Kode Nama Satuan Harga Stok

OBAT
OB000001 Lacto B Sacchet SAC 7139 40
OB000002 Orezinc 60 ml BTL 38976 3
OB000003 Opivask 5 TAB 6160 30
OB000004 Opimox 500 TAB 3456 3
OB000005 Opicef 500 TAB 11000 40
OB000006 Cetirgi TAB 2750 29
OB000007 Cetirgi Syr BTL 39600 2
OB000008 Tequinol TAB 13750 30
OB000009 Valeptik syr BTL 88000 2
OB000010 Diaformin XR 500 TAB 2200 500
OB000011 Trogyl TAB 1980 0
OB000012 Gliaride 2 TAB 4950 297
OB000013 Prednicort 8 TAB 4950 270
OB000014 Prednicort 4 TAB 3300 260
OB000015 Opicort 4 TAB 3520 30
OB000016 Moxic 7,5 TAB 6050 5
OB000017 Vomigo 4 TAB 13200 38
OB000018 Vomigo 8 TAB 17600 9
OB000019 Ostarin 100 syr BTL 24200 2
OB000020 Piralen TAB 660 100
OB000021 Rofiden supp SUP 13750 0
OB000022 Fluzep TAB 1430 100
OB000023 Gerdilium tab TAB 4400 29
OB000024 Zitolin Tab TAB 38500 6
OB000025 Opiprol 5 TAB 2 30
OB000026 Gerdilium Drop BTL 2 0
OB000027 Opiphentin 300 TAB 10450 30
OB000028 Bioxon Inj VL 231000 1
OB000029 Dexprofen Inj AMP 39600 5
OB000030 Ottogenta Inj AMP 13200 2
OB000031 Biocef Inj VL 17600 3
OB000032 Vomigo 4 Inj AMP 31900 1
OB000033 Vomigo 8 Inj AMP 60500 5
OB000034 Toramin Inj AMP 41800 0
OB000035 Cefazol 1 Gr VL 143000 6
OB000036 Cernevit Inj VL 236500 10
OB000037 Hexilon 125 mg Inj VL 110000 5
OB000038 Kalfoxim 100 mg Inj VL 165000 5
OB000039 Kalnex 500 mg TAB 3685 222
OB000040 Kalnex 50 mg/ml Inj AMP 12650 2
OB000041 Kalnex 100 mg/ml Inj AMP 16500 4
OB000042 Kombiglyze TAB 15593 8
OB000043 Liprolac Sach SAC 7333 90
OB000044 Pronicy Filco TAB 306 285
OB000045 Starmuno Kap CAP 10083 86
OB000046 Urdahex 250 mg Cap CAP 10633 60
OB000047 Propofol Inj VL 67500 5
OB000048 Clinovir 400 mg TAB 10313 30
OB000049 Celebrex 100 mg TAB 14163 40
OB000050 Duphaston TAB 23815 78
OB000051 Flagystatin Ovula SUP 24223 30
OB000052 Forxiga 10 mg TAB 21141 28
OB000053 Trolip 100 mg CAP 6188 30
OB000054 Pharolit SAC 1644 20
OB000055 Pedialyte BTL 37950 5
OB000056 Primolut N TAB 7191 96
OB000057 Pro TB 2 Kid TAB 4125 84
OB000058 Pro TB 3 Kid TAB 5844 84
OB000059 Pro TB 4 TAB 6783 140
OB000060 Progynova 2 mg TAB 11507 125
OB000061 Sirplus Jeruk BTL 16445 3
OB000062 Sirplus Strawberry BTL 16445 4
OB000063 Sirplus Anggur BTL 16445 2
OB000064 Thrombo aspilet tab TAB 1041 2
OB000065 Phenytoin 100 mg kapsul CAP 1028 200
OB000066 Eclid 50 mg TAB 1482 100
OB000067 Glurenorm 30 mg TAB 6566 200
OB000068 Farmadral 10 mg TAB 304 100
OB000069 Cedocard 5 mg TAB 1489 180
OB000070 Erlamycetin Salep Mata 1% TUB 14575 2
OB000071 Pregnacare Tab TAB 4800 401
OB000072 Osteocare tab TAB 4800 621
OB000073 Orixal 500 TAB 4334 30
OB000074 Alofar 300 TAB 808 200
OB000075 Yusimox DS BTL 5775 5
OB000076 Yusimox Forte DS BTL 8360 5
OB000077 Scopma Plus TAB 1467 100
OB000078 Calcifar Plus ( Calsium, vit D3 200 IU) TAB 300 100
OB000079 Kaditic 50 TAB 400 100
OB000080 Tidifar 200 TAB 577 100
OB000081 Fondazen TAB 400 197
OB000082 Cezzvit 250 (tablet) TAB 336 162
OB000083 Helixim 100 BTL 6005 18
OB000084 Farsiretic 40 mg TAB 315 92
OB000085 Lavarix TAB 4000 0
OB000086 Nestacort (hidrocortison 2,5%) TUB 7810 5
OB000087 Zantifar 150 TAB 361 89
OB000088 Megatic 50 TAB 500 3
OB000089 MEGATIC Emulgel TUB 12000 3
OB000090 Kralix BTL 14410 5
OB000091 Selvim 20 TAB 630 150
OB000092 Latibet 5 mg TAB 300 100
OB000093 Lecozinc tab TAB 320 200
OB000094 Cazetin Drops BTL 26290 3
OB000095 Glikos 850 TAB 450 11
OB000096 Flasicox 15 mg TAB 1000 50
OB000097 Vesperum sy BTL 6500 3
OB000098 Vesperum drops BTL 13750 3
OB000099 Tramofal TAB 550 48
OB000100 winatin TAB 400 100
OB000101 oxicobal TAB 605 100
OB000102 Rexavin 500 TAB 1660 100
OB000103 FARSIFEN FORTE Suspens BTL 8635 4
OB000104 FARSIFEN 400 TAB 550 200
OB000105 MILORIN TAB 2000 50
OB000106 DOHIXAT 100 mg CAP 530 168
OB000107 TROVILON DS BTL 13950 5
OB000108 GENALTEN Cream TUB 4675 0
OB000109 CYDIFAR (blister) TAB 150 100
OB000110 ZIDALEV 500 TAB 1500 40
OB000111 DIASTRIX TAB 200 90
OB000112 FARGETIX TAB 500 169
OB000113 FASIDOL 500 TAB 300 200
OB000114 FASIDOL Syrup BTL 6000 4
OB000115 FAXIDEN 10 TAB 200 200
OB000116 TRIANTA TAB 300 190
OB000117 TRIANTA Suspensi BTL 6200 4
OB000118 LOKEV 20 CAP 600 100
OB000119 BRONCHOSAL TAB 250 100
OB000120 CEFILA DRY SYR 30 ML BTL 91300 2
OB000121 CEFILA 100 TAB TAB 21450 285
OB000122 CEFILA 200 TAB TAB 33000 30
OB000123 LASAL 2 MG TAB TAB 1375 0
OB000124 LATROPIL SYR BTL 52800 0
OB000125 PROMAVIT CAP 3630 50
OB000126 MICROGEST 100 MG CAP 13200 178
OB000127 LAMESON 4MG TAB TAB 3630 49
OB000128 MYONEP TAB TAB 5280 0
OB000129 FASTOR 20 MG TAB 15400 0
OB000130 CIFLON TAB 9350 0
OB000131 LACOSIB 60 MG TAB 8250 30
OB000132 LASAL COM AMP 12100 0
OB000133 ROSTIN 20 MG TAB 13200 0
OB000134 FERVIT DROP BTL 35200 2
OB000135 L - ACYS CAP 3300 0
OB000136 IMUNOS TABLET TAB 8085 0
OB000137 TOFEDEX TAB TAB 7260 30
OB000138 REBAMID TAB TAB 3740 0
OB000139 LASGAN CAP CAP 15400 20
OB000140 LACTRIN TAB CAP 4675 0
OB000141 LAPIBION TAB TAB 1430 0
OB000142 L-BIO CAPS CAP 7700 0
OB000143 L-BIO SACH SAC 7700 30
OB000144 LAPIBROZ TAB 3960 0
OB000145 APIALYS DROP BTL 44000 2
OB000146 MEGAZING TAB 3025 0
OB000147 LAPIBAL 500 MG CAP CAP 2475 100
OB000148 TIRIZ TAB TAB 3960 0
OB000149 PIDOVIX TAB TAB 16500 0
OB000150 TINEURON TAB TAB 10890 0
OB000151 IMUNOS SYRUP BTL 69300 0
OB000152 CAL - 95 TAB 5720 30
OB000153 ODR 4 MG SYRUP BTL 101200 2
OB000154 TOPAZOL INJEKSI VL 161700 1
OB000155 LACTOPAIN INJEKSI AMP 44000 7
OB000156 CEFXON INJEKSI VL 231000 2
OB000157 LAMESON INJEKSI VL 104500 2
OB000158 LAPIBAL INJEKSI AMP 27500 0
OB000159 ODR 4 MG INJEKSI AMP 35200 28
