20 mg Tablet 1,000 1,000 400 400 600 Rp 253 Rajawali
652 Zink 20 mg/5 ml Botol 83 83 10 3 13 70 Rp 2,489 Tempo
653 Zyfort inj Ampul - - - - Rp 5,376 AMS
92,216
Mengetahui Padang Panjang, 31 Januari 2022

Kepala Instalasi Farmasi Penanggung jawab
Rahmi Safyanti, S. Farm, Apt Delli Syam.S.Si.Apt

Nip 19811118 201001 2 010 Nip 19750213 200312 2 004
Rp 2,178,000 Rp -
Rp 1,565,500 Rp -
Rp 401,458 Rp -
Rp 607,585 Rp -
Rp 7,349,980 Rp 600,000
Rp 173,339 Rp -
Rp 35,249 Rp -
Rp 776,380 Rp -
Rp 4,124,769 Rp -
Rp 2,100,296 Rp -
Rp 822,982 Rp -
Rp 9,680,000 Rp 1,750,000
Rp 1,716,000 Rp -
Rp 3,508,793 Rp -
Rp 208,065 Rp -
Rp 274,703 Rp -
Rp 662,502 Rp -
Rp 12,960,000 Rp -
Rp 700,500 Rp -
Rp 499,950 Rp -
Rp 753,720 Rp -
Rp 3,880,522 Rp -
Rp 4,256,752 Rp -
Rp -
Rp 7,905,397 Rp -
Rp 1,750,000 Rp -
Rp 730,015 Rp -
Rp 1,234,950 Rp -
Rp 1,000,000 Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
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Rp -
Rp -
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Rp 1,401,000
Rp -
Rp -
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Rp -
Rp -
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Rp -
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Rp -
Rp -
Rp -
Rp -
Rp -
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Rp -
Rp -
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Rp -
Rp 9,680,000
Rp -
Rp -
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Rp -
Rp -
Rp -
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Rp -
Rp -
Rp -
Rp -
Rp -
Rp 274,704
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
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Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,999,800
Rp 107,635
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 3,880,522
Rp 803,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
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Rp -
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Rp -
Rp -
Rp -
Rp -
Rp 24,750
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 7,349,978
Rp -
Rp -
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Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,890,000
Rp -
Rp -
Rp -
Rp -
Rp -
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Rp 173,339
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 776,380
Rp -
Rp -
Rp 750,000
Rp -
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Rp -
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Rp 12,162,150
Rp -
Rp -
Rp -
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Rp 3,508,800
Rp -
Rp -
Rp -
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Rp 1,716,000
Rp -
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Rp 35,250
Rp -
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Rp 1,235,000
Rp -
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Rp 2,178,000
Rp -
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Rp 753,720
Rp -
Rp -
Rp -
Rp -
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Rp -
Rp -
Rp -
Rp -
Rp 401,458
Rp -
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Rp 12,960,000
Rp -
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Rp -
Rp -
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Rp 4,124,760
Rp -
Rp -
Rp -
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Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 265,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 185,570
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 662,500
Rp 208,065
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
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Rp -
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ed 01/22 Rp -
Rp -
Rp -
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ed 01/22 Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 71,857,407 Rp 71,857,380 Rp (27)

RSUD PADANG PANJANG
BULAN : FEBRUARI 2022

KELUAR Retur/ Bayar
1 A.B.U Vial - 10 10 - 10 Rp 517,132 Indofarma 1

5 Acarbose 50 mg Tablet 1,000 1,000 500 500 500 Rp 600 AAM 5
6 Acetylsistein 200 mg Tablet - 2,000 2,000 - 2,000 Rp 825 Penta Valent 6

10 Acyclovir 5% cream Tube 10 10 10 10 - Rp 3,391 K.Farma 10
11 Acyclovir 5% cream Tube 100 100 15 15 85 Rp 4,043 K.Farma 11
12 Adalat Oros 30 mg Tablet 3,960 3,000 6,960 3,960 3,960 3,000 Rp 3,986 P.Padang
13 Akilen ear drop Botol 128 128 70 70 58 Rp 35,000 BSP 12
15 Allopurinol 100 mg Tablet 17,600 17,600 3,000 3,000 14,600 Rp 87 Enseval 14
18 Alprazolam 0.5 mg Tablet 5,800 5,800 - 5,800 Rp 78 Merapi 17
19 Ambroxol 15 mg/5 ml Botol 176 176 50 10 60 116 Rp 3,264 Indofarma 18
20 Ambroxol 15 mg/5 ml Botol 50 50 50 50 - GFK
21 Ambroxol 30 mg Tablet 2,100 2,100 1,000 200 1,200 900 Rp 231 Indofarma 19
22 Ambroxol 30 mg Tablet 5,000 5,000 - 5,000 Rp 246 Indofarma 20
23 Aminofusin Hepar Botol 13 13 3 3 6 7 Rp 79,500 Enseval 21
24 Aminofusin Pead inf Botol - - - - Rp 56,784 Enseval 22
25 Aminofusin Pead inf Botol - - - - RSAM 23
26 Aminosteril infan 6% Botol 3 3 - 3 Rp 39,000 APL 24
30 Aminophylin 24 mg/ml Amp 30 30 - 30 Rp 2,704 K.Farma 28
32 Amiodaron 50 mg/ ml Amp - - - - Rp 8,700 APL 30
33 Amiodaron 50 mg/ ml Amp - 60 60 35 25 60 - Rp 6,118 APL 31
34 Amiparen infus Botol 48 48 - 48 Rp 96,650 Merapi 32

35 Amitriptilin 25 mg Tablet - 3,000 3,000 500 500 2,500 Rp 175 P.Padang 33
36 Amlodipin 10 mg Tablet 53,200 20,000 73,200 100 100 73,100 Rp 72 Merapi 34
37 Amlodipin 5 mg Tablet 59,700 59,700 23,100 300 23,400 36,300 Rp 53 Tempo 35
38 Amoxicillin 500 mg Tablet 11,100 11,100 2,000 300 100 2,400 8,700 Rp 261 Enseval 36
39 Amoxicillin dry syr Botol - - - - Rp 2,783 Indofarma 37
40 Amoxicillin drop Botol 140 140 10 10 130 Rp 13,500 TSJ 38
41 Amoxicillin 1 gr Vial - - - - Rp 9,450 Rajawali 39
42 Ampicilin 1 gr Vial - - - - Rp 8,649 P.Padang 40
43 Ampicilin 1 gr Vial - 100 100 60 20 20 100 - Rp 8,580 P.Padang 41
44 Ampicilin 1 gr Vial 80 80 80 80 - Rp 8,988 TSJ 42
45 Anemolat 1 mg Tablet - - - - Rp 165 Rajawali 43

46 Anemolat 1 mg Tablet - - - - Rp 220 K.Farma 44
47 Antasida Botol 26 26 26 26 - Rp 1,725 Indofarma 45
48 Antasida Botol 20 20 20 20 - GFK
49 Antihemorroid supp Supp 690 180 870 100 100 770 Rp 3,250 K.Farma 46
50 Apidra Solastar Pen 180 180 - 180 Rp 89,500 APL 47
51 Aqua pro injeksi / Otsu-WI Botol 2,270 2,270 960 480 240 1,680 590 Rp 2,625 Merapi 48
52 Aripiprazole 10 mg Tablet - 600 600 400 400 200 Rp 19,500 AAM 49

