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No.

N A M A O B A T KMSAN 2014 2015 2016 2017


1 ACCU CHECK GO LANCET pcs 635
2 ACYCLOVIR SALEP 5 % tube 3,440 3,440 3,151 3,151
3 ACYCLOVIR TABLET 400MG tablet 336 336 349 365
4 AIR RAKSA DENTAL USE botol
5 ALBENDAZOLE TABLET 400 MG tablet 366 344 344
6 ALKOHOL SWAB 2 PLY 100 PCS pcs 100 100 100 189
7 ALLOPURINOL TABLET 100 MG tablet 86 86 90 89
8 ALLOPURINOL TABLET 300 MG tablet
9 AMALGAM POWDER F 400 botol
10 AMBEVEN CAPSUL kapsul 1,270
11 AMBROXOL TABLET 30 MG tablet 124 159 159
12 AMINOPHYLLINE INJEKSI 25 MG/ML ampul 3,822 3,345 2,998
13 AMINOPHYLLINE TABLET 200 MG tablet 80
14 AMITRIPTYLINE TABLET 25 MG tablet 112 112 143
15 AMLODIPINE TABLET 10 MG tablet 330 145 104
16 AMLODIPINE TABLET 5 MG tablet 187 187 187
17 AMOXYCILLIN SIRUP 125 MG/5 ML botol 2,445 2,445 2,090 1,881
18 AMOXYCILLIN TABLET 500 MG tablet 261 232 190
19 ANHYDROUS DEXTROSE INJEKSI 40 ampul
20 ANTACIDA DOEN II SUSPENSI (ALLU botol 2,160 2,160 2,025
21 ANTACIDA TABLET 400 MG tablet 72 62 58
22 ANTI-A MONOCLONAL 10 ML ( REAGEN botol 456,500 68,200 68,200
23 ANTI-AB MONOCLONAL 10 ML (REAGE botol 68,200 68,200
24 ANTI-B MONOCLONAL 10 ML ( REAGEN botol 92,510 92,510
25 ANTI-D MONOCLONAL 10 ML ( REAGE botol 195,800 114,070 114,070
26 ANTIFUNGI SALEP pot 1,719 1,904 4,323
27 ANTI-SNAKE VENOM INJEKSI ( SABU vial 468,919 468,919 473,000 462,000
28 ANUSOL SUPPOSITORIA supp
29 AQUA PRO INJ STERIL botol 3,190 2,750
30 AQUADEST STERIL (1000ml ) botol 13,090
31 AQUAGEL LUBRICATING JELLY botol 34,528
32 ASAM MEFENAMAT TABLET 500 MG tablet 112 112 106 100
33 ASCORBIC ACID (VITAMIN C) TABLET tablet 135 159 125 114
34 ASCORBIC ACID (VITAMIN C) TABLET tablet
35 ASEPTAN 500 ML botol 22,000 34,500
36 ASERING INFUS BOTOL 500ML botol 9,275
37 ASPIRIN (ASETOSAL) TABLET 80 MG tablet 148 148
38 ATROPINE SULPHATE INJEKSI 0.25 M ampul 1,230 1,350 1,672 1,540
39 ATTAPULGITE TABLET 600 MG tablet 190 142
40 BACITRACIN|POLYMYXIN B SULPHATE tube 2,516 2,516 2,516
41 BAHAN TAMBAL GIGI SEMENTARA ( CA botol 165,000
42 BECEFORT SIRUP botol 15,760
43 BECEFORT TABSAL GULA tablet 785
44 BEDAK SALISIL SERBUK 2 % pcs 1,250 1,250 1,025
45 BETAHISTINE TABLET 6 MG tablet 149
46 BETAMETASON CREAM 0,1 % tube
47 BISACODYL SUPPOSITORIA 10 MG suppo 6,045 5,800
48 BISACODYL TABLET 5MG tablet 1,100 1,100
49 BISMUTH SUBGALLATE|ZINC OXIDE| supp
50 BISOPROLOL FUMARATE TABLET 5 M tablet 645 645 330 260
51 BLOOD LANCET pcs 146
52 BLOOD MIXING DEVICES AND BLOOD set 1,127,500
53 BLOOD TRANFUSION SET pcs 3,600
54 BLUE TIPS KLINIPET pcs
55 BOX SLIDE kotak 75,430 75,430
56 CALCIDOR Calcium Hydroxide Composit kotak 264,000
57 CALCIUM GLUCONATE INJEKSI 10 % ampul 14,997 9,955
58 CALCIUM LACTATE TABLET 500 MG tablet 52 56
59 CAPTOPRIL TABLET 25 MG tablet 84 84
60 CARBAMAZEPINE TABLET 200 MG tablet 245 270 228
61 CAT GUT CHROMIC 2 - 0 pcs 5,583 5,583
62 CAT GUT CHROMIC 3 - 0 pcs 5,583 5,583 57051.2
63 CAT GUT PLAIN 2 - 0 pcs 5,583 5,583 53210
64 CAT GUT PLAIN 3 - 0 pcs 5,583 5,583 62901.8
65 CEFADROXIL TABLET 500 MG tablet 509 516 450
66 CEFIXIME CAPSUL 100 MG kapsul 590
67 CEFIXIME CAPSUL 200 MG kapsul 3,306 2,218
68 CEFOTAXIME INJEKSI 1 G/VIAL vial 6,800 2,950 4,898 4,282
69 CELL CLEAN botol
70 CELL PACK box 2,266,000
