PEMBERIAN HARGA JUAL APOTIK

NO

NAMA OBAT
1 CURCUMA SYP
2 INPEPSA SYP
3 DULCOLACTOL SYP
4 ACYCLOVIR 400MG TAB
5 AMBR0X0L TAB
6 AMIPAREN SOLUTION.

HNA
14,410
53,900
58,685
757
159
56,300

PPN
10%
1,441
5,390
5,869
76
16
5,630

MARGIN
25%
3,602.50
13,475.00
14,671.25
189.25
39.75
14,075.00

U R/
500
500
500
500
500
500
500

UAL APOTIK
HARGA
19,954
73,265
79,725
1,522
715
76,505

HARGA JUAL SEBENARNYA

20,000
73,000
80,000
1,500
1,000
77,000

DAFTAR HARGA OBAT RS

NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41

NAMA OBAT
ACARBOSE 100 MG TABLET
ACARBOSE 50 MG TABLET
ACETOSAL 100MG TAB
ACTRAPID HM 100 IU/ML 10ML
ACTRAPID VIAL 1000UI IN ml
ACYCLOVIR 200MG TAB
ACYCLOVIR 400MG TAB
ACYCLOVIR CREAM
ADALAT OROS (NIFEDIPIN SR 20MG)
ALBENDAZOL SUSPENSI 200MG/5ML
ALBENDAZOLE TABLET 400mg
ALLOPURINOL 100MG
ALLOPURINOL TABLET 300MG
ALPRAZOLAM 0.25mg
ALPRAZOLAM 1MG TAB
AMBROXOL SYRUP
AMBROXOL TABLET 30MG
AMINOFILIN 200MG TABLET
AMINOFILIN INJEKSI 24MG/ML
Amiparin inf
AMITRYPTILIN 25MG TAB
Amlodipin tablet 10 mg
Amlodipin tablet 5 mg
Amoksisilin kapsul/kaplet/tablet scored 500 mg
Amoksisilin sirup kering 125 mg/ 5 ml
AMOXYCILIN 250MG CAPSUL
AMPICILIN 500MG TAB
AMPICILINE SYR 125MG
Ampisilin serbuk injeksi i.v. 1000 mg/vial
ANTALGIN 500MG TAB
ANTALGIN INJEKSI
ANTASIDA SYRUP
ANTASIDA TABLET
ANTI BAKTERI DOEN SALEP KOMBINASI
ANTI HAEMORHOID SUPP
ANTI MALARIA DOEN KOMBINASI SULFADOXIN
ANTIFUNGI SALEP ( 2-4 )
ANTIMIGREN :ERGOTAMIN TARTRAT 1MG+KOFEIN 50MG
APTIL SOLUTION
AQUA PRO INJEKSI 20 ml
AQUA PRO INJEKSI 25ml

42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88

ARTEM/ARTEMETER INJEKSI
ARTESUNATE INJ 60MG
ASAM ASKORBAT (VIT C ) 250 MG
ASAM ASKORBAT 50MG (VITC)
ASAM FOLAT TABLET 1MG
ASAM MEFENAMAT 500MG TAB
ASAM TRANEXAMAT INJEKSI 500mg
ASERING SOLUTION
ATENOLOL TAB 50 MG
ATROPINE SO4 0,25MG/ML INJEKSI
ATROPINE SO4 TAB 0,5 MG
AZITROMYCIN SYRUP 200mg IN 5ml
AZITROMYCIN TABLET 500mg
BENZATIN BENZYL PENICILLIN 2.4 JUTA IU
BEROTEC SOLUTION
BESI II SO4 TAB. SALUT KOMB.
BETAHISTIN MESILATE 6MG
BETHAMETHASON CR 0,1%
BRICASMA RESPULES 2.5mg IN ml
BROMHEXIN TABLET
BUPIVACAIN SPINAL 5mg
CALCIUM LACTATE TABLET
CALSIUM CARBONATE TAB500MG
CANDESARTAN CILEXETIL TAB 16mg
CAPTOPRIL 12,5MG TAB
CAPTOPRIL 25MG TAB
CARBAMAZEPIN TABLET 200MG
CATAPRES 100MG/ML (CLONIDIN INJK)
CEFADROXIL 500MG CAPSUL
CEFADROXIL SYRUP 60ML (125MG/5ML)
CEFIXIME 100MG CAPS
CEFIXIME SYRUP 30ML ( 100MG/5ML)
CEFOPERAZONE SERBUK INJKESI 1G
CEFOPERAZONE SULBACTAM INJEKSI
CEFOTAXIM 1G INJEKSI
CEFTRIAXON 1G INJEKSI
CEFUROXIME INJ 750MG
CETIRIZINE 10MG
CETIRIZINE SYRUP 60ML (5MG/5ML)
CHLORAMPHENICOL 250MG CAPSUL
CHLORAMPHENICOL EAR DROPS
CHLORAMPHENICOL EYE DROPS
CHLORAMPHENICOL SALEP MATA 1%
CHLOROQUIN PO4 250MG TABLET
CHLORPENIRAMINA MALEAT ( C T M )
CHLORPROMAZINA 25MG TABLET
CHLORPROMAZINA INJEKSI25MG

89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135

CIMETIDIN 200MG TAB

CIPROFLOXACIN 500MG TAB
CIPROFLOXACIN INFUS 2% 100ML (200MG/100ML)
CIPROFLOXACIN TETES MATA 0,3%
CITICOLIN 125mg INJEKSI
CITICOLIN 500mg TABLET
CLINDAMICYN 150MG
CLINDAMICYN 300MG
CLOPIDOGREL 75mg TABLET
CO- AMOXYCLAV 625MG TAB
COARTEM TABLET
CODEIN 10MG TAB
CODEIN 15MG TAB
CODEIN 20MG TAB
COFACT 500 IU/20 ml
COMBIVENT UDV 2,5ml/VIAL
Cotrimoksazol SYP(Sulfametoksazol 200 mg + Trimetoprim 40 mg / 5 ml
COTRIMOXAZOLE 120MG PED. TABLET
COTRIMOXAZOLE 480MG TABLET
DANOCLAV TABLET
DARPLEX TABLET (D-ARTEP)
DARYANTULLE
DEXAMETHASON INJ
DEXAMETHASON TABLET
DEXTRAN SOL 70% 500ML
DEXTROMETORPHAN SYRUP
DEXTROMETORPHAN TAB 15 MG
DIAZEPAM 2MG TABLET
DIAZEPAM 5MG TABLET
DIAZEPAM INJEKSI
DIGOKSIN TAB 0,25MG TABLET
DILTIAZEM TABLET 30MG
DIMENHIDRINAT 10MG TABLET
DIMENHIDRINATE 50MG TABLET
DIPHENHIDRAMIN INJ
DOBUTAMIN 50mg INJEKSI
Domperidon suspensi/sirup 5 mg/5 ml
DOMPERIDONE TAB
DOPAMIN GIULINI INJEKSI 10ML (20MG/ML)
DOXICYCLIN CAPSUL 100MG
DULCOLAX SUPP (BISAKODIL SUPPOSITORIA 5MG)
DUROGESIC PATCH 25mu MATRIX
EPHEDRINE 25MG TABLET
Epinefrin (Adrenalin) injeksi i.v/s.k./i.m 1 mg/ml
Eritromisin sirup kering 200 mg/ 5 ml
ERYTOMISIN 250MG CAPSUL
ERYTOMISIN 500MG TABLET

136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182

ETAKRIDINE LAKTATE SOL 300ML

ETANOL 70% 100ml
ETHAMBUTOL 500MG TAB
EUGENOL SOLUTION
FAMOTIDINE 20MG TABLET
FAMOTIDINE 40MG TABLET
FARMABES INJEKSI 25mg
FARSORBID INJEKSI (ISOSORBID DINITRAT INJEKSI)
FENITHOIN NATR. 30MG CAP
FENITHOIN NATR. INJ
FENOFIBRAT 100mg CAPSUL
FENOL GLISEROL TETES TELINGA
FENTANIL INJEKSI im.iv 0.05mg IN ml
FENTANYL patch 25mcg
FLAGYL SUPPOSITORIA 500mg
FLUCONAZOLE 150mg
FLUORIDE 1MG TAB
FUROSEMIDE INJ
FUROSEMIDE TAB 40 MG
GARAM ORALIT 200 ML AIR
GEMFIBROZIL 600MG TAB
GENOINT SALEP MATA 0.3%
GENTAMICYN INJ 40 MG
GENTAMICYN SALEP
GENTAMICYN TTS MATA 0,3%
GENTIAN VIOLET LARUTAN 1 %
GLIBENCLAMIDE TAB
GLICERIL GUAICOLAT TAB 100 MG
GLIMEPIRIDE 1MG TAB
GLIMEPIRIDE 2MG TAB
GLIMEPIRIDE 3MG TAB
GLIMEPIRIDE 4MG TAB
GLUCOSA 40% SOL 25ML
GLUKOSA 5% 0.25NS
GLUKOSA 5% 0.5NS
GLUKOSA LARUTAN INFUS 10 %(500ML)
GLUKOSA LARUTAN INFUS 5 %(500ML)
GRISEOFULVIN 125 MG TAB
GRISEOFULVIN 500 MG TAB
HALOPERIDOL 2MG
HALOPERIDOL 5MG
HALOPERIDOL TABLET 1.5mg
HALOTHANE INHALASI
HIDRO CHLORTIAZIDE TAB 25 MG
HIDRO CHLORTIAZIDE TAB 25 MG
HIDROCORTISON CREAM 1%
HIDROCORTISONE KRIM 2,5 %

183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229

HIDROXY ETHYL STARCH (WIDAHES)

HUMAN ALBUMIN 20% 100ML
HYDROCHLORTIAZIDE TABLET 25MG (H.C.T)
HYOSCINE-N-BUTILBROMIDE 10MG
IBUPROFEN 200MG TABLET
IBUPROFEN 400MG TABLET
IBUPROFEN SIRUP 100MG/5ML
IBUPROFEN SYR 100MG/ML
IBUPROFEN SYR 200MG/ML
IMPLANON. ETONOGESTREL
ISONIAZIDE 100MG TABLET
ISONIAZIDE 300MG TABLET
ISOSORBID DINITRATE ( I S D N ) TABLET
ISOSORBID DINITRATE SUBLINGUAL 5mg
ISOTIC ADRETOR 0.25% SOL
ITRACONAZOLE 100MG TAB
KAEN 1 B SOLUTION
KAEN 3 A SOLUTION
KAEN 3 B SOLUTION
KAEN MG3 SOLUTION
KALIPAR
KALIUM DIKLOFENAC 50MG
KANAMYCIN HJ INJK 1 G
KETOCONAZOLE CREAM 2% 10 G
KETOKONAZOLE CR 15G
KETOKONAZOLE TAB 200MG
KETOPROFEN INJEKSI 100MG
KETOPROFEN TABLET 100MG
KETOROLAC INJEKSI 30MG/ML
KININA SO4 222MG TABLET
KLOBAZAM 10mg
KLOMIFEN SITRAT TAB 50MG
KLONIDIN HCL 0,15MG TAB
KSR. KALIUM KLORIDA
KTM. KETAMIN INJEKSI
LANSOPRAZOLE CAPS 30MG
LAXADINE EMULSI 60ml
LEVEMIR FLEX PEN 100U/ML
LEVOFLOXACIN 500MG TAB
LEVOSOL (NOREPINEPHRINE)INJK 8MG/8ML
LIDOCAIN 2% INJEKSI
LIDOCAIN COMP. INJEKSI(PEHACAIN)
LISINOPRIL 10mg
LISINOPRIL 5mg
LODOMER 5 MG(HALOPERIDOL INJEKSI 5 MG/ML )
LOPERAMIDE TABLET 2MG
LORATADINE TAB 10MG

230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276

MAGNESIUM SO4 (MGSO4) INJ 40%

MANNITOL INFUS 20%
MARTOS SOLUTION
MEBENDAZOL 100MG SYRUP
MELOXICAM 7.5mg TAB
MELOXICAM SUPPOSITORIA
MEROPENEM 500mg INJEKSI
MEROPENEM INJEKSI 1g
METFORMIN 500MG
METHYL DOPA TABLET
METHYLERGOMETRIN MALEAT INJEKSI
METHYLERGOMETRIN MALEAT TABLET 0,125MG
METHYLPREDNISOLON 125mg INJEKSI
METHYLPREDNISOLON 16mg TABLET
METHYLPREDNISOLON TAB 4MG
METHYLPREDNISOLON TAB 8MG
METOCLOPRAMIDE HCL 5 MG
METOCLOPRAMIDE INJEKSI
METOCLOPRAMIDE SYRUP 5MG/5ML
METOCLOPRAMIDE TABLET 10 MG
METRONIDAZOLE 250MG TABLET
METRONIDAZOLE 500MG
METRONIDAZOLE INFUS 500MG/100ML
MEYLON INJEKSI
MICONAZOLE CREAM 2%
MILOZ 15 INJEKSI
MINIASTI (ASAM ASETILSALISILAT TABLET 80MG)
MOLACORT TABLET
MOMETHASONE CR
MORFIN INJ
MORPHIN INJEKSI im.sk.iv 10mg
MORPHIN TABLET 10MG
NATRIUM CHLORIDA SOL. 500ML (0,9 %)
NATRIUM DICLOFENAC 25MG
NATRIUM DICLOFENAC 50MG
NEOMICYN CAPSUL 500MG
NIFEDIPIN 10MG TABLET
NITRAL TABLET 0.5mg
NITROKAF FORTE
NOKOBA(NALOXONE HCL 0,4MG/ML (0,8MG/2ML)
NOTRIXUM INJEKSI 2.5mg
NYSTATIN 100.000IU VAGINAL TABLET
NYSTATIN 500.000IU ORAL TABLET
OBAT BATUK HITAM
OFLOXACIN 400MG TAB
OMEPRAZOLE CAPSUL 20MG
OMEPRAZOLE INJEKSI 40mg IN 10ml