53 Arixtra 2,5 mg Ampul 130 100 230 50 50 180 Rp 225,290 AAM 50
54 Arkine 2 mg Tablet - - - - Rp 762 Sapta Sari 51
55 Artesunate Ampul - - - - Pinjaman 52
56 Asam Folat 1 mg Tablet 3,400 3,400 3,400 3,400 - Rp 58 K.Farma 53
57 Asam Folat 1 mg Tablet 1,000 1,000 1,000 1,000 - GFK
58 Asam Mefenamat 500 mg Tablet 31,500 31,500 4,000 600 4,600 26,900 Rp 111 Enseval 54
59 Asam Tranexamat 250 mg/5 ml Ampul 390 390 - 390 Rp 1,813 AAM 55
60 Asam Tranexamat 500 mg Tablet 3,800 3,800 - 3,800 Rp 1,683 TSJ 56
61 Asam Tranexamat 500 mg/5 ml Ampul 1,690 1,690 300 50 350 1,340 Rp 2,088 AAM 57
62 Asam Valproat 250 mg/5 ml Botol 200 200 - 200 Rp 12,123 AAM 58
63 Ascorbic Acid 200 mg Ampul - 300 300 50 30 80 220 Rp 7,700 Merapi 59
64 Ascorbic Acid 200 mg Ampul 45 45 45 45 - Rp 8,800 Merapi 60
65 Ascorbic Acid 1000 mg Ampul - - - - Rp 17,600 Merapi 61
66 Asering infus Botol 340 240 580 80 20 140 240 340 Rp 9,680 Merapi 62
67 Aspilets 80 mg Tablet 10,800 10,800 1,000 200 1,200 9,600 Rp 611 K.Farma 63
68 Atorvastatin 20 mg Tablet - - - - Rp 1,265 K.Farma 64
69 Atorvastatin 20 mg Tablet 1,470 6,000 7,470 1,890 60 1,950 5,520 Rp 467 AAM 65
70 Atracurium 50 mg Ampul - - - - Rp 14,235 APL 66
71 Atracurium 25 mg Ampul - - - - Rp 11,737 Indofarma 67
72 Atracurium 25 mg Ampul - 15 15 - 15 Rp 8,978 APL 68
73 Atropin Sulfat 0,25 mg/ml Ampul 400 400 - 400 Rp 1,718 APL 69
74 Avamys Nasal Spray Box 85 85 50 50 35 Rp 115,400 APL 70
75 Azitromicin 500 mg Tablet 2,320 2,320 400 260 160 820 1,500 Rp 1,300 K.Farma 71
76 Bactesyn 1,5 g Ampul 85 150 235 20 20 215 Rp 20,010 Enseval 72
77 Bamgetol Tablet - - - - Rp 1,287 Merapi 73
78 Bedak Kocok Anak 100 ml Botol 45 45 - 45 Rp 7,898 Panay 74
79 Bedak Kocok Dewasa 100 ml Botol - - - - Rp 20,020 APM 75
80 Bedak Kocok Dewasa 200 ml Botol 67 67 1 1 66 Rp 21,461 Panay 76
81 Berotec MDI Box 114 402 516 168 6 174 342 Rp 86,930 APL 77
82 Berotec MDI Box - - - - RSAM 78
83 Betadine kumur 190 ml Botol 48 48 12 12 36 Rp 28,215 P.Padang
84 Betahistin 6 mg Tablet 13,900 20,000 33,900 5,000 200 5,200 28,700 Rp 88 AAM 79
85 Betametason 0.1% cream Tube 75 75 - 75 Rp 1,520 K.Farma 80
86 Bfluid Botol 340 340 20 10 50 80 260 Rp 76,300 Merapi 81
87 Bisacodyl Tablet - - - - Rp 327 AMS 82
88 Bisacodyl Tablet 600 600 - 600 Rp 216 K.Farma 83
89 Bisoprolol 5 mg Tablet 27,600 27,600 2,220 2,220 25,380 Rp 137 AAM 84
90 Bisoprolol 5 mg Tablet - - - - GFK 85
91 Bisoprolol 2,5 mg Tablet 3,800 90,000 93,800 8,800 100 8,900 84,900 Rp 129 AAM 86
92 Bisoprolol 2,5 mg Tablet - - - - Rp 275 Enseval 87
93 Bricasma 0,5 mg/ml Vial - - - - Rp 12,558 APL 88
94 Brilinta 90 mg Tablet 1,120 1,120 1,120 1,120 - Rp 8,404 APL 89
95 Bucain spinal 0,5 mg Ampul 200 200 150 150 50 Rp 48,400 UDC 90
96 C. Asternof 5 ml Botol - - - - Rp 21,483 P.Valent 91
97 C. Asternof 0,6 ml Strip 100 100 20 20 80 Rp 20,972 P.Valent 92
98 C. Augentonic 0.6 ml Strip 100 100 - 100 Rp 22,122 P.Valent 93
99 C. Carpin 2% 0,6 ml Strip 60 60 - 60 Rp 18,030 P.Valent 94
100 C. Catarlen 0,6 ml Strip 97 97 - 97 Rp 20,460 P.Valent 95
101 C. Cendrid 0,6 ml Strip - - - - Rp 17,007 P.Valent 96
102 C. Cenfresh 0,6 ml Strip 260 300 560 200 200 360 Rp 23,529 P.Valent 97
103 C. Conver 0,6 ml Strip - - - - Rp 16,496 P.Valent 98
104 C. Efrisel 5 ml Botol - - - - Rp 15,601 P.Valent 99
105 C. Efrisel 5 ml Botol 40 40 - 40 Rp 14,900 P.Valent 100
106 C. Efrisel 0,6 ml Strip - - - - Rp 15,600 P.Valent 101
107 C. Fenicol 1% E.O Tube - - - - Rp - P.Valent 102
108 C. Floxa 0,6 ml Strip 140 140 60 60 80 Rp 27,364 P.Valent 103
109 C. Gentamicin 3,5 g Tube 110 110 - 110 Rp 37,212 P.Valent 104
110 C. Gentamicin 3,5 g Tube - - - - Rp 37,210 P.Valent 105
111 C.Gentamicin 5 ml Botol - - - - Rp 29,026 P.Valent 106
112 C.Gentamicin 5 ml Botol 20 20 - 20 Rp 22,300 P.Valent 107
113 C. Hervis 3,5 g Tube 20 20 20 20 - Rp 37,594 P.Valent 108
114 C. Hervis 3,5 g Tube 30 30 - 30 Rp 37,595 P.Valent 109
115 C. Homatro 2% 5 ml Botol 10 10 - 10 Rp 36,316 P.Valent 110
116 C. Homatro 2% 5 ml Botol 5 5 5 5 - Rp 36,317 P.Valent 111
117 C. LFX 0,6 ml Strip 115 115 1 1 114 Rp 70,587 P.Valent 112
118 C. LFX 5 ml Botol - - - - Rp 68,557 K.Farma
119 C. Lyteers 15 ml Botol 130 130 30 30 100 Rp 23,018 P.Valent
122 C. Mycetin 3,5 g Tube 42 50 92 20 20 72 Rp 13,043 P.Valent
123 C. Mydriatil 1% ed Botol - - - - Rp 39,971 P.Valent
124 C. Mydriatil 0.5% Botol 35 35 15 15 20 Rp 29,538 P.Valent
125 C. Noncort 0,6 ml Strip 40 10 50 - 50 Rp 43,221 P.Valent
126 C. Pantocain 0,5% ed Botol - - - - Rp 13,555 P.Valent
128 C. Pantocain 2% 5 ml Botol 53 53 15 15 38 Rp 13,555 P.Valent
129 C. Polidex 0,6 ml Strip 152 152 - 152 Rp 27,110 P.Valent
130 C. Polipred 0,6 ml Strip 5 5 - 5 Rp 17,775 P.Valent
132 C. Polygrant 3,5 g Tube 100 100 20 5 25 75 Rp 18,925 K.Farma
133 C. Protagenta 0,6 ml Strip 210 210 60 60 150 Rp 36,700 P.Valent
135 C. Timol 0.5 % 0,6 ml Strip 138 138 3 3 135 Rp 26,342 P.Valent
137 C. Tobroson 0,6 ml Strip 69 80 149 - 149 Rp 29,667 P.Valent
138 C. Tropin 0,5% 0,6 ml botol - - - - Rp 12,756 P.Valent
140 C. Vasacon 0.6 ml strip 40 60 100 - 100 Rp 14,194 P.Valent
142 C. Vernacel 0,6 ml Strip 165 50 215 - 215 Rp 21,227 P.Valent
144 C. Vitrolenta 5 ml Botol 100 70 170 50 50 120 Rp 33,503 P.Valent
145 C. Vosama Strip 20 20 - 20 Rp 18,030 P.Valent
146 C. Xitrol eo Tube - - - - Rp 37,489 P.Valent
148 Ca. Gluconas 10% 10 ml Ampul 48 48 - 48 Rp 5,723 APL
150 Calsium laktat 500 mg Tablet 7,600 7,600 3,000 3,000 4,600 Rp 63 Merapi
152 Candesartan 16 mg Tablet 22,980 33,000 55,980 21,600 90 90 21,780 34,200 Rp 319 AAM
153 Candesartan 8 mg Tablet 34,320 24,000 58,320 14,400 90 14,490 43,830 Rp 212 AAM
155 Captopril 25 mg Tablet 7,500 7,500 - 7,500 Rp 75 K.Farma
156 Carbamazepin 200 mg Tablet 4,300 2,100 6,400 3,000 3,000 3,400 Rp 198 Merapi
158 Carmed urea 10% Tube 74 74 45 45 29 Rp 28,710 AMS
159 Carvedilol 6,25 mg Tablet 1,900 6,000 7,900 - 7,900 Rp 1,309 K.Farma
160 Cefadroxyl 500 mg Tablet 4,900 4,900 300 500 800 4,100 Rp 580 Enseval
161 Cefadroxyl 125 mg/5 ml Botol 200 200 - 200 Rp 4,340 K.Farma
164 Cefixime 100 mg Tablet - 16,400 16,400 10,800 500 200 11,500 4,900 Rp 387 Enseval
165 Cefixime 100 mg/5 ml Botol 80 100 180 20 15 35 145 Rp 4,947 AAM
167 Cefotaxim 1 g Vial - 300 300 100 20 20 140 160 Rp 2,850 Enseval
169 Ceftriaxon 1 g inj Vial 1,402 2,000 3,402 864 288 100 1,252 2,150 Rp 2,850 Enseval
171 Cetirizin 10 mg Tablet - - - - GFK
172 Cetirizin 10 mg Tablet 31,700 20,000 51,700 2,000 1,000 100 1,000 4,100 47,600 Rp 50 Merapi
173 Cetirizin 5 mg/5 ml Botol 40 100 140 60 10 70 70 Rp 2,153 Merapi
176 Cilostazol 100 mg Tablet 2,500 2,500 2,000 2,000 500 Rp 5,852 TSJ
177 Ciprofloxacin 500 mg Tablet 1,500 10,000 11,500 500 100 600 10,900 Rp 250 Enseval
180 Citicolin 250 mg/ml amp - 1,000 1,000 - 1,000 Rp 4,002 P.Padang
182 Citicolin 500 mg Tablet 1,400 2,000 3,400 - 3,400 Rp 2,750 Enseval
183 Clindamicin 150 mg Tablet 5,000 5,000 1,000 1,000 4,000 Rp 677 AMS
185 Clindamycin 300 mg Tablet 1,000 1,000 100 100 900 Rp 522 Merapi
186 Clobazam 10 mg Tablet - 10,000 10,000 - 10,000 Rp 384 AAM
187 Clobazam 10 mg Tablet 5,000 5,000 4,000 4,000 1,000 Rp 776 AAM
188 Clonidine 0,15 mg Tablet 5,500 5,500 2,500 2,500 3,000 Rp 146 K.Farma
189 Clopidogrel 75 mg Tablet 45,840 30,000 75,840 23,040 150 90 23,280 52,560 Rp 575 K.Farma
191 Clorpromazine/CPZ 100 mg tab 200 200 - 200 Rp 433 K.Farma
192 Clozapin 100 mg Tablet 2,200 2,200 500 500 1,700 Rp 1,197 AAM
193 Clozapin 25 mg Tablet 3,000 3,000 1,200 1,200 1,800 Rp 473 AAM
194 Co-Amoxyclav 625 mg Tablet 840 840 - 840 Rp 4,158 AAM
195 Codein 10 mg Tablet 3,800 3,800 1,500 200 1,700 2,100 Rp 600 K.Farma
196 Colcitine 0,5 mg Tablet 330 330 330 330 - Rp 2,414 APL
197 Colcitine 0,5 mg Tablet 1,650 1,650 570 30 600 1,050 Rp 649 APL
198 Comafusin hepar Botol 6 20 26 6 6 20 Rp 79,130 Enseval
199 Combivent UDV Ampul - - - - Rp 3,500 APL
202 CTM/Chlorpheniramini maleat 4 mg Tablet - - - - Rp 25 K.Farma
204 Curcuma blister Tablet 6,360 12,000 18,360 3,000 240 3,240 15,120 Rp 876 P.Padang
205 D 10% otsu Botol 40 200 240 - 240 Rp 7,200 Merapi
206 D 40%, Otsu Ampul 166 100 266 12 10 22 244 Rp 7,000 Merapi
207 D 5 % Otsu Botol 340 200 540 60 60 480 Rp 6,627 Merapi
212 Desoximethason cream Tube 192 132 324 108 108 216 Rp 9,000 AAM
214 Dexametason 0.5 mg Tablet 100 100 100 100 - Rp 136 K.Farma
215 Dexametason 0.5 mg Tablet 2,000 2,000 400 300 700 1,300 Rp 163 K.Farma
216 Dexametason 0,5 mg/ml Ampul 30 30 30 30 - Rp 1,152 K.Farma
217 Dexametason 0,5 mg/ml Ampul 1,000 1,000 100 100 100 100 400 600 Rp 968 K.Farma
221 Diazepam 2 mg Tablet 1,500 6,000 7,500 1,000 100 1,100 6,400 Rp 70 P.Padang
222 Diazepam 5 mg Tablet 2,300 2,300 1,000 1,000 1,300 Rp 114 Merapi
223 Diazepam 5 mg/ ml Ampul 60 60 20 30 10 60 - Rp 1,545 K.Farma
225 Digoxin 0.25 mg Tablet 1,000 5,000 6,000 1,000 1,000 5,000 Rp 124 P.Padang
226 Diltiazem 30 mg Tablet 8,000 8,000 100 100 7,900 Rp 135 AAM
227 Diphenhydramine 10 mg/ ml Vial 30 30 30 30 - Rp 825 K.Farma
229 Divalprex sodium 250 mg Tablet 8,000 5,400 13,400 3,000 3,000 10,400 Rp 990 AMS
231 Dobutamin 50 mg Ampul 50 50 50 50 - Rp 8,497 AAM
232 Domperidon Syrup 60 ml Botol - - - - Rp 2,359 Indofarma
233 Domperidon 10 mg Tablet 2,200 2,200 200 700 900 1,300 Rp 73 Merapi
234 Donepezil 5 mg Tablet 600 600 600 600 - Rp 1,600 IGM
235 Dopamed 250 mg Tablet 500 500 1,000 - 1,000 Rp 1,014 AAM
237 Dorner Tablet 600 3,000 3,600 600 60 660 2,940 Rp 4,900 APL
238 Doxicyclin 100 mg Tablet - - - - Rp 289 AAM
239 Dulcolac 5 mg supp Supp 24 24 24 24 - Rp 5,085 APL
242 Dumin rectal 125 mg/2.5 ml Tube 55 55 30 25 55 - Rp 15,355 AAM
243 Dumin rectal 125 mg/2.5 ml Tube 200 200 45 45 155 Rp 16,123 AAM
248 Eferison 50 mg Tablet 29,400 29,400 12,000 200 12,200 17,200 Rp 983 Merapi
250 Epinephrine 0,1% Ampul 90 120 210 - 210 Rp 2,772 Rajawali
251 Epodion 2000 iu Ampul 10 10 - 10 Rp 57,000 UDC
252 Ergotamine Coffein Tablet 2,900 2,900 - 2,900 Rp 217 K.Farma
255 Erphafillin 200 mg Tablet 16,500 16,500 2,000 200 2,200 14,300 Rp 153 Sapta Sari
256 Erphahexin Tablet - 4,000 4,000 - 4,000 Rp 122 Sapta Sari
261 Erythromycin 200 mg/ 5 ml Botol 10 10 2 2 8 Rp 6,785 K.Farma
262 Etadium 2 mg Tablet 500 500 - 500 Rp 183 APM
263 Etambutol 500 mg Tablet 900 900 - 900 Rp 447 Dosniroha
264 Eugenol 10 ml Botol - - - - GFK

272 Farmavon 2 mg/ml Ampul 310 310 100 100 210 Rp 37,752 P.Padang
278 Fenobarbital 30 mg Tablet 3,300 3,300 2,000 100 2,100 1,200 Rp 182 K.Farma

280 Fentanyl 0.5 mg/ml Ampul - 180 180 50 50 130 Rp 28,274 K.Farma
281 Fetik Supp 250 250 50 120 50 30 250 - Rp 10,890 Enseval
282 Fibrion 1500000 IU Tablet - - - - Rp 3,400,000 AAM
284 Flamicort 10 mg/ ml Vial 30 30 20 20 10 Rp 110,000 AAM
285 Flixotide Nebules 2 ml Ampul 20 200 220 100 20 120 100 Rp 14,738 APL
286 Fluconazol 150 mg Tablet - - - - Rp 18,800 K.Farma
287 Fluimucil granule sachet 4,500 4,500 900 1,050 510 2,460 2,040 Rp 3,230 APL
288 Flunarizin 5 mg Tablet 7,480 7,480 3,840 3,840 3,640 Rp 894 P.Valent/MPI
289 Fluoxetine 20 mg Tablet 4,980 4,980 1,800 1,800 3,180 Rp 387 AAM
290 Fonylin 60 mg Tablet 3,300 4,500 7,800 3,300 3,300 4,500 Rp 3,300 AAM
292 Framycetine sulfate Pcs - 100 100 10 40 20 70 30 Rp 10,175 APL
293 Fresofol 1% Ampul 50 50 - 50 Rp 11,000 APL
294 Fucilex cream Tube 21 21 - 21 Rp 7,150 MBS
295 Furosemid 40 mg Tablet 36,800 36,800 200 200 36,600 Rp 145 K.Farma
297 Furosemid 10 mg/ ml Ampul 1,200 1,200 200 100 300 900 Rp 3,850 P.Padang
298 Fusycom cr Tube 100 100 - 100 Rp 19,096 APL
299 Gabapentin 100 mg Tablet 10,450 20,000 30,450 12,600 100 12,700 17,750 Rp 1,025 APL
300 Garam ingris sac/30gr 698 698 10 10 688 Rp 2,040 Bratako
301 Gelafusal infus Botol 20 20 10 10 10 Rp 145,015 AAM
302 Gelofusin inf botol - - - - Rp 145,015 Dosniroha
303 Gemfibrozil 300 mg Tablet - - - - Rp 462 K.Farma
304 Gemfibrozil 300 mg Tablet 6,000 6,000 2,000 2,000 4,000 Rp 315 K.Farma
305 Gentalex cream Tube - - - - Rp 2,350 Kebayoran
307 Gentamicin sulfate 0,1% Tube 410 410 100 100 310 Rp 2,849 K.Farma
309 Glaucon 100 mg Tablet 1,680 1,680 20 20 1,660 Rp 3,887 P.Valent
312 Gliclazide 80 mg Tablet 1,000 1,000 - 1,000 Rp 235 Tempo
315 Glimepiride 2 mg Tablet 9,700 5,000 14,700 5,000 5,000 9,700 Rp 123 Enseval
316 Gliquidon 30 mg Tablet 9,900 9,900 5,000 5,000 4,900 Rp 1,000 AAM
317 Glucosamin Tablet 7,900 10,000 17,900 3,000 3,000 14,900 Rp 1,198 Merapi
318 Glucosamin Tablet - - - - Rp 1,106 Merapi
319 Griseovulfin 125 mg Tablet 200 200 - 200 Rp 326 K.Farma
324 Hemapo 3000 ui Ampul 154 154 53 53 101 Rp 80,000 Enseval
325 Heparin sodium 5000 iu Vial 80 300 380 20 80 100 280 Rp 46,635 P.Padang
327 Herbesser CD 100 mg Tablet 1,900 6,000 7,900 4,000 4,000 3,900 Rp 4,750 AAM
329 Hidroklortiazid 25 mg Tablet 2,000 3,000 5,000 1,000 1,000 4,000 Rp 148 K.Farma
330 Hidrokortison 2.5% salep Tube 115 115 - 115 Rp 2,475 K.Farma
333 Humalog Mix 25 Pen 150 460 610 250 250 360 Rp 112,000 APL
335 Human Albumin 20% 50 ml Botol 3 3 - 3 Rp 445,000 AAM
336 Hydroxychloroquin Tablet 150 150 60 60 90 Rp 2,585 MBS
337 Hyocine-N-Butylbromide Ampul 30 30 60 - 60 Rp 5,778 APL
338 Hyocine-N-Butylbromide Tablet 1,000 1,000 - 1,000 Rp 1,050 Rajawali
345 Iliadin spray Pcs 20 20 40 20 20 20 Rp 38,819 APL
346 Iliadin drop anak Pcs - - - - Rp 36,817 APL
347 INH 100 mg Tablet 900 5,000 5,900 - 5,900 Rp 75 K.Farma
348 INH 300 mg Tablet 3,000 3,000 6,000 1,000 1,000 5,000 Rp 150 K.Farma
350 Iron sucrose Ampul 30 30 20 20 10 Rp 27,500 AMS
351 ISDN 1 mg/ ml Ampul - 50 50 20 20 30 Rp 17,500 AMS
352 Isoflurance 250 ml Botol - - - - Rp 400,000 P.Padang
353 Isosorbid Dinitrat/ISDN 5 mg Tablet 3,400 5,000 8,400 500 200 700 7,700 Rp 88 P.Padang
355 Ka EN 1B Botol 120 200 320 60 80 140 180 Rp 10,350 Merapi
356 Ka EN MG3 Botol 80 80 - 80 Rp 10,750 Merapi
360 KCl 7.4 % Otsu Ampul 94 94 10 10 84 Rp 3,472 Merapi
362 Kendaron 200 mg Tablet 240 240 150 30 180 60 Rp 1,027 APL
363 Ketamin 100 mg/ ml Ampul 20 20 - 20 Rp 14,788 AAM
364 Ketokonazol 200 mg Tablet 1,700 1,700 500 100 600 1,100 Rp 260 Enseval
365 Ketokonazol Cream 2% 10gr Tube - - - - Rp 2,399 K.Farma
366 Ketoprofen 100 mg Tablet - 2,000 2,000 - 2,000 Rp 726 P.Padang
367 Ketoprofen 100 mg Tablet 1,100 1,100 400 100 500 600 Rp 1,080 AMS
369 Ketorolac 30 mg inj Ampul 650 650 170 150 200 50 570 80 Rp 880 AAM
370 Ketorolac 30 mg inj Ampul 30 30 30 30 - Rp 6,014 AMS