71 CHLORAMPHENICOL DROPS 0,5 % ( T botol
72 CHLORAMPHENICOL DROPS 3 % ( TT botol 1,980 1,980
73 CHLORAMPHENICOL INJEKSI 1 G/VIA vial 9,653 7,260 13,200
74 CHLORAMPHENICOL KAPSUL 250 MG kapsul 249
75 CHLORAMPHENICOL SALEP MATA 1% tube 1,600 1,600 1,798
76 CHLORPROMAZINE HCL TABLET 100 tablet 244 144 144
77 CIPROFLOXACIN TABLET 500 MG tablet 250 255 281 240
78 COTRIMOXAZOLE SIRUP 240 MG/5 ML botol 2,167 2,167 2,140 2,286
79 COTRIMOXAZOLE TABLET 480 MG tablet 138 138 151
80 COVER GLASS pak 144,600 144,595
81 CURASPON CUBE kotak
82 CYANOCOBALAMIN INJEKSI 500 MCG ampul 1,076 1,078
83 DEMACOLIN TABLET tablet 277 277
84 DENGUE IgG/IgM pcs 99,440
85 DENGUE NS1Ag pcs 139,260
86 DENTORIT botol
87 DEVITALISASI PASTA NON ARSEN 6 G pot 148,500
88 DEXAMETHASONE INJEKSI 5 MG/ML ampul 1,580 1,580 1,518 1,567
89 DEXAMETHASONE TABLET 0.5 MG tablet 62 62 44
90 DIAZEPAM CAIRAN INJEKSI 5 MG/ML ampul 2,344 4,180 4,180
91 DIAZEPAM ENEMA 10 MG/2.5 ML suppo 44,000 16,748 17,577
92 DIAZEPAM TABLET 2 MG tablet 45 45 56
93 DICLOFENAC SODIUM TABLET 50 MG tablet 176 176 122
94 DIGOXIN TABLET 0.25 MG tablet 97 97 105 104
95 DIMENHYDRINATE TABLET 50 MG tablet 104 104
96 DIPHENHYDRAMIN INJEKSI ampul 1,050 1,050 1,175
97 DOMPERIDONE SIRUP 60 ML botol 3,000
98 DOXYCYCLINE TABLET 100 MG tablet 240 270 269
99 ECG Gel botol 29,540
100 EFEDRIN TABLET 25 MG tablet
101 EPINEPHRINE INJEKSI 0.1 % ampul 8,100 8,100 2,204 1,749
102 ERITROMISIN 500 MG tablet 850 930 730 730
103 ETHANOL 100 ML botol 2,500 2,500
104 ETHYL CHLORIDE SPRAY botol 104,000
105 EUGENOL LIQUID botol 16,667
106 EXAMINATION GLOVES SIZE L ( HAND pcs
107 EXAMINATION GLOVES SIZE M ( HAN pcs 462 496
108 FERROUS FUMARATE TABLET ( TTD ) tablet 44 50 355
109 FILM IV DRESSING pcs 2,220
110 FLUFENAZINE INJEKSI 25 MG\/ML ampul 55,000 57,500
111 FOKUS DIAGNOSTIC ANTI HIV ( REAG pcs 14,970.4 14,470
112 FOKUS SYPHILIS ( REAGEN SYPHILIS strip 7,975 26,671
113 FOLLEY CATHETER 2 WAY NO. 16 pcs 8,000 8,000 13,090 13,090
114 FOLLEY CATHETER 2 WAY NO. 18 pcs 8,000 8,000 13,090 13,090
115 FRAMYCETIN SULPHATE BP 1% (KASA lembar 16,500 20,845
116 FUROSEMIDE INJEKSI 10 MG\/ML ampul 1,829 1,829
117 FUROSEMIDE TABLET 40 MG tablet 90 85 78 80
118 FURSULTIAMINE HCL INJ( ALINAMIN F ampul 14,960
119 GARAM ORALIT SERBUK sachet 292 288 264
120 GEMFIBROZIL TABLET 300 MG tablet 380 364
121 GENTAMYCIN INJEKSI 40 MG/ML ampul 3,399
122 GENTAMYCIN INJEKSI 80 MG/ML ampul 4,400 4,400
123 GENTAMYCIN TM 0.3% botol 3,194 3,194 4,000 4,170
124 GENTAMYCIN SALEP 0.1 % tube 1,848 3,450
125 GENTAMYCIN SALEP MATA 0,3% tube 6,600
126 GENTIAN VIOLET LIQUID botol 900 900
127 GLASS IONOMER CEMENT ART Fuji IX pcs 605,000
128 GLIBENCLAMIDE TABLET 5 MG tablet 54 56 80
129 GLIMEPIRIDE TABLET 2 MG tablet 289 289
130 GLISERIL GUIAKOLAT TABLET 100 MG tablet 28
131 GLUCOSE INFUS 5 % botol 5,200 6,900 6,900
132 GLUCOSE|SODIUM LACTATE|SODIUM C botol
133 GLUCOSE|SODIUM LACTATE|POTASSIU botol
134 GRISEOFULVIN TABLET 125 MG tablet 209 209
135 HALDOL DECANOAS INJEKSI 50 MG/M ampul 97,500
136 HALOPERIDOL TABLET 1.5 MG tablet 60 69 66 66
137 HALOPERIDOL TABLET 5 MG tablet 96 96 75 96
138 HIDROKORTISON CREAM 2,5% tube 3,000 2,798 2,650 2,640
139 HIOSIN BUTILBROMIDA Tablet 10 Mg tablet 2,333
140 HYDROCHLOROTHIAZIDE TABLET 25 tablet 149