OB000160 HYSON INJEKSI VL 99000 2
OB000161 LAPIXIME INJEKSI VL 165000 0
OB000162 TOFEDEX INJEKSI AMP 49500 5
OB000163 ESOLA INJEKSI VL 181500 1
OB000164 Ovacare Tab TAB 7200 1270
OB000165 Oligocare Tab TAB 7200 480
OB000166 Ultra D3 Tab TAB 1650 480
OB000167 Dopamet 250 Mg Tab TAB 2571 248
OB000168 Cendo Genta Salep Mata TUB 50016 3
OB000169 Lactacyd woman 60 ml BTL 28956 0
OB000170 Maltofer Fol TAB 3584 42
OB000171 Thyrozol 10 Tab TAB 2967 300
OB000172 histigo TAB 1155 100
OB000173 Analsik Tab TAB 1700 0
OB000174 Asam Folat (Folavit) 1000 mcg TAB 2095 254
OB000175 Braxidin TAB 1221 0
OB000176 Nifedin TAB 737 0
OB000177 Valisanbe TAB 429 475
OB000178 Tensicap TAB 4389
OB000179 Sancoidan Kapsul CAP 16500 150
OB000180 Sanprima TAB 1052 500
OB000181 Sanmol TAB 319 271
OB000182 Sanmol Infus BTL 67200 0
OB000183 Lapraz CAP 13178 85
OB000184 Pumpitor VL 165000 100
OB000185 Pumpitor Caps CAP 1448 5
OB000186 Vipalbumin Caps CAP 7400 54
OB000187 Profertil TAB 18150 51
OB000188 Water For Injection (WFI) 25 ml VL 2650 122
OB000189 Dextrose 5% 500 ml BTL 13254 17
OB000190 Dextrose 10% 500 ml BTL 14400 28
OB000191 NaCl 0,9% 500 ml BTL 6800 49
OB000192 NaCl 0,9% 100 ml BTL 6149 55
OB000193 Ringer Laktat (RL) 500 ml BTL 7630 12
OB000194 Asering 500 ml (Ringer Asetat) BTL 8800 39
OB000195 KCl 25 ml VL 3223 0
OB000196 Prolacta DHA CAP 4900 187
OB000197 Ossoral TAB 4400 52
OB000198 Prothyra 10' TAB 4800 78
OB000199 Metvell 0,5 TAB 2700 90
OB000200 Noprostol 0,2 TAB 9200 30
OB000201 Femaplex TAB 18332 15
OB000202 Prenatin DF TAB 3846 580
OB000203 Hi-Bone TAB 3300 66
OB000204 Ultrasonic Gel (USG Gel) 250 ml BTL 22500 3
OB000205 Mucera 30 TAB 1320 100
OB000206 Asam Folat (Folavit) 400 mcg TAB 1000 328
OB000207 Irtan 300 TAB 12375 60
OB000208 Indexon 0,5 TAB 1100 220
OB000209 Flagyl Tab TAB 9230 8
OB000210 Kondom Sutra PCS 2000 288
OB000211 Vaksin Euvax B 0,5 VL 76000 1
OB000212 Atropin Sulfas Injeksi AMP 4000 60
OB000213 Aminophillin Injeksi AMP 5000 5
OB000214 Calcii Glukonas Injeksi AMP 23500 10
OB000215 Cordarone Injeksi AMP 63000 0
OB000216 Sibital Injeksi AMP 14200 0
OB000217 Stesolid AMP 16500 0
OB000218 Dexamethason Injeksi AMP 3000 22
OB000219 Tutosol Flexibag 500 ml PCS 78650 5
OB000220 Terastarch 1 Flexybag PCS 226875 7
OB000221 Faridexon 0,5 TAB 1200 300
OB000222 Alkohol 70% 1 L BTL 25000 1
OB000223 Alkohol 96% 1 L BTL 35000 3
OB000224 Metvell 0,2 Injeksi AMP 19000 33
OB000225 Oxyla Injeksi AMP 25300 24
OB000226 Lactamam TAB 3500 125
OB000227 Bunascan injeksi AMP 101166 2
OB000228 Neo-K Injeksi AMP 17050 7
OB000229 Pehacain injeksi AMP 3891 12
OB000230 Norepinefrin injeksi AMP 82500 10
OB000231 Buscopan injeksi AMP 47131 2
OB000232 Cedocard injeksi AMP 108281 1
OB000233 Furamin injeksi AMP 15125 5
OB000234 Lasix injeksi AMP 25799 0
OB000235 Furosemid injeksi AMP 4428 0
OB000236 Epinefrin injeksi AMP 7604 11
OB000237 Fentanyl injeksi AMP 64372 7
OB000238 MgSO4 40% BTL 12000 14
OB000239 Combivent Nebulizer AMP 26148 2
OB000240 Ventolin Nebulizer AMP 13805 2
OB000241 Glisodin Caps '30 CAP 7000 0
OB000242 Tramus Injeksi 2,5 ml AMP 66000 5
OB000243 Miloz Injeksi 5 ml AMP 30000 0
OB000244 Gonal Pen 300 IU PCS 2292100 1
OB000245 Neostigmin Injeksi AMP 25300 5
OB000246 Amiodaron Injeksi AMP 16500 4
OB000247 Formalin 37% Galon 10 L BTL 770000 1
OB000248 Efedrin Injeksi AMP 68750 7
OB000249 Seretide Diskus 250 mcg PCS 346346 2
OB000250 Ventolin Inhaler PCS 157730 2
OB000251 Symbicort 160/4,5 60 doses PCS 401312 2
OB000252 Q-Ten 100 mg CAP 10890 40
OB000253 Inlacin 100 mg TAB 5500 60
OB000254 Folamil Genio CAP 4180 150
OB000255 Ketamin Injeksi AMP 220000 1
OB000256 Enervon C 4 TAB 2000 74
OB000257 Lidocaine Injeksi AMP 2000 0
OB000258 Lavit-C 1000 mg AMP 33000 13
OB000259 Vaksin Tuberculin PPD VL 811100 5
OB000260 Vaksin Hepatitis B 0,5 ml VL 67336 18
OB000261 BCG Kering VL 271500 5
OB000262 Campak Kering VL 161700 5
OB000263 Pentabio VL 175560 9
OB000264 Vaksin IPV VL 381150 9
OB000265 Lapimox Kaplet TAB 3025 117
OB000266 Ikamicetin Salep Kulit TUB 10000 11
OB000267 Gonal Vial 75 IU VL 573457.5 5
OB000268 Cataflam Fast 50 mg SAC 11000 17
OB000269 Lameson Suspensi 4 mg/5 ml BTL 82500 4
OB000270 Tamolive Infus 1000 mg BTL 70000 5
OB000271 Meiact Tab 200 mg TAB 26500 20
OB000272 Lasal Sirup 2 mg BTL 28600 5
OB000273 Asifit Tab TAB 1500 54
OB000274 Ovidrel Pen 250/10 g VL 774158 2
OB000275 Metformin 850 mg TAB 540 500
OB000276 Amphicillin 1 Gr Injeksi VL 16500 3
OB000277 Vicillin VL 8250 2
OB000278 Gentamicin Salep TUB 5000 5
OB000279 Pronalges Suppo SUP 19500 20
OB000280 Nicardipin HCl Injeksi AMP 88000 8
OB000281 Orinox 60 mg Tab TAB 7865 60
OB000282 Ranitidine 25 mg/ml Injeksi AMP 3465 20
OB000283 Veluntine Plus AMP 9350 20
OB000284 Cendo Genta Tetes Mata VL 31350 5
OB000285 Candesartan 8 mg (OGB) TAB 6500 69
OB000286 Inviclot Injeksi 5 ml VL 108808 8
OB000287 Aviter Sachet SAC 35200 21
OB000288 Coten 100 TAB 16500 30
OB000289 Inbion Caps CAP 2900 100
OB000290 Inlacta DHA For Mother CAP 7425 30
OB000291 Interlac Tablet Kunyah TAB 10450 30
OB000292 Interlac Sachet SAC 11000 26
OB000293 Interlac Drop BTL 286000 1
OB000294 Galstar Tab TAB 3850 100
OB000295 Rosagen Sachet SAC 27500 15
OB000296 Microgynon TAB 1000 728
OB000297 Diane 35 TAB 7500 105
OB000298 Yaz Tablet TAB 11000 140
OB000299 Sevoflurane Baxter 250 ml BTL 3712500 1
OB000300 Vopicain 5 mg VL 57750 2
OB000301 Fartolin Expectoran BTL 44000 0
OB000302 Lupred Tab 5 mg TAB 3300 30
OB000303 Fartison Injeksi VL 104500 2
OB000304 Renasistin Drop BTL 55000 1
OB000305 Curmunos syrup 60 ml BTL 88000 1