372 Kidmin inf Botol 180 180 - 180 Rp 54,620 Merapi
373 Kompolax Botol - - - - Rp 5,555 Indofarma
374 KSR 600 mg Tablet 1,600 3,000 4,600 500 100 600 4,000 Rp 1,842 AAM
375 KTM Vial - - - - Rp 116,035 MPI
376 Lacto B sachet - - - - Rp 6,230 P.Valent
377 Laktulosa Botol 14 14 2 2 12 Rp 27,225 Indofarma

378 Lanolin gram 1,000 1,000 - 1,000 Rp 605 Bratako
379 Lansoprazol 30 mg Tablet - 50,000 50,000 12,000 12,000 38,000 Rp 278 Enseval
380 Lansoprazol 30 mg Tablet 20,000 20,000 19,180 520 300 20,000 - Rp 608 P.Valent
381 Lansoprazol Ampul 10 10 - 10 Rp 93,704 P.Padang
382 Lansoprazol Ampul 200 200 - 200 Rp 93,708 P.Padang
385 Lasix Ampul - - - - Rp 18,576 APL
386 Lasix Ampul 35 35 35 35 - Rp 20,640 APL
387 Lasix Ampul 375 375 175 125 75 375 - Rp 19,691 APL
388 Lasix Ampul 250 250 50 50 50 100 250 - Rp 21,878 APL
391 Levofloxacin 500 mg Tablet 7,400 7,400 500 500 6,900 Rp 544 Enseval
392 Levofloxacin Inf 500 mg Botol 250 250 16 16 32 218 Rp 8,713 AAM
393 Levofloxacin Inf 750 mg Botol - - - - Rp 85,014 AAM
394 Levopar Tablet 2,000 2,000 100 100 1,900 Rp 904 K.Farma
395 Levosif syr Botol 216 216 100 30 15 145 71 Rp 36,960 AAM
396 Levosif syr Botol 200 200 - 200 Rp 40,920 AAM
397 Levothyroxine 100 mcg Tablet 4,470 4,470 1,200 1,200 3,270 Rp 890 AMS
398 Lexavon syrup Botol 15 15 15 15 - Rp 4,250 Kebayoran
399 Lexavon syrup Botol 600 600 180 30 210 390 Rp 5,800 Kebayoran
400 Lidocain compositum Ampul 360 360 60 60 300 Rp 1,286 K.Farma ed02/
401 Lidocain Ampul 300 300 100 100 200 Rp 891 K.Farma
402 Lidocain Ampul - - - - Rp 1,221 Rajawali
406 Loratadin 10 mg Tablet - 1,000 1,000 100 100 200 800 Rp 111 Enseval
407 Lorazepam 2 mg Tablet 1,500 1,500 1,000 1,000 500 Rp 615 Merapi
408 Lovenox 0,4 Ampul 74 74 30 30 44 Rp 90,660 APL
409 Lovenox 0,6 Ampul 408 408 120 40 20 180 228 Rp 125,325 APL
411 Manitol 20%, 250 ml Botol - - - - Rp 28,275 Merapi
412 Manitol 20%, 250 ml Botol 75 75 10 10 65 Rp 24,350 Merapi
414 Mecobalamin 500 mg Tablet 13,100 30,000 43,100 7,200 7,200 35,900 Rp 501 P.Valent
415 Mecobalamin inj Ampul 126 100 226 50 20 70 156 Rp 6,600 P.Valent
416 Meloxicam 15 mg Tablet 2,950 2,950 - 2,950 Rp 385 Enseval
419 Meprovent nebu Ampul 900 900 100 100 160 360 540 Rp 3,677 K.Farma
420 Meropenem 1 gr Vial 108 108 88 10 10 108 - Rp 27,435 Enseval
423 Mestinon Tablet 1,350 1,350 150 150 1,200 Rp 7,850 APL
424 Metformin 500 mg Tablet 18,200 18,200 5,000 200 5,200 13,000 Rp 77 Enseval
425 Methoclorpramid 5 mg Tablet 100 100 100 100 - Rp 121 K.Farma
427 Methylergometrin 10 mg/ml Ampul 100 100 30 30 60 40 Rp 3,273 AMS
428 Methylergometrin 10 mg/ml Ampul 400 200 600 - 600 Rp 1,023 AAM
432 Metilprednisolon 125 mg Ampul 115 72 187 80 10 80 170 17 Rp 10,912 K.Farma
433 Metilprednisolon 16 mg Tablet - - - - Rp 558 AAM
434 Metilprednisolon 4 mg Tablet 12,900 12,900 300 200 500 12,400 Rp 102 Enseval
436 Metronidazol 500 mg Tablet - - - - Rp 251 P.Padang
437 Metronidazol 500 mg Tablet 3,800 3,800 1,000 100 1,100 2,700 Rp 137 Rajawali
438 Metronidazol infus Botol 100 400 500 72 72 428 Rp 5,885 K.Farma
439 Metronidazol 125 mg/5 ml Botol 84 84 84 84 - Rp 3,950 Sapta Sari ed02/
440 Meylon Ampul - - - - Rp 6,448 Merapi
441 Meylon Ampul 27 27 - 27 Rp 6,750 Merapi
442 Mg SO4 40% Ampul 71 71 - 71 Rp 4,290 Merapi
443 Miconazol cream Tube 199 199 - 199 Rp 1,900 K.Farma
445 Midazolam 1 mg/ml Ampul 30 30 20 20 10 Rp 4,444 APL
448 Miniaspi 80 mg Tablet - - - - Rp 105 Merapi
449 Miniaspi 80 mg Tablet 1,700 1,700 1,600 100 1,700 - Rp 89 Merapi
450 Misoprostol Tablet 570 570 - 570 Rp 3,850 P.Valent
453 Mometason cr 10 gr Tube 290 290 100 100 190 Rp 5,743 AAM
454 Morfin 10 mg Tablet 360 360 - 360 Rp 1,199 K.Farma
455 N-Ace Ampul - - - - Rp 10,000 P.Padang
456 Na Cl 0.9%, 500 ml Botol 2,272 2,272 1,022 60 20 1,102 1,170 Rp 6,900 Merapi
457 Na Cl 3 %, Otsu Botol 320 320 40 40 280 Rp 30,335 Merapi
458 Na. Diclofenac 25 mg Tablet 10,450 10,450 8,400 8,400 2,050 Rp 115 K.Farma
459 Na. Diclofenac 50 mg Tablet - - - - Rp 108 K.Farma
460 Nacl 0,9 % 100 ml Botol 250 250 20 35 10 65 185 Rp 6,764 Merapi
461 Nairet inj Ampul 100 200 300 90 35 100 225 75 Rp 17,160 MBS
462 Nasacort Box - - - - Rp 111,999 APL
463 Natrium Bicarbonat Tablet 2,800 2,800 2,800 2,800 - Rp 57 T. Gugun
464 Natrium Bicarbonat Tablet 20,000 20,000 9,200 200 9,400 10,600 Rp 69 T. Gugun
465 Neostigmine Ampul - 10 10 - 10 Rp 7,050 APL

466 Nerilon Cream 15 g Tube 225 225 90 5 95 130 Rp 27,363 Enseval

470 New antides Tablet - 1,000 1,000 200 200 400 600 GFK
472 Nicardipine HCL 10 mg Ampul 110 110 50 50 60 Rp 7,872 AAM
473 Nifedipine 10 mg Tablet 1,000 1,000 1,000 1,000 - Rp 220 K.Farma
474 Niflec Powder sachet 10 10 - 10 Rp 123,500 Merapi
475 Nitral 500 mg Tablet 6,570 13,980 20,550 - 20,550 Rp 1,415 AAM
476 Nitrokaf retard Tablet 12,900 10,000 22,900 18,900 18,900 4,000 Rp 1,640 K.Farma
479 Nopres 20 Mg Tablet - - - - Rp 676 AAM
480 Norephineprin inj 4 mg Ampul - - - - Rp 23,490 APL
481 Norephineprin inj 4 mg Ampul 290 290 50 50 240 Rp 6,298 AAM
482 Norestil 5 mg Tablet 300 300 - 300 Rp 2,420 Penta Valent
486 Novorapid flexpen Pen 485 250 735 300 15 5 320 415 Rp 89,500 AAM
487 NTG Ampul 140 140 30 10 40 100 Rp 64,350 AAM
489 Nystatin drop Botol 75 75 20 10 10 40 35 Rp 11,750 MPI
493 Octalbin 25 % 100 ml Botol 12 12 6 6 6 Rp 1,590,001 Enseval
494 Octalbin 20 % 100 ml Botol 25 25 3 3 22 Rp 905,000 Enseval
496 Olanzapine 10 mg Tablet 1,200 1,200 300 300 900 Rp 4,000 AAM
497 Olanzapine 5 mg Tablet 1,440 1,440 - 1,440 Rp 713 AAM
499 Omeprazol 20 mg Tablet 6,090 6,090 - 6,090 Rp 129 K.Farma
500 Omeprazol 20 mg Tablet 1,140 1,140 60 60 1,080 Rp 396 P.Padang
501 Omeprazole 40 mg Ampul 2,090 2,090 300 200 150 650 1,440 Rp 5,346 K.Farma
502 Omeprazole 40 mg Ampul - - - - Rp 6,999 Merapi
503 Ondansetron 4 mg Tablet - - - - Rp 385 P.Padang
504 Ondansetron 4 mg Tablet 1,200 1,200 300 60 360 840 Rp 270 AAM
505 Ondansetron 4 mg Tablet 780 780 - 780 Rp 970 AAM
506 Ondansetron 4 mg/2ml Ampul 1,160 1,160 100 300 100 100 600 560 Rp 873 AAM
507 Oralit sachet 100 100 100 100 - Rp 274 K.Farma
508 Oralit sachet 500 500 - 500 Rp 869 K.Farma
509 Orphen 4 mg Tablet - - - - Rp 60 Sapta Sari

511 Osteocal Tablet 2,664 2,664 2,664 2,664 - Rp 500 Kebayoran
512 Osteocal Tablet 20,016 20,016 1,656 72 1,728 18,288 Rp 540 Kebayoran
514 Oxytocin Ampul 300 200 500 100 100 200 300 Rp 1,126 APL
515 Pan Amin G Inf Botol 14 14 10 10 4 Rp 51,460 Merapi
516 Paracetamol 500 mg Tablet 17,100 17,100 6,400 2,500 1,100 10,000 7,100 Rp 216 T. Gugun
517 Paracetamol Drop Botol 27 27 25 2 27 - Rp 6,981 Indofarma

518 Paracetamol Drop Botol - 100 100 5 10 15 85 Rp 5,113 Rajawali
519 Paracetamol infus Botol - - - - Rp 11,990 k.Farma
520 Paracetamol infus Botol 200 185 385 80 20 5 40 145 240 Rp 8,880 Enseval
521 Paracetamol 120 mg/5 ml Botol 217 350 567 100 100 5 205 362 Rp 1,160 Merapi
522 Pehacain Ampul 40 40 - 40 Rp 3,113 Rajawali
524 Permethrin salep Tube 200 200 - 200 Rp 6,578 APL
525 Pethidin 50 mg/ml Ampul - - - - Rp 19,481 K.Farma
526 Phenitoin 100 mg Tablet 11,300 11,300 - 11,300 Rp 484 Kebayoran
528 Phenitoin (Na) 50 mg/ml Ampul 90 90 - 90 Rp 2,596 K.Farma
529 Phenol glyserol tetes telinga 10 % Botol 48 48 24 24 24 Rp 2,764 Rajawali
531 Phytomenadion 10 mg/5 ml Ampul - - - - Rp 5,025 K.Farma
532 Phytomenadion 10 mg/5 ml Ampul - - - - Rp 3,600 Rajawali
533 Phytomenadion (vit K1) 2mg Ampul - - - - Rp 3,867 Rajawali
534 Phytomenadion 10 mg Tablet 1,600 1,600 - 1,600 Rp 781 Rajawali

535 Piracetam 1200 mg Tablet - - - - Rp 877 APL
536 Piracetam 400 mg Tablet 300 300 300 300 - Rp 331 AAM
537 Piracetam 800 mg Tablet - 3,000 3,000 1,500 100 1,600 1,400 Rp 590 AAM
540 Piracetam inj 3 gram Ampul - 80 80 30 10 40 40 Rp 6,363 P.Padang
541 Pirazinamide 500 mg Tablet 500 500 - 500 Rp 401 K.Farma
545 Pramifrol 0,375 mg Tablet 4,440 4,440 - 4,440 Rp 3,050 P.Padang

548 Prednison 5 mg Tablet 1,500 1,500 500 500 1,000 Rp 162 K.Farma
551 Propanolol 10 mg Tablet 11,900 11,900 2,000 2,000 9,900 Rp 88 AAM
552 Propanolol 10 mg Tablet - - - - Rp 59 K.Farma
554 Propyltiouracyl 100 mg Tablet 5,000 10,000 15,000 2,000 100 2,100 12,900 Rp 405 AAM
555 Proris Supp - - - - Rp 5,041
556 Protofen Supp - - - - Rp 1,998 K.Farma
557 Prove D3 1000 iu Tablet 3,600 3,600 300 300 600 3,000 Rp 2,200 Enseval
559 Purifying cleansing milk AX 500 ml Botol 5 5 5 5 - Rp 139,700 Mutiara
562 Quetiapine XR 200 Tablet 100 100 - 100 Rp 13,400 P.Padang
563 Ramipril 2,5 mg Tablet 13,300 13,300 - 13,300 Rp 240 AAM

566 Ramipril 10 mg Tablet 6,600 6,600 - 6,600 Rp 710 AMS
567 Ranitidin 150 mg Tablet 43,100 20,000 63,100 7,200 1,000 300 8,500 54,600 Rp 85 AAM
568 Ranitidin 50 mg/ 2 ml Ampul 50 4,000 4,050 - 4,050 Rp 858 K.Farma
569 Ranitidin 50 mg/ 2 ml Ampul 2,000 2,000 720 400 200 1,320 680 Rp 2,056 Enseval
571 Renogen 2000 IU Ampul - 30 30 30 30 - Rp 57,000 APL
572 Retaphyl SR 300 mg Tablet 6,700 6,700 1,000 1,000 5,700 Rp 1,170 K.Farma
575 Revatio 20 mg Tablet 180 540 720 90 90 180 540 Rp 36,000 AAM
577 Rifampisin 450 mg Tablet 2,900 2,000 4,900 - 4,900 Rp 934 K.Farma
580 Ringer Lactat inf Botol 1,200 3,000 4,200 680 500 260 1,440 2,760 Rp 7,703 Merapi
583 Risperidon 3 mg Tablet 1,000 20,000 21,000 2,000 2,000 19,000 Rp 259 AAM
584 Ryzodeg flex touch Ampul 70 70 50 50 20 Rp 112,000 AAM
586 Sagestam 40 mg/ 2 ml Ampul 670 670 50 50 80 180 490 Rp 8,571 BSP
587 Salbutamol 2 mg Tablet 7,700 7,700 1,000 300 200 1,500 6,200 Rp 79 K.Farma
588 Salbutamol 1 mg/ml Ampul 150 150 50 50 100 50 Rp 4,900 AAM
590 Sammoxin 125 mg/ 5 ml Botol 375 375 100 30 130 245 Rp 3,700 T.Gugun
592 Scobutrin 10 mg Tablet 200 200 100 100 200 - Rp 2,118 MBS
594 Seretide Diskus 100 mg Box 69 80 149 20 1 21 128 Rp 111,850 APL
597 Sertralin 50 mg Tablet 4,100 4,100 500 500 3,600 Rp 1,345 K.Farma
598 Serum albifastin Ampul 5 5 5 5 - Rp 29,260 Mutiara
599 Serum claryfine Ampul 5 5 5 5 - Rp 27,720 Mutiara
600 Serum phytocell Ampul 5 5 5 5 - Rp 33,660 Mutiara