141 HYDROGEN PEROXIDE LIQUID 3% botol 30,250
142 HYOSCINE INJEKSI 20 MG/ML ampul 4,500 34,210
143 IBUPROFEN SUSPENSI botol 3,499 2,475
144 IBUPROFEN TABLET 400 MG tablet 150 150 127 111
145 INFUSION SET DEWASA pcs 3,200 4,975 7,920 7,920
146 INFUSION SET PEDIATRIC pcs 3,500 3,500 7,920 7,920
147 IPRATROPIUM BROMIDE|SALBUTAMOL vial 11,781 11,781 4,995 5,700
148 ISOSORBIDE DINITRATE TABLET 5 M tablet 88 105 88 90
149 IV CATHETER NO 18 pcs 3,800 7,018 7,018
150 IV CATHETER NO 20 pcs 3,800 7,018 7,018
151 IV CATHETER NO 22 pcs 3,800 7,018 7,018 15,785
152 IV CATHETER NO 24 pcs 3,800 7,018 7,018
153 JARUM JAHIT KULIT GT 12 pak 20,350
154 JARUM JAHIT OTOT GR 8 pak 20,350
155 JELLY DOPPLER (ONEMED ULTRASONI botol 82,500 12,584
156 KACA SLIDE TES TB kotak 13,200 13,200 17,600 17,600
157 KA-EN 3A botol 10,050
158 KA-EN 3B botol 10,050
159 KAPAS PEMBALUT HIDROFIL DRC 250 bungkus 12,500 12,500
160 KARTU GOLONGAN DARAH lembar
161 KASA GULUNG 40 yard x 80 CM rol
162 KASA HYDROFIL 3 M x 15 CM rol
163 KASA HYDROFIL 4 M X 10 CM rol 1,500 1,500
164 KASA STERIL 16 X 16 CM lembar 344 363 500 493.75
165 KERTAS EKG pcs
166 KERTAS LAKMUS pak
167 KERTAS LENSA pcs
168 KERTAS SARING pcs
169 KERTAS USG pcs
170 KETOCONAZOLE SALEP 2% tube 2,569 2,569 2,545
171 KETOCONAZOLE TABLET 200 MG tablet 300 280
172 KETOROLAC INJEKSI 30 MG/ML ampul 1,290
173 KLORFENIRAMIN MALEAT (CTM) TABL tablet 12 51 42 36
174 KLORFENOL KAMFER MENTHOL (CHK botol
175 LIDOCAINE|EPINEPHRINE INJEKSI ampul 1,295 4,500 1,845 1,113
176 LISOL botol 41,000 41,000
177 LODOMER CAIRAN INJEKSI 5 MG/ML ampul 6,250 6,250
178 LOPERAMIDE TABLET 2 MG tablet 89 89 89 80
179 LORATADINE TABLET 10 MG tablet 154 154 123
180 MAGNESIUM SULFAT INJEKSI 20% vial 6,050 2,800 3,200 3,200
181 MAGNESIUM SULFAT INJEKSI 40% vial 6,050 3,500 3,650 3,650
182 MASKER KARET ( EARLOP) pcs 330 440 440 396
183 MASKER N95 pcs
184 MASKER NEBULIZER ANAK pcs 28,300 28,300
185 MASKER NEBULIZER DEWASA pcs 28,300 28,300
186 MASKER OKSIGEN ADULT pcs 23,650
187 MASKER OKSIGEN PEDIATRIC pcs 23,650 23,650
188 MASKER TALI (TIESON ) pcs 480
189 METAMIZOLE SODIUM INJEKSI 500 M ampul 10,200 10,200 9,301
190 METFORMIN HCL TABLET 500 MG tablet 110 113 100 113
191 METFORMIN TABLET 850 MG tablet
192 METHYLERGOMETRINE INJEKSI 0.2 ampul 6,963 2,750 7,287.5
193 METHYLPREDNISOLONE INJEKSI 125 vial 14,486
194 METHYLPREDNISOLONE TABLET 4 M tablet 205 150
195 METILERGOMETRIN MALEAT 0,125 MG tablet 147 154 2,640
196 METOCLOPRAMIDE CAIRAN INJEKSI ampul
197 METOCLOPRAMIDE TABLET 10 MG tablet 99 99 90
198 METOCLOPRAMIDE TABLET 5 MG tablet 108
199 METRONIDAZOL TABLET 500 MG tablet 160 160 133 113
200 MICONAZOLE SALEP 2% tube 3,000
201 MISOPROSTOL O,2 MG TABLET tablet 10,285
202 MUCUS EXTRACTOR FR 10 pcs 11,000 11,550
203 MUCUS EXTRACTOR FR 10 u/ Ranap pcs 11,330
204 MULTIVITAMIN SIRUP botol 6,380 6,380
205 MULTIVITAMIN TABLET 30 ( OBIMIN AF tablet 1,732.5
206 MUMMIFYING PASTA pot 214,500
207 NASAL OKSIGEN ANAK pcs 5,500 5,500
208 NASAL OKSIGEN DEWASA pcs 5,500 5,500 6,600
209 NATRIUM / SODIUM KLORIDA INFUS 0 botol 4,900 4,700 6,410 6,410
210 NEOMYCIN SULPHATE SALEP 15G ( B tube 12,980 12,980 12,000
211 NIFEDIPINE TABLET 10 MG tablet 110 110 104 99
212 NIFEDIPINE TABLET 20 MG ( ADALAT ) tablet
213 NYSTATIN 100.000 IUVg tablet 480 480 523