OB000306 Dextrose 40% 25 ml AMP 9900 6
OB000307 NaCl 0,9% 25 ml AMP 8000 14
OB000280 Mefinal TAB 1468.5 124
OB000304 Cobazim Caps CAP 4950 85
OB000303 Adalat Oros TAB 5500 9
OB000304 Hystolan 20 mg TAB 6188 3
OB000306 Daylax 3350 SAC 25500 7
OB000304 Chlor Ethyl 100 ml BTL 1
ALKES
A000000001 Optime Rapid 2/0 S30AL Benang Partus PCS 72406 9
A000000002 Optime 0 S35F Benang Partus PCS 110000 0
A000000003 Apron 0,25 Cosmomed PCS 1920 22
A000000004 Blood Set Cosmomed PCS 6090 0
A000000005 Kasa hidrofil 10 x 4 PCS 2046 5
A000000006 Oxygen Nasal Canul Dewasa Onemed PCS 6272 0
A000000007 Winner Transparent Tegaderm 6 x 7 PCS 2883 23
A000000008 Underpad Healer Sensi PCS 4000 72
A000000009 Urine Bag Standard Cosmomed PCS 4363 0
A000000010 Handschoon Nitril M PCS 4400 0
A000000011 Handschoon steril Gammex uk 6,5 PCS 19250 29
A000000012 NRM Dewasa Cosmomed PCS 22300 0
A000000013 NRM Anak Cosmomed PCS 22300 1
A000000014 Tongue spatel disposible PCS 300 100
A000000015 Winner Adhesive Dressing 5 Cm X 1 M PCS 6000 6
A000000016 Winner Adhesive Dressing 10 Cm X 5 M (5 m) PCS 35500 4
A000000017 Masker GP Care PCS 600 0
A000000018 Folley Catheter 2 Way 16 Cosmo PCS 12600 2
A000000019 Pampers L Dr. P PCS 7000 15
A000000020 Cervical collar M PCS 173800 2
A000000021 Cervical collar L PCS 173800 2
A000000022 Electrode anak PCS 3000 50
A000000023 Infus Set Macro Onemed PCS 3502 0
A000000024 Infus Set Pediatric Terumo PCS 15068 17
A000000025 Alkohol Swab Onemed PCS 150 0
A000000026 Micropore 0,5 Inchi 3M PCS 11330 3
A000000027 Needle No. 26 Terumo PCS 1000 171
A000000028 Spuit 5 cc Onemed PCS 700 56
A000000029 Spuit 3 cc Onemed PCS 700 64
A000000030 Spuit 1 cc Onemed PCS 650 37
A000000031 Spuit 50 cc Eccentric Onemed PCS 12463 19
A000000032 Spuit 20 cc Terumo PCS 6231 31
A000000033 Spuit 10 cc Onemed PCS 6231 96
A000000034 Tongue Spatel Disposable Onemed PCS 250 100
A000000035 Torniquet Remedi PCS 20394 0
A000000036 Kasa Steril DP PCS 460 0
A000000037 IV Catheter NO 14 Abbocath PCS 19368 1
A000000038 Electrode Dewasa Vermed PCS 250 50
A000000039 Nasal Canul Dewasa GEA PCS 5150 2
A000000040 Nasal Canul Anak GEA PCS 5150 2
A000000041 Nasal Canul Bayi Besmed PCS 6231 0
A000000042 Handschoen Steril No 7 GAMMEX PCS 19250 24
A000000043 Handschoen Steril No 7,5 GAMMEX PCS 19250 61
A000000044 NGT No. 5 Panjang 40 cm Terumo PCS 26172 7
A000000045 NGT No. 8 Panjang 40 cm Terumo PCS 26240 7
A000000046 NGT No. 12 Terumo PCS 26240 2
A000000047 NGT No. 14 Terumo PCS 26240 5
A000000048 NGT No. 16 Terumo PCS 26240 5
A000000049 Armsling Uk. M Luciana PCS 23793 5
A000000050 Armsling Uk. L Luciana PCS 23793 5
A000000051 Verban No. 5 cm DP PCS 1600 29
A000000052 Verban No. 10 DP PCS 3175 11
A000000053 Suction Catheter No. 8 Onemed PCS 6232 0
A000000054 Suction Catheter No. 10 Onemed PCS 5665 0
A000000055 Suction Catheter No. 12 Onemed PCS 6232 0
A000000056 Suction Catheter No. 14 Onemed PCS 5665 0
A000000057 Folley Catheter No. 8 Rusch PCS 48492 2
A000000058 Folley Catheter No. 14 Rusch PCS 18467 5
A000000059 Folley Catheter No. 16 Rusch PCS 18467 21
A000000060 Spinocan No. 25 B. Braun PCS 32857 3
A000000061 ETT With Cuff Size 2.5 mm PCS 45980 0
A000000062 ETT Cuffed Murphy Size 3.0 mm PCS 38500 12
A000000063 ETT Cuffed Murphy Size 3.5 mm PCS 38500 12
A000000064 ETT Cuffed Murphy Size 4.0 mm PCS 38500 13
A000000065 ETT Cuffed Murphy Size 4.5 mm PCS 38500 8
A000000066 ETT Cuffed Murphy Size 5.0 mm PCS 38500 7
A000000067 ETT Cuffed Murphy Size 5.5 mm PCS 38500 3
A000000068 ETT Cuffed Murphy Size 6.0 mm PCS 38500 8
A000000069 ETT Cuffed Murphy Size 6.5 mm PCS 38500 3
A000000070 ETT Cuffed Murphy Size 7.0 mm PCS 38500 11
A000000071 ETT Cuffed Murphy Size 7.5 mm PCS 38500 6
A000000072 Guedel Airway 0/050 mm Sterile PCS 14300 9
A000000073 Guedel Airway 1/060 mm Sterile PCS 14300 8
A000000074 Guedel Airway 2/070 mm Sterile PCS 14300 8
A000000075 Guedel Airway 3/080 mm Sterile PCS 14300 3
A000000076 Guedel Airway 4/090 mm Sterile PCS 14300 8
A000000077 Guedel Airway 5/100 mm Sterile PCS 14300 10
A000000078 Threeway Stopcock-Blue PCS 11550 9
A000000079 Extension W/ Three Way Stopcock 10 cm PCS 19250 10
A000000080 Handschoon Gamex No. 6 PCS 17500 47
Winner Non Woven Adhesive Wound Dressing
A000000081 15 x 5 PCS 65200 0
A000000082 Sarung Tangan Non Sterile M PCS 4000 450
A000000083 Sarung Tangan Non Sterile S PCS 4000 0
A000000084 Kertas USG PCS 195000 0
A000000085 Kassa Gulung Onemed Panjang PCS 118000 0
A000000086 Povidone Iodine 10% 1 L Onemed PCS 69000 1
A000000087 Spinal Needle Anastesi Ukuran 25 G PCS 27000 11
A000000088 Spinal Needle Anastesi Ukuran 26 G PCS 27000 12
A000000089 Extention Tube Uk 75 cm PCS 13200 2
A000000090 Extention Tube Uk 150 cm PCS 32500 13
A000000091 Laminaria L PCS 82500 2
A000000092 IV Catheter NO 18 Ecocann PCS 6600 0
A000000093 IV Catheter NO 20 Ecocann PCS 6600 0
A000000094 IV Catheter NO 22 Ecocann PCS 6600 0
A000000095 IV Catheter NO 24 Ecocann PCS 6600 0
A000000096 Kassa X-Ray PCS 1820 0
A000000097 Tensocrepe 7,5 cm PCS 67650 4
A000000098 Tensocrepe 10 cm PCS 77000 4
A000000099 Tensocrepe 15 cm PCS 107800 4
A000000100 Transofix PCS 8250 56
A000000101 Wing Needle Terumo 236 PCS 10450 9
A000000102 Masker Nebulizer Adult GEA PCS 13200 2
A000000103 Masker Hijab N3 PCS 550 650
A000000104 Oxygen Mask Dewasa SALTER PCS 29700 3
A000000105 LMA Supreme SU Size 3 PCS 750800 0
A000000106 LMA Supreme SU Size 2,5 PCS 778000 0
A000000107 LMA Supreme SU Size 2 PCS 750800 0
A000000108 Folley Catheter No. 12 Rusch PCS 18467 4
