Laporan Igd 2018

LAPORAN STOK OPNAME OBAT GENERIK BPJS DEPO FARMASI IGD PERIODE MARET 2018
INSTALASI FARMASI RSUD PAMBALAH BATUNG
HARGA HARGA
STOK STOK
NO NAMA OBAT SATUAN SATUAN FEB SATUAN PEMASUKAN total ED
AWAL AKHIR
(2017) MARET (2018)
SEDIAAN INFUS
1 Aqua Pro Injeksi floz Rp 2,750 Rp 2,750 87 - -

2 Asering Infus kolf Rp 9,275 Rp 9,275 28 - -
3 Ciprofloksasin infus botol Rp 10,890 Rp 10,890 - -
4 D40 % floz Rp 3,963 Rp 3,963 15 - -
5 D5 % 1/2 Infus kolf Rp 9,415 Rp 9,415 18 - -
6 D5 % 1/4 Infus kolf Rp 9,360 Rp 9,360 - -
7 Fluconazol infus botol Rp 29,540 Rp 29,540 - -
8 Futrolit softbag Rp 39,327 Rp 39,327 - -
9 Glukosa 10 kolf Rp 7,500 Rp 7,500 10 - -
10 Glukosa 5 kolf Rp 7,287 Rp 7,287 12 - -
11 Hidromal softbag Rp 49,600 Rp 49,600 - -
12 KCl floz Rp 7,524 Rp 7,524 22 - -
13 Levofloksasin 500 mg botol Rp 26,881 Rp 26,881 13 - -
14 Levofloksasin 750mg botol Rp 136,125 Rp 136,125 8 - -
15 Manitol kolf Rp 44,000 Rp 44,000 6 - -
16 Metronidazol infus botol Rp 9,680 Rp 9,680 22 - -
17 Meylon inj floz Rp 10,890 Rp 10,890 5 - -
18 MgSO4 20 % floz Rp 3,200 Rp 3,200 - -
19 MgSO4 40 % floz Rp 3,650 Rp 3,650 4 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
20 Moxifloxacin inf botol Rp 214,500 Rp 214,500 2 - -

21 Nacl kolf Rp 6,292 Rp 6,292 37 - -
22 Paracetamol infus botol Rp 30,250 Rp 30,250 - -
23 RL infus kolf Rp 7,095 Rp 7,095 27 - -
24 Kendal Infus kolf Rp 47,272 Rp 47,272 4 - -
SEDIAAN MATA, KULIT, DLL
1 Asiklovir salep kulit tube Rp 2,997 Rp 2,997 6 - -

2 Avamys tabung Rp 102,999 Rp 102,999 - -
3 Berotec inhaler tabung Rp 80,000 Rp 80,000 0 - -
4 Betametason SK tube Rp 2,026 Rp 2,026 27 - -
5 Bioplacenton salep Rp 13,557 Rp 13,557 12 - -
6 Burnazin cream tube Rp 52,376 Rp 52,376 4 - -
7 Combivent nebules amp/vial Rp 5,700 Rp 5,700 129 - -
8 Fenol Gliserol tube Rp 2,246 Rp 2,246 - -
9 Genoin Salep tube Rp 5,104 Rp 5,104 - -
10 Gentamisin Salep kulit / genoint tube Rp 2,126 Rp 2,126 19 - -
11 Gentamisin salep mata tube Rp 3,960 Rp 3,960 - -
12 Gentamisin tetes mata botol Rp 3,297 Rp 3,297 - -
13 Gentian violet botol Rp 6,655 Rp 6,655 - -
14 Hidrokortison salep kulit tube Rp 11,132 Rp 11,132 29 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
15 Iliadin Spray botol Rp 37,900 Rp 37,900 - -

16 Ketokonazole salep kulit tube Rp 2,200 Rp 2,200 3 - -
17 Kloramfenikol salep mata tube Rp 1,850 Rp 1,850 - -
18 Kloramfenikol tetes mata botol Rp 2,750 Rp 2,750 - -
19 Miconazole salep kulit tube Rp 3,736 Rp 3,736 28 - -
20 Oksitetrasiklin salep kulit tube Rp 1,649 Rp 1,649 - -
21 Oksitetrasiklin salep mata tube Rp 2,772 Rp 2,772 - -
22 PK botol Rp 3,300 Rp 3,300 - -
SEDIAAN SIRUP
1 Ambroxol sirup 15mg botol Rp 3,627 Rp 3,627 3 - -

2 Amoksilin Sirup botol Rp 5,626 Rp 5,626 8 - -
3 Amoxillin drop botol Rp 10,780 Rp 10,780 - -
4 Antasida sirup botol Rp 3,184 Rp 3,184 0 - -
5 Cefadroxyl syr botol Rp 4,999 Rp 4,999 - -
6 Cefixime sirup botol Rp 11,880 Rp 11,880 0 - -
7 Cetirizin syr botol Rp 10,440 Rp 10,440 15 - -
8 Cloramfenikol Sirup botol Rp 7,783 Rp 7,783 - -
9 Cotrimoksazol Sirup botol Rp 2,225 Rp 2,225 12 - -
10 Domperidon Sirup botol Rp 9,000 Rp 9,000 7 - -
11 Gavistal / Metoklopramid botol Rp 2,520 Rp 2,520 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
12 Ibuprofen syr 100 mg botol Rp 4,225 Rp 4,225 6 - -

13 Lactulax botol Rp 48,400 Rp 48,400 - -
14 Nystatin drop botol Rp 21,780 Rp 21,780 14 - -
15 OBH botol Rp 4,100 Rp 4,100 - -
16 Paracetamol drop botol Rp 8,124 Rp 8,124 13 - -
17 Paracetamol sirup botol Rp 1,012 Rp 1,012 23 - -
18 Plantacid syr botol Rp 8,910 Rp 8,910 1 - -
19 Salbutamol syr botol Rp 4,916 Rp 4,916 11 - -
20 Sucralfat Syr botol Rp 10,100 Rp 10,100 10 - -
SEDIAAN TABLET ORAL
1 Acarbose 50 (Eclid) tab / cap Rp 657 Rp 657 - -

2 Acetyl systein tab / cap Rp 1,100 Rp 1,100 35 - -
3 Allopurinol tab 100 MG tab / cap Rp 120 Rp 120 70 - -
4 Allopurinol tab 300 MG tab / cap Rp 230 Rp 230 - -
5 Ambroxol tab tab / cap Rp 744 Rp 744 111 - -
6 Aminofilin tab tab / cap Rp 103 Rp 103 95 - -
7 Amlodipin 10 mg tab / cap Rp 167 Rp 167 197 - -
8 Amlodipin 5 mg tab tab / cap Rp 116 Rp 116 311 - -
9 Amoksilin 500 mg tab tab / cap Rp 209 Rp 209 99 - -
10 Amvar tab / cap Rp 5,445 Rp 5,445 47 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
11 antasida tab tab / cap Rp 59 Rp 59 45 - -

12 Asam Folat tab / cap Rp 138 Rp 138 504 - -
13 Asam Mefenamat tab / cap Rp 102 Rp 102 78 - -
14 Asam Tranexamat 500 tab / cap Rp 1,069 Rp 1,069 121 - -
15 Asiklovir 200 mg tab / cap Rp 359 Rp 359 - -
16 Asiklovir 400 mg tab / cap Rp 571 Rp 571 70 - -
17 Aspar k tab (Kalipar) tab / cap Rp 682 Rp 682 38 - -
18 Aspilet tab / cap Rp 94 Rp 94 35 - -
19 Atorvastatin 10 mg tab / cap Rp 1,892 Rp 1,892 177 - -
20 Atorvastatin 20 mg tab / cap Rp 2,989 Rp 2,989 174 - -
21 Attalpugit (Pularex) tab / cap Rp 160 Rp 160 206 - -
22 Azitromisin 500 mg tab / cap Rp 8,800 Rp 8,800 - -
23 Betahistin tab tab / cap Rp 151 Rp 151 27 - -
24 Bisakodil (Dulkolax) tab tab / cap Rp 1,030 Rp 1,030 50 - -
25 Bisoprolol 2,5 mg / concor tab / cap Rp 650 Rp 650 - -
26 Bisoprolol 5 mg tab / cap Rp 298 Rp 298 268 - -
27 Calsium Lactat tab / cap Rp 57 Rp 57 113 - -
Candersartan 8 mg (canderin) tab / cap Rp 770 Rp 770 158 - -
28 Candesartan 16 mg tab / cap Rp - Rp - 204 - -
29 Captopril 12,5 mg tab / cap Rp 69 Rp 69 256 - -
30 Captopril 25 mg tab / cap Rp 105 Rp 105 279 - -
31 Cefadroxyl 500 tab / cap Rp 560 Rp 560 415 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
32 Cefiksim 100 mg tab / cap Rp 1,676 Rp 1,676 220 - -

33 Cetirizin 10 mg tab / cap Rp 120 Rp 120 287 - -
34 Cilostazol tab 100 mg tab / cap Rp 8,000 Rp 8,000 189 - -
35 Ciproflokasin 500 mg tab / cap Rp 320 Rp 320 192 - -
36 Citicolin 500 mg tab / cap Rp 5,940 Rp 5,940 30 - -
37 Clindamisin 300 mg tab / cap Rp 660 Rp 660 - -
38 Clonidin tab tab / cap Rp 205 Rp 205 100 - -
39 Clopidogrel tab / cap Rp 1,799 Rp 1,799 243 - -
40 Co- amoxiclav tab / cap Rp 5,808 Rp 5,808 100 - -
41 Cotrimoxazol 480 tab tab / cap Rp 267 Rp 267 - -
42 CTM tab tab / cap Rp 45 Rp 45 51 - -
43 Curcuma tab tab / cap Rp 78 Rp 78 132 - -
44 Cytodrox tab / cap Rp 5,280 Rp 5,280 - -
45 Dexametason tab tab / cap Rp 92 Rp 92 70 - -
46 Dexketopropen tab / cap Rp 2,970 Rp 2,970 - -
47 Digoksin tab tab / cap Rp 109 Rp 109 90 - -
48 Diltiazem 30 mg tab / cap Rp 144 Rp 144 - -
49 Dimenhidrinat tab / cap Rp 142 Rp 142 - -
50 Doksisiklin tab tab / cap Rp 290 Rp 290 - -
51 Domperidone tab tab / cap Rp 118 Rp 118 53 - -
52 Dopamet tab / cap Rp 1,050 Rp 1,050 - -
53 Eperison (Perilax) tab / cap Rp 1,309 Rp 1,309 418 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
54 Erytromisin 250 mg tab / cap Rp 509 Rp 509 - -

55 Etambutol tab tab / cap Rp 574 Rp 574 - -
56 Fenofibrate 100 mg tab / cap Rp 605 Rp 605 - -
57 Fenofibrate 300 mg tab / cap Rp 1,303 Rp 1,303 - -
58 Ferrosulfat tab / cap Rp 400 Rp 400 47 - -
59 Finasteride 5 mg tab / finro tab / cap Rp 1,919 Rp 1,919 27 - -
60 Fluconazol tab / cap Rp 20,700 Rp 20,700 - -
61 Flunarizine 10 mg tab / cap Rp 3,325 Rp 3,325 - -
62 Flunarizine 5 mg tab / cap Rp 2,090 Rp 2,090 88 - -
63 Furosemid tab tab / cap Rp 181 Rp 181 179 - -
64 Gabexal tab / cap Rp 1,639 Rp 1,639 - -
65 Gemfibrozil 300 mg tab / cap Rp 386 Rp 386 - -
66 GG tab tab / cap Rp 45 Rp 45 41 - -
67 Glibenklamid tab tab / cap Rp 92 Rp 92 90 - -
68 Glikuidon (Lodem) tab / cap Rp 3,648 Rp 3,648 - -
69 Glimepirid 2 mg tab / cap Rp 296 Rp 296 137 - -
70 Glimepirid 3 mg tab / cap Rp 319 Rp 319 - -
71 Glukodex tab / cap Rp 245 Rp 245 - -
72 Glukosamine tab tab / cap Rp 704 Rp 704 5 - -
73 Harnal / Hytroz tab / cap Rp 1,425 Rp 1,425 - -
74 Herbesser tab / cap Rp 4,290 Rp 4,290 - -
75 Hidroklorotiazid 25 mg tab / cap Rp 171 Rp 171 205 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
76 Ibuprofen 400 mg tab tab / cap Rp 180 Rp 180 70 - -

77 Interhistin tab tab / cap Rp 589 Rp 589 - -
78 Isoniazid 300 mg tab / cap Rp 116 Rp 116 - -
79 Isosorbid Dinitrat 5 mg tab / cap Rp 104 Rp 104 309 - -
80 Ketokonazole tab tab / cap Rp 340 Rp 340 200 - -
81 Ketorolac tab tab / cap Rp 2,151 Rp 2,151 199 - -
82 KSR tab / cap Rp 1,700 Rp 1,700 77 - -
83 Lansoprazole tab / cap Rp 878 Rp 878 59 - -
84 Levofloksasin 500 mg tab tab / cap Rp 686 Rp 686 30 - -
85 Lisinopril 10 mg / noperten tab / cap Rp 485 Rp 485 195 - -
86 Lisinopril 5 mg / noperten tab / cap Rp 410 Rp 410 150 - -
87 Loperamid tab tab / cap Rp 105 Rp 105 56 - -
88 Loratadine tab tab / cap Rp 233 Rp 233 75 - -
89 Mecobalamin tab tab / cap Rp 654 Rp 654 84 - -
90 Meloksikam 15 mg tab / cap Rp 731 Rp 731 200 - -
91 Meloksikam 7,5 mg tab / cap Rp 397 Rp 397 200 - -
92 Metformin tab tab / cap Rp 110 Rp 110 93 - -
93 Metil ergometrin tab tab / cap Rp 271 Rp 271 - -
94 Metilprednisolon 16 mg tab / cap Rp 1,169 Rp 1,169 90 - -
95 Metilprednisolon 4 mg tab / cap Rp 220 Rp 220 280 - -
96 Metilprednisolon 8 mg tab / cap Rp 393 Rp 393 190 - -
97 Metochlorpramid tab tab / cap Rp 143 Rp 143 95 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
98 Metronidazol tab tab / cap Rp 273 Rp 273 55 - -

99 Micardis tab / cap Rp 7,150 Rp 7,150 - -
100 Na diklofenak 50 mg tab / cap Rp 245 Rp 245 210 - -
101 Natrium Bicarbonat tab / cap Rp 110 Rp 110 73 - -
102 Neurodex tab tab / cap Rp 484 Rp 484 204 - -
103 Nifedipin tab tab / cap Rp 110 Rp 110 96 - -
104 Norelut / Norestil tab / cap Rp 2,552 Rp 2,552 - -
105 Omeprazole tab tab / cap Rp 326 Rp 326 318 - -
106 Ondansetron tab 4 MG tab / cap Rp 523 Rp 523 5 - -
107 Ondansetron tab 8 MG tab / cap Rp 440 Rp 440 194 - -
108 Oralit tab / cap Rp 418 Rp 418 23 - -
109 Ostovel tab / cap Rp 1,690 Rp 1,690 - -
110 Parasetamol 500 mg tab / cap Rp 142 Rp 142 323 - -
111 pioglitazone (deculin) 15 mg tab / cap Rp 3,300 Rp 3,300 - -
112 Pioglitazone (deculin) 30 mg tab / cap Rp 4,950 Rp 4,950 - -
113 Piracetam 1200 mg tab / cap Rp 1,166 Rp 1,166 171 - -
114 Piracetam 800 mg tab / cap Rp 682 Rp 682 - -
115 Pirazinamid 500 mg tab / cap Rp 238 Rp 238 - -
116 Prednison tab / cap Rp 144 Rp 144 - -
117 Pregabalin 75 mg tab / cap Rp 7,472 Rp 7,472 28 - -
118 Propanolol 10 mg tab / cap Rp 72 Rp 72 - -
119 Propanolol 40 mg tab / cap Rp 126 Rp 126 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
120 Provera / hystolan / medroksiproge tab / cap Rp 2,521 Rp 2,521 - -

121 PTU tab / cap Rp 451 Rp 451 - -
122 Ranitidin tab tab / cap Rp 110 Rp 110 310 - -
123 Retaphyl tab / cap Rp 2,143 Rp 2,143 - -
124 Rifampisin 450 mg tab / cap Rp 1,146 Rp 1,146 - -
125 Rifanh 150/150 tab / cap Rp 7,246 Rp 7,246 - -
126 Rimactazid tab / cap Rp 6,471 Rp 6,471 - -
127 Rimstar/rifastar tab / cap Rp 5,115 Rp 5,115 - -
128 Salbutamol 2 mg tab / cap Rp 78 Rp 78 71 - -
129 Sifrol 0,375 mg tab tab / cap Rp 8,000 Rp 8,000 - -
130 Simarc / warfarin tab / cap Rp 950 Rp 950 - -
131 Simvastatin 10mg tab tab / cap Rp 67 Rp 67 100 - -
132 Simvastatin 20 mg tab / cap Rp 1,026 Rp 1,026 24 - -
133 Spironolakton 100 mg tab / cap Rp 1,000 Rp 1,000 99 - -
134 Spironolakton 25 mg tab / cap Rp 335 Rp 335 58 - -
135 Sulfasalazin tab / cap Rp 2,090 Rp 2,090 - -
136 Tetrasiklin 250 mg tab / cap Rp 378 Rp 378 - -
137 Thiamfenikol 500 mg tab / cap Rp 985 Rp 985 - -
138 Tramadol tab tab / cap Rp 329 Rp 329 - -
139 Urotractin tab / cap Rp 1,815 Rp 1,815 - -
140 Ursodeoksi tab tab / cap Rp 2,723 Rp 2,723 - -
141 Vitamin A tab / cap Rp 686 Rp 686 49 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
142 Vitamin B Komplek tab / cap Rp 120 Rp 120 291 - -

143 Vitamin B1 tab / cap Rp 85 Rp 85 - -
146 Vitamin C 100 MG tab / cap Rp 121 Rp 121 - -
147 Vitamin C 50 MG tab / cap Rp 120 Rp 120 124 - -
148 Vitamin K tab / cap Rp 790 Rp 790 - -
149 Zinc tab tab / cap Rp 592 Rp 592 - -
RACIKAN / PRODUKSI
1 Racikan 3 (Analtram) tab / cap Rp 854 Rp 854 34 - -
SEDIAAN INJEKSI
1 Amikasin inj amp/vial Rp 71,874 Rp 71,874 - -

2 Aminofilin inj amp/vial Rp 3,080 Rp 3,080 13 - -
3 Amoksilin inj amp/vial Rp 9,900 Rp 9,900 10 - -
4 Ampisilin inj amp/vial Rp 10,188 Rp 10,188 2 - -
5 Antrain Inj amp/vial Rp 5,511 Rp 5,511 123 - -
6 Arixtra amp/vial Rp 265,833 Rp 265,833 11 - -
7 As. Tranexamat 500 mg inj amp/vial Rp 2,530 Rp 2,530 28 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
8 Atropin inj amp/vial Rp 1,264 Rp 1,264 99 - -

9 Biocombin inj amp/vial Rp 4,070 Rp 4,070 3 - -
10 Ca. Glukonas inj amp/vial Rp 9,955 Rp 9,955 9 - -
11 Cefazolin amp/vial Rp 19,675 Rp 19,675 - -
12 Cefepime amp/vial Rp 38,285 Rp 38,285 - -
13 Cefirome inj amp/vial Rp 79,200 Rp 79,200 - -
14 Cefoporazon Sulbactam amp/vial Rp 79,200 Rp 79,200 - -
15 Ceftazidime inj amp/vial Rp 15,903 Rp 15,903 - -
16 Cernevit amp/vial Rp 157,713 Rp 157,713 1 - -
17 Citikolin 250 mg inj amp/vial Rp 10,709 Rp 10,709 - -
18 Citikolin 500 mg inj amp/vial Rp 21,600 Rp 21,600 107 - -
19 Dexametason inj amp/vial Rp 1,641 Rp 1,641 86 - -
20 Dipenhidramin inj amp/vial Rp 1,220 Rp 1,220 16 - -
21 Dobutamin inj amp/vial Rp 15,087 Rp 15,087 12 - -
22 Dopamin inj / UDOPA amp/vial Rp 7,480 Rp 7,480 7 - -
23 Epinefrin inj amp/vial Rp 6,692 Rp 6,692 70 - -
24 Esomeprazol amp/vial Rp 14,924 Rp 14,924 18 - -
25 Fitomenadion inj 10 mg amp/vial Rp 4,167 Rp 4,167 - -
26 Fitomenadion inj 2 mg amp/vial Rp 4,083 Rp 4,083 96 - -
27 Flamicort amp/vial Rp 53,482 Rp 53,482 - -
28 Furosemid inj amp/vial Rp 2,058 Rp 2,058 319 - -
29 Gentamisin inj amp/vial Rp 3,896 Rp 3,896 19 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
30 Herbesser inj 2 mg amp/vial Rp 148,500 Rp 148,500 - -

31 Ketorolac 30 mg inj amp/vial Rp 2,250 Rp 2,250 46 - -
32 Klonidin (catapres) inj amp/vial Rp 32,600 Rp 32,600 - -
33 Lidokain Compusitum amp/vial Rp 2,112 Rp 2,112 - -
34 Lidokain inj amp/vial Rp 1,000 Rp 1,000 117 - -
35 Mecobalamin inj amp/vial Rp 6,600 Rp 6,600 35 - -
36 Meropenem 1 gr inj amp/vial Rp 42,743 Rp 42,743 - -
37 Metil prednisolon 125 mg inj amp/vial Rp 12,800 Rp 12,800 81 - -
38 Metoklorpramid inj / metolon amp/vial Rp 8,910 Rp 8,910 - -
39 Nefrofer (Cosmofer) amp/vial Rp 44,000 Rp 44,000 15 - -
40 Nicardipine inj amp/vial Rp 34,979 Rp 34,979 4 - -
41 Nokoba amp/vial Rp 82,060 Rp 82,060 - -
42 Omeprazole inj amp/vial Rp 14,924 Rp 14,924 32 - -
43 Ondansetron inj amp/vial Rp 3,328 Rp 3,328 258 - -
44 Pantoprazole inj amp/vial Rp 37,400 Rp 37,400 - -
45 Piracetam 1 gr inj amp/vial Rp 4,235 Rp 4,235 49 - -
46 Piracetam 3 gr inj amp/vial Rp 13,170 Rp 13,170 37 - -
47 Pycin 750 mg amp/vial Rp 68,063 Rp 68,063 4 - -
48 Ranitidin inj amp/vial Rp 1,600 Rp 1,600 397 - -
49 Sefotaxim inj amp/vial Rp 5,995 Rp 5,995 30 - -
50 Seftriaxon inj amp/vial Rp 11,000 Rp 11,000 224 - -
51 Tramadol inj amp/vial Rp 1,720 Rp 1,720 18 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
52 Vitamin c inj amp/vial Rp 6,413 Rp 6,413 8 - -
SEDIAAN DI KULKAS
1 Anti hemoroid supp Rp 3,300 Rp 3,300 50 - -

2 Apidra plexpen Rp 87,000 Rp 87,000 - -
3 ATS 1500 IU ampul Rp 165,000 Rp 165,000 11 - -
4 Dulcolax supp 10 mg (stolax) supp Rp 5,800 Rp 5,800 - -
5 Dulcolax supp 5 mg supp Rp 5,800 Rp 5,800 - -
8 Lantus / lavemir plexpen Rp 85,000 Rp 85,000 4 - -
9 Metil ergometrin inj ampul Rp 3,278 Rp 3,278 - -
10 Noporavid plexpen Rp 87,000 Rp 87,000 3 - -
11 Norepinefrine ampul Rp 66,000 Rp 66,000 27 - -
12 Novomix plexpen Rp 110,000 Rp 110,000 - -
15 Oksitosin inj ampul Rp 1,899 Rp 1,899 100 - -
16 SABU vial Rp 640,530 Rp 640,530 5 - -
17 Suprafenid supp Rp 2,789 Rp 2,789 12 - -
18 Tetagam inj vial Rp 170,000 Rp 170,000 - -
19 Vaksin rabies vial Rp 140,445 Rp 140,445 - -
20
BAKHP
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
1 Cutimed Gel Rp 45,591 Rp 45,591 9 - -

2 Cutimed Siltec 10X10 Rp 37,756 Rp 37,756 8 - -
3 Disp 1 CC Rp 744 Rp 744 358 - -
4 Disp 10 CC Rp 1,072 Rp 1,072 180 - -
5 Disp 3 CC Rp 750 Rp 750 59 - -
6 Disp 5 CC Rp 893 Rp 893 171 - -
7 Disp 50CC Lubang Pinggir Rp 4,259 Rp 4,259 23 - -
8 Disp 50CC Lubang Tengah Rp 4,260 Rp 4,260 37 - -
9 Elastamol Haff Rp 34,069 Rp 34,069 17 - -
10 ETT Nonking 2,5 Rp 357,500 Rp 357,500 - -
11 ETT Nonking 3 Rp 357,000 Rp 357,000 - -
12 ETT Nonking 3,5 Rp 357,000 Rp 357,000 - -
13 ETT Nonking 5 Rp 357,000 Rp 357,000 - -
14 Folley Cathether 10 Rp 42,565 Rp 42,565 21 - -
18 Handscund 6 Rp 6,594 Rp 6,594 80 - -
19 Handscund 6,5 Rp 6,594 Rp 6,594 79 - -
20 Handscund 7 Rp 6,594 Rp 6,594 64 - -
21 Handscund 7,5 Rp 6,595 Rp 6,595 40 - -
22 Infuset Macro Rp 4,756 Rp 4,756 74 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
23 Infuset Micro Rp 5,104 Rp 5,104 56 - -

24 Injec Tomat Rp 7,550 Rp 7,550 6 - -
25 Kasa kotak 16x16 Rp 3,300 Rp 3,300 18 - -
26 Masker NRM Adult Rp 19,154 Rp 19,154 20 - -
27 Masker NRM Child Rp 19,154 Rp 19,154 17 - -
28 Masker Rebrehting Adult Rp 38,500 Rp 38,500 - -
29 Masker REbrehting Child Rp 38,500 Rp 38,500 - -
30 NGT 16 Rp 17,600 Rp 17,600 30 - -
31 NGT 3,5 Rp 25,850 Rp 25,850 - -
32 NGT 5 Rp 25,850 Rp 25,850 - -
33 NGT 8 Rp 18,711 Rp 18,711 - -
34 Poligyps 10 cm Rp 35,693 Rp 35,693 - -
35 Selang Oksigen Anak Rp 6,325 Rp 6,325 33 - -
36 Selang Oksigen Bayi Rp 8,906 Rp 8,906 29 - -
37 Selang Oksigen Dewasa Rp 7,808 Rp 7,808 38 - -
38 Softband 10 cm Rp 99,000 Rp 99,000 2 - -
39 Softband 15 cm Rp 29,700 Rp 29,700 5 - -
40 Spalax 15x5 Rp 33,000 Rp 33,000 9 - -
41 Spalax 45x7 Rp 4,950 Rp 4,950 2 - -
42 Spalax 5x10 Rp 33,000 Rp 33,000 6 - -
43 Spalax 60x7 Rp 7,150 Rp 7,150 15 - -
44 Spalax 75x6 Rp 8,030 Rp 8,030 15 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
45 Spalax 90x7 Rp 121,000 Rp 121,000 0 - -

46 Suction Cathether 12 Rp 3,016 Rp 3,016 6 - -
49 Surflo 18 Rp 11,279 Rp 11,279 94 - -
50 Surflo 20 Rp 9,900 Rp 9,900 19 - -
51 Surflo 22 Rp 9,900 Rp 9,900 111 - -
52 Surflo 24 Rp 9,900 Rp 9,900 177 - -
53 Surflo W 22 Rp 25,289 Rp 25,289 10 - -
54 Surfo W 26 Rp 24,291 Rp 24,291 46 - -
55 Tensocrape 15 cm Rp 41,870 Rp 41,870 11 - -
56 Tensocrape 7,5 cm Rp 27,660 Rp 27,660 11 - -
57 Tensocrpae 10 cm Rp 32,892 Rp 32,892 1 - -
58 Transfusi set Rp 25,245 Rp 25,245 87 - -
59 Urinebag Rp 3,465 Rp 3,465 37 - -
60 Selang SCT Rp 35,552 Rp 35,552 25 - -
61 Disp 20CC Rp 1,728 Rp 1,728 63 - -
62 ETT NON KING 6,5 Rp 357,500 Rp 357,500 0 - -
63 3-Way stopcock Rp 22,627 Rp 22,627 4 - -
64 Novotwist Rp 2,083 Rp 2,083 13 - -
65 Masker NRM Bayi Rp 19,154 Rp 19,154 3 - -
66 Underpad Rp 3,933 Rp 3,933 19 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
67 Actimove M Rp 84,260 Rp 84,260 1 - -

68 Actimove S Rp 84,260 Rp 84,260 2 - -
69 Spalak 70x7 Rp 88,000 Rp 88,000 9 - -
70 Daryantull Rp 9,250 Rp 9,250 5 - -
BENANG
1 Catgut Crhom 3/0 DS 19 Rp 57,200 Rp 57,200 11 - -

2 Catgut Plain 2/0 HR 37 Rp 35,285 Rp 35,285 36 - -
3 Premilene 3/0 DS 24 Rp 51,988 Rp 51,988 33 - -
4 Premilene 6/0 DS 12 Rp 51,088 Rp 51,088 23 - -
5 Premiline 5/0 DS 16 Rp 57,186 Rp 57,186 29 - -
6 Silk 3/0 HR 25 Rp 370,624 Rp 370,624 8 - -
7 Silk 5/0 DS Rp 49,912 Rp 49,912 26 - -
OBAT PELENGKAP
1 Aminefron Rp 6,793 Rp 6,793 91 - -

2 Antimo Rp 384 Rp 384 100 - -
3 Antrain 500 mg Rp 1,679 Rp 1,679 60 - -
4 Aspar-K Rp 2,474 Rp 2,474 - -
5 Car-Q Rp 9,666 Rp 9,666 25 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
6 Colistine Rp 6,160 Rp 6,160 5 - -

7 FG Troches Rp 1,081 Rp 1,081 34 - -
8 Gastrul Rp 11,172 Rp 11,172 50 - -
9 Gitas Rp 5,494 Rp 5,494 1 - -
10 Imunos Rp 6,971 Rp 6,971 3 - -
11 Lactrin Rp 4,290 Rp 4,290 30 - -
12 L-Bio Rp 6,435 Rp 6,435 39 - -
13 Levopar Rp 1,240 Rp 1,240 39 - -
14 Lipofood Rp 4,987 Rp 4,987 90 - -
15 Maltofer Fol Rp 2,949 Rp 2,949 17 - -
16 Mefinal Rp 1,285 Rp 1,285 90 - -
17 Osfit DHA Rp 4,070 Rp 4,070 35 - -
18 Proliver Rp 5,363 Rp 5,363 7 - -
19 Promavit Rp 2,681 Rp 2,681 35 - -
20 Rhinofed Rp 1,694 Rp 1,694 120
21 Rhinos Rp 5,121 Rp 5,121 43 - -
22 Sanmol 500 mg Rp 272 Rp 272 96 - -
23 Sistenol Rp 1,568 Rp 1,568 15 - -
24 Tremenza Rp 1,447 Rp 1,447 33 - -
25 Vip Albumin Rp 6,435 Rp 6,435 67 - -
LAIN-LAIN
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
1 Thrombopob Rp 51,455 Rp 51,455 8 - -

2 Ventolin Nebu Rp 4,000 Rp 4,000 14 - -
SYRUP
1 Apialis Drop Rp 25,393 Rp 25,393 3 - -

2 Apialis Sirup Rp 29,494 Rp 29,494 5 - -
3 Elkana Sirup Rp 46,085 Rp 46,085 5 - -
4 Gastrinal Rp 25,204 Rp 25,204 6 - -
5 Imunos Sirup Rp 85,800 Rp 85,800 5 - -
6 Mucos Sirup Rp 15,675 Rp 15,675 11 - -
7 Oxoril Rp 29,150 Rp 29,150 6 - -
8 Pralax Sirup Rp 66,495 Rp 66,495 0 - -
9 PSIDII Sirup Rp 34,485 Rp 34,485 10 - -
10 Sanmol Drop Rp 15,100 Rp 15,100 9 - -
11 Sanmol Sirup Rp 11,234 Rp 11,234 2 - -
12 Tiriz drop Rp 64,350 Rp 64,350 0 - -
13 Vometa Drop Rp 41,278 Rp 41,278 4 - -
14 Vometa Sirup Rp 41,278 Rp 41,278 4 - -
15 Zick Sirup Rp 4,958 Rp 4,958 10 - -
HARGA HARGA
STOK STOK
AWAL AKHIR
(2017) MARET (2018)
INJEKSI
1 Acran Injeksi Rp 20,189 Rp 20,189 - -

2 Gitas Injeksi Rp 24,929 Rp 24,929 44 - -
3 Norages Injeksi Rp 8,955 Rp 8,955 27 - -
4 NS PIGGY 100 CC Rp 11,047 Rp 11,047 14 - -
5 Tiaryt Injeksi Rp 16,500 Rp 16,500 5 - -
6 Salin 3% Rp 23,714 Rp 23,714 8 - -
7 Forumen Rp 24,714 Rp 24,714 1 - -
8 Tarivid Rp 36,900 Rp 36,900 1 - -
9 Topazol Injeksi Rp 148,005 Rp 148,005 - -
TOTAL
Kepala instalasi Farmasi
Ina Septina S . Farm Apt

NIP; 19810922 200604 2 016
LAPORAN STOK OPNAME OBAT GENERIK BPJS DEPO FARMASI IGD PERIODE APRIL 2018
HARGA HARGA PENGELUARAN

STOK NILAI STOK NILAI NILAI
NO NAMA OBAT SATUAN SATUAN FEB SATUAN PEMASUKA TOTAL
AWAL FEBRUARI PEMASUKAN PENGELUARAN
(2017) MARET (2018) N IGD MUTASI
SEDIAAN INFUS
1 Aqua Pro Injeksi floz Rp 2,750 Rp 2,750 87 Rp 239,250 Rp - 87 - 87 Rp 239,250

2 Asering Infus kolf Rp 9,275 Rp 9,275 28 Rp 259,700 Rp - 28 - 28 Rp 259,700
3 Ciprofloksasin infus botol Rp 10,890 Rp 10,890 Rp - Rp - - - - Rp -
4 D40 % floz Rp 3,963 Rp 3,963 15 Rp 59,445 Rp - 15 - 15 Rp 59,445
5 D5 % 1/2 Infus kolf Rp 9,415 Rp 9,415 18 Rp 169,470 Rp - 18 - 18 Rp 169,470
6 D5 % 1/4 Infus kolf Rp 9,360 Rp 9,360 Rp - Rp - - - - Rp -
7 Fluconazol infus botol Rp 29,540 Rp 29,540 Rp - Rp - - - - Rp -
8 Futrolit softbag Rp 39,327 Rp 39,327 Rp - Rp - - - - Rp -
9 Glukosa 10 kolf Rp 7,500 Rp 7,500 10 Rp 75,000 Rp - 10 - 10 Rp 75,000
11 Hidromal softbag Rp 49,600 Rp 49,600 Rp - Rp - - - - Rp -
12 KCl floz Rp 7,524 Rp 7,524 22 Rp 165,528 Rp - 22 - 22 Rp 165,528
13 Levofloksasin 500 mg botol Rp 26,881 Rp 26,881 13 Rp 349,453 Rp - 13 - 13 Rp 349,453
14 Levofloksasin 750mg botol Rp 136,125 Rp 136,125 8 Rp 1,089,000 Rp - 8 - 8 Rp 1,089,000
15 Manitol kolf Rp 44,000 Rp 44,000 6 Rp 264,000 Rp - 6 - 6 Rp 264,000
16 Metronidazol infus botol Rp 9,680 Rp 9,680 22 Rp 212,960 Rp - 22 - 22 Rp 212,960
17 Meylon inj floz Rp 10,890 Rp 10,890 5 Rp 54,450 Rp - 5 - 5 Rp 54,450
18 MgSO4 20 % floz Rp 3,200 Rp 3,200 Rp - Rp - - - - Rp -
19 MgSO4 40 % floz Rp 3,650 Rp 3,650 4 Rp 14,600 Rp - 4 - 4 Rp 14,600