214 NYSTATIN DROP 100.000 IU/ML (KAND botol
215 NYSTATIN TABLET SALUT 500.000 IU tablet 640 640
216 OBAT BATUK HITAM PLUS SIRUP botol 9,350 9,350 9,350
217 OBAT FLU SIRUP botol 17,000
218 Oksigen 1 m3 set
219 Oksigen 1 m3 refill set 40,000 40,000
220 Oksigen 6 m3 set
221 Oksigen 6 m3 refill set 75,000 75,000
222 OMEPRAZOLE KAPSUL 20 MG kapsul 211 211 160 140
223 ONDANSETRON INJEKSI MG/ML ampul 2,400 2,400 1,650 1,254
224 ONEMED SURGICAL BLADE NO. 11 pcs 957
225 OXYTETRACYCLINE SALEP 3% tube 1,646 1,646 1,646
226 OXYTETRACYCLINE SALEP MATA 1% tube 2,658 2,658 2,585
227 OXYTOCIN INJEKSI 10 MCG/ML ampul 10,846 2,200 9,350
228 PARACETAMOL SIRUP 120 MG\/5 ML botol 1,438 1,438 1,074 1,010
229 PARACETAMOL TABLET 100 MG tablet 97 97
230 PARACETAMOL TABLET 500 MG tablet 79 97 56 49
231 PECTIN/KAOLIN SIRUP ( Neo Kaominal botol 6,325
232 PEMUTIH DESINFEKTAN 1000 ML botol
233 PEMUTIH DESINFEKTAN 200 ML botol
234 PEMUTIH DESINFEKTAN 500 ML botol 9,000 11,550
235 PEMUTIH DESINFEKTAN 500 ML u/ Ra botol 8,800
236 PHENOBARBITONE TABLET 30 MG tablet 82 220 275
237 PHYTOMENADION (VIT. K) INJEKSI 2MGampul 1,566 17,775 19,525
238 PHYTOMENADION (VIT. K) INJEKSI 2MGampul 18,700
239 PHYTOMENADIONE (VITAMIN K) TABL tablet 630 630 691 686
240 PIRACETAM INJEKSI 1 G/5 ML ampul 17,105
241 PIRACETAM TABLET 400 MG tablet 194
242 PIRACETAM TABLET 800 MG tablet 803 803
243 PIRIDOKSIN HCL ( VIT. B6 ) 10 MG tablet 22 110 118 118
244 PIROXICAM TABLET 20 MG tablet 105 105 135
245 PLESTER 5 YARD X 2,5 INCH rol
246 PLESTER NON WOVEN 10 CM X 5 M rol
247 POT SPUTUM pcs 1,750 5,890
248 POT URINE LOKAL pcs
249 POVIDON IODINE CAIRAN 10 % 30 ML botol 2,163
250 POVIDON IODINE CAIRAN 10 % 300 M botol 14,203 14,203 18,000 17,996
251 POVIDON IODINE CAIRAN 10 % 60 ML botol 3,700 5,500
252 POVIDON IODINE CAIRAN 10 % 60 ML U botol 35,475
253 POVIDON IODINE SALEP 10 % ( BETA tube
254 PREDNISOLONE TABLET 5 MG tablet 64 114
255 PROPANOLOL TABLET 40 MG tablet 107 107
256 PYRANTEL PAMOATE TABLET 125 MG tablet 311 298 291
257 RANITIDINE INJEKSI 50 MG/2 ML amp 1,140 1,140 1,390
258 RANITIDINE TABLET 150 MG tablet 120 120 105 98
259 RAPID 1 HIV (SD ) strip 39,600 14,340
260 RAPID 2 HIV ( Intec ) strip 41,633 22,450 22,396
261 RAPID 3 HIV ( Oncoprobe ) strip 68,640 53,900 23,386
262 REAGEN WIDAL kit 946,000 266,640
263 REAGEN ZIEHL NEELSEN 100 ML paket 540,100 540,100 276,600 276,600
264 RESERPINE TABLET 0,25 MG tablet
265 RETINOL PALMITATE TABLET 100000 I kapsul 242 260 284
266 RETINOL PALMITATE TABLET 200000 I kapsul 432 459 519
267 RIBOFLAVIN|NICOTINAMIDE|CALCIUM tablet 22 107 115 115
268 RISPERIDONE TABLET 2 MG tablet 1,008 1,008 347
269 RPR SYPHILIS (PLASMATEC) strip 4,150
270 SAFETY BOX pcs 31,900 31,900 15,710
271 SALBUTAMOL TABLET 2 MG tablet 60 59 78
272 SALBUTAMOL TABLET 4 MG (SEBAGAI tablet 89 89 83
273 SALEP 2-4 KOMBINASI: ASAM SALISI pot 2,530 2,000 2,000 2,527
274 SARUNG TANGAN GYNECOLOG psg 16,775
275 SARUNG TANGAN MICROTOUCH NITRI pcs 627
276 SARUNG TANGAN STERIL 6,5 psg 325 4,180 3,938 3,938
277 SARUNG TANGAN STERIL 7,5 psg 325 4,180 3,938
278 SEMEN SENG FOSFAT 30 Gram( SERB botol 114,400
279 SILK 2 - 0 pcs 3,056 3,056 29,346
280 SILK 3 - 0 pcs 3,056 3,056 25,567
281 SIMVASTATIN TABLET 10 MG tablet 169 169 131 111