277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323

ONDANSETRON 8mg INJEKSI

ONDANSETRON INJEKSI 4mg IN 2 ml
ONDANSETRON TABLET 4MG
OTSU KCl 7.46%
OXYTETRACYCLIN SALEP 3%
OXYTETRACYCLIN SALEP MATA 1%
OXYTOCIN INJEKSI/INDUXIN
PAKET STOP TB KATEGORI 1
PAKET STOP TB KATEGORI 2
PAN AMIN G SOLUTION
PANTOPRAZOL INJEKSI 40 MG
PAPAVERIN HCL NJEKSI
PAPAVERIN HCL TABLET
PARACETAMOL 500MG TABLET
PARACETAMOL DROPS 15ML (100MG/ML)
PARACETAMOL INFUS 100ML (10MG/ML)
PARACETAMOL SYRUP 60ML (120MG/5ML)
PEHATRIM FORTE
PENTOXIFILIN 400MG TAB
PENTOXIFILIN INJ 300MG/15ML
PERFENAZINE TAB 4MG
PETHIDINE INJ 2ML (50MG/ML)
PHENOBARBITAL 30MG TAB
PHENOBARBITAL INJEKSI
PHENYIL BUTAZONE TABLET
PHYTOMENADION ( VIT K ) INJ 10 MG / 1 ML
PHYTOMENADION ( VIT K ) TAB 10 MG
PIRACETAM 400MG CAPSUL
PIRACETAM INJEKSI 1G/5ML (200MG/ML)
PIRACETAM INJEKSI 3G/15ML (200MG/ML)
PIRACETAM TAB 800MG
PIROXICAM 10MG TABLET
PIROXICAM 20MG TABLET
POVIDONE IODINE 300ML
PRAVASTATIN TABLET 20mg
PREDNISON TABLET
PRIMAQUIN TABLET
PRIMOLUT N (NORETHISTERONE 5MG)
PROPANOLOL 40MG TABLET
PROPANOLOL TABLET 10mg
PROPILTIOURASIL 100MG TABLET
PROSOGAN INJEKSI
PROTOFEN (KETOPROFEN SUPPO 10MG)
PROTOFEN (KETOPROFEN SUPPO 10MG)
PULAREX TABLET
PULMICORT RESPULES 0.25mg in ml
PYRANTEL PAMOATE SYR 60 ML( 125MG/ML)

324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370

PYRANTEL PAMOATE TABLET

PYRAZINAMDE 500MG TABLET
PYRIDOXIN TABLET (VIT. B 6 )
RANITIDINE 150MG TABLET
RANITIDINE INJEKSI 2ML (25MG/ML)
RECOFOL-N 20 ML (PROPOFOL) INJEKSI (10MG/ML)
RESERPINE 0,10MG TABLET
RESERPINE 0,25MG TABLET
RIFAMPICIN 300MG CAPSUL
RIFAMPICIN 450MG TABLET
RIFAMPICIN 600MG TABLET
RINGER LACTATE SOL 500ML
RISPERIDONE 1MG
SALBUTAMOL 2MG TABLET
SALBUTAMOL 4MG
SALYCIL BEDAK
SEFIXIM SYRUP 100mg IN ml
SEFTAZIDIM INJEKSI 1g
SERETIDE DISCUSS 100mcg
SIMVASTATIN TABLET 10MG
SOFT U DERM CREAM
SOJOURN TM (SEVAFLURANE,USP)
SPIRAMICYN 500MG TABLET
SPIRONOLAKTON TAB 100 MG
SPIRONOLAKTON TAB 25 MG
STESOLID INJK 2ML/5AMPL (10MG/2ML) IM/IV
STESOLID RECTAL 10MG/2,5ML
STREPTOMICYN SO4 INJEKSI
SULFACETAMIDA TETES MATA
SULFADOXINE PYRIMETHAMINE 500MG-25MG
SYNARCUS CREAM
TATAGAM P INJEKSI 1ML (250 IU)
TEOFILIN 150MG TAB
TERBUTALIN SO4 TAB 2,5MGTAB
TERRELL TM (ISOFLURANE,USP)
TETRACYCLIN 250MG CAPSUL
THIAMIN 50MG TABLET
THROMBO ASPILETS TABLET
THYROZOL 10
TRAMADOL CAPSUL 50MG
TRAMADOL INJ
ULSIDEX TABLET 500MG (SUKRALFAT TABLET 500 MG )
VENTOLIN INHALER
VITAMIN A CAPS 100,000 IU
VITAMIN A TABLET 50,000IU
VITAMIN B COMP. TABLET
VITKA INFANT INJEKSI 1ML (PHYTOMENADIONE INJEKSI 2MG/ML)

371
372
373
374
375
376
377
378
379
380
381
382

WIDA 2 A
WIDA D5 0.25 NS
WIDA D5 0.5 NS
WIDA D5 NS
WIDA HSD
WIDA RD
XYLOCAINE JELLY 2%
YODIUM POVIDON SOL 10% 1LTR
YODIUM POVIDON SOL 10% 30 ML
ZINC 20mg TABLET
Zinc tablet dispersible20 mg
ZIRCUM SYRUP

R HARGA OBAT RSUD SCHOLOO KEYEN 2016

HNA
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

PPN
0%
908
657
143,500
138,000
476
757
3,755
2,999
4,619
415
100
300
475
243
128
4,320
56,300
480
391
218
288
2,790
317
6,120
181
1,600
2,409
3,019
3,806
622
2,063
162
22,686
5,060

MARGIN
35%
317.80
229.95
50,225.00
48,300.00
166.53
265.03
1,314.38
1,049.65
1,616.65
145.25
35.00
105.00
166.25
85.05
44.84
1,512.00
19,705.00
168.00
136.85
76.30
100.80
976.50
111.09
2,142.00
63.44
560.00
843.15
1,056.65
1,332.10
217.70
721.88
56.70
7,940.10
1,771.00

U R/
500
500
500
500
500
500
500
500
500
500
500
500
500
500

500
500
500
500
500
500
500
500
500
500

500
500
500
500
500
500
500
500
500
500
500

HARGA
1,726
1,387
194,225
186,800
1,142
1,522
5,570
4,549
6,736
1,060
635
905
1,141
828
673
6,332
76,505
1,148
1,028
794
889
4,267
929
8,762
745
2,660
3,752
4,576
5,638
1,340
3,284
719
31,126
7,331

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

191
114
57
139
4,000
9,000
1,518
37,500
5,400
117,500
49
1,108
1,824
6,250
31,680
70
5,880
81
173
294
30,600
618
5,984
1,100
10,500
14,645
5,394
8,955
211
9,599
320
1,920
186
46
-

66.85
39.90
19.95
48.65
1,400.00
3,150.00
531.30
13,125.00
1,890.00
41,125.00
17.15
387.80
638.33
2,187.50
11,088.00
24.64
2,058.00
28.35
60.47
102.90
10,710.00
216.30
2,094.40
385.00
3,675.00
5,125.75
1,887.90
3,134.23
73.85
3,359.65
111.93
671.83
65.10
15.96
-

500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500

500
500
500

758
654
577
688
5,900
12,650
2,549
51,125
7,790
159,125
566
1,996
2,962
8,938
43,268
595
8,438
609
733
897
41,810
1,334
8,578
1,985
14,675
20,271
7,782
12,589
785
13,459
932
3,091
751
562
-

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

138
420
24,487
451
678
3,220
600
4,400,000
5,990
2,590
91
199
6,067
19,800
1,897
107
-

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

172
180
125
125
1,157
68,607
3,833
484
11,760
325
4,990
188,000
62
9,720
8,495
600
1,116

48.26
147.09
8,570.45
157.85
237.30
1,127.00
210.00
###
2,096.50
906.50
31.88
69.80
2,123.45
6,930.00
663.95
37.54
60.20
62.88
43.75
43.75
405.01
24,012.45
1,341.55
169.52
4,116.00
113.75
1,746.50
65,800.00
21.70
3,402.00
2,973.25
210.00
390.60

500
500
500

500
500

500
500

500
500
500
500
500
500
500
500
500

500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500

686
1,067
33,557
1,109
1,415
4,847
1,310
5,940,500
8,587
3,997
623
769
8,690
27,230
3,061
645
732
743
669
669
2,062
93,119
5,675
1,154
16,376
939
7,237
254,300
584
13,622
11,968
1,310
2,007

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

2,875
22,625
40,920
1,075
1,210
40,000
2,472

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

346
815
4,079
523
6,840
6,240
263
100
83
770,000

Rp
Rp
Rp

186
3,084
3,358

1,006.25
7,918.75
14,322.00
376.25
423.50
14,000.14
865.20
121.10
285.25
1,427.65
183.05
2,394.00
2,184.00
92.05
35.00
29.05
269,500.00
65.10
1,079.40
1,175.41

500
500

500

500
500
500

500
500
500
500

500

500
500
500

500
500
500
500
500
500

4,381
31,044
55,742
1,951
2,134
54,501
3,837
967
1,600
6,007
1,206
9,734
8,924
855
635
612
1,040,000
751
4,663
5,034

Rp

33,000

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

132
171
4,199
10,000
10,000
5,200
3,083
349
3,036
799
258
1,580
132,000
596
85,000
503
64,680
1,315
2,129
720
420
7,500
107
185

11,550.00
46.20
59.85
1,469.65
3,500.00
3,500.00
1,820.00
1,079.16
122.15
1,062.60
279.65
90.37
553.00
46,200.00
208.60
29,750.00
176.05
22,638.00
460.15
745.22
252.00
147.00
2,625.00
37.45
64.75

500

500
500
500

500
500

500
500
500

500
500

500
500
500
500
500
500
500
500
500
500
500
500
500
500

45,050
678
731
6,169
14,000
14,000
7,520
4,662
971
4,599
1,579
849
2,633
178,700
1,305
115,250
1,179
87,818
2,275
3,374
1,472
1,067
10,625
644
750

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

23,375
62,000
35,000
7,650
830
7,920
158,400
88,759
261
3,850
185
25,500
900
444
440
130
9,559
172
265
14,400
7,440
3,600
178
12,599
1,750
5,640
217
235
140
2,171
73,900
537
720
1,716
883
240
49,000

8,181.25
21,700.00
12,250.00
2,677.50
290.50
2,772.00
55,440.00
31,065.65
91.35
1,347.50
64.75
8,925.00
315.00
155.40
154.00
45.50
3,345.65
60.06
92.64
5,040.00
2,604.00
1,260.00
62.30
4,409.65
612.50
1,974.00
75.95
82.25
49.00
759.85
25,865.00
187.91
252.00
600.60
308.89
84.00
17,150.00

500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500

500
500
500
500
500
500

500
500
500
500
500
500
500
500
500
500
500
500
500
500

32,056
84,200
47,750
10,828
1,621
11,192
214,340
120,325
852
5,698
750
34,925
1,715
1,099
1,094
675
13,405
732
857
19,940
10,544
5,360
740
17,509
2,863
8,114
793
817
689
3,431
100,265
1,225
1,472
2,817
1,691
824
66,650

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

10,560
2,700
1,090
2,460
2,888
2,750
45,000
60,000
636
119
6,240
49,500
1,675
17,400
2,398
1,140
7,464
20,526
127
2,700
269
2,618
130
90
383
-

Rp
Rp
Rp

3,266
240
8,900
10,420

3,696.00
945.00
381.50
861.00
1,010.69
962.50
15,750.00
21,000.00
222.60
41.79
2,184.00
17,325.00
586.25
6,090.00
839.43
398.96
2,612.40
7,184.10
44.40
945.00
94.15
916.30
45.50
31.50
134.05
1,143.10
84.00
3,115.00
3,647.00

500
500
500
500
500
500

500
500
500
500
500
500
500

500

500
500
500
500

500
500
500
500
500
500
500

500
500
500
500

14,756
4,145
1,972
3,821
4,398
4,213
61,250
81,500
1,359
661
8,924
67,325
2,761
23,990
3,738
2,039
10,576
28,210
671
4,145
863
4,034
676
622
1,017
4,909
824
12,515
14,567

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

384
280
21
140
1,680
119,988
576
792
1,107
6,240
499
103
117
10,500
121,000
2,860,000
1,849
400
14,300
39,204
2,280
622
3,000
170,000
1,787,500
45
704
1,135
396
7,682
530
355
144
7,500