601 Sevoflurane 250 ml Botol - 10 10 10 10 - Rp 899,000 AMS
603 Sibital 200 mg/2 ml Ampul 50 50 - 50 Rp 9,801 Sapta Sari
606 Simvastatin 10 mg Tablet 19,540 10,000 29,540 - 29,540 Rp 68 Enseval
608 Sistenol Tablet 280 280 150 150 130 Rp 1,870 AAM
614 Spiriva 2,5 mcg respimat Box 30 30 20 20 10 Rp 445,000 Tempo
615 Spironolacton 25 mg Tablet 46,500 15,000 61,500 23,100 100 23,200 38,300 Rp 200 AAM
616 Spironolacton 100 mg Tablet 500 1,000 1,500 - 1,500 Rp 530 AAM
617 Stalevo 100 mg Tablet 1,110 2,010 3,120 600 600 2,520 Rp 8,800 AAM
619 Stesolid rectal 10 mg supp - - - - Rp 19,192 AAM
620 Stesolid rectal 10 mg supp 30 30 - 30 Rp 19,197 AAM
621 Stesolid rectal 5 mg supp - 30 30 5 5 25 Rp 13,203 AAM
622 Sucralfat Botol 23 23 23 23 - Rp 8,206 APL
623 Sucralfat Botol 500 500 250 100 20 370 130 Rp 9,306 APL
624 Sucralfat 500 mg Tablet 8,900 8,900 4,000 500 300 4,800 4,100 Rp 222 AAM
625 Sulfadiazine silver oint 10 mg Tube 5 5 - 5 Rp 18,557 K.Farma
626 Sulfadiazine silver oint 10 mg Tube 20 20 - 20 Rp 20,700 K.Farma
628 Sunscreen gel 20 g Tube 30 30 30 30 - Rp 29,150 Mutiara
630 Suprasma inhaler box 97 97 - 97 Rp 22,000 AAM
631 Symbicort inh 160 Botol 20 30 50 25 25 25 Rp 150,704 APL
633 Tablet tambah darah(ferro fumarat) Tablet 3,620 3,620 100 100 3,520 Rp 238 K.Farma
634 Tamsulosin 0,4 mg Tablet - 2,010 2,010 - 2,010 Rp 4,356 AMS
638 Tetagam P Syringe Box 86 86 - 86 Rp 146,800 AAM
639 Thiamfenicol 500 mg Tablet 300 300 300 300 - Rp 1,056 TSJ
640 Thiamfenicol 125 mg/5 ml Botol 66 66 - 66 Rp 16,500 TSJ
641 Thyrozol 10 mg Tablet - - - - Rp 1,325 AAM
642 Tramadol 100 mg Ampul - - - - Rp 4,161 Penta Valent
643 Tramadol 100 mg Ampul - 200 200 100 100 100 Rp 4,132 TSJ

645 Trihexipenidil 2 mg Tablet 10,900 10,900 4,000 4,000 6,900 Rp 63 Merapi
646 Triofusin Inf Botol 18 18 18 18 - Rp 53,890 Enseval return
648 Urinter 500 mg Tablet 100 100 100 100 - Rp 3,630 Enseval
649 Urinter 500 mg Tablet 1,900 1,900 1,000 1,000 900 Rp 4,235 Enseval
650 Ursode oxycholic acid 250 mg Tablet - - - - Rp 2,268 AAM

651 Ursode oxycholic acid 250 mg Tablet 240 3,000 3,240 - 3,240 Rp 1,679 AAM
654 V - Blok 25 mg Tablet 1,410 1,410 1,020 1,020 390 Rp 1,210 Enseval
658 Verapamil 80 mg Tablet 800 2,000 2,800 500 100 600 2,200 Rp 455 K.Farma
661 Vitamin B. 1/ Thiamin HCL 50 mg Tablet 14,500 14,500 - 14,500 Rp 192 K.Farma
662 Vitamin B. 6/ Pyridoxin 10 mg Tablet 5,900 5,900 2,000 100 2,100 3,800 Rp 71 K.Farma
663 Vitamin C /Asam Askorbat 50 mg Tablet 8,100 8,100 100 100 8,000 Rp 43 K.Farma
665 Vitamin B.Complex Tablet 13,500 13,500 9,000 1,000 500 10,500 3,000 Rp 68 T.Gugun
666 Vitamin B.Complex Tablet 30,000 30,000 - 30,000 Rp 121 K.Farma
667 Voluven 6% 500 ml Botol - - - - Rp 21,780 APL

668 Warfarin 2 mg Tablet 7,900 7,900 1,000 1,000 6,900 Rp 669 AMS
669 Wibrom 8 mg Tablet 1,900 1,900 1,000 400 100 1,500 400 Rp 107 Sapta Sari
677 Zinat tab 500 mg Tablet 100 100 - 100 Rp 4,725 APL
678 Zink 20 mg Tablet 600 600 200 100 300 300 Rp 253 Rajawali
679 Zink 20 mg/5 ml Botol 70 70 10 5 15 55 Rp 2,489 Tempo
627,874
Mengetahui Padang Panjang, 28 Februari 2022

Kepala Instalasi Farmasi Penanggung jawab

Nip 19811118 201001 2 010 Nip 19750213 200312 2 004
Rp 3,479,850 Rp 5,171,320
Rp 486,050 Rp -
Rp 2,310,000 Rp -
Rp 511,300 Rp -
Rp 8,316,000 Rp -
Rp 13,990,500 Rp 1,650,000
Rp 6,891,677 Rp -
Rp 2,745,941 Rp -
Rp 968,000 Rp -
Rp 332,640 Rp -
Rp 914,522 Rp 404,250
Rp 11,958,000
Rp 14,774,677 Rp -
Rp 15,015,000 Rp -
Rp 8,755,560 Rp -
Rp 5,876,801 Rp -
Rp 4,050,000 Rp -
Rp 17,688,000 Rp -
Rp 28,500,000 Rp -
Rp 10,527,000 Rp -
Rp 5,724,700 Rp -
Rp 507,000 Rp -
Rp 8,490,000 Rp -
Rp 11,610,000
Rp 11,700,000 Rp -
Rp 22,529,000 Rp -
Rp 10,991,600 Rp -
Rp 10,711,371 Rp -
Rp 3,920,000 Rp -
Rp 10,679,988 Rp -
Rp 22,400,004 Rp -
Rp 25,200,004 Rp 367,079
Rp 16,800,003 Rp -
Rp 14,000,002 Rp 525,000
Rp 173,339 Rp 1,440,000
Rp 776,380 Rp -
Rp 1,473,802 Rp -
Rp 4,521,132 Rp -
Rp 24,079,526 Rp -
Rp 8,948,016 Rp -
Rp 437,577 Rp -
Rp 5,526,015 Rp 858,000
Rp 12,571,570 Rp -
Rp 134,669 Rp -
Rp 225,200 Rp -
Rp 1,709,994 Rp -
Rp 3,839,999 Rp 585,000
Rp 415,800 Rp -
Rp 928,000 Rp -
Rp 6,534,000 Rp 11,700,000
Rp 1,837,836 Rp 22,529,000
Rp 3,251,556 Rp -
Rp 3,224,548 Rp -
Rp 875,000 Rp -
Rp 8,990,000 Rp -
Rp 11,291,700 Rp -
Rp 20,500,000 Rp -
Rp 374,832 Rp -
Rp 6,457,799 Rp -
Rp 440,000 Rp 2,310,000
Rp 492,262 Rp -
Rp 5,346,000 Rp -
Rp 971,974 Rp 2,323,200
Rp 620,000 Rp -
Rp 18,366,768 Rp -
Rp 4,112,064 Rp 2,802,000
Rp 420,000 Rp -
Rp 1,452,000 Rp -
Rp 254,522 Rp 134,670
Rp 4,653,000 Rp -
Rp 9,581,000 Rp -
Rp 23,108,999 Rp -
Rp 7,858,600 Rp 3,001,515
Rp 1,215,300 Rp -
Rp 14,699,960 Rp -
Rp 4,002,075 Rp -
Rp 1,473,802 Rp -
Rp 5,171,320 Rp 34,945,739
Rp 874,500 Rp -
Rp 1,354,320
Rp 3,432,000 Rp 1,760,000
Rp 16,400,010 Rp -
Rp 10,208,000 Rp -
Rp 3,136,991 Rp -
Rp 584,991 Rp -
Rp 10,513,800 Rp -
Rp 22,375,000 Rp -
Rp 17,250,200 Rp 11,610,000
Rp 785,664 Rp -
Rp 1,582,592 Rp -
Rp 2,500,000 Rp -
Rp 3,001,515 Rp -
Rp 5,469,585 Rp -
Rp 855,000 Rp -
Rp 6,995,002 Rp -
Rp 2,590,000 Rp -
Rp 1,151,700 Rp -
Rp 1,642,800 Rp -
Rp 13,900,007 Rp 7,058,700
Rp 1,440,000 Rp -
Rp 6,539,500 Rp -
Rp 11,958,000 Rp -
Rp 2,590,000 Rp -
Rp 826,471 Rp -
Rp 1,340,000 Rp -
Rp 525,000 Rp -
Rp 4,620,000 Rp -
Rp 10,866,212 Rp -
Rp 1,650,000 Rp -
Rp 858,000 Rp -
Rp 1,354,320 Rp -
Rp 19,440,000 Rp -
Rp 2,395,250 Rp -
Rp 3,432,000 Rp -
Rp -
Rp -
Rp -
Rp -
Rp 652,163
Rp -
Rp -
Rp 432,210
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 2,373,360
Rp -
Rp -
Rp 851,648
Rp -
Rp 1,061,363
Rp -
Rp 2,345,228
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 10,527,000
Rp 5,088,000
Rp -
Rp -
Rp 415,800
Rp -
Rp -
Rp 7,854,000
Rp -
Rp -
Rp -
Rp -
Rp 6,346,800
Rp 494,700
Rp 788,800
Rp 855,000
Rp -
Rp 5,700,000
Rp -
Rp -
Rp 999,900
Rp 215,270
Rp -
Rp -
Rp -
Rp 2,500,000
Rp -
Rp -
Rp 4,002,075
Rp -
Rp 5,500,000
Rp -
Rp -
Rp 522,000
Rp 3,840,000
Rp -
Rp -
Rp 17,250,201
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,582,592
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 10,513,800
Rp 1,440,000
Rp 700,000
Rp 1,325,400
Rp -
Rp -
Rp -
Rp -
Rp 1,188,000
Rp -
Rp -
Rp -
Rp -
Rp 968,000
Rp -
Rp -
Rp -
Rp 420,000
Rp -
Rp -
Rp -
Rp 620,000
Rp -
Rp -
Rp -
Rp 5,346,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 507,000
Rp -
Rp 14,699,955
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 3,224,548
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 332,640
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 486,050
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 5,089,320
Rp -
Rp -
Rp -
Rp -
Rp 2,947,600
Rp -
Rp -
Rp -
Rp -
Rp 14,850,000
Rp -
Rp 1,017,500
Rp -
Rp -
Rp -
Rp -
Rp 4,620,000
Rp -
Rp 20,500,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 615,000
Rp -
Rp 11,976,250
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 13,990,500
Rp -
Rp 28,500,000
Rp -
Rp 444,000
Rp -
Rp -
Rp -
Rp 51,520,009
Rp 30,800,006
Rp -
Rp -
Rp 173,339
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 776,380
Rp -
Rp 375,000
Rp 450,000
Rp -
Rp -
Rp 875,000
Rp -
Rp 440,000
Rp -
Rp 2,070,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,452,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 5,526,015
Rp -
Rp -
Rp -
Rp -
Rp 13,900,000
Rp -
Rp -
Rp 18,741,600
Rp 10,680,000
Rp -
Rp -
Rp -
Rp 7,383,938
Rp 5,469,585
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 8,184,000
Rp -
Rp -
Rp 3,479,850
ed02/22 Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 111,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 15,015,000
Rp 660,000
Rp -
Rp 1,039,500
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 204,600
Rp -
Rp -
Rp -
Rp 785,664
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 2,354,000
ed02/22 Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 3,432,000
Rp -
Rp -
Rp -
Rp 70,500
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 19,781,700
Rp 16,400,010
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 22,375,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 756,600
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 225,200
Rp -
Rp -
Rp -
Rp 511,300
Rp -
Rp 1,642,800
Rp 406,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,770,615
Rp -
Rp -
Rp 509,040
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 4,050,000
Rp -
Rp -
Rp -
Rp -
Rp 698,500
Rp -
Rp -
Rp 1,340,000
Rp -
Rp -
Rp -
Rp -
Rp 1,700,000
Rp 3,432,000
Rp 4,112,064
Rp -
Rp 1,709,994
Rp -
Rp -
Rp -
Rp 19,440,000
Rp -
Rp 1,868,000
Rp -
Rp -
Rp 23,109,000
Rp -
Rp -
Rp 5,180,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 8,948,000
Rp 12,571,600
Rp -
Rp -
Rp 146,300
Rp 138,600
Rp 168,300
Rp 8,990,000
Rp -
Rp -
Rp -
Rp -
Rp 680,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 3,000,000
Rp 530,000
Rp 17,688,000
Rp -
Rp -
Rp 575,910
Rp 396,090
Rp -
Rp 4,653,000
Rp -
Rp -
Rp 413,996
Rp -
Rp 874,500
Rp -
Rp -
Rp 4,521,120
Rp -
Rp -
Rp 8,755,560
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 826,470
Rp -
Rp -
return Enseval Rp -
Rp -
Rp -
Rp -
Rp -
Rp 5,037,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 910,195
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 749,819,236 Rp 749,818,913 Rp (323)