SODIUM CHLORIDE|POTASSIUM
CHLORIDE|MAGNESIUM CHLORIDE
HEXAHYDRATE|CALCIUM CHLORIDE
DIHYDRATE| SODIUM ACETATE
TRIHYDRATE|MALIC ACID INFUS
282 ( WIDA RS ) botol
SODIUM CHLORIDE|SODIUM
LACTATE|POTASSIUM CHLORIDE|
CALCIUM CHLORIDE DIHYDRATE
283 INFUS ( RINGER LAKTAT ) botol 5,200 5,200 7,150 7,150
284 SPUIT 1 CC pcs 650 650
285 SPUIT 10 CC pcs 925 1,298 1,298
286 SPUIT 3 CC pcs 650 650 792
287 SPUIT 5 CC pcs 750 979 979 979
288 STOPPING FLETCHER SERBUK DAN botol
289 STRIP ASAM URAT strip 5,060 5,060
290 STRIP GLUKOSA strip 2,992 2,992
291 STRIP HbsAg strip 21,900 10,547
292 STRIP PROTEIN URINE strip 1,045
293 STRIP TES KEHAMILAN strip 1,939 1,936
294 STRIP TOTAL KOLESTEROL strip 23,100 23,100
295 STRIP URIN 10 PARAMETER strip 1,352
296 SULBACTAM|AMPICILLIN INJEKSI vial 4,000 10,202.5
297 SULBACTAM|AMPICILLIN INJEKSI U/ vial 12,650
298 SULFACETAMIDE DROPS 15 % ( TM ) botol 3,465 3,465
299 SW FOR TIBIAL ANCHOR ( STROMATO botol 1,507,000
300 TETANUS ANTITOXIN TABLET 1500 IU/ ampul 125,400 125,400 126,500 126,500
301 TETRASIKLIN CAPSUL 500 MG kapsul 334 300
302 THERMAL PAPER VARIANT rol 42,900
303 THIAMINE HCL (VITAMIN B1) TABLET 5 tablet 38 36 86 82
304 THIAMINE|CYANOCOBALAMIN|PYRIDOXA tablet 440 440 440 770
305 THIAMPHENICOL CAPSUL 500 MG kapsul 680 680
306 TRANEXAMIC ACID CAPSUL 500MG kapsul 1,386
307 TRANEXAMIC ACID INJEKSI 100 MG/M ampul 2,489 2,190
308 TRANEXAMIC ACID INJEKSI 50 MG/ML ampul 3,334 2,950 2,950
309 TRICRESOL FORMALIN (TKF) 10 ML botol
310 TRIHEKSIFENIDIL 2 MG tablet 40 40 95 88
311 UNDERPAD pcs 2,860 5,200 4,620 4,620
312 URINE BAG pcs 4,000 4,000 3,000 5,500
313 VACUTAINER K3 EDTA 3 ML pcs 1,691 1,691
314 VACUTAINER PLN PLH 13 X 100 6.0 pcs 2,695
315 VAKSIN HEPATITIS Big pcs
316 VENTOLIN ROTACAPS SERBUK INHAL kapsul 431 431 450
317 VENTOLIN ROTAHALER : SALBUTAMO pcs 5,867 5,867
318 VICRYL 2-0 u/ Persalinan pcs 107,965
319 VIKIA HIV 1V2 strip 497,280 36,850 19,839
320 VITAMIN B1 , VITAMIN B6 , VITAMIN B1 ampul 5,297 5,297 10,010
321 VITAMIN Komb Vit B Komplek & C ( PRIT tablet 1,100
322 WING NEEDLE pcs 1,400 1,400
323 YELLOW TIP pcs 120
324 ZINC SULPHATE TABLET 20 MG tablet 440 474 514 513
325 SYNTOCINON CAIRAN INJEKSI 10 IU/ ampul 26,675
326 ALBOTHYL CONCENTRAT 10ML botol
327 ALBOTHYL CONCENTRAT 5ML botol
328 ETAKRIDIN LARUTAN 0,1% botol
329 PHENOL GLYCEROL TT 10% botol
330 MINERAL MIX sachet
331 SARUNG TANGAN MICROTOUCH NITRI pcs
332 SARUNG TANGAN MICROTOUCH NITRI pcs
333 AMOXYCILLIN SIRUP 250 MG/5 ML botol
334 ACETYLCYSTEIN tablet
335 SARUNG TANGAN STERIL NO.7 pasang
336 LIDOCAIN INJ amp
337 FLASH BLOOD SAFETY pcs
338 0
339 0 0
340 0 0
341 0 0
342 0 0
343 0 0
344 0 0
0 0 0
0 PROGRAM 0
1 ALBENDAZOLE TABLET 400 MG tablet 366 344 344
2 ALKOHOL SWAB 2 PLY 100 PCS pcs 100 100 100 189
3 AMITRIPTYLINE TABLET 25 MG tablet 112 112 143
4 BENZATHINE BENZYLPENICILLIN INJEK vial
5 BOX SLIDE kotak 75,430 75,430
6 CALCIUM GLUCONATE INJEKSI 10 % ampul 14,997 9,955
7 CARBAMAZEPINE TABLET 200 MG tablet 245 270 228
8 CEFIXIME CAPSUL 100 MG kapsul 590
9 CEFIXIME CAPSUL 200 MG kapsul 3,306 2,218
10 CHLORPROMAZINE HCL TABLET 100 tablet 244 144 144
11 CHLORPROMAZINE HCL TABLET 25 M tablet
12 DIAZEPAM CAIRAN INJEKSI 5 MG/ML ampul 2,344 4,180 4,180
13 DIAZEPAM TABLET 2 MG tablet 45 45 56
14 DOXYCYCLINE TABLET 100 MG tablet 240 270 269
15 EFAVIRENZ TABLET 600 MG tablet 6,375
16 EXAMINATION GLOVES SIZE L ( HAND pcs 462 496
17 FENOBARBITAL INJECTION 100 MG/M ampul
18 FERROUS FUMARATE TABLET ( TTD ) tablet 44 50 355
19 FLUFENAZINE INJEKSI 25 MG\/ML ampul 55,000 57,500
20 FOKUS DIAGNOSTIC ANTI HIV ( REAG pcs 14,970.4 14,470
21 FOLIC ACID|FERROUS SULPHATE TABL tablet 355
22 GARAM ORALIT SERBUK sachet 292 288 264
23 GENTAMYCIN 40 CAIRAN INJEKSI 40 ampul 3,399
24 GENTAMYCIN 80 CAIRAN INJEKSI 80 ampul 4,400 4,400