134.42
97.96
7.31
49.00
588.00
41,995.80
201.60
277.20
387.45
2,184.00
174.65
35.99
40.95
3,675.00
42,350.00
###
647.22
140.00
5,005.00
13,721.40
798.00
217.70
1,050.00
59,500.00
625,625.00
15.88
246.40
397.25
138.60
2,688.84
185.50
124.25
50.40
2,625.00

500
500
500
500
500
500

500
500
500
500
500
500
500
500
500

500
500
500
500
500
500
500
500
500

500
500
500
500
500
500
500
500
500
500

1,018
878
528
689
2,768
162,484
1,278
1,569
1,994
8,924
1,174
639
658
14,675
163,850
3,861,500
2,996
1,040
19,805
53,425
3,578
1,340
4,550
230,000
2,413,625
561
1,450
2,032
1,035
10,871
1,216
979
694
10,625

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

9,240
9,240
6,800
9,500
6,930
50,400
569
-

3,234.00
3,234.00
2,380.00
3,325.00
2,425.50
17,640.00
199.15
-

500
500
500
500
500
500

500

12,974
12,974
9,680
13,325
9,856
68,540
1,268
-

HARGA JUAL SEBENARNYA

1,800
14,000
194,000
186,000
1,000
1,500
6,000
5,000
7,000
1,000
1,000
900
1,000

1,000
1,000
6,000
76,000
1,000
1,000
1,000
1,000
4,000
1,000

9,000
1,000
3,000
4,000
5,000
6,000
1,000
3,000
700
31,000
7,000

1,000
600
600
700
6,000
13,000
3,000
51,000
8,000
160,000
500
2,000
3,000
9,000
43,000
600
8,000
600
700
900
41,000
1,000
9,000
2,000
15,000
20,000
8,000
13,000
800
13,000
1,000

3,000
600
600

700
1,000
34,000

1,000
1,500

5,000
1,000

5,940,000
8,000
4,000
700
800
9,000
27,000
3,000
600

700
700
700
700
2,000
93,000
6,000
1,000
16,000
1,000
7,000
254,000
600
14,000
12,000
1,000
2,000

4,000
31,000

56,000

2,000
2,000
54,000

4,000
1,000
1,600
6,000

1,200

1,000
9,000
900

600
600
1,040,000
700
5,000
5,000

45,000

700
700
6,000

14,000
14,000

8,000
5,000
1,000

5,000
1,600

900
2,600
178,000
13,000
116,000
1,000
88,000
2,000
3,000
1,000
1,000
11,000
600
800

32,000
84,000
47,000
11,000
1,600
11,000
214,000
120,000

60,000
8,000
35,000
1,700
1,000
1,000
700
13,000

800
900
20,000
11,000
5,000
700

16,000
3,000
8,000
8,000
800
700
3,000
100,000
1,000
15,000
3,000
1,600
800
67,000

15,000
4,000
2,000
4,000
4,000
4,000

61,000
82,000
1,300
700
9,000
67,000
3,000

24,000

4,000
2,000
11,000
28,000

700
4,000
900
4,000
700
700
1,000

5,000
800
13,000
15,000

1,000
900
500
700
3,000
162,000

1,000
1,500
2,000
9,000
1,000
700
700
15,000
164,000

3,861,000
3,000
1,000
20,000
53,000
4,000
1,300
5,000
230,000

2,414,000
600
1,500
2,000
1,000
11,000
1,000
1,000
700
11,000

13,000
13,000
10,000
13,000
10,000
69,000

1,200

DAFTAR HARGA JUAL OBAT RSUD SCHOLOO KEYEN 2016

NO

NAMA OBAT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94

ACARBOSE 100 MG TABLET

ACARBOSE 50 MG TABLET
ACETOSAL 100MG TAB
ACTRAPID VIAL 1000UI IN ml
ACYCLOVIR 200MG TAB
ACYCLOVIR 400MG TAB
ACYCLOVIR CREAM
ADALAT OROS (NIFEDIPIN SR 20MG)
ALBENDAZOL SUSPENSI 200MG/5ML
ALBENDAZOLE TABLET 400mg
ALLOPURINOL 100MG
ALLOPURINOL TABLET 300MG
ALPRAZOLAM 0.25mg
ALPRAZOLAM 1MG TAB
AMBROXOL SYRUP
AMBROXOL TABLET 30MG
AMINOFILIN 200MG TABLET
AMINOFILIN INJEKSI 24MG/ML
Amiparin inf
AMITRYPTILIN 25MG TAB
Amlodipin tablet 10 mg
Amlodipin tablet 5 mg
Amoksisilin kapsul/kaplet/tablet scored 500 mg
Amoksisilin sirup kering 125 mg/ 5 ml
AMOXYCILIN 250MG CAPSUL
AMPICILIN 500MG TAB
AMPICILINE SYR 125MG
Ampisilin serbuk injeksi i.v. 1000 mg/vial
ANTALGIN 500MG TAB
ANTALGIN INJEKSI
ANTASIDA SYRUP
ANTASIDA TABLET
ANTI BAKTERI DOEN SALEP KOMBINASI
ANTI HAEMORHOID SUPP
ANTI MALARIA DOEN KOMBINASI SULFADOXIN
ANTIFUNGI SALEP ( 2-4 )
ANTIMIGREN :ERGOTAMIN TARTRAT 1MG+KOFEIN 50MG
APTIL SOLUTION
AQUA PRO INJEKSI 20 ml
AQUA PRO INJEKSI 25ml
ARTEM/ARTEMETER INJEKSI
ARTESUNATE INJ 60MG
ASAM ASKORBAT (VIT C ) 250 MG
ASAM ASKORBAT 50MG (VITC)
ASAM FOLAT TABLET 1MG
ASAM MEFENAMAT 500MG TAB
ASAM TRANEXAMAT INJEKSI 500mg
ASERING SOLUTION
ATENOLOL TAB 50 MG
ATROPINE SO4 0,25MG/ML INJEKSI
ATROPINE SO4 TAB 0,5 MG
AZITROMYCIN SYRUP 200mg IN 5ml
AZITROMYCIN TABLET 500mg
BENZATIN BENZYL PENICILLIN 2.4 JUTA IU
BEROTEC SOLUTION
BESI II SO4 TAB. SALUT KOMB.
BETAHISTIN MESILATE 6MG
BETHAMETHASON CR 0,1%
BRICASMA RESPULES 2.5mg IN ml
BROMHEXIN TABLET
BUPIVACAIN SPINAL 5mg
CALCIUM LACTATE TABLET
CALSIUM CARBONATE TAB500MG
CANDESARTAN CILEXETIL TAB 16mg
CAPTOPRIL 12,5MG TAB
CAPTOPRIL 25MG TAB
CARBAMAZEPIN TABLET 200MG
CATAPRES 100MG/ML (CLONIDIN INJK)
CEFADROXIL 500MG CAPSUL
CEFADROXIL SYRUP 60ML (125MG/5ML)
CEFIXIME 100MG CAPS
CEFIXIME SYRUP 30ML ( 100MG/5ML)
CEFOPERAZONE SERBUK INJKESI 1G
CEFOPERAZONE SULBACTAM INJEKSI
CEFOTAXIM 1G INJEKSI
CEFTRIAXON 1G INJEKSI
CEFUROXIME INJ 750MG
CETIRIZINE 10MG
CETIRIZINE SYRUP 60ML (5MG/5ML)
CHLORAMPHENICOL 250MG CAPSUL
CHLORAMPHENICOL EAR DROPS
CHLORAMPHENICOL EYE DROPS
CHLORAMPHENICOL SALEP MATA 1%
CHLOROQUIN PO4 250MG TABLET
CHLORPENIRAMINA MALEAT ( C T M )
CHLORPROMAZINA 25MG TABLET
CHLORPROMAZINA INJEKSI25MG
CIMETIDIN 200MG TAB
CIPROFLOXACIN 500MG TAB
CIPROFLOXACIN INFUS 2% 100ML (200MG/100ML)
CIPROFLOXACIN TETES MATA 0,3%
CITICOLIN 125mg INJEKSI
CITICOLIN 500mg TABLET

HNA
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

825
597
130,455
125,455
433
688
3,414
2,726
4,199
377
91
273
432
221
116
3,927
51,182
436
355
198
262
2,536
289
5,564
165
1,455
2,190
2,745
3,460
565
1,875
147
20,624
4,600
174
104
52
126
3,636
8,182
1,380
34,091
4,909
106,818
45
1,007
1,658
5,682
28,800
64
5,345
74
157
267
27,818
562
5,440
1,000
9,545
13,314
4,904
8,141
192
8,726
291
1,745
169
41
125
382
22,261
-

MARGIN
35%
289
209
45,659
43,909
151
241
1,195
954
1,470
132
32
95
151
77
41
1,375
17,914
153
124
69
92
888
101
1,947
58
509
767
961
1,211
198
656
52
7,218
1,610
61
36
18
44
1,273
2,864
483
11,932
1,718
37,386
16
353
580
1,989
10,080
22
1,871
26
55
94
9,736
197
1,904
350
3,341
4,660
1,716
2,849
67
3,054
102
611
59
15
44
134
7,791
-

HARGA DPP
1,114
806
176,114
169,364
584
929
4,609
3,681
5,669
509
123
368
583
298
157
5,302
69,095
589
480
268
353
3,424
390
7,511
222
1,964
2,957
3,705
4,671
763
2,531
199
27,842
6,210
234
140
70
171
4,909
11,045
1,863
46,023
6,627
144,205
60
1,360
2,238
7,670
38,880
86
7,216
99
212
361
37,555
758
7,344
1,350
12,886
17,973
6,620
10,990
259
11,781
392
2,356
228
56
169
516
30,052
-

PPN
10%
111.44
80.63
17,611.36
16,936.36
58.39
92.93
460.89
368.06
566.88
50.93
12.27
36.82
58.30
29.82
15.72
530.18
6,909.55
58.91
47.99
26.75
35.35
342.41
38.95
751.09
22.24
196.36
295.65
370.51
467.10
76.34
253.13
19.88
2,784.19
621.00
23.44
13.99
7.00
17.06
490.91
1,104.55
186.30
4,602.27
662.73
14,420.45
6.01
135.98
223.83
767.05
3,888.00
8.64
721.64
9.94
21.20
36.08
3,755.45
75.85
734.40
135.00
1,288.64
1,797.34
661.99
1,099.01
25.90
1,178.06
39.25
235.58
22.83
5.60
16.92
51.58
3,005.22
-

HARGA FIX
1,226
887
193,725
186,300
642
1,022
5,070
4,049
6,236
560
135
405
641
328
173
5,832
76,005
648
528
294
389
3,767
429
8,262
245
2,160
3,252
4,076
5,138
840
2,784
219
30,626
6,831
258
154
77
188
5,400
12,150
2,049
50,625
7,290
158,625
66
1,496
2,462
8,438
42,768
95
7,938
109
233
397
41,310
834
8,078
1,485
14,175
19,771
7,282
12,089
285
12,959
432
2,591
251
62
186
567
33,057
-

HARGA PEMBULATAN
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

1,200
900
193,700
186,300
600
1,000
5,100
4,000
6,200
600
100
400
600
300
200
5,800
76,000
600
500
300
400
3,800
400
8,300
200
2,200
3,300
4,100
5,100
800
2,800
200
30,600
6,800
300
200
100
200
5,400
12,200
2,000
50,600
7,300
158,600
100
1,500
2,500
8,400
42,800
100
7,900
100
200
400
41,300
800
8,100
1,500
14,200
19,800
7,300
12,100
300
13,000
400
2,600
300
100
200
600
33,100
-