20 Moxifloxacin inf botol Rp 214,500 Rp 214,500 2 Rp 429,000 Rp - 2 - 2 Rp 429,000

21 Nacl kolf Rp 6,292 Rp 6,292 37 Rp 232,804 Rp - 37 - 37 Rp 232,804
22 Paracetamol infus botol Rp 30,250 Rp 30,250 Rp - Rp - - - - Rp -
23 RL infus kolf Rp 7,095 Rp 7,095 27 Rp 191,565 Rp - 27 - 27 Rp 191,565
24 Kendal Infus kolf Rp 47,272 Rp 47,272 4 Rp 189,088 Rp - 4 - 4 Rp 189,088
1 Asiklovir salep kulit tube Rp 2,997 Rp 2,997 6 Rp 17,982 Rp - 6 - 6 Rp 17,982

2 Avamys tabung Rp 102,999 Rp 102,999 Rp - Rp - - - - Rp -
3 Berotec inhaler tabung Rp 80,000 Rp 80,000 0 Rp - Rp - - - - Rp -
4 Betametason SK tube Rp 2,026 Rp 2,026 27 Rp 54,702 Rp - 27 - 27 Rp 54,702
5 Bioplacenton salep Rp 13,557 Rp 13,557 12 Rp 162,684 Rp - 12 - 12 Rp 162,684
6 Burnazin cream tube Rp 52,376 Rp 52,376 4 Rp 209,504 Rp - 4 - 4 Rp 209,504
7 Combivent nebules amp/vial Rp 5,700 Rp 5,700 129 Rp 735,300 Rp - 129 - 129 Rp 735,300
8 Fenol Gliserol tube Rp 2,246 Rp 2,246 Rp - Rp - - - - Rp -
9 Genoin Salep tube Rp 5,104 Rp 5,104 Rp - Rp - - - - Rp -
10 Gentamisin Salep kulit / genoint tube Rp 2,126 Rp 2,126 19 Rp 40,394 Rp - 19 - 19 Rp 40,394
11 Gentamisin salep mata tube Rp 3,960 Rp 3,960 Rp - Rp - - - - Rp -
12 Gentamisin tetes mata botol Rp 3,297 Rp 3,297 Rp - Rp - - - - Rp -
13 Gentian violet botol Rp 6,655 Rp 6,655 Rp - Rp - - - - Rp -
14 Hidrokortison salep kulit tube Rp 11,132 Rp 11,132 29 Rp 322,828 Rp - 29 - 29 Rp 322,828

15 Iliadin Spray botol Rp 37,900 Rp 37,900 Rp - Rp - - - - Rp -

16 Ketokonazole salep kulit tube Rp 2,200 Rp 2,200 3 Rp 6,600 Rp - 3 - 3 Rp 6,600
17 Kloramfenikol salep mata tube Rp 1,850 Rp 1,850 Rp - Rp - - - - Rp -
18 Kloramfenikol tetes mata botol Rp 2,750 Rp 2,750 Rp - Rp - - - - Rp -
19 Miconazole salep kulit tube Rp 3,736 Rp 3,736 28 Rp 104,608 Rp - 28 - 28 Rp 104,608
20 Oksitetrasiklin salep kulit tube Rp 1,649 Rp 1,649 Rp - Rp - - - - Rp -
21 Oksitetrasiklin salep mata tube Rp 2,772 Rp 2,772 Rp - Rp - - - - Rp -
22 PK botol Rp 3,300 Rp 3,300 Rp - Rp - - - - Rp -
SEDIAAN SIRUP
1 Ambroxol sirup 15mg botol Rp 3,627 Rp 3,627 3 Rp 10,881 Rp - 3 - 3 Rp 10,881

2 Amoksilin Sirup botol Rp 5,626 Rp 5,626 8 Rp 45,008 Rp - 8 - 8 Rp 45,008
3 Amoxillin drop botol Rp 10,780 Rp 10,780 Rp - Rp - - - - Rp -
4 Antasida sirup botol Rp 3,184 Rp 3,184 0 Rp - Rp - - - - Rp -
5 Cefadroxyl syr botol Rp 4,999 Rp 4,999 Rp - Rp - - - - Rp -
6 Cefixime sirup botol Rp 11,880 Rp 11,880 0 Rp - Rp - - - - Rp -
7 Cetirizin syr botol Rp 10,440 Rp 10,440 15 Rp 156,600 Rp - 15 - 15 Rp 156,600
8 Cloramfenikol Sirup botol Rp 7,783 Rp 7,783 Rp - Rp - - - - Rp -
9 Cotrimoksazol Sirup botol Rp 2,225 Rp 2,225 12 Rp 26,700 Rp - 12 - 12 Rp 26,700
10 Domperidon Sirup botol Rp 9,000 Rp 9,000 7 Rp 63,000 Rp - 7 - 7 Rp 63,000
11 Gavistal / Metoklopramid botol Rp 2,520 Rp 2,520 Rp - Rp - - - - Rp -

12 Ibuprofen syr 100 mg botol Rp 4,225 Rp 4,225 6 Rp 25,350 Rp - 6 - 6 Rp 25,350

13 Lactulax botol Rp 48,400 Rp 48,400 Rp - Rp - - - - Rp -
14 Nystatin drop botol Rp 21,780 Rp 21,780 14 Rp 304,920 Rp - 14 - 14 Rp 304,920
15 OBH botol Rp 4,100 Rp 4,100 Rp - Rp - - - - Rp -
16 Paracetamol drop botol Rp 8,124 Rp 8,124 13 Rp 105,612 Rp - 13 - 13 Rp 105,612
17 Paracetamol sirup botol Rp 1,012 Rp 1,012 23 Rp 23,276 Rp - 23 - 23 Rp 23,276
18 Plantacid syr botol Rp 8,910 Rp 8,910 1 Rp 8,910 Rp - 1 - 1 Rp 8,910
19 Salbutamol syr botol Rp 4,916 Rp 4,916 11 Rp 54,076 Rp - 11 - 11 Rp 54,076
20 Sucralfat Syr botol Rp 10,100 Rp 10,100 10 Rp 101,000 Rp - 10 - 10 Rp 101,000
SEDIAAN TABLET ORAL
1 Acarbose 50 (Eclid) tab / cap Rp 657 Rp 657 Rp - Rp - - - - Rp -

2 Acetyl systein tab / cap Rp 1,100 Rp 1,100 35 Rp 38,500 Rp - 35 - 35 Rp 38,500
3 Allopurinol tab 100 MG tab / cap Rp 120 Rp 120 70 Rp 8,400 Rp - 70 - 70 Rp 8,400
4 Allopurinol tab 300 MG tab / cap Rp 230 Rp 230 Rp - Rp - - - - Rp -
5 Ambroxol tab tab / cap Rp 744 Rp 744 111 Rp 82,584 Rp - 111 - 111 Rp 82,584
6 Aminofilin tab tab / cap Rp 103 Rp 103 95 Rp 9,785 Rp - 95 - 95 Rp 9,785
7 Amlodipin 10 mg tab / cap Rp 167 Rp 167 197 Rp 32,899 Rp - 197 - 197 Rp 32,899
8 Amlodipin 5 mg tab tab / cap Rp 116 Rp 116 311 Rp 36,076 Rp - 311 - 311 Rp 36,076
9 Amoksilin 500 mg tab tab / cap Rp 209 Rp 209 99 Rp 20,691 Rp - 99 - 99 Rp 20,691
10 Amvar tab / cap Rp 5,445 Rp 5,445 47 Rp 255,915 Rp - 47 - 47 Rp 255,915

11 antasida tab tab / cap Rp 59 Rp 59 45 Rp 2,655 Rp - 45 - 45 Rp 2,655

12 Asam Folat tab / cap Rp 138 Rp 138 504 Rp 69,552 Rp - 504 - 504 Rp 69,552
13 Asam Mefenamat tab / cap Rp 102 Rp 102 78 Rp 7,956 Rp - 78 - 78 Rp 7,956
14 Asam Tranexamat 500 tab / cap Rp 1,069 Rp 1,069 121 Rp 129,349 Rp - 121 - 121 Rp 129,349
15 Asiklovir 200 mg tab / cap Rp 359 Rp 359 Rp - Rp - - - - Rp -
16 Asiklovir 400 mg tab / cap Rp 571 Rp 571 70 Rp 39,970 Rp - 70 - 70 Rp 39,970
17 Aspar k tab (Kalipar) tab / cap Rp 682 Rp 682 38 Rp 25,916 Rp - 38 - 38 Rp 25,916
18 Aspilet tab / cap Rp 94 Rp 94 35 Rp 3,290 Rp - 35 - 35 Rp 3,290
19 Atorvastatin 10 mg tab / cap Rp 1,892 Rp 1,892 177 Rp 334,884 Rp - 177 - 177 Rp 334,884
21 Attalpugit (Pularex) tab / cap Rp 160 Rp 160 206 Rp 32,960 Rp - 206 - 206 Rp 32,960
22 Azitromisin 500 mg tab / cap Rp 8,800 Rp 8,800 Rp - Rp - - - - Rp -
23 Betahistin tab tab / cap Rp 151 Rp 151 27 Rp 4,077 Rp - 27 - 27 Rp 4,077
24 Bisakodil (Dulkolax) tab tab / cap Rp 1,030 Rp 1,030 50 Rp 51,500 Rp - 50 - 50 Rp 51,500
25 Bisoprolol 2,5 mg / concor tab / cap Rp 650 Rp 650 Rp - Rp - - - - Rp -
26 Bisoprolol 5 mg tab / cap Rp 298 Rp 298 268 Rp 79,864 Rp - 268 - 268 Rp 79,864
27 Calsium Lactat tab / cap Rp 57 Rp 57 113 Rp 6,441 Rp - 113 - 113 Rp 6,441
Candersartan 8 mg (canderin) tab / cap Rp 770 Rp 770 158 Rp 121,660 Rp - 158 - 158 Rp 121,660
28 Candesartan 16 mg tab / cap Rp - Rp - 204 Rp - Rp - 204 - 204 Rp -
29 Captopril 12,5 mg tab / cap Rp 69 Rp 69 256 Rp 17,664 Rp - 256 - 256 Rp 17,664
30 Captopril 25 mg tab / cap Rp 105 Rp 105 279 Rp 29,295 Rp - 279 - 279 Rp 29,295
31 Cefadroxyl 500 tab / cap Rp 560 Rp 560 415 Rp 232,400 Rp - 415 - 415 Rp 232,400

32 Cefiksim 100 mg tab / cap Rp 1,676 Rp 1,676 220 Rp 368,720 Rp - 220 - 220 Rp 368,720
33 Cetirizin 10 mg tab / cap Rp 120 Rp 120 287 Rp 34,440 Rp - 287 - 287 Rp 34,440
34 Cilostazol tab 100 mg tab / cap Rp 8,000 Rp 8,000 189 Rp 1,512,000 Rp - 189 - 189 Rp 1,512,000
35 Ciproflokasin 500 mg tab / cap Rp 320 Rp 320 192 Rp 61,440 Rp - 192 - 192 Rp 61,440
36 Citicolin 500 mg tab / cap Rp 5,940 Rp 5,940 30 Rp 178,200 Rp - 30 - 30 Rp 178,200
37 Clindamisin 300 mg tab / cap Rp 660 Rp 660 Rp - Rp - - - - Rp -
38 Clonidin tab tab / cap Rp 205 Rp 205 100 Rp 20,500 Rp - 100 - 100 Rp 20,500
39 Clopidogrel tab / cap Rp 1,799 Rp 1,799 243 Rp 437,157 Rp - 243 - 243 Rp 437,157
40 Co- amoxiclav tab / cap Rp 5,808 Rp 5,808 100 Rp 580,800 Rp - 100 - 100 Rp 580,800
41 Cotrimoxazol 480 tab tab / cap Rp 267 Rp 267 Rp - Rp - - - - Rp -
42 CTM tab tab / cap Rp 45 Rp 45 51 Rp 2,295 Rp - 51 - 51 Rp 2,295
43 Curcuma tab tab / cap Rp 78 Rp 78 132 Rp 10,296 Rp - 132 - 132 Rp 10,296
44 Cytodrox tab / cap Rp 5,280 Rp 5,280 Rp - Rp - - - - Rp -
45 Dexametason tab tab / cap Rp 92 Rp 92 70 Rp 6,440 Rp - 70 - 70 Rp 6,440
46 Dexketopropen tab / cap Rp 2,970 Rp 2,970 Rp - Rp - - - - Rp -
47 Digoksin tab tab / cap Rp 109 Rp 109 90 Rp 9,810 Rp - 90 - 90 Rp 9,810
48 Diltiazem 30 mg tab / cap Rp 144 Rp 144 Rp - Rp - - - - Rp -
49 Dimenhidrinat tab / cap Rp 142 Rp 142 Rp - Rp - - - - Rp -
50 Doksisiklin tab tab / cap Rp 290 Rp 290 Rp - Rp - - - - Rp -
51 Domperidone tab tab / cap Rp 118 Rp 118 53 Rp 6,254 Rp - 53 - 53 Rp 6,254
52 Dopamet tab / cap Rp 1,050 Rp 1,050 Rp - Rp - - - - Rp -
53 Eperison (Perilax) tab / cap Rp 1,309 Rp 1,309 418 Rp 547,162 Rp - 418 - 418 Rp 547,162

54 Erytromisin 250 mg tab / cap Rp 509 Rp 509 Rp - Rp - - - - Rp -

55 Etambutol tab tab / cap Rp 574 Rp 574 Rp - Rp - - - - Rp -
56 Fenofibrate 100 mg tab / cap Rp 605 Rp 605 Rp - Rp - - - - Rp -
57 Fenofibrate 300 mg tab / cap Rp 1,303 Rp 1,303 Rp - Rp - - - - Rp -
58 Ferrosulfat tab / cap Rp 400 Rp 400 47 Rp 18,800 Rp - 47 - 47 Rp 18,800
59 Finasteride 5 mg tab / finro tab / cap Rp 1,919 Rp 1,919 27 Rp 51,813 Rp - 27 - 27 Rp 51,813
60 Fluconazol tab / cap Rp 20,700 Rp 20,700 Rp - Rp - - - - Rp -
61 Flunarizine 10 mg tab / cap Rp 3,325 Rp 3,325 Rp - Rp - - - - Rp -
62 Flunarizine 5 mg tab / cap Rp 2,090 Rp 2,090 88 Rp 183,920 Rp - 88 - 88 Rp 183,920
63 Furosemid tab tab / cap Rp 181 Rp 181 179 Rp 32,399 Rp - 179 - 179 Rp 32,399
64 Gabexal tab / cap Rp 1,639 Rp 1,639 Rp - Rp - - - - Rp -
65 Gemfibrozil 300 mg tab / cap Rp 386 Rp 386 Rp - Rp - - - - Rp -
66 GG tab tab / cap Rp 45 Rp 45 41 Rp 1,845 Rp - 41 - 41 Rp 1,845
67 Glibenklamid tab tab / cap Rp 92 Rp 92 90 Rp 8,280 Rp - 90 - 90 Rp 8,280
68 Glikuidon (Lodem) tab / cap Rp 3,648 Rp 3,648 Rp - Rp - - - - Rp -
69 Glimepirid 2 mg tab / cap Rp 296 Rp 296 137 Rp 40,552 Rp - 137 - 137 Rp 40,552
70 Glimepirid 3 mg tab / cap Rp 319 Rp 319 Rp - Rp - - - - Rp -
71 Glukodex tab / cap Rp 245 Rp 245 Rp - Rp - - - - Rp -
72 Glukosamine tab tab / cap Rp 704 Rp 704 5 Rp 3,520 Rp - 5 - 5 Rp 3,520
73 Harnal / Hytroz tab / cap Rp 1,425 Rp 1,425 Rp - Rp - - - - Rp -
74 Herbesser tab / cap Rp 4,290 Rp 4,290 Rp - Rp - - - - Rp -
75 Hidroklorotiazid 25 mg tab / cap Rp 171 Rp 171 205 Rp 35,055 Rp - 205 - 205 Rp 35,055

76 Ibuprofen 400 mg tab tab / cap Rp 180 Rp 180 70 Rp 12,600 Rp - 70 - 70 Rp 12,600

77 Interhistin tab tab / cap Rp 589 Rp 589 Rp - Rp - - - - Rp -
78 Isoniazid 300 mg tab / cap Rp 116 Rp 116 Rp - Rp - - - - Rp -
79 Isosorbid Dinitrat 5 mg tab / cap Rp 104 Rp 104 309 Rp 32,136 Rp - 309 - 309 Rp 32,136
80 Ketokonazole tab tab / cap Rp 340 Rp 340 200 Rp 68,000 Rp - 200 - 200 Rp 68,000
81 Ketorolac tab tab / cap Rp 2,151 Rp 2,151 199 Rp 428,049 Rp - 199 - 199 Rp 428,049
82 KSR tab / cap Rp 1,700 Rp 1,700 77 Rp 130,900 Rp - 77 - 77 Rp 130,900
83 Lansoprazole tab / cap Rp 878 Rp 878 59 Rp 51,802 Rp - 59 - 59 Rp 51,802
84 Levofloksasin 500 mg tab tab / cap Rp 686 Rp 686 30 Rp 20,580 Rp - 30 - 30 Rp 20,580
85 Lisinopril 10 mg / noperten tab / cap Rp 485 Rp 485 195 Rp 94,575 Rp - 195 - 195 Rp 94,575
87 Loperamid tab tab / cap Rp 105 Rp 105 56 Rp 5,880 Rp - 56 - 56 Rp 5,880
88 Loratadine tab tab / cap Rp 233 Rp 233 75 Rp 17,475 Rp - 75 - 75 Rp 17,475
89 Mecobalamin tab tab / cap Rp 654 Rp 654 84 Rp 54,936 Rp - 84 - 84 Rp 54,936
90 Meloksikam 15 mg tab / cap Rp 731 Rp 731 200 Rp 146,200 Rp - 200 - 200 Rp 146,200
91 Meloksikam 7,5 mg tab / cap Rp 397 Rp 397 200 Rp 79,400 Rp - 200 - 200 Rp 79,400
92 Metformin tab tab / cap Rp 110 Rp 110 93 Rp 10,230 Rp - 93 - 93 Rp 10,230
93 Metil ergometrin tab tab / cap Rp 271 Rp 271 Rp - Rp - - - - Rp -
94 Metilprednisolon 16 mg tab / cap Rp 1,169 Rp 1,169 90 Rp 105,210 Rp - 90 - 90 Rp 105,210
95 Metilprednisolon 4 mg tab / cap Rp 220 Rp 220 280 Rp 61,600 Rp - 280 - 280 Rp 61,600
96 Metilprednisolon 8 mg tab / cap Rp 393 Rp 393 190 Rp 74,670 Rp - 190 - 190 Rp 74,670
97 Metochlorpramid tab tab / cap Rp 143 Rp 143 95 Rp 13,585 Rp - 95 - 95 Rp 13,585

98 Metronidazol tab tab / cap Rp 273 Rp 273 55 Rp 15,015 Rp - 55 - 55 Rp 15,015

99 Micardis tab / cap Rp 7,150 Rp 7,150 Rp - Rp - - - - Rp -
100 Na diklofenak 50 mg tab / cap Rp 245 Rp 245 210 Rp 51,450 Rp - 210 - 210 Rp 51,450
101 Natrium Bicarbonat tab / cap Rp 110 Rp 110 73 Rp 8,030 Rp - 73 - 73 Rp 8,030
102 Neurodex tab tab / cap Rp 484 Rp 484 204 Rp 98,736 Rp - 204 - 204 Rp 98,736
103 Nifedipin tab tab / cap Rp 110 Rp 110 96 Rp 10,560 Rp - 96 - 96 Rp 10,560
104 Norelut / Norestil tab / cap Rp 2,552 Rp 2,552 Rp - Rp - - - - Rp -
105 Omeprazole tab tab / cap Rp 326 Rp 326 318 Rp 103,668 Rp - 318 - 318 Rp 103,668
106 Ondansetron tab 4 MG tab / cap Rp 523 Rp 523 5 Rp 2,615 Rp - 5 - 5 Rp 2,615
108 Oralit tab / cap Rp 418 Rp 418 23 Rp 9,614 Rp - 23 - 23 Rp 9,614
109 Ostovel tab / cap Rp 1,690 Rp 1,690 Rp - Rp - - - - Rp -
110 Parasetamol 500 mg tab / cap Rp 142 Rp 142 323 Rp 45,866 Rp - 323 - 323 Rp 45,866
111 pioglitazone (deculin) 15 mg tab / cap Rp 3,300 Rp 3,300 Rp - Rp - - - - Rp -
112 Pioglitazone (deculin) 30 mg tab / cap Rp 4,950 Rp 4,950 Rp - Rp - - - - Rp -
113 Piracetam 1200 mg tab / cap Rp 1,166 Rp 1,166 171 Rp 199,386 Rp - 171 - 171 Rp 199,386
114 Piracetam 800 mg tab / cap Rp 682 Rp 682 Rp - Rp - - - - Rp -
115 Pirazinamid 500 mg tab / cap Rp 238 Rp 238 Rp - Rp - - - - Rp -
116 Prednison tab / cap Rp 144 Rp 144 Rp - Rp - - - - Rp -
117 Pregabalin 75 mg tab / cap Rp 7,472 Rp 7,472 28 Rp 209,216 Rp - 28 - 28 Rp 209,216
118 Propanolol 10 mg tab / cap Rp 72 Rp 72 Rp - Rp - - - - Rp -

120 Provera / hystolan / medroksiproge tab / cap Rp 2,521 Rp 2,521 Rp - Rp - - - - Rp -

121 PTU tab / cap Rp 451 Rp 451 Rp - Rp - - - - Rp -
122 Ranitidin tab tab / cap Rp 110 Rp 110 310 Rp 34,100 Rp - 310 - 310 Rp 34,100
123 Retaphyl tab / cap Rp 2,143 Rp 2,143 Rp - Rp - - - - Rp -
124 Rifampisin 450 mg tab / cap Rp 1,146 Rp 1,146 Rp - Rp - - - - Rp -
125 Rifanh 150/150 tab / cap Rp 7,246 Rp 7,246 Rp - Rp - - - - Rp -
126 Rimactazid tab / cap Rp 6,471 Rp 6,471 Rp - Rp - - - - Rp -
127 Rimstar/rifastar tab / cap Rp 5,115 Rp 5,115 Rp - Rp - - - - Rp -
128 Salbutamol 2 mg tab / cap Rp 78 Rp 78 71 Rp 5,538 Rp - 71 - 71 Rp 5,538
129 Sifrol 0,375 mg tab tab / cap Rp 8,000 Rp 8,000 Rp - Rp - - - - Rp -
130 Simarc / warfarin tab / cap Rp 950 Rp 950 Rp - Rp - - - - Rp -
131 Simvastatin 10mg tab tab / cap Rp 67 Rp 67 100 Rp 6,700 Rp - 100 - 100 Rp 6,700
132 Simvastatin 20 mg tab / cap Rp 1,026 Rp 1,026 24 Rp 24,624 Rp - 24 - 24 Rp 24,624
133 Spironolakton 100 mg tab / cap Rp 1,000 Rp 1,000 99 Rp 99,000 Rp - 99 - 99 Rp 99,000
134 Spironolakton 25 mg tab / cap Rp 335 Rp 335 58 Rp 19,430 Rp - 58 - 58 Rp 19,430
135 Sulfasalazin tab / cap Rp 2,090 Rp 2,090 Rp - Rp - - - - Rp -
136 Tetrasiklin 250 mg tab / cap Rp 378 Rp 378 Rp - Rp - - - - Rp -
137 Thiamfenikol 500 mg tab / cap Rp 985 Rp 985 Rp - Rp - - - - Rp -
138 Tramadol tab tab / cap Rp 329 Rp 329 Rp - Rp - - - - Rp -
139 Urotractin tab / cap Rp 1,815 Rp 1,815 Rp - Rp - - - - Rp -
140 Ursodeoksi tab tab / cap Rp 2,723 Rp 2,723 Rp - Rp - - - - Rp -
141 Vitamin A tab / cap Rp 686 Rp 686 49 Rp 33,614 Rp - 49 - 49 Rp 33,614

142 Vitamin B Komplek tab / cap Rp 120 Rp 120 291 Rp 34,920 Rp - 291 - 291 Rp 34,920
143 Vitamin B1 tab / cap Rp 85 Rp 85 Rp - Rp - - - - Rp -
146 Vitamin C 100 MG tab / cap Rp 121 Rp 121 Rp - Rp - - - - Rp -
147 Vitamin C 50 MG tab / cap Rp 120 Rp 120 124 Rp 14,880 Rp - 124 - 124 Rp 14,880
148 Vitamin K tab / cap Rp 790 Rp 790 Rp - Rp - - - - Rp -
149 Zinc tab tab / cap Rp 592 Rp 592 Rp - Rp - - - - Rp -
RACIKAN / PRODUKSI
1 Racikan 3 (Analtram) tab / cap Rp 854 Rp 854 34 Rp 29,036 Rp - 34 - 34 Rp 29,036
SEDIAAN INJEKSI
1 Amikasin inj amp/vial Rp 71,874 Rp 71,874 Rp - Rp - - - - Rp -

2 Aminofilin inj amp/vial Rp 3,080 Rp 3,080 13 Rp 40,040 Rp - 13 - 13 Rp 40,040
3 Amoksilin inj amp/vial Rp 9,900 Rp 9,900 10 Rp 99,000 Rp - 10 - 10 Rp 99,000
4 Ampisilin inj amp/vial Rp 10,188 Rp 10,188 2 Rp 20,376 Rp - 2 - 2 Rp 20,376
5 Antrain Inj amp/vial Rp 5,511 Rp 5,511 123 Rp 677,853 Rp - 123 - 123 Rp 677,853
6 Arixtra amp/vial Rp 265,833 Rp 265,833 11 Rp 2,924,163 Rp - 11 - 11 Rp 2,924,163
7 As. Tranexamat 500 mg inj amp/vial Rp 2,530 Rp 2,530 28 Rp 70,840 Rp - 28 - 28 Rp 70,840

8 Atropin inj amp/vial Rp 1,264 Rp 1,264 99 Rp 125,136 Rp - 99 - 99 Rp 125,136

9 Biocombin inj amp/vial Rp 4,070 Rp 4,070 3 Rp 12,210 Rp - 3 - 3 Rp 12,210
10 Ca. Glukonas inj amp/vial Rp 9,955 Rp 9,955 9 Rp 89,595 Rp - 9 - 9 Rp 89,595
11 Cefazolin amp/vial Rp 19,675 Rp 19,675 Rp - Rp - - - - Rp -
12 Cefepime amp/vial Rp 38,285 Rp 38,285 Rp - Rp - - - - Rp -
13 Cefirome inj amp/vial Rp 79,200 Rp 79,200 Rp - Rp - - - - Rp -
14 Cefoporazon Sulbactam amp/vial Rp 79,200 Rp 79,200 Rp - Rp - - - - Rp -
15 Ceftazidime inj amp/vial Rp 15,903 Rp 15,903 Rp - Rp - - - - Rp -
16 Cernevit amp/vial Rp 157,713 Rp 157,713 1 Rp 157,713 Rp - 1 - 1 Rp 157,713
17 Citikolin 250 mg inj amp/vial Rp 10,709 Rp 10,709 Rp - Rp - - - - Rp -
18 Citikolin 500 mg inj amp/vial Rp 21,600 Rp 21,600 107 Rp 2,311,200 Rp - 107 - 107 Rp 2,311,200
19 Dexametason inj amp/vial Rp 1,641 Rp 1,641 86 Rp 141,126 Rp - 86 - 86 Rp 141,126
20 Dipenhidramin inj amp/vial Rp 1,220 Rp 1,220 16 Rp 19,520 Rp - 16 - 16 Rp 19,520
21 Dobutamin inj amp/vial Rp 15,087 Rp 15,087 12 Rp 181,044 Rp - 12 - 12 Rp 181,044
22 Dopamin inj / UDOPA amp/vial Rp 7,480 Rp 7,480 7 Rp 52,360 Rp - 7 - 7 Rp 52,360
23 Epinefrin inj amp/vial Rp 6,692 Rp 6,692 70 Rp 468,440 Rp - 70 - 70 Rp 468,440
24 Esomeprazol amp/vial Rp 14,924 Rp 14,924 18 Rp 268,632 Rp - 18 - 18 Rp 268,632
25 Fitomenadion inj 10 mg amp/vial Rp 4,167 Rp 4,167 Rp - Rp - - - - Rp -
26 Fitomenadion inj 2 mg amp/vial Rp 4,083 Rp 4,083 96 Rp 391,968 Rp - 96 - 96 Rp 391,968
27 Flamicort amp/vial Rp 53,482 Rp 53,482 Rp - Rp - - - - Rp -
28 Furosemid inj amp/vial Rp 2,058 Rp 2,058 319 Rp 656,502 Rp - 319 - 319 Rp 656,502
29 Gentamisin inj amp/vial Rp 3,896 Rp 3,896 19 Rp 74,024 Rp - 19 - 19 Rp 74,024

30 Herbesser inj 2 mg amp/vial Rp 148,500 Rp 148,500 Rp - Rp - - - - Rp -

31 Ketorolac 30 mg inj amp/vial Rp 2,250 Rp 2,250 46 Rp 103,500 Rp - 46 - 46 Rp 103,500
32 Klonidin (catapres) inj amp/vial Rp 32,600 Rp 32,600 Rp - Rp - - - - Rp -
33 Lidokain Compusitum amp/vial Rp 2,112 Rp 2,112 Rp - Rp - - - - Rp -
34 Lidokain inj amp/vial Rp 1,000 Rp 1,000 117 Rp 117,000 Rp - 117 - 117 Rp 117,000
35 Mecobalamin inj amp/vial Rp 6,600 Rp 6,600 35 Rp 231,000 Rp - 35 - 35 Rp 231,000
36 Meropenem 1 gr inj amp/vial Rp 42,743 Rp 42,743 Rp - Rp - - - - Rp -
37 Metil prednisolon 125 mg inj amp/vial Rp 12,800 Rp 12,800 81 Rp 1,036,800 Rp - 81 - 81 Rp 1,036,800
38 Metoklorpramid inj / metolon amp/vial Rp 8,910 Rp 8,910 Rp - Rp - - - - Rp -
39 Nefrofer (Cosmofer) amp/vial Rp 44,000 Rp 44,000 15 Rp 660,000 Rp - 15 - 15 Rp 660,000
40 Nicardipine inj amp/vial Rp 34,979 Rp 34,979 4 Rp 139,916 Rp - 4 - 4 Rp 139,916
41 Nokoba amp/vial Rp 82,060 Rp 82,060 Rp - Rp - - - - Rp -
42 Omeprazole inj amp/vial Rp 14,924 Rp 14,924 32 Rp 477,568 Rp - 32 - 32 Rp 477,568
43 Ondansetron inj amp/vial Rp 3,328 Rp 3,328 258 Rp 858,624 Rp - 258 - 258 Rp 858,624
44 Pantoprazole inj amp/vial Rp 37,400 Rp 37,400 Rp - Rp - - - - Rp -
45 Piracetam 1 gr inj amp/vial Rp 4,235 Rp 4,235 49 Rp 207,515 Rp - 49 - 49 Rp 207,515
46 Piracetam 3 gr inj amp/vial Rp 13,170 Rp 13,170 37 Rp 487,290 Rp - 37 - 37 Rp 487,290
47 Pycin 750 mg amp/vial Rp 68,063 Rp 68,063 4 Rp 272,252 Rp - 4 - 4 Rp 272,252
48 Ranitidin inj amp/vial Rp 1,600 Rp 1,600 397 Rp 635,200 Rp - 397 - 397 Rp 635,200
49 Sefotaxim inj amp/vial Rp 5,995 Rp 5,995 30 Rp 179,850 Rp - 30 - 30 Rp 179,850
50 Seftriaxon inj amp/vial Rp 11,000 Rp 11,000 224 Rp 2,464,000 Rp - 224 - 224 Rp 2,464,000
51 Tramadol inj amp/vial Rp 1,720 Rp 1,720 18 Rp 30,960 Rp - 18 - 18 Rp 30,960

52 Vitamin c inj amp/vial Rp 6,413 Rp 6,413 8 Rp 51,304 Rp - 8 - 8 Rp 51,304
SEDIAAN DI KULKAS
1 Anti hemoroid supp Rp 3,300 Rp 3,300 50 Rp 165,000 Rp - 50 - 50 Rp 165,000

2 Apidra plexpen Rp 87,000 Rp 87,000 Rp - Rp - - - - Rp -
3 ATS 1500 IU ampul Rp 165,000 Rp 165,000 11 Rp 1,815,000 Rp - 11 - 11 Rp 1,815,000
4 Dulcolax supp 10 mg (stolax) supp Rp 5,800 Rp 5,800 Rp - Rp - - - - Rp -
5 Dulcolax supp 5 mg supp Rp 5,800 Rp 5,800 Rp - Rp - - - - Rp -
8 Lantus / lavemir plexpen Rp 85,000 Rp 85,000 4 Rp 340,000 Rp - 4 - 4 Rp 340,000
9 Metil ergometrin inj ampul Rp 3,278 Rp 3,278 Rp - Rp - - - - Rp -
10 Noporavid plexpen Rp 87,000 Rp 87,000 3 Rp 261,000 Rp - 3 - 3 Rp 261,000
11 Norepinefrine ampul Rp 66,000 Rp 66,000 27 Rp 1,782,000 Rp - 27 - 27 Rp 1,782,000
12 Novomix plexpen Rp 110,000 Rp 110,000 Rp - Rp - - - - Rp -
15 Oksitosin inj ampul Rp 1,899 Rp 1,899 100 Rp 189,900 Rp - 100 - 100 Rp 189,900
16 SABU vial Rp 640,530 Rp 640,530 5 Rp 3,202,650 Rp - 5 - 5 Rp 3,202,650
17 Suprafenid supp Rp 2,789 Rp 2,789 12 Rp 33,468 Rp - 12 - 12 Rp 33,468
18 Tetagam inj vial Rp 170,000 Rp 170,000 Rp - Rp - - - - Rp -
19 Vaksin rabies vial Rp 140,445 Rp 140,445 Rp - Rp - - - - Rp -
20
BAKHP

1 Cutimed Gel Rp 45,591 Rp 45,591 9 Rp 410,319 Rp - 9 - 9 Rp 410,319

2 Cutimed Siltec 10X10 Rp 37,756 Rp 37,756 8 Rp 302,048 Rp - 8 - 8 Rp 302,048
3 Disp 1 CC Rp 744 Rp 744 358 Rp 266,352 Rp - 358 - 358 Rp 266,352
4 Disp 10 CC Rp 1,072 Rp 1,072 180 Rp 192,960 Rp - 180 - 180 Rp 192,960
7 Disp 50CC Lubang Pinggir Rp 4,259 Rp 4,259 23 Rp 97,957 Rp - 23 - 23 Rp 97,957
8 Disp 50CC Lubang Tengah Rp 4,260 Rp 4,260 37 Rp 157,620 Rp - 37 - 37 Rp 157,620
9 Elastamol Haff Rp 34,069 Rp 34,069 17 Rp 579,173 Rp - 17 - 17 Rp 579,173
10 ETT Nonking 2,5 Rp 357,500 Rp 357,500 Rp - Rp - - - - Rp -
11 ETT Nonking 3 Rp 357,000 Rp 357,000 Rp - Rp - - - - Rp -
12 ETT Nonking 3,5 Rp 357,000 Rp 357,000 Rp - Rp - - - - Rp -
13 ETT Nonking 5 Rp 357,000 Rp 357,000 Rp - Rp - - - - Rp -
14 Folley Cathether 10 Rp 42,565 Rp 42,565 21 Rp 893,865 Rp - 21 - 21 Rp 893,865
17 Folley Cathether 8 Rp 39,726 Rp 39,726 26 Rp 1,032,876 Rp - 26 - 26 Rp 1,032,876
18 Handscund 6 Rp 6,594 Rp 6,594 80 Rp 527,520 Rp - 80 - 80 Rp 527,520
19 Handscund 6,5 Rp 6,594 Rp 6,594 79 Rp 520,926 Rp - 79 - 79 Rp 520,926
20 Handscund 7 Rp 6,594 Rp 6,594 64 Rp 422,016 Rp - 64 - 64 Rp 422,016
21 Handscund 7,5 Rp 6,595 Rp 6,595 40 Rp 263,800 Rp - 40 - 40 Rp 263,800
22 Infuset Macro Rp 4,756 Rp 4,756 74 Rp 351,944 Rp - 74 - 74 Rp 351,944