RSUD PADANG PANJANG
BULAN : MARET 2022

KELUAR Retur/ Bayar
1 A.B.U Vial 10 10 5 5 5 Rp 517,132 Indofarma 1

5 Acarbose 50 mg Tablet 500 1,000 1,500 1,000 1,000 500 Rp 600 AAM 5
6 Acetylsistein 200 mg Tablet 2,000 2,000 2,000 2,000 - Rp 825 Penta Valent 6
Acetylsistein 200 mg Tablet 19,800 19,800 7,920 1,500 600 10,020 9,780 Rp 307 Indofarma
10 Acyclovir 5% cream Tube - - - - Rp 3,391 K.Farma 10
11 Acyclovir 5% cream Tube 85 85 - 85 Rp 4,043 K.Farma 11
12 Adalat Oros 30 mg Tablet 3,000 3,000 6,000 1,890 1,890 4,110 Rp 3,986 P.Padang 12
13 Akilen ear drop Botol 58 120 178 48 48 130 Rp 35,000 BSP 13
15 Allopurinol 100 mg Tablet 14,600 14,600 5,000 100 5,100 9,500 Rp 87 Enseval 15
18 Alprazolam 0.5 mg Tablet 5,800 5,800 1,000 1,000 4,800 Rp 78 Merapi 18
19 Ambroxol 15 mg/5 ml Botol 116 116 50 50 66 Rp 3,264 Indofarma 19
20 Ambroxol 15 mg/5 ml Botol - - - - GFK 20
21 Ambroxol 30 mg Tablet 900 900 900 900 - Rp 231 Indofarma 21
22 Ambroxol 30 mg Tablet 5,000 5,000 2,100 300 2,400 2,600 Rp 246 Indofarma 22
23 Aminofusin Hepar Botol 7 10 17 2 3 5 12 Rp 79,500 Enseval 23
24 Aminofusin Pead inf Botol - 5 5 - 5 Rp 57,300 Enseval 24
25 Aminofusin Pead inf Botol - - - - RSAM 25
26 Aminosteril infan 6% Botol 3 3 - 3 Rp 39,000 APL 26
30 Aminophylin 24 mg/ml Amp 30 30 - 30 Rp 2,704 K.Farma 30
32 Amiodaron 50 mg/ ml Amp - - - - Rp 8,700 APL 32
33 Amiodaron 50 mg/ ml Amp - 130 130 50 25 75 55 Rp 6,118 APL 33
Amiodaron 200 mg Tablet 200 200 200 200 - Yarsi
34 Amiparen infus Botol 48 48 - 48 Rp 96,650 Merapi 34
35 Amitriptilin 25 mg Tablet 2,500 2,500 500 500 2,000 Rp 175 P.Padang 35
36 Amlodipin 10 mg Tablet 73,100 73,100 20,000 20,000 53,100 Rp 72 Merapi 36
37 Amlodipin 5 mg Tablet 36,300 36,300 - 36,300 Rp 53 Tempo 37
38 Amoxicillin 500 mg Tablet 8,700 8,700 - 8,700 Rp 261 Enseval 38
39 Amoxicillin dry syr Botol - - - - Rp 2,783 Indofarma 39
40 Amoxicillin drop Botol 130 130 10 10 120 Rp 13,500 TSJ 40
41 Amoxicillin 1 gr Vial - - - - Rp 9,450 Rajawali 41
44 Ampicilin 1 gr Vial - - - - Rp 8,988 TSJ 44
Ampicilin 1 gr Vial 240 240 50 40 90 150 GFK
45 Anemolat 1 mg Tablet - - - - Rp 165 Rajawali 45
46 Anemolat 1 mg Tablet - - - - Rp 220 K.Farma 46
47 Antasida Botol - 300 300 100 100 20 220 80 Rp 1,725 Rajawali 47
48 Antasida Botol - - - - GFK 48
49 Antihemorroid supp Supp 770 770 20 20 750 Rp 3,250 K.Farma 49
50 Apidra Solastar Pen 180 180 - 180 Rp 89,500 APL 50
51 Aqua pro injeksi / Otsu-WI Botol 590 590 240 240 350 Rp 2,625 Merapi 51
Aqua pro injeksi / Otsu-WI Botol 3,840 3,840 480 480 12 972 2,868 Rp 2,650 PPI
52 Aripiprazole 10 mg Tablet 200 1,000 1,200 200 200 1,000 Rp 19,500 AAM 52
53 Arixtra 2,5 mg Ampul 180 180 - 180 Rp 225,290 AAM 53
54 Arkine 2 mg Tablet - - - - Rp 762 Sapta Sari 54
55 Artesunate Ampul - - - - Pinjaman 55
56 Asam Folat 1 mg Tablet - - - - Rp 58 K.Farma 56
57 Asam Folat 1 mg Tablet - 7,000 7,000 6,500 200 200 6,900 100 GFK 57
58 Asam Mefenamat 500 mg Tablet 26,900 26,900 4,000 500 100 4,600 22,300 Rp 111 Enseval 58
59 Asam Tranexamat 250 mg/5 ml Ampul 390 390 30 30 360 Rp 1,813 AAM 59
60 Asam Tranexamat 500 mg Tablet 3,800 3,800 1,000 200 1,200 2,600 Rp 1,683 TSJ 60
61 Asam Tranexamat 500 mg/5 ml Ampul 1,340 1,340 100 30 50 180 1,160 Rp 2,088 AAM 61
62 Asam Valproat 250 mg/5 ml Botol 200 100 300 150 150 150 Rp 12,123 AAM 62
63 Ascorbic Acid 200 mg Ampul 220 220 100 100 120 Rp 7,700 Merapi 63
66 Asering infus Botol 340 300 640 40 140 40 220 420 Rp 9,680 Merapi 66
67 Aspilets 80 mg Tablet 9,600 9,600 9,000 9,000 600 Rp 611 K.Farma 67
68 Atorvastatin 20 mg Tablet - - - - Rp 1,265 K.Farma 68
69 Atorvastatin 20 mg Tablet 5,520 5,520 60 60 120 5,400 Rp 467 AAM 69
70 Atracurium 50 mg Ampul - - - - Rp 14,235 APL 70
71 Atracurium 25 mg Ampul - - - - Rp 11,737 Indofarma 71
72 Atracurium 25 mg Ampul 15 85 100 - 100 Rp 8,978 APL 72
73 Atropin Sulfat 0,25 mg/ml Ampul 400 400 - 400 Rp 1,718 APL 73
74 Avamys Nasal Spray Box 35 70 105 - 105 Rp 115,400 APL 74
75 Azitromicin 500 mg Tablet 1,500 1,960 3,460 700 100 160 960 2,500 Rp 1,300 K.Farma 75
76 Bactesyn 1,5 g Ampul 215 215 20 20 195 Rp 20,010 Enseval 76
77 Bamgetol Tablet - - - - Rp 1,287 Merapi 77
78 Bedak Kocok Anak 100 ml Botol 45 45 - 45 Rp 7,898 Panay 78
79 Bedak Kocok Dewasa 100 ml Botol - - - - Rp 20,020 APM 79
80 Bedak Kocok Dewasa 200 ml Botol 66 66 20 20 46 Rp 21,461 Panay 80
81 Berotec MDI Box 342 200 542 168 168 374 Rp 86,930 APL 81
82 Berotec MDI Box - - - - RSAM 82
83 Betadine kumur 190 ml Botol 36 36 12 12 24 Rp 28,215 P.Padang 83
84 Betahistin 6 mg Tablet 28,700 28,700 5,000 400 5,400 23,300 Rp 88 AAM 84
85 Betametason 0.1% cream Tube 75 75 25 25 50 Rp 1,520 K.Farma 85
86 Bfluid Botol 260 200 460 20 20 440 Rp 76,300 Merapi 86
87 Bisacodyl Tablet - - - - Rp 327 AMS 87
88 Bisacodyl Tablet 600 600 100 100 500 Rp 216 K.Farma 88
89 Bisoprolol 5 mg Tablet 25,380 25,380 5,400 5,400 19,980 Rp 137 AAM 89
90 Bisoprolol 5 mg Tablet - - - - GFK 90
91 Bisoprolol 2,5 mg Tablet 84,900 40,000 124,900 30,000 100 30,100 94,800 Rp 129 AAM 91
92 Bisoprolol 2,5 mg Tablet - - - - Rp 275 Enseval 92
93 Bricasma 0,5 mg/ml Vial - - - - Rp 12,558 APL 93
94 Brilinta 90 mg Tablet - 1,680 1,680 560 560 1,120 Rp 8,404 APL 94
95 Bucain spinal 0,5 mg Ampul 50 300 350 - 350 Rp 48,400 UDC 95
96 C. Asternof 5 ml Botol - - - - Rp 21,483 P.Valent 96
97 C. Asternof 0,6 ml Strip 80 80 - 80 Rp 20,972 P.Valent 97
98 C. Augentonic 0.6 ml Strip 100 100 - 100 Rp 22,122 P.Valent 98
99 C. Carpin 2% 0,6 ml Strip 60 60 - 60 Rp 18,030 P.Valent 99
100 C. Catarlen 0,6 ml Strip 97 97 97 97 - Rp 20,460 P.Valent 100
101 C. Cendrid 0,6 ml Strip - - - - Rp 17,007 P.Valent 101
102 C. Cenfresh 0,6 ml Strip 360 220 580 200 7 207 373 Rp 23,529 P.Valent 102
103 C. Conver 0,6 ml Strip - 80 80 - 80 Rp 16,496 P.Valent 103
104 C. Efrisel 5 ml Botol - - - - Rp 15,601 P.Valent 104
105 C. Efrisel 5 ml Botol 40 40 - 40 Rp 14,900 P.Valent 105
106 C. Efrisel 0,6 ml Strip - - - - Rp 15,600 P.Valent 106
107 C. Fenicol 1% E.O Tube - - - - Rp - P.Valent
108 C. Floxa 0,6 ml Strip 80 200 280 60 4 64 216 Rp 27,364 P.Valent
109 C. Gentamicin 3,5 g Tube 110 110 - 110 Rp 37,212 P.Valent
110 C. Gentamicin 3,5 g Tube - - - - Rp 37,210 P.Valent
111 C.Gentamicin 5 ml Botol - - - - Rp 29,026 P.Valent
112 C.Gentamicin 5 ml Botol 20 20 2 2 18 Rp 22,300 P.Valent
113 C. Hervis 3,5 g Tube - - - - Rp 37,594 P.Valent
114 C. Hervis 3,5 g Tube 30 30 10 10 20 Rp 37,595 P.Valent
115 C. Homatro 2% 5 ml Botol 10 10 - 10 Rp 36,316 P.Valent
116 C. Homatro 2% 5 ml Botol - - - - Rp 36,317 P.Valent
117 C. LFX 0,6 ml Strip 114 114 1 1 113 Rp 70,587 P.Valent
118 C. LFX 5 ml Botol - - - - Rp 68,557 K.Farma
119 C. Lyteers 15 ml Botol 100 100 - 100 Rp 23,018 P.Valent
122 C. Mycetin 3,5 g Tube 72 72 20 20 52 Rp 13,043 P.Valent
123 C. Mydriatil 1% ed Botol - - - - Rp 39,971 P.Valent
124 C. Mydriatil 0.5% Botol 20 20 - 20 Rp 29,538 P.Valent
125 C. Noncort 0,6 ml Strip 50 60 110 - 110 Rp 43,221 P.Valent
126 C. Pantocain 0,5% ed Botol - - - - Rp 13,555 P.Valent
128 C. Pantocain 2% 5 ml Botol 38 38 - 38 Rp 13,555 P.Valent
129 C. Polidex 0,6 ml Strip 152 100 252 100 100 152 Rp 27,110 P.Valent
130 C. Polipred 0,6 ml Strip 5 40 45 - 45 Rp 17,775 P.Valent
132 C. Polygrant 3,5 g Tube 75 75 - 75 Rp 18,925 K.Farma
133 C. Protagenta 0,6 ml Strip 150 120 270 60 60 210 Rp 36,700 P.Valent
135 C. Timol 0.5 % 0,6 ml Strip 135 60 195 60 60 135 Rp 26,342 P.Valent
137 C. Tobroson 0,6 ml Strip 149 149 - 149 Rp 29,667 P.Valent
138 C. Tropin 0,5% 0,6 ml botol - - - - Rp 12,756 P.Valent
140 C. Vasacon 0.6 ml strip 100 100 - 100 Rp 14,194 P.Valent
142 C. Vernacel 0,6 ml Strip 215 215 60 60 155 Rp 21,227 P.Valent
144 C. Vitrolenta 5 ml Botol 120 120 - 120 Rp 33,503 P.Valent
145 C. Vosama Strip 20 20 - 20 Rp 18,030 P.Valent
146 C. Xitrol eo Tube - - - - Rp 37,489 P.Valent
148 Ca. Gluconas 10% 10 ml Ampul 48 48 24 24 24 Rp 5,723 APL
152 Candesartan 16 mg Tablet 34,200 18,000 52,200 19,440 150 60 19,650 32,550 Rp 319 AAM
153 Candesartan 8 mg Tablet 43,830 43,830 12,240 210 12,450 31,380 Rp 212 AAM
155 Captopril 25 mg Tablet 7,500 7,500 - 7,500 Rp 75 K.Farma
156 Carbamazepin 200 mg Tablet 3,400 3,400 3,000 3,000 400 Rp 198 Merapi
158 Carmed urea 10% Tube 29 29 29 29 - Rp 28,710 AMS
159 Carvedilol 6,25 mg Tablet 7,900 7,900 2,000 2,000 5,900 Rp 1,309 K.Farma
160 Cefadroxyl 500 mg Tablet 4,100 4,100 500 500 3,600 Rp 580 Enseval
161 Cefadroxyl 125 mg/5 ml Botol 200 200 - 200 Rp 4,340 K.Farma
164 Cefixime 100 mg Tablet 4,900 30,000 34,900 3,600 1,000 4,600 30,300 Rp 387 Enseval
165 Cefixime 100 mg/5 ml Botol 145 145 50 6 56 89 Rp 4,947 AAM
167 Cefotaxim 1 g Vial 160 200 360 100 20 20 140 220 Rp 2,850 Enseval
169 Ceftriaxon 1 g inj Vial 2,150 2,150 288 288 160 736 1,414 Rp 2,850 Enseval
171 Cetirizin 10 mg Tablet - - - - GFK
172 Cetirizin 10 mg Tablet 47,600 47,600 6,000 300 100 6,400 41,200 Rp 50 Merapi
173 Cetirizin 5 mg/5 ml Botol 70 70 20 10 30 40 Rp 2,153 Merapi
176 Cilostazol 100 mg Tablet 500 500 - 500 Rp 5,852 TSJ
Cilostazol 100 mg Tablet 3,000 3,000 - 3,000 Rp 5,900 TSJ
177 Ciprofloxacin 500 mg Tablet 10,900 10,900 1,000 200 1,200 9,700 Rp 250 Enseval
179 Citicolin 250 mg/ml amp 10 10 10 10 - Rp 4,700 Enseval
180 Citicolin 250 mg/ml amp 1,000 1,000 200 90 290 710 Rp 4,002 P.Padang
182 Citicolin 500 mg Tablet 3,400 3,400 - 3,400 Rp 2,750 Enseval
183 Clindamicin 150 mg Tablet 4,000 4,000 - 4,000 Rp 677 AMS
185 Clindamycin 300 mg Tablet 900 900 - 900 Rp 522 Merapi
186 Clobazam 10 mg Tablet 10,000 10,000 2,000 2,000 8,000 Rp 384 AAM
187 Clobazam 10 mg Tablet 1,000 1,000 1,000 1,000 - Rp 776 AAM
188 Clonidine 0,15 mg Tablet 3,000 3,000 2,900 100 3,000 - Rp 146 K.Farma
189 Clopidogrel 75 mg Tablet 52,560 52,560 31,680 240 90 32,010 20,550 Rp 575 K.Farma
191 Clorpromazine/CPZ 100 mg tab 200 200 - 200 Rp 433 K.Farma
192 Clozapin 100 mg Tablet 1,700 1,700 - 1,700 Rp 1,197 AAM
193 Clozapin 25 mg Tablet 1,800 1,500 3,300 2,000 2,000 1,300 Rp 473 AAM
194 Co-Amoxyclav 625 mg Tablet 840 840 30 30 810 Rp 4,158 AAM
195 Codein 10 mg Tablet 2,100 2,100 1,000 1,000 1,100 Rp 600 K.Farma
196 Colcitine 0,5 mg Tablet - - - - Rp 2,414 APL