95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193

CLINDAMICYN 150MG
CLINDAMICYN 300MG
CLOPIDOGREL 75mg TABLET
CO- AMOXYCLAV 625MG TAB
COARTEM TABLET
CODEIN 10MG TAB
CODEIN 15MG TAB
CODEIN 20MG TAB
COFACT 500 IU/20 ml
COMBIVENT UDV 2,5ml/VIAL
Cotrimoksazol SYP(Sulfametoksazol 200 mg + Trimetoprim 40 mg / 5 ml
COTRIMOXAZOLE 120MG PED. TABLET
COTRIMOXAZOLE 480MG TABLET
DANOCLAV TABLET
DARPLEX TABLET (D-ARTEP)
DARYANTULLE
DEXAMETHASON INJ
DEXAMETHASON TABLET
DEXTRAN SOL 70% 500ML
DEXTROMETORPHAN SYRUP
DEXTROMETORPHAN TAB 15 MG
DIAZEPAM 2MG TABLET
DIAZEPAM 5MG TABLET
DIAZEPAM INJEKSI
DIGOKSIN TAB 0,25MG TABLET
DILTIAZEM TABLET 30MG
DIMENHIDRINAT 10MG TABLET
DIMENHIDRINATE 50MG TABLET
DIPHENHIDRAMIN INJ
DOBUTAMIN 50mg INJEKSI
Domperidon suspensi/sirup 5 mg/5 ml
DOMPERIDONE TAB
DOPAMIN GIULINI INJEKSI 10ML (20MG/ML)
DOXICYCLIN CAPSUL 100MG
DULCOLAX SUPP (BISAKODIL SUPPOSITORIA 5MG)
DUROGESIC PATCH 25mu MATRIX
EPHEDRINE 25MG TABLET
Epinefrin (Adrenalin) injeksi i.v/s.k./i.m 1 mg/ml
Eritromisin sirup kering 200 mg/ 5 ml
ERYTOMISIN 250MG CAPSUL
ERYTOMISIN 500MG TABLET
ETAKRIDINE LAKTATE SOL 300ML
ETANOL 70% 100ml
ETHAMBUTOL 500MG TAB
EUGENOL SOLUTION
FAMOTIDINE 20MG TABLET
FAMOTIDINE 40MG TABLET
FARMABES INJEKSI 25mg
FARSORBID INJEKSI (ISOSORBID DINITRAT INJEKSI)
FENITHOIN NATR. 30MG CAP
FENITHOIN NATR. INJ
FENOFIBRAT 100mg CAPSUL
FENOL GLISEROL TETES TELINGA
FENTANIL INJEKSI im.iv 0.05mg IN ml
FENTANYL patch 25mcg
FLAGYL SUPPOSITORIA 500mg
FLUCONAZOLE 150mg
FLUORIDE 1MG TAB
FUROSEMIDE INJ
FUROSEMIDE TAB 40 MG
GARAM ORALIT 200 ML AIR
GEMFIBROZIL 600MG TAB
GENOINT SALEP MATA 0.3%
GENTAMICYN INJ 40 MG
GENTAMICYN SALEP
GENTAMICYN TTS MATA 0,3%
GENTIAN VIOLET LARUTAN 1 %
GLIBENCLAMIDE TAB
GLICERIL GUAICOLAT TAB 100 MG
GLIMEPIRIDE 1MG TAB
GLIMEPIRIDE 2MG TAB
GLIMEPIRIDE 3MG TAB
GLIMEPIRIDE 4MG TAB
GLUCOSA 40% SOL 25ML
GLUKOSA 5% 0.25NS
GLUKOSA 5% 0.5NS
GLUKOSA LARUTAN INFUS 10 %(500ML)
GLUKOSA LARUTAN INFUS 5 %(500ML)
GRISEOFULVIN 125 MG TAB
GRISEOFULVIN 500 MG TAB
HALOPERIDOL 2MG
HALOPERIDOL 5MG
HALOPERIDOL TABLET 1.5mg
HALOTHANE INHALASI
HIDRO CHLORTIAZIDE TAB 25 MG
HIDRO CHLORTIAZIDE TAB 25 MG
HIDROCORTISON CREAM 1%
HIDROCORTISONE KRIM 2,5 %
HIDROXY ETHYL STARCH (WIDAHES)
HUMAN ALBUMIN 20% 100ML
HYDROCHLORTIAZIDE TABLET 25MG (H.C.T)
HYOSCINE-N-BUTILBROMIDE 10MG
IBUPROFEN 200MG TABLET
IBUPROFEN 400MG TABLET
IBUPROFEN SIRUP 100MG/5ML
IBUPROFEN SYR 100MG/ML
IBUPROFEN SYR 200MG/ML
IMPLANON. ETONOGESTREL
ISONIAZIDE 100MG TABLET

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

410
616
2,927
545
4,000,000
5,445
2,355
83
181
5,515
18,000
1,725
97
156
163
114
114
1,052
62,370
3,485
440
10,691
295
4,536
170,909
56
8,836
7,723
545
1,015
2,614
20,568
37,200
977
1,100
36,364
2,247
315
741
3,708
475
6,218
5,673
239
91
75
700,000
169
2,804
3,053
30,000
120
155
3,817
-

144
216
1,025
191
1,400,000
1,906
824
29
63
1,930
6,300
604
34
55
57
40
40
368
21,830
1,220
154
3,742
103
1,588
59,818
20
3,093
2,703
191
355
915
7,199
13,020
342
385
12,727
787
110
259
1,298
166
2,176
1,985
84
32
26
245,000
59
981
1,069
10,500
42
54
1,336
-

554
832
3,952
736
5,400,000
7,351
3,179
112
245
7,446
24,300
2,328
132
211
220
153
153
1,420
84,200
4,704
594
14,433
399
6,124
230,727
76
11,929
10,426
736
1,370
3,528
27,767
50,220
1,319
1,485
49,091
3,034
425
1,000
5,006
642
8,395
7,658
323
123
102
945,000
228
3,785
4,122
40,500
162
210
5,153
-

55.35
83.21
395.18
73.64
540,000.00
735.14
317.86
11.18
24.47
744.59
2,430.00
232.81
13.16
21.11
22.05
15.34
15.34
142.02
8,419.95
470.41
59.44
1,443.27
39.89
612.41
23,072.73
7.61
1,192.91
1,042.57
73.64
136.96
352.84
2,776.70
5,022.00
131.93
148.50
4,909.14
303.38
42.46
100.02
500.60
64.19
839.45
765.82
32.28
12.27
10.19
94,500.00
22.83
378.49
412.16
4,050.00
16.20
20.99
515.33
-

609
915
4,347
810
5,940,000
8,087
3,497
123
269
8,190
26,730
2,561
145
232
243
169
169
1,562
92,619
5,175
654
15,876
439
6,737
253,800
84
13,122
11,468
810
1,507
3,881
30,544
55,242
1,451
1,634
54,001
3,337
467
1,100
5,507
706
9,234
8,424
355
135
112
1,039,500
251
4,163
4,534
44,550
178
231
5,669
-

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

600
900
4,300
800
5,940,000
8,100
3,500
100
300
8,200
26,700
2,600
100
200
200
200
200
1,600
92,600
5,200
700
15,900
400
6,700
253,800
100
13,100
11,500
800
1,500
3,900
30,500
55,200
1,500
1,600
54,000
3,300
500
1,100
5,500
700
9,200
8,400
400
100
100
1,039,500
300
4,200
4,500
44,600
200
200
5,700
-

194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292

ISONIAZIDE 300MG TABLET

ISOSORBID DINITRATE ( I S D N ) TABLET
ISOSORBID DINITRATE SUBLINGUAL 5mg
ISOTIC ADRETOR 0.25% SOL
ITRACONAZOLE 100MG TAB
KAEN 1 B SOLUTION
KAEN 3 A SOLUTION
KAEN 3 B SOLUTION
KAEN MG3 SOLUTION
KALIPAR
KALIUM DIKLOFENAC 50MG
KANAMYCIN HJ INJK 1 G
KETOCONAZOLE CREAM 2% 10 G
KETOKONAZOLE CR 15G
KETOKONAZOLE TAB 200MG
KETOPROFEN INJEKSI 100MG
KETOPROFEN TABLET 100MG
KETOROLAC INJEKSI 30MG/ML
KININA SO4 222MG TABLET
KLOBAZAM 10mg
KLOMIFEN SITRAT TAB 50MG
KLONIDIN HCL 0,15MG TAB
KSR. KALIUM KLORIDA
KTM. KETAMIN INJEKSI
LANSOPRAZOLE CAPS 30MG
LAXADINE EMULSI 60ml
LEVEMIR FLEX PEN 100U/ML
LEVOFLOXACIN 500MG TAB
LEVOSOL (NOREPINEPHRINE)INJK 8MG/8ML
LIDOCAIN 2% INJEKSI
LIDOCAIN COMP. INJEKSI(PEHACAIN)
LISINOPRIL 10mg
LISINOPRIL 5mg
LODOMER 5 MG(HALOPERIDOL INJEKSI 5 MG/ML )
LOPERAMIDE TABLET 2MG
LORATADINE TAB 10MG
MAGNESIUM SO4 (MGSO4) INJ 40%
MANNITOL INFUS 20%
MARTOS SOLUTION
MEBENDAZOL 100MG SYRUP
MELOXICAM 7.5mg TAB
MELOXICAM SUPPOSITORIA
MEROPENEM 500mg INJEKSI
MEROPENEM INJEKSI 1g
METFORMIN 500MG
METHYL DOPA TABLET
METHYLERGOMETRIN MALEAT INJEKSI
METHYLERGOMETRIN MALEAT TABLET 0,125MG
METHYLPREDNISOLON 125mg INJEKSI
METHYLPREDNISOLON 16mg TABLET
METHYLPREDNISOLON TAB 4MG
METHYLPREDNISOLON TAB 8MG
METOCLOPRAMIDE HCL 5 MG
METOCLOPRAMIDE INJEKSI
METOCLOPRAMIDE SYRUP 5MG/5ML
METOCLOPRAMIDE TABLET 10 MG
METRONIDAZOLE 250MG TABLET
METRONIDAZOLE 500MG
METRONIDAZOLE INFUS 500MG/100ML
MEYLON INJEKSI
MICONAZOLE CREAM 2%
MILOZ 15 INJEKSI
MINIASTI (ASAM ASETILSALISILAT TABLET 80MG)
MOLACORT TABLET
MOMETHASONE CR
MORFIN INJ
MORPHIN INJEKSI im.sk.iv 10mg
MORPHIN TABLET 10MG
NATRIUM CHLORIDA SOL. 500ML (0,9 %)
NATRIUM DICLOFENAC 25MG
NATRIUM DICLOFENAC 50MG
NEOMICYN CAPSUL 500MG
NIFEDIPIN 10MG TABLET
NITRAL TABLET 0.5mg
NITROKAF FORTE
NOKOBA(NALOXONE HCL 0,4MG/ML (0,8MG/2ML)
NOTRIXUM INJEKSI 2.5mg
NYSTATIN 100.000IU VAGINAL TABLET
NYSTATIN 500.000IU ORAL TABLET
OBAT BATUK HITAM
OFLOXACIN 400MG TAB
OMEPRAZOLE CAPSUL 20MG
OMEPRAZOLE INJEKSI 40mg IN 10ml
ONDANSETRON 8mg INJEKSI
ONDANSETRON INJEKSI 4mg IN 2 ml
ONDANSETRON TABLET 4MG
OTSU KCl 7.46%
OXYTETRACYCLIN SALEP 3%
OXYTETRACYCLIN SALEP MATA 1%
OXYTOCIN INJEKSI/INDUXIN
PAKET STOP TB KATEGORI 1
PAKET STOP TB KATEGORI 2
PAN AMIN G SOLUTION
PANTOPRAZOL INJEKSI 40 MG
PAPAVERIN HCL NJEKSI
PAPAVERIN HCL TABLET
PARACETAMOL 500MG TABLET
PARACETAMOL DROPS 15ML (100MG/ML)
PARACETAMOL INFUS 100ML (10MG/ML)

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

9,091
9,091
4,727
2,803
317
2,760
726
235
1,436
120,000
542
77,273
457
58,800
1,195
1,936
655
382
6,818
97
168
21,250
56,364
31,818
6,955
755
7,200
144,000
80,690
237
3,500
168
23,182
818
404
400
118
8,690
156
241
13,091
6,764
3,273
162
11,454
1,591
5,127
197
214
127
1,974
67,182
488
655
1,560
802
218
44,545
9,600
2,455
991
2,236
2,625
2,500
40,909
54,545
578
109
5,673
45,000

3,182
3,182
1,655
981
111
966
254
82
503
42,000
190
27,045
160
20,580
418
677
229
134
2,386
34
59
7,438
19,727
11,136
2,434
264
2,520
50,400
28,242
83
1,225
59
8,114
286
141
140
41
3,042
55
84
4,582
2,367
1,145
57
4,009
557
1,795
69
75
45
691
23,514
171
229
546
281
76
15,591
3,360
859
347
783
919
875
14,318
19,091
202
38
1,985
15,750

12,273
12,273
6,382
3,784
428
3,726
981
317
1,939
162,000
731
104,318
617
79,380
1,614
2,613
884
515
9,205
131
227
28,688
76,091
42,955
9,389
1,019
9,720
194,400
108,932
320
4,725
227
31,295
1,105
545
540
160
11,732
211
325
17,673
9,131
4,418
218
15,462
2,148
6,922
266
288
172
2,664
90,695
659
884
2,106
1,083
295
60,136
12,960
3,314
1,338
3,019
3,544
3,375
55,227
73,636
781
147
7,658
60,750

1,227.27
1,227.27
638.18
378.41
42.83
372.60
98.06
31.69
193.91
16,200.00
73.15
10,431.82
61.73
7,938.00
161.35
261.31
88.36
51.55
920.45
13.13
22.70
2,868.75
7,609.09
4,295.45
938.86
101.86
972.00
19,440.00
10,893.15
32.03
472.50
22.70
3,129.55
110.45
54.49
54.00
15.95
1,173.15
21.06
32.48
1,767.27
913.09
441.82
21.85
1,546.24
214.77
692.18
26.63
28.84
17.18
266.44
9,069.55
65.89
88.36
210.60
108.31
29.45
6,013.64
1,296.00
331.36
133.77
301.91
354.40
337.50
5,522.73
7,363.64
78.05
14.65
765.82
6,075.00

13,500
13,500
7,020
4,162
471
4,099
1,079
349
2,133
178,200
805
114,750
679
87,318
1,775
2,874
972
567
10,125
144
250
31,556
83,700
47,250
10,328
1,121
10,692
213,840
119,825
352
5,198
250
34,425
1,215
599
594
175
12,905
232
357
19,440
10,044
4,860
240
17,009
2,363
7,614
293
317
189
2,931
99,765
725
972
2,317
1,191
324
66,150
14,256
3,645
1,472
3,321
3,898
3,713
60,750
81,000
859
161
8,424
66,825