23 Infuset Micro Rp 5,104 Rp 5,104 56 Rp 285,824 Rp - 56 - 56 Rp 285,824

24 Injec Tomat Rp 7,550 Rp 7,550 6 Rp 45,300 Rp - 6 - 6 Rp 45,300
25 Kasa kotak 16x16 Rp 3,300 Rp 3,300 18 Rp 59,400 Rp - 18 - 18 Rp 59,400
26 Masker NRM Adult Rp 19,154 Rp 19,154 20 Rp 383,080 Rp - 20 - 20 Rp 383,080
27 Masker NRM Child Rp 19,154 Rp 19,154 17 Rp 325,618 Rp - 17 - 17 Rp 325,618
28 Masker Rebrehting Adult Rp 38,500 Rp 38,500 Rp - Rp - - - - Rp -
29 Masker REbrehting Child Rp 38,500 Rp 38,500 Rp - Rp - - - - Rp -
30 NGT 16 Rp 17,600 Rp 17,600 30 Rp 528,000 Rp - 30 - 30 Rp 528,000
31 NGT 3,5 Rp 25,850 Rp 25,850 Rp - Rp - - - - Rp -
32 NGT 5 Rp 25,850 Rp 25,850 Rp - Rp - - - - Rp -
33 NGT 8 Rp 18,711 Rp 18,711 Rp - Rp - - - - Rp -
34 Poligyps 10 cm Rp 35,693 Rp 35,693 Rp - Rp - - - - Rp -
35 Selang Oksigen Anak Rp 6,325 Rp 6,325 33 Rp 208,725 Rp - 33 - 33 Rp 208,725
36 Selang Oksigen Bayi Rp 8,906 Rp 8,906 29 Rp 258,274 Rp - 29 - 29 Rp 258,274
37 Selang Oksigen Dewasa Rp 7,808 Rp 7,808 38 Rp 296,704 Rp - 38 - 38 Rp 296,704
38 Softband 10 cm Rp 99,000 Rp 99,000 2 Rp 198,000 Rp - 2 - 2 Rp 198,000
39 Softband 15 cm Rp 29,700 Rp 29,700 5 Rp 148,500 Rp - 5 - 5 Rp 148,500
40 Spalax 15x5 Rp 33,000 Rp 33,000 9 Rp 297,000 Rp - 9 - 9 Rp 297,000

45 Spalax 90x7 Rp 121,000 Rp 121,000 0 Rp - Rp - - - - Rp -

46 Suction Cathether 12 Rp 3,016 Rp 3,016 6 Rp 18,096 Rp - 6 - 6 Rp 18,096
49 Surflo 18 Rp 11,279 Rp 11,279 94 Rp 1,060,226 Rp - 94 - 94 Rp 1,060,226
50 Surflo 20 Rp 9,900 Rp 9,900 19 Rp 188,100 Rp - 19 - 19 Rp 188,100
53 Surflo W 22 Rp 25,289 Rp 25,289 10 Rp 252,890 Rp - 10 - 10 Rp 252,890
54 Surfo W 26 Rp 24,291 Rp 24,291 46 Rp 1,117,386 Rp - 46 - 46 Rp 1,117,386
55 Tensocrape 15 cm Rp 41,870 Rp 41,870 11 Rp 460,570 Rp - 11 - 11 Rp 460,570
56 Tensocrape 7,5 cm Rp 27,660 Rp 27,660 11 Rp 304,260 Rp - 11 - 11 Rp 304,260
57 Tensocrpae 10 cm Rp 32,892 Rp 32,892 1 Rp 32,892 Rp - 1 - 1 Rp 32,892
58 Transfusi set Rp 25,245 Rp 25,245 87 Rp 2,196,315 Rp - 87 - 87 Rp 2,196,315
59 Urinebag Rp 3,465 Rp 3,465 37 Rp 128,205 Rp - 37 - 37 Rp 128,205
60 Selang SCT Rp 35,552 Rp 35,552 25 Rp 888,800 Rp - 25 - 25 Rp 888,800
61 Disp 20CC Rp 1,728 Rp 1,728 63 Rp 108,864 Rp - 63 - 63 Rp 108,864
62 ETT NON KING 6,5 Rp 357,500 Rp 357,500 0 Rp - Rp - - - - Rp -
63 3-Way stopcock Rp 22,627 Rp 22,627 4 Rp 90,508 Rp - 4 - 4 Rp 90,508
64 Novotwist Rp 2,083 Rp 2,083 13 Rp 27,079 Rp - 13 - 13 Rp 27,079
65 Masker NRM Bayi Rp 19,154 Rp 19,154 3 Rp 57,462 Rp - 3 - 3 Rp 57,462
66 Underpad Rp 3,933 Rp 3,933 19 Rp 74,727 Rp - 19 - 19 Rp 74,727

67 Actimove M Rp 84,260 Rp 84,260 1 Rp 84,260 Rp - 1 - 1 Rp 84,260

68 Actimove S Rp 84,260 Rp 84,260 2 Rp 168,520 Rp - 2 - 2 Rp 168,520
69 Spalak 70x7 Rp 88,000 Rp 88,000 9 Rp 792,000 Rp - 9 - 9 Rp 792,000
70 Daryantull Rp 9,250 Rp 9,250 5 Rp 46,250 Rp - 15 - 15 Rp 138,750
BENANG
1 Catgut Crhom 3/0 DS 19 Rp 57,200 Rp 57,200 11 Rp 629,200 Rp - 11 - 11 Rp 629,200

2 Catgut Plain 2/0 HR 37 Rp 35,285 Rp 35,285 36 Rp 1,270,260 Rp - 36 - 36 Rp 1,270,260
3 Premilene 3/0 DS 24 Rp 51,988 Rp 51,988 33 Rp 1,715,604 Rp - 33 - 33 Rp 1,715,604
4 Premilene 6/0 DS 12 Rp 51,088 Rp 51,088 23 Rp 1,175,024 Rp - 23 - 23 Rp 1,175,024
5 Premiline 5/0 DS 16 Rp 57,186 Rp 57,186 29 Rp 1,658,394 Rp - 29 - 29 Rp 1,658,394
6 Silk 3/0 HR 25 Rp 370,624 Rp 370,624 8 Rp 2,964,992 Rp - 8 - 8 Rp 2,964,992
7 Silk 5/0 DS Rp 49,912 Rp 49,912 26 Rp 1,297,712 Rp - 26 - 26 Rp 1,297,712
OBAT PELENGKAP
1 Aminefron Rp 6,793 Rp 6,793 91 Rp 618,163 Rp - 91 - 91 Rp 618,163

2 Antimo Rp 384 Rp 384 100 Rp 38,400 Rp - 100 - 100 Rp 38,400
3 Antrain 500 mg Rp 1,679 Rp 1,679 60 Rp 100,740 Rp - 60 - 60 Rp 100,740
4 Aspar-K Rp 2,474 Rp 2,474 Rp - Rp - - - - Rp -
5 Car-Q Rp 9,666 Rp 9,666 25 Rp 241,650 Rp - 25 - 25 Rp 241,650

6 Colistine Rp 6,160 Rp 6,160 5 Rp 30,800 Rp - 5 - 5 Rp 30,800

7 FG Troches Rp 1,081 Rp 1,081 34 Rp 36,754 Rp - 34 - 34 Rp 36,754
8 Gastrul Rp 11,172 Rp 11,172 50 Rp 558,600 Rp - 50 - 50 Rp 558,600
9 Gitas Rp 5,494 Rp 5,494 1 Rp 5,494 Rp - 1 - 1 Rp 5,494
10 Imunos Rp 6,971 Rp 6,971 3 Rp 20,913 Rp - 3 - 3 Rp 20,913
11 Lactrin Rp 4,290 Rp 4,290 30 Rp 128,700 Rp - 30 - 30 Rp 128,700
12 L-Bio Rp 6,435 Rp 6,435 39 Rp 250,965 Rp - 39 - 39 Rp 250,965
13 Levopar Rp 1,240 Rp 1,240 39 Rp 48,360 Rp - 39 - 39 Rp 48,360
14 Lipofood Rp 4,987 Rp 4,987 90 Rp 448,830 Rp - 90 - 90 Rp 448,830
15 Maltofer Fol Rp 2,949 Rp 2,949 17 Rp 50,133 Rp - 17 - 17 Rp 50,133
16 Mefinal Rp 1,285 Rp 1,285 90 Rp 115,650 Rp - 90 - 90 Rp 115,650
17 Osfit DHA Rp 4,070 Rp 4,070 35 Rp 142,450 Rp - 35 - 35 Rp 142,450
18 Proliver Rp 5,363 Rp 5,363 7 Rp 37,541 Rp - 7 - 7 Rp 37,541
19 Promavit Rp 2,681 Rp 2,681 35 Rp 93,835 Rp - 35 - 35 Rp 93,835
20 Rhinofed Rp 1,694 Rp 1,694 120 Rp 203,280 Rp - 10 10 Rp 16,940
21 Rhinos Rp 5,121 Rp 5,121 43 Rp 220,203 Rp - 43 - 43 Rp 220,203
22 Sanmol 500 mg Rp 272 Rp 272 96 Rp 26,112 Rp - 96 - 96 Rp 26,112
23 Sistenol Rp 1,568 Rp 1,568 15 Rp 23,520 Rp - 15 - 15 Rp 23,520
24 Tremenza Rp 1,447 Rp 1,447 33 Rp 47,751 Rp - 33 - 33 Rp 47,751
25 Vip Albumin Rp 6,435 Rp 6,435 67 Rp 431,145 Rp - 67 - 67 Rp 431,145
LAIN-LAIN

1 Thrombopob Rp 51,455 Rp 51,455 8 Rp 411,640 Rp - 8 - 8 Rp 411,640

2 Ventolin Nebu Rp 4,000 Rp 4,000 14 Rp 56,000 Rp - 14 - 14 Rp 56,000
SYRUP
1 Apialis Drop Rp 25,393 Rp 25,393 3 Rp 76,179 Rp - 3 - 3 Rp 76,179

2 Apialis Sirup Rp 29,494 Rp 29,494 5 Rp 147,470 Rp - 5 - 5 Rp 147,470
3 Elkana Sirup Rp 46,085 Rp 46,085 5 Rp 230,425 Rp - 5 - 5 Rp 230,425
4 Gastrinal Rp 25,204 Rp 25,204 6 Rp 151,224 Rp - 6 - 6 Rp 151,224
5 Imunos Sirup Rp 85,800 Rp 85,800 5 Rp 429,000 Rp - 5 - 5 Rp 429,000
6 Mucos Sirup Rp 15,675 Rp 15,675 11 Rp 172,425 Rp - 11 - 11 Rp 172,425
7 Oxoril Rp 29,150 Rp 29,150 6 Rp 174,900 Rp - 6 - 6 Rp 174,900
8 Pralax Sirup Rp 66,495 Rp 66,495 0 Rp - Rp - - - - Rp -
9 PSIDII Sirup Rp 34,485 Rp 34,485 10 Rp 344,850 Rp - 10 - 10 Rp 344,850
10 Sanmol Drop Rp 15,100 Rp 15,100 9 Rp 135,900 Rp - 9 - 9 Rp 135,900
11 Sanmol Sirup Rp 11,234 Rp 11,234 2 Rp 22,468 Rp - 2 - 2 Rp 22,468
12 Tiriz drop Rp 64,350 Rp 64,350 0 Rp - Rp - - - - Rp -
13 Vometa Drop Rp 41,278 Rp 41,278 4 Rp 165,112 Rp - 4 - 4 Rp 165,112
14 Vometa Sirup Rp 41,278 Rp 41,278 4 Rp 165,112 Rp - 4 - 4 Rp 165,112
15 Zick Sirup Rp 4,958 Rp 4,958 10 Rp 49,580 Rp - 10 - 10 Rp 49,580

INJEKSI
1 Acran Injeksi Rp 20,189 Rp 20,189 Rp - Rp - - - - Rp -

2 Gitas Injeksi Rp 24,929 Rp 24,929 44 Rp 1,096,876 Rp - 44 - 44 Rp 1,096,876
3 Norages Injeksi Rp 8,955 Rp 8,955 27 Rp 241,785 Rp - 27 - 27 Rp 241,785
4 NS PIGGY 100 CC Rp 11,047 Rp 11,047 14 Rp 154,658 Rp - 14 - 14 Rp 154,658
5 Tiaryt Injeksi Rp 16,500 Rp 16,500 5 Rp 82,500 Rp - 5 - 5 Rp 82,500
6 Salin 3% Rp 23,714 Rp 23,714 8 Rp 189,712 Rp - 8 - 8 Rp 189,712
7 Forumen Rp 24,714 Rp 24,714 1 Rp 24,714 Rp - 1 - 1 Rp 24,714
8 Tarivid Rp 36,900 Rp 36,900 1 Rp 36,900 Rp - 1 - 1 Rp 36,900
9 Topazol Injeksi Rp 148,005 Rp 148,005 Rp - Rp - - - - Rp -
TOTAL Rp 80,431,225 Rp - Rp 80,351,959
Amuntai, 05 Maret 2018

Kepala instalasi Farmasi Mengetahui,
PJ Depo IGD
Ina Septina S . Farm Apt Sri Warni

NIP; 19810922 200604 2 016 Nip : 19890725 200903 2 00
ERIK BPJS DEPO FARMASI IGD PERIODE APRIL 2018
MASI RSUD PAMBALAH BATUNG
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
Rp -

Mengetahui,
PJ Depo IGD
Sri Warni
Nip : 19890725 200903 2 001

SEDIAAN INFUS
1 Aqua Pro Injeksi floz Rp 2,750 Rp 2,750 99 Rp 272,250 240 Rp 660,000 252 - 252 Rp 693,000
2 Asering Infus kolf Rp 9,275 Rp 9,275 41 Rp 380,275 Rp - 13 - 13 Rp 120,575
3 Ciprofloksasin infus botol Rp 10,890 Rp 10,890 Rp - Rp - - - - Rp -
4 D40 % floz Rp 3,963 Rp 3,963 6 Rp 23,778 20 Rp 79,260 11 - 11 Rp 43,593
7 Fluconazol infus botol Rp 29,540 Rp 29,540 Rp - Rp - - - - Rp -
8 Futrolit softbag Rp 39,327 Rp 39,327 Rp - Rp - - - - Rp -
10 Glukosa 5 kolf Rp 7,287 Rp 7,287 6 Rp 43,722 20 Rp 145,740 14 - 14 Rp 102,018
11 Hidromal softbag Rp 49,600 Rp 49,600 Rp - Rp - - - - Rp -
12 KCl floz Rp 7,524 Rp 7,524 4 Rp 30,096 20 Rp 150,480 2 - 2 Rp 15,048
13 Levofloksasin 500 mg botol Rp 26,881 Rp 26,881 16 Rp 430,096 Rp - 3 - 3 Rp 80,643
14 Levofloksasin 750mg botol Rp 136,125 Rp 136,125 9 Rp 1,225,125 Rp - 1 - 1 Rp 136,125
15 Manitol kolf Rp 44,000 Rp 44,000 13 Rp 572,000 10 Rp 440,000 17 - 17 Rp 748,000
16 Metronidazol infus botol Rp 9,680 Rp 9,680 31 Rp 300,080 Rp - 9 - 9 Rp 87,120
17 Meylon inj floz Rp 10,890 Rp 10,890 5 Rp 54,450 Rp - - - - Rp -
18 MgSO4 20 % floz Rp 3,200 Rp 3,200 Rp - Rp - - - - Rp -
19 MgSO4 40 % floz Rp 3,650 Rp 3,650 4 Rp 14,600 Rp - - - - Rp -

20 Moxifloxacin inf botol Rp 214,500 Rp 214,500 1 Rp 214,500 1 Rp 214,500 - - - Rp -

21 Nacl kolf Rp 6,292 Rp 6,292 48 Rp 302,016 100 Rp 629,200 111 - 111 Rp 698,412
22 Paracetamol infus botol Rp 30,250 Rp 30,250 38 Rp 1,149,500 Rp - 38 - 38 Rp 1,149,500
23 RL infus kolf Rp 7,095 Rp 7,095 52 Rp 368,940 100 Rp 709,500 125 - 125 Rp 886,875
24 Kendal Infus kolf Rp 47,272 Rp 47,272 Rp - 5 Rp 236,360 1 - 1 Rp 47,272
1 Asiklovir salep kulit tube Rp 2,997 Rp 2,997 8 Rp 23,976 Rp - 2 - 2 Rp 5,994

2 Avamys tabung Rp 102,999 Rp 102,999 Rp - Rp - - - - Rp -
3 Berotec inhaler tabung Rp 80,000 Rp 80,000 3 Rp 240,000 Rp - 3 - 3 Rp 240,000
4 Betametason SK tube Rp 2,026 Rp 2,026 Rp - 28 Rp 56,728 1 - 1 Rp 2,026
5 Bioplacenton salep Rp 13,557 Rp 13,557 20 Rp 271,140 Rp - 8 - 8 Rp 108,456
6 Burnazin cream tube Rp 52,376 Rp 52,376 8 Rp 419,008 Rp - 4 - 4 Rp 209,504
7 Combivent nebules amp/vial Rp 5,700 Rp 5,700 45 Rp 256,500 200 Rp 1,140,000 116 - 116 Rp 661,200
8 Fenol Gliserol tube Rp 2,246 Rp 2,246 Rp - Rp - - - - Rp -
9 Genoin Salep tube Rp 5,104 Rp 5,104 Rp - Rp - - - - Rp -
10 Gentamisin Salep kulit / genoint tube Rp 2,126 Rp 2,126 24 Rp 51,024 Rp - 5 - 5 Rp 10,630
11 Gentamisin salep mata tube Rp 3,960 Rp 3,960 Rp - Rp - - - - Rp -
12 Gentamisin tetes mata botol Rp 3,297 Rp 3,297 Rp - Rp - - - - Rp -
13 Gentian violet botol Rp 6,655 Rp 6,655 Rp - Rp - - - - Rp -
14 Hidrokortison salep kulit tube Rp 11,132 Rp 11,132 29 Rp 322,828 Rp - - - - Rp -

15 Iliadin Spray botol Rp 37,900 Rp 37,900 Rp - Rp - - - - Rp -

16 Ketokonazole salep kulit tube Rp 2,200 Rp 2,200 25 Rp 55,000 Rp - 22 - 22 Rp 48,400
17 Kloramfenikol salep mata tube Rp 1,850 Rp 1,850 Rp - Rp - - - - Rp -
18 Kloramfenikol tetes mata botol Rp 2,750 Rp 2,750 Rp - Rp - - - - Rp -
19 Miconazole salep kulit tube Rp 3,736 Rp 3,736 Rp - 29 Rp 108,344 1 - 1 Rp 3,736
20 Oksitetrasiklin salep kulit tube Rp 1,649 Rp 1,649 Rp - Rp - - - - Rp -
21 Oksitetrasiklin salep mata tube Rp 2,772 Rp 2,772 Rp - Rp - - - - Rp -
22 PK botol Rp 3,300 Rp 3,300 Rp - Rp - - - - Rp -
SEDIAAN SIRUP
1 Ambroxol sirup 15mg botol Rp 3,627 Rp 3,627 4 Rp 14,508 Rp - 1 - 1 Rp 3,627

2 Amoksilin Sirup botol Rp 5,626 Rp 5,626 18 Rp 101,268 Rp - 10 - 10 Rp 56,260
3 Amoxillin drop botol Rp 10,780 Rp 10,780 Rp - Rp - - - - Rp -
4 Antasida sirup botol Rp 3,184 Rp 3,184 32 Rp 101,888 Rp - 32 - 32 Rp 101,888
5 Cefadroxyl syr botol Rp 4,999 Rp 4,999 Rp - Rp - - - - Rp -
6 Cefixime sirup botol Rp 11,880 Rp 11,880 0 Rp - 5 Rp 59,400 5 - 5 Rp 59,400
7 Cetirizin syr botol Rp 10,440 Rp 10,440 1 Rp 10,440 20 Rp 208,800 6 - 6 Rp 62,640
8 Cloramfenikol Sirup botol Rp 7,783 Rp 7,783 Rp - Rp - - - - Rp -
9 Cotrimoksazol Sirup botol Rp 2,225 Rp 2,225 3 Rp 6,675 10 Rp 22,250 1 - 1 Rp 2,225
10 Domperidon Sirup botol Rp 9,000 Rp 9,000 9 Rp 81,000 Rp - 2 - 2 Rp 18,000
11 Gavistal / Metoklopramid botol Rp 2,520 Rp 2,520 Rp - Rp - - - - Rp -

12 Ibuprofen syr 100 mg botol Rp 4,225 Rp 4,225 3 Rp 12,675 10 Rp 42,250 7 - 7 Rp 29,575

13 Lactulax botol Rp 48,400 Rp 48,400 Rp - Rp - - - - Rp -
14 Nystatin drop botol Rp 21,780 Rp 21,780 9 Rp 196,020 10 Rp 217,800 5 - 5 Rp 108,900
15 OBH botol Rp 4,100 Rp 4,100 Rp - Rp - - - - Rp -
16 Paracetamol drop botol Rp 8,124 Rp 8,124 5 Rp 40,620 20 Rp 162,480 12 - 12 Rp 97,488
17 Paracetamol sirup botol Rp 1,012 Rp 1,012 48 Rp 48,576 Rp - 25 - 25 Rp 25,300
18 Plantacid syr botol Rp 8,910 Rp 8,910 Rp - 2 Rp 17,820 1 - 1 Rp 8,910
19 Salbutamol syr botol Rp 4,916 Rp 4,916 8 Rp 39,328 10 Rp 49,160 7 - 7 Rp 34,412
20 Sucralfat Syr botol Rp 10,100 Rp 10,100 14 Rp 141,400 70 Rp 707,000 74 - 74 Rp 747,400
SEDIAAN TABLET ORAL
1 Acarbose 50 (Eclid) tab / cap Rp 657 Rp 657 Rp - Rp - - - - Rp -

2 Acetyl systein tab / cap Rp 1,100 Rp 1,100 Rp - 60 Rp 66,000 25 - 25 Rp 27,500
3 Allopurinol tab 100 MG tab / cap Rp 120 Rp 120 Rp - 100 Rp 12,000 30 - 30 Rp 3,600
4 Allopurinol tab 300 MG tab / cap Rp 230 Rp 230 Rp - Rp - - - - Rp -
5 Ambroxol tab tab / cap Rp 744 Rp 744 41 Rp 30,504 300 Rp 223,200 230 - 230 Rp 171,120
6 Aminofilin tab tab / cap Rp 103 Rp 103 Rp - 100 Rp 10,300 5 - 5 Rp 515
7 Amlodipin 10 mg tab / cap Rp 167 Rp 167 20 Rp 3,340 300 Rp 50,100 123 - 123 Rp 20,541
8 Amlodipin 5 mg tab tab / cap Rp 116 Rp 116 79 Rp 9,164 300 Rp 34,800 68 - 68 Rp 7,888
9 Amoksilin 500 mg tab tab / cap Rp 209 Rp 209 485 Rp 101,365 Rp - 386 - 386 Rp 80,674
10 Amvar tab / cap Rp 5,445 Rp 5,445 Rp - 150 Rp 816,750 103 - 103 Rp 560,835

11 antasida tab tab / cap Rp 59 Rp 59 97 Rp 5,723 Rp - 52 - 52 Rp 3,068

12 Asam Folat tab / cap Rp 138 Rp 138 566 Rp 78,108 Rp - 62 - 62 Rp 8,556
13 Asam Mefenamat tab / cap Rp 102 Rp 102 140 Rp 14,280 Rp - 62 - 62 Rp 6,324
14 Asam Tranexamat 500 tab / cap Rp 1,069 Rp 1,069 166 Rp 177,454 Rp - 45 - 45 Rp 48,105
15 Asiklovir 200 mg tab / cap Rp 359 Rp 359 Rp - Rp - - - - Rp -
16 Asiklovir 400 mg tab / cap Rp 571 Rp 571 70 Rp 39,970 Rp - - - - Rp -
17 Aspar k tab (Kalipar) tab / cap Rp 682 Rp 682 47 Rp 32,054 Rp - 9 - 9 Rp 6,138
18 Aspilet tab / cap Rp 94 Rp 94 82 Rp 7,708 Rp - 47 - 47 Rp 4,418
19 Atorvastatin 10 mg tab / cap Rp 1,892 Rp 1,892 177 Rp 334,884 Rp - - - - Rp -
21 Attalpugit (Pularex) tab / cap Rp 160 Rp 160 23 Rp 3,680 300 Rp 48,000 117 - 117 Rp 18,720
22 Azitromisin 500 mg tab / cap Rp 8,800 Rp 8,800 Rp - Rp - - - - Rp -
23 Betahistin tab tab / cap Rp 151 Rp 151 100 Rp 15,100 Rp - 73 - 73 Rp 11,023
24 Bisakodil (Dulkolax) tab tab / cap Rp 1,030 Rp 1,030 50 Rp 51,500 Rp - - - - Rp -
25 Bisoprolol 2,5 mg / concor tab / cap Rp 650 Rp 650 Rp - Rp - - - - Rp -
26 Bisoprolol 5 mg tab / cap Rp 298 Rp 298 314 Rp 93,572 Rp - 46 - 46 Rp 13,708
27 Calsium Lactat tab / cap Rp 57 Rp 57 113 Rp 6,441 Rp - - - - Rp -
Candersartan 8 mg (canderin) tab / cap Rp 770 Rp 770 190 Rp 146,300 Rp - 32 - 32 Rp 24,640
28 Candesartan 16 mg tab / cap Rp - Rp - 207 Rp - Rp - 3 - 3 Rp -
29 Captopril 12,5 mg tab / cap Rp 69 Rp 69 277 Rp 19,113 Rp - 21 - 21 Rp 1,449
30 Captopril 25 mg tab / cap Rp 105 Rp 105 119 Rp 12,495 300 Rp 31,500 140 - 140 Rp 14,700
31 Cefadroxyl 500 tab / cap Rp 560 Rp 560 75 Rp 42,000 500 Rp 280,000 160 - 160 Rp 89,600

32 Cefiksim 100 mg tab / cap Rp 1,676 Rp 1,676 290 Rp 486,040 Rp - 70 - 70 Rp 117,320

33 Cetirizin 10 mg tab / cap Rp 120 Rp 120 462 Rp 55,440 Rp - 175 - 175 Rp 21,000
34 Cilostazol tab 100 mg tab / cap Rp 8,000 Rp 8,000 198 Rp 1,584,000 Rp - 9 - 9 Rp 72,000
35 Ciproflokasin 500 mg tab / cap Rp 320 Rp 320 200 Rp 64,000 Rp - 8 - 8 Rp 2,560
36 Citicolin 500 mg tab / cap Rp 5,940 Rp 5,940 40 Rp 237,600 Rp - 10 - 10 Rp 59,400
37 Clindamisin 300 mg tab / cap Rp 660 Rp 660 Rp - Rp - - - - Rp -
38 Clonidin tab tab / cap Rp 205 Rp 205 100 Rp 20,500 Rp - - - - Rp -
39 Clopidogrel tab / cap Rp 1,799 Rp 1,799 354 Rp 636,846 Rp - 111 - 111 Rp 199,689
40 Co- amoxiclav tab / cap Rp 5,808 Rp 5,808 142 Rp 824,736 Rp - 42 - 42 Rp 243,936
41 Cotrimoxazol 480 tab tab / cap Rp 267 Rp 267 90 Rp 24,030 Rp - 90 - 90 Rp 24,030
42 CTM tab tab / cap Rp 45 Rp 45 82 Rp 3,690 Rp - 31 - 31 Rp 1,395
43 Curcuma tab tab / cap Rp 78 Rp 78 126 Rp 9,828 100 Rp 7,800 94 - 94 Rp 7,332
44 Cytodrox tab / cap Rp 5,280 Rp 5,280 Rp - Rp - - - - Rp -
45 Dexametason tab tab / cap Rp 92 Rp 92 38 Rp 3,496 100 Rp 9,200 68 - 68 Rp 6,256
46 Dexketopropen tab / cap Rp 2,970 Rp 2,970 Rp - Rp - - - - Rp -
47 Digoksin tab tab / cap Rp 109 Rp 109 100 Rp 10,900 Rp - 10 - 10 Rp 1,090
48 Diltiazem 30 mg tab / cap Rp 144 Rp 144 Rp - Rp - - - - Rp -
49 Dimenhidrinat tab / cap Rp 142 Rp 142 Rp - Rp - - - - Rp -
50 Doksisiklin tab tab / cap Rp 290 Rp 290 Rp - Rp - - - - Rp -
51 Domperidone tab tab / cap Rp 118 Rp 118 78 Rp 9,204 Rp - 25 - 25 Rp 2,950
52 Dopamet tab / cap Rp 1,050 Rp 1,050 Rp - Rp - - - - Rp -
53 Eperison (Perilax) tab / cap Rp 1,309 Rp 1,309 481 Rp 629,629 Rp - 63 - 63 Rp 82,467

54 Erytromisin 250 mg tab / cap Rp 509 Rp 509 Rp - Rp - - - - Rp -

55 Etambutol tab tab / cap Rp 574 Rp 574 Rp - Rp - - - - Rp -
56 Fenofibrate 100 mg tab / cap Rp 605 Rp 605 Rp - Rp - - - - Rp -
57 Fenofibrate 300 mg tab / cap Rp 1,303 Rp 1,303 Rp - Rp - - - - Rp -
58 Ferrosulfat tab / cap Rp 400 Rp 400 53 Rp 21,200 Rp - 6 - 6 Rp 2,400
59 Finasteride 5 mg tab / finro tab / cap Rp 1,919 Rp 1,919 Rp - 40 Rp 76,760 13 - 13 Rp 24,947
60 Fluconazol tab / cap Rp 20,700 Rp 20,700 Rp - Rp - - - - Rp -
61 Flunarizine 10 mg tab / cap Rp 3,325 Rp 3,325 Rp - Rp - - - - Rp -
62 Flunarizine 5 mg tab / cap Rp 2,090 Rp 2,090 92 Rp 192,280 Rp - 4 - 4 Rp 8,360
63 Furosemid tab tab / cap Rp 181 Rp 181 Rp - 200 Rp 36,200 21 - 21 Rp 3,801
64 Gabexal tab / cap Rp 1,639 Rp 1,639 Rp - Rp - - - - Rp -
65 Gemfibrozil 300 mg tab / cap Rp 386 Rp 386 Rp - Rp - - - - Rp -
66 GG tab tab / cap Rp 45 Rp 45 41 Rp 1,845 Rp - - - - Rp -
67 Glibenklamid tab tab / cap Rp 92 Rp 92 99 Rp 9,108 Rp - 9 - 9 Rp 828
68 Glikuidon (Lodem) tab / cap Rp 3,648 Rp 3,648 Rp - Rp - - - - Rp -
69 Glimepirid 2 mg tab / cap Rp 296 Rp 296 140 Rp 41,440 Rp - 3 - 3 Rp 888
70 Glimepirid 3 mg tab / cap Rp 319 Rp 319 Rp - Rp - - - - Rp -
71 Glukodex tab / cap Rp 245 Rp 245 Rp - Rp - - - - Rp -
72 Glukosamine tab tab / cap Rp 704 Rp 704 35 Rp 24,640 Rp - 30 - 30 Rp 21,120
73 Harnal / Hytroz tab / cap Rp 1,425 Rp 1,425 Rp - Rp - - - - Rp -
74 Herbesser tab / cap Rp 4,290 Rp 4,290 Rp - Rp - - - - Rp -
75 Hidroklorotiazid 25 mg tab / cap Rp 171 Rp 171 215 Rp 36,765 Rp - 10 - 10 Rp 1,710

76 Ibuprofen 400 mg tab tab / cap Rp 180 Rp 180 90 Rp 16,200 Rp - 20 - 20 Rp 3,600

77 Interhistin tab tab / cap Rp 589 Rp 589 Rp - Rp - - - - Rp -
78 Isoniazid 300 mg tab / cap Rp 116 Rp 116 Rp - Rp - - - - Rp -
79 Isosorbid Dinitrat 5 mg tab / cap Rp 104 Rp 104 360 Rp 37,440 Rp - 51 - 51 Rp 5,304
80 Ketokonazole tab tab / cap Rp 340 Rp 340 200 Rp 68,000 Rp - - - - Rp -
81 Ketorolac tab tab / cap Rp 2,151 Rp 2,151 73 Rp 157,023 150 Rp 322,650 24 - 24 Rp 51,624
82 KSR tab / cap Rp 1,700 Rp 1,700 97 Rp 164,900 Rp - 20 - 20 Rp 34,000
83 Lansoprazole tab / cap Rp 878 Rp 878 110 Rp 96,580 Rp - 51 - 51 Rp 44,778
84 Levofloksasin 500 mg tab tab / cap Rp 686 Rp 686 40 Rp 27,440 Rp - 10 - 10 Rp 6,860
85 Lisinopril 10 mg / noperten tab / cap Rp 485 Rp 485 196 Rp 95,060 Rp - 1 - 1 Rp 485
87 Loperamid tab tab / cap Rp 105 Rp 105 76 Rp 7,980 Rp - 20 - 20 Rp 2,100
88 Loratadine tab tab / cap Rp 233 Rp 233 90 Rp 20,970 Rp - 15 - 15 Rp 3,495
89 Mecobalamin tab tab / cap Rp 654 Rp 654 162 Rp 105,948 Rp - 78 - 78 Rp 51,012
90 Meloksikam 15 mg tab / cap Rp 731 Rp 731 200 Rp 146,200 Rp - - - - Rp -
91 Meloksikam 7,5 mg tab / cap Rp 397 Rp 397 200 Rp 79,400 Rp - - - - Rp -
92 Metformin tab tab / cap Rp 110 Rp 110 253 Rp 27,830 Rp - 160 - 160 Rp 17,600
93 Metil ergometrin tab tab / cap Rp 271 Rp 271 Rp - Rp - - - - Rp -
94 Metilprednisolon 16 mg tab / cap Rp 1,169 Rp 1,169 90 Rp 105,210 Rp - - - - Rp -
95 Metilprednisolon 4 mg tab / cap Rp 220 Rp 220 32 Rp 7,040 500 Rp 110,000 252 - 252 Rp 55,440
96 Metilprednisolon 8 mg tab / cap Rp 393 Rp 393 190 Rp 74,670 Rp - - - - Rp -
97 Metochlorpramid tab tab / cap Rp 143 Rp 143 95 Rp 13,585 Rp - - - - Rp -