25 HALDOL DECANOAS CAIRAN INJEKSI ampul 97,500
26 HALOPERIDOL TABLET 1.5 MG tablet 60 69 66 66
27 HALOPERIDOL TABLET 5 MG tablet 96 96 75 96
28 IODIUM POVIDON LIQUID 2.5 % botol 5,275 5,275
29 ISONIAZID TABLET 100 MG tablet
30 ISONIAZID TABLET 300 MG tablet 1,228
31 ISONIAZID|PYRIDOXINE|PYRAZINAMID paket 214,900 214,900 203,259
32 ISONIAZID|RIFAMPICIN|PYRAZINAMID paket 1,198,000 1,199,990 1,199,990 1,199,990
33 JARUM VACUTAINER pcs 1,228
34 KACA SLIDE TB kotak 13,200 13,200 17,600 17,600
35 KOMBIPAK AZITHROMYCIN - CEFIXIM paket
36 LAMIVUDINE TABLET 150 MG tablet 1,500
37 LODOMER CAIRAN INJEKSI 5 MG/ML ampul 6,250 6,250
38 MAGNESIUM SULFAT INJEKSI 20% vial 6,050 2,800 3,200 3,200
39 MAGNESIUM SULFAT INJEKSI 40% vial 6,050 3,500 3,650 3,650
40 MDT COMBI MB ADULT : RIFAMPICIN blister 27,852 27,852 30,595 28,424
41 MDT COMBI MB CHILD : RIFAMPICIN 3 blister 19,800 20,700
42 MDT COMBI PB ADULT : RIFAMPICIN blister 9,770 9,770
43 MDT COMBI PB CHILD : RIFAMPICIN B blister 9,770
44 METHYLERGOMETRINE INJEKSI 0.2 ampul 6,963 2,750 7,288
45 METILERGOMETRIN MALEAT 0,125 MG tablet 147 154 2,640
46 MINERAL MIX sachet 2,450 2,450 2,695 2,695
47 NEVIRAPINE TABLET 200 MG tablet 2,800
48 OAT Sisipan paket
49 OXYTETRACYCLINE SALEP MATA 1% tube 2,658 2,658 2,585
50 OXYTOCIN CAIRAN INJEKSI 10 MCG/ ampul 10,846 2,200 9,350
51 PHENOBARBITONE TABLET 30 MG tablet 82 220 275
52 PIRIDOKSIN HCL ( VIT. B6 ) TABLET 2 tablet
53 POT SPUTUM pcs 1,750 5,890
54 POT URINE LOKAL pcs
55 PREDNISOLONE TABLET 5 MG tablet 64 114
56 RAPID 1 HIV strip 39,600 14,340
57 RAPID 2 HIV strip 41,633 22,450 22,396
58 RAPID 3 HIV strip 68,640 53,900 23,386
59 REAGEN ZIEHL NEELSEN 100 ML paket 540,100 540,100 276,600 276,600
60 RETINOL PALMITATE TABLET 100000 I kapsul 242 260 284
61 RETINOL PALMITATE TABLET 200000 I kapsul 432 459 519
RIFAMPICIN|ISONIAZID|RIFAMPICIN|
PYRAZINAMIDE|ETHAMBUTOL|
62 ISONIAZID KOMBINASI ( OAT I ) paket 288,100 359,990 359,990
RIFAMPICIN|ISONIAZID|RIFAMPICIN|
PYRAZINAMIDE|ETHAMBUTOL|
63 ISONIAZID KOMBINASI ( FDC I&3) paket 359,950 359,950 359,950 359,985
64 RISPERIDONE TABLET 2 MG tablet 1,008 1,008 347
65 RPR SYPHILIS (PLASMATEC) strip 4,150
66 SAFETY BOX pcs 31,900 31,900 15,710
67 SD SYPHILIS TEST STRIP strip 7,975 26,671
68 STEROFOAM BESAR pcs
69 STEROFOAM KECIL pcs
70 STREPTOMYCIN SULPHATE SERBUK IN vial
71 STRIP HbsAg strip
72 SYNTOCINON CAIRAN INJEKSI 10 IU/ ampul 26,675
73 TENOFOVIR DISOPROXIL FUMARATE tablet 8,100
74 TENOFOVIR|LAMIVUDINE|EFAVIRENZ tablet 11,359.7
75 TRIHEKSIFENIDIL 2 MG tablet 40 40 95 88
76 VACUTAINER HOLDER pcs
77 VACUTAINER SST pcs 7,480 7,480
78 VIKIA HIV 1V2 strip 497,280 36,850 19,839
79 YELLOW TIP pcs 120
80 ZIDOVUDINE 300 MG + LAMIVUDINE 1 tablet 3,700
81 ZINC SULPHATE TABLET 20 MG tablet 440 474 514 513
82 KONDOM pcs
83 LUBRIKAN pcs
84 MASKER N 95 1860 pcs
85 MASKER N 95 1860S pcs
86 MASKER N 95 1870 pcs
87 POT SPUTUM /16 pcs
88 POT SPUTUM /18 pcs
89 LAMIVUDINE TABLET 150 MG/17 tablet
90 RAPID TEST SYPHILIS strip
91 TENOFOVIR|LAMIVUDINE|EFAVIRENZ TAtablet
92 OAT II (ISONIAZID|RIFAMPICIN|PYR paket
93 TRIHEKSIFENIDIL 2 MG/19 tablet
0 0 0
0 BUFFER PROPINSI 0
1 ACYCLOVIR SALEP 5 % tube 3,440 3,440 3,151 3,151
2 ACYCLOVIR TABLET 400MG tablet 336 336 349 365
3 ALLOPURINOL TABLET 100 MG tablet 86 86 90 89
4 AMBROXOL TABLET 30 MG tablet 124 159 159
5 AMINOPHYLLINE INJEKSI 25 MG/ML ampul 3,822 3,345 2,998
6 AMINOPHYLLINE TABLET 200 MG tablet 80
7 AMOXYCILLIN SIRUP 125 MG/5 ML botol 2,445 2,445 2,090 1,881
8 AMOXYCILLIN TABLET 500 MG tablet 261 232 190
9 ANTACIDA DOEN II SUSPENSI (ALLU botol 2,160 2,160 2,025
10 ANTACIDA TABLET 400 MG tablet 72 62 58
11 ANTIFUNGI SALEP pot 1,719 1,904 4,323
12 AQUA PRO INJ STERIL botol 3,190 2,750
13 ASAM MEFENAMAT TABLET 500 MG tablet 112 112 106 100