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

13,500
13,500
7,000
4,200
500
4,100
1,100
300
2,100
178,200
800
114,800
700
87,300
1,800
2,900
1,000
600
10,100
100
300
31,600
83,700
47,300
10,300
1,100
10,700
213,800
119,800
400
5,200
300
34,400
1,200
600
600
200
12,900
200
400
19,400
10,000
4,900
200
17,000
2,400
7,600
300
300
200
2,900
99,800
700
1,000
2,300
1,200
300
66,200
14,300
3,600
1,500
3,300
3,900
3,700
60,800
81,000
900
200
8,000
66,800

293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373

PARACETAMOL SYRUP 60ML (120MG/5ML)

PEHATRIM FORTE
PENTOXIFILIN 400MG TAB
PENTOXIFILIN INJ 300MG/15ML
PERFENAZINE TAB 4MG
PETHIDINE INJ 2ML (50MG/ML)
PHENOBARBITAL 30MG TAB
PHENOBARBITAL INJEKSI
PHENYIL BUTAZONE TABLET
PHYTOMENADION ( VIT K ) INJ 10 MG / 1 ML
PHYTOMENADION ( VIT K ) TAB 10 MG
PIRACETAM 400MG CAPSUL
PIRACETAM INJEKSI 1G/5ML (200MG/ML)
PIRACETAM INJEKSI 3G/15ML (200MG/ML)
PIRACETAM TAB 800MG
PIROXICAM 10MG TABLET
PIROXICAM 20MG TABLET
POVIDONE IODINE 300ML
PRAVASTATIN TABLET 20mg
PREDNISON TABLET
PRIMAQUIN TABLET
PRIMOLUT N (NORETHISTERONE 5MG)
PROPANOLOL 40MG TABLET
PROPANOLOL TABLET 10mg
PROPILTIOURASIL 100MG TABLET
PROSOGAN INJEKSI
PROTOFEN (KETOPROFEN SUPPO 10MG)
PROTOFEN (KETOPROFEN SUPPO 10MG)
PULAREX TABLET
PULMICORT RESPULES 0.25mg in ml
PYRANTEL PAMOATE SYR 60 ML( 125MG/ML)
PYRANTEL PAMOATE TABLET
PYRAZINAMDE 500MG TABLET
PYRIDOXIN TABLET (VIT. B 6 )
RANITIDINE 150MG TABLET
RANITIDINE INJEKSI 2ML (25MG/ML)
RECOFOL-N 20 ML (PROPOFOL) INJEKSI (10MG/ML)
RESERPINE 0,10MG TABLET
RESERPINE 0,25MG TABLET
RIFAMPICIN 300MG CAPSUL
RIFAMPICIN 450MG TABLET
RIFAMPICIN 600MG TABLET
RINGER LACTATE SOL 500ML
RISPERIDONE 1MG
SALBUTAMOL 2MG TABLET
SALBUTAMOL 4MG
SALYCIL BEDAK
SEFIXIM SYRUP 100mg IN ml
SEFTAZIDIM INJEKSI 1g
SERETIDE DISCUSS 100mcg
SIMVASTATIN TABLET 10MG
SOFT U DERM CREAM
SOJOURN TM (SEVAFLURANE,USP)
SPIRAMICYN 500MG TABLET
SPIRONOLAKTON TAB 100 MG
SPIRONOLAKTON TAB 25 MG
STESOLID INJK 2ML/5AMPL (10MG/2ML) IM/IV
STESOLID RECTAL 10MG/2,5ML
STREPTOMICYN SO4 INJEKSI
SULFACETAMIDA TETES MATA
SULFADOXINE PYRIMETHAMINE 500MG-25MG
SYNARCUS CREAM
TATAGAM P INJEKSI 1ML (250 IU)
TEOFILIN 150MG TAB
TERBUTALIN SO4 TAB 2,5MGTAB
TERRELL TM (ISOFLURANE,USP)
TETRACYCLIN 250MG CAPSUL
THIAMIN 50MG TABLET
THROMBO ASPILETS TABLET
THYROZOL 10
TRAMADOL CAPSUL 50MG
TRAMADOL INJ
ULSIDEX TABLET 500MG (SUKRALFAT TABLET 500 MG )
VENTOLIN INHALER
VITAMIN A CAPS 100,000 IU
VITAMIN A TABLET 50,000IU
VITAMIN B COMP. TABLET
VITKA INFANT INJEKSI 1ML (PHYTOMENADIONE INJEKSI 2MG/ML)
WIDA 2 A
WIDA D5 0.25 NS
WIDA D5 0.5 NS

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

1,523
15,818
2,180
1,036
6,785
18,660
115
2,455
245
2,380
118
82
348
2,969
218
8,091
9,473
349
254
19
127
1,527
109,080
524
720
1,006
5,673
454
93
106
9,545
110,000
2,600,000
1,681
364
13,000
35,640
2,073
565
2,727
154,545
1,625,000
41
640
1,032
360
6,984
482
323
131
6,818
8,400
8,400

533
5,536
763
363
2,375
6,531
40
859
86
833
41
29
122
1,039
76
2,832
3,315
122
89
7
45
535
38,178
183
252
352
1,985
159
33
37
3,341
38,500
910,000
588
127
4,550
12,474
725
198
955
54,091
568,750
14
224
361
126
2,444
169
113
46
2,386
2,940
2,940

2,056
21,355
2,943
1,399
9,160
25,191
156
3,314
330
3,213
160
110
470
4,008
295
10,923
12,788
471
344
26
172
2,062
147,258
707
972
1,359
7,658
612
126
144
12,886
148,500
3,510,000
2,269
491
17,550
48,114
2,798
763
3,682
208,636
2,193,750
56
864
1,393
486
9,428
650
436
177
9,205
11,340
11,340

205.57
2,135.45
294.35
139.89
916.04
2,519.10
15.57
331.36
33.01
321.30
15.95
11.05
47.00
400.83
29.45
1,092.27
1,278.82
47.13
34.35
2.56
17.18
206.18
14,725.80
70.69
97.20
135.86
765.82
61.24
12.62
14.36
1,288.64
14,850.00
351,000.00
226.95
49.09
1,755.00
4,811.40
279.82
76.34
368.18
20,863.64
219,375.00
5.57
86.40
139.30
48.60
942.84
65.05
43.57
17.67
920.45
1,134.00
1,134.00

2,261
23,490
3,238
1,539
10,076
27,710
171
3,645
363
3,534
176
122
517
4,409
324
12,015
14,067
518
378
28
189
2,268
161,984
778
1,069
1,494
8,424
674
139
158
14,175
163,350
3,861,000
2,496
540
19,305
52,925
3,078
840
4,050
229,500
2,413,125
61
950
1,532
535
10,371
716
479
194
10,125
12,474
12,474

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

2,300
23,500
3,200
1,500
10,100
27,700
200
3,600
400
3,500
200
100
500
4,400
300
12,000
14,100
500
400
100
200
2,300
162,000
800
1,100
1,500
8,400
700
100
200
14,200
163,400
3,861,000
2,500
500
19,300
52,900
3,100
800
4,100
229,500
2,413,100
100
1,000
1,500
500
10,400
700
500
200
10,100
12,500
12,500

374
375
376
377
378
379
380
381
382

WIDA D5 NS
WIDA HSD
WIDA RD
XYLOCAINE JELLY 2%
YODIUM POVIDON SOL 10% 1LTR
YODIUM POVIDON SOL 10% 30 ML
ZINC 20mg TABLET
Zinc tablet dispersible20 mg
ZIRCUM SYRUP

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

6,182
8,636
6,300
45,818
517
-

2,164
3,023
2,205
16,036
181
-

8,345
11,659
8,505
61,855
698
-

834.55
1,165.91
850.50
6,185.45
69.83
-

9,180
12,825
9,356
68,040
768
-

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

Teminabuan, 01 Juni 2016

Plt. DIREKTUR RSUD SCHOLOO KEYEN

dr.FELIX DUWIT,MSc, MPH, SpPD

NIP. 19670812 199712 1 001

9,200
12,800
9,400
68,000
800
-

DAFTAR HARGA BAH

NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40

NAMA BMHP
ALKOHOL 70 %, 1 LITER
ALKOHOL SWABS
AMBUBAG NEONATUS
AMBUBAG PEDIATRIK
AQUA STERIL FOR IRIGASI 1000ML
ARM SLING UK L
ARM SLING UK M
ARM SLING DEWASA
ARMSLING PEDIATRI
ARSEN SEPTODONT
ASEPTIC GEL 5 LITER
ASEPTIC GEL 500CC DISPENSER
B1STURINO10
BENANG VICRYL 1 POLYSORB
BENANG VICRYL 2 POLYSORB
BENANG VICRYL 2/0 POLYSORB
BENANG VICRYL 3/0 POLYSORB
BENANG VICRYL 4/0 POLYSORB
BISTURI NO 15
BISTURI NO 19
BISTURI NO 20
BISTURI NO 21
BISTURIN0 11
BLOOD BAG SINGLE 250CC (KANTONG DARAH)
BLOOD BAG TRIPLE 350CC (KANTONG DARAH)
BONDING 10 ML
BOR ARKANSAS ALPIN CA
BOR BULAT KECIL DENTAL USE
BOR BULAT SEDANG DENTAL USE
BOR FISSURE KECIL DENTAL USE
BOR FISSURE SILINDER BESAR DENTAL USE
BOR FISSURE SILINDER SEDANG
BOR FISSURE SILINDER TEPERED DENTAL USE
BOR INVERTED KECIL DENTAL USE
BOR INVERTED SEDANG DENTAL USE
BOR LANCIP PANJANG EDENTA
BOR TULANG UK.23MM DENTAL USE
BOR TULANG UK.28MM DENTAL USE
BOUFANT DAP
CALIXYL DENTAL USE

41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87

CATGUT CHROMIC NO 0 (WITH NEEDLE)

CATGUT CHROMIC NO 0 ROLL
CATGUT CHROMIC NO 1 (WITH NEEDLE)
CATGUT CHROMIC NO 1 (WITH NEEDLE) HR- 48 TAPER
CATGUT CHROMIC NO 1 ROLL
CATGUT CHROMIC NO 2 (WITH NEEDLE) HR-50 TAPER
CATGUT CHROMIC NO 2 ROLL
CATGUT CHROMIC NO 2/0 (WITH NEEDLE)HR-37 TAPER
CATGUT CHROMIC NO 2/0 ROLL
CATGUT CHROMIC NO 3 ROLL
CATGUT CHROMIC NO 3/0 (WITH NEEDLE)
CATGUT CHROMIC NO 3/0 ROLL
CATGUT CHROMIC NO 4/0 (WITH NEEDLE)
CATGUT CHROMIC NO 4/0 ROLL
CATGUT CHROMIC NO.3 WITH NEEDLE
CATGUT PLAIN NO 0 (WITH NEEDLE)
CATGUT PLAIN NO 0 ROLL
CATGUT PLAIN NO 1 (WITH NEEDLE)
CATGUT PLAIN NO 1 ROLL
CATGUT PLAIN NO 2 ROLL
CATGUT PLAIN NO 2/0 (WITH NEEDLE)
CATGUT PLAIN NO 2/0 ROLL
CATGUT PLAIN NO 3/0 (WITH NEEDLE)
CATGUT PLAIN NO 3/0 ROLL
CATGUT PLAIN NO 4/0 (WITH NEEDLE)HR-26 TAPER
CATGUT PLAIN NO 4/0 ROLL
CHATETER SUCTION 6
CHATETER SUCTION NO 10
CHATETER SUCTION NO 12
CHATETER SUCTION NO 8
CHATETER SUCTION NO. 14
CHATETER SUCTION NO. 16
CHATETER SUCTION NO. 18
CHKM DENTAL USE
CHLORHEXIDIN 4% SOL, 5LITER
COLAR NECK DEWASA L
COLAR NECK PEDIATRIKs
COLARNECKPEDIATRIM
COMPOSITE A 3 5 SOLARE
CRESOPHATE SEPTODONT
DEXON 1/0 9828-71
DIAPER BANITORE UKURAN L
DIAPER BANITORE UKURAN M
DISP 1 CC
DISP 20 CC
DISP 50 CC
DISP10CC