98 Metronidazol tab tab / cap Rp 273 Rp 273 70 Rp 19,110 Rp - 15 - 15 Rp 4,095

99 Micardis tab / cap Rp 7,150 Rp 7,150 Rp - Rp - - - - Rp -
100 Na diklofenak 50 mg tab / cap Rp 245 Rp 245 130 Rp 31,850 300 Rp 73,500 220 - 220 Rp 53,900
101 Natrium Bicarbonat tab / cap Rp 110 Rp 110 94 Rp 10,340 Rp - 21 - 21 Rp 2,310
102 Neurodex tab tab / cap Rp 484 Rp 484 121 Rp 58,564 200 Rp 96,800 117 - 117 Rp 56,628
103 Nifedipin tab tab / cap Rp 110 Rp 110 100 Rp 11,000 Rp - 4 - 4 Rp 440
104 Norelut / Norestil tab / cap Rp 2,552 Rp 2,552 Rp - Rp - - - - Rp -
105 Omeprazole tab tab / cap Rp 326 Rp 326 175 Rp 57,050 500 Rp 163,000 357 - 357 Rp 116,382
107 Ondansetron tab 8 MG tab / cap Rp 440 Rp 440 120 Rp 52,800 120 Rp 52,800 46 - 46 Rp 20,240
108 Oralit tab / cap Rp 418 Rp 418 100 Rp 41,800 20 Rp 8,360 97 - 97 Rp 40,546
109 Ostovel tab / cap Rp 1,690 Rp 1,690 Rp - Rp - - - - Rp -
110 Parasetamol 500 mg tab / cap Rp 142 Rp 142 223 Rp 31,666 500 Rp 71,000 400 - 400 Rp 56,800
111 pioglitazone (deculin) 15 mg tab / cap Rp 3,300 Rp 3,300 Rp - Rp - - - - Rp -
112 Pioglitazone (deculin) 30 mg tab / cap Rp 4,950 Rp 4,950 Rp - Rp - - - - Rp -
113 Piracetam 1200 mg tab / cap Rp 1,166 Rp 1,166 181 Rp 211,046 Rp - 10 - 10 Rp 11,660
114 Piracetam 800 mg tab / cap Rp 682 Rp 682 Rp - Rp - - - - Rp -
115 Pirazinamid 500 mg tab / cap Rp 238 Rp 238 Rp - Rp - - - - Rp -
116 Prednison tab / cap Rp 144 Rp 144 Rp - Rp - - - - Rp -
117 Pregabalin 75 mg tab / cap Rp 7,472 Rp 7,472 28 Rp 209,216 Rp - - - - Rp -

120 Provera / hystolan / medroksiproge tab / cap Rp 2,521 Rp 2,521 Rp - Rp - - - - Rp -

121 PTU tab / cap Rp 451 Rp 451 Rp - Rp - - - - Rp -
122 Ranitidin tab tab / cap Rp 110 Rp 110 118 Rp 12,980 1,000 Rp 110,000 808 - 808 Rp 88,880
123 Retaphyl tab / cap Rp 2,143 Rp 2,143 Rp - Rp - - - - Rp -
124 Rifampisin 450 mg tab / cap Rp 1,146 Rp 1,146 Rp - Rp - - - - Rp -
125 Rifanh 150/150 tab / cap Rp 7,246 Rp 7,246 Rp - Rp - - - - Rp -
126 Rimactazid tab / cap Rp 6,471 Rp 6,471 Rp - Rp - - - - Rp -
127 Rimstar/rifastar tab / cap Rp 5,115 Rp 5,115 Rp - Rp - - - - Rp -
128 Salbutamol 2 mg tab / cap Rp 78 Rp 78 85 Rp 6,630 Rp - 14 - 14 Rp 1,092
129 Sifrol 0,375 mg tab tab / cap Rp 8,000 Rp 8,000 Rp - Rp - - - - Rp -
130 Simarc / warfarin tab / cap Rp 950 Rp 950 Rp - Rp - - - - Rp -
131 Simvastatin 10mg tab tab / cap Rp 67 Rp 67 100 Rp 6,700 Rp - - - - Rp -
132 Simvastatin 20 mg tab / cap Rp 1,026 Rp 1,026 59 Rp 60,534 Rp - 35 - 35 Rp 35,910
133 Spironolakton 100 mg tab / cap Rp 1,000 Rp 1,000 99 Rp 99,000 Rp - - - - Rp -
134 Spironolakton 25 mg tab / cap Rp 335 Rp 335 86 Rp 28,810 Rp - 28 - 28 Rp 9,380
135 Sulfasalazin tab / cap Rp 2,090 Rp 2,090 Rp - Rp - - - - Rp -
136 Tetrasiklin 250 mg tab / cap Rp 378 Rp 378 Rp - Rp - - - - Rp -
137 Thiamfenikol 500 mg tab / cap Rp 985 Rp 985 Rp - Rp - - - - Rp -
138 Tramadol tab tab / cap Rp 329 Rp 329 Rp - Rp - - - - Rp -
139 Urotractin tab / cap Rp 1,815 Rp 1,815 Rp - Rp - - - - Rp -
140 Ursodeoksi tab tab / cap Rp 2,723 Rp 2,723 Rp - Rp - - - - Rp -
141 Vitamin A tab / cap Rp 686 Rp 686 49 Rp 33,614 Rp - - - - Rp -

142 Vitamin B Komplek tab / cap Rp 120 Rp 120 59 Rp 7,080 300 Rp 36,000 68 - 68 Rp 8,160
146 Vitamin C 100 MG tab / cap Rp 121 Rp 121 Rp - Rp - - - - Rp -
147 Vitamin C 50 MG tab / cap Rp 120 Rp 120 200 Rp 24,000 Rp - 76 - 76 Rp 9,120
148 Vitamin K tab / cap Rp 790 Rp 790 Rp - Rp - - - - Rp -
149 Zinc tab tab / cap Rp 592 Rp 592 Rp - Rp - - - - Rp -
RACIKAN / PRODUKSI
1 Racikan 3 (Analtram) tab / cap Rp 854 Rp 854 39 Rp 33,306 Rp - 5 - 5 Rp 4,270
SEDIAAN INJEKSI
1 Amikasin inj amp/vial Rp 71,874 Rp 71,874 Rp - Rp - - - - Rp -

2 Aminofilin inj amp/vial Rp 3,080 Rp 3,080 18 Rp 55,440 Rp - 5 - 5 Rp 15,400
3 Amoksilin inj amp/vial Rp 9,900 Rp 9,900 10 Rp 99,000 Rp - - - - Rp -
4 Ampisilin inj amp/vial Rp 10,188 Rp 10,188 6 Rp 61,128 5 Rp 50,940 9 - 9 Rp 91,692
5 Antrain Inj amp/vial Rp 5,511 Rp 5,511 6 Rp 33,066 215 Rp 1,184,865 98 - 98 Rp 540,078
6 Arixtra amp/vial Rp 265,833 Rp 265,833 2 Rp 531,666 10 Rp 2,658,330 1 - 1 Rp 265,833
7 As. Tranexamat 500 mg inj amp/vial Rp 2,530 Rp 2,530 94 Rp 237,820 Rp - 66 - 66 Rp 166,980

8 Atropin inj amp/vial Rp 1,264 Rp 1,264 100 Rp 126,400 Rp - 1 - 1 Rp 1,264

9 Biocombin inj amp/vial Rp 4,070 Rp 4,070 12 Rp 48,840 5 Rp 20,350 14 - 14 Rp 56,980
10 Ca. Glukonas inj amp/vial Rp 9,955 Rp 9,955 9 Rp 89,595 Rp - - - - Rp -
11 Cefazolin amp/vial Rp 19,675 Rp 19,675 Rp - Rp - - - - Rp -
12 Cefepime amp/vial Rp 38,285 Rp 38,285 Rp - Rp - - - - Rp -
13 Cefirome inj amp/vial Rp 79,200 Rp 79,200 Rp - Rp - - - - Rp -
14 Cefoporazon Sulbactam amp/vial Rp 79,200 Rp 79,200 Rp - Rp - - - - Rp -
15 Ceftazidime inj amp/vial Rp 15,903 Rp 15,903 Rp - Rp - - - - Rp -
16 Cernevit amp/vial Rp 157,713 Rp 157,713 4 Rp 630,852 Rp - 3 - 3 Rp 473,139
17 Citikolin 250 mg inj amp/vial Rp 10,709 Rp 10,709 1 Rp 10,709 Rp - 1 - 1 Rp 10,709
18 Citikolin 500 mg inj amp/vial Rp 21,600 Rp 21,600 1 Rp 21,600 200 Rp 4,320,000 94 - 94 Rp 2,030,400
19 Dexametason inj amp/vial Rp 1,641 Rp 1,641 96 Rp 157,536 Rp - 10 - 10 Rp 16,410
20 Dipenhidramin inj amp/vial Rp 1,220 Rp 1,220 28 Rp 34,160 Rp - 12 - 12 Rp 14,640
21 Dobutamin inj amp/vial Rp 15,087 Rp 15,087 12 Rp 181,044 Rp - - - - Rp -
22 Dopamin inj / UDOPA amp/vial Rp 7,480 Rp 7,480 9 Rp 67,320 Rp - 2 - 2 Rp 14,960
23 Epinefrin inj amp/vial Rp 6,692 Rp 6,692 8 Rp 53,536 90 Rp 602,280 28 - 28 Rp 187,376
24 Esomeprazol amp/vial Rp 14,924 Rp 14,924 20 Rp 298,480 Rp - 2 - 2 Rp 29,848
25 Fitomenadion inj 10 mg amp/vial Rp 4,167 Rp 4,167 Rp - Rp - - - - Rp -
26 Fitomenadion inj 2 mg amp/vial Rp 4,083 Rp 4,083 115 Rp 469,545 Rp - 19 - 19 Rp 77,577
27 Flamicort amp/vial Rp 53,482 Rp 53,482 Rp - Rp - - - - Rp -
28 Furosemid inj amp/vial Rp 2,058 Rp 2,058 45 Rp 92,610 300 Rp 617,400 26 - 26 Rp 53,508
29 Gentamisin inj amp/vial Rp 3,896 Rp 3,896 20 Rp 77,920 Rp - 1 - 1 Rp 3,896

30 Herbesser inj 2 mg amp/vial Rp 148,500 Rp 148,500 Rp - Rp - - - - Rp -

31 Ketorolac 30 mg inj amp/vial Rp 2,250 Rp 2,250 24 Rp 54,000 156 Rp 351,000 134 - 134 Rp 301,500
32 Klonidin (catapres) inj amp/vial Rp 32,600 Rp 32,600 Rp - Rp - - - - Rp -
33 Lidokain Compusitum amp/vial Rp 2,112 Rp 2,112 Rp - Rp - - - - Rp -
34 Lidokain inj amp/vial Rp 1,000 Rp 1,000 34 Rp 34,000 100 Rp 100,000 17 - 17 Rp 17,000
35 Mecobalamin inj amp/vial Rp 6,600 Rp 6,600 55 Rp 363,000 Rp - 20 - 20 Rp 132,000
36 Meropenem 1 gr inj amp/vial Rp 42,743 Rp 42,743 Rp - Rp - - - - Rp -
37 Metil prednisolon 125 mg inj amp/vial Rp 12,800 Rp 12,800 35 Rp 448,000 108 Rp 1,382,400 62 - 62 Rp 793,600
38 Metoklorpramid inj / metolon amp/vial Rp 8,910 Rp 8,910 Rp - Rp - - - - Rp -
39 Nefrofer (Cosmofer) amp/vial Rp 44,000 Rp 44,000 Rp - 30 Rp 1,320,000 15 - 15 Rp 660,000
40 Nicardipine inj amp/vial Rp 34,979 Rp 34,979 17 Rp 594,643 10 Rp 349,790 23 - 23 Rp 804,517
41 Nokoba amp/vial Rp 82,060 Rp 82,060 Rp - Rp - - - - Rp -
42 Omeprazole inj amp/vial Rp 14,924 Rp 14,924 60 Rp 895,440 150 Rp 2,238,600 178 - 178 Rp 2,656,472
43 Ondansetron inj amp/vial Rp 3,328 Rp 3,328 49 Rp 163,072 400 Rp 1,331,200 191 - 191 Rp 635,648
44 Pantoprazole inj amp/vial Rp 37,400 Rp 37,400 Rp - Rp - - - - Rp -
45 Piracetam 1 gr inj amp/vial Rp 4,235 Rp 4,235 41 Rp 173,635 50 Rp 211,750 42 - 42 Rp 177,870
46 Piracetam 3 gr inj amp/vial Rp 13,170 Rp 13,170 17 Rp 223,890 40 Rp 526,800 20 - 20 Rp 263,400
47 Pycin 750 mg amp/vial Rp 68,063 Rp 68,063 2 Rp 136,126 2 Rp 136,126 - - - Rp -
48 Ranitidin inj amp/vial Rp 1,600 Rp 1,600 94 Rp 150,400 700 Rp 1,120,000 397 - 397 Rp 635,200
49 Sefotaxim inj amp/vial Rp 5,995 Rp 5,995 35 Rp 209,825 Rp - 5 - 5 Rp 29,975
50 Seftriaxon inj amp/vial Rp 11,000 Rp 11,000 100 Rp 1,100,000 288 Rp 3,168,000 164 - 164 Rp 1,804,000
51 Tramadol inj amp/vial Rp 1,720 Rp 1,720 18 Rp 30,960 Rp - - - - Rp -

52 Vitamin c inj amp/vial Rp 6,413 Rp 6,413 3 Rp 19,239 20 Rp 128,260 15 - 15 Rp 96,195
SEDIAAN DI KULKAS
1 Anti hemoroid supp Rp 3,300 Rp 3,300 Rp - 50 Rp 165,000 - - - Rp -

2 Apidra plexpen Rp 87,000 Rp 87,000 Rp - Rp - - - - Rp -
3 ATS 1500 IU ampul Rp 165,000 Rp 165,000 15 Rp 2,475,000 Rp - 4 - 4 Rp 660,000
4 Dulcolax supp 10 mg (stolax) supp Rp 5,800 Rp 5,800 Rp - Rp - - - - Rp -
5 Dulcolax supp 5 mg supp Rp 5,800 Rp 5,800 Rp - Rp - - - - Rp -
8 Lantus / lavemir plexpen Rp 85,000 Rp 85,000 4 Rp 340,000 Rp - - - - Rp -
9 Metil ergometrin inj ampul Rp 3,278 Rp 3,278 Rp - Rp - - - - Rp -
10 Noporavid plexpen Rp 87,000 Rp 87,000 3 Rp 261,000 Rp - - - - Rp -
11 Norepinefrine ampul Rp 66,000 Rp 66,000 12 Rp 792,000 20 Rp 1,320,000 5 - 5 Rp 330,000
12 Novomix plexpen Rp 110,000 Rp 110,000 Rp - Rp - - - - Rp -
15 Oksitosin inj ampul Rp 1,899 Rp 1,899 100 Rp 189,900 Rp - - - - Rp -
16 SABU vial Rp 640,530 Rp 640,530 6 Rp 3,843,180 Rp - 1 - 1 Rp 640,530
17 Suprafenid supp Rp 2,789 Rp 2,789 1 Rp 2,789 20 Rp 55,780 9 - 9 Rp 25,101
18 Tetagam inj vial Rp 170,000 Rp 170,000 Rp - Rp - - - - Rp -
19 Vaksin rabies vial Rp 140,445 Rp 140,445 Rp - Rp - - - - Rp -
20
BAKHP

1 Cutimed Gel Rp 45,591 Rp 45,591 9 Rp 410,319 Rp - - - - Rp -

2 Cutimed Siltec 10X10 Rp 37,756 Rp 37,756 8 Rp 302,048 Rp - - - - Rp -
3 Disp 1 CC Rp 744 Rp 744 39 Rp 29,016 500 Rp 372,000 181 - 181 Rp 134,664
4 Disp 10 CC Rp 1,072 Rp 1,072 166 Rp 177,952 400 Rp 428,800 386 - 386 Rp 413,792
5 Disp 3 CC Rp 750 Rp 750 66 Rp 49,500 1200 Rp 900,000 1,207 - 1,207 Rp 905,250
6 Disp 5 CC Rp 893 Rp 893 31 Rp 27,683 500 Rp 446,500 360 - 360 Rp 321,480
7 Disp 50CC Lubang Pinggir Rp 4,259 Rp 4,259 16 Rp 68,144 25 Rp 106,475 18 - 18 Rp 76,662
8 Disp 50CC Lubang Tengah Rp 4,260 Rp 4,260 59 Rp 251,340 Rp - 22 - 22 Rp 93,720
9 Elastamol Haff Rp 34,069 Rp 34,069 5 Rp 170,345 50 Rp 1,703,450 38 - 38 Rp 1,294,622
10 ETT Nonking 2,5 Rp 357,500 Rp 357,500 1 Rp 357,500 Rp - 1 - 1 Rp 357,500
11 ETT Nonking 3 Rp 357,000 Rp 357,000 1 Rp 357,000 Rp - 1 - 1 Rp 357,000
12 ETT Nonking 3,5 Rp 357,000 Rp 357,000 1 Rp 357,000 Rp - 1 - 1 Rp 357,000
13 ETT Nonking 5 Rp 357,000 Rp 357,000 1 Rp 357,000 Rp - 1 - 1 Rp 357,000
14 Folley Cathether 10 Rp 42,565 Rp 42,565 7 Rp 297,955 20 Rp 851,300 6 - 6 Rp 255,390
18 Handscund 6 Rp 6,594 Rp 6,594 49 Rp 323,106 50 Rp 329,700 19 - 19 Rp 125,286
19 Handscund 6,5 Rp 6,594 Rp 6,594 47 Rp 309,918 32 Rp 211,008 - - - Rp -
20 Handscund 7 Rp 6,594 Rp 6,594 15 Rp 98,910 100 Rp 659,400 51 - 51 Rp 336,294
21 Handscund 7,5 Rp 6,595 Rp 6,595 24 Rp 158,280 100 Rp 659,500 84 - 84 Rp 553,980
22 Infuset Macro Rp 4,756 Rp 4,756 13 Rp 61,828 350 Rp 1,664,600 289 - 289 Rp 1,374,484

23 Infuset Micro Rp 5,104 Rp 5,104 10 Rp 51,040 50 Rp 255,200 4 - 4 Rp 20,416

24 Injec Tomat Rp 7,550 Rp 7,550 23 Rp 173,650 Rp - 17 - 17 Rp 128,350
25 Kasa kotak 16x16 Rp 3,300 Rp 3,300 Rp - 20 Rp 66,000 2 - 2 Rp 6,600
26 Masker NRM Adult Rp 19,154 Rp 19,154 4 Rp 76,616 30 Rp 574,620 14 - 14 Rp 268,156
27 Masker NRM Child Rp 19,154 Rp 19,154 1 Rp 19,154 20 Rp 383,080 4 - 4 Rp 76,616
28 Masker Rebrehting Adult Rp 38,500 Rp 38,500 Rp - Rp - - - - Rp -
29 Masker REbrehting Child Rp 38,500 Rp 38,500 Rp - Rp - - - - Rp -
30 NGT 16 Rp 17,600 Rp 17,600 47 Rp 827,200 Rp - 17 - 17 Rp 299,200
31 NGT 3,5 Rp 25,850 Rp 25,850 4 Rp 103,400 Rp - 4 - 4 Rp 103,400
32 NGT 5 Rp 25,850 Rp 25,850 5 Rp 129,250 Rp - 5 - 5 Rp 129,250
33 NGT 8 Rp 18,711 Rp 18,711 5 Rp 93,555 Rp - 5 - 5 Rp 93,555
34 Poligyps 10 cm Rp 35,693 Rp 35,693 1 Rp 35,693 Rp - 1 - 1 Rp 35,693
35 Selang Oksigen Anak Rp 6,325 Rp 6,325 4 Rp 25,300 41 Rp 259,325 12 - 12 Rp 75,900
36 Selang Oksigen Bayi Rp 8,906 Rp 8,906 5 Rp 44,530 30 Rp 267,180 6 - 6 Rp 53,436
37 Selang Oksigen Dewasa Rp 7,808 Rp 7,808 40 Rp 312,320 90 Rp 702,720 92 - 92 Rp 718,336
38 Softband 10 cm Rp 99,000 Rp 99,000 2 Rp 198,000 Rp - - - - Rp -
39 Softband 15 cm Rp 29,700 Rp 29,700 5 Rp 148,500 Rp - - - - Rp -
40 Spalax 15x5 Rp 33,000 Rp 33,000 3 Rp 99,000 20 Rp 660,000 14 - 14 Rp 462,000
44 Spalax 75x6 Rp 8,030 Rp 8,030 15 Rp 120,450 Rp - - - - Rp -


49 Surflo 18 Rp 11,279 Rp 11,279 34 Rp 383,486 100 Rp 1,127,900 40 - 40 Rp 451,160
50 Surflo 20 Rp 9,900 Rp 9,900 30 Rp 297,000 100 Rp 990,000 111 - 111 Rp 1,098,900
51 Surflo 22 Rp 9,900 Rp 9,900 163 Rp 1,613,700 300 Rp 2,970,000 352 - 352 Rp 3,484,800
52 Surflo 24 Rp 9,900 Rp 9,900 64 Rp 633,600 200 Rp 1,980,000 87 - 87 Rp 861,300
53 Surflo W 22 Rp 25,289 Rp 25,289 3 Rp 75,867 16 Rp 404,624 9 - 9 Rp 227,601
54 Surfo W 26 Rp 24,291 Rp 24,291 54 Rp 1,311,714 Rp - 8 - 8 Rp 194,328
55 Tensocrape 15 cm Rp 41,870 Rp 41,870 12 Rp 502,440 Rp - 1 - 1 Rp 41,870
56 Tensocrape 7,5 cm Rp 27,660 Rp 27,660 12 Rp 331,920 Rp - 1 - 1 Rp 27,660
57 Tensocrpae 10 cm Rp 32,892 Rp 32,892 7 Rp 230,244 Rp - 6 - 6 Rp 197,352
58 Transfusi set Rp 25,245 Rp 25,245 15 Rp 378,675 200 Rp 5,049,000 128 - 128 Rp 3,231,360
59 Urinebag Rp 3,465 Rp 3,465 Rp - 50 Rp 173,250 13 - 13 Rp 45,045
60 Selang SCT Rp 35,552 Rp 35,552 Rp - 25 Rp 888,800 - - - Rp -
61 Disp 20CC Rp 1,728 Rp 1,728 19 Rp 32,832 69 Rp 119,232 25 - 25 Rp 43,200
62 ETT NON KING 6,5 Rp 357,500 Rp 357,500 Rp - 1 Rp 357,500 1 - 1 Rp 357,500
63 3-Way stopcock Rp 22,627 Rp 22,627 Rp - 60 Rp 1,357,620 56 - 56 Rp 1,267,112
64 Novotwist Rp 2,083 Rp 2,083 Rp - 50 Rp 104,150 37 - 37 Rp 77,071
65 Masker NRM Bayi Rp 19,154 Rp 19,154 Rp - 10 Rp 191,540 7 - 7 Rp 134,078
66 Underpad Rp 3,933 Rp 3,933 Rp - 20 Rp 78,660 1 - 1 Rp 3,933

67 Actimove M Rp 84,260 Rp 84,260 Rp - 2 Rp 168,520 1 - 1 Rp 84,260

68 Actimove S Rp 84,260 Rp 84,260 Rp - 2 Rp 168,520 - - - Rp -
69 Spalak 70x7 Rp 88,000 Rp 88,000 Rp - 10 Rp 880,000 1 - 1 Rp 88,000
70 Daryantull Rp 9,250 Rp 9,250 Rp - 20 Rp 185,000 15 - 15 Rp 138,750
BENANG
1 Catgut Crhom 3/0 DS 19 Rp 57,200 Rp 57,200 14 Rp 800,800 Rp - 3 - 3 Rp 171,600

2 Catgut Plain 2/0 HR 37 Rp 35,285 Rp 35,285 Rp - 36 Rp 1,270,260 - - - Rp -
3 Premilene 3/0 DS 24 Rp 51,988 Rp 51,988 35 Rp 1,819,580 Rp - 2 - 2 Rp 103,976
4 Premilene 6/0 DS 12 Rp 51,088 Rp 51,088 23 Rp 1,175,024 Rp - - - - Rp -
5 Premiline 5/0 DS 16 Rp 57,186 Rp 57,186 32 Rp 1,829,952 36 Rp 2,058,696 39 - 39 Rp 2,230,254
6 Silk 3/0 HR 25 Rp 370,624 Rp 370,624 6 Rp 2,223,744 24 Rp 8,894,976 22 - 22 Rp 8,153,728
7 Silk 5/0 DS Rp 49,912 Rp 49,912 2 Rp 99,824 36 Rp 1,796,832 12 - 12 Rp 598,944
OBAT PELENGKAP
1 Aminefron Rp 6,793 Rp 6,793 97 Rp 658,921 Rp - 6 - 6 Rp 40,758

2 Antimo Rp 384 Rp 384 100 Rp 38,400 Rp - - - - Rp -
3 Antrain 500 mg Rp 1,679 Rp 1,679 160 Rp 268,640 Rp - 100 - 100 Rp 167,900
4 Aspar-K Rp 2,474 Rp 2,474 2 Rp 4,948 Rp - 2 - 2 Rp 4,948
5 Car-Q Rp 9,666 Rp 9,666 25 Rp 241,650 Rp - - - - Rp -

6 Colistine Rp 6,160 Rp 6,160 5 Rp 30,800 Rp - - - - Rp -

7 FG Troches Rp 1,081 Rp 1,081 92 Rp 99,452 Rp - 58 - 58 Rp 62,698
8 Gastrul Rp 11,172 Rp 11,172 58 Rp 647,976 30 Rp 335,160 38 - 38 Rp 424,536
9 Gitas Rp 5,494 Rp 5,494 89 Rp 488,966 Rp - 88 - 88 Rp 483,472
10 Imunos Rp 6,971 Rp 6,971 4 Rp 27,884 20 Rp 139,420 21 - 21 Rp 146,391
11 Lactrin Rp 4,290 Rp 4,290 1 Rp 4,290 60 Rp 257,400 31 - 31 Rp 132,990
12 L-Bio Rp 6,435 Rp 6,435 62 Rp 398,970 62 Rp 398,970 85 - 85 Rp 546,975
13 Levopar Rp 1,240 Rp 1,240 39 Rp 48,360 Rp - - - - Rp -
14 Lipofood Rp 4,987 Rp 4,987 100 Rp 498,700 Rp - 10 - 10 Rp 49,870
15 Maltofer Fol Rp 2,949 Rp 2,949 33 Rp 97,317 Rp - 16 - 16 Rp 47,184
16 Mefinal Rp 1,285 Rp 1,285 90 Rp 115,650 Rp - - - - Rp -
17 Osfit DHA Rp 4,070 Rp 4,070 0 Rp - 90 Rp 366,300 55 - 55 Rp 223,850
18 Proliver Rp 5,363 Rp 5,363 Rp - 10 Rp 53,630 3 - 3 Rp 16,089
19 Promavit Rp 2,681 Rp 2,681 43 Rp 115,283 Rp - 8 - 8 Rp 21,448
20 Rhinofed Rp 1,694 Rp 1,694 Rp - 130 Rp 220,220 10 10 Rp 16,940
21 Rhinos Rp 5,121 Rp 5,121 69 Rp 353,349 Rp - 26 - 26 Rp 133,146
22 Sanmol 500 mg Rp 272 Rp 272 96 Rp 26,112 Rp - - - - Rp -
23 Sistenol Rp 1,568 Rp 1,568 10 Rp 15,680 20 Rp 31,360 15 - 15 Rp 23,520
24 Tremenza Rp 1,447 Rp 1,447 14 Rp 20,258 100 Rp 144,700 81 - 81 Rp 117,207
25 Vip Albumin Rp 6,435 Rp 6,435 1 Rp 6,435 90 Rp 579,150 24 - 24 Rp 154,440
LAIN-LAIN

1 Thrombopob Rp 51,455 Rp 51,455 9 Rp 463,095 Rp - 1 - 1 Rp 51,455

2 Ventolin Nebu Rp 4,000 Rp 4,000 7 Rp 28,000 30 Rp 120,000 23 - 23 Rp 92,000
SYRUP
1 Apialis Drop Rp 25,393 Rp 25,393 5 Rp 126,965 Rp - 2 - 2 Rp 50,786

2 Apialis Sirup Rp 29,494 Rp 29,494 6 Rp 176,964 15 Rp 442,410 16 - 16 Rp 471,904
3 Elkana Sirup Rp 46,085 Rp 46,085 5 Rp 230,425 Rp - - - - Rp -
4 Gastrinal Rp 25,204 Rp 25,204 9 Rp 226,836 Rp - 3 - 3 Rp 75,612
5 Imunos Sirup Rp 85,800 Rp 85,800 0 Rp - 7 Rp 600,600 2 - 2 Rp 171,600
6 Mucos Sirup Rp 15,675 Rp 15,675 11 Rp 172,425 Rp - - - - Rp -
7 Oxoril Rp 29,150 Rp 29,150 18 Rp 524,700 Rp - 12 - 12 Rp 349,800
8 Pralax Sirup Rp 66,495 Rp 66,495 1 Rp 66,495 Rp - 1 - 1 Rp 66,495
9 PSIDII Sirup Rp 34,485 Rp 34,485 10 Rp 344,850 Rp - - - - Rp -
10 Sanmol Drop Rp 15,100 Rp 15,100 10 Rp 151,000 Rp - 1 - 1 Rp 15,100
11 Sanmol Sirup Rp 11,234 Rp 11,234 5 Rp 56,170 Rp - 3 - 3 Rp 33,702
12 Tiriz drop Rp 64,350 Rp 64,350 1 Rp 64,350 Rp - 1 - 1 Rp 64,350
13 Vometa Drop Rp 41,278 Rp 41,278 4 Rp 165,112 Rp - - - - Rp -
14 Vometa Sirup Rp 41,278 Rp 41,278 4 Rp 165,112 Rp - - - - Rp -
15 Zick Sirup Rp 4,958 Rp 4,958 0 Rp - 10 Rp 49,580 - - - Rp -

INJEKSI
1 Acran Injeksi Rp 20,189 Rp 20,189 34 Rp 686,426 Rp - 34 - 34 Rp 686,426

2 Gitas Injeksi Rp 24,929 Rp 24,929 58 Rp 1,445,882 Rp - 14 - 14 Rp 349,006
3 Norages Injeksi Rp 8,955 Rp 8,955 61 Rp 546,255 Rp - 34 - 34 Rp 304,470
4 NS PIGGY 100 CC Rp 11,047 Rp 11,047 9 Rp 99,423 10 Rp 110,470 5 - 5 Rp 55,235
5 Tiaryt Injeksi Rp 16,500 Rp 16,500 5 Rp 82,500 Rp - - - - Rp -
6 Salin 3% Rp 23,714 Rp 23,714 1 Rp 23,714 10 Rp 237,140 3 - 3 Rp 71,142
7 Forumen Rp 24,714 Rp 24,714 Rp - 2 Rp 49,428 1 - 1 Rp 24,714
8 Tarivid Rp 36,900 Rp 36,900 Rp - 2 Rp 73,800 1 - 1 Rp 36,900
9 Topazol Injeksi Rp 148,005 Rp 148,005 0 Rp - Rp - - - - Rp -
TOTAL Rp 65,707,946 Rp 80,729,859 Rp 66,006,580

PJ Depo IGD

NIP; 19810922 200604 2 016 Nip : 19890725 200903 2 00
ERIK BPJS DEPO FARMASI IGD PERIODE MARET 2018
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 87 Rp 239,250
- - 28 Rp 259,700
- - Rp -
- - 15 Rp 59,445
- - 18 Rp 169,470
- - Rp -
- - Rp -
- - Rp -
- - 10 Rp 75,000
- - 12 Rp 87,444
- - Rp -
- - 22 Rp 165,528
- - 13 Rp 349,453
- - 8 Rp 1,089,000
- - 6 Rp 264,000
- - 22 Rp 212,960
- - 5 Rp 54,450
- - Rp -
- - 4 Rp 14,600
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 2 Rp 429,000
- - 37 Rp 232,804
- - Rp -
- - 27 Rp 191,565
- - 4 Rp 189,088
- - 6 Rp 17,982
- - Rp -
- - 0 Rp -
- - 27 Rp 54,702
- - 12 Rp 162,684
- - 4 Rp 209,504
- - 129 Rp 735,300
- - Rp -
- - Rp -
- - 19 Rp 40,394
- - Rp -
- - Rp -
- - Rp -
- - 29 Rp 322,828
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - 3 Rp 6,600
- - Rp -
- - Rp -
- - 28 Rp 104,608
- - Rp -
- - Rp -
- - Rp -
- - 3 Rp 10,881
- - 8 Rp 45,008
- - Rp -
- - 0 Rp -
- - Rp -
- - 0 Rp -
- - 15 Rp 156,600
- - Rp -
- - 12 Rp 26,700
- - 7 Rp 63,000
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 6 Rp 25,350
- - Rp -
- - 14 Rp 304,920
- - Rp -
- - 13 Rp 105,612
- - 23 Rp 23,276
- - 1 Rp 8,910
- - 11 Rp 54,076
- - 10 Rp 101,000
- - Rp -
- - 35 Rp 38,500
- - 70 Rp 8,400
- - Rp -
- - 111 Rp 82,584
- - 95 Rp 9,785
- - 197 Rp 32,899
- - 311 Rp 36,076
- - 99 Rp 20,691
- - 47 Rp 255,915
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 45 Rp 2,655
- - 504 Rp 69,552
- - 78 Rp 7,956
- - 121 Rp 129,349
- - Rp -
- - 70 Rp 39,970
- - 38 Rp 25,916
- - 35 Rp 3,290
- - 177 Rp 334,884
- - 174 Rp 520,086
- - 206 Rp 32,960
- - Rp -
- - 27 Rp 4,077
- - 50 Rp 51,500
- - Rp -
- - 268 Rp 79,864
- - 113 Rp 6,441
- - 158 Rp 121,660
- - 204 Rp -
- - 256 Rp 17,664
- - 279 Rp 29,295
- - 415 Rp 232,400
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 220 Rp 368,720
- - 287 Rp 34,440
- - 189 Rp 1,512,000
- - 192 Rp 61,440
- - 30 Rp 178,200
- - Rp -
- - 100 Rp 20,500
- - 243 Rp 437,157
- - 100 Rp 580,800
- - Rp -
- - 51 Rp 2,295
- - 132 Rp 10,296
- - Rp -
- - 70 Rp 6,440
- - Rp -
- - 90 Rp 9,810
- - Rp -
- - Rp -
- - Rp -
- - 53 Rp 6,254
- - Rp -
- - 418 Rp 547,162
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - 47 Rp 18,800
- - 27 Rp 51,813
- - Rp -
- - Rp -
- - 88 Rp 183,920
- - 179 Rp 32,399
- - Rp -
- - Rp -
- - 41 Rp 1,845
- - 90 Rp 8,280
- - Rp -
- - 137 Rp 40,552
- - Rp -
- - Rp -
- - 5 Rp 3,520
- - Rp -
- - Rp -
- - 205 Rp 35,055
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 70 Rp 12,600
- - Rp -
- - Rp -
- - 309 Rp 32,136
- - 200 Rp 68,000
- - 199 Rp 428,049
- - 77 Rp 130,900
- - 59 Rp 51,802
- - 30 Rp 20,580
- - 195 Rp 94,575
- - 150 Rp 61,500
- - 56 Rp 5,880
- - 75 Rp 17,475
- - 84 Rp 54,936
- - 200 Rp 146,200
- - 200 Rp 79,400
- - 93 Rp 10,230
- - Rp -
- - 90 Rp 105,210
- - 280 Rp 61,600
- - 190 Rp 74,670
- - 95 Rp 13,585
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 55 Rp 15,015
- - Rp -
- - 210 Rp 51,450
- - 73 Rp 8,030
- - 204 Rp 98,736
- - 96 Rp 10,560
- - Rp -
- - 318 Rp 103,668
- - 5 Rp 2,615
- - 194 Rp 85,360
- - 23 Rp 9,614
- - Rp -
- - 323 Rp 45,866
- - Rp -
- - Rp -
- - 171 Rp 199,386
- - Rp -
- - Rp -
- - Rp -
- - 28 Rp 209,216
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - Rp -
- - 310 Rp 34,100
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - 71 Rp 5,538
- - Rp -
- - Rp -
- - 100 Rp 6,700
- - 24 Rp 24,624
- - 99 Rp 99,000
- - 58 Rp 19,430
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - 49 Rp 33,614
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 291 Rp 34,920
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - 124 Rp 14,880
- - Rp -
- - Rp -
- - 34 Rp 29,036
- - Rp -
- - 13 Rp 40,040
- - 10 Rp 99,000
- - 2 Rp 20,376
- - 123 Rp 677,853
- - 11 Rp 2,924,163
- - 28 Rp 70,840
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 99 Rp 125,136
- - 3 Rp 12,210
- - 9 Rp 89,595
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - 1 Rp 157,713
- - Rp -
- - 107 Rp 2,311,200
- - 86 Rp 141,126
- - 16 Rp 19,520
- - 12 Rp 181,044
- - 7 Rp 52,360
- - 70 Rp 468,440
- - 18 Rp 268,632
- - Rp -
- - 96 Rp 391,968
- - Rp -
- - 319 Rp 656,502
- - 19 Rp 74,024
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - 46 Rp 103,500
- - Rp -
- - Rp -
- - 117 Rp 117,000
- - 35 Rp 231,000
- - Rp -
- - 81 Rp 1,036,800
- - Rp -
- - 15 Rp 660,000
- - 4 Rp 139,916
- - Rp -
- - 32 Rp 477,568
- - 258 Rp 858,624
- - Rp -
- - 49 Rp 207,515
- - 37 Rp 487,290
- - 4 Rp 272,252
- - 397 Rp 635,200
- - 30 Rp 179,850
- - 224 Rp 2,464,000
- - 18 Rp 30,960
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 8 Rp 51,304
- - 50 Rp 165,000
- - Rp -
- - 11 Rp 1,815,000
- - Rp -
- - Rp -
- - 4 Rp 340,000
- - Rp -
- - 3 Rp 261,000
- - 27 Rp 1,782,000
- - Rp -
- - 100 Rp 189,900
- - 5 Rp 3,202,650
- - 12 Rp 33,468
- - Rp -
- - Rp -
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 9 Rp 410,319
- - 8 Rp 302,048
- - 358 Rp 266,352
- - 180 Rp 192,960
- - 59 Rp 44,250
- - 171 Rp 152,703
- - 23 Rp 97,957
- - 37 Rp 157,620
- - 17 Rp 579,173
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - 21 Rp 893,865
- - 17 Rp 205,700
- - 17 Rp 205,700
- - 26 Rp 1,032,876
- - 80 Rp 527,520
- - 79 Rp 520,926
- - 64 Rp 422,016
- - 40 Rp 263,800
- - 74 Rp 351,944
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 56 Rp 285,824
- - 6 Rp 45,300
- - 18 Rp 59,400
- - 20 Rp 383,080
- - 17 Rp 325,618
- - Rp -
- - Rp -
- - 30 Rp 528,000
- - Rp -
- - Rp -
- - Rp -
- - Rp -
- - 33 Rp 208,725
- - 29 Rp 258,274
- - 38 Rp 296,704
- - 2 Rp 198,000
- - 5 Rp 148,500
- - 9 Rp 297,000
- - 2 Rp 9,900
- - 6 Rp 198,000
- - 15 Rp 107,250
- - 15 Rp 120,450
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 0 Rp -
- - 6 Rp 18,096
- - 8 Rp 24,128
- - 9 Rp 27,144
- - 94 Rp 1,060,226
- - 19 Rp 188,100
- - 111 Rp 1,098,900
- - 177 Rp 1,752,300
- - 10 Rp 252,890
- - 46 Rp 1,117,386
- - 11 Rp 460,570
- - 11 Rp 304,260
- - 1 Rp 32,892
- - 87 Rp 2,196,315
- - 37 Rp 128,205
- - 25 Rp 888,800
- - 63 Rp 108,864
- - 0 Rp -
- - 4 Rp 90,508
- - 13 Rp 27,079
- - 3 Rp 57,462
- - 19 Rp 74,727
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 1 Rp 84,260
- - 2 Rp 168,520
- - 9 Rp 792,000
- - 5 Rp 46,250
- - 11 Rp 629,200
- - 36 Rp 1,270,260
- - 33 Rp 1,715,604
- - 23 Rp 1,175,024
- - 29 Rp 1,658,394
- - 8 Rp 2,964,992
- - 26 Rp 1,297,712
- - 91 Rp 618,163
- - 100 Rp 38,400
- - 60 Rp 100,740
- - Rp -
- - 25 Rp 241,650
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 5 Rp 30,800
- - 34 Rp 36,754
- - 50 Rp 558,600
- - 1 Rp 5,494
- - 3 Rp 20,913
- - 30 Rp 128,700
- - 39 Rp 250,965
- - 39 Rp 48,360
- - 90 Rp 448,830
- - 17 Rp 50,133
- - 90 Rp 115,650
- - 35 Rp 142,450
- - 7 Rp 37,541
- - 35 Rp 93,835
120 Rp 203,280
- - 43 Rp 220,203
- - 96 Rp 26,112
- - 15 Rp 23,520
- - 33 Rp 47,751
- - 67 Rp 431,145
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - 8 Rp 411,640
- - 14 Rp 56,000
- - 3 Rp 76,179
- - 5 Rp 147,470
- - 5 Rp 230,425
- - 6 Rp 151,224
- - 5 Rp 429,000
- - 11 Rp 172,425
- - 6 Rp 174,900
- - 0 Rp -
- - 10 Rp 344,850
- - 9 Rp 135,900
- - 2 Rp 22,468
- - 0 Rp -
- - 4 Rp 165,112
- - 4 Rp 165,112
- - 10 Rp 49,580
STOK NILAI STOK