197 Colcitine 0,5 mg Tablet 1,050 1,050 - 1,050 Rp 649 APL
198 Comafusin hepar Botol 20 20 - 20 Rp 79,130 Enseval
199 Combivent UDV Ampul - - - - Rp 3,500 APL
202 CTM/Chlorpheniramini maleat 4 mg Tablet - 300 300 300 300 - GFK
204 Curcuma blister Tablet 15,120 15,120 2,400 600 3,000 12,120 Rp 876 P.Padang
205 D 10% otsu Botol 240 240 20 20 20 60 180 Rp 7,200 Merapi
206 D 40%, Otsu Ampul 244 244 18 10 28 216 Rp 7,000 Merapi
207 D 5 % Otsu Botol 480 480 40 40 440 Rp 6,627 Merapi
212 Desoximethason cream Tube 216 216 108 6 114 102 Rp 9,000 AAM
214 Dexametason 0.5 mg Tablet - - - - Rp 136 K.Farma
215 Dexametason 0.5 mg Tablet 1,300 1,300 500 100 600 700 Rp 163 K.Farma
216 Dexametason 0,5 mg/ml Ampul - - - - Rp 1,152 K.Farma
217 Dexametason 0,5 mg/ml Ampul 600 1,000 1,600 200 100 300 1,300 Rp 968 K.Farma
221 Diazepam 2 mg Tablet 6,400 6,400 2,500 100 2,600 3,800 Rp 70 P.Padang
222 Diazepam 5 mg Tablet 1,300 1,300 1,000 1,000 300 Rp 114 Merapi
223 Diazepam 5 mg/ ml Ampul - 200 200 10 10 190 Rp 1,545 K.Farma
225 Digoxin 0.25 mg Tablet 5,000 5,000 - 5,000 Rp 124 P.Padang
226 Diltiazem 30 mg Tablet 7,900 7,900 3,000 3,000 4,900 Rp 135 AAM
227 Diphenhydramine 10 mg/ ml Vial - 60 60 - 60 Rp 825 K.Farma
229 Divalprex sodium 250 mg Tablet 10,400 6,600 17,000 6,000 6,000 11,000 Rp 990 AMS
231 Dobutamin 50 mg Ampul - 50 50 - 50 Rp 8,497 AAM
232 Domperidon Syrup 60 ml Botol - 100 100 10 10 90 Rp 2,359 Indofarma
233 Domperidon 10 mg Tablet 1,300 1,300 500 300 200 1,000 300 Rp 73 Merapi
234 Donepezil 5 mg Tablet - 900 900 - 900 Rp 1,600 IGM
235 Dopamed 250 mg Tablet 1,000 1,000 - 1,000 Rp 1,014 AAM
237 Dorner Tablet 2,940 2,940 600 600 2,340 Rp 4,900 APL
238 Doxicyclin 100 mg Tablet - - - - Rp 289 AAM
239 Dulcolac 5 mg supp Supp - - - - Rp 5,085 APL
242 Dumin rectal 125 mg/2.5 ml Tube - - - - Rp 15,355 AAM
243 Dumin rectal 125 mg/2.5 ml Tube 155 155 65 65 90 Rp 16,123 AAM
246 Efedrin 50 mg/ ml Ampul - 100 100 30 30 70 Rp 6,486 APL
248 Eferison 50 mg Tablet 17,200 17,000 34,200 16,000 200 16,200 18,000 Rp 983 Merapi
250 Epinephrine 0,1% Ampul 210 210 - 210 Rp 2,772 Rajawali
251 Epodion 2000 iu Ampul 10 30 40 21 21 19 Rp 57,000 UDC
252 Ergotamine Coffein Tablet 2,900 2,900 2,000 100 2,100 800 Rp 217 K.Farma
255 Erphafillin 200 mg Tablet 14,300 14,300 6,000 400 6,400 7,900 Rp 153 Sapta Sari
256 Erphahexin Tablet 4,000 4,000 - 4,000 Rp 122 Sapta Sari
261 Erythromycin 200 mg/ 5 ml Botol 8 8 - 8 Rp 6,785 K.Farma
262 Etadium 2 mg Tablet 500 500 100 100 200 300 Rp 183 APM
263 Etambutol 500 mg Tablet 900 900 500 500 400 Rp 447 Dosniroha
264 Eugenol 10 ml Botol - 5 5 5 5 - Rp 20,150 K.Farma
Facial scrub 250 g Botol 5 5 5 5 - Rp 68,200 Mutiara
272 Farmavon 2 mg/ml Ampul 210 210 50 10 30 90 120 Rp 37,752 P.Padang
278 Fenobarbital 30 mg Tablet 1,200 1,200 1,000 1,000 200 Rp 182 K.Farma
Fenobarbital 30 mg Tablet 5,200 5,200 2,000 2,000 3,200 GFK
280 Fentanyl 0.5 mg/ml Ampul 130 130 - 130 Rp 28,274 K.Farma
281 Fetik Supp - - - - Rp 10,890 Enseval
282 Fetik Supp - 500 500 100 150 100 50 400 100 Rp 11,435 Enseval
284 Flamicort 10 mg/ ml Vial 10 10 - 10 Rp 110,000 AAM
285 Flixotide Nebules 2 ml Ampul 100 250 350 - 350 Rp 14,738 APL
286 Fluconazol 150 mg Tablet - - - - Rp 18,800 K.Farma
287 Fluimucil granule sachet 2,040 2,040 1,080 450 510 2,040 - Rp 3,230 APL
288 Flunarizin 5 mg Tablet 3,640 6,000 9,640 2,560 200 80 2,840 6,800 Rp 894 P.Valent/MPI
289 Fluoxetine 20 mg Tablet 3,180 3,180 - 3,180 Rp 387 AAM
290 Fonylin 60 mg Tablet 4,500 5,400 9,900 - 9,900 Rp 3,300 AAM
292 Framycetine sulfate Pcs 30 30 20 10 30 - Rp 10,175 APL
293 Fresofol 1% Ampul 50 50 - 50 Rp 11,000 APL
294 Fucilex cream Tube 21 21 21 21 - Rp 7,150 MBS
295 Furosemid 40 mg Tablet 36,600 36,600 5,000 400 5,400 31,200 Rp 145 K.Farma
297 Furosemid 10 mg/ ml Ampul 900 900 590 200 110 900 - Rp 3,850 P.Padang
298 Fusycom cr Tube 100 100 70 5 75 25 Rp 19,096 APL
299 Gabapentin 100 mg Tablet 17,750 20,000 37,750 12,600 50 12,650 25,100 Rp 1,025 APL
300 Garam ingris sac/30gr 688 688 10 10 678 Rp 2,040 Bratako
301 Gelafusal infus Botol 10 10 10 10 - Rp 145,015 AAM
302 Gelofusin inf botol - 32 32 - 32 Rp 144,817 P.Padang
303 Gemfibrozil 300 mg Tablet - - - - Rp 462 K.Farma
304 Gemfibrozil 300 mg Tablet 4,000 10,000 14,000 6,000 6,000 8,000 Rp 315 K.Farma
305 Gentalex cream Tube - - - - Rp 2,350 Kebayoran
307 Gentamicin sulfate 0,1% Tube 310 310 100 30 10 140 170 Rp 2,849 K.Farma
309 Glaucon 100 mg Tablet 1,660 1,660 200 200 1,460 Rp 3,887 P.Valent
312 Gliclazide 80 mg Tablet 1,000 1,000 1,000 1,000 - Rp 235 Tempo
315 Glimepiride 2 mg Tablet 9,700 6,000 15,700 3,000 3,000 12,700 Rp 123 Enseval
316 Gliquidon 30 mg Tablet 4,900 9,000 13,900 7,000 7,000 6,900 Rp 1,000 AAM
317 Glucosamin Tablet 14,900 14,900 5,000 5,000 9,900 Rp 1,198 Merapi
318 Glucosamin Tablet - - - - Rp 1,106 Merapi
319 Griseovulfin 125 mg Tablet 200 200 - 200 Rp 326 K.Farma
324 Hemapo 3000 ui Ampul 101 50 151 51 51 100 Rp 80,000 Enseval
325 Heparin sodium 5000 iu Vial 280 300 580 280 280 300 Rp 46,635 P.Padang
327 Herbesser CD 100 mg Tablet 3,900 4,500 8,400 5,000 5,000 3,400 Rp 4,750 AAM
329 Hidroklortiazid 25 mg Tablet 4,000 4,000 1,000 1,000 2,000 2,000 Rp 148 K.Farma
330 Hidrokortison 2.5% salep Tube 115 115 - 115 Rp 2,475 K.Farma
335 Human Albumin 20% 50 ml Botol 3 3 - 3 Rp 445,000 AAM
336 Hydroxychloroquin Tablet 90 90 90 90 - Rp 2,585 MBS
337 Hyocine-N-Butylbromide Ampul 60 60 - 60 Rp 5,778 APL
338 Hyocine-N-Butylbromide Tablet 1,000 1,000 - 1,000 Rp 1,050 Rajawali
345 Iliadin spray Pcs 20 50 70 20 20 50 Rp 38,819 APL
346 Iliadin drop anak Pcs - - - - Rp 36,817 APL
347 INH 100 mg Tablet 5,900 5,900 - 5,900 Rp 75 K.Farma
348 INH 300 mg Tablet 5,000 5,000 - 5,000 Rp 150 K.Farma
350 Iron sucrose Ampul 10 60 70 - 70 Rp 27,500 AMS
351 ISDN 1 mg/ ml Ampul 30 50 80 10 10 70 Rp 17,500 AMS
352 Isoflurance 250 ml Botol - 6 6 6 6 - Rp 400,000 P.Padang
353 Isosorbid Dinitrat/ISDN 5 mg Tablet 7,700 7,700 3,000 100 3,100 4,600 Rp 88 P.Padang
355 Ka EN 1B Botol 180 160 340 60 20 80 260 Rp 10,350 Merapi
356 Ka EN MG3 Botol 80 80 20 20 60 Rp 10,750 Merapi
360 KCl 7.4 % Otsu Ampul 84 84 10 6 16 68 Rp 3,472 Merapi
362 Kendaron 200 mg Tablet 60 60 60 60 - Rp 1,027 APL
363 Ketamin 100 mg/ ml Ampul 20 20 10 10 10 Rp 14,788 AAM
364 Ketokonazol 200 mg Tablet 1,100 1,100 600 600 500 Rp 260 Enseval
365 Ketokonazol Cream 2% 10gr Tube - - - - Rp 2,399 K.Farma
366 Ketoprofen 100 mg Tablet 2,000 2,000 4,000 1,400 200 1,600 2,400 Rp 726 P.Padang
367 Ketoprofen 100 mg Tablet 600 600 600 600 - Rp 1,080 AMS
369 Ketorolac 30 mg Ampul 80 80 30 50 80 - Rp 880 AAM
370 Ketorolac 30 mg Ampul - - - - Rp 6,014 AMS
Ketorolac 30 mg Ampul 10 10 - 10 GFK
Ketorolac 30 mg Ampul 900 900 - 900 Rp 6,683 AMS
372 Kidmin inf Botol 180 180 20 20 160 Rp 54,620 Merapi
373 Kompolax Botol - 300 300 - 300 Rp 5,370 Indofarma
374 KSR 600 mg Tablet 4,000 4,000 500 200 700 3,300 Rp 1,842 AAM
375 KTM Vial - - - - Rp 116,035 MPI
376 Lacto B sachet - - - - Rp 6,230 P.Valent
Lacto B sachet 200 200 40 40 160 Rp 6,490 P.Valent
377 Laktulosa Botol 12 12 10 10 2 Rp 27,225 Indofarma
378 Lanolin gram 1,000 1,000 1,000 1,000 - Rp 605 Bratako ed03/2
379 Lansoprazol 30 mg Tablet 38,000 25,000 63,000 24,000 1,000 25,000 38,000 Rp 278 Enseval
380 Lansoprazol 30 mg Tablet - - - - Rp 608 P.Valent
381 Lansoprazol Ampul 10 10 10 10 - Rp 93,704 P.Padang
382 Lansoprazol Ampul 200 200 10 20 30 170 Rp 93,708 P.Padang
391 Levofloxacin 500 mg Tablet 6,900 6,900 - 6,900 Rp 544 Enseval
392 Levofloxacin Inf 500 mg Botol 218 218 - 218 Rp 8,713 AAM
393 Levofloxacin Inf 750 mg Botol - - - - Rp 85,014 AAM
394 Levopar Tablet 1,900 3,000 4,900 - 4,900 Rp 904 K.Farma
395 Levosif syr Botol 71 71 - 71 Rp 36,960 AAM
396 Levosif syr Botol 200 200 200 200 - Rp 40,920 AAM
397 Levothyroxine 100 mcg Tablet 3,270 1,560 4,830 - 4,830 Rp 890 AMS
398 Lexavon syrup Botol - - - - Rp 4,250 Kebayoran
399 Lexavon syrup Botol 390 390 120 60 180 210 Rp 5,800 Kebayoran
400 Lidocain compositum Ampul 300 300 30 30 270 Rp 1,286 K.Farma
401 Lidocain Ampul 200 1,200 1,400 100 100 1,300 Rp 891 K.Farma
402 Lidocain Ampul - - - - Rp 1,221 Rajawali
406 Loratadin 10 mg Tablet 800 1,000 1,800 - 1,800 Rp 111 Enseval
407 Lorazepam 2 mg Tablet 500 5,000 5,500 500 500 5,000 Rp 615 Merapi
408 Lovenox 0,4 Ampul 44 76 120 12 12 108 Rp 90,660 APL
409 Lovenox 0,6 Ampul 228 160 388 80 20 100 288 Rp 125,325 APL
411 Manitol 20%, 250 ml Botol - - - - Rp 28,275 Merapi
412 Manitol 20%, 250 ml Botol 65 65 - 65 Rp 24,350 Merapi
Massage scrub 250 g Botol 5 5 5 5 - Rp 75,900 Mutiara
414 Mecobalamin 500 mg Tablet 35,900 35,900 7,500 100 7,600 28,300 Rp 501 P.Valent
415 Mecobalamin inj Ampul 156 156 - 156 Rp 6,600 P.Valent
416 Meloxicam 15 mg Tablet 2,950 2,950 500 500 2,450 Rp 385 Enseval
Meloxicam 15 mg Tablet 4,000 4,000 - 4,000 Rp 320 MBS
Meloxicam 7,5 mg Tablet 19,000 19,000 6,600 6,600 12,400 Rp 273 MBS
419 Meprovent nebu Ampul 540 320 860 200 200 100 500 360 Rp 3,677 K.Farma
420 Meropenem 1 gr Vial - 400 400 - 400 Rp 27,435 Enseval
423 Mestinon Tablet 1,200 1,200 750 750 450 Rp 7,850 APL
424 Metformin 500 mg Tablet 13,000 13,000 7,000 7,000 6,000 Rp 77 Enseval
425 Methoclorpramid 5 mg Tablet - - - - Rp 121 K.Farma
427 Methylergometrin 10 mg/ml Ampul 40 40 40 40 - Rp 3,273 AMS
428 Methylergometrin 10 mg/ml Ampul 600 600 100 100 500 Rp 1,023 AAM
432 Metilprednisolon 125 mg Ampul 17 500 517 20 20 497 Rp 10,912 K.Farma
433 Metilprednisolon 16 mg Tablet - - - - Rp 558 AAM
434 Metilprednisolon 4 mg Tablet 12,400 12,400 3,000 200 3,200 9,200 Rp 102 Enseval
436 Metronidazol 500 mg Tablet - - - - Rp 251 P.Padang
437 Metronidazol 500 mg Tablet 2,700 2,700 1,000 1,000 1,700 Rp 137 Rajawali
438 Metronidazol infus Botol 428 428 120 24 24 168 260 Rp 5,885 K.Farma
439 Metronidazol 125 mg/5 ml Botol - - - - Rp 3,950 Sapta Sari
440 Meylon Ampul - - - - Rp 6,448 Merapi
441 Meylon Ampul 27 27 - 27 Rp 6,750 Merapi
442 Mg SO4 40% Ampul 71 71 10 6 16 55 Rp 4,290 Merapi
443 Miconazol cream Tube 199 199 50 50 149 Rp 1,900 K.Farma
445 Midazolam 1 mg/ml Ampul 10 100 110 20 20 90 Rp 4,444 APL
450 Misoprostol Tablet 570 570 - 570 Rp 3,850 P.Valent