88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134

DISP3CC
DISP5CC
DISPO 50 CC LUBANG PINGGIR(WITHOUT NEEDLE)
DISPOSIBLE NEEDLE CITOJECT 30G
ELASTIC VERBAND 4 INCHI
ELASTIC VERBAND 6 INCHI
ENDOMETHASONE septodont
ENDOTRACHEAL TUBE NO 3
ENDOTRACHEAL TUBE NO 3,5
ENDOTRACHEAL TUBE NO 4
ENDOTRACHEAL TUBE NO 4,5
ENDOTRACHEAL TUBE NO 5
ENDOTRACHEAL TUBE NO 5,5
ENDOTRACHEAL TUBE NO 6
ENDOTRACHEAL TUBE NO 6,5
ENDOTRACHEAL TUBE NO 7
ENDOTRACHEAL TUBE NO 7,5
ETSAWP DENTAL
ETT NON KINGKING NO 3,5
ETT NON KINGKING NO 6
ETT NON KINGKING NO 6,5
ETT NON KINGKING NO 7
ETT NON KINGKING NO 7,5
ETT NON KINGKING NO. 8
ETTNON KINGKING NO 5
EXTENSION TUBE
FOLEY CHATETER NO 14 2 WAY
FOLEY CHATETER NO 16
FOLEY CHATETER NO 20
FOLEY CHATETER NO 20 THREE WAY (3 WAY)
FOLEY CHATETER NO 22
FOLEY CHATETER NO 8
FOLEYCHATETERN0 12
FOLEYCHATETERN0 18
FOLEYCHATETERNO10
FORMALIN SOL. 40%
FUJI II GC
GLASS IONOMER POWDER LIQUID
GUEDEL AIRWAYS DISP.STERIL NO.1
GUEDEL AIRWAYS DISP.STERIL NO.2
GUEDEL AIRWAYS DISP.STERIL NO.4
GUEDEL AIRWAYS DISP.STERIL NO.O
GYPSONA 6 INCHI
GYPSONA4INCHI
H202 (PERHYDROL) 50%
I.V CHATETER NO 18
I.V CHATETER NO 20

135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181

I.V CHATETER NO 22
I.V CHATETER NO 24
I.V CHATETER NO 26
ID BAND BAYI BLUE
ID BAND BAYI PINK
INFUSION SET MACRO
INFUSION SET MICRO
JACKSON-REES SET
JARUM CITOJECT N027 G dental use
JARUM KULIT NO. 0
JARUM KULIT NO. 10
JARUM KULIT NO. 12
JARUM KULIT NO. 8
JARUM KULIT NO.6
JARUM OTOT NO. 0
JARUM OTOT NO. 10
JARUM OTOT NO. 12
JARUM OTOT NO. 8
JARUM SPINAL NO. 25
JARUM SPINAL NO. 26G
JARUM SPINAL NO. 27G
JET NEBULIZER MASK PEDIATRIC
JET NEBULIZER MASKADULT
KANTONG DARAH 350ML
KAPAS BERLEMAK 1000G
KAPAS PUTIH 1000 G
KAPAS PUTIH 500 G
KASA ROLL 40 X 80
KASA ROLL DRC 36 M X 80 CM
KASASTERIL
KERTAS LAKMUS(OBGYN)
KRUKKETIAKL
KRUKKETIAKM
KRUKKETIAKS
L M A (LARINGEAL MASK AIRWAYS
LAMINARIA STICK
LOGICAT SET /CVC NO.12F
LOGICAT SET/CVC NO.7F
MASKER OXYGENT DEWASA rebreathing
MASKER OXYGENT PEDIATRI rebreathing
MASKER SURGICAL EARLOOP
MAYO SEGALA UKURAN (000,00,0,1,2,3,4,5) <@
MICROBRUSH BONDING APLICATOR
NASAL CAN U LA 02 DEWASA
NASAL CANUL 02 BAYI (INFANT)
NASAL CANULA 02 PEDIATRI
NEEDLE NO. 23

182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228

NELATHON CHATETER NO. 10

NELATHON CHATETER NO. 12
NELATHON CHATETER NO.16
NELATHON CHATETER NO.18
NELATHON CHATETER NO.8
NEONATAL I.VARM BOARD
ORIGINAL PERFUSSOR
PAPERPOINT GUTTA PERCHA UK. 15 40
PEDIATRIC ARM BOAR
PISPOT BAB
PLESTER HIPAVYX
PLESTER HIPAVYX 10CM X 5M (NEW)
PLESTER HIPAVYX 15CM X 5M
PLESTER ROLL
PLESTER ROLL (LEUKOPLAST 7,5 CM X 4,5M)
PLESTER WPAMPLOP
POVIDONE VAGINAL DOUCHE 100ML
POVIDONE VAGINAL DOUCHE ALAT
RESERVOIR BAG (1 LTR)
RESERVOIR BAG (2 LTR)
SARUNG TANGAN (L)
SARUNG TANGAN (M)
SARUNG TANGAN (S)
SARUNG TANGAN GYNAECOLOG PANJANG
SARUNG TANGAN NO. 7 (STERIL)
SARUNG TANGAN NO. 8 (STERIL)
SARUNG TANGAN NO.6,5 (STERiL)
SARUNG TANGAN NO.7,5 (STERiL)
SCALER MANUAL MICRO
SHARP CONTAINER 5 LTR
SILK BLACK NO. 2/0 (WITH NEEDLE) DS -24 (CUTTING)
SILK BLACK NO. 3/0 (WITH NEEDLE) DS-24 (CUTTING)
SILK BLACK NO. 1 DS-24 (CUTTING)
SILK BLACK NO. 1 HR37MM
SILK BLACK NO.2 HR-37 (TAPER)
SILK NO 1 ROLL
SILK NO 2 ROLL
SILK NO 2/0 (WITH NEEDLE) HR-26 TAPER
SILK NO 2/0 ROLL
SILK NO 3 ROLL
SILK NO 3/0 (WITH NEEDLE) HR-20 TAPER
SILK NO 3/0 ROLL
SILK NO 4/0 (WITH NEEDLE) DS-19 CUTTING
SILK NO 5/0 (WITH NEEDLE)
SILK NO. 2 WITH NEEDLE
SILK NO. 3 WITH NEEDLE
SITO BRUSH (PAP SMEAR)

229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270

SOFT BAND 4 INCHI

SOFT BAND 6 INCHI
STOMACH TUBE NO 10
STOMACH TUBE NO 12
STOMACH TUBE NO 16
STOMACH TUBE NO 18
STOMACH TUBE NO 3,5
STOMACH TUBE NO 5
STOMACH TUBE NO 6
STOMACH TUBE NO 8
SUMZEHER
SUNGKUP 02 DEWASA
SUNGKUP 02 PEDIATRI
SURGICRYL NO.2 HR 40
T- PLAIN P 87 NO.3-0
TAMBALAN SEMENTARA
T-CHROMIC C27 NO 2-0
T-CHROMIC C44 NO.3-0
T-CHROMIC C57 NO 2-0
THREE WAY
TKF
T-LENE L18 NO. 4-0
T-MONO M51 NO 3-0
T-PLAIN P121 NO 3-0
TRANSFUSION SET INFUS
TRANSMISSION JELLY 82 G
T-SILK S22 NO.3-0
T-SILK S23 NO.3-0
T-SILK S25 NO.2-0
T-SILK S78 NO 4-0
TSR
T-VIO V4 NO 3-0
ULTRACAL
ULTRASONIC GEL 5 LTR
UMBILICAL CORD CLEMP BLUE
UMBILICAL CORD CLEMP NYLON
UNDERPADS 60X90
URINE BAG
WING NEEDLE N0.23
WING NEEDLE N0.25
WING NEEDLE N0.27
XYLESTESIN A
NB : Per 1 Item Obat/Recipe dikenakan Charge Biaya Resep Rp. 500,-

DAFTAR HARGA BAHAN MEDIS HABIS PAKAI 2016

PPN
HNA
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

41,745
25,234
23,007
30,000
48,125
192,262
28,839
75,166
60,500
116,160
1,054
1,045
1,045
1,100
1,045
55,000
113,300
-

MARGIN
25
1,043,625
630,850
575,182
750,000
1,203,125
4,806,550
720,975
1,879,158
1,512,500
2,904,000
26,349
26,122
26,123
27,500
26,122
1,375,000
2,832,500
-

U R/
500
500
500

500
500
500

500
500

500
500
500
500
500
500
500
500
500
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
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

30,966
41,796
45,545
1,386,000
48,345
1,732,500
35,445
1,430,000
1,386,000
41,796
1,430,000
41,796
41,796
70,662
3,542
1,739,375
1,356,740
53,900
35,515
5,431
4,927
4,927
4,927
4,927
4,927
1,221,000
1,674
3,245
7,854
2,359

774,150
1,044,900
1,138,625
34,650,000
1,208,625
43,312,500
886,125
35,750,000
34,650,000
1,044,900
35,750,000
1,044,900
1,044,900
1,766,553
88,550
43,484,375
33,918,500
1,347,500
887,875
135,775
123,175
123,175
123,175
123,175
123,175
30,525,000
41,854
81,125
196,338
58,983

500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500

500
500
500
500
500
500
500
500

500

500
500
500
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
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

1,845
1,825
19,250
125,388
33,000
47,891
65,306
65,306
87,075
65,306
65,306
73,469
68,750
69,392
72,747
53,859
412,500
97,000
412,500
294,643
412,500
97,000
391,838
73,334
11,040
17,241
11,040
44,850
18,150
19,250
25,361
24,200
18,150
49,267
14,420
14,420
14,420
14,420
70,441
52,800
36,666
17,763
18,113

46,117
45,618
481,250
3,134,700
825,000
1,197,275
1,632,650
1,632,650
2,176,867
1,632,650
1,632,650
1,836,731
1,718,750
1,734,792
1,818,667
1,346,469
10,312,500
2,425,000
10,312,500
7,366,071
10,312,500
2,425,000
9,795,950
1,833,342
276,000
431,025
276,000
1,121,250
453,750
481,250
634,028
605,000
453,750
1,231,678
360,500
360,500
360,500
360,500
1,761,023
1,320,000
916,656
444,075
452,834

500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500

500
500
500
500
500
500
500
500
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
Rp
Rp
RP
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

8,584
17,765
23,510
1,742
1,742
11,267
14,157
125,388
22,916
22,916
22,916
41,800
50,000
65,202
55,000
46,200
157,300
100,375

214,600
444,137
587,750
43,550
43,550
281,675
353,930
3,134,700
572,907
572,907
572,905
1,045,000
1,250,000
1,630,048
1,375,000
1,155,000
3,932,500
2,509,375

500
500
500
500
500
500
500

156,735
170,000
252,344
252,344
252,344
366,666
325,000
325,000
20,900
52,245
433
12,100
6,600
11,319
-

3,918,375
4,250,000
6,308,600
6,308,600
6,308,600
9,166,659
8,125,000
8,125,000
522,500
1,306,125
10,825
302,500
165,000
282,975
-

500
500

500
500

500
500

500
500
500
500
500
500
500

500
500
500
500
500
500
500
500
500

500
500
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
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

9,613
9,613
9,613
9,613
9,613
25,705
183,334
144,100
202,617
48,382
35,532
36,049
406
406
902
10,064
17,600
17,600
17,600
60,082
25,945
25,045
26,545
16,804
24,555
715,000
22,945
616,000
22,345
25,145
47,021
47,021
47,021
-

240,325
240,325
240,325
240,325
240,325
642,625
4,583,350
3,602,500
5,065,425
1,209,556
888,300
901,225
10,156
10,156
22,550
251,592
440,000
440,000
440,000
1,502,050
648,625
626,125
663,625
420,100
613,875
17,875,000
573,625
15,400,000
558,625
628,625
1,175,525
1,175,525
1,175,525
-

500
500
500
500
500
500

500
500
500
500
500
500

500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
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
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

iaya Resep Rp. 500,-

31,350
45,100
23,792
23,792
29,040
19,250
18,000
23,792
29,040
30,477
34,830
101,200
44,700
51,500
52,500
53,500
86,434
63,200
88,150
50,000
23,471
44,000
34,500
38,000
38,500
32,500
64,200
240,328
3,004
3,004
6,008
8,309
1,932
1,932
-

783,750
1,127,500
594,800
594,800
726,000
481,250
450,000
594,800
726,000
761,925
870,750
2,530,000
1,117,500
1,287,500
1,312,500
1,337,500
2,160,843
1,580,000
2,203,750
1,250,000
586,765
1,100,000
862,500
950,000
962,500
812,500
1,605,000
6,008,200
75,100
75,100
150,200
207,733
48,300
48,300
-

500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500
500

KAI 2016
HARGA
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

1,085,870
656,584
598,689
780,500
1,251,750
4,999,312
750,314
1,954,824
1,573,500
3,020,660
27,903
27,667
27,667
29,100
27,667
1,430,500
2,946,300
-

HARGA JUAL SEBENARNYA

57,000
35,000

32,000
41,000
65,000

260,000
40,000

100,000
82,000
160,000
2,000
2,000
2,000
2,000
2,000
75,000
153,000

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

805,616
1,087,196
1,184,670
36,036,500
1,257,470
45,045,500
922,070
37,180,500
36,036,500
1,087,196
37,180,500
1,087,196
1,087,196
1,837,715
92,592
45,224,250
35,275,740
1,401,900
923,890
141,706
128,602
128,602
128,602
128,602
128,602
31,746,500
44,028
84,870
204,692
61,842

42,000
56,000
62,000
1,871,000
66,000
2,330,000
48,000
1,931,000
1,871,000
56,000
1,931,000
56,000
56,000
96,000
5,000
2,348,000
1,832,000