ED NILAI ED
AKHIR AKHIR
- - Rp -
- - 44 Rp 1,096,876
- - 27 Rp 241,785
- - 14 Rp 154,658
- - 5 Rp 82,500
- - 8 Rp 189,712
- - 1 Rp 24,714
- - 1 Rp 36,900
- - Rp -
Rp 80,431,225

Mengetahui,
PJ Depo IGD
Sri Warni
Nip : 19890725 200903 2 001
LAPORAN STOK OPNAME OBAT GENERIK BPJS DEPO FARMASI IGD PERIODE FEBRUARI 2018
PENGELUARAN
HARGA SATUAN HARGA SATUAN STOK NILAI STOK NILAI
NO NAMA OBAT SATUAN PEMASUKAN NILAI PEMASUKAN TOTAL ED NILAI ED
DES (2017) JANUARI (2018) AWAL FEBRUARI PENGELUARAN
IGD MUTASI
SEDIAAN INFUS
3 Aqua Pro Injeksi floz Rp 2,750 Rp 2,750 Rp - 240 Rp 660,000 141 - 141 Rp 387,750 - -
4 Asering Infus kolf Rp 9,275 Rp 9,275 Rp - 48 Rp 445,200 7 - 7 Rp 64,925 - -
5 Ciprofloksasin infus botol Rp 10,890 Rp 10,890 Rp - Rp - - - - Rp - - -
6 D40 % floz Rp 3,963 Rp 3,963 Rp - 10 Rp 39,630 4 - 4 Rp 15,852 - -
7 D5 % 1/2 Infus kolf Rp 9,415 Rp 9,415 Rp - 48 Rp 451,920 17 - 17 Rp 160,055 - -
8 D5 % 1/4 Infus kolf Rp 9,360 Rp 9,360 Rp - 48 Rp 449,280 1 - 1 Rp 9,360 - -
9 Fluconazol infus botol Rp 29,540 Rp 29,540 Rp - Rp - - - - Rp - - -
10 Futrolit softbag Rp 39,327 Rp 39,327 Rp - Rp - - - - Rp - - -
11 Glukosa 10 kolf Rp 7,500 Rp 7,500 Rp - 20 Rp 150,000 3 - 3 Rp 22,500 - -
12 Glukosa 5 kolf Rp 7,287 Rp 7,287 Rp - 48 Rp 349,776 42 - 42 Rp 306,054 - -
13 Hidromal softbag Rp 49,600 Rp 49,600 Rp - Rp - - - - Rp - - -
14 KCl floz Rp 7,524 Rp 7,524 Rp - 4 Rp 30,096 - - - Rp - - -
15 Levofloksasin 500 mg botol Rp 26,881 Rp 26,881 Rp - 34 Rp 913,954 18 - 18 Rp 483,858 - -
16 Levofloksasin 750mg botol Rp 136,125 Rp 136,125 Rp - 11 Rp 1,497,375 2 - 2 Rp 272,250 - -
17 Manitol kolf Rp 44,000 Rp 44,000 Rp - 20 Rp 880,000 7 - 7 Rp 308,000 - -
18 Metronidazol infus botol Rp 9,680 Rp 9,680 Rp - 32 Rp 309,760 1 - 1 Rp 9,680 - -
19 Meylon inj floz Rp 10,890 Rp 10,890 Rp - 5 Rp 54,450 - - - Rp - - -
20 MgSO4 20 % floz Rp 3,200 Rp 3,200 Rp - Rp - - - - Rp - - -
21 MgSO4 40 % floz Rp 3,650 Rp 3,650 Rp - 5 Rp 18,250 1 - 1 Rp 3,650 - -
PENGELUARAN
IGD MUTASI
22 Moxifloxacin inf botol Rp 214,500 Rp 214,500 Rp - 2 Rp 429,000 1 - 1 Rp 214,500 - -

23 Nacl kolf Rp 6,292 Rp 6,292 Rp - 100 Rp 629,200 52 - 52 Rp 327,184 - -
25 Paracetamol infus botol Rp 30,250 Rp 30,250 Rp - 40 Rp 1,210,000 2 - 2 Rp 60,500 - -
26 RL infus kolf Rp 7,095 Rp 7,095 Rp - 210 Rp 1,489,950 158 - 158 Rp 1,121,010 - -
27 Kendal kolf Rp 47,272 Rp 47,272 Rp - Rp - - - Rp - - -
1 Asiklovir salep kulit tube Rp 2,997 Rp 2,997 Rp - 10 Rp 29,970 2 - 2 Rp 5,994 - -

2 Avamys tabung Rp 102,999 Rp 102,999 Rp - Rp - - - - Rp - - -
3 Berotec inhaler tabung Rp 80,000 Rp 80,000 Rp - 5 Rp 400,000 2 - 2 Rp 160,000 - -
4 Betametason SK tube Rp 2,026 Rp 2,026 Rp - 28 Rp 56,728 28 - 28 Rp 56,728 - -
5 Bioplacenton salep Rp 13,557 Rp - 20 Rp 271,140 - - - Rp - - -
6 Burnazin cream tube Rp 52,376 Rp 52,376 Rp - 10 Rp 523,760 2 - 2 Rp 104,752 - -
7 Combivent nebules amp/vial Rp 5,700 Rp 5,700 Rp - 120 Rp 684,000 75 - 75 Rp 427,500 - -
8 Fenol Gliserol tube Rp 2,246 Rp 2,246 Rp - Rp - - - - Rp - - -
9 Genoin Salep tube Rp 5,104 Rp 5,104 Rp - Rp - - - - Rp - - -
10 Gentamisin Salep kulit / genoint tube Rp 2,126 Rp 2,126 Rp - 24 Rp 51,024 - - - Rp - - -
11 Gentamisin salep mata tube Rp 3,960 Rp 3,960 Rp - Rp - - - - Rp - - -
12 Gentamisin tetes mata botol Rp 3,297 Rp 3,297 Rp - Rp - - - - Rp - - -
13 Gentian violet botol Rp 6,655 Rp 6,655 Rp - Rp - - - - Rp - - -
14 Hidrokortison salep kulit tube Rp 11,132 Rp 11,132 Rp - 29 Rp 322,828 - - - Rp - - -
PENGELUARAN
IGD MUTASI
15 Iliadin Spray botol Rp 37,900 Rp 37,900 Rp - Rp - - - - Rp - - -

16 Ketokonazole salep kulit tube Rp 2,200 Rp 2,200 Rp - 25 Rp 55,000 - - - Rp - - -
17 Kloramfenikol salep mata tube Rp 1,850 Rp 1,850 Rp - Rp - - - - Rp - - -
18 Kloramfenikol tetes mata botol Rp 2,750 Rp 2,750 Rp - Rp - - - - Rp - - -
19 Miconazole salep kulit tube Rp 3,736 Rp 3,736 Rp - - Rp - - - - Rp - - -
20 Oksitetrasiklin salep kulit tube Rp 1,649 Rp 1,649 Rp - Rp - - - - Rp - - -
21 Oksitetrasiklin salep mata tube Rp 2,772 Rp 2,772 Rp - Rp - - - - Rp - - -
22 PK botol Rp - Rp 3,300 Rp - Rp - - - - Rp - - -
SEDIAAN SIRUP
1 Ambroxol sirup 15mg botol Rp 3,627 Rp 3,627 Rp - 5 Rp 18,135 1 - 1 Rp 3,627 - -

2 Amoksilin Sirup botol Rp 5,626 Rp 5,626 Rp - 25 Rp 140,650 7 - 7 Rp 39,382 - -
3 Amoxillin drop botol Rp 10,780 Rp 10,780 Rp - Rp - - - - Rp - - -
4 Antasida sirup botol Rp 3,184 Rp 3,184 Rp - 80 Rp 254,720 48 - 48 Rp 152,832 - -
5 Cefadroxyl syr botol Rp 4,999 Rp 4,999 Rp - Rp - - - - Rp - - -
6 Cefixime sirup botol Rp 11,880 Rp 11,880 Rp - Rp - - - - Rp - - -
7 Cetirizin syr botol Rp 10,440 Rp 10,440 Rp - 10 Rp 104,400 9 - 9 Rp 93,960 - -
8 Cloramfenikol Sirup botol Rp 7,783 Rp 7,783 Rp - Rp - - - - Rp - - -
9 Cotrimoksazol Sirup botol Rp 2,225 Rp 2,225 Rp - 5 Rp 11,125 2 - 2 Rp 4,450 - -
10 Domperidon Sirup botol Rp 9,000 Rp 9,000 Rp - 15 Rp 135,000 6 - 6 Rp 54,000 - -
11 Gavistal / Metoklopramid botol Rp 2,520 Rp 2,520 Rp - Rp - - - - Rp - - -
PENGELUARAN
IGD MUTASI
12 Ibuprofen syr 100 mg botol Rp 4,225 Rp 4,225 Rp - 5 Rp 21,125 2 - 2 Rp 8,450 - -

13 Lactulax botol Rp 48,400 Rp 48,400 Rp - Rp - - - - Rp - - -
14 Nystatin drop botol Rp 21,780 Rp 21,780 Rp - 10 Rp 217,800 1 - 1 Rp 21,780 - -
15 OBH botol Rp 4,100 Rp 4,100 Rp - Rp - - - - Rp - - -
16 Paracetamol drop botol Rp 8,124 Rp 8,124 Rp - 10 Rp 81,240 5 - 5 Rp 40,620 - -
17 Paracetamol sirup botol Rp 1,012 Rp 1,012 Rp - 70 Rp 70,840 22 - 22 Rp 22,264 - -
18 Plantacid syr botol Rp 8,910 Rp 8,910 Rp - Rp - - - - Rp - - -
19 Salbutamol syr botol Rp 4,916 Rp 4,916 Rp - 10 Rp 49,160 2 - 2 Rp 9,832 - -
20 Sucralfat Syr botol Rp 10,100 Rp 10,100 Rp - 40 Rp 404,000 26 - 26 Rp 262,600 - -
SEDIAAN TABLET ORAL
1 Acarbose 50 (Eclid) tab / cap Rp 657 Rp 657 Rp - Rp - - - - Rp - - -

2 Acetyl systein tab / cap Rp 1,100 Rp 1,100 Rp - Rp - - - - Rp - - -
3 Allopurinol tab 100 MG tab / cap Rp 120 Rp 120 Rp - Rp - - - - Rp - - -
4 Allopurinol tab 300 MG tab / cap Rp 230 Rp 230 Rp - Rp - - - - Rp - - -
5 Ambroxol tab tab / cap Rp 744 Rp 744 Rp - 200 Rp 148,800 159 - 159 Rp 118,296 - -
6 Aminofilin tab tab / cap Rp 103 Rp 103 Rp - Rp - - - - Rp - - -
7 Amlodipin 10 mg tab / cap Rp 167 Rp 167 Rp - 120 Rp 20,040 100 - 100 Rp 16,700 - -
8 Amlodipin 5 mg tab tab / cap Rp 116 Rp 116 Rp - 120 Rp 13,920 41 - 41 Rp 4,756 - -
9 Amoksilin 500 mg tab tab / cap Rp 209 Rp 209 Rp - 800 Rp 167,200 315 - 315 Rp 65,835 - -
10 Amvar tab / cap Rp 5,445 Rp 5,445 Rp - Rp - - - - Rp - - -
PENGELUARAN
IGD MUTASI
11 antasida tab tab / cap Rp 59 Rp 59 Rp - 100 Rp 5,900 3 - 3 Rp 177 - -

12 Asam Folat tab / cap Rp 138 Rp 138 Rp - 600 Rp 82,800 34 - 34 Rp 4,692 - -
13 Asam Mefenamat tab / cap Rp 102 Rp 102 Rp - 300 Rp 30,600 160 - 160 Rp 16,320 - -
14 Asam Tranexamat 500 tab / cap Rp 1,069 Rp 1,069 Rp - 200 Rp 213,800 34 - 34 Rp 36,346 - -
15 Asiklovir 200 mg tab / cap Rp 359 Rp 359 Rp - Rp - - - - Rp - - -
16 Asiklovir 400 mg tab / cap Rp 571 Rp 571 Rp - 100 Rp 57,100 30 - 30 Rp 17,130 - -
17 Aspar k tab (Kalipar) tab / cap Rp 682 Rp 682 Rp - 50 Rp 34,100 3 - 3 Rp 2,046 - -
18 Aspilet tab / cap Rp 94 Rp 94 Rp - 100 Rp 9,400 18 - 18 Rp 1,692 - -
19 Atorvastatin 10 mg tab / cap Rp 1,892 Rp 1,892 Rp - 180 Rp 340,560 3 - 3 Rp 5,676 - -
20 Atorvastatin 20 mg tab / cap Rp 2,989 Rp 2,989 Rp - 180 Rp 538,020 4 - 4 Rp 11,956 - -
21 Attalpugit (Pularex) tab / cap Rp 160 Rp 160 Rp - 100 Rp 16,000 77 - 77 Rp 12,320 - -
22 Azitromisin 500 mg tab / cap Rp 8,800 Rp 8,800 Rp - Rp - - - - Rp - - -
23 Betahistin tab tab / cap Rp 151 Rp 151 Rp - 150 Rp 22,650 50 - 50 Rp 7,550 - -
24 Bisakodil (Dulkolax) tab tab / cap Rp 1,030 Rp 1,030 Rp - 50 Rp 51,500 - - - Rp - - -
25 Bisoprolol 2,5 mg / concor tab / cap Rp 650 Rp 650 Rp - Rp - - - - Rp - - -
26 Bisoprolol 5 mg tab / cap Rp 298 Rp 298 Rp - 350 Rp 104,300 36 - 36 Rp 10,728 - -
27 Calsium Lactat tab / cap Rp 57 Rp 57 Rp - 113 Rp 6,441 - - - Rp - - -
Candersartan 8 mg (canderin) tab / cap Rp 770 Rp 770 Rp - 210 Rp 161,700 20 - 20 Rp 15,400 - -
28 Candesartan 16 mg tab / cap Rp - 210 Rp - 3 - 3 Rp - - -
29 Captopril 12,5 mg tab / cap Rp 69 Rp 69 Rp - 300 Rp 20,700 23 - 23 Rp 1,587 - -
30 Captopril 25 mg tab / cap Rp 105 Rp 105 Rp - 300 Rp 31,500 181 - 181 Rp 19,005 - -
31 Cefadroxyl 500 tab / cap Rp 560 Rp 560 Rp - 200 Rp 112,000 125 - 125 Rp 70,000 - -
PENGELUARAN
IGD MUTASI
32 Cefiksim 100 mg tab / cap Rp 1,676 Rp 1,676 Rp - 300 Rp 502,800 10 - 10 Rp 16,760 - -

33 Cetirizin 10 mg tab / cap Rp 120 Rp 120 Rp - 600 Rp 72,000 138 - 138 Rp 16,560 - -
34 Cilostazol tab 100 mg tab / cap Rp 8,000 Rp 8,000 Rp - 200 Rp 1,600,000 2 - 2 Rp 16,000 - -
35 Ciproflokasin 500 mg tab / cap Rp 320 Rp 320 Rp - 200 Rp 64,000 - - - Rp - - -
36 Citicolin 500 mg tab / cap Rp 5,940 Rp 5,940 Rp - 90 Rp 534,600 50 - 50 Rp 297,000 - -
37 Clindamisin 300 mg tab / cap Rp 660 Rp 660 Rp - Rp - - - - Rp - - -
38 Clonidin tab tab / cap Rp 205 Rp 205 Rp - 100 Rp 20,500 - - - Rp - - -
39 Clopidogrel tab / cap Rp 1,799 Rp 1,799 Rp - 390 Rp 701,610 36 - 36 Rp 64,764 - -
40 Co- amoxiclav tab / cap Rp 5,808 Rp 5,808 Rp - 170 Rp 987,360 28 - 28 Rp 162,624 - -
41 Cotrimoxazol 480 tab tab / cap Rp 267 Rp 267 Rp - 100 Rp 26,700 10 - 10 Rp 2,670 - -
42 CTM tab tab / cap Rp 45 Rp 45 Rp - 100 Rp 4,500 18 - 18 Rp 810 - -
43 Curcuma tab tab / cap Rp 78 Rp 78 Rp - 200 Rp 15,600 74 - 74 Rp 5,772 - -
44 Cytodrox tab / cap Rp 5,280 Rp 5,280 Rp - Rp - - - - Rp - - -
45 Dexametason tab tab / cap Rp 92 Rp 92 Rp - 100 Rp 9,200 62 - 62 Rp 5,704 - -
46 Dexketopropen tab / cap Rp 2,970 Rp 2,970 Rp - Rp - - - - Rp - - -
47 Digoksin tab tab / cap Rp 109 Rp 109 Rp - 100 Rp 10,900 - - - Rp - - -
48 Diltiazem 30 mg tab / cap Rp 144 Rp 144 Rp - Rp - - - - Rp - - -
49 Dimenhidrinat tab / cap Rp 142 Rp 142 Rp - Rp - - - - Rp - - -
50 Doksisiklin tab tab / cap Rp 290 Rp 290 Rp - Rp - - - - Rp - - -
51 Domperidone tab tab / cap Rp 118 Rp 118 Rp - 100 Rp 11,800 22 - 22 Rp 2,596 - -
52 Dopamet tab / cap Rp 1,050 Rp 1,050 Rp - Rp - - - - Rp - - -
53 Eperison (Perilax) tab / cap Rp 1,309 Rp 1,309 Rp - 500 Rp 654,500 19 - 19 Rp 24,871 - -
PENGELUARAN
IGD MUTASI
54 Erytromisin 250 mg tab / cap Rp 509 Rp 509 Rp - Rp - - - - Rp - - -

55 Etambutol tab tab / cap Rp 574 Rp 574 Rp - Rp - - - - Rp - - -
56 Fenofibrate 100 mg tab / cap Rp 605 Rp 605 Rp - Rp - - - - Rp - - -
57 Fenofibrate 300 mg tab / cap Rp 1,303 Rp 1,303 Rp - Rp - - - - Rp - - -
58 Ferrosulfat tab / cap Rp 400 Rp 400 Rp - 100 Rp 40,000 47 - 47 Rp 18,800 - -
59 Finasteride 5 mg tab / finro tab / cap Rp 1,919 Rp 1,919 Rp - Rp - - - - Rp - - -
60 Fluconazol tab / cap Rp 20,700 Rp 20,700 Rp - Rp - - - - Rp - - -
61 Flunarizine 10 mg tab / cap Rp 3,325 Rp 3,325 Rp - Rp - - - - Rp - - -
62 Flunarizine 5 mg tab / cap Rp 2,090 Rp 2,090 Rp - 100 Rp 209,000 8 - 8 Rp 16,720 - -
63 Furosemid tab tab / cap Rp 181 Rp 181 Rp - Rp - - - - Rp - - -
64 Gabexal tab / cap Rp 1,639 Rp 1,639 Rp - Rp - - - - Rp - - -
65 Gemfibrozil 300 mg tab / cap Rp 386 Rp 386 Rp - Rp - - - - Rp - - -
66 GG tab tab / cap Rp 45 Rp 45 Rp - 51 Rp 2,295 10 - 10 Rp 450 - -
67 Glibenklamid tab tab / cap Rp 92 Rp 92 Rp - 100 Rp 9,200 1 - 1 Rp 92 - -
68 Glikuidon (Lodem) tab / cap Rp 3,648 Rp 3,648 Rp - Rp - - - - Rp - - -
69 Glimepirid 2 mg tab / cap Rp 296 Rp 296 Rp - 150 Rp 44,400 10 - 10 Rp 2,960 - -
70 Glimepirid 3 mg tab / cap Rp 319 Rp 319 Rp - Rp - - - - Rp - - -
71 Glukodex tab / cap Rp 245 Rp 245 Rp - Rp - - - - Rp - - -
72 Glukosamine tab tab / cap Rp 704 Rp 704 Rp - 60 Rp 42,240 25 - 25 Rp 17,600 - -
73 Harnal / Hytroz tab / cap Rp 1,425 Rp 1,425 Rp - Rp - - - - Rp - - -
74 Herbesser tab / cap Rp 4,290 Rp 4,290 Rp - Rp - - - - Rp - - -
75 Hidroklorotiazid 25 mg tab / cap Rp 171 Rp 171 Rp - 220 Rp 37,620 5 - 5 Rp 855 - -
PENGELUARAN
IGD MUTASI
76 Ibuprofen 400 mg tab tab / cap Rp 180 Rp 180 Rp - 100 Rp 18,000 10 - 10 Rp 1,800 - -
77 Interhistin tab tab / cap Rp 589 Rp 589 Rp - Rp - - - - Rp - - -
78 Isoniazid 300 mg tab / cap Rp 116 Rp 116 Rp - Rp - - - - Rp - - -
79 Isosorbid Dinitrat 5 mg tab / cap Rp 104 Rp 104 Rp - 400 Rp 41,600 40 - 40 Rp 4,160 - -
80 Ketokonazole tab tab / cap Rp 340 Rp 340 Rp - 200 Rp 68,000 - - - Rp - - -
81 Ketorolac tab tab / cap Rp 2,151 Rp 2,151 Rp - 90 Rp 193,590 17 - 17 Rp 36,567 - -
82 KSR tab / cap Rp 1,700 Rp 1,700 Rp - 100 Rp 170,000 3 - 3 Rp 5,100 - -
83 Lansoprazole tab / cap Rp 878 Rp 878 Rp - 180 Rp 158,040 70 - 70 Rp 61,460 - -
84 Levofloksasin 500 mg tab tab / cap Rp 686 Rp 686 Rp - 50 Rp 34,300 10 - 10 Rp 6,860 - -
85 Lisinopril 10 mg / noperten tab / cap Rp 485 Rp 485 Rp - 200 Rp 97,000 4 - 4 Rp 1,940 - -
86 Lisinopril 5 mg / noperten tab / cap Rp 410 Rp 410 Rp - 200 Rp 82,000 1 - 1 Rp 410 - -
87 Loperamid tab tab / cap Rp 105 Rp 105 Rp - 100 Rp 10,500 24 - 24 Rp 2,520 - -
88 Loratadine tab tab / cap Rp 233 Rp 233 Rp - 100 Rp 23,300 10 - 10 Rp 2,330 - -
89 Mecobalamin tab tab / cap Rp 654 Rp 654 Rp - 200 Rp 130,800 38 - 38 Rp 24,852 - -
90 Meloksikam 15 mg tab / cap Rp 731 Rp 731 Rp - 200 Rp 146,200 - - - Rp - - -
91 Meloksikam 7,5 mg tab / cap Rp 397 Rp 397 Rp - 200 Rp 79,400 - - - Rp - - -
92 Metformin tab tab / cap Rp 110 Rp 110 Rp - 300 Rp 33,000 47 - 47 Rp 5,170 - -
93 Metil ergometrin tab tab / cap Rp 271 Rp 271 Rp - 200 Rp 54,200 200 - 200 Rp 54,200 - -
94 Metilprednisolon 16 mg tab / cap Rp 1,169 Rp 1,169 Rp - 90 Rp 105,210 - - - Rp - - -
95 Metilprednisolon 4 mg tab / cap Rp 220 Rp 220 Rp - 200 Rp 44,000 168 - 168 Rp 36,960 - -
96 Metilprednisolon 8 mg tab / cap Rp 393 Rp 393 Rp - 200 Rp 78,600 10 - 10 Rp 3,930 - -
97 Metochlorpramid tab tab / cap Rp 143 Rp 143 Rp - 100 Rp 14,300 5 - 5 Rp 715 - -
PENGELUARAN
IGD MUTASI
98 Metronidazol tab tab / cap Rp 273 Rp 273 Rp - 100 Rp 27,300 30 - 30 Rp 8,190 - -

99 Micardis tab / cap Rp 7,150 Rp 7,150 Rp - Rp - - - - Rp - - -
100 Na diklofenak 50 mg tab / cap Rp 245 Rp 245 Rp - 270 Rp 66,150 140 - 140 Rp 34,300 - -
101 Natrium Bicarbonat tab / cap Rp 110 Rp 110 Rp - 100 Rp 11,000 6 - 6 Rp 660 - -
102 Neurodex tab tab / cap Rp 484 Rp 484 Rp - 200 Rp 96,800 79 - 79 Rp 38,236 - -
103 Nifedipin tab tab / cap Rp 110 Rp 110 Rp - 100 Rp 11,000 - - - Rp - - -
104 Norelut / Norestil tab / cap Rp 2,552 Rp 2,552 Rp - Rp - - - - Rp - - -
105 Omeprazole tab tab / cap Rp 326 Rp 326 Rp - 240 Rp 78,240 65 - 65 Rp 21,190 - -
106 Ondansetron tab 4 MG tab / cap Rp 523 Rp 523 Rp - 120 Rp 62,760 67 - 67 Rp 35,041 - -
107 Ondansetron tab 8 MG tab / cap Rp 440 Rp 440 Rp - 120 Rp 52,800 - - - Rp - - -
108 Oralit tab / cap Rp 418 Rp 418 Rp - 100 Rp 41,800 - - - Rp - - -
109 Ostovel tab / cap Rp 1,690 Rp 1,690 Rp - Rp - - - - Rp - - -
110 Parasetamol 500 mg tab / cap Rp 142 Rp 142 Rp - 600 Rp 85,200 377 - 377 Rp 53,534 - -
111 pioglitazone (deculin) 15 mg tab / cap Rp 3,300 Rp 3,300 Rp - Rp - - - - Rp - - -
112 Pioglitazone (deculin) 30 mg tab / cap Rp - Rp 4,950 Rp - Rp - - - - Rp - - -
113 Piracetam 1200 mg tab / cap Rp 1,166 Rp 1,166 Rp - 200 Rp 233,200 19 - 19 Rp 22,154 - -
114 Piracetam 800 mg tab / cap Rp 682 Rp 682 Rp - Rp - - - - Rp - - -
115 Pirazinamid 500 mg tab / cap Rp 238 Rp 238 Rp - Rp - - - - Rp - - -
116 Prednison tab / cap Rp 144 Rp 144 Rp - Rp - - - - Rp - - -
117 Pregabalin 75 mg tab / cap Rp 7,472 Rp 7,472 Rp - 30 Rp 224,160 2 - 2 Rp 14,944 - -
118 Propanolol 10 mg tab / cap Rp 72 Rp 72 Rp - Rp - - - - Rp - - -
119 Propanolol 40 mg tab / cap Rp 126 Rp 126 Rp - Rp - - - - Rp - - -
PENGELUARAN
IGD MUTASI
120 Provera / hystolan / medroksiprogesteron tab / cap Rp 2,521 Rp 2,521 Rp - Rp - - - - Rp - - -

121 PTU tab / cap Rp 451 Rp 451 Rp - Rp - - - - Rp - - -
122 Ranitidin tab tab / cap Rp 110 Rp 110 Rp - 400 Rp 44,000 282 - 282 Rp 31,020 - -
123 Retaphyl tab / cap Rp 2,143 Rp 2,143 Rp - Rp - - - - Rp - - -
124 Rifampisin 450 mg tab / cap Rp 1,146 Rp 1,146 Rp - Rp - - - - Rp - - -
125 Rifanh 150/150 tab / cap Rp 7,246 Rp 7,246 Rp - Rp - - - - Rp - - -
126 Rimactazid tab / cap Rp 6,471 Rp 6,471 Rp - Rp - - - - Rp - - -
127 Rimstar/rifastar tab / cap Rp 5,115 Rp 5,115 Rp - Rp - - - - Rp - - -
128 Salbutamol 2 mg tab / cap Rp 78 Rp 78 Rp - 200 Rp 15,600 115 - 115 Rp 8,970 - -
129 Sifrol 0,375 mg tab tab / cap Rp 8,000 Rp 8,000 Rp - Rp - - - - Rp - - -
130 Simarc / warfarin tab / cap Rp 950 Rp 950 Rp - Rp - - - - Rp - - -
131 Simvastatin 10mg tab tab / cap Rp 67 Rp 67 Rp - 100 Rp 6,700 - - - Rp - - -
132 Simvastatin 20 mg tab / cap Rp 1,026 Rp 1,026 Rp - 60 Rp 61,560 1 - 1 Rp 1,026 - -
133 Spironolakton 100 mg tab / cap Rp 1,000 Rp 1,000 Rp - 100 Rp 100,000 1 - 1 Rp 1,000 - -
134 Spironolakton 25 mg tab / cap Rp 335 Rp 335 Rp - 100 Rp 33,500 14 - 14 Rp 4,690 - -
135 Sulfasalazin tab / cap Rp 2,090 Rp 2,090 Rp - Rp - - - - Rp - - -
136 Tetrasiklin 250 mg tab / cap Rp 378 Rp 378 Rp - Rp - - - - Rp - - -
137 Thiamfenikol 500 mg tab / cap Rp 985 Rp 985 Rp - Rp - - - - Rp - - -
138 Tramadol tab tab / cap Rp 329 Rp 329 Rp - Rp - - - - Rp - - -
139 Urotractin tab / cap Rp 1,815 Rp 1,815 Rp - Rp - - - - Rp - - -
140 Ursodeoksi tab tab / cap Rp 2,723 Rp 2,723 Rp - Rp - - - - Rp - - -
141 Vitamin A tab / cap Rp 686 Rp 686 Rp - 50 Rp 34,300 1 - 1 Rp 686 - -
PENGELUARAN
IGD MUTASI
142 Vitamin B Komplek tab / cap Rp 120 Rp 120 Rp - 100 Rp 12,000 41 - 41 Rp 4,920 - -
143 Vitamin B1 tab / cap Rp 85 Rp 85 Rp - Rp - - - - Rp - - -
146 Vitamin C 100 MG tab / cap Rp 121 Rp 121 Rp - Rp - - - - Rp - - -
147 Vitamin C 50 MG tab / cap Rp 120 Rp 120 Rp - 200 Rp 24,000 - - - Rp - - -
148 Vitamin K tab / cap Rp 790 Rp 790 Rp - Rp - - - - Rp - - -
149 Zinc tab tab / cap Rp 592 Rp 592 Rp - Rp - - - - Rp - - -
RACIKAN / PRODUKSI
1 Racikan 3 (Analtram) tab / cap Rp 854 Rp 854 Rp - 50 Rp 42,700 11 - 11 Rp 9,394 - -
SEDIAAN INJEKSI
1 Amikasin inj amp/vial Rp 71,874 Rp 71,874 Rp - Rp - - - - Rp - - -

2 Aminofilin inj amp/vial Rp 3,080 Rp 3,080 Rp - 24 Rp 73,920 6 - 6 Rp 18,480 - -
3 Amoksilin inj amp/vial Rp 9,900 Rp 9,900 Rp - 10 Rp 99,000 - - - Rp - - -
4 Ampisilin inj amp/vial Rp 10,188 Rp 10,188 Rp - 10 Rp 101,880 4 - 4 Rp 40,752 - -
5 Antrain Inj amp/vial Rp 5,511 Rp 5,511 Rp - 110 Rp 606,210 104 - 104 Rp 573,144 - -
6 Arixtra amp/vial Rp 265,833 Rp 265,833 Rp - 5 Rp 1,329,165 3 - 3 Rp 797,499 - -
7 As. Tranexamat 500 mg inj amp/vial Rp 2,530 Rp 2,530 Rp - 150 Rp 379,500 56 - 56 Rp 141,680 - -
PENGELUARAN
IGD MUTASI
8 Atropin inj amp/vial Rp 1,264 Rp 1,264 Rp - 100 Rp 126,400 - - - Rp - - -