A000000109 Folley Catheter No. 18 Rusch PCS 18467 9
A000000110 My Jelly 82 gr Lubricant Gel TUB 27810 3
A000000111 Dental Disposable Set PCS 12000 23
A000000112 Sarung Tangan Non Sterile L PCS 4000 0
A000000113 Nurse Cap Remidi PCS 1100 0
A000000114 Suction Catheter RMD No. 6 PCS 7000 5
A000000115 Suction Catheter RMD No. 10 PCS 7000 7
A000000116 Suction Catheter RMD No. 12 PCS 7000 8
A000000117 Suction Catheter RMD No. 14 PCS 7000 8
A000000118 Suction Catheter RMD No. 16 PCS 7000 5
A000000119 Alkohol Swab Falmed PCS 300 0
A000000120 Bisturi Ukuran 20 Onemed PCS 3000 53
A000000121 Pembalut Maternity Ukuran M PCS 4000 0
A000000122 Pembalut Maternity Ukuran L PCS 8000 0
A000000123 Povidone Iodine 10% 60 ml PCS 9000 5
A000000124 Suction Curretage No. 6 Medgyn PCS 42900 13
A000000125 Suction Curretage No. 8 Steril Medical PCS 42900 6
A000000126 Suction Curretage No. 10 Medgyn PCS 77000 7
A000000127 Suction Connecting Tube Pahsco PCS 51920 0
A000000128 Masker Earloop N3 PCS 600 50
A000000129 Glove Obgyn One Care 54 cm PCS 60500 16
A000000130 IV Cath Wing and Port Ecocann no 18 PCS 7000 0
A000000131 IV Cath Wing and Port Ecocann no 20 PCS 7000 13
A000000132 IV Cath Wing and Port Ecocann no 22 PCS 7000 0
A000000133 IV Cath Wing and Port Ecocann no 24 PCS 7000 0
A000000134 Safety Box N3 5L PCS 17000 1
A000000135 Suction Connecting Tube Media Standard PCS 24500 11
A000000136 Torniquet Biasa PCS 18500 1
A000000137 Underpad Diapro PCS 4500 0
A000000138 Plesterin Onemed PCS 500 305
A000000139 Ambubag Neonatus PCS 308000 0
A000000140 Advantime 3/0 D20F Benang SC PCS 112530 12
A000000141 Optime 1 S40G Benang SC PCS 104720 0
A000000142 Optime 0 S35G Benang SC PCS 90100 0
A000000143 Corolene 2/0 S30A PCS 91500 2
A000000144 Corolene 3/0 S20H PCS 128700 2
A000000145 Corolene 5/0 S10K PCS 110880 1
A000000146 Optime 2/0 S30G PCS 91542 2
A000000147 Inseminasi Intra Uterin (IUI) PCS 109000 8
A000000148 Umbilical Cord Onemed PCS 3000 31
A000000149 Plain 0 G3721 Atramat PCS 80000 3
A000000150 Chromic 0 G3711 Atramat PCS 80000 7
A000000151 Chromic 1 Tap Covidien PCS 83600 36
A000000152 Sofsilk 3/0 Tap Covidien PCS 66000 1
A000000153 Sofsilk 2/0 Tap Covidien PCS 66000 36
A000000154 Sofsilk 2/0 Cut Covidien PCS 77000 3
A000000155 Sofsilk 1 Tap Covidien PCS 60500 5
A000000156 Surgipro 3/0 Cut Covidien PCS 99000 4
A000000157 Biosyn 4/0 Cut Covidien PCS 154000 1
A000000158 Biosyn 3/0 Cut Covidien PCS 154000 0
A000000159 Polysorb 1 Tap Covidien PCS 143000 5
A000000160 Polysorb 0 Tap Covidien PCS 108900 2
A000000161 Popok Bayi Sweety Bronze Comf NB PCS 17000 14
A000000162 Cotton Ball 120 PCS 500 500
A000000163 Apron Vinyl PCS 28000 0
A000000164 Daryatule PCS 34100 9
A000000165 Cytology Brush PCS 18500 100
A000000166 Minyak Telon Plus 90 ml PCS 39000 5
A000000167 Nasal Oxygen Anak Cosmomed PCS 7500 10
A000000168 Nasal Oxygen Bayi Cosmomed PCS 7500 6
A000000169 Infus Set Dewasa Cosmomed PCS 5000 1
A000000170 Infus Set Anak Cosmomed PCS 5500 9
A000000171 ECG Electrode Dewasa Onemed PCS 3500 50
A000000172 Vaseline Swab PCS 77000 10
A000000173 IUD Andalan PCS 35000 1
A000000174 Infus Set Dewasa N3 PCS 4500 20
A000000175 Cotton Swab Stick PCS 600 25
A000000176 Cotton Swab Big Head PCS 1400 25
A000000177 Cervical Brush PCS 4700 9
A000000178 Gel Sponge Standar PCS 82500 10
A000000179 Gel Sponge Anal PCS 220000 10
A000000180 Vicryl 2/0 Atramat PCS 88000 12
A000000181 Opsite Post OP 25 x 10 cm PCS 41800 24
A000000182 Lina Pen PCS 132000 20
A000000183 Handschoen Steril No 6 GAMMEX PCS 19250 47
A000000184 ETT Non Cuffed 3,0 Rusch PCS 54000 3
A000000185 ETT Non Cuffed 3,5 Rusch PCS 54000 4
A000000186 ETT Non Cuffed 4,0 Rusch PCS 54000 3
A000000187 Bisturi Lotus No 11 PCS 85
A000000188 Cyclofem PCS 17000 17
A000000189 Deponeo PCS 15000 16
A000000190 Litmus Paper Nesco Lab PCS 6
A000000191 NRM N3 Dewasa PCS 15000 23
A000000192 NRM N3 Anak PCS 15000 8
A000000193 Nasal Oxygen Canul Cosmomed Dewasa PCS 2
A000000194 Biosyn 3/0 Cut Covidien PCS 130240 31
A000000195 Chromic 2/0 Tap Covidien PCS 67000 36
A000000196 Milrub NR ECO 5 L BTL 396000 2
A000000197 Suction Catheter No. 8 Cosmomed PCS 3100 21
A000000198 Hazmat 75 Granasi PCS 61000 0
A000000199 Masker KN 95 PCS 5000 28
A000000200 Hernia Mesh PCS 187000 10
A000000201 IV Cath Surflo 18 G PCS 11000 4
A000000202 IV Cath Surflo 20 G PCS 11000 0
A000000203 IV Cath Surflo 22 G PCS 11000 1
A000000204 Kasa Steril IFA FARMA PCS 6000 32
A000000205 Plester Coklat Kecil PCS 8250 10
A000000206 Plester Coklat Besar PCS 33550 5
A000000207 PD Cable C2 PCS 236500 1
A000000208 PD Plate Child Mono (S1) PCS 41250 10
A000000209 PD Plate Adult Mono (M1) PCS 41250 10
A000000210 Surgical Gown Disposable PCS 39000 9
A000000211 Transfusi Set GEA PCS 8800 17
A000000212 Kasa Gulung DRC PCS 244860 0
A000000213 Thoracic Catheter 24 CH PCS 213400 2
A000000214 Masker Tali Winner PCS 792 150
A000000215 Alkohol Swab Cosmomed PCS 300 0
A000000216 Softex Maternity PCS 5000 17
A000000217 Spalk Infus S PCS 6600 6
A000000218 Spuit Insulin 0,5 ml PCS 4000 19
A000000219 IV Cath Inflo No. 18 PCS 6000 49
A000000220 IV Cath GEA No. 20 PCS 6000 0
A000000221 IV Cath Inflo No. 22 PCS 6000 48
A000000222 IV Cath Inflo No. 24 PCS 6000 50
A000000223 Urine Bag With Hanger N3 PCS 4400 17
A000000224 Celana Sunat Ukuran M PCS 20000 5
A000000225 Celana Sunat Ukuran XL PCS 20000 4
A000000226 Stepler Hemoroid PCS 3850000 1
A000000227 Nasopharyngeal Airway PCS 176000 5
A000000228 Kasa X-Ray PCS 24200 10
A000000229 Laminaria S PCS 82500 2
A000000230 Alkohol Swab Sensi PCS 100
 Total