73,000
48,000
9,000
7,000
7,000
7,000
7,000
7,000

1,648,000

3,000
5,000
11,000
4,000

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

48,462
47,943
501,000
3,260,588
858,500
1,245,666
1,698,456
1,698,456
2,264,441
1,698,456
1,698,456
1,910,701
1,788,000
1,804,683
1,891,913
1,400,828
10,725,500
2,522,500
10,725,500
7,661,214
10,725,500
2,522,500
10,188,288
1,907,176
287,540
448,766
287,540
1,166,600
472,400
501,000
659,889
629,700
472,400
1,281,445
375,420
375,420
375,420
375,420
1,831,964
1,373,300
953,823
462,338
471,448

3,000
3,000
26,000
170,000
45,000
65,000
89,000
89,000
118,000
89,000
89,000
100,000
93,000
94,000
99,000
73,000
557,000
131,000
557,000
398,000
557,000
131,000
529,000
99,000
15,000
23,000
15,000
61,000
25,000
26,000
34,000
33,000
25,000
67,000

20,000
20,000
20,000
20,000
96,000
7,200
50,000
24,000
25,000

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

223,684
462,403
611,760
45,792
45,792
293,442
368,587
3,260,588
596,323
596,323
596,321
1,087,300
1,300,500
1,695,749
1,430,500
1,201,700
4,090,300
2,610,250
4,075,610
4,420,500
6,561,444
6,561,444
6,561,444
9,533,825
8,450,500
8,450,500
543,900
1,358,870
11,758
315,100
172,100
294,794
-

12,000
24,000
32,000
3,000
4,000
16,000
20,000
169,000
31,000

31,000
31,000

57,000
68,000
88,000
75,000
62,000
212,000
136,000
212,000
230,000

341,000
341,000
341,000
495,000
439,000
439,000
29,000
71,000
1,000

17,000
10,000
15,000

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

250,438
250,438
250,438
250,438
250,438
668,830
4,767,184
3,747,100
5,268,542
1,258,439
924,332
937,774
11,063
11,063
23,952
262,155
458,100
458,100
458,100
1,562,632
675,070
651,670
690,670
437,404
638,930
18,590,500
597,070
16,016,500
581,470
654,270
1,223,046
1,223,046
1,223,046
-

13,000
13,000
13,000
13,000
13,000
35,000

248,000
195,000
274,000
66,000
48,000
49,000

1,000
1,000
2,000
14,000
24,000
24,260
24,000
81,000
35,000
34,000
36,000
23,000
33,000
965,000
31,000
832,000
30,000
34,000
64,000
64,000
64,000

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

815,600
1,173,100
619,092
619,092
755,540
501,000
468,500
619,092
755,540
792,902
906,080
2,631,700
1,162,700
1,339,500
1,365,500
1,391,500
2,247,777
1,643,700
2,292,400
1,300,500
610,736
1,144,500
897,500
988,500
1,001,500
845,500
1,669,700
6,249,028
78,604
78,604
156,708
216,543
50,732
50,732
-

42,000
61,000
32,000
32,000
39,000
26,000
25,000
32,000
39,000
41,000
47,000
137,120
60,000
70,000
71,000
72,000
117,000
86,000
119,000
68,000
32,000
60,000
47,000
51,000
52,000
44,000
87,000
324,000
5,000
5,000
9,000
12,000
3,000
3,000

1,728.67

DAFTAR HARGA JUAL BAHAN MEDIS HABIS PAKAI 2016

NO

NAMA BMHP
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89

ALKOHOL 70 %, 1 LITER
ALKOHOL SWABS
AMBUBAG NEONATUS
AMBUBAG PEDIATRIK
AQUA STERIL FOR IRIGASI 1000ML
ARM SLING UK L
ARM SLING UK M
ARM SLING DEWASA
ARMSLING PEDIATRI
ARSEN SEPTODONT
ASEPTIC GEL 5 LITER
ASEPTIC GEL 500CC DISPENSER
B1STURINO10
BENANG VICRYL 1 POLYSORB
BENANG VICRYL 2 POLYSORB
BENANG VICRYL 2/0 POLYSORB
BENANG VICRYL 3/0 POLYSORB
BENANG VICRYL 4/0 POLYSORB
BISTURI NO 15
BISTURI NO 19
BISTURI NO 20
BISTURI NO 21
BISTURIN0 11
BLOOD BAG SINGLE 250CC (KANTONG DARAH)
BLOOD BAG TRIPLE 350CC (KANTONG DARAH)
BONDING 10 ML
BOR ARKANSAS ALPIN CA
BOR BULAT KECIL DENTAL USE
BOR BULAT SEDANG DENTAL USE
BOR FISSURE KECIL DENTAL USE
BOR FISSURE SILINDER BESAR DENTAL USE
BOR FISSURE SILINDER SEDANG
BOR FISSURE SILINDER TEPERED DENTAL USE
BOR INVERTED KECIL DENTAL USE
BOR INVERTED SEDANG DENTAL USE
BOR LANCIP PANJANG EDENTA
BOR TULANG UK.23MM DENTAL USE
BOR TULANG UK.28MM DENTAL USE
BOUFANT DAP
CALIXYL DENTAL USE
CATGUT CHROMIC NO 0 (WITH NEEDLE)
CATGUT CHROMIC NO 0 ROLL
CATGUT CHROMIC NO 1 (WITH NEEDLE)
CATGUT CHROMIC NO 1 (WITH NEEDLE) HR- 48 TAPER
CATGUT CHROMIC NO 1 ROLL
CATGUT CHROMIC NO 2 (WITH NEEDLE) HR-50 TAPER
CATGUT CHROMIC NO 2 ROLL
CATGUT CHROMIC NO 2/0 (WITH NEEDLE)HR-37 TAPER
CATGUT CHROMIC NO 2/0 ROLL
CATGUT CHROMIC NO 3 ROLL
CATGUT CHROMIC NO 3/0 (WITH NEEDLE)
CATGUT CHROMIC NO 3/0 ROLL
CATGUT CHROMIC NO 4/0 (WITH NEEDLE)
CATGUT CHROMIC NO 4/0 ROLL
CATGUT CHROMIC NO.3 WITH NEEDLE
CATGUT PLAIN NO 0 (WITH NEEDLE)
CATGUT PLAIN NO 0 ROLL
CATGUT PLAIN NO 1 (WITH NEEDLE)
CATGUT PLAIN NO 1 ROLL
CATGUT PLAIN NO 2 ROLL
CATGUT PLAIN NO 2/0 (WITH NEEDLE)
CATGUT PLAIN NO 2/0 ROLL
CATGUT PLAIN NO 3/0 (WITH NEEDLE)
CATGUT PLAIN NO 3/0 ROLL
CATGUT PLAIN NO 4/0 (WITH NEEDLE)HR-26 TAPER
CATGUT PLAIN NO 4/0 ROLL
CHATETER SUCTION 6
CHATETER SUCTION NO 10
CHATETER SUCTION NO 12
CHATETER SUCTION NO 8
CHATETER SUCTION NO. 14
CHATETER SUCTION NO. 16
CHATETER SUCTION NO. 18
CHKM DENTAL USE
CHLORHEXIDIN 4% SOL, 5LITER
COLAR NECK DEWASA L
COLAR NECK PEDIATRIKs
COLARNECKPEDIATRIM
COMPOSITE A 3 5 SOLARE
CRESOPHATE SEPTODONT
DEXON 1/0 9828-71
DIAPER BANITORE UKURAN L
DIAPER BANITORE UKURAN M
DISP 1 CC
DISP 20 CC
DISP 50 CC
DISP10CC
DISP3CC
DISP5CC

HNA
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

37,950
22,940
20,916
27,273
43,750
174,784
26,217
68,333
55,000
105,600
958
950
950
1,000
950
50,000
103,000
28,151
37,996
41,405
1,260,000
43,950
1,575,000
32,223
1,300,000
1,260,000
37,996
1,300,000
37,996
37,996
64,238
3,220
1,581,250
1,233,400
49,000
32,286
4,937
4,479
4,479
4,479
4,479
4,479
1,110,000
1,522
2,950
7,140
2,145
1,677
1,659

MARGIN
35%
13,283
8,029
7,321
9,545
15,313
61,174
9,176
23,917
19,250
36,960
335
332
332
350
332
17,500
36,050
9,853
13,299
14,492
441,000
15,383
551,250
11,278
455,000
441,000
13,299
455,000
13,299
13,299
22,483
1,127
553,438
431,690
17,150
11,300
1,728
1,568
1,568
1,568
1,568
1,568
388,500
533
1,033
2,499
751
587
581

HARGA DPP

51,233
30,969
28,236
36,818
59,063
235,958
35,393
92,250
74,250
142,560
1,294
1,282
1,282
1,350
1,282
67,500
139,050
38,004
51,295
55,896
1,701,000
59,333
2,126,250
43,501
1,755,000
1,701,000
51,295
1,755,000
51,295
51,295
86,722
4,347
2,134,688
1,665,090
66,150
43,587
6,665
6,047
6,047
6,047
6,047
6,047
1,498,500
2,055
3,983
9,638
2,896
2,264
2,239

PPN
10%
5,123
3,097
2,824
3,682
5,906
23,596
3,539
9,225
7,425
14,256
129
128
128
135
128
6,750
13,905
3,800
5,130
5,590
170,100
5,933
212,625
4,350
175,500
170,100
5,130
175,500
5,130
5,130
8,672
435
213,469
166,509
6,615
4,359
667
605
605
605
605
605
149,850
205
398
964
290
226
224

HARGA FIX

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

56,356
34,066
31,060
40,500
64,969
259,554
38,933
101,475
81,675
156,816
1,423
1,411
1,411
1,485
1,411
74,250
152,955
41,804
56,425
61,486
1,871,100
65,266
2,338,875
47,851
1,930,500
1,871,100
56,425
1,930,500
56,425
56,425
95,394
4,782
2,348,156
1,831,599
72,765
47,945
7,332
6,651
6,651
6,651
6,651
6,651
1,648,350
2,260
4,381
10,602
3,185
2,490
2,463

HARGA PEMBULATAN

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

56,400
34,100
31,100
40,500
65,000
259,600
38,900
101,500
81,700
156,800
1,400
1,400
1,400
1,500
1,400
74,300
153,000
41,800
56,400
61,500
1,871,100
65,300
2,338,900
47,900
1,930,500
1,871,100
56,400
1,930,500
56,400
56,400
95,400
4,800
2,348,200
1,831,600
72,800
47,900
7,300
6,700
6,700
6,700
6,700
6,700
1,648,400
2,300
4,400
10,600
3,200
2,500
2,500

90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182

DISPO 50 CC LUBANG PINGGIR(WITHOUT NEEDLE)

DISPOSIBLE NEEDLE CITOJECT 30G
ELASTIC VERBAND 4 INCHI
ELASTIC VERBAND 6 INCHI
ENDOMETHASONE septodont
ENDOTRACHEAL TUBE NO 3
ENDOTRACHEAL TUBE NO 3,5
ENDOTRACHEAL TUBE NO 4
ENDOTRACHEAL TUBE NO 4,5
ENDOTRACHEAL TUBE NO 5
ENDOTRACHEAL TUBE NO 5,5
ENDOTRACHEAL TUBE NO 6
ENDOTRACHEAL TUBE NO 6,5
ENDOTRACHEAL TUBE NO 7
ENDOTRACHEAL TUBE NO 7,5
ETSAWP DENTAL
ETT NON KINGKING NO 3,5
ETT NON KINGKING NO 6
ETT NON KINGKING NO 6,5
ETT NON KINGKING NO 7
ETT NON KINGKING NO 7,5
ETT NON KINGKING NO. 8
ETTNON KINGKING NO 5
EXTENSION TUBE
FOLEY CHATETER NO 14 2 WAY
FOLEY CHATETER NO 16
FOLEY CHATETER NO 20
FOLEY CHATETER NO 20 THREE WAY (3 WAY)
FOLEY CHATETER NO 22
FOLEY CHATETER NO 8
FOLEYCHATETERN0 12
FOLEYCHATETERN0 18
FOLEYCHATETERNO10
FORMALIN SOL. 40%
FUJI II GC
GLASS IONOMER POWDER LIQUID
GUEDEL AIRWAYS DISP.STERIL NO.1
GUEDEL AIRWAYS DISP.STERIL NO.2
GUEDEL AIRWAYS DISP.STERIL NO.4
GUEDEL AIRWAYS DISP.STERIL NO.O
GYPSONA 6 INCHI
GYPSONA4INCHI
H202 (PERHYDROL) 50%
I.V CHATETER NO 18
I.V CHATETER NO 20
I.V CHATETER NO 22
I.V CHATETER NO 24
I.V CHATETER NO 26
ID BAND BAYI BLUE
ID BAND BAYI PINK
INFUSION SET MACRO
INFUSION SET MICRO
JACKSON-REES SET
JARUM CITOJECT N027 G dental use
JARUM KULIT NO. 0
JARUM KULIT NO. 10
JARUM KULIT NO. 12
JARUM KULIT NO. 8
JARUM KULIT NO.6
JARUM OTOT NO. 0
JARUM OTOT NO. 10
JARUM OTOT NO. 12
JARUM OTOT NO. 8
JARUM SPINAL NO. 25
JARUM SPINAL NO. 26G
JARUM SPINAL NO. 27G
JET NEBULIZER MASK PEDIATRIC
JET NEBULIZER MASKADULT
KANTONG DARAH 350ML
KAPAS BERLEMAK 1000G
KAPAS PUTIH 1000 G
KAPAS PUTIH 500 G
KASA ROLL 40 X 80
KASA ROLL DRC 36 M X 80 CM
KASASTERIL
KERTAS LAKMUS(OBGYN)
KRUKKETIAKL
KRUKKETIAKM
KRUKKETIAKS
L M A (LARINGEAL MASK AIRWAYS
LAMINARIA STICK
LOGICAT SET /CVC NO.12F
LOGICAT SET/CVC NO.7F
MASKER OXYGENT DEWASA rebreathing
MASKER OXYGENT PEDIATRI rebreathing
MASKER SURGICAL EARLOOP
MAYO SEGALA UKURAN (000,00,0,1,2,3,4,5) <@
MICROBRUSH BONDING APLICATOR
NASAL CAN U LA 02 DEWASA
NASAL CANUL 02 BAYI (INFANT)
NASAL CANULA 02 PEDIATRI
NEEDLE NO. 23
NELATHON CHATETER NO. 10