453 Mometason cr 10 gr Tube 190 190 - 190 Rp 5,743 AAM
454 Morfin 10 mg Tablet 360 360 - 360 Rp 1,199 K.Farma
455 Morfin 10 mg/ ml Ampul - 10 10 2 2 8 Rp 29,900 K.Farma
456 Na Cl 0.9%, 500 ml Botol 1,170 2,700 3,870 1,329 100 80 240 1,749 2,121 Rp 6,900 Merapi
457 Na Cl 3 %, Otsu Botol 280 280 20 20 20 60 220 Rp 30,335 Merapi
458 Na. Diclofenac 25 mg Tablet 2,050 30,000 32,050 5,600 100 5,700 26,350 Rp 115 K.Farma
459 Na. Diclofenac 50 mg Tablet - 5,000 5,000 - 5,000 Rp 108 K.Farma
460 Nacl 0,9 % 100 ml Botol 185 185 20 10 30 155 Rp 6,764 Merapi
461 Nairet inj Ampul 75 75 50 25 75 - Rp 17,160 MBS
462 Naloxone HCL 0,4 mg/ ml Ampul - 5 5 5 5 - Rp 48,478 APL
463 Natrium Bicarbonat Tablet - - - - Rp 57 T. Gugun
464 Natrium Bicarbonat Tablet 10,600 10,600 - 10,600 Rp 69 T. Gugun
Natrium Bicarbonat Tablet 20,000 20,000 - 20,000 Rp 77 T. Gugun
465 Neostigmine Ampul 10 10 - 10 Rp 7,050 APL
466 Nerilon Cream 15 g Tube 130 130 100 100 30 Rp 27,363 Enseval
Nerilon Cream 15 g Tube 200 200 - 200 Rp 28,738 Enseval
470 New antides Tablet 600 600 - 600 GFK
472 Nicardipine HCL 10 mg Ampul 60 60 10 10 50 Rp 7,872 AAM
473 Nifedipine 10 mg Tablet - - - - Rp 220 K.Farma
474 Niflec Powder sachet 10 10 3 3 7 Rp 123,500 Merapi
475 Nitral 500 mg Tablet 20,550 20,550 9,600 9,600 10,950 Rp 1,415 AAM
476 Nitrokaf retard Tablet 4,000 27,000 31,000 16,000 16,000 15,000 Rp 1,640 K.Farma
479 Nopres 20 Mg Tablet - - - - Rp 676 AAM
480 Norephineprin inj 4 mg Ampul - - - - Rp 23,490 APL
481 Norephineprin inj 4 mg Ampul 240 240 100 40 140 100 Rp 6,298 AAM
482 Norestil 5 mg Tablet 300 900 1,200 300 300 900 Rp 2,420 Penta Valent
486 Novorapid flexpen Pen 415 500 915 350 15 5 370 545 Rp 89,500 AAM
487 NTG Ampul 100 100 30 10 40 60 Rp 64,350 AAM
489 Nystatin drop Botol 35 35 10 10 25 Rp 11,750 MPI
493 Octalbin 25 % 100 ml Botol 6 5 11 - 11 Rp 1,590,001 Enseval
494 Octalbin 20 % 100 ml Botol 22 22 3 2 5 17 Rp 905,000 Enseval
496 Olanzapine 10 mg Tablet 900 900 300 300 600 Rp 4,000 AAM
497 Olanzapine 5 mg Tablet 1,440 1,440 - 1,440 Rp 713 AAM
499 Omeprazol 20 mg Tablet 6,090 6,090 2,880 2,880 3,210 Rp 129 K.Farma
500 Omeprazol 20 mg Tablet 1,080 1,080 1,020 60 1,080 - Rp 396 P.Padang
501 Omeprazole 40 mg Ampul 1,440 1,500 2,940 50 50 2,890 Rp 5,346 K.Farma
502 Omeprazole 40 mg Ampul - - - - Rp 6,999 Merapi
503 Ondansetron 4 mg Tablet - - - - Rp 385 P.Padang
504 Ondansetron 4 mg Tablet 840 840 480 240 120 840 - Rp 270 AAM
505 Ondansetron 4 mg Tablet 780 780 780 780 - Rp 970 AAM
506 Ondansetron 4 mg/2ml Ampul 560 560 100 125 150 150 525 35 Rp 873 AAM
507 Oralit sachet - - - - Rp 274 K.Farma
508 Oralit sachet 500 500 200 100 300 200 Rp 869 K.Farma
Oralit sachet 1,000 1,000 - 1,000 Rp 280 Rajawali
509 Orphen 4 mg Tablet - - - - Rp 60 Sapta Sari
511 Osteocal Tablet - - - - Rp 500 Kebayoran
512 Osteocal Tablet 18,288 18,288 4,320 144 4,464 13,824 Rp 540 Kebayoran
514 Oxytocin Ampul 300 400 700 100 100 600 Rp 1,126 APL
515 Pan Amin G Inf Botol 4 36 40 - 40 Rp 51,460 Merapi
516 Paracetamol 500 mg Tablet 7,100 7,100 5,600 1,000 500 7,100 - Rp 216 T. Gugun
Paracetamol 500 mg Tablet 50,000 50,000 5,200 1,000 400 6,600 43,400 Rp 140 P.Padang
517 Paracetamol Drop Botol - - - - Rp 6,981 Indofarma
518 Paracetamol Drop Botol 85 85 20 15 35 50 Rp 5,113 Rajawali
519 Paracetamol infus Botol - - - - Rp 11,990 k.Farma
520 Paracetamol infus Botol 240 200 440 20 20 5 20 65 375 Rp 8,880 Enseval
521 Paracetamol 120 mg/5 ml Botol 362 362 100 100 200 162 Rp 1,160 Merapi
522 Pehacain Ampul 40 40 40 40 - Rp 3,113 Rajawali
524 Permethrin salep Tube 200 200 20 5 25 175 Rp 6,578 APL
525 Pethidin 50 mg/ml Ampul - 10 10 - 10 Rp 13,300 K.Farma
526 Phenitoin 100 mg Tablet 11,300 11,300 4,800 4,800 6,500 Rp 484 Kebayoran
528 Phenitoin (Na) 50 mg/ml Ampul 90 90 - 90 Rp 2,596 K.Farma
529 Phenol glyserol tetes telinga 10 % Botol 24 24 24 24 - Rp 2,764 Rajawali
531 Phytomenadion 10 mg/5 ml Ampul - - - - Rp 5,025 K.Farma
532 Phytomenadion 10 mg/5 ml Ampul - 2,700 2,700 - 2,700 Rp 3,600 Rajawali
533 Phytomenadion (vit K1) 2mg Ampul - 300 300 120 120 180 Rp 1,452 Rajawali
Phytomenadion (vit K1) 2mg Ampul 30 30 30 30 - GFK
534 Phytomenadion 10 mg Tablet 1,600 6,500 8,100 1,000 100 1,100 7,000 Rp 781 Rajawali
535 Piracetam 1200 mg Tablet - 400 400 - 400 Rp 951 AAM
536 Piracetam 400 mg Tablet - 1,000 1,000 1,000 1,000 - Rp 331 AAM
537 Piracetam 800 mg Tablet 1,400 1,200 2,600 1,000 1,000 1,600 Rp 590 AAM
540 Piracetam inj 3 gram Ampul 40 40 - 40 Rp 6,363 P.Padang
541 Pirazinamide 500 mg Tablet 500 500 500 500 - Rp 401 K.Farma
544 Plavix 300 mg Tablet - 50 50 - 50 Rp 17,308 APL
Povidon iodine 1L Botol 50 50 50 50 - Rp 32,129 Rajawali
545 Pramifrol 0,375 mg Tablet 4,440 4,440 900 900 3,540 Rp 3,050 P.Padang
548 Prednison 5 mg Tablet 1,000 1,000 - 1,000 Rp 162 K.Farma
551 Propanolol 10 mg Tablet 9,900 5,000 14,900 6,000 6,000 8,900 Rp 88 AAM
552 Propanolol 10 mg Tablet - - - - Rp 59 K.Farma
554 Propyltiouracyl 100 mg Tablet 12,900 12,900 5,000 5,000 7,900 Rp 405 AAM
555 Proris Supp - - - - Rp 5,041
556 Protofen Supp - 680 680 - 680 Rp 1,998 K.Farma
557 Prove D3 1000 iu Tablet 3,000 3,000 150 150 300 600 2,400 Rp 2,200 Enseval
559 Purifying cleansing milk AX 500 ml Botol - - - - Rp 139,700 Mutiara
562 Quetiapine XR 200 Tablet 100 100 100 100 - Rp 13,400 P.Padang
Quetiapine 100 mg Tablet 180 180 180 180 - Rp 8,800 P.Padang
563 Ramipril 2,5 mg Tablet 13,300 13,300 1,000 1,000 12,300 Rp 240 AAM
566 Ramipril 10 mg Tablet 6,600 6,600 2,100 2,100 4,500 Rp 710 AMS
567 Ranitidin 150 mg Tablet 54,600 54,600 10,800 2,000 300 13,100 41,500 Rp 85 AAM
568 Ranitidin 50 mg/ 2 ml Ampul 4,050 1,475 5,525 20 380 400 800 4,725 Rp 858 K.Farma
569 Ranitidin 50 mg/ 2 ml Ampul 680 680 680 680 - Rp 2,056 Enseval
571 Renogen 2000 IU Ampul - 50 50 - 50 Rp 57,000 APL
572 Retaphyl SR 300 mg Tablet 5,700 5,700 2,000 2,000 3,700 Rp 1,170 K.Farma
575 Revatio 20 mg Tablet 540 540 1,080 270 270 810 Rp 36,000 AAM
577 Rifampisin 450 mg Tablet 4,900 4,900 1,000 1,000 3,900 Rp 934 K.Farma
580 Ringer Lactat inf Botol 2,760 1,560 4,320 520 300 200 20 1,040 3,280 Rp 7,703 Merapi
584 Ryzodeg flex touch Ampul 20 100 120 50 50 70 Rp 112,000 AAM
586 Sagestam 40 mg/ 2 ml Ampul 490 490 50 50 440 Rp 8,571 BSP
587 Salbutamol 2 mg Tablet 6,200 6,200 3,000 100 3,100 3,100 Rp 79 K.Farma
588 Salbutamol 1 mg/ml Ampul 50 200 250 50 50 30 130 120 Rp 4,900 AAM
590 Sammoxin 125 mg/ 5 ml Botol 245 245 10 10 235 Rp 3,700 T.Gugun
592 Scobutrin 10 mg Tablet - - - - Rp 2,118 MBS
595 Seretide Diskus 250 mg Box 174 174 25 25 149 Rp 125,716 APL
597 Sertralin 50 mg Tablet 3,600 3,600 500 500 3,100 Rp 1,345 K.Farma
598 Serum albifastin Ampul - - - - Rp 29,260 Mutiara
599 Serum claryfine Ampul - - - - Rp 27,720 Mutiara
Serum moistarflex Ampul 5 5 5 5 - Rp 29,260 Mutiara
600 Serum phytocell Ampul - - - - Rp 33,660 Mutiara
601 Sevoflurane 250 ml Botol - - - - Rp 899,000 AMS
603 Sibital 200 mg/2 ml Ampul 50 50 20 20 30 Rp 9,801 Sapta Sari
606 Simvastatin 10 mg Tablet 29,540 29,540 - 29,540 Rp 68 Enseval
608 Sistenol Tablet 130 130 - 130 Rp 1,870 AAM
609 Sistenol Tablet - 240 240 - 240 Rp 2,057 AAM
614 Spiriva 2,5 mcg respimat Box 10 50 60 - 60 Rp 445,000 Tempo
615 Spironolacton 25 mg Tablet 38,300 24,000 62,300 15,000 100 15,100 47,200 Rp 200 AAM
616 Spironolacton 100 mg Tablet 1,500 1,500 - 1,500 Rp 530 AAM
617 Stalevo 100 mg Tablet 2,520 2,520 - 2,520 Rp 8,800 AAM
619 Stesolid rectal 10 mg supp - - - - Rp 19,192 AAM
620 Stesolid rectal 10 mg supp 30 30 5 5 25 Rp 19,197 AAM
621 Stesolid rectal 5 mg supp 25 25 5 5 20 Rp 13,203 AAM
622 Sucralfat Botol - - - - Rp 8,206 APL
623 Sucralfat Botol 130 1,000 1,130 430 150 20 600 530 Rp 9,306 APL
624 Sucralfat 500 mg Tablet 4,100 4,000 8,100 1,000 1,000 7,100 Rp 222 AAM
625 Sulfadiazine silver oint 10 mg Tube 5 5 5 5 - Rp 18,557 K.Farma
626 Sulfadiazine silver oint 10 mg Tube 20 20 5 2 2 9 11 Rp 20,700 K.Farma
628 Sunscreen gel 20 g Tube - - - - Rp 29,150 Mutiara
630 Suprasma inhaler box 97 97 30 30 67 Rp 22,000 AAM
631 Symbicort inh 160 Botol 25 50 75 - 75 Rp 150,704 APL
633 Tablet tambah darah(ferro fumarat) Tablet 3,520 3,520 3,120 3,120 400 Rp 238 K.Farma
634 Tamsulosin 0,4 mg Tablet 2,010 2,010 600 600 1,410 Rp 4,356 AMS
638 Tetagam P Syringe Box 86 40 126 12 30 42 84 Rp 146,800 AAM
639 Thiamfenicol 500 mg Tablet - - - - Rp 1,056 TSJ
640 Thiamfenicol 125 mg/5 ml Botol 66 66 46 20 66 - Rp 16,500 TSJ
641 Thyrozol 10 mg Tablet - 1,000 1,000 500 500 500 Rp 1,325 AAM
642 Tramadol 100 mg Ampul - - - - Rp 4,161 Penta Valent
643 Tramadol 100 mg Ampul 100 100 100 100 - Rp 4,132 TSJ
Triamcinolon 10 mg/ ml Ampul 100 100 - 100 Rp 33,500 AMS
645 Trihexipenidil 2 mg Tablet 6,900 6,900 6,000 6,000 900 Rp 63 Merapi
646 Triofusin Inf Botol - - - - Rp 53,890 Enseval
648 Urinter 500 mg Tablet - - - - Rp 3,630 Enseval
649 Urinter 500 mg Tablet 900 900 500 100 600 300 Rp 4,235 Enseval
Urinter 500 mg Tablet 2,000 2,000 - 2,000 Rp 3,812 Enseval
650 Ursode oxycholic acid 250 mg Tablet - - - - Rp 2,268 AAM
651 Ursode oxycholic acid 250 mg Tablet 3,240 3,240 600 600 2,640 Rp 1,679 AAM
654 V - Blok 25 mg Tablet 390 1,590 1,980 990 990 990 Rp 1,210 Enseval
658 Verapamil 80 mg Tablet 2,200 2,200 1,000 1,000 1,200 Rp 455 K.Farma
661 Vitamin B. 1/ Thiamin HCL 50 mg Tablet 14,500 14,500 - 14,500 Rp 192 K.Farma
662 Vitamin B. 6/ Pyridoxin 10 mg Tablet 3,800 3,800 2,000 100 2,100 1,700 Rp 71 K.Farma
663 Vitamin C /Asam Askorbat 50 mg Tablet 8,000 8,000 100 100 7,900 Rp 43 K.Farma
665 Vitamin B.Complex Tablet 3,000 3,000 3,000 3,000 - Rp 68 T.Gugun
666 Vitamin B.Complex Tablet 30,000 30,000 12,000 500 12,500 17,500 Rp 121 K.Farma
Vitka infant Ampul 100 100 80 20 100 - Rp 6,600 Rajawali
667 Voluven 6% 500 ml Botol - - - - Rp 21,780 APL
668 Warfarin 2 mg Tablet 6,900 6,900 - 6,900 Rp 669 AMS
669 Wibrom 8 mg Tablet 400 400 200 200 200 Rp 107 Sapta Sari
677 Zinat tab 500 mg Tablet 100 100 100 100 - Rp 4,725 APL return
678 Zink 20 mg Tablet 300 1,000 1,300 100 100 1,200 Rp 253 Rajawali
679 Zink 20 mg/5 ml Botol 55 55 5 5 50 Rp 2,489 Tempo
491,058
Mengetahui Padang Panjang, 31 Maret 2022