26956.8

42900
10296

148500
82500

7865
198000

2 untuk kuret
14300
17160

18480

84700

36850
 5737.5
63018.75

184119
Rp 506,068.75

179775

287675
3.75
20556.25

39037.5

37895
120000
120000

2000
8400
45397.8
3150
 4693

13500

1430

11225.5

18550

6077.5
1500
26250
4560
6500

7800

3750
7750

402187.5

68062.5
132000
136125
135000
135000
14437.5
77130

35840
 11550

78562.5

5577

4147

256971

134680
113437.5
3445
21206.4

8840
7993.7
11445

122500
165000
60000
47250
46000
114575
115380
123750

30000

6875

2600
 30400

25575
5058.3

15600

109200

272250
68750
156750

35000
 13000
42900

87536.8
17647.5
21021
228228
99099
47190
13000
Rp 745,494.75
55000

29250
Rp 3,019,216
Rp 40,500

Rp 11,550
Rp 6,500
Rp 52,000

Rp 195,000

Rp 57,200

Rp 70,000
Rp 57,200

Rp 10,000
Rp 18,356
Rp 49,500

2496
9135
10639.2

8649
5000

22880
24062.5

9000
49700

9105.2

225

1100
 770
1300

32403.8
7788.75
8100.3

11960

25025

36640.8

24007.1
30030
25025

10400

10560

10725
13585
 2250
3900
10400

11700

10500

650

146289

155232

136250
400400

44330
24050

6500

45500
5850

54340

19500
 20625

3183.18
 DAFTAR BIAYA OBAT DAN BHP KURETASE
No. Nama Bentuk Jumlah HARGA KELAS III KELAS II KELAS I VIP VVIP
1 Underpad PCS 2 Rp 5,000 Rp 13,000 Rp 14,000 Rp 15,000 Rp 16,000 Rp 17,000
2 Suction Curretage No. 10 Steril Medical PCS 1 Rp 77,000 Rp 100,100 Rp 107,800 Rp 115,500 Rp 123,200 Rp 130,900
3 Selang Connecting Tube Media Standard PCS 1 Rp 51,920 Rp 67,496 Rp 72,688 Rp 77,880 Rp 83,072 Rp 88,264
4 Spuit 5 cc PCS 4 Rp 1,000 Rp 5,200 Rp 5,600 Rp 6,000 Rp 6,400 Rp 6,800
5 Pembalut Melahirkan L PCS 2 Rp 5,000 Rp 13,000 Rp 14,000 Rp 15,000 Rp 16,000 Rp 17,000
6 Water For Injection (WFI) Plabot 4 Rp 2,650 Rp 13,780 Rp 14,840 Rp 15,900 Rp 16,960 Rp 18,020
7 Ringer Lactat Plabot 1 Rp 7,630 Rp 9,919 Rp 10,682 Rp 11,445 Rp 12,208 Rp 12,971
8 Pehacaine Ampul 4 Rp 4,000 Rp 20,800 Rp 22,400 Rp 24,000 Rp 25,600 Rp 27,200
9 Oxyla Ampul 1 Rp 25,300 Rp 32,890 Rp 35,420 Rp 37,950 Rp 40,480 Rp 43,010
10 Metvell Tab Tablet 10 Rp 2,700 Rp 35,100 Rp 37,800 Rp 40,500 Rp 43,200 Rp 45,900
11 Dohixat tab Tablet 3 Rp 1,000 Rp 3,900 Rp 4,200 Rp 4,500 Rp 4,800 Rp 5,100
12 Opimox Tablet 15 Rp 3,025 Rp 58,988 Rp 63,525 Rp 68,063 Rp 72,600 Rp 77,138
13 Noprostol Tablet 2 Rp 9,200 Rp 23,920 Rp 25,760 Rp 27,600 Rp 29,440 Rp 31,280
14 Pronalges Suppo Suppo 2 Rp 19,500 Rp 50,700 Rp 54,600 Rp 58,500 Rp 62,400 Rp 66,300
16 Handschoon Sterile 6,5 PCS 2 Rp 19,250 Rp 50,050 Rp 53,900 Rp 57,750 Rp 61,600 Rp 65,450
17 Handschoon Sterile 7 PCS 2 Rp 22,300 Rp 57,980 Rp 62,440 Rp 66,900 Rp 71,360 Rp 75,820
18 Transofix PCS 1 Rp 8,500 Rp 11,050 Rp 11,900 Rp 12,750 Rp 13,600 Rp 14,450
19 Tranfusi Set PCS 1 Rp 8,800 Rp 11,440 Rp 12,320 Rp 13,200 Rp 14,080 Rp 14,960
20 Apron PCS 3 Rp 2,000 Rp 7,800 Rp 8,400 Rp 9,000 Rp 9,600 Rp 10,200
21 Povidone Iodine 60 ml PCS 2 Rp 9,000 Rp 23,400 Rp 25,200 Rp 27,000 Rp 28,800 Rp 30,600
TOTAL Rp 610,513 Rp 657,475 Rp 704,438 Rp 751,400 Rp 798,363
 DAFTAR BIAYA OBAT DAN BHP PAKET LAPARATOMY
No. Nama Bentuk Jumlah HARGA KELAS III
1 WFI Plabot 2 Rp 2,650 Rp 6,890
2 Pampers Dr. P Pcs 2 Rp 7,000 Rp 18,200
3 Handschoon gammex 6,5 Tablet 2 Rp 19,250 Rp 50,050
4 Handschoon gammex 7 Pcs 2 Rp 19,250 Rp 50,050
5 Handschoon Gammex 7,5 Pcs 2 Rp 19,250 Rp 50,050
6 Metvell Injeksi Ampul 3 Rp 19,000 Rp 74,100
7 NaCl 0,9% 500 ml Plabot 1 Rp 6,800 Rp 8,840
8 Ringer Laktat Plabot 1 Rp 7,630 Rp 9,919
9 Spuit 3 cc Pcs 1 Rp 1,000 Rp 1,300
10 Spuit 5 cc Pcs 3 Rp 1,000 Rp 3,900
11 Oxyla Ampul 3 Rp 25,300 Rp 98,670
12 Underpad Healer Pcs 2 Rp 5,000 Rp 13,000
13 Polysorb 1 Pcs 3 Rp 143,000 Rp 557,700
14 advantime 3/0 Pcs 1 Rp 112,530 Rp 146,289
15 Plain 0 Pcs 1 Rp 80,000 Rp 104,000
16 Apron Pcs 3 Rp 1,920 Rp 7,488
17 Transofix Pcs 1 Rp 8,250 Rp 10,725
18 Bisturi no 20 Pcs 5 Rp 3,000 Rp 19,500
19 Urine Bag Pcs 1 Rp 3,000 Rp 3,900
20 Folley Cath no 16 Pcs 1 Rp 18,467 Rp 24,007
21 Opsite Pcs 1 Rp 41,800 Rp 54,340
22 Kassa X-Ray Pack 2 Rp 24,200 Rp 62,920
23 Darm Kas Pcs 1 Rp 24,000 Rp 31,200
24 Daryatule Pcs 1 Rp 34,100 Rp 44,330
TOTAL Rp 627,397 Rp 1,451,368
 KELAS II KELAS I VIP VVIP
Rp 7,420 Rp 7,950 Rp 8,480 Rp 9,010
Rp 19,600 Rp 21,000 Rp 22,400 Rp 23,800
Rp 53,900 Rp 57,750 Rp 61,600 Rp 65,450
Rp 53,900 Rp 57,750 Rp 61,600 Rp 65,450
Rp 53,900 Rp 57,750 Rp 61,600 Rp 65,450
Rp 79,800 Rp 85,500 Rp 91,200 Rp 96,900
Rp 9,520 Rp 10,200 Rp 10,880 Rp 11,560
Rp 10,682 Rp 11,445 Rp 12,208 Rp 12,971
Rp 1,400 Rp 1,500 Rp 1,600 Rp 1,700
Rp 4,200 Rp 4,500 Rp 4,800 Rp 5,100
Rp 106,260 Rp 113,850 Rp 121,440 Rp 129,030
Rp 14,000 Rp 15,000 Rp 16,000 Rp 17,000
Rp 600,600 Rp 643,500 Rp 686,400 Rp 729,300