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

17,500
113,989
30,000
43,537
59,369
59,369
79,159
59,369
59,369
66,790
62,500
63,083
66,133
48,963
375,000
88,182
375,000
267,857
375,000
88,182
356,216
66,667
10,036
15,674
10,036
40,773
16,500
17,500
23,056
22,000
16,500
44,788
13,109
13,109
13,109
13,109
64,037
48,000
33,333
16,148
16,467
7,804
16,150
21,373
1,584
1,584
10,243
12,870
113,989
20,833
20,833
20,833
38,000
45,455
59,274
50,000
42,000
143,000
91,250
142,486
154,545
229,404
229,404
229,404
333,333
295,455
295,455
19,000
47,495
394
11,000
6,000
10,290
8,739

6,125
39,896
10,500
15,238
20,779
20,779
27,706
20,779
20,779
23,377
21,875
22,079
23,147
17,137
131,250
30,864
131,250
93,750
131,250
30,864
124,676
23,333
3,513
5,486
3,513
14,270
5,775
6,125
8,069
7,700
5,775
15,676
4,588
4,588
4,588
4,588
22,413
16,800
11,667
5,652
5,763
2,731
5,653
7,480
554
554
3,585
4,505
39,896
7,292
7,292
7,292
13,300
15,909
20,746
17,500
14,700
50,050
31,938
49,870
54,091
80,291
80,291
80,291
116,667
103,409
103,409
6,650
16,623
138
3,850
2,100
3,602
3,059

23,625
153,885
40,500
58,775
80,148
80,148
106,864
80,148
80,148
90,167
84,375
85,163
89,280
66,099
506,250
119,045
506,250
361,607
506,250
119,045
480,892
90,000
13,549
21,159
13,549
55,043
22,275
23,625
31,125
29,700
22,275
60,464
17,697
17,697
17,697
17,697
86,450
64,800
44,999
21,800
22,230
10,535
21,803
28,853
2,138
2,138
13,828
17,375
153,885
28,125
28,125
28,124
51,300
61,364
80,021
67,500
56,700
193,050
123,188
192,357
208,636
309,695
309,695
309,695
450,000
398,864
398,864
25,650
64,119
531
14,850
8,100
13,892
11,798

2,363
15,389
4,050
5,878
8,015
8,015
10,686
8,015
8,015
9,017
8,438
8,516
8,928
6,610
50,625
11,905
50,625
36,161
50,625
11,905
48,089
9,000
1,355
2,116
1,355
5,504
2,228
2,363
3,113
2,970
2,228
6,046
1,770
1,770
1,770
1,770
8,645
6,480
4,500
2,180
2,223
1,053
2,180
2,885
214
214
1,383
1,737
15,389
2,812
2,812
2,812
5,130
6,136
8,002
6,750
5,670
19,305
12,319
19,236
20,864
30,969
30,969
30,969
45,000
39,886
39,886
2,565
6,412
53
1,485
810
1,389
1,180

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

25,988
169,274
44,550
64,653
88,163
88,163
117,551
88,163
88,163
99,183
92,813
93,679
98,208
72,709
556,875
130,950
556,875
397,768
556,875
130,950
528,981
99,000
14,904
23,275
14,904
60,548
24,503
25,988
34,238
32,670
24,503
66,511
19,467
19,467
19,467
19,467
95,095
71,280
49,499
23,980
24,453
11,588
23,983
31,739
2,352
2,352
15,210
19,112
169,274
30,937
30,937
30,937
56,430
67,500
88,023
74,250
62,370
212,355
135,506
211,592
229,500
340,664
340,664
340,664
495,000
438,750
438,750
28,215
70,531
585
16,335
8,910
15,281
12,978

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

26,000
169,300
44,600
64,600
88,200
88,200
117,600
88,200
88,200
99,200
92,800
93,700
98,200
72,700
556,900
131,000
556,900
397,800
556,900
131,000
529,000
99,000
14,900
23,300
14,900
60,500
24,500
26,000
34,200
32,700
24,500
66,500
19,500
19,500
19,500
19,500
95,100
71,300
49,500
24,000
24,500
11,600
24,000
31,700
2,400
2,400
15,200
19,100
169,300
30,900
30,900
30,900
56,400
67,500
88,000
74,300
62,400
212,400
135,500
211,600
229,500
340,700
340,700
340,700
495,000
438,800
438,800
28,200
70,500
600
16,300
8,900
15,300
13,000

183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253

NELATHON CHATETER NO. 12

NELATHON CHATETER NO.16
NELATHON CHATETER NO.18
NELATHON CHATETER NO.8
NEONATAL I.VARM BOARD
ORIGINAL PERFUSSOR
PAPERPOINT GUTTA PERCHA UK. 15 40
PEDIATRIC ARM BOAR
PISPOT BAB
PLESTER HIPAVYX
PLESTER HIPAVYX 10CM X 5M (NEW)
PLESTER HIPAVYX 15CM X 5M
PLESTER ROLL
PLESTER ROLL (LEUKOPLAST 7,5 CM X 4,5M)
PLESTER WPAMPLOP
POVIDONE VAGINAL DOUCHE 100ML
POVIDONE VAGINAL DOUCHE ALAT
RESERVOIR BAG (1 LTR)
RESERVOIR BAG (2 LTR)
SARUNG TANGAN (L)
SARUNG TANGAN (M)
SARUNG TANGAN (S)
SARUNG TANGAN GYNAECOLOG PANJANG
SARUNG TANGAN NO. 7 (STERIL)
SARUNG TANGAN NO. 8 (STERIL)
SARUNG TANGAN NO.6,5 (STERiL)
SARUNG TANGAN NO.7,5 (STERiL)
SCALER MANUAL MICRO
SHARP CONTAINER 5 LTR
SILK BLACK NO. 2/0 (WITH NEEDLE) DS -24 (CUTTING)
SILK BLACK NO. 3/0 (WITH NEEDLE) DS-24 (CUTTING)
SILK BLACK NO. 1 DS-24 (CUTTING)
SILK BLACK NO. 1 HR37MM
SILK BLACK NO.2 HR-37 (TAPER)
SILK NO 1 ROLL
SILK NO 2 ROLL
SILK NO 2/0 (WITH NEEDLE) HR-26 TAPER
SILK NO 2/0 ROLL
SILK NO 3 ROLL
SILK NO 3/0 (WITH NEEDLE) HR-20 TAPER
SILK NO 3/0 ROLL
SILK NO 4/0 (WITH NEEDLE) DS-19 CUTTING
SILK NO 5/0 (WITH NEEDLE)
SILK NO. 2 WITH NEEDLE
SILK NO. 3 WITH NEEDLE
SITO BRUSH (PAP SMEAR)
SOFT BAND 4 INCHI
SOFT BAND 6 INCHI
STOMACH TUBE NO 10
STOMACH TUBE NO 12
STOMACH TUBE NO 16
STOMACH TUBE NO 18
STOMACH TUBE NO 3,5
STOMACH TUBE NO 5
STOMACH TUBE NO 6
STOMACH TUBE NO 8
SUMZEHER
SUNGKUP 02 DEWASA
SUNGKUP 02 PEDIATRI
SURGICRYL NO.2 HR 40
T- PLAIN P 87 NO.3-0
TAMBALAN SEMENTARA
T-CHROMIC C27 NO 2-0
T-CHROMIC C44 NO.3-0
T-CHROMIC C57 NO 2-0
THREE WAY
TKF
T-LENE L18 NO. 4-0
T-MONO M51 NO 3-0
T-PLAIN P121 NO 3-0
TRANSFUSION SET INFUS

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

8,739
8,739
8,739
8,739
23,368
166,667
131,000
184,197
43,984
32,302
32,772
369
369
820
9,149
16,000
16,000
16,000
54,620
23,586
22,768
24,132
15,276
22,323
650,000
20,859
560,000
20,314
22,859
42,746
42,746
42,746
28,500
41,000
21,629
21,629
26,400
17,500
16,364
21,629
26,400
27,706
31,664
92,000
40,636
46,818
47,727
48,636
78,576
57,455
80,136
45,455
21,337

3,059
3,059
3,059
3,059
8,179
58,334
45,850
64,469
15,394
11,306
11,470
129
129
287
3,202
5,600
5,600
5,600
19,117
8,255
7,969
8,446
5,347
7,813
227,500
7,301
196,000
7,110
8,001
14,961
14,961
14,961
9,975
14,350
7,570
7,570
9,240
6,125
5,727
7,570
9,240
9,697
11,082
32,200
14,223
16,386
16,705
17,023
27,502
20,109
28,048
15,909
7,468

11,798
11,798
11,798
11,798
31,547
225,001
176,850
248,666
59,378
43,607
44,242
499
499
1,107
12,351
21,600
21,600
21,600
73,737
31,842
30,737
32,578
20,623
30,136
877,500
28,160
756,000
27,423
30,860
57,708
57,708
57,708
38,475
55,350
29,199
29,199
35,640
23,625
22,091
29,199
35,640
37,404
42,746
124,200
54,859
63,205
64,432
65,659
106,078
77,564
108,184
61,364
28,805

1,180
1,180
1,180
1,180
3,155
22,500
17,685
24,867
5,938
4,361
4,424
50
50
111
1,235
2,160
2,160
2,160
7,374
3,184
3,074
3,258
2,062
3,014
87,750
2,816
75,600
2,742
3,086
5,771
5,771
5,771
3,848
5,535
2,920
2,920
3,564
2,363
2,209
2,920
3,564
3,740
4,275
12,420
5,486
6,320
6,443
6,566
10,608
7,756
10,818
6,136
2,880

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

12,978
12,978
12,978
12,978
34,702
247,501
194,535
273,533
65,316
47,968
48,666
548
548
1,218
13,586
23,760
23,760
23,760
81,111
35,026
33,811
35,836
22,685
33,149
965,250
30,976
831,600
30,166
33,946
63,478
63,478
63,478
42,323
60,885
32,119
32,119
39,204
25,988
24,300
32,119
39,204
41,144
47,021
136,620
60,345
69,525
70,875
72,225
116,686
85,320
119,003
67,500
31,685

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

13,000
13,000
13,000
13,000
34,700
247,500
194,500
273,500
65,300
48,000
48,700
500
500
1,200
13,600
23,800
23,800
23,800
81,100
35,000
33,800
35,800
22,700
33,100
965,300
31,000
831,600
30,200
33,900
63,500
63,500
63,500
42,300
60,900
32,100
32,100
39,200
26,000
24,300
32,100
39,200
41,100
47,000
136,600
60,300
69,500
70,900
72,200
116,700
85,300
119,000
67,500
31,700

254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270

TRANSMISSION JELLY 82 G
T-SILK S22 NO.3-0
T-SILK S23 NO.3-0
T-SILK S25 NO.2-0
T-SILK S78 NO 4-0
TSR
T-VIO V4 NO 3-0
ULTRACAL
ULTRASONIC GEL 5 LTR
UMBILICAL CORD CLEMP BLUE
UMBILICAL CORD CLEMP NYLON
UNDERPADS 60X90
URINE BAG
WING NEEDLE N0.23
WING NEEDLE N0.25
WING NEEDLE N0.27
XYLESTESIN A

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

40,000
31,364
34,545
35,000
29,545
58,364
218,480
2,731
2,731
5,462
7,554
1,756
1,756
-

14,000
10,977
12,091
12,250
10,341
20,427
76,468
956
956
1,912
2,644
615
615
-

54,000
42,341
46,636
47,250
39,886
78,791
294,948
3,687
3,687
7,373
10,198
2,371
2,371
-

5,400
4,234
4,664
4,725
3,989
7,879
29,495
369
369
737
1,020
237
237
-

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

59,400
46,575
51,300
51,975
43,875
86,670
324,443
4,055
4,055
8,111
11,218
2,608
2,608
-

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

59,400
46,600
51,300
52,000
43,900
86,700
324,400
4,100
4,100
8,100
11,200
2,600
2,600
-

Teminabuan, 01 Juni 2016

Plt. DIREKTUR RSUD SCHOLOO KEYEN

dr.FELIX DUWIT,MSc, MPH, SpPD

NIP. 19670812 199712 1 001