Kepala Instalasi Farmasi Total 491,058 627874 92216 Penanggung jawab
1,211,148

Nip 19811118 201001 2 010 Nip 19750213 200312 2 004
Rp 1,611,001 Rp -
Rp 14,520,000 Rp -
Rp 866,800 Rp -
Rp 660,000 Rp -
Rp 1,440,000 Rp 600,000
Rp 9,412,480 Rp -
Rp 6,078,600
Rp -
Rp -
Rp 21,375,000 Rp -
Rp 17,820,000 Rp -
Rp 1,584,000 Rp -
Rp 19,646,826 Rp 11,958,000
Rp 11,200,000 Rp 4,200,000
Rp 1,388,400 Rp -
Rp 6,534,000 Rp -
Rp 1,650,000 Rp -
Rp 5,872,000 Rp -
Rp 1,709,999 Rp -
Rp 4,200,000 Rp -
Rp 534,600
Rp 2,355,399 Rp -
Rp 2,896,344 Rp -
Rp 1,606,450 Rp 795,000
Rp 1,298,000 Rp 286,500
Rp 8,787,570
Rp 11,829,500 Rp -
Rp 17,799,980 Rp -
Rp 15,680,002 Rp -
Rp 17,920,003 Rp -
Rp 6,890,144 Rp -
Rp 20,052,032 Rp -
Rp 11,762,498 Rp -
Rp 1,940,950 Rp 795,337
Rp 22,249,975 Rp -
Rp 9,955,136 Rp -
Rp 17,385,940 Rp -
Rp 8,452,400 Rp -
Rp 19,499,999 Rp -
Rp 16,717,800 Rp -
Rp 17,700,001 Rp -
Rp 15,181,320 Rp -
Rp 13,370,500 Rp -
Rp 7,535,220 Rp -
Rp 2,712,006 Rp -
Rp 308,990 Rp -
Rp 1,265,550 Rp -
Rp 1,537,000 Rp 517,500
Rp 100,749
Rp 2,547,961 Rp -
Rp 5,400,010 Rp -
Rp 133,000 Rp -
Rp 10,175,616
Rp 2,849,990 Rp 19,500,000
Rp 19,680,012 Rp -
Rp 299,000 Rp -
Rp 1,325,005 Rp -
Rp 795,337 Rp -
Rp 9,306,000
Rp 753,398 Rp -
Rp 15,702,000 Rp -
Rp 2,100,300 Rp -
Rp 2,178,000 Rp -
Rp 7,950,002 Rp 1,212,300
Rp 10,974,000 Rp -
Rp 13,029,000 Rp -
Rp 1,923,900 Rp -
Rp 11,958,000 Rp 2,904,000
Rp 1,737,806 Rp -
Rp 24,600,015 Rp -
Rp 4,320,008 Rp -
Rp 5,362,500 Rp -
Rp 20,585,000 Rp -
Rp 1,176,630 Rp 763,128
Rp 5,717,250 Rp -
Rp 795,003 Rp 8,077,994
Rp 6,950,003 Rp 2,548,000
Rp 20,500,000 Rp -
Rp 112,600 Rp -
Rp 10,175,616 Rp -
Rp 4,706,240 Rp -
Rp 6,462,260 Rp -
Rp 1,358,630 Rp 17,385,940
Rp 4,439,600 Rp -
Rp 444,400 Rp -
Rp 648,604 Rp -
Rp 3,585,560 Rp -
Rp 18,630,000 Rp 15,260,000
Rp 19,440,000 Rp -
Rp 2,400,000 Rp -
Rp 13,990,500 Rp -
Rp 6,078,598 Rp -
Rp 875,000 Rp 5,160,000
Rp 424,850 Rp -
Rp 6,412,561 Rp -
Rp 3,075,000 Rp 14,118,720
Rp 242,390 Rp 14,520,000
Rp 763,128 Rp -
Rp 7,280,001 Rp -
Rp 337,801 Rp -
Rp 3,350,000 Rp -
Rp 24,165,000 Rp -
Rp 865,397 Rp -
Rp 15,260,080 Rp 5,176,380
Rp 6,014,250 Rp 1,319,670
Rp 4,286,485 Rp -
Rp 12,016,680 Rp -
Rp 1,776,000 Rp -
Rp -
Rp 5,472,800
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 2,593,260
Rp -
Rp -
Rp -
Rp 2,710,950
Rp 710,985
Rp -
Rp -
Rp 4,404,015
Rp -
Rp 1,580,535
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 5,742,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 11,610,000
Rp -
Rp -
Rp 570,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 17,700,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 709,500
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 968,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 309,000
Rp -
Rp -
Rp -
Rp 49,500
Rp -
Rp 6,534,000
Rp -
Rp 424,850
Rp 235,900
Rp -
Rp 1,440,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 648,600
Rp -
Rp 16,717,800
Rp -
Rp -
Rp 1,710,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 100,750
Rp -
Rp -
Rp -
Rp -
Rp 341,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 5,717,250
Rp -
Rp -
Rp 3,684,500
Rp -
Rp -
Rp 5,362,500
Rp -
Rp 17,820,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 20,500,000
Rp -
Rp -
Rp 4,634,144
Rp -
Rp 3,150,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 738,000
Rp 9,000,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 3,999,985
Rp 13,990,500
Rp -
Rp 21,375,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 40,880,007
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,940,950
Rp -
Rp -
Rp -
Rp -
Rp 1,650,000
Rp 875,000
Rp 2,400,000
Rp -
Rp -
Rp 1,656,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,452,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 6,014,250
Rp -
Rp -
Rp 1,611,000
Rp -
Rp -
Rp -
Rp 1,298,000
Rp -
ed03/22 Rp -
Rp 6,950,000
Rp -
Rp -
Rp -
Rp 17,800,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 2,712,000
Rp -
Rp -
Rp 1,388,400
Rp -
Rp -
Rp -
Rp 1,069,200
Rp -
Rp -
Rp -
Rp -
Rp 111,000
Rp 3,075,000
Rp 6,890,145
Rp 20,052,032
Rp -
Rp -
Rp -
Rp -
Rp 379,500
Rp -
Rp -
Rp -
Rp -
Rp 1,280,372
Rp -
Rp 5,181,870
Rp 1,176,630
Rp 10,974,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 5,456,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 444,400
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 299,000
Rp 18,630,000
Rp -
Rp 3,449,820
Rp 539,990
Rp -
Rp -
Rp 242,390
Rp -
Rp -
Rp 1,537,000
Rp -
Rp -
Rp 5,747,500
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 44,280,027
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 2,178,000
Rp -
Rp -
Rp -
Rp 44,750,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 7,950,003
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 8,019,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 280,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 450,400
Rp 1,852,560
Rp -
Rp 7,000,400
Rp -
Rp -
Rp -
Rp 1,776,000
Rp -
Rp -
Rp -
Rp -
Rp 133,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 9,720,000
Rp 435,600
Rp 5,076,500
Rp 380,318
Rp 331,485
Rp 708,246
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 865,395
Rp 1,606,450
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 441,670
Rp -
Rp -
Rp -
Rp -
Rp 1,358,640
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,584,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,265,550
Rp -
Rp -
Rp 2,849,990
Rp -
Rp -
Rp -
Rp 19,440,000
Rp -
Rp -
Rp -
Rp -
Rp 12,016,680
Rp -
Rp -
Rp -
Rp 11,200,000
Rp -
Rp -
Rp -
Rp 980,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 3,355,500
Rp -
Rp 6,599,616
Rp -
Rp -
Rp -
Rp 146,300
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 493,680
Rp -
Rp -
Rp -
Rp -
Rp 22,250,000
Rp 4,800,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 9,306,000
Rp 888,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 7,535,200
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 5,872,000
Rp -
Rp -
Rp 1,325,000
Rp -
Rp -
Rp 3,350,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 7,623,000
Rp -
Rp -
Rp -
Rp -
Rp 1,923,900
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 660,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
return APL Rp -
Rp 253,000
Rp -
Rp -
Rp 777,082,925 Rp 777,082,577 Rp (349)
Generik : 83
Non generik : 54

Bulan: Januari 2022: No. Nama Obat Satuan Harga PBF

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LPLPO OBAT GUDANG FARMASI

RSUD PADANG PANJANG

BULAN : JANUARI 2022

1 A.B.U Vial 5 5 5 5 - Rp 517,132 Indofarma 1

7 Acyclovir 200 mg Tablet 500 500 - 500 Rp 565 K.Farma 7

11 Adalat Oros 30 mg Tablet 3,990 3,990 30 30 3,960 Rp 3,986 P.Padang 11

34 Amlodipin 10 mg Tablet 68,400 68,400 15,000 200 15,200 53,200 Rp 72 Merapi

43 Anemolat 1 mg Tablet - - - - Rp 165 Rajawali

49 Aripiprazole 10 mg Tablet 100 100 100 100 - Rp 19,500 AAM

79 Betahistin 6 mg Tablet 19,400 19,400 5,000 500 5,500 13,900 Rp 88 AAM

172 Ciprofloxacin 500 mg Tablet 1,500 1,500 - 1,500 Rp 250 Enseval

180 Clobazam 10 mg Tablet 1,100 1,100 1,100 1,100 - Rp 384 AAM

211 DHD frimal Tablet - - - - GFK

236 Eas Pfrimer inf Botol - - - - Rp 53,000 Enseval

261 Fargoxin 0,25 mg Tablet - - - - Rp 12 Kebayoran

271 Fenobarbital 50 mg/ml Ampul 30 30 - 30 Rp 1,700 K.Farma

289 Fusycom cr Tube 100 100 - 100 Rp 19,096 APL

362 Ketorolac tablet Tablet - - - - Rp 1,894 AMS

368 Laktulosa 60 ml Botol 14 14 - 14 Rp 27,225 Indofarma

377 L Bio sachet - - - - Rp 5,775 P.Valent

386 Lidocain compositum Ampul 360 360 - 360 Rp 1,286 K.Farma

450 Neostigmine Ampul 10 5 15 15 15 - Rp 7,050 APL

452 Neurodex Tablet - - - - Rp 560 AAM

501 Paracetamol Drop Botol 47 47 20 20 27 Rp 6,981 Indofarma

502 Paracetamol infus Botol 35 35 8 24 3 35 - Rp 11,990 k.Farma

528 Pramifrol 0,375 mg Tablet 4,440 4,440 - 4,440 Rp 3,050 P.Padang

542 Pyrantel 125 mg Tablet 200 200 - 200 Rp 692 K.Farma

544 Ramipril 2,5 mg Tablet 13,300 13,300 - 13,300 Rp 240 AAM

550 Recofol N Ampul - - - - Rp 78,375 K.Farma

578 Sevoflurane 250 ml Botol - - - - Rp 899,000 AMS

597 Stesolid rectal 5 mg supp 5 5 5 5 - Rp 13,203 AAM

601 Sulfadoxine Pyremetamin Tablet - - - - Rp 544 K.Farma

602 Suprafenid 100 mg supp - - - - Rp 2,380 K.Farma

616 Treatson 0,125 mg Tablet - - - - Rp 2,200 AAM

640 Voluven 6% 500 ml Botol 3 3 3 3 - Rp 21,780 APL ed 01/22

Mengetahui Padang Panjang, 31 Januari 2022

Rahmi Safyanti, S. Farm, Apt Delli Syam.S.Si.Apt

Rp 71,857,407 Rp 71,857,380 Rp (27)

BULAN : FEBRUARI 2022

1 A.B.U Vial - 10 10 - 10 Rp 517,132 Indofarma 1

7 Acyclovir 200 mg Tablet 500 500 - 500 Rp 565 K.Farma 7

34 Amiparen infus Botol 48 48 - 48 Rp 96,650 Merapi 32

45 Anemolat 1 mg Tablet - - - - Rp 165 Rajawali 43

52 Aripiprazole 10 mg Tablet - 600 600 400 400 200 Rp 19,500 AAM 49

269 Fargoxin 0,25 mg Tablet - - - - Rp 12 Kebayoran

279 Fenobarbital 50 mg/ml Ampul 30 30 - 30 Rp 1,700 K.Farma

371 Ketorolac tablet Tablet - - - - Rp 1,894 AMS

377 Laktulosa Botol 14 14 2 2 12 Rp 27,225 Indofarma

465 Neostigmine Ampul - 10 10 - 10 Rp 7,050 APL

467 Neurodex Tablet - - - - Rp 560 AAM

509 Orphen 4 mg Tablet - - - - Rp 60 Sapta Sari

517 Paracetamol Drop Botol 27 27 25 2 27 - Rp 6,981 Indofarma

534 Phytomenadion 10 mg Tablet 1,600 1,600 - 1,600 Rp 781 Rajawali

545 Pramifrol 0,375 mg Tablet 4,440 4,440 - 4,440 Rp 3,050 P.Padang

563 Ramipril 2,5 mg Tablet 13,300 13,300 - 13,300 Rp 240 AAM

600 Serum phytocell Ampul 5 5 5 5 - Rp 33,660 Mutiara

644 Trifluoferazin 5 mg Tablet 3,700 3,700 - 3,700 Rp 302 Merapi

650 Ursode oxycholic acid 250 mg Tablet - - - - Rp 2,268 AAM

667 Voluven 6% 500 ml Botol - - - - Rp 21,780 APL

Mengetahui Padang Panjang, 28 Februari 2022

Rahmi Safyanti, S. Farm, Apt Delli Syam.S.Si.Apt

Rp 749,819,236 Rp 749,818,913 Rp (323)

BULAN : MARET 2022