RENCANA PENGGUNAAN DANA BIDANG OPERASIONAL RS

HARGA
NO NAMA BARANG SATUAN JUMLAH TOTAL
SATUAN JUMLAH
1 2 3 4 5 6
A. MAKAN PASIEN Rp -
1 Apel kg 60
2 Air Mineral isi ulang galon 2250
3 Arcis kg 25
4 Ayam kg 4235
5 B. goreng bks 52
6 Bakso Ikan kg 15
7 Bawang Merah kg 32
8 Bawang putih kg 115
9 Bayam Ikat Ikat
10 Beras goni 65
11 Bihun bks 125
12 Brocoli kg 122
13 Bumbu
14 Buncis kg 286
15 Bunga Kol kg 70
16 Cabe kg 25
17 Cabe Rawit kg 20
18 Chauge kg 25
19 Cuka btl 75
20 Daging kg 19
21 Daun Pre kg 160
22 Gambas kg 112
23 Garam sok 15
24 Gula goni 27
25 Gula Merah kg 100
26 Hioko ons 15
27 Ikan kg 476
28 Ikan Bawal kg 889.5
29 Ikan Mujair kg 175.4
30 Ikan Selar kg 635.4
31 Jahe kg 25
32 Jali-Jali kg 250
33 Jeruk kg 278
34 Jeruk nipis biji 240
35 Kacang Hijau kg 200
36 Kacang Merah kg 190
37 Kacang Panjang kg 175
38 Kecap Angsa btl 678
39 Kentang kg 660
40 Kol kg 321
41 Kulit Tahu bks 1854
42 Kwetiau kg 450
43 labu jipang biji 200
44 Merica btl 12
45 Mie kg 150
46 Mie Kuning kg 30
47 Mietiau kg 50
48 Minyak Wijen btl 8
49 Misua bks 650
50 Mokui ons 51
51 Pandan Ikat 40
52 Pepaya buah 351
53 Pisang sisir 853
54 Poileng kg 250
55 Pok Chai kg 180
56 Roti bks 700
57 Rempah Obat bks 25
58 Sania 2 ltr ktk 35
59 Sawi kg 250
60 Sawi Pahit kg 250
61 Sawi Putih kg 250
62 Sayur paret Ikat 375
63 Semangka kg 450
64 sop pre kg 25
65 Sumpit bks 500
66 Susu Kental ktk 12
67 Tahu ptg 3500
68 Tauco kg 15
69 Tauge kg 100
70 daun the kg 30
71 Telur ayam btr 60000
72 Tepung Kanji bks 15
73 Tepung maizena ktk 330
74 Tepung Sajiku bks 675
75 Tepung Segitiga bks 35
76 Tomat kg 250
77 Tunas Kol kg 300
78 vanili btl 25
79 Wortel kg 2500
B. BIAYA KEPERLUAN PASIEN Rp -
1 London Bridge bh 280
2 Gantungan Baju bh 75
3 Sikat Gigi set 35
4 Pasta Gigi set 35
5 Tissue gulung dus 40
6 Tissue Petak bgks 1000
7 Dettol 500 ml gln 60
8 Pipet Bengkok bks 300
9 Handuk Good Morning lsn 300
10 Timbangan Pasien bh 1
11 Pisau Silet pcs 15
12 Gilingan Obat bh 2
13 Gelang pasien blue ktk 15
14 Gelang pasien pink ktk 15
15 Gelang pasien ungu ktk 15
16 Gelang pasien kuning ktk 20
17 Gelang pasien merah ktk 2
C. GAS MEDIK Rp -
1 O2 tbg 3320
2 UDT tbg 105
3 O2 Mini tbg 205
4 N2O tbg 5
D. PENUNJANG MEDIS
1. REAGENT LAB Rp -
1 Accucheck Performa box 70
2 Biosite kit 4
3 Blood Lancet kit 35
4 Blue Tips pack 14
5 Cup Sampel Tutup pack 4
6 D-Dimeo kit 3
7 Deck Glass box 10
8 DHF kit 10
9 Golda Anti - A kit 2
10 Golda Anti - AB kit 2
11 Golda Anti - B kit 2
12 Golda Anti - D kit 2
13 Giemsa 500 ml btl 9
14 HBA1C kit 50
15 ICT-M Alania kit 2
16 ICT-TB kit 1
17 K. Golda pack 4
18 Natrium Citrat 3,8 % btl 1
19 NSA1S kit 8
20 Obyek Glass box 75
21 Pen KGD pcs 2
22 Persebat pcs 1
23 Planotest kit 2
24 Sampel Cop White pack 2
25 T. Citrat box 2
26 Tabung Beku box 50
27 Tissue Lensa box 2
28 Tubex / Salmonela test 8
29 White Tips pack 1
30 Widal pack 1
31 Yellow Tips pack 12
32 Multistick ktk 10
33 Albumin Tes 400
34 Alkaline Phosphatase Tes 435
35 Bilirubin Total Tes 760
36 Bilirunin Direct Tes 760
37 Cholesterol Tes 700
38 CK-NAC Tes 30
39 Creatinine Tes 1172
40 Elektrolit paket 12
41 Gamma GT Tes 224
42 HDL Tes 698
43 Hematology Analyzer Tes 4158
44 LDH Tes 14
45 SGOT Tes 1300
46 SGPT Tes 1350
47 Total Protein Tes 500
48 Triglycerides Tes 698
49 Urea Tes 1100
50 Uric Acid Tes 700
2.Biaya Radiologi & CT-Scan Rp -
1 Film 24X30 cm box 8
2 Film 30X40 cm box 8
3 Film 35X35 cm box 8
4 Film 35X43 cm box 8
5 Kertas USG box 30
6 Film 14X17 CT-SCAN box 10
7 Omnipaque 50 CC box 5
8 Omnipaque 20 CC box 10
3. OBAT-OBATAN Rp -
A. ALKES
1 monocryl 4/0 45 cm 12's pcs 17
2 Abb 26 pcs 57
3 Alkohol 96% 1000 cc / 1l btl 543
4 Alkohol swabs 100's pcs 13,215
5 Angiocath plus pcs 10,188
6 Ansell gamex no. 6,5 sterile pcs 3,582
7 Blood adm.set / tb-a200l pcs 756
8 Bonewax / w810 24's pcs 23
9 Botol susu pcs 56
10 Btr4812-3 pcs 93
11 Camelux bks 81
12 Cat gut chromic 3/0 h828t 24's pcs 88
13 Cat gut chromic 4/0 g181t 24's pcs 29
14 Cavafix double lumen (402-10) - 4fr pcs 8
15 Cavafix double lumen (502-10) - 5fr pcs 5
16 Cavafix double lumen (702-20) - 7fr pcs 115
17 Cervical collar 'soft' box 1
18 Coated vicryl 0