14 ASCORBIC ACID (VITAMIN C) TABLET tablet 135 159 125 114
15 ASCORBIC ACID (VITAMIN C) TABLET tablet
16 ASPIRIN (ASETOSAL) TABLET 80 MG tablet 148 148
17 BACITRACIN|POLYMYXIN B SULPHATE tube 2,516 2,516 2,516
18 BECEFORT SIRUP botol 15,760
19 BECEFORT TABSAL GULA tablet 785
20 BETAMETASON CREAM 0,1 % tube
21 BISOPROLOL FUMARATE TABLET 5 M tablet 645 645 330 260
22 CEFADROXIL TABLET 500 MG tablet 509 516 450
23 CHLORAMPHENICOL DROPS 0,5 % ( T botol
24 CHLORAMPHENICOL DROPS 3 % ( TT botol 1,980 1,980
25 CHLORAMPHENICOL KAPSUL 250 MG kapsul 249
26 CHLORAMPHENICOL SALEP MATA 1% tube 1,600 1,600 1,798
27 CIPROFLOXACIN TABLET 500 MG tablet 250 255 281 240
28 COTRIMOXAZOLE TABLET 480 MG tablet 138 138 151
29 CYANOCOBALAMIN INJEKSI 500 MCG ampul 1,076 1,078
30 DEMACOLIN TABLET tablet 277 277
31 DICLOFENAC SODIUM TABLET 50 MG tablet 176 176 122
32 DIGOXIN TABLET 0.25 MG tablet 97 97 105 104
33 DIMENHYDRINATE TABLET 50 MG tablet 104 104
34 DIPHENHYDRAMIN INJEKSI ampul 1,050 1,050 1,175
35 ERITROMISIN 500 MG tablet 850 930 730 730
36 FUROSEMIDE INJEKSI 10 MG\/ML ampul 1,829 1,829
37 FUROSEMIDE TABLET 40 MG tablet 90 85 78 80
38 GENTAMYCIN TM 0.3% botol 3,194 3,194 4,000 4,170
39 GENTAMYCIN SALEP 0.1 % tube 1,848 3,450
40 GENTAMYCIN SALEP MATA 0,3% tube 6,600
41 GENTIAN VIOLET CAIRAN OBAT LUAR botol 900 900
42 GLIBENCLAMIDE TABLET 5 MG tablet 54 56 80
43 GLIMEPIRIDE TABLET 2 MG tablet 289 289
44 GLISERIL GUIAKOLAT TABLET 100 MG tablet 28
45 GRISEOFULVIN TABLET 125 MG tablet 209 209
46 HIDROKORTISON CREAM 2,5% tube 3,000 2,798 2,650 2,640
47 HYDROCHLOROTHIAZIDE TABLET 25 tablet 149
48 IBUPROFEN TABLET 400 MG tablet 150 150 127 111
49 IKANEURON tablet 2,251 2,251
50 ISOSORBIDE DINITRATE TABLET 5 M tablet 88 105 88 90
51 KETOCONAZOLE SALEP 2% tube 2,569 2,569 2,545
52 KETOCONAZOLE TABLET 200 MG tablet 300 280
53 KLORFENIRAMIN MALEAT (CTM) TABL tablet 12 51 42 36
54 LIDOCAINE|EPINEPHRINE INJEKSI ampul 1,295 1,845 1,113
55 LOPERAMIDE TABLET 2 MG tablet 89 89 89 80
56 METFORMIN HCL TABLET 500 MG tablet 110 113 100 113
57 METOCLOPRAMIDE TABLET 10 MG tablet 99 99 90
58 METRONIDAZOL TABLET 500 MG tablet 160 160 133 113
59 NIFEDIPINE TABLET 10 MG tablet 110 110 104 99
60 NOVABION tablet 344 344
61 NYSTATIN 100.000 IUVg tablet 480 480 523
62 NYSTATIN TABLET SALUT 500.000 IU tablet 640 640
63 OBAT BATUK HITAM PLUS SIRUP botol 2,460
64 OBAT FLU SIRUP botol 17,000
65 OMEPRAZOLE KAPSUL 20 MG kapsul 211 211 160 140
66 OXYTETRACYCLINE SALEP 3% tube 1,646 1,646 1,646
67 PARACETAMOL SIRUP 120 MG\/5 ML botol 1,438 1,438 1,074 1,010
68 PARACETAMOL TABLET 100 MG tablet 97 97
69 PARACETAMOL TABLET 500 MG tablet 79 97 56 49
70 PHYTOMENADIONE (VITAMIN K) TABL tablet 630 630 691 686
71 PIRIDOKSIN HCL ( VIT. B6 ) 10 MG tablet 22 110 118 118
72 PIROXICAM TABLET 20 MG tablet 105 105 135
73 RANITIDINE TABLET 150 MG tablet 120 120 105 98
74 RECOVIT tablet 550 550
75 RIBOFLAVIN|NICOTINAMIDE|CALCIUM tablet 22 107 115 115
76 SALBUTAMOL TABLET 2 MG tablet 60 59 78
77 SALBUTAMOL TABLET 4 MG (SEBAGAI tablet 89 89 83
78 SALEP 2-4 KOMBINASI: ASAM SALISI pot 2,530 2,000 2,000 2,527
79 SIMVASTATIN TABLET 10 MG tablet 169 169 131 111
80 SULBACTAM|AMPICILLIN INJEKSI vial 4,000 10,202.5
81 SULFACETAMIDE DROPS 15 % ( TM ) botol 3,465 3,465
82 SULFADIAZINE SILVER SALEP 10 MG/ tube 23,000 23,000 23,000
83 THIAMINE HCL (VITAMIN B1) TABLET 5 tablet 38 36 86 82
84 THIAMINE|CYANOCOBALAMIN|PYRIDOXA tablet 440 440 440 770
85 VISTO TM botol 13,000
86 VITAMIN B1 , VITAMIN B6 , VITAMIN B1 ampul 5,297 5,297 10,010
87 DOXYCYCLINE TABLET 100 MG tablet 240 270 269
88 IV CATETHER NO 20 pcs
89 IV CATETHER NO 22 pcs
90 KASA STERIL 16 X 16 CM lembar
91 ALKOHOL 70% botol
92 ATTAPULGITE TAB tablet
93 PREDNISON TAB 5MG tablet
2018 2019
635.25