Rp 157,542 Rp 168,795 Rp 180,048 Rp 191,301
Rp 112,000 Rp 120,000 Rp 128,000 Rp 136,000
Rp 8,064 Rp 8,640 Rp 9,216 Rp 9,792
Rp 11,550 Rp 12,375 Rp 13,200 Rp 14,025
Rp 21,000 Rp 22,500 Rp 24,000 Rp 25,500
Rp 4,200 Rp 4,500 Rp 4,800 Rp 5,100
Rp 25,854 Rp 27,701 Rp 29,547 Rp 31,394
Rp 58,520 Rp 62,700 Rp 66,880 Rp 71,060
Rp 67,760 Rp 72,600 Rp 77,440 Rp 82,280
Rp 33,600 Rp 36,000 Rp 38,400 Rp 40,800
Rp 47,740 Rp 51,150 Rp 54,560 Rp 57,970
Rp 1,563,012 Rp 1,674,656 Rp 1,786,299 Rp 1,897,943
 DAFTAR BIAYA OBAT DAN BHP PAKET MELAHIRKAN NORMAL
No. Nama Bentuk Jumlah HARGA Kelas III Kelas II Kelas I VIP VVIP
1 Opimox Tablet 12 Rp 3,025 Rp 47,190 Rp 50,820 Rp 54,450 Rp 58,080 Rp 61,710
2 WFI Plabot 2 Rp 2,650 Rp 6,890 Rp 7,420 Rp 7,950 Rp 8,480 Rp 9,010
3 Blood set Pcs 1 Rp 8,800 Rp 11,440 Rp 12,320 Rp 13,200 Rp 14,080 Rp 14,960
4 Pembalut Melahirkan M Pcs 2 Rp 5,000 Rp 13,000 Rp 14,000 Rp 15,000 Rp 16,000 Rp 17,000
5 Pampers Dr. P Pcs 2 Rp 7,000 Rp 18,200 Rp 19,600 Rp 21,000 Rp 22,400 Rp 23,800
6 Asifit Tab Tablet 12 Rp 1,500 Rp 23,400 Rp 25,200 Rp 27,000 Rp 28,800 Rp 30,600
7 Handschoon gammex 6,5 Pcs 2 Rp 19,250 Rp 50,050 Rp 53,900 Rp 57,750 Rp 61,600 Rp 65,450
8 Handschoon gammex 7 Pcs 2 Rp 22,300 Rp 57,980 Rp 62,440 Rp 66,900 Rp 71,360 Rp 75,820
9 IV Cath no 18 Pcs 1 Rp 7,000 Rp 9,100 Rp 9,800 Rp 10,500 Rp 11,200 Rp 11,900
12 Lactamam Tablet 12 Rp 3,500 Rp 54,600 Rp 58,800 Rp 63,000 Rp 67,200 Rp 71,400
13 Pehacaine Ampul 3 Rp 4,000 Rp 15,600 Rp 16,800 Rp 18,000 Rp 19,200 Rp 20,400
14 Metvell Injeksi Ampul 2 Rp 19,000 Rp 49,400 Rp 53,200 Rp 57,000 Rp 60,800 Rp 64,600
15 NaCl 0,9% 500 ml Plabot 2 Rp 6,800 Rp 17,680 Rp 19,040 Rp 20,400 Rp 21,760 Rp 23,120
16 Oxygen Nasal Canul Pcs 1 Rp 7,000 Rp 9,100 Rp 9,800 Rp 10,500 Rp 11,200 Rp 11,900
17 Ringer Laktat Plabot 1 Rp 7,630 Rp 9,919 Rp 10,682 Rp 11,445 Rp 12,208 Rp 12,971
18 Sanmol Tablet 10 Rp 500 Rp 6,500 Rp 7,000 Rp 7,500 Rp 8,000 Rp 8,500
19 Spuit 3 cc Pcs 4 Rp 1,000 Rp 5,200 Rp 5,600 Rp 6,000 Rp 6,400 Rp 6,800
20 Spuit 5 cc Pcs 4 Rp 1,000 Rp 5,200 Rp 5,600 Rp 6,000 Rp 6,400 Rp 6,800
22 Povidone Iodine 60 ml Botol 2 Rp 9,000 Rp 23,400 Rp 25,200 Rp 27,000 Rp 28,800 Rp 30,600
23 Oxyla Ampul 2 Rp 25,300 Rp 65,780 Rp 70,840 Rp 75,900 Rp 80,960 Rp 86,020
24 Tegaderm 6x7 Pcs 2 Rp 2,883 Rp 7,496 Rp 8,072 Rp 8,649 Rp 9,226 Rp 9,802
25 Underpad Healer Pcs 4 Rp 5,000 Rp 26,000 Rp 28,000 Rp 30,000 Rp 32,000 Rp 34,000
26 NRM Pcs 1 Rp 15,000 Rp 19,500 Rp 21,000 Rp 22,500 Rp 24,000 Rp 25,500
27 Optime 0 Pcs 2 Rp 72,406 Rp 188,256 Rp 202,737 Rp 217,218 Rp 231,699 Rp 246,180
28 Optime 2/0 Pcs 1 Rp 110,000 Rp 143,000 Rp 154,000 Rp 165,000 Rp 176,000 Rp 187,000
29 Apron Pcs 3 Rp 2,000 Rp 7,800 Rp 8,400 Rp 9,000 Rp 9,600 Rp 10,200
30 Transofix Pcs 1 Rp 8,500 Rp 11,050 Rp 11,900 Rp 12,750 Rp 13,600 Rp 14,450
31 Surgical Gawn Pcs 1 Rp 39,000 Rp 50,700 Rp 54,600 Rp 58,500 Rp 62,400 Rp 66,300
32 Sarung Tangan Panjang Pcs 1 Rp 60,500 Rp 78,650 Rp 84,700 Rp 90,750 Rp 96,800 Rp 102,850
33 D5% Pcs 1 Rp 13,254 Rp 17,230 Rp 18,556 Rp 19,881 Rp 21,206 Rp 22,532
TOTAL Rp 1,049,311 Rp 1,130,027 Rp 1,210,743 Rp 1,291,459 Rp 1,372,175
 DAFTAR BIAYA OBAT DAN BHP PAKET MELAHIRKAN CAESAR
No. Nama Bentuk Jumlah HARGA KELAS III KELAS II KELAS I VIP VVIP
1 Cefazole Ampul 3 Rp 143,000 Rp 557,700 Rp 600,600 Rp 643,500 Rp 686,400 Rp 729,300
2 WFI Plabot 2 Rp 2,650 Rp 6,890 Rp 7,420 Rp 7,950 Rp 8,480 Rp 9,010
3 Blood set Pcs 1 Rp 8,800 Rp 11,440 Rp 12,320 Rp 13,200 Rp 14,080 Rp 14,960
4 Pembalut Melahirkan M Pcs 2 Rp 5,000 Rp 13,000 Rp 14,000 Rp 15,000 Rp 16,000 Rp 17,000
5 Pampers Dr. P Pcs 2 Rp 7,000 Rp 18,200 Rp 19,600 Rp 21,000 Rp 22,400 Rp 23,800
6 Asifit Kaps Tablet 4 Rp 1,500 Rp 7,800 Rp 8,400 Rp 9,000 Rp 9,600 Rp 10,200
7 Handschoon gammex 6,5 Pcs 2 Rp 19,250 Rp 50,050 Rp 53,900 Rp 57,750 Rp 61,600 Rp 65,450
8 Handschoon Gammex 7 Pcs 2 Rp 22,300 Rp 57,980 Rp 62,440 Rp 66,900 Rp 71,360 Rp 75,820
9 IV Cath no 18 Pcs 1 Rp 7,000 Rp 9,100 Rp 9,800 Rp 10,500 Rp 11,200 Rp 11,900
12 Lactamam Tablet 12 Rp 3,500 Rp 54,600 Rp 58,800 Rp 63,000 Rp 67,200 Rp 71,400
13 Metvell Injeksi Ampul 2 Rp 19,000 Rp 49,400 Rp 53,200 Rp 57,000 Rp 60,800 Rp 64,600
14 NaCl 0,9% 500 ml Plabot 2 Rp 6,800 Rp 17,680 Rp 19,040 Rp 20,400 Rp 21,760 Rp 23,120
15 Oxygen Nasal Canul Pcs 1 Rp 7,000 Rp 9,100 Rp 9,800 Rp 10,500 Rp 11,200 Rp 11,900
16 Ringer Laktat Plabot 1 Rp 7,630 Rp 9,919 Rp 10,682 Rp 11,445 Rp 12,208 Rp 12,971
17 Sanmol Tablet 10 Rp 500 Rp 6,500 Rp 7,000 Rp 7,500 Rp 8,000 Rp 8,500
18 Spuit 3 cc Pcs 1 Rp 1,000 Rp 1,300 Rp 1,400 Rp 1,500 Rp 1,600 Rp 1,700
19 Spuit 5 cc Pcs 4 Rp 1,000 Rp 5,200 Rp 5,600 Rp 6,000 Rp 6,400 Rp 6,800