9 Biocombin inj amp/vial Rp 4,070 Rp 4,070 Rp - 25 Rp 101,750 13 - 13 Rp 52,910 - -
10 Ca. Glukonas inj amp/vial Rp 9,955 Rp 9,955 Rp - 10 Rp 99,550 1 - 1 Rp 9,955 - -
11 Cefazolin amp/vial Rp 19,675 Rp 19,675 Rp - Rp - - - - Rp - - -
12 Cefepime amp/vial Rp 38,285 Rp 38,285 Rp - Rp - - - - Rp - - -
13 Cefirome inj amp/vial Rp 79,200 Rp 79,200 Rp - Rp - - - - Rp - - -
14 Cefoporazon Sulbactam amp/vial Rp 79,200 Rp 79,200 Rp - Rp - - - - Rp - - -
15 Ceftazidime inj amp/vial Rp 15,903 Rp 15,903 Rp - Rp - - - - Rp - - -
16 Cernevit amp/vial Rp 157,713 Rp 157,713 Rp - 5 Rp 788,565 1 - 1 Rp 157,713 - -
17 Citikolin 250 mg inj amp/vial Rp 10,709 Rp 10,709 Rp - 60 Rp 642,540 59 - 59 Rp 631,831 - -
18 Citikolin 500 mg inj amp/vial Rp 21,600 Rp 21,600 Rp - 60 Rp 1,296,000 59 - 59 Rp 1,274,400 - -
19 Dexametason inj amp/vial Rp 1,641 Rp 1,641 Rp - 100 Rp 164,100 4 - 4 Rp 6,564 - -
20 Dipenhidramin inj amp/vial Rp 1,220 Rp 1,220 Rp - 30 Rp 36,600 2 - 2 Rp 2,440 - -
21 Dobutamin inj amp/vial Rp 15,087 Rp 15,087 Rp - 12 Rp 181,044 - - - Rp - - -
22 Dopamin inj / UDOPA amp/vial Rp 7,480 Rp 7,480 Rp - 10 Rp 74,800 1 - 1 Rp 7,480 - -
23 Epinefrin inj amp/vial Rp 6,692 Rp 6,692 Rp - 15 Rp 100,380 7 - 7 Rp 46,844 - -
24 Esomeprazol amp/vial Rp 14,924 Rp 14,924 Rp - 20 Rp 298,480 - - - Rp - - -
25 Fitomenadion inj 10 mg amp/vial Rp 4,167 Rp 4,167 Rp - Rp - - - - Rp - - -
26 Fitomenadion inj 2 mg amp/vial Rp 4,083 Rp 4,083 Rp - 120 Rp 489,960 5 - 5 Rp 20,415 - -
27 Flamicort amp/vial Rp 53,482 Rp 53,482 Rp - Rp - - - - Rp - - -
28 Furosemid inj amp/vial Rp 2,058 Rp 2,058 Rp - 50 Rp 102,900 5 - 5 Rp 10,290 - -
29 Gentamisin inj amp/vial Rp 3,896 Rp 3,896 Rp - 20 Rp 77,920 - - - Rp - - -
PENGELUARAN
IGD MUTASI
30 Herbesser inj 2 mg amp/vial Rp 148,500 Rp 148,500 Rp - Rp - - - - Rp - - -

31 Ketorolac 30 mg inj amp/vial Rp 2,250 Rp 2,250 Rp - 110 Rp 247,500 86 - 86 Rp 193,500 - -
32 Klonidin (catapres) inj amp/vial Rp 32,600 Rp 32,600 Rp - Rp - - - - Rp - - -
33 Lidokain Compusitum amp/vial Rp 2,112 Rp 2,112 Rp - Rp - - - - Rp - - -
34 Lidokain inj amp/vial Rp 1,000 Rp 1,000 Rp - 50 Rp 50,000 16 - 16 Rp 16,000 - -
35 Mecobalamin inj amp/vial Rp 6,600 Rp 6,600 Rp - 60 Rp 396,000 5 - 5 Rp 33,000 - -
36 Meropenem 1 gr inj amp/vial Rp 42,743 Rp 42,743 Rp - Rp - - - - Rp - - -
37 Metil prednisolon 125 mg inj amp/vial Rp 12,800 Rp 12,800 Rp - 70 Rp 896,000 35 - 35 Rp 448,000 - -
38 Metoklorpramid inj / metolon amp/vial Rp 8,910 Rp 8,910 Rp - Rp - - - - Rp - - -
39 Nefrofer (Cosmofer) amp/vial Rp 44,000 Rp 44,000 Rp - Rp - - - - Rp - - -
40 Nicardipine inj amp/vial Rp 34,979 Rp 34,979 Rp - 30 Rp 1,049,370 13 - 13 Rp 454,727 - -
41 Nokoba amp/vial Rp 82,060 Rp 82,060 Rp - Rp - - - - Rp - - -
42 Omeprazole inj amp/vial Rp 14,924 Rp 14,924 Rp - 230 Rp 3,432,520 170 - 170 Rp 2,537,080 - -
43 Ondansetron inj amp/vial Rp 3,328 Rp 3,328 Rp - 200 Rp 665,600 151 - 151 Rp 502,528 - -
44 Pantoprazole inj amp/vial Rp 37,400 Rp 37,400 Rp - Rp - - - - Rp - - -
45 Piracetam 1 gr inj amp/vial Rp 4,235 Rp 4,235 Rp - 60 Rp 254,100 19 - 19 Rp 80,465 - -
46 Piracetam 3 gr inj amp/vial Rp 13,170 Rp 13,170 Rp - 35 Rp 460,950 18 - 18 Rp 237,060 - -
47 Pycin 750 mg amp/vial Rp 68,063 Rp 68,063 Rp - 2 Rp 136,126 - - - Rp - - -
48 Ranitidin inj amp/vial Rp 1,600 Rp 1,600 Rp - 250 Rp 400,000 156 - 156 Rp 249,600 - -
49 Sefotaxim inj amp/vial Rp 5,995 Rp 5,995 Rp - 35 Rp 209,825 - - - Rp - - -
50 Seftriaxon inj amp/vial Rp 11,000 Rp 11,000 Rp - 185 Rp 2,035,000 85 - 85 Rp 935,000 - -
51 Tramadol inj amp/vial Rp 1,720 Rp 1,720 Rp - 20 Rp 34,400 2 - 2 Rp 3,440 - -
PENGELUARAN
IGD MUTASI
52 Vitamin c inj amp/vial Rp 6,413 Rp 6,413 Rp - 20 Rp 128,260 17 - 17 Rp 109,021 - -
SEDIAAN DI KULKAS
1 Anti hemoroid supp Rp 3,300 Rp 3,300 Rp - - - - Rp - - -

2 Apidra plexpen Rp 87,000 Rp 87,000 Rp - Rp - - - - Rp - - -
3 ATS 1500 IU ampul Rp 165,000 Rp 165,000 Rp - 20 Rp 3,300,000 5 - 5 Rp 825,000 - -
4 Dulcolax supp 10 mg (stolax) supp Rp 5,800 Rp 5,800 Rp - Rp - - - - Rp - - -
5 Dulcolax supp 5 mg supp Rp 5,800 Rp 5,800 Rp - Rp - - - - Rp - - -
8 Lantus / lavemir plexpen Rp 85,000 Rp 85,000 Rp - 5 Rp 425,000 1 - 1 Rp 85,000 - -
9 Metil ergometrin inj ampul Rp 3,278 Rp 3,278 Rp - Rp - - - - Rp - - -
10 Noporavid plexpen Rp 87,000 Rp 87,000 Rp - 4 Rp 348,000 1 - 1 Rp 87,000 - -
11 Norepinefrine ampul Rp 66,000 Rp - 24 Rp 1,584,000 12 - 12 Rp 792,000 - -
12 Novomix plexpen Rp 110,000 Rp 110,000 Rp - Rp - - - - Rp - - -
15 Oksitosin inj ampul Rp 1,899 Rp 1,899 Rp - 100 Rp 189,900 - - - Rp - - -
16 SABU vial Rp 640,530 Rp 640,530 Rp - 6 Rp 3,843,180 - - - Rp - - -
17 Suprafenid supp Rp 2,789 Rp 2,789 Rp - 20 Rp 55,780 19 - 19 Rp 52,991 - -
18 Tetagam inj vial Rp 170,000 Rp 170,000 Rp - Rp - - - - Rp - - -
19 Vaksin rabies vial Rp 140,445 Rp 140,445 Rp - Rp - - - - Rp - - -
Rp - Rp - - - - Rp - - -
BAKHP Rp - - - - Rp - - -
PENGELUARAN
IGD MUTASI
1 Cutimed Gel Rp 45,591 Rp - 10 Rp 455,910 1 - 1 Rp 45,591 - -

2 Cutimed Siltec 10X10 Rp 37,756 Rp - 10 Rp 377,560 2 - 2 Rp 75,512 - -
3 Disp 1 CC Rp 744 Rp - 200 Rp 148,800 161 - 161 Rp 119,784 - -
4 Disp 10 CC Rp 1,072 Rp - 415 Rp 444,880 249 - 249 Rp 266,928 - -
5 Disp 3 CC Rp 750 Rp - 409 Rp 306,750 343 - 343 Rp 257,250 - -
6 Disp 5 CC Rp 893 Rp - 715 Rp 638,495 684 - 684 Rp 610,812 - -
7 Disp 50CC Lubang Pinggir Rp 4,259 Rp - 30 Rp 127,770 14 - 14 Rp 59,626 - -
8 Disp 50CC Lubang Tengah Rp 4,260 Rp - 75 Rp 319,500 16 - 16 Rp 68,160 - -
9 Elastamol Haff Rp 34,069 Rp - 40 Rp 1,362,760 35 - 35 Rp 1,192,415 - -
10 ETT Nonking 2,5 Rp 357,500 Rp - 1 Rp 357,500 - - - Rp - - -
11 ETT Nonking 3 Rp 357,000 Rp - 1 Rp 357,000 - - - Rp - - -
12 ETT Nonking 3,5 Rp 357,000 Rp - 1 Rp 357,000 - - - Rp - - -
13 ETT Nonking 5 Rp 357,000 Rp - 1 Rp 357,000 - - - Rp - - -
14 Folley Cathether 10 Rp 42,565 Rp - 10 Rp 425,650 3 - 3 Rp 127,695 - -
18 Handscund 6 Rp 6,594 Rp - 50 Rp 329,700 1 - 1 Rp 6,594 - -
19 Handscund 6,5 Rp 6,594 Rp - 50 Rp 329,700 3 - 3 Rp 19,782 - -
20 Handscund 7 Rp 6,594 Rp - 50 Rp 329,700 35 - 35 Rp 230,790 - -
21 Handscund 7,5 Rp 6,595 Rp - 50 Rp 329,750 26 - 26 Rp 171,470 - -
22 Infuset Macro Rp 4,756 Rp - 300 Rp 1,426,800 287 - 287 Rp 1,364,972 - -
PENGELUARAN
IGD MUTASI
23 Infuset Micro Rp 5,104 Rp - 50 Rp 255,200 40 - 40 Rp 204,160 - -

24 Injec Tomat Rp 7,550 Rp - 35 Rp 264,250 12 - 12 Rp 90,600 - -
25 Kasa kotak 16x16 Rp 3,300 Rp - Rp - - - - Rp - - -
26 Masker NRM Adult Rp 19,154 Rp - 5 Rp 95,770 1 - 1 Rp 19,154 - -
27 Masker NRM Child Rp 19,154 Rp - 2 Rp 38,308 1 - 1 Rp 19,154 - -
28 Masker Rebrehting Adult Rp 38,500 Rp - Rp - - - - Rp - - -
29 Masker REbrehting Child Rp 38,500 Rp - Rp - - - - Rp - - -
30 NGT 16 Rp 17,600 Rp - 55 Rp 968,000 8 - 8 Rp 140,800 - -
31 NGT 3,5 Rp 25,850 Rp - 5 Rp 129,250 1 - 1 Rp 25,850 - -
32 NGT 5 Rp 25,850 Rp - 5 Rp 129,250 - - - Rp - - -
33 NGT 8 Rp 18,711 Rp - 5 Rp 93,555 - - - Rp - - -
34 Poligyps 10 cm Rp 35,693 Rp - 1 Rp 35,693 - - - Rp - - -
35 Selang Oksigen Anak Rp 6,325 Rp - 15 Rp 94,875 11 - 11 Rp 69,575 - -
36 Selang Oksigen Bayi Rp 8,906 Rp - 10 Rp 89,060 5 - 5 Rp 44,530 - -
37 Selang Oksigen Dewasa Rp 7,808 Rp - 80 Rp 624,640 40 - 40 Rp 312,320 - -
38 Softband 10 cm Rp 99,000 Rp - 2 Rp 198,000 - - - Rp - - -
39 Softband 15 cm Rp 29,700 Rp - 5 Rp 148,500 - - - Rp - - -
40 Spalax 15x5 Rp 33,000 Rp - 10 Rp 330,000 7 - 7 Rp 231,000 - -
41 Spalax 45x7 Rp 4,950 Rp - 3 Rp 14,850 - - - Rp - - -
PENGELUARAN
IGD MUTASI

46 Suction Cathether 12 Rp 3,016 Rp - 10 Rp 30,160 2 - 2 Rp 6,032 - -
47 Suction Cathether 6 Rp 3,016 Rp - 10 Rp 30,160 - - - Rp - - -
48 Suction Cathether 8 Rp 3,016 Rp - 10 Rp 30,160 - - - Rp - - -
49 Surflo 18 Rp 11,279 Rp - 50 Rp 563,950 16 - 16 Rp 180,464 - -
50 Surflo 20 Rp 9,900 Rp - 100 Rp 990,000 70 - 70 Rp 693,000 - -
51 Surflo 22 Rp 9,900 Rp - 400 Rp 3,960,000 237 - 237 Rp 2,346,300 - -
52 Surflo 24 Rp 9,900 Rp - 150 Rp 1,485,000 86 - 86 Rp 851,400 - -
53 Surflo W 22 Rp 25,289 Rp - 5 Rp 126,445 2 - 2 Rp 50,578 - -
54 Surfo W 26 Rp 24,291 Rp - 55 Rp 1,336,005 1 - 1 Rp 24,291 - -
55 Tensocrape 15 cm Rp 41,870 Rp - 12 Rp 502,440 - - - Rp - - -
56 Tensocrape 7,5 cm Rp 27,660 Rp - 12 Rp 331,920 - - - Rp - - -
57 Tensocrpae 10 cm Rp 32,892 Rp - 10 Rp 328,920 3 - 3 Rp 98,676 - -
58 Transfusi set Rp 25,245 Rp - 100 Rp 2,524,500 85 - 85 Rp 2,145,825 - -
59 Urinebag Rp 3,465 Rp - Rp - - - Rp - - -
60 Selang SCT Rp 35,552 Rp - Rp - - - Rp - - -
61 Disp 20 CC Rp 1,728 Rp - 20 Rp 34,560 1 - 1 Rp 1,728 - -
62 ETT NON KING 6,5 Rp 357,500 Rp - Rp - - - Rp - - -
63 3-Way stopcock Rp 22,627 Rp - Rp - - - Rp - - -
64 Novotwist Rp 2,083 Rp - Rp - - - Rp - - -
65 Masker NRM Bayi Rp 19,154 Rp - Rp - - - Rp - - -
66 Underpad Rp 3,933 Rp - Rp - - - Rp - - -
PENGELUARAN
IGD MUTASI
67 Actimove M Rp 84,260 Rp - Rp - - - Rp - - -
68 Actimove S Rp 84,260 Rp - Rp - - - Rp - - -
69 Spalak 70x7 Rp 88,000 Rp - Rp - - - Rp - - -
70 Daryantull Rp 9,250 Rp - Rp - - - Rp - - -
BENANG Rp - - - - Rp - - -
1 Catgut Crhom 3/0 DS 19 Rp 57,200 Rp - 17 Rp 972,400 3 - 3 Rp 171,600 - -

2 Catgut Plain 2/0 HR 37 Rp 35,285 Rp -
3 Premilene 3/0 DS 24 Rp 51,988 Rp - 36 Rp 1,871,568 1 - 1 Rp 51,988 - -
4 Premilene 6/0 DS 12 Rp 51,088 Rp - 36 Rp 1,839,168 13 - 13 Rp 664,144 - -
5 Premiline 5/0 DS 16 Rp 57,186 Rp - 36 Rp 2,058,696 4 - 4 Rp 228,744 - -
6 Silk 3/0 HR 25 Rp 370,624 Rp - 30 Rp 11,118,720 24 - 24 Rp 8,894,976 - -
7 Silk 5/0 DS Rp 49,912 Rp - 5 Rp 249,560 3 - 3 Rp 149,736 - -
OBAT PELENGKAP Rp - - - - Rp - - -
1 Aminefron Rp 6,793 Rp - 100 Rp 679,300 3 - 3 Rp 20,379 - -

2 Antimo Rp 384 Rp - 100 Rp 38,400 - - - Rp - - -
3 Antrain 500 mg Rp 1,679 Rp - 200 Rp 335,800 40 - 40 Rp 67,160 - -
4 Aspar-K Rp 2,474 Rp - 2 Rp 4,948 - - - Rp - - -
5 Car-Q Rp 9,666 Rp - 30 Rp 289,980 5 - 5 Rp 48,330 - -
PENGELUARAN
IGD MUTASI
6 Colistine Rp 6,160 Rp - 6 Rp 36,960 1 - 1 Rp 6,160 - -

7 FG Troches Rp 1,081 Rp - 100 Rp 108,100 8 - 8 Rp 8,648 - -
8 Gastrul Rp 11,172 Rp - 60 Rp 670,320 2 - 2 Rp 22,344 - -
9 Gitas Rp 5,494 Rp - 150 Rp 824,100 61 - 61 Rp 335,134 - -
10 Imunos Rp 6,971 Rp - 80 Rp 557,680 76 - 76 Rp 529,796 - -
11 Lactrin Rp 4,290 Rp - 60 Rp 257,400 59 - 59 Rp 253,110 - -
12 L-Bio Rp 6,435 Rp - 90 Rp 579,150 28 - 28 Rp 180,180 - -
13 Levopar Rp 1,240 Rp - 40 Rp 49,600 1 - 1 Rp 1,240 - -
14 Lipofood Rp 4,987 Rp - 100 Rp 498,700 - - - Rp - - -
15 Maltofer Fol Rp 2,949 Rp - 60 Rp 176,940 27 - 27 Rp 79,623 - -
16 Mefinal Rp 1,285 Rp - 100 Rp 128,500 10 - 10 Rp 12,850 - -
17 Osfit DHA Rp 4,070 Rp - 10 Rp 40,700 10 - 10 Rp 40,700 - -
18 Proliver Rp 5,363 Rp - Rp - - - - Rp - - -
19 Promavit Rp 2,681 Rp - 60 Rp 160,860 17 - 17 Rp 45,577 - -
20 Rhinofed Rp 1,694 Rp - Rp -
21 Rhinos Rp 5,121 Rp - 100 Rp 512,100 31 - 31 Rp 158,751 - -
22 Sanmol 500 mg Rp 272 Rp - 100 Rp 27,200 4 - 4 Rp 1,088 - -
23 Sistenol Rp 1,568 Rp - 20 Rp 31,360 10 - 10 Rp 15,680 - -
24 Tremenza Rp 1,447 Rp - 70 Rp 101,290 56 - 56 Rp 81,032 - -
25 Vip Albumin Rp 6,435 Rp - 10 Rp 64,350 9 - 9 Rp 57,915 - -
LAIN-LAIN
PENGELUARAN
IGD MUTASI
1 Thrombopob Rp 51,455 Rp - 10 Rp 514,550 1 - 1 Rp 51,455 - -

2 Ventolin Nebu Rp 4,000 Rp - 18 Rp 72,000 11 - 11 Rp 44,000 - -
SYRUP Rp - - - - Rp - - -
1 Apialis Drop Rp 25,393 Rp - 10 Rp 253,930 5 - 5 Rp 126,965 - -

2 Apialis Sirup Rp 29,494 Rp - 10 Rp 294,940 4 - 4 Rp 117,976 - -
3 Elkana Sirup Rp 46,085 Rp - 5 Rp 230,425 - - - Rp - - -
4 Gastrinal Rp 25,204 Rp - 10 Rp 252,040 1 - 1 Rp 25,204 - -
5 Imunos Sirup Rp 85,800 Rp - 2 Rp 171,600 2 - 2 Rp 171,600 - -
6 Mucos Sirup Rp 15,675 Rp - 12 Rp 188,100 1 - 1 Rp 15,675 - -
7 Oxoril Rp 29,150 Rp - 30 Rp 874,500 12 - 12 Rp 349,800 - -
8 Pralax Sirup Rp 66,495 Rp - 2 Rp 132,990 1 - 1 Rp 66,495 - -
9 PSIDII Sirup Rp 34,485 Rp - 10 Rp 344,850 - - - Rp - - -
10 Sanmol Drop Rp 15,100 Rp - 10 Rp 151,000 - - - Rp - - -
11 Sanmol Sirup Rp 11,234 Rp - 10 Rp 112,340 5 - 5 Rp 56,170 - -
12 Tiriz drop Rp 64,350 Rp - 3 Rp 193,050 2 - 2 Rp 128,700 - -
13 Vometa Drop Rp 41,278 Rp - 5 Rp 206,390 1 - 1 Rp 41,278 - -
14 Vometa Sirup Rp 41,278 Rp - 5 Rp 206,390 1 - 1 Rp 41,278 - -
15 Zinc Sirup Rp 4,958 Rp - Rp - - - - Rp - - -
PENGELUARAN
IGD MUTASI
INJEKSI Rp - - - - Rp - - -
1 Acran Injeksi Rp 20,189 Rp - 35 Rp 706,615 1 - 1 Rp 20,189 - -

2 Gitas Injeksi Rp 24,929 Rp - 70 Rp 1,745,030 12 - 12 Rp 299,148 - -
3 Norages Injeksi Rp 8,955 Rp - 70 Rp 626,850 9 - 9 Rp 80,595 - -
4 NS PIGGY 100 CC Rp 11,047 Rp - 10 Rp 110,470 1 - 1 Rp 11,047 - -
5 Tiaryt Injeksi Rp 16,500 Rp - 5 Rp 82,500 - - - Rp - - -
6 Salin 3% Rp 23,714 Rp - 2 Rp 47,428 1 - 1 Rp 23,714 - -
7 Forumen Rp 24,714 Rp - Rp - - Rp - - -
8 Tarivid Rp 36,900 Rp - Rp - - Rp - - -
9 Topazol Rp 148,005 Rp - Rp - - Rp - - -
TOTAL Rp - Rp 111,022,521 Rp 45,314,575
Amuntai, 01 Februari 2018

PENGELUARAN
IGD MUTASI

PJ Depo IGD

NIP; 19810922 200604 2 016 Nip : 19890725 200903 2 001
BPJS DEPO FARMASI IGD PERIODE FEBRUARI 2018
I RSUD PAMBALAH BATUNG
STOK AKHIR NILAI STOK AKHIR
99 Rp 272,250
41 Rp 380,275
Rp -
6 Rp 23,778
31 Rp 291,865
47 Rp 439,920
Rp -
Rp -
17 Rp 127,500
6 Rp 43,722
Rp -
4 Rp 30,096
16 Rp 430,096
9 Rp 1,225,125
13 Rp 572,000
31 Rp 300,080
5 Rp 54,450
Rp -
4 Rp 14,600
1 Rp 214,500
48 Rp 302,016
38 Rp 1,149,500
52 Rp 368,940
Rp -
8 Rp 23,976
Rp -
3 Rp 240,000
Rp -
20 Rp 271,140
8 Rp 419,008
45 Rp 256,500
Rp -
Rp -
24 Rp 51,024
Rp -
Rp -
Rp -
29 Rp 322,828
Rp -
25 Rp 55,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
4 Rp 14,508
18 Rp 101,268
Rp -
32 Rp 101,888
Rp -
Rp -
1 Rp 10,440
Rp -
3 Rp 6,675
9 Rp 81,000
Rp -
3 Rp 12,675
Rp -
9 Rp 196,020
Rp -
5 Rp 40,620
48 Rp 48,576
Rp -
8 Rp 39,328
14 Rp 141,400
Rp -
Rp -
Rp -
Rp -
41 Rp 30,504
Rp -
20 Rp 3,340
79 Rp 9,164
485 Rp 101,365
Rp -
97 Rp 5,723
566 Rp 78,108
140 Rp 14,280
166 Rp 177,454
Rp -
70 Rp 39,970
47 Rp 32,054
82 Rp 7,708
177 Rp 334,884
176 Rp 526,064
23 Rp 3,680
Rp -
100 Rp 15,100
50 Rp 51,500
Rp -
314 Rp 93,572
113 Rp 6,441
190 Rp 146,300
207 Rp -
277 Rp 19,113
119 Rp 12,495
75 Rp 42,000
290 Rp 486,040
462 Rp 55,440
198 Rp 1,584,000
200 Rp 64,000
40 Rp 237,600
Rp -
100 Rp 20,500
354 Rp 636,846
142 Rp 824,736
90 Rp 24,030
82 Rp 3,690
126 Rp 9,828
Rp -
38 Rp 3,496
Rp -
100 Rp 10,900
Rp -
Rp -
Rp -
78 Rp 9,204
Rp -
481 Rp 629,629
Rp -
Rp -
Rp -
Rp -
53 Rp 21,200
Rp -
Rp -
Rp -
92 Rp 192,280
Rp -
Rp -
Rp -
41 Rp 1,845
99 Rp 9,108
Rp -
140 Rp 41,440
Rp -
Rp -
35 Rp 24,640
Rp -
Rp -
215 Rp 36,765
90 Rp 16,200
Rp -
Rp -
360 Rp 37,440
200 Rp 68,000
73 Rp 157,023
97 Rp 164,900
110 Rp 96,580
40 Rp 27,440
196 Rp 95,060
199 Rp 81,590
76 Rp 7,980
90 Rp 20,970
162 Rp 105,948
200 Rp 146,200
200 Rp 79,400
253 Rp 27,830
Rp -
90 Rp 105,210
32 Rp 7,040
190 Rp 74,670
95 Rp 13,585
70 Rp 19,110
Rp -
130 Rp 31,850
94 Rp 10,340
121 Rp 58,564
100 Rp 11,000
Rp -
175 Rp 57,050
53 Rp 27,719
120 Rp 52,800
100 Rp 41,800
Rp -
223 Rp 31,666
Rp -
Rp -
181 Rp 211,046
Rp -
Rp -
Rp -
28 Rp 209,216
Rp -
Rp -
Rp -
Rp -
118 Rp 12,980
Rp -
Rp -
Rp -
Rp -
Rp -
85 Rp 6,630
Rp -
Rp -
100 Rp 6,700
59 Rp 60,534
99 Rp 99,000
86 Rp 28,810
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
49 Rp 33,614
59 Rp 7,080
Rp -
Rp -
Rp -
Rp -
200 Rp 24,000
Rp -
Rp -
39 Rp 33,306
Rp -
18 Rp 55,440
10 Rp 99,000
6 Rp 61,128
6 Rp 33,066
2 Rp 531,666
94 Rp 237,820
100 Rp 126,400
12 Rp 48,840
9 Rp 89,595
Rp -
Rp -
Rp -
Rp -
Rp -
4 Rp 630,852
1 Rp 10,709
1 Rp 21,600
96 Rp 157,536
28 Rp 34,160
12 Rp 181,044
9 Rp 67,320
8 Rp 53,536
20 Rp 298,480
Rp -
115 Rp 469,545
Rp -
45 Rp 92,610
20 Rp 77,920
Rp -
24 Rp 54,000
Rp -
Rp -
34 Rp 34,000
55 Rp 363,000
Rp -
35 Rp 448,000
Rp -
Rp -
17 Rp 594,643
Rp -
60 Rp 895,440
49 Rp 163,072
Rp -
41 Rp 173,635
17 Rp 223,890
2 Rp 136,126
94 Rp 150,400
35 Rp 209,825
100 Rp 1,100,000
18 Rp 30,960
3 Rp 19,239
Rp -
Rp -
15 Rp 2,475,000
Rp -
Rp -
4 Rp 340,000
Rp -
3 Rp 261,000
12 Rp 792,000
Rp -
100 Rp 189,900
6 Rp 3,843,180
1 Rp 2,789
Rp -
Rp -
Rp -
Rp -
9 Rp 410,319
8 Rp 302,048
39 Rp 29,016
166 Rp 177,952
66 Rp 49,500
31 Rp 27,683
16 Rp 68,144
59 Rp 251,340
5 Rp 170,345
1 Rp 357,500
1 Rp 357,000
1 Rp 357,000
1 Rp 357,000
7 Rp 297,955
9 Rp 108,900
7 Rp 84,700
9 Rp 357,534
49 Rp 323,106
47 Rp 309,918
15 Rp 98,910
24 Rp 158,280
13 Rp 61,828
10 Rp 51,040
23 Rp 173,650
Rp -
4 Rp 76,616
1 Rp 19,154
Rp -
Rp -
47 Rp 827,200
4 Rp 103,400
5 Rp 129,250
5 Rp 93,555
1 Rp 35,693
4 Rp 25,300
5 Rp 44,530
40 Rp 312,320
2 Rp 198,000
5 Rp 148,500
3 Rp 99,000
3 Rp 14,850
15 Rp 495,000
20 Rp 143,000
15 Rp 120,450
3 Rp 363,000
8 Rp 24,128
10 Rp 30,160
10 Rp 30,160
34 Rp 383,486
30 Rp 297,000
163 Rp 1,613,700
64 Rp 633,600
3 Rp 75,867
54 Rp 1,311,714
12 Rp 502,440
12 Rp 331,920
7 Rp 230,244
15 Rp 378,675
Rp -
Rp -
19 Rp 32,832
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
14 Rp 800,800
35 Rp 1,819,580
23 Rp 1,175,024
32 Rp 1,829,952
6 Rp 2,223,744
2 Rp 99,824
Rp -
97 Rp 658,921
100 Rp 38,400
160 Rp 268,640
2 Rp 4,948
25 Rp 241,650
5 Rp 30,800
92 Rp 99,452
58 Rp 647,976
89 Rp 488,966
4 Rp 27,884
1 Rp 4,290
62 Rp 398,970
39 Rp 48,360
100 Rp 498,700
33 Rp 97,317
90 Rp 115,650
0 Rp -
Rp -
43 Rp 115,283
69 Rp 353,349
96 Rp 26,112
10 Rp 15,680
14 Rp 20,258
1 Rp 6,435
9 Rp 463,095
7 Rp 28,000
Rp -
5 Rp 126,965
6 Rp 176,964
5 Rp 230,425
9 Rp 226,836
0 Rp -
11 Rp 172,425
18 Rp 524,700
1 Rp 66,495
10 Rp 344,850
10 Rp 151,000
5 Rp 56,170
1 Rp 64,350
4 Rp 165,112
4 Rp 165,112
Rp -
Rp -
34 Rp 686,426
58 Rp 1,445,882
61 Rp 546,255
9 Rp 99,423
5 Rp 82,500
1 Rp 23,714
Rp -
Rp -
Rp -
Rp 65,707,946

Mengetahui,
PJ Depo IGD
Sri Warni
Nip : 19890725 200903 2 001
LAPORAN STOK OPNAME OBAT GENERIK BPJS DEPO FARMASI RANAP PERIODE JANUARI 2018
PENGELUARAN
HARGA SATUAN HARGA SATUAN STOK NILAI STOK NILAI STOK NILAI
NO NAMA OBAT SATUAN PEMASUKAN NILAI PEMASUKAN TOTAL ED
DES (2017) JANUARI (2018) AWAL DESEMBER JANUARI PENGELUARAN
RANAP MUTASI
SEDIAAN INFUS
1 Aminofusin botol Rp 52,000 Rp 52,000 12 Rp 624,000 Rp 624,000 - Rp - - - - Rp - -

2 Aminosteril Infan kolf Rp 43,450 Rp 43,450 74 Rp 3,215,300 Rp 3,215,300 - Rp - 29 - 29 Rp 1,260,050 -
3 Aqua Pro Injeksi floz Rp 2,750 Rp 2,750 3,559 Rp 9,787,250 Rp 9,787,250 4,800 Rp 13,200,000 2,599 - 2,599 Rp 7,147,250 -
4 Asering Infus kolf Rp 9,275 Rp 9,275 152 Rp 1,409,800 Rp 1,409,800 - Rp - 20 - 20 Rp 185,500 -
5 Ciprofloksasin infus botol Rp 10,890 Rp 10,890 64 Rp 696,960 Rp 696,960 - Rp - 7 - 7 Rp 76,230 -
6 D40 % floz Rp 3,963 Rp 3,963 515 Rp 2,040,945 Rp 2,040,945 22 Rp 87,186 126 - 126 Rp 499,338 -
7 D5 % 1/2 Infus kolf Rp 9,415 Rp 9,415 831 Rp 7,823,865 Rp 7,823,865 4 Rp 37,660 167 - 167 Rp 1,572,305 -
8 D5 % 1/4 Infus kolf Rp 9,360 Rp 9,360 146 Rp 1,366,560 Rp 1,366,560 200 Rp 1,872,000 89 - 89 Rp 833,040 -
9 Fluconazol infus botol Rp 29,540 Rp 29,540 8 Rp 236,320 Rp 236,320 - Rp - 6 - 6 Rp 177,240 -
10 Futrolit softbag Rp 39,327 Rp 39,327 27 Rp 1,061,829 Rp 1,061,829 - Rp - 5 - 5 Rp 196,635 -
11 Glukosa 10 kolf Rp 7,500 Rp 7,500 89 Rp 667,500 Rp 667,500 102 Rp 765,000 94 - 94 Rp 705,000 -
12 Glukosa 5 kolf Rp 7,287 Rp 7,287 1,016 Rp 7,403,592 Rp 7,403,592 2,010 Rp 14,646,870 546 - 546 Rp 3,978,702 -
13 Hidromal softbag Rp 49,600 Rp 49,600 88 Rp 4,364,800 Rp 4,364,800 - Rp - 43 - 43 Rp 2,132,800 -
14 KCl floz Rp 7,524 Rp 7,524 13 Rp 97,812 Rp 97,812 8 Rp 60,192 17 - 17 Rp 127,908 -
15 Levofloksasin 500 mg botol Rp 26,881 Rp 26,881 222 Rp 5,967,582 Rp 5,967,582 8 Rp 215,048 58 - 58 Rp 1,559,098 -
16 Levofloksasin 750mg botol Rp 136,125 Rp 136,125 480 Rp 65,340,000 Rp 65,340,000 - Rp - 146 - 146 Rp 19,874,250 -
17 Manitol kolf Rp 44,000 Rp 44,000 Rp - Rp - 200 Rp 8,800,000 49 - 49 Rp 2,156,000 -
18 Metronidazol infus botol Rp 9,680 Rp 9,680 432 Rp 4,181,760 Rp 4,181,760 544 Rp 5,265,920 444 - 444 Rp 4,297,920 -
19 Meylon inj floz Rp 10,890 Rp 10,890 76 Rp 827,640 Rp 827,640 - Rp - 16 - 16 Rp 174,240 -
PENGELUARAN
RANAP MUTASI
20 MgSO4 20 % floz Rp 3,200 Rp 3,200 70 Rp 224,000 Rp 224,000 - Rp - 32 - 32 Rp 102,400 -

21 MgSO4 40 % floz Rp 3,650 Rp 3,650 246 Rp 897,900 Rp 897,900 - Rp - 220 - 220 Rp 803,000 -
22 Moxifloxacin inf botol Rp 214,500 Rp 214,500 Rp - Rp - 100 Rp 21,450,000 44 - 44 Rp 9,438,000 -
23 Nacl kolf Rp 6,292 Rp 6,292 2,242 Rp 14,106,664 Rp 14,106,664 1,021 Rp 6,424,132 2,090 - 2,090 Rp 13,150,280 -
24 Ofloxacin infus botol Rp 63,223 Rp 63,223 18 Rp 1,138,014 Rp 1,138,014 - Rp - - - - Rp - -
25 Paracetamol infus botol Rp 30,250 Rp 30,250 727 Rp 21,991,750 Rp 21,991,750 570 Rp 17,242,500 724 - 724 Rp 21,901,000 -
26 RL infus kolf Rp 7,095 Rp 7,095 1,684 Rp 11,947,980 Rp 11,947,980 4,000 Rp 28,380,000 3,569 - 3,569 Rp 25,322,055 -
1 Asiklovir salep kulit tube Rp 2,997 Rp 2,997 19 Rp 56,943 Rp 56,943 - Rp - 16 - 16 Rp 47,952 -

2 Avamys tabung Rp 102,999 Rp 102,999 6 Rp 617,994 Rp 617,994 - Rp - 3 - 3 Rp 308,997 -
3 Berotec inhaler tabung Rp 80,000 Rp 80,000 11 Rp 880,000 Rp 880,000 - Rp - 3 - 3 Rp 240,000 -
4 Betametason SK tube Rp 2,026 Rp 2,026 12 Rp 24,312 Rp 24,312 - Rp - 3 - 3 Rp 6,078 -
5 Burnazin cream tube Rp 52,376 Rp 52,376 30 Rp 1,571,280 Rp 1,571,280 - Rp - 1 - 1 Rp 52,376 -
6 Combivent nebules amp/vial Rp 5,700 Rp 5,700 124 Rp 706,800 Rp 706,800 700 Rp 3,990,000 441 - 441 Rp 2,513,700 -
7 Fenol Gliserol tube Rp 2,246 Rp 2,246 - Rp - Rp - - Rp - - - - Rp - -
8 Genoin Salep tube Rp 5,104 Rp 5,104 - Rp - Rp - - Rp - - - - Rp - -
9 Gentamisin Salep kulit / genoint tube Rp 2,126 Rp 2,126 2 Rp 4,252 Rp 4,252 20 Rp 42,520 10 - 10 Rp 21,260 -
10 Gentamisin salep mata tube Rp 3,960 Rp 3,960 - Rp - Rp - - Rp - - - - Rp - -
11 Gentamisin tetes mata botol Rp 3,297 Rp 3,297 - Rp - Rp - - Rp - - - - Rp - -
12 Gentian violet botol Rp 6,655 Rp 6,655 18 Rp 119,790 Rp 119,790 - Rp - - - - Rp - -
PENGELUARAN
RANAP MUTASI
13 Hidrokortison salep kulit tube Rp 11,132 Rp 11,132 24 Rp 267,168 Rp 267,168 - Rp - 8 - 8 Rp 89,056 -

14 Iliadin Spray botol Rp 37,900 Rp 37,900 - Rp - Rp - 6 Rp 227,400 - 6 6 Rp 227,400 -
15 Ketokonazole salep kulit tube Rp 2,200 Rp 2,200 43 Rp 94,600 Rp 94,600 - Rp - 4 - 4 Rp 8,800 -
16 Kloramfenikol salep mata tube Rp 1,850 Rp 1,850 19 Rp 35,150 Rp 35,150 - Rp - 9 - 9 Rp 16,650 -
17 Kloramfenikol tetes mata botol Rp 2,750 Rp 2,750 - Rp - Rp - - Rp - - - - Rp - -
18 Miconazole salep kulit tube Rp 3,736 Rp 3,736 3 Rp 11,208 Rp 11,208 - Rp - 1 - 1 Rp 3,736 -
19 Oksitetrasiklin salep kulit tube Rp 1,649 Rp 1,649 22 Rp 36,278 Rp 36,278 - Rp - 3 - 3 Rp 4,947 -
20 Oksitetrasiklin salep mata tube Rp 2,772 Rp 2,772 5 Rp 13,860 Rp 13,860 - Rp - - - - Rp - -
21 PK botol Rp - Rp - 7 Rp - Rp - - Rp - 7 - 7 Rp - -
22 salep 24 tube Rp 1,352 Rp 1,352 - Rp - Rp - - Rp - - - - Rp - -
23 Seretide discus 100 tabung Rp 110,917 Rp 110,917 - Rp - Rp - - Rp - - - - Rp - -
24 Seretide discus 250 tabung Rp 124,668 Rp 124,668 7 Rp 872,676 Rp 872,676 - Rp - 1 - 1 Rp 124,668 -
25 Symbicort turbu 160 mcg tabung Rp 134,500 Rp 134,500 - Rp - Rp - - Rp - - - - Rp - -
OBAT PROGRAM
1 albendazol tab / cap Rp - Rp - 108 Rp - Rp - - - - - - Rp - -

2 Artem inj ampul Rp - Rp - 2 Rp - Rp - - - 2 - 2 Rp - -
3 Artesunate inj ampul Rp - Rp - - Rp - Rp - - - - - - Rp - -
4 D Artepp (anti malaria) tab / cap Rp - Rp - 9 Rp - Rp - - - - - - Rp - -
5 Dietylcarbamazepin tab / cap Rp - Rp - 200 Rp - Rp - - - - - Rp - -
6 Kinin inj ampul Rp - Rp - - Rp - Rp - - - - - Rp - -
PENGELUARAN
RANAP MUTASI
7 Kinin tablet tab / cap Rp - Rp - - Rp - Rp - - - - - Rp - -

8 Primaquin tab tab / cap Rp - Rp - 21 Rp - Rp - - - - - - Rp - -
SEDIAAN SIRUP
1 Ambroxol sirup 15mg botol Rp 3,627 Rp 3,627 28 Rp 101,556 Rp 101,556 50 Rp 181,350 13 - 13 Rp 47,151 -
2 Amoksilin Sirup botol Rp 5,626 Rp 5,626 57 Rp 320,682 Rp 320,682 50 Rp 281,300 49 - 49 Rp 275,674 -
3 Amoxillin drop botol Rp 10,780 Rp 10,780 - Rp - Rp - - Rp - - - - Rp - -
4 Antasida sirup botol Rp 3,184 Rp 3,184 97 Rp 308,848 Rp 308,848 340 Rp 1,082,560 392 - 392 Rp 1,248,128 -
5 Cefadroxyl syr botol Rp 4,999 Rp 4,999 18 Rp 89,982 Rp 89,982 - Rp - 3 - 3 Rp 14,997 -
6 Cefixime sirup botol Rp 11,880 Rp 11,880 54 Rp 641,520 Rp 641,520 - Rp - 28 - 28 Rp 332,640 -
7 Cetirizin syr botol Rp 10,440 Rp 10,440 50 Rp 522,000 Rp 522,000 - Rp - 30 - 30 Rp 313,200 -
8 Cloramfenikol Sirup botol Rp 7,783 Rp 7,783 9 Rp 70,047 Rp 70,047 - Rp - - - - Rp - -
9 Cotrimoksazol Sirup botol Rp 2,225 Rp 2,225 26 Rp 57,850 Rp 57,850 - Rp - 7 - 7 Rp 15,575 -
10 Domperidon Sirup botol Rp 9,000 Rp 9,000 30 Rp 270,000 Rp 270,000 - Rp - - - - Rp - -
11 Gavistal / Metoklopramid botol Rp 2,520 Rp 2,520 3 Rp 7,560 Rp 7,560 - Rp - - - - Rp - -
12 Ibuprofen syr 100 mg botol Rp 4,225 Rp 4,225 8 Rp 33,800 Rp 33,800 - Rp - 6 - 6 Rp 25,350 -
13 Lactulax botol Rp 48,400 Rp 48,400 - Rp - Rp - 53 Rp 2,565,200 3 - 3 Rp 145,200 -
14 Nystatin drop botol Rp 21,780 Rp 21,780 4 Rp 87,120 Rp 87,120 30 Rp 653,400 29 - 29 Rp 631,620 -
15 OBH botol Rp 4,100 Rp 4,100 45 Rp 184,500 Rp 184,500 - Rp - 16 - 16 Rp 65,600 -
16 Paracetamol sirup botol Rp 1,012 Rp 1,012 72 Rp 72,864 Rp 72,864 100 Rp 101,200 82 - 82 Rp 82,984 -
17 Paracetamol drop botol Rp 8,124 Rp 8,124 69 Rp 560,556 Rp 560,556 - Rp - 30 - 30 Rp 243,720 -
PENGELUARAN
RANAP MUTASI
18 Plantacid syr botol Rp 8,910 Rp 8,910 17 Rp 151,470 Rp 151,470 - Rp - 2 - 2 Rp 17,820 -

19 Salbutamol syr botol Rp 4,916 Rp 4,916 70 Rp 344,120 Rp 344,120 - Rp - 36 - 36 Rp 176,976 -
20 Sucralfat Syr botol Rp 10,100 Rp 10,100 131 Rp 1,323,100 Rp 1,323,100 300 Rp 3,030,000 324 - 324 Rp 3,272,400 -
SEDIAAN TABLET ORAL
1 Acarbose 50 (Eclid) tab / cap Rp 657 Rp 657 80 Rp 52,560 Rp 52,560 - Rp - 70 - 70 Rp 45,990 -

2 Acetyl systein tab / cap Rp 1,100 Rp 1,100 553 Rp 608,300 Rp 608,300 - Rp - 200 - 200 Rp 220,000 -
3 Allopurinol tab 100 MG tab / cap Rp 120 Rp 120 513 Rp 61,560 Rp 61,560 - Rp - 167 - 167 Rp 20,040 -
4 Allopurinol tab 300 MG tab / cap Rp 230 Rp 230 323 Rp 74,290 Rp 74,290 - Rp - 323 - 323 Rp 74,290 -
5 Ambroxol tab tab / cap Rp 744 Rp 744 875 Rp 651,000 Rp 651,000 1,900 Rp 1,413,600 2,332 - 2,332 Rp 1,735,008 -
6 Aminofilin tab tab / cap Rp 103 Rp 103 62 Rp 6,386 Rp 6,386 500 Rp 51,500 45 - 45 Rp 4,635 -
7 Amlodipin 10 mg tab / cap Rp 167 Rp 167 622 Rp 103,874 Rp 103,874 750 Rp 125,250 1,155 - 1,155 Rp 192,885 -
8 Amlodipin 5 mg tab tab / cap Rp 116 Rp 116 604 Rp 70,064 Rp 70,064 600 Rp 69,600 732 - 732 Rp 84,912 -
9 Amoksilin 500 mg tab tab / cap Rp 209 Rp 209 576 Rp 120,384 Rp 120,384 500 Rp 104,500 485 - 485 Rp 101,365 -
10 Amvar tab / cap Rp 5,445 Rp 5,445 278 Rp 1,513,710 Rp 1,513,710 - Rp - 56 - 56 Rp 304,920 -
11 antasida tab tab / cap Rp 59 Rp 59 717 Rp 42,303 Rp 42,303 300 Rp 17,700 279 - 279 Rp 16,461 -
12 Asam Folat tab / cap Rp 138 Rp 138 591 Rp 81,558 Rp 81,558 500 Rp 69,000 695 - 695 Rp 95,910 -
13 Asam Mefenamat tab / cap Rp 102 Rp 102 1,768 Rp 180,336 Rp 180,336 3,500 Rp 357,000 4,404 - 4,404 Rp 449,208 -
14 Asam Tranexamat 500 tab / cap Rp 1,069 Rp 1,069 788 Rp 842,372 Rp 842,372 300 Rp 320,700 394 - 394 Rp 421,186 -
15 Asiklovir 200 mg tab / cap Rp 359 Rp 359 139 Rp 49,901 Rp 49,901 - Rp - 50 - 50 Rp 17,950 -
16 Asiklovir 400 mg tab / cap Rp 571 Rp 571 449 Rp 256,379 Rp 256,379 - Rp - 224 - 224 Rp 127,904 -
PENGELUARAN
RANAP MUTASI
17 Aspar k tab (Kalipar) tab / cap Rp 682 Rp 682 326 Rp 222,332 Rp 222,332 300 Rp 204,600 202 - 202 Rp 137,764 -
18 Aspilet tab / cap Rp 94 Rp 94 593 Rp 55,742 Rp 55,742 - Rp - 127 - 127 Rp 11,938 -
19 Atorvastatin 10 mg tab / cap Rp 1,892 Rp 1,892 515 Rp 974,380 Rp 974,380 - Rp - 134 - 134 Rp 253,528 -
20 Atorvastatin 20 mg tab / cap Rp 2,989 Rp 2,989 483 Rp 1,443,687 Rp 1,443,687 - Rp - 127 - 127 Rp 379,603 -
21 Attalpugit (Pularex) tab / cap Rp 160 Rp 160 840 Rp 134,400 Rp 134,400 - Rp - 213 - 213 Rp 34,080 -
22 Azitromisin 500 mg tab / cap Rp 8,800 Rp 8,800 47 Rp 413,600 Rp 413,600 - Rp - 1 - 1 Rp 8,800 -
23 Betahistin tab tab / cap Rp 151 Rp 151 871 Rp 131,521 Rp 131,521 750 Rp 113,250 1,323 - 1,323 Rp 199,773 -
24 Bisakodil (Dulkolax) tab tab / cap Rp 1,030 Rp 1,030 184 Rp 189,520 Rp 189,520 - Rp - 184 - 184 Rp 189,520 -
25 Bisoprolol 2,5 mg / concor tab / cap Rp 650 Rp 650 253 Rp 164,450 Rp 164,450 500 Rp 325,000 98 - 98 Rp 63,700 -
26 Bisoprolol 5 mg tab / cap Rp 298 Rp 298 400 Rp 119,200 Rp 119,200 - Rp - 181 - 181 Rp 53,938 -
27 Calsium Lactat tab / cap Rp 57 Rp 57 1,460 Rp 83,220 Rp 83,220 - Rp - 769 - 769 Rp 43,833 -
28 Candersartan 8 mg (canderin) tab / cap Rp 770 Rp 770 546 Rp 420,420 Rp 420,420 - Rp - 372 - 372 Rp 286,440 -
29 Captopril 12,5 mg tab / cap Rp 69 Rp 69 359 Rp 24,771 Rp 24,771 300 Rp 20,700 152 - 152 Rp 10,488 -
30 Captopril 25 mg tab / cap Rp 105 Rp 105 930 Rp 97,650 Rp 97,650 300 Rp 31,500 930 - 930 Rp 97,650 -
31 Cefadroxyl 500 tab / cap Rp 560 Rp 560 1,087 Rp 608,720 Rp 608,720 3,500 Rp 1,960,000 4,174 - 4,174 Rp 2,337,440 -
32 Cefiksim 100 mg tab / cap Rp 1,676 Rp 1,676 1,001 Rp 1,677,676 Rp 1,677,676 1,000 Rp 1,676,000 1,041 - 1,041 Rp 1,744,716 -
33 Cetirizin 10 mg tab / cap Rp 120 Rp 120 501 Rp 60,120 Rp 60,120 800 Rp 96,000 629 - 629 Rp 75,480 -
34 Cilostazol tab 100 mg tab / cap Rp 8,000 Rp 8,000 890 Rp 7,120,000 Rp 7,120,000 500 Rp 4,000,000 1,077 - 1,077 Rp 8,616,000 -
35 Ciproflokasin 500 mg tab / cap Rp 320 Rp 320 1,513 Rp 484,160 Rp 484,160 - Rp - 689 - 689 Rp 220,480 -
36 Citicolin 500 mg tab / cap Rp 5,940 Rp 5,940 448 Rp 2,661,120 Rp 2,661,120 600 Rp 3,564,000 546 - 546 Rp 3,243,240 -
37 Clindamisin 300 mg tab / cap Rp 660 Rp 660 104 Rp 68,640 Rp 68,640 300 Rp 198,000 228 - 228 Rp 150,480 -
38 Clonidin tab tab / cap Rp 205 Rp 205 474 Rp 97,170 Rp 97,170 - Rp - - - - Rp - -
PENGELUARAN
RANAP MUTASI
39 Clopidogrel tab / cap Rp 1,799 Rp 1,799 536 Rp 964,264 Rp 964,264 - Rp - 198 - 198 Rp 356,202 -
40 Co- amoxiclav tab / cap Rp 5,808 Rp 5,808 29 Rp 168,432 Rp 168,432 150 Rp 871,200 76 - 76 Rp 441,408 -
41 Cotrimoxazol 480 tab tab / cap Rp 267 Rp 267 295 Rp 78,765 Rp 78,765 500 Rp 133,500 273 - 273 Rp 72,891 -
42 CTM tab tab / cap Rp 45 Rp 45 764 Rp 34,380 Rp 34,380 - Rp - 139 - 139 Rp 6,255 -
43 Cytodrox tab / cap Rp 5,280 Rp 5,280 39 Rp 205,920 Rp 205,920 - Rp - - - - Rp - -
44 Curcuma tab tab / cap Rp 78 Rp 78 789 Rp 61,542 Rp 61,542 500 Rp 39,000 896 - 896 Rp 69,888 -
45 Dexametason tab tab / cap Rp 92 Rp 92 505 Rp 46,460 Rp 46,460 500 Rp 46,000 630 - 630 Rp 57,960 -
46 Dexketopropen tab / cap Rp 2,970 Rp 2,970 20 Rp 59,400 Rp 59,400 - Rp - 16 - 16 Rp 47,520 -
47 Digoksin tab tab / cap Rp 109 Rp 109 520 Rp 56,680 Rp 56,680 300 Rp 32,700 260 - 260 Rp 28,340 -
48 Diltiazem 30 mg tab / cap Rp 144 Rp 144 108 Rp 15,552 Rp 15,552 - Rp - 10 - 10 Rp 1,440 -
49 Dimenhidrinat tab / cap Rp 142 Rp 142 604 Rp 85,768 Rp 85,768 300 Rp 42,600 544 - 544 Rp 77,248 -
50 Doksisiklin tab tab / cap Rp 290 Rp 290 240 Rp 69,600 Rp 69,600 - Rp - 30 - 30 Rp 8,700 -
51 Domperidone tab tab / cap Rp 118 Rp 118 212 Rp 25,016 Rp 25,016 300 Rp 35,400 62 - 62 Rp 7,316 -
52 Dopamet tab / cap Rp 1,050 Rp 1,050 209 Rp 219,450 Rp 219,450 - Rp - 10 - 10 Rp 10,500 -
53 Eperison (Perilax) tab / cap Rp 1,309 Rp 1,309 737 Rp 964,733 Rp 964,733 500 Rp 654,500 737 - 737 Rp 964,733 -
54 Erytromisin 250 mg tab / cap Rp 509 Rp 509 100 Rp 50,900 Rp 50,900 - Rp - 10 - 10 Rp 5,090 -
55 Etambutol tab tab / cap Rp 574 Rp 574 492 Rp 282,408 Rp 282,408 - Rp - 24 - 24 Rp 13,776 -
56 Fenofibrate 100 mg tab / cap Rp 605 Rp 605 237 Rp 143,385 Rp 143,385 1,300 Rp 786,500 1,222 - 1,222 Rp 739,310 -
57 Fenofibrate 300 mg tab / cap Rp 1,303 Rp 1,303 596 Rp 776,588 Rp 776,588 - Rp - 28 - 28 Rp 36,484 -
58 Ferrosulfat tab / cap Rp 400 Rp 400 1,900 Rp 760,000 Rp 760,000 800 Rp 320,000 2,454 - 2,454 Rp 981,600 -
59 Finasteride 5 mg tab / finro tab / cap Rp 1,919 Rp 1,919 171 Rp 328,149 Rp 328,149 90 Rp 172,710 28 - 28 Rp 53,732 -
60 Fluconazol tab / cap Rp 20,700 Rp 20,700 190 Rp 3,933,000 Rp 3,933,000 - Rp - 17 - 17 Rp 351,900 -
PENGELUARAN
RANAP MUTASI
61 Flunarizine 10 mg tab / cap Rp 3,325 Rp 3,325 847 Rp 2,816,275 Rp 2,816,275 - Rp - 176 - 176 Rp 585,200 -
62 Flunarizine 5 mg tab / cap Rp 2,090 Rp 2,090 406 Rp 848,540 Rp 848,540 - Rp - 42 - 42 Rp 87,780 -
63 Furosemid tab tab / cap Rp 181 Rp 181 521 Rp 94,301 Rp 94,301 300 Rp 54,300 370 - 370 Rp 66,970 -
64 Gabexal tab / cap Rp 1,639 Rp 1,639 246 Rp 403,194 Rp 403,194 - Rp - 66 - 66 Rp 108,174 -
65 Gemfibrozil 300 mg tab / cap Rp 386 Rp 386 285 Rp 110,010 Rp 110,010 - Rp - - - - Rp - -
66 GG tab tab / cap Rp 45 Rp 45 55 Rp 2,475 Rp 2,475 1,000 Rp 45,000 115 - 115 Rp 5,175 -
67 Glibenklamid tab tab / cap Rp 92 Rp 92 561 Rp 51,612 Rp 51,612 - Rp - 6 - 6 Rp 552 -
68 Glikuidon (Lodem) tab / cap Rp 3,648 Rp 3,648 205 Rp 747,840 Rp 747,840 - Rp - - - - Rp - -
69 Glimepirid 2 mg tab / cap Rp 296 Rp 296 685 Rp 202,760 Rp 202,760 - Rp - 185 - 185 Rp 54,760 -
70 Glimepirid 3 mg tab / cap Rp 319 Rp 319 240 Rp 76,560 Rp 76,560 - Rp - 2 - 2 Rp 638 -
71 Glukodex tab / cap Rp 245 Rp 245 344 Rp 84,280 Rp 84,280 - Rp - 2 - 2 Rp 490 -
72 Glukosamine tab tab / cap Rp 704 Rp 704 953 Rp 670,912 Rp 670,912 - Rp - 706 - 706 Rp 497,024 -
73 Harnal / Hytroz tab / cap Rp 1,425 Rp 1,425 336 Rp 478,800 Rp 478,800 - Rp - 29 - 29 Rp 41,325 -
74 Herbesser tab / cap Rp 4,290 Rp 4,290 149 Rp 639,210 Rp 639,210 - Rp - 29 - 29 Rp 124,410 -
75 Hidroklorotiazid 25 mg tab / cap Rp 171 Rp 171 177 Rp 30,267 Rp 30,267 - Rp - 90 - 90 Rp 15,390 -
76 Ibuprofen 400 mg tab tab / cap Rp 180 Rp 180 101 Rp 18,180 Rp 18,180 300 Rp 54,000 105 - 105 Rp 18,900 -
77 Isoniazid 300 mg tab / cap Rp 116 Rp 116 1,246 Rp 144,536 Rp 144,536 - Rp - 29 - 29 Rp 3,364 -
78 Interhistin tab tab / cap Rp 589 Rp 589 300 Rp 176,700 Rp 176,700 400 Rp 235,600 86 - 86 Rp 50,654 -
79 Isosorbid Dinitrat 5 mg tab / cap Rp 104 Rp 104 1,153 Rp 119,912 Rp 119,912 - Rp - 356 - 356 Rp 37,024 -
80 Ketokonazole tab tab / cap Rp 340 Rp 340 148 Rp 50,320 Rp 50,320 - Rp - 15 - 15 Rp 5,100 -
81 Ketorolac tab tab / cap Rp 2,151 Rp 2,151 55 Rp 118,305 Rp 118,305 750 Rp 1,613,250 629 - 629 Rp 1,352,979 -
82 KSR tab / cap Rp 1,700 Rp 1,700 160 Rp 272,000 Rp 272,000 500 Rp 850,000 102 - 102 Rp 173,400 -
PENGELUARAN
RANAP MUTASI
83 Lansoprazole tab / cap Rp 878 Rp 878 167 Rp 146,626 Rp 146,626 400 Rp 351,200 408 - 408 Rp 358,224 -
84 Levofloksasin 500 mg tab tab / cap Rp 686 Rp 686 677 Rp 464,422 Rp 464,422 300 Rp 205,800 809 - 809 Rp 554,974 -
85 Lisinopril 10 mg / noperten tab / cap Rp 485 Rp 485 368 Rp 178,480 Rp 178,480 - Rp - 80 - 80 Rp 38,800 -
86 Lisinopril 5 mg / noperten tab / cap Rp 410 Rp 410 290 Rp 118,900 Rp 118,900 - Rp - 18 - 18 Rp 7,380 -
87 Loperamid tab tab / cap Rp 105 Rp 105 458 Rp 48,090 Rp 48,090 - Rp - 98 - 98 Rp 10,290 -
88 Loratadine tab tab / cap Rp 233 Rp 233 484 Rp 112,772 Rp 112,772 - Rp - 207 - 207 Rp 48,231 -
89 Mecobalamin tab tab / cap Rp 654 Rp 654 476 Rp 311,304 Rp 311,304 1,200 Rp 784,800 1,268 - 1,268 Rp 829,272 -
90 Meloksikam 15 mg tab / cap Rp 731 Rp 731 384 Rp 280,704 Rp 280,704 300 Rp 219,300 50 - 50 Rp 36,550 -
91 Meloksikam 7,5 mg tab / cap Rp 397 Rp 397 178 Rp 70,666 Rp 70,666 550 Rp 218,350 651 - 651 Rp 258,447 -
92 Metformin tab tab / cap Rp 110 Rp 110 1,193 Rp 131,230 Rp 131,230 1,000 Rp 110,000 1,006 - 1,006 Rp 110,660 -
93 Metil ergometrin tab tab / cap Rp 271 Rp 271 1,166 Rp 315,986 Rp 315,986 - Rp - 739 - 739 Rp 200,269 -
94 Metilprednisolon 16 mg tab / cap Rp 1,169 Rp 1,169 639 Rp 746,991 Rp 746,991 - Rp - 34 - 34 Rp 39,746 -
95 Metilprednisolon 4 mg tab / cap Rp 220 Rp 220 849 Rp 186,780 Rp 186,780 800 Rp 176,000 1,395 - 1,395 Rp 306,900 -
96 Metilprednisolon 8 mg tab / cap Rp 393 Rp 393 661 Rp 259,773 Rp 259,773 - Rp - 199 - 199 Rp 78,207 -
97 Metochlorpramid tab tab / cap Rp 143 Rp 143 686 Rp 98,098 Rp 98,098 - Rp - 115 - 115 Rp 16,445 -
98 Metronidazol tab tab / cap Rp 273 Rp 273 474 Rp 129,402 Rp 129,402 1,000 Rp 273,000 563 - 563 Rp 153,699 -
99 Micardis tab / cap Rp 7,150 Rp 7,150 44 Rp 314,600 Rp 314,600 - Rp - - - - Rp - -
100 Natrium Bicarbonat tab / cap Rp 110 Rp 110 269 Rp 29,590 Rp 29,590 300 Rp 33,000 223 - 223 Rp 24,530 -
101 Na diklofenak 50 mg tab / cap Rp 245 Rp 245 366 Rp 89,670 Rp 89,670 500 Rp 122,500 830 - 830 Rp 203,350 -
102 Neurodex tab tab / cap Rp 484 Rp 484 1,237 Rp 598,708 Rp 598,708 400 Rp 193,600 659 - 659 Rp 318,956 -
103 Nifedipin tab tab / cap Rp 110 Rp 110 391 Rp 43,010 Rp 43,010 700 Rp 77,000 410 - 410 Rp 45,100 -
104 Norelut / Norestil tab / cap Rp 2,552 Rp 2,552 42 Rp 107,184 Rp 107,184 - Rp - 30 - 30 Rp 76,560 -
PENGELUARAN
RANAP MUTASI
105 Omeprazole tab tab / cap Rp 326 Rp 326 772 Rp 251,672 Rp 251,672 1,920 Rp 625,920 2,207 - 2,207 Rp 719,482 -
106 Ondansetron tab 4 MG tab / cap Rp 523 Rp 523 569 Rp 297,587 Rp 297,587 120 Rp 62,760 617 - 617 Rp 322,691 -
107 Ondansetron tab 8 MG tab / cap Rp 440 Rp 440 315 Rp 138,600 Rp 138,600 - Rp - 53 - 53 Rp 23,320 -
108 Oralit tab / cap Rp 418 Rp 418 100 Rp 41,800 Rp 41,800 200 Rp 83,600 106 - 106 Rp 44,308 -
109 Ostovel tab / cap Rp 1,690 Rp 1,690 60 Rp 101,400 Rp 101,400 - Rp - - - - Rp - -
110 Parasetamol 500 mg tab / cap Rp 142 Rp 142 799 Rp 113,458 Rp 113,458 1,000 Rp 142,000 1,389 - 1,389 Rp 197,238 -
111 pioglitazone (deculin) 15 mg tab / cap Rp 3,300 Rp 3,300 96 Rp 316,800 Rp 316,800 - Rp - 6 - 6 Rp 19,800 -
112 Pioglitazone (deculin) 30 mg tab / cap Rp - Rp 4,950 - Rp - Rp - 90 Rp 445,500 - - - Rp - -
113 Piracetam 1200 mg tab / cap Rp 1,166 Rp 1,166 198 Rp 230,868 Rp 230,868 600 Rp 699,600 614 - 614 Rp 715,924 -
114 Piracetam 800 mg tab / cap Rp 682 Rp 682 6 Rp 4,092 Rp 4,092 - Rp - - - - Rp - -
115 Prednison tab / cap Rp 144 Rp 144 209 Rp 30,096 Rp 30,096 800 Rp 115,200 413 - 413 Rp 59,472 -
116 Pregabalin 75 mg tab / cap Rp 7,472 Rp 7,472 717 Rp 5,357,424 Rp 5,357,424 - Rp - 458 - 458 Rp 3,422,176 -
117 Propanolol 10 mg tab / cap Rp 72 Rp 72 329 Rp 23,688 Rp 23,688 - Rp - 238 - 238 Rp 17,136 -
118 Propanolol 40 mg tab / cap Rp 126 Rp 126 208 Rp 26,208 Rp 26,208 - Rp - 21 - 21 Rp 2,646 -
119 Provera / hystolan / medroksiprogesteron tab / cap Rp 2,521 Rp 2,521 150 Rp 378,150 Rp 378,150 - Rp - - - - Rp - -
120 PTU tab / cap Rp 451 Rp 451 314 Rp 141,614 Rp 141,614 - Rp - 179 - 179 Rp 80,729 -
121 Pirazinamid 500 mg tab / cap Rp 238 Rp 238 500 Rp 119,000 Rp 119,000 - Rp - 53 - 53 Rp 12,614 -
122 Ranitidin tab tab / cap Rp 110 Rp 110 1,452 Rp 159,720 Rp 159,720 2,500 Rp 275,000 2,805 - 2,805 Rp 308,550 -
123 Retaphyl tab / cap Rp 2,143 Rp 2,143 432 Rp 925,776 Rp 925,776 - Rp - 82 - 82 Rp 175,726 -
124 Rifampisin 450 mg tab / cap Rp 1,146 Rp 1,146 325 Rp 372,450 Rp 372,450 - Rp - 46 - 46 Rp 52,716 -
125 Rifanh 150/150 tab / cap Rp 7,246 Rp 7,246 36 Rp 260,856 Rp 260,856 - Rp - 36 - 36 Rp 260,856 -
126 Rimactazid tab / cap Rp 6,471 Rp 6,471 64 Rp 414,144 Rp 414,144 - Rp - - - - Rp - -
PENGELUARAN
RANAP MUTASI
127 Rimstar/rifastar tab / cap Rp 5,115 Rp 5,115 277 Rp 1,416,855 Rp 1,416,855 150 Rp 767,250 253 - 253 Rp 1,294,095 -
128 Salbutamol 2 mg tab / cap Rp 78 Rp 78 612 Rp 47,736 Rp 47,736 500 Rp 39,000 660 - 660 Rp 51,480 -
129 Sifrol 0,375 mg tab tab / cap Rp 8,000 Rp 8,000 32 Rp 256,000 Rp 256,000 - Rp - - - - Rp - -
130 Simarc / warfarin tab / cap Rp 950 Rp 950 39 Rp 37,050 Rp 37,050 - Rp - - - - Rp - -
131 Simvastatin 10mg tab tab / cap Rp 67 Rp 67 620 Rp 41,540 Rp 41,540 - Rp - 80 - 80 Rp 5,360 -
132 Simvastatin 20 mg tab / cap Rp 1,026 Rp 1,026 431 Rp 442,206 Rp 442,206 300 Rp 307,800 422 - 422 Rp 432,972 -
133 Spironolakton 100 mg tab / cap Rp 1,000 Rp 1,000 41 Rp 41,000 Rp 41,000 500 Rp 500,000 104 - 104 Rp 104,000 -
134 Spironolakton 25 mg tab / cap Rp 335 Rp 335 141 Rp 47,235 Rp 47,235 500 Rp 167,500 208 - 208 Rp 69,680 -
135 Sulfasalazin tab / cap Rp 2,090 Rp 2,090 61 Rp 127,490 Rp 127,490 200 Rp 418,000 82 - 82 Rp 171,380 -
136 Tetrasiklin 250 mg tab / cap Rp 378 Rp 378 816 Rp 308,448 Rp 308,448 200 Rp 75,600 737 - 737 Rp 278,586 -
137 Thiamfenikol 500 mg tab / cap Rp 985 Rp 985 22 Rp 21,670 Rp 21,670 - Rp - - - - Rp - -
138 Tramadol tab tab / cap Rp 329 Rp 329 215 Rp 70,735 Rp 70,735 1,000 Rp 329,000 215 - 215 Rp 70,735 -
139 Urotractin tab / cap Rp 1,815 Rp 1,815 326 Rp 591,690 Rp 591,690 - Rp - - - - Rp - -
140 Ursodeoksi tab tab / cap Rp 2,723 Rp 2,723 434 Rp 1,181,782 Rp 1,181,782 - Rp - 79 - 79 Rp 215,117 -
141 Vitamin A tab / cap Rp 686 Rp 686 116 Rp 79,576 Rp 79,576 500 Rp 343,000 351 - 351 Rp 240,786 -
142 Vitamin B1 tab / cap Rp 85 Rp 85 700 Rp 59,500 Rp 59,500 - Rp - 45 - 45 Rp 3,825 -
143 Vitamin B6 tab / cap Rp 135 Rp 135 578 Rp 78,030 Rp 78,030 - Rp - 349 - 349 Rp 47,115 -
144 Vitamin B12 tab / cap Rp 550 Rp 550 803 Rp 441,650 Rp 441,650 - Rp - - - - Rp - -
145 Vitamin B Komplek tab / cap Rp 120 Rp 120 565 Rp 67,800 Rp 67,800 1,000 Rp 120,000 592 - 592 Rp 71,040 -
146 Vitamin C 100 MG tab / cap Rp 121 Rp 121 - Rp - Rp - - Rp - - - - Rp - -
147 Vitamin C 50 MG tab / cap Rp 120 Rp 120 225 Rp 27,000 Rp 27,000 500 Rp 60,000 662 - 662 Rp 79,440 -
148 Vitamin K tab / cap Rp 790 Rp 790 492 Rp 388,680 Rp 388,680 - Rp - 129 - 129 Rp 101,910 -
PENGELUARAN
RANAP MUTASI
149 Zinc tab tab / cap Rp 592 Rp 592 201 Rp 118,992 Rp 118,992 - Rp - 70 - 70 Rp 41,440 -
RACIKAN / PRODUKSI
1 Racikan 3 (Analtram) tab / cap Rp - Rp - 142 Rp - Rp - - 142 - 142 Rp - -
SEDIAAN INJEKSI
1 Amikasin inj amp/vial Rp 71,874 Rp 71,874 3 Rp 215,622 Rp 215,622 5 Rp 359,370 2 - 2 Rp 143,748 -

2 Aminofilin inj amp/vial Rp 3,080 Rp 3,080 89 Rp 274,120 Rp 274,120 72 Rp 221,760 128 - 128 Rp 394,240 -
3 Amoksilin inj amp/vial Rp 9,900 Rp 9,900 31 Rp 306,900 Rp 306,900 5 Rp 49,500 25 - 25 Rp 247,500 -
4 Ampisilin inj amp/vial Rp 10,188 Rp 10,188 77 Rp 784,476 Rp 784,476 50 Rp 509,400 113 - 113 Rp 1,151,244 -
5 Antrain Inj amp/vial Rp 5,511 Rp 5,511 1,113 Rp 6,133,743 Rp 6,133,743 - Rp - 981 - 981 Rp 5,406,291 -
6 Arixtra amp/vial Rp 265,833 Rp 265,833 52 Rp 13,823,316 Rp 13,823,316 - Rp - 15 - 15 Rp 3,987,495 -
7 As. Tranexamat 500 mg inj amp/vial Rp 2,530 Rp 2,530 516 Rp 1,305,480 Rp 1,305,480 1,180 Rp 2,985,400 1,109 - 1,109 Rp 2,805,770 -
8 Atropin inj amp/vial Rp 1,264 Rp 1,264 52 Rp 65,728 Rp 65,728 31 Rp 39,184 41 - 41 Rp 51,824 -
9 Biocombin inj amp/vial Rp 4,070 Rp 4,070 96 Rp 390,720 Rp 390,720 - Rp - 70 - 70 Rp 284,900 -
10 Ca. Glukonas inj amp/vial Rp 9,955 Rp 9,955 68 Rp 676,940 Rp 676,940 - Rp - 63 - 63 Rp 627,165 -
11 Cefepime amp/vial Rp 38,285 Rp 38,285 14 Rp 535,990 Rp 535,990 - Rp - - - - Rp - -
12 Cefazolin amp/vial Rp 19,675 Rp 19,675 140 Rp 2,754,500 Rp 2,754,500 120 Rp 2,361,000 105 - 105 Rp 2,065,875 -
13 Cefirome inj amp/vial Rp 79,200 Rp 79,200 26 Rp 2,059,200 Rp 2,059,200 Rp - - - - Rp - -
14 Cefoporazon Sulbactam amp/vial Rp 79,200 Rp 79,200 24 Rp 1,900,800 Rp 1,900,800 Rp - 6 - 6 Rp 475,200 -
PENGELUARAN
RANAP MUTASI
15 Ceftazidime inj amp/vial Rp 15,903 Rp 15,903 51 Rp 811,053 Rp 811,053 50 Rp 795,150 75 - 75 Rp 1,192,725 -

16 Cernevit amp/vial Rp 157,713 Rp 157,713 55 Rp 8,674,215 Rp 8,674,215 600 Rp 94,627,800 499 - 499 Rp 78,698,787 -
17 Citikolin 250 mg inj amp/vial Rp 10,709 Rp 10,709 150 Rp 1,606,350 Rp 1,606,350 300 Rp 3,212,700 446 - 446 Rp 4,776,214 -
18 Citikolin 500 mg inj amp/vial Rp 21,600 Rp 21,600 361 Rp 7,797,600 Rp 7,797,600 400 Rp 8,640,000 686 - 686 Rp 14,817,600 -
19 Dexametason inj amp/vial Rp 1,641 Rp 1,641 330 Rp 541,530 Rp 541,530 300 Rp 492,300 524 - 524 Rp 859,884 -
20 Dipenhidramin inj amp/vial Rp 1,220 Rp 1,220 120 Rp 146,400 Rp 146,400 60 Rp 73,200 170 - 170 Rp 207,400 -
21 Dobutamin inj amp/vial Rp 15,087 Rp 15,087 34 Rp 512,958 Rp 512,958 7 Rp 105,609 25 - 25 Rp 377,175 -
22 Dopamin inj / UDOPA amp/vial Rp 7,480 Rp 7,480 Rp - Rp - - Rp - - - - Rp - -
23 Epinefrin inj amp/vial Rp 6,692 Rp 6,692 115 Rp 769,580 Rp 769,580 Rp - 49 - 49 Rp 327,908 -
24 Esomeprazol amp/vial Rp 14,924 Rp 14,924 85 Rp 1,268,540 Rp 1,268,540 160 Rp 2,387,840 184 - 184 Rp 2,746,016 -
25 Fitomenadion inj 2 mg amp/vial Rp 4,083 Rp 4,083 542 Rp 2,212,986 Rp 2,212,986 300 Rp 1,224,900 670 - 670 Rp 2,735,610 -
26 Fitomenadion inj 10 mg amp/vial Rp 4,167 Rp 4,167 49 Rp 204,183 Rp 204,183 - Rp - - - - Rp - -
27 Flamicort amp/vial Rp 53,482 Rp 53,482 10 Rp 534,820 Rp 534,820 - Rp - 5 - 5 Rp 267,410 -
28 Furosemid inj amp/vial Rp 2,058 Rp 2,058 295 Rp 607,110 Rp 607,110 200 Rp 411,600 375 - 375 Rp 771,750 -
29 Gentamisin inj amp/vial Rp 3,896 Rp 3,896 66 Rp 257,136 Rp 257,136 100 Rp 389,600 153 - 153 Rp 596,088 -
30 Herbesser inj 2 mg amp/vial Rp 148,500 Rp 148,500 5 Rp 742,500 Rp 742,500 - Rp - - - - Rp - -
31 Ketorolac 30 mg inj amp/vial Rp 2,250 Rp 2,250 942 Rp 2,119,500 Rp 2,119,500 1,368 Rp 3,078,000 1,863 - 1,863 Rp 4,191,750 -
32 Klonidin (catapres) inj amp/vial Rp 32,600 Rp 32,600 64 Rp 2,086,400 Rp 2,086,400 - Rp - 5 - 5 Rp 163,000 -
33 Lidokain Compusitum amp/vial Rp 2,112 Rp 2,112 35 Rp 73,920 Rp 73,920 - Rp - 4 - 4 Rp 8,448 -
34 Lidokain inj amp/vial Rp 1,000 Rp 1,000 63 Rp 63,000 Rp 63,000 500 Rp 500,000 376 - 376 Rp 376,000 -
35 Mecobalamin inj amp/vial Rp 6,600 Rp 6,600 252 Rp 1,663,200 Rp 1,663,200 400 Rp 2,640,000 485 - 485 Rp 3,201,000 -
36 Meropenem 1 gr inj amp/vial Rp 42,743 Rp 42,743 80 Rp 3,419,440 Rp 3,419,440 250 Rp 10,685,750 279 - 279 Rp 11,925,297 -
PENGELUARAN
RANAP MUTASI
37 Metil prednisolon 125 mg inj amp/vial Rp 12,800 Rp 12,800 266 Rp 3,404,800 Rp 3,404,800 362 Rp 4,633,600 628 - 628 Rp 8,038,400 -
38 Metoklorpramid inj / metolon amp/vial Rp 8,910 Rp 8,910 3 Rp 26,730 Rp 26,730 7 Rp 62,370 3 - 3 Rp 26,730 -
39 Nefrofer (Cosmofer) amp/vial Rp 44,000 Rp 44,000 50 Rp 2,200,000 Rp 2,200,000 - Rp - 28 - 28 Rp 1,232,000 -
40 Nicardipine inj amp/vial Rp 34,979 Rp 34,979 190 Rp 6,646,010 Rp 6,646,010 240 Rp 8,394,960 226 - 226 Rp 7,905,254 -
41 Nokoba amp/vial Rp 82,060 Rp 82,060 8 Rp 656,480 Rp 656,480 - Rp - 8 - 8 Rp 656,480 -
42 Omeprazole inj amp/vial Rp 14,924 Rp 14,924 494 Rp 7,372,456 Rp 7,372,456 720 Rp 10,745,280 1,030 - 1,030 Rp 15,371,720 -
43 Ondansetron inj amp/vial Rp 3,328 Rp 3,328 364 Rp 1,211,392 Rp 1,211,392 993 Rp 3,304,704 1,253 - 1,253 Rp 4,169,984 -
44 Pantoprazole inj amp/vial Rp 37,400 Rp 37,400 13 Rp 486,200 Rp 486,200 - Rp - 12 - 12 Rp 448,800 -
45 Piracetam 1 gr inj amp/vial Rp 4,235 Rp 4,235 224 Rp 948,640 Rp 948,640 500 Rp 2,117,500 592 - 592 Rp 2,507,120 -
46 Piracetam 3 gr inj amp/vial Rp 13,170 Rp 13,170 252 Rp 3,318,840 Rp 3,318,840 64 Rp 842,880 294 - 294 Rp 3,871,980 -
47 Pycin 750 mg amp/vial Rp 68,063 Rp 68,063 30 Rp 2,041,890 Rp 2,041,890 200 Rp 13,612,600 65 - 65 Rp 4,424,095 -
48 Ranitidin inj amp/vial Rp 1,600 Rp 1,600 1,045 Rp 1,672,000 Rp 1,672,000 2,700 Rp 4,320,000 3,126 - 3,126 Rp 5,001,600 -
49 Sefotaxim inj amp/vial Rp 5,995 Rp 5,995 236 Rp 1,414,820 Rp 1,414,820 288 Rp 1,726,560 308 - 308 Rp 1,846,460 -
50 Seftriaxon inj amp/vial Rp 11,000 Rp 11,000 530 Rp 5,830,000 Rp 5,830,000 1,728 Rp 19,008,000 1,837 - 1,837 Rp 20,207,000 -
51 Tramadol inj amp/vial Rp 1,720 Rp 1,720 97 Rp 166,840 Rp 166,840 - Rp - 70 - 70 Rp 120,400 -
52 Vitamin c inj amp/vial Rp 6,413 Rp 6,413 191 Rp 1,224,883 Rp 1,224,883 - Rp - 35 - 35 Rp 224,455 -
SEDIAAN DI KULKAS
1 Anti hemoroid supp Rp 3,300 Rp 3,300 59 Rp 194,700 Rp 194,700 - Rp - 3 - 3 Rp 9,900 -

2 Apidra plexpen Rp 87,000 Rp 87,000 Rp - Rp - - Rp - - - - Rp - -
3 ATS 1500 IU ampul Rp 165,000 Rp 165,000 74 Rp 12,210,000 Rp 12,210,000 - Rp - 9 - 9 Rp 1,485,000 -
PENGELUARAN
RANAP MUTASI
4 Dulcolax supp 10 mg (stolax) supp Rp 5,800 Rp 5,800 37 Rp 214,600 Rp 214,600 - Rp - 3 - 3 Rp 17,400 -

5 Dulcolax supp 5 mg supp Rp 5,800 Rp 5,800 12 Rp 69,600 Rp 69,600 - Rp - 4 - 4 Rp 23,200 -
6 Human Albuman 100 cc botol Rp 849,895 Rp 849,895 111 Rp 94,338,345 Rp 94,338,345 - Rp - 16 - 16 Rp 13,598,320 -
7 Human Albuman 50 CC botol Rp 409,147 Rp 409,147 155 Rp 63,417,785 Rp 63,417,785 - Rp - 47 - 47 Rp 19,229,909 -
8 Lantus / lavemir plexpen Rp 85,000 Rp 85,000 14 Rp 1,190,000 Rp 1,190,000 20 Rp 1,700,000 15 - 15 Rp 1,275,000 -
9 Metil ergometrin inj ampul Rp 3,278 Rp 3,278 154 Rp 504,812 Rp 504,812 100 Rp 327,800 71 - 71 Rp 232,738 -
10 Noporavid plexpen Rp 87,000 Rp 87,000 22 Rp 1,914,000 Rp 1,914,000 - Rp - 12 - 12 Rp 1,044,000 -
11 Novomix plexpen Rp 110,000 Rp 110,000 29 Rp 3,190,000 Rp 3,190,000 - Rp - - - - Rp - -
12 Octalbin 25% 100ml botol Rp 1,500,000 Rp 1,500,000 - Rp - Rp - - Rp - - - - Rp - -
13 Octalbin 25% 50mg botol Rp 772,171 Rp 772,171 42 Rp 32,431,182 Rp 32,431,182 100 Rp 77,217,100 76 - 76 Rp 58,684,996 -
14 Oksitosin inj ampul Rp 1,899 Rp 1,899 413 Rp 784,287 Rp 784,287 700 Rp 1,329,300 641 100 741 Rp 1,407,159 -
15 SABU vial Rp 640,530 Rp 640,530 8 Rp 5,124,240 Rp 5,124,240 - Rp - - - - Rp - -
16 Suprafenid supp Rp 2,789 Rp 2,789 41 Rp 114,349 Rp 114,349 50 Rp 139,450 36 - 36 Rp 100,404 -
17 Tetagam inj vial Rp 170,000 Rp 170,000 - Rp - Rp - Rp - - - - Rp - -
18 Vaksin rabies vial Rp 140,445 Rp 140,445 - Rp - Rp - - Rp - - - - Rp - -
19 Vancep vial Rp 209,000 Rp 209,000 - Rp - Rp - - Rp - - - - Rp - -
Rp 559,375,457 Rp 559,375,457 Rp 444,919,045 Rp 490,350,806
Mengetahui Amuntai, 01 Februari 201

PJ Obat BPJS
PENGELUARAN
RANAP MUTASI
Ina Septina S . Farm Apt

NIP; 19810922 200604 2 016 Eva Erlia, S.Farm., Apt
JS DEPO FARMASI RANAP PERIODE JANUARI 2018
RSUD PAMBALAH BATUNG
NILAI ED STOK AKHIR NILAI STOK AKHIR
- 12 Rp 624,000
- 45 Rp 1,955,250
- 5760 Rp 15,840,000
- 132 Rp 1,224,300
- 57 Rp 620,730
- 411 Rp 1,628,793
- 668 Rp 6,289,220
- 257 Rp 2,405,520
- 2 Rp 59,080
- 22 Rp 865,194
- 97 Rp 727,500
- 2480 Rp 18,071,760
- 45 Rp 2,232,000
- 4 Rp 30,096
- 172 Rp 4,623,532
- 334 Rp 45,465,750
- 151 Rp 6,644,000
- 532 Rp 5,149,760
- 60 Rp 653,400
- 38 Rp 121,600
- 26 Rp 94,900
- 56 Rp 12,012,000
- 1173 Rp 7,380,516
- 18 Rp 1,138,014
- 573 Rp 17,333,250
- 2115 Rp 15,005,925
- 3 Rp 8,991
- 3 Rp 308,997
- 8 Rp 640,000
- 9 Rp 18,234
- 29 Rp 1,518,904
- 383 Rp 2,183,100
- 0 Rp -
- 0 Rp -
- 12 Rp 25,512
- 0 Rp -
- 0 Rp -
- 18 Rp 119,790
- 16 Rp 178,112
- 0 Rp -
- 39 Rp 85,800
- 10 Rp 18,500
- 0 Rp -
- 2 Rp 7,472
- 19 Rp 31,331
- 5 Rp 13,860
- 0 Rp -
- 0 Rp -
- 0 Rp -
- 6 Rp 748,008
- 0 Rp -
Rp -
Rp -
Rp -
- 108 Rp -
- 0 Rp -
- 0 Rp -
- 9 Rp -
- 200 Rp -
- 0 Rp -
- 0 Rp -
- 21 Rp -
Rp -
Rp -
Rp -
- 65 Rp 235,755
- 58 Rp 326,308
- 0 Rp -
- 45 Rp 143,280
- 15 Rp 74,985
- 26 Rp 308,880
- 20 Rp 208,800
- 9 Rp 70,047
- 19 Rp 42,275
- 30 Rp 270,000
- 3 Rp 7,560
- 2 Rp 8,450
- 50 Rp 2,420,000
- 5 Rp 108,900
- 29 Rp 118,900
- 90 Rp 91,080
- 39 Rp 316,836
- 15 Rp 133,650
- 34 Rp 167,144
- 107 Rp 1,080,700
- 10 Rp 6,570
- 353 Rp 388,300
- 346 Rp 41,520
- 0 Rp -
- 443 Rp 329,592
- 517 Rp 53,251
- 217 Rp 36,239
- 472 Rp 54,752
- 591 Rp 123,519
- 222 Rp 1,208,790
- 738 Rp 43,542
- 396 Rp 54,648
- 864 Rp 88,128
- 694 Rp 741,886
- 89 Rp 31,951
- 225 Rp 128,475
- 424 Rp 289,168
- 466 Rp 43,804
- 381 Rp 720,852
- 356 Rp 1,064,084
- 627 Rp 100,320
- 46 Rp 404,800
- 298 Rp 44,998
- 0 Rp -
- 655 Rp 425,750
- 219 Rp 65,262
- 691 Rp 39,387
- 174 Rp 133,980
- 507 Rp 34,983
- 300 Rp 31,500
- 413 Rp 231,280
- 960 Rp 1,608,960
- 672 Rp 80,640
- 313 Rp 2,504,000
- 824 Rp 263,680
- 502 Rp 2,981,880
- 176 Rp 116,160
- 474 Rp 97,170
- 338 Rp 608,062
- 103 Rp 598,224
- 522 Rp 139,374
- 625 Rp 28,125
- 39 Rp 205,920
- 393 Rp 30,654
- 375 Rp 34,500
- 4 Rp 11,880
- 560 Rp 61,040
- 98 Rp 14,112
- 360 Rp 51,120
- 210 Rp 60,900
- 450 Rp 53,100
- 199 Rp 208,950
- 500 Rp 654,500
- 90 Rp 45,810
- 468 Rp 268,632
- 315 Rp 190,575
- 568 Rp 740,104
- 246 Rp 98,400
- 233 Rp 447,127
- 173 Rp 3,581,100
- 671 Rp 2,231,075
- 364 Rp 760,760
- 451 Rp 81,631
- 180 Rp 295,020
- 285 Rp 110,010
- 940 Rp 42,300
- 555 Rp 51,060
- 205 Rp 747,840
- 500 Rp 148,000
- 238 Rp 75,922
- 342 Rp 83,790
- 247 Rp 173,888
- 307 Rp 437,475
- 120 Rp 514,800
- 87 Rp 14,877
- 296 Rp 53,280
- 1217 Rp 141,172
- 614 Rp 361,646
- 797 Rp 82,888
- 133 Rp 45,220
- 176 Rp 378,576
- 558 Rp 948,600
- 159 Rp 139,602
- 168 Rp 115,248
- 288 Rp 139,680
- 272 Rp 111,520
- 360 Rp 37,800
- 277 Rp 64,541
- 408 Rp 266,832
- 634 Rp 463,454
- 77 Rp 30,569
- 1187 Rp 130,570
- 427 Rp 115,717
- 605 Rp 707,245
- 254 Rp 55,880
- 462 Rp 181,566
- 571 Rp 81,653
- 911 Rp 248,703
- 44 Rp 314,600
- 346 Rp 38,060
- 36 Rp 8,820
- 978 Rp 473,352
- 681 Rp 74,910
- 12 Rp 30,624
- 485 Rp 158,110
- 72 Rp 37,656
- 262 Rp 115,280
- 194 Rp 81,092
- 60 Rp 101,400
- 410 Rp 58,220
- 90 Rp 297,000
- 90 Rp 445,500
- 184 Rp 214,544
- 6 Rp 4,092
- 596 Rp 85,824
- 259 Rp 1,935,248
- 91 Rp 6,552
- 187 Rp 23,562
- 150 Rp 378,150
- 135 Rp 60,885
- 447 Rp 106,386
- 1147 Rp 126,170
- 350 Rp 750,050
- 279 Rp 319,734
- 0 Rp -
- 64 Rp 414,144
- 174 Rp 890,010
- 452 Rp 35,256
- 32 Rp 256,000
- 39 Rp 37,050
- 540 Rp 36,180
- 309 Rp 317,034
- 437 Rp 437,000
- 433 Rp 145,055
- 179 Rp 374,110
- 279 Rp 105,462
- 22 Rp 21,670
- 1000 Rp 329,000
- 326 Rp 591,690
- 355 Rp 966,665
- 265 Rp 181,790
- 655 Rp 55,675
- 229 Rp 30,915
- 803 Rp 441,650
- 973 Rp 116,760
- 0 Rp -
- 63 Rp 7,560
- 363 Rp 286,770
- 131 Rp 77,552
- 0 Rp -
- 6 Rp 431,244
- 33 Rp 101,640
- 11 Rp 108,900
- 14 Rp 142,632
- 132 Rp 727,452
- 37 Rp 9,835,821
- 587 Rp 1,485,110
- 42 Rp 53,088
- 26 Rp 105,820
- 5 Rp 49,775
- 14 Rp 535,990
- 155 Rp 3,049,625
- 26 Rp 2,059,200
- 18 Rp 1,425,600
- 26 Rp 413,478
- 156 Rp 24,603,228
- 4 Rp 42,836
- 75 Rp 1,620,000
- 106 Rp 173,946
- 10 Rp 12,200
- 16 Rp 241,392
- 0 Rp -
- 66 Rp 441,672
- 61 Rp 910,364
- 172 Rp 702,276
- 49 Rp 204,183
- 5 Rp 267,410
- 120 Rp 246,960
- 13 Rp 50,648
- 5 Rp 742,500
- 447 Rp 1,005,750
- 59 Rp 1,923,400
- 31 Rp 65,472
- 187 Rp 187,000
- 167 Rp 1,102,200
- 51 Rp 2,179,893
- 0 Rp -
- 7 Rp 62,370
- 22 Rp 968,000
- 204 Rp 7,135,716
- 0 Rp -
- 184 Rp 2,746,016
- 104 Rp 346,112
- 1 Rp 37,400
- 132 Rp 559,020
- 22 Rp 289,740
- 165 Rp 11,230,395
- 619 Rp 990,400
- 216 Rp 1,294,920
- 421 Rp 4,631,000
- 27 Rp 46,440
- 156 Rp 1,000,428
- 56 Rp 184,800
- 0 Rp -
- 65 Rp 10,725,000
- 34 Rp 197,200
- 8 Rp 46,400
- 95 Rp 80,740,025
- 108 Rp 44,187,876
- 19 Rp 1,615,000
- 183 Rp 599,874
- 10 Rp 870,000
- 29 Rp 3,190,000
- 0 Rp -
- 66 Rp 50,963,286
- 472 Rp 896,328
- 8 Rp 5,124,240
- 55 Rp 153,395
- Rp -
- 0 Rp -
- 0 Rp -
Rp 514,133,596

Mengetahui,
PJ Obat BPJS
Eva Erlia, S.Farm., Apt

STOK OPNAME BPJS RAWAT INAP
NO NAMA OBAT FEBRUARI MARET APRIL MEI
AMPRAHAN SO AMPRAHAN SO AMPRAHAN SO AMPRAHAN
SEDIAAN INFUS
1 Aminofusin
2 Aminosteril Infan
3 Aqua Pro Injeksi
4 Asering Infus
5 Ciprofloksasin infus
6 D40 %
7 D5 % 1/2 Infus
8 D5 % 1/4 Infus
9 Fluconazol infus
10 Futrolit
11 Glukosa 10
12 Glukosa 5
13 Hidromal
14 KCl
15 Levofloksasin 500 mg
16 Levofloksasin 750mg
17 Manitol
18 Metronidazol infus
19 Meylon inj
20 MgSO4 20 %
21 MgSO4 40 %
22 Moxifloxacin inf
23 Nacl
24 Ofloxacin infus
25 Paracetamol infus
26 RL infus
1 Asiklovir salep kulit
2 Avamys
3 Berotec inhaler
4 Betametason SK
5 Burnazin cream
6 Combivent nebules
7 Fenol Gliserol
8 Genoin Salep
9 Gentamisin Salep kulit / genoint
10 Gentamisin salep mata
11 Gentamisin tetes mata
12 Gentian violet
13 Hidrokortison salep kulit
14 Iliadin Spray
15 Ketokonazole salep kulit
16 Kloramfenikol salep mata
17 Kloramfenikol tetes mata
18 Miconazole salep kulit
19 Oksitetrasiklin salep kulit
20 Oksitetrasiklin salep mata
21 PK
22 salep 24
23 Seretide discus 100
24 Seretide discus 250
25 Symbicort turbu 160 mcg
OBAT PROGRAM
1 albendazol
2 Artem inj
3 Artesunate inj
4 D Artepp (anti malaria)
5 Dietylcarbamazepin
6 Kinin inj
7 Kinin tablet
8 Primaquin tab
SEDIAAN SIRUP
1 Ambroxol sirup 15mg
2 Amoksilin Sirup
3 Amoxillin drop
4 Antasida sirup
5 Cefadroxyl syr
6 Cefixime sirup
7 Cetirizin syr
8 Cloramfenikol Sirup
9 Cotrimoksazol Sirup
10 Domperidon Sirup
11 Gavistal / Metoklopramid
12 Ibuprofen syr 100 mg
13 Lactulax
14 Nystatin drop
15 OBH
16 Paracetamol sirup
17 Paracetamol drop
18 Plantacid syr
19 Salbutamol syr
20 Sucralfat Syr
SEDIAAN TABLET ORAL
1 Acarbose 50 (Eclid)
2 Acetyl systein
3 Allopurinol tab 100 MG
4 Allopurinol tab 300 MG
5 Ambroxol tab
6 Aminofilin tab
7 Amlodipin 10 mg
8 Amlodipin 5 mg tab
9 Amoksilin 500 mg tab
10 Amvar
11 antasida tab
12 Asam Folat
13 Asam Mefenamat
14 Asam Tranexamat 500
15 Asiklovir 200 mg
16 Asiklovir 400 mg
17 Aspar k tab (Kalipar)
18 Aspilet
19 Atorvastatin 10 mg
20 Atorvastatin 20 mg
21 Attalpugit (Pularex)
22 Azitromisin 500 mg
23 Betahistin tab
24 Bisakodil (Dulkolax) tab
25 Bisoprolol 2,5 mg / concor
26 Bisoprolol 5 mg
27 Calsium Lactat
28 Candersartan 8 mg (canderin)
29 Captopril 12,5 mg
30 Captopril 25 mg
31 Cefadroxyl 500
32 Cefiksim 100 mg
33 Cetirizin 10 mg
34 Cilostazol tab 100 mg
35 Ciproflokasin 500 mg
36 Citicolin 500 mg
37 Clindamisin 300 mg
38 Clonidin tab
39 Clopidogrel
40 Co- amoxiclav
41 Cotrimoxazol 480 tab
42 CTM tab
43 Cytodrox
44 Curcuma tab
45 Dexametason tab
46 Dexketopropen
47 Digoksin tab
48 Diltiazem 30 mg
49 Dimenhidrinat
50 Doksisiklin tab
51 Domperidone tab
52 Dopamet
53 Eperison (Perilax)
54 Erytromisin 250 mg
55 Etambutol tab
56 Fenofibrate 100 mg
57 Fenofibrate 300 mg
58 Ferrosulfat
59 Finasteride 5 mg tab / finro
60 Fluconazol
61 Flunarizine 10 mg
62 Flunarizine 5 mg
63 Furosemid tab
64 Gabexal
65 Gemfibrozil 300 mg
66 GG tab
67 Glibenklamid tab
68 Glikuidon (Lodem)
69 Glimepirid 2 mg
70 Glimepirid 3 mg
71 Glukodex
72 Glukosamine tab
73 Harnal / Hytroz
74 Herbesser
75 Hidroklorotiazid 25 mg
76 Ibuprofen 400 mg tab
77 Isoniazid 300 mg
78 Interhistin tab
79 Isosorbid Dinitrat 5 mg
80 Ketokonazole tab
81 Ketorolac tab
82 KSR
83 Lansoprazole
84 Levofloksasin 500 mg tab
85 Lisinopril 10 mg / noperten
86 Lisinopril 5 mg / noperten
87 Loperamid tab
88 Loratadine tab
89 Mecobalamin tab
90 Meloksikam 15 mg
91 Meloksikam 7,5 mg
92 Metformin tab
93 Metil ergometrin tab
94 Metilprednisolon 16 mg
97 Metochlorpramid tab
98 Metronidazol tab
99 Micardis
100 Natrium Bicarbonat
101 Na diklofenak 50 mg
102 Neurodex tab
103 Nifedipin tab
104 Norelut / Norestil
105 Omeprazole tab
106 Ondansetron tab 4 MG
107 Ondansetron tab 8 MG
108 Oralit
109 Ostovel
110 Parasetamol 500 mg
111 pioglitazone (deculin) 15 mg
112 Pioglitazone (deculin) 30 mg
113 Piracetam 1200 mg
114 Piracetam 800 mg
115 Prednison
116 Pregabalin 75 mg
117 Propanolol 10 mg
118 Propanolol 40 mg
119 Provera / hystolan / medroksiprogesteron
120 PTU
121 Pirazinamid 500 mg
122 Ranitidin tab
123 Retaphyl
124 Rifampisin 450 mg
125 Rifanh 150/150
126 Rimactazid
127 Rimstar/rifastar
128 Salbutamol 2 mg
129 Sifrol 0,375 mg tab
130 Simarc / warfarin
131 Simvastatin 10mg tab
132 Simvastatin 20 mg
133 Spironolakton 100 mg
134 Spironolakton 25 mg
135 Sulfasalazin
136 Tetrasiklin 250 mg
137 Thiamfenikol 500 mg
138 Tramadol tab
139 Urotractin
140 Ursodeoksi tab
141 Vitamin A
142 Vitamin B1
143 Vitamin B6
144 Vitamin B12
145 Vitamin B Komplek
146 Vitamin C 100 MG
147 Vitamin C 50 MG
148 Vitamin K
149 Zinc tab
RACIKAN / PRODUKSI
1 Racikan 3 (Analtram)
SEDIAAN INJEKSI
1 Amikasin inj
2 Aminofilin inj
3 Amoksilin inj
4 Ampisilin inj
5 Antrain Inj
6 Arixtra
7 As. Tranexamat 500 mg inj
8 Atropin inj
9 Biocombin inj
10 Ca. Glukonas inj

11 Cefepime
12 Cefazolin
13 Cefirome inj
14 Cefoporazon Sulbactam
15 Ceftazidime inj
16 Cernevit
17 Citikolin 250 mg inj
18 Citikolin 500 mg inj
19 Dexametason inj
20 Dipenhidramin inj
21 Dobutamin inj
22 Dopamin inj / UDOPA
23 Epinefrin inj
24 Esomeprazol
25 Fitomenadion inj 2 mg
26 Fitomenadion inj 10 mg
27 Flamicort
28 Furosemid inj
29 Gentamisin inj
30 Herbesser inj 2 mg
31 Ketorolac 30 mg inj
32 Klonidin (catapres) inj
33 Lidokain Compusitum
34 Lidokain inj
35 Mecobalamin inj
36 Meropenem 1 gr inj
37 Metil prednisolon 125 mg inj
38 Metoklorpramid inj / metolon
39 Nefrofer (Cosmofer)
40 Nicardipine inj
41 Nokoba
42 Omeprazole inj
43 Ondansetron inj
44 Pantoprazole inj
45 Piracetam 1 gr inj
46 Piracetam 3 gr inj
47 Pycin 750 mg
48 Ranitidin inj
49 Sefotaxim inj
50 Seftriaxon inj
51 Tramadol inj
52 Vitamin c inj
SEDIAAN DI KULKAS
1 Anti hemoroid
2 Apidra
3 ATS 1500 IU
4 Dulcolax supp 10 mg (stolax)
5 Dulcolax supp 5 mg
6 Human Albuman 100 cc
7 Human Albuman 50 CC
8 Lantus / lavemir
9 Metil ergometrin inj
10 Noporavid
11 Novomix
12 Octalbin 25% 100ml
13 Octalbin 25% 50mg
14 Oksitosin inj
15 SABU
16 Suprafenid
17 Tetagam inj
18 Vaksin rabies
19 Vancep
E BPJS RAWAT INAP
MEI
SO

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LAPORAN STOK OPNAME OBAT GENERIK BPJS DEPO FARMASI IGD PERIODE MARET 2018

INSTALASI FARMASI RSUD PAMBALAH BATUNG

1 Aqua Pro Injeksi floz Rp 2,750 Rp 2,750 87 - -

20 Moxifloxacin inf botol Rp 214,500 Rp 214,500 2 - -

SEDIAAN MATA, KULIT, DLL

1 Asiklovir salep kulit tube Rp 2,997 Rp 2,997 6 - -

15 Iliadin Spray botol Rp 37,900 Rp 37,900 - -

1 Ambroxol sirup 15mg botol Rp 3,627 Rp 3,627 3 - -

12 Ibuprofen syr 100 mg botol Rp 4,225 Rp 4,225 6 - -

SEDIAAN TABLET ORAL

1 Acarbose 50 (Eclid) tab / cap Rp 657 Rp 657 - -

11 antasida tab tab / cap Rp 59 Rp 59 45 - -

32 Cefiksim 100 mg tab / cap Rp 1,676 Rp 1,676 220 - -

54 Erytromisin 250 mg tab / cap Rp 509 Rp 509 - -

76 Ibuprofen 400 mg tab tab / cap Rp 180 Rp 180 70 - -

98 Metronidazol tab tab / cap Rp 273 Rp 273 55 - -

120 Provera / hystolan / medroksiproge tab / cap Rp 2,521 Rp 2,521 - -

142 Vitamin B Komplek tab / cap Rp 120 Rp 120 291 - -

1 Racikan 3 (Analtram) tab / cap Rp 854 Rp 854 34 - -

1 Amikasin inj amp/vial Rp 71,874 Rp 71,874 - -

8 Atropin inj amp/vial Rp 1,264 Rp 1,264 99 - -

30 Herbesser inj 2 mg amp/vial Rp 148,500 Rp 148,500 - -

52 Vitamin c inj amp/vial Rp 6,413 Rp 6,413 8 - -

1 Anti hemoroid supp Rp 3,300 Rp 3,300 50 - -

1 Cutimed Gel Rp 45,591 Rp 45,591 9 - -

23 Infuset Micro Rp 5,104 Rp 5,104 56 - -

45 Spalax 90x7 Rp 121,000 Rp 121,000 0 - -

67 Actimove M Rp 84,260 Rp 84,260 1 - -

1 Catgut Crhom 3/0 DS 19 Rp 57,200 Rp 57,200 11 - -

1 Aminefron Rp 6,793 Rp 6,793 91 - -

6 Colistine Rp 6,160 Rp 6,160 5 - -

1 Thrombopob Rp 51,455 Rp 51,455 8 - -

1 Apialis Drop Rp 25,393 Rp 25,393 3 - -

1 Acran Injeksi Rp 20,189 Rp 20,189 - -

Kepala instalasi Farmasi

Ina Septina S . Farm Apt

HARGA HARGA PENGELUARAN

1 Aqua Pro Injeksi floz Rp 2,750 Rp 2,750 87 Rp 239,250 Rp - 87 - 87 Rp 239,250

HARGA HARGA PENGELUARAN

20 Moxifloxacin inf botol Rp 214,500 Rp 214,500 2 Rp 429,000 Rp - 2 - 2 Rp 429,000

SEDIAAN MATA, KULIT, DLL

1 Asiklovir salep kulit tube Rp 2,997 Rp 2,997 6 Rp 17,982 Rp - 6 - 6 Rp 17,982

HARGA HARGA PENGELUARAN

15 Iliadin Spray botol Rp 37,900 Rp 37,900 Rp - Rp - - - - Rp -

1 Ambroxol sirup 15mg botol Rp 3,627 Rp 3,627 3 Rp 10,881 Rp - 3 - 3 Rp 10,881

HARGA HARGA PENGELUARAN

12 Ibuprofen syr 100 mg botol Rp 4,225 Rp 4,225 6 Rp 25,350 Rp - 6 - 6 Rp 25,350

SEDIAAN TABLET ORAL

1 Acarbose 50 (Eclid) tab / cap Rp 657 Rp 657 Rp - Rp - - - - Rp -

HARGA HARGA PENGELUARAN

11 antasida tab tab / cap Rp 59 Rp 59 45 Rp 2,655 Rp - 45 - 45 Rp 2,655

HARGA HARGA PENGELUARAN

HARGA HARGA PENGELUARAN

54 Erytromisin 250 mg tab / cap Rp 509 Rp 509 Rp - Rp - - - - Rp -

HARGA HARGA PENGELUARAN

76 Ibuprofen 400 mg tab tab / cap Rp 180 Rp 180 70 Rp 12,600 Rp - 70 - 70 Rp 12,600

HARGA HARGA PENGELUARAN

98 Metronidazol tab tab / cap Rp 273 Rp 273 55 Rp 15,015 Rp - 55 - 55 Rp 15,015

HARGA HARGA PENGELUARAN

120 Provera / hystolan / medroksiproge tab / cap Rp 2,521 Rp 2,521 Rp - Rp - - - - Rp -

HARGA HARGA PENGELUARAN

1 Racikan 3 (Analtram) tab / cap Rp 854 Rp 854 34 Rp 29,036 Rp - 34 - 34 Rp 29,036

1 Amikasin inj amp/vial Rp 71,874 Rp 71,874 Rp - Rp - - - - Rp -