405

110 116
104
210

2,976
89
167
93
70 75
2,000
233 249

1,995 2,129
54 58

4,798
479,996 512,204

2,860

105

105 105
34,500

99 105
1,595
136 145
3,035

110 110
1,430
5,900 5,900
3,167 3,167
236
146 101.20

7,800

59 63
75
230
34,170
34,170

35,740
478

2,370
4,200 4,482

310
1,881
147 157
265
2,052 2,190
125 133

1,097 1,097

1,735
18,279 18,279
86 86
115 123
104 104
105 112
1,095 1,168
2,700 2,700
264

1,408

462
462
354
2,244
59,800 63,813
14,877
13,900
11,000 11,565
11,000 11,565

1,333
77

372

4,232 4,232

2,675 2,675

119
207 207

6,900 7,363
10,696
11,435
210
101,300
59
56 60
2,475 2,475

155 155

2,721
122
4,800 5,096
5,100
4,550 4,550
89
7,000 6,277
7,000 6,277
7,000 6,685
6,685

12,584

13,400

112,500
1,430
1,600
500 460.6

2,518
270 288

22 23

1,145

3,328 3,328
3,796 3,796
396 411.4
6,512
16,000
16,000

480

102
150 160
134 143
210
3,960
80 85

124
3,414 3,414

7,040

6,600
6,600
6,410 6,840

3,350
560

40,000 46,000

75,000 85,000
130 139
1,070 1,124

1,107 1,181

53 140

171

710 758
131

43,850 44,767

23,890
23,890
16,798
68 73
81

1,155 1,188

14,344

288 288
517 517
89
273 287

63 67
70
2,796
19,360
572

7,600

20,610
117

9,646 10,293
7,150 7,630

1,298 1,463
792 924
979 1,045

5,060 6,000
2,992 3,200
10,547
1,045
1,939 1,939
23,100 25,000

8,237

130,999

85 91

1,584
1,945 2,076

85 91
4,620
5,500
1,691 870
1,719
1,325,000

19,500
2,764
3,116
572
572
3,628
373
3,938
1,226
1,600

404 404

167
14,500
77,690

144

264
6,375 6,630
400

355.00 354
57,500
13,235

264 257

96

293
173
232,518
1,199,990 1,297,894

22,500 20,000
30,030
1,560

31,760 41,784

12,659

2,684

2,726.9
2,940 3,058

1,900

60
4,953.0 2,728

14,340 11,975
12,500
13,375
254,642 257,644
288 288
517 517

317,018 317,018

359,985 389,344
347
4,120

20,400 20,400
27,500
6,700

9,870 9,878

8,100
11,359.7 11,359.7
85

19,480

3,700 3,848
524
358
486
19,835
19,835
21,335
5,890
4,953
1,500
9,611
2,902.3
1,384,983
91

86 97

91
1,881
190

72

6,350

125

2,924

1,349
236
450
1,098

104

78

1,850
2,675

119
289

245

111

173
2,545

1,845
85

99

523

160

49

123
135

115
131
8,237

86

268
3,800
3,800
460.6
2,900
145
68