21 Povidone Iodine 60 ml Botol 2 Rp 9,000 Rp 23,400 Rp 25,200 Rp 27,000 Rp 28,800 Rp 30,600
22 Oxyla Ampul 2 Rp 25,300 Rp 65,780 Rp 70,840 Rp 75,900 Rp 80,960 Rp 86,020
23 Tegaderm 6x7 Pcs 2 Rp 2,883 Rp 7,496 Rp 8,072 Rp 8,649 Rp 9,226 Rp 9,802
24 Underpad Healer Pcs 4 Rp 5,000 Rp 26,000 Rp 28,000 Rp 30,000 Rp 32,000 Rp 34,000
25 NRM Pcs 1 Rp 15,000 Rp 19,500 Rp 21,000 Rp 22,500 Rp 24,000 Rp 25,500
26 Optime 1 Pcs 4 Rp 104,720 Rp 544,544 Rp 586,432 Rp 628,320 Rp 670,208 Rp 712,096
27 advantime 3/0 Pcs 2 Rp 112,530 Rp 292,578 Rp 315,084 Rp 337,590 Rp 360,096 Rp 382,602
29 Plain 0 Pcs 1 Rp 80,000 Rp 104,000 Rp 112,000 Rp 120,000 Rp 128,000 Rp 136,000
31 Apron Pcs 3 Rp 2,000 Rp 7,800 Rp 8,400 Rp 9,000 Rp 9,600 Rp 10,200
32 Transofix Pcs 1 Rp 8,500 Rp 11,050 Rp 11,900 Rp 12,750 Rp 13,600 Rp 14,450
33 Surgical Gawn Pcs 1 Rp 39,000 Rp 50,700 Rp 54,600 Rp 58,500 Rp 62,400 Rp 66,300
34 Sarung Tangan Panjang Pcs 2 Rp 60,500 Rp 157,300 Rp 169,400 Rp 181,500 Rp 193,600 Rp 205,700
35 D5% Pcs 1 Rp 13,254 Rp 17,230 Rp 18,556 Rp 19,881 Rp 21,206 Rp 22,532
36 Bisturi no 20 Pcs 5 Rp 3,000 Rp 19,500 Rp 21,000 Rp 22,500 Rp 24,000 Rp 25,500
37 Urine Bag Pcs 1 Rp 4,400 Rp 5,720 Rp 6,160 Rp 6,600 Rp 7,040 Rp 7,480
38 Folley Cath no 16 Pcs 1 Rp 18,467 Rp 24,007 Rp 25,854 Rp 27,701 Rp 29,547 Rp 31,394
39 Opsite Pcs 1 Rp 41,800 Rp 54,340 Rp 58,520 Rp 62,700 Rp 66,880 Rp 71,060
40 Daryatule Pcs 1 Rp 34,100 Rp 44,330 Rp 47,740 Rp 51,150 Rp 54,560 Rp 57,970
TOTAL Rp 2,361,134 Rp 2,542,760 Rp 2,724,386 Rp 2,906,011 Rp 3,087,637
 DAFTAR BIAYA OBAT DAN BHP PAKET BAYI dan RESUSITASI
No. Nama Bentuk Jumlah HARGA KELAS III KELAS II KELAS I VIP VVIP
1 Handscoon Gammex 6,5 PCS 2 Rp 19,250 Rp 50,050 Rp 53,900 Rp 57,750 Rp 61,600 Rp 65,450
2 Handscoon Gammex 7 PCS 2 Rp 22,300 Rp 57,980 Rp 62,440 Rp 66,900 Rp 71,360 Rp 75,820
3 Underpad Healer PCS 1 Rp 5,000 Rp 6,500 Rp 7,000 Rp 7,500 Rp 8,000 Rp 8,500
4 Neo-K Injeksi Ampul 1 Rp 17,050 Rp 22,165 Rp 23,870 Rp 25,575 Rp 27,280 Rp 28,985
5 Epinefrin Ampul 1 Rp 7,604 Rp 9,885 Rp 10,646 Rp 11,406 Rp 12,166 Rp 12,927
6 D10% Plabot 1 Rp 14,400 Rp 18,720 Rp 20,160 Rp 21,600 Rp 23,040 Rp 24,480
7 Spuit 1 cc Tubercullin PCS 1 Rp 1,000 Rp 1,300 Rp 1,400 Rp 1,500 Rp 1,600 Rp 1,700
8 Spuit 3 cc PCS 1 Rp 1,000 Rp 1,300 Rp 1,400 Rp 1,500 Rp 1,600 Rp 1,700
9 Vaksin Hepatitis B 0,5 ml PCS 1 Rp 67,336 Rp 87,537 Rp 94,270 Rp 101,004 Rp 107,738 Rp 114,471
10 Cendo Genta Salep PCS 1 Rp 50,016 Rp 65,021 Rp 70,022 Rp 75,024 Rp 80,026 Rp 85,027
11 Umbilical Cord Clamp PCS 1 Rp 3,000 Rp 3,900 Rp 4,200 Rp 4,500 Rp 4,800 Rp 5,100
12 Betadine 60 ml PCS 1 Rp 9,000 Rp 11,700 Rp 12,600 Rp 13,500 Rp 14,400 Rp 15,300
13 Diapers Newborn PCS 3 Rp 17,000 Rp 66,300 Rp 71,400 Rp 76,500 Rp 81,600 Rp 86,700
14 Selang Oksigen Bayi PCS 1 Rp 7,500 Rp 9,750 Rp 10,500 Rp 11,250 Rp 12,000 Rp 12,750
15 ETT 3,5 Non Cuffed PCS 1 Rp 54,000 Rp 70,200 Rp 75,600 Rp 81,000 Rp 86,400 Rp 91,800
16 ETT 4 Non Cuffed PCS 1 Rp 54,000 Rp 70,200 Rp 75,600 Rp 81,000 Rp 86,400 Rp 91,800
17 Suction Biru PCS 1 Rp 7,000 Rp 9,100 Rp 9,800 Rp 10,500 Rp 11,200 Rp 11,900
18 Suction Putih PCS 1 Rp 7,000 Rp 9,100 Rp 9,800 Rp 10,500 Rp 11,200 Rp 11,900
19 NGT no 5 PCS 1 Rp 26,172 Rp 34,024 Rp 36,641 Rp 39,258 Rp 41,875 Rp 44,492
20 Infus set mikro PCS 1 Rp 15,068 Rp 19,588 Rp 21,095 Rp 22,602 Rp 24,109 Rp 25,616
21 NaCl 0,9% 100 ml Plabot 1 Rp 6,800 Rp 8,840 Rp 9,520 Rp 10,200 Rp 10,880 Rp 11,560
TOTAL Rp 633,160 Rp 681,864 Rp 730,569 Rp 779,274 Rp 827,978
 DAFTAR BIAYA OBAT DAN BHP OPERASI KISTA (Pasien Ny. Nafiatus)
Jumlah
No Nama Bentuk yang Harga Total
diberikan
1 Handschoon Sterile 6,5 PCS 1 19000 19000
2 Handschoon Sterile 7 PCS 3 19000 57000
3 Handschoon Sterile 7,5 PCS 1 19000 19000
4 Urine bag PCS 1 6000 6000
5 Povidone Iodine 10% 1 L Botol 1 12000 12000
6 Povidone Iodine 10% 60 ml Botol 1 88000 88000
7 Spuit 3 cc PCS 1 1000 1000
8 Spuit 5 cc PCS 2 1000 2000
9 Spuit 10 cc PCS 2 3000 6000
10 Extension Spinocan No. 26 PCS 1 32000 32000
11 Pisau Cukur PCS 1 17000 17000
12 WFI Plabot 4 3500 14000
13 RL Plabot 2 10000 20000
14 NaCl Plabot 1 9000 9000
15 Sungkup Dewasa PCS 1 29000 29000
16 Folley Catheter 16 PCS 1 16000 16000
17 Underpad PCS 1 5000 5000
18 Faceshield PCS 5 0 0
19 Masker N95 PCS 8 26000 208000
20 Apron PCS 5 2600 13000
21 Bupivacaine VIAL 1 133000 133000
22 Efedrine AMP 1
23 Ondansentron AMP 1 46000 46000
24 Sanmol Infus BTL 1 87500 87500
25 Optime 0 PCS 1 117000 117000
26 Optime 1 PCS 1 135000 135000
27 Plain 0 PCS 1 104000 104000
28 Chromic 0 PCS 1 104000 104000
29 Alkohol 70% BTL 1 33000 33000
30 Guedel 0 PCS 1 19000 19000
31 Bisturi 20 PCS 1 1500 1500
32 Oppsite PCS 1 54000 54000
33 Hypafix PCS 1 8000 8000
TOTAL Rp 1,415,000

DAFTAR BIAYA OBAT DAN BHP OPERASI KISTA

Jumlah
No Nama Bentuk yang Harga Total
diberikan
HARI 1
1 Cefazol Vial 3 186000 558000
2 Three way PCS 1 16000 16000
3 NaCl 100 ml Plabot 1 8000 8000
4 RL 500 ml Plabot 1 10000 10000
5 Spuit 10 cc Pcs 1 1300 1300
POST OP (HARI 2)
1 Sanmol Infus botol 3 87500 262500
2 ODR 4 mg Vial 3 46000 138000
3 Tutosol Plabot 3 103000 309000
4 Spuit 3 cc PCS 2 1000 2000
5 Spuit 5 cc PCS 1 1000 1000
6 Spuit 10 cc PCS 1 1000 1000
7 Hypafix PCS 1 8000 8000
8 Alkohol Swab PCS 6 400 2400
9 Three way PCS 1 16000 16000
10 Abochet 18 PCS 1 9000 9000
11 Tegaderm PCS 1 4000 4000
12 Blood Tranfusion Set PCS 1 6500 6500
13 RL 500 ml Plabot 1 10000 10000
14 NaCl 100 ml Plabot 1 8000 8000
15 Cefazol Vial 1 186000 186000
16 Handschoon PCS 3 5000 15000
POST OP (HARI 3)
1 Pempres L PCS 1 9000 9000
2 Infus set PCS 1 6500 6500
3 Abocath 20 PCS 1 9000 9000
4 Tegaderm PCS 1 4000 4000
5 Handschoon PCS 2 5000 10000
6 Ringer Laktat 500 ml Plabot 1 10000 10000
8 Duphaston TAB 7 31000 217000
POST OP (HARI 4)
1 Spuit 10 cc PCS 1 1000 1000
2 Handschoon PCS 2 5000 10000
3 Sanmol Infus Botol 1 87500 87500
4 Ringer Laktat 500 ml Plabot 1 10000 10000
TOTAL Rp 1,945,700
 DAFTAR BIAYA OBAT DAN BHP PAKET ANASTESI ELA
TOTAL
No. Nama Bentuk Jumlah Kriteria HARGA
Kelas III Kelas II Kelas I VIP VVIP
1 Epidural Kit Set 1 Wajib
2 Fentanyl Ampul 1 Wajib Rp 64,372 Rp 83,684 Rp 90,121 Rp 96,558 Rp 102,995 Rp 109,432
3 Lidocaine Ampul 2 Wajib Rp 2,000 Rp 5,200 Rp 5,600 Rp 6,000 Rp 6,400 Rp 6,800
4 Efedrin Ampul 1 Optional Rp 68,750 Rp 89,375 Rp 96,250 Rp 103,125 Rp 110,000 Rp 116,875
5 Pehacaine Ampul 1 Wajib Rp 4,000 Rp 5,200 Rp 5,600 Rp 6,000 Rp 6,400 Rp 6,800
6 NaCl 0,9% 100 ml Plabot 1 Wajib Rp 6,149 Rp 7,994 Rp 8,609 Rp 9,224 Rp 9,838 Rp 10,453
7 Levobupivacaine (Levica/Vopicaine) Vial 2 Wajib Rp 57,750 Rp 150,150 Rp 161,700 Rp 173,250 Rp 184,800 Rp 196,350
8 Spinal Needle 25/26 PCS 1 Optional jika combine ILA Rp 27,000 Rp 35,100 Rp 37,800 Rp 40,500 Rp 43,200 Rp 45,900
9 Bupivacaine 0,5% hiperbarik (Bunascan) Ampul 1 Optional jika combine ILA Rp 101,166 Rp 131,516 Rp 141,632 Rp 151,749 Rp 161,866 Rp 171,982
10 Gammex 7 atau 7,5 Pcs 1 Wajib Rp 19,250 Rp 25,025 Rp 26,950 Rp 28,875 Rp 30,800 Rp 32,725
11 Plester Hypafix panjang 10 cm Pcs 1 Wajib Rp 35,500 Rp 46,150 Rp 49,700 Rp 53,250 Rp 56,800 Rp 60,350
12 Betadine 60 ml Tablet 1 Wajib Rp 9,000 Rp 11,700 Rp 12,600 Rp 13,500 Rp 14,400 Rp 15,300
13 Kasa Sterile 1 bandle PCS 1 Wajib Rp 6,000 Rp 7,800 Rp 8,400 Rp 9,000 Rp 9,600 Rp 10,200
TOTAL Rp 598,893 Rp 644,962 Rp 691,031 Rp 737,099 Rp 783,168
 DAFTAR ITEM TOOLKIT
STOCK ON GENERAL
No. Nama Satuan Jumlah HARGA KELAS III KELAS II KELAS I VIP VVIP
1 Propofol Vial 2 Rp 67,500 Rp 87,750 Rp 189,000 Rp 202,500 Rp 216,000 Rp 229,500
2 Ondansentron Ampul 2 Rp 35,200 Rp 45,760 Rp 98,560 Rp 105,600 Rp 112,640 Rp 119,680
3 Ketorolac Ampul 2 Rp 44,000 Rp 57,200 Rp 123,200 Rp 132,000 Rp 140,800 Rp 149,600
4 Midazolam Ampul 2 Rp 30,000 Rp 39,000 Rp 84,000 Rp 90,000 Rp 96,000 Rp 102,000
5 Ketamin Vial 2 Rp 220,000 Rp 286,000 Rp 616,000 Rp 660,000 Rp 704,000 Rp 748,000
6 Tramuz Ampul 2 Rp 66,000 Rp 85,800 Rp 184,800 Rp 198,000 Rp 211,200 Rp 224,400
7 Atropine Sulfat Ampul 2 Rp 4,000 Rp 5,200 Rp 11,200 Rp 12,000 Rp 12,800 Rp 13,600
8 Fentanyl Injeksi Ampul 2 Rp 64,372 Rp 83,684 Rp 180,242 Rp 193,116 Rp 205,990 Rp 218,865
9 Sevoflurane Baxter botol 2 Rp 3,712,500 Rp 4,826,250 Rp 10,395,000 Rp 11,137,500 Rp 11,880,000 Rp 12,622,500
10 Spuit 3 cc pcs 2 Rp 1,000 Rp 1,300 Rp 2,800 Rp 3,000 Rp 3,200 Rp 3,400
11 Spuit 5 cc pcs 2 Rp 1,000 Rp 1,300 Rp 2,800 Rp 3,000 Rp 3,200 Rp 3,400
12 Spuit 10 cc pcs 2 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509
13 ET size 7 pcs 2 Rp 38,500 Rp 50,050 Rp 107,800 Rp 115,500 Rp 123,200 Rp 130,900
14 ET size 7,5 pcs 2 Rp 38,500 Rp 50,050 Rp 107,800 Rp 115,500 Rp 123,200 Rp 130,900
15 Prostigmine Vial 2 Rp 25,300 Rp 32,890 Rp 70,840 Rp 75,900 Rp 80,960 Rp 86,020
16 LMA no 3 pcs 2 Rp 750,800 Rp 976,040 Rp 2,102,240 Rp 2,252,400 Rp 2,402,560 Rp 2,552,720
17 LMA no 2 pcs 2 Rp 750,800 Rp 976,040 Rp 2,102,240 Rp 2,252,400 Rp 2,402,560 Rp 2,552,720
18 LMA no 2,5 pcs 2 Rp 778,000 Rp 1,011,400 Rp 2,178,400 Rp 2,334,000 Rp 2,489,600 Rp 2,645,200
19 Canul suction vacum pcs 2 Rp 7,000 Rp 9,100 Rp 19,600 Rp 21,000 Rp 22,400 Rp 23,800
20 Sungkup facemask dewasa pcs 2 Rp 22,300 Rp 28,990 Rp 62,440 Rp 66,900 Rp 71,360 Rp 75,820
21 Sungkup facemask anak pcs 2 Rp 22,300 Rp 28,990 Rp 62,440 Rp 66,900 Rp 71,360 Rp 75,820
22 Sungkup facemask bayi pcs 2 Rp 22,300 Rp 28,990 Rp 62,440 Rp 66,900 Rp 71,360 Rp 75,820
23 Handschoon Sterile 7,5 pcs 2 Rp 19,250 Rp 25,025 Rp 53,900 Rp 57,750 Rp 61,600 Rp 65,450
24 Handschoon Sterile 7 pcs 2 Rp 19,250 Rp 25,025 Rp 53,900 Rp 57,750 Rp 61,600 Rp 65,450
25 Infus Set Makro pcs 2 Rp 15,068 Rp 19,588 Rp 42,190 Rp 45,204 Rp 48,218 Rp 51,231
 DAFTAR ITEM TOOLKIT
STOCK ON REGIONAL
No. Nama Satuan Jumlah HARGA KELAS III KELAS II KELAS I VIP VVIP
1 Bupivacaine Ampul 1 Rp 101,166 Rp 131,516 Rp 141,632 Rp 151,749 Rp 161,866 Rp 171,982
2 Spinocan no 26 pcs 1 Rp 27,000 Rp 35,100 Rp 37,800 Rp 40,500 Rp 43,200 Rp 45,900
3 Handschoon sterile 7 pcs 1 Rp 19,250 Rp 25,025 Rp 26,950 Rp 28,875 Rp 30,800 Rp 32,725
4 Handschoon sterile 7,5 pcs 1 Rp 19,250 Rp 25,025 Rp 26,950 Rp 28,875 Rp 30,800 Rp 32,725
5 Efedrine Ampul 1 Rp 68,750 Rp 89,375 Rp 96,250 Rp 103,125 Rp 110,000 Rp 116,875
6 Ondansentrone Ampul 1 Rp 35,200 Rp 45,760 Rp 49,280 Rp 52,800 Rp 56,320 Rp 59,840
7 Ketorolac Ampul 1 Rp 44,000 Rp 57,200 Rp 61,600 Rp 66,000 Rp 70,400 Rp 74,800
8 Misoprostol pcs 3 Rp 9,200 Rp 35,880 Rp 38,640 Rp 41,400 Rp 44,160 Rp 46,920
9 Asam Tranexamat Inj Ampul 2 Rp 16,500 Rp 42,900 Rp 46,200 Rp 49,500 Rp 52,800 Rp 56,100
10 Rofiden supp Supp 1 Rp 19,500 Rp 25,350 Rp 27,300 Rp 29,250 Rp 31,200 Rp 33,150
11 Spuit 3 cc pcs 1 Rp 1,000 Rp 1,300 Rp 1,400 Rp 1,500 Rp 1,600 Rp 1,700
12 Spuit 5 cc pcs 1 Rp 1,000 Rp 1,300 Rp 1,400 Rp 1,500 Rp 1,600 Rp 1,700
13 Spuit 10 cc pcs 1 Rp 6,500 Rp 8,450 Rp 9,100 Rp 9,750 Rp 10,400 Rp 11,050
14 ETT 7 pcs 1 Rp 38,500 Rp 50,050 Rp 53,900 Rp 57,750 Rp 61,600 Rp 65,450
15 ETT 7,5 pcs 1 Rp 38,500 Rp 50,050 Rp 53,900 Rp 57,750 Rp 61,600 Rp 65,450
16 Dexamethason Ampul 1 Rp 3,000 Rp 3,900 Rp 4,200 Rp 4,500 Rp 4,800 Rp 5,100
17 Epinefrin Ampul 1 Rp 7,604 Rp 9,885 Rp 10,646 Rp 11,406 Rp 12,166 Rp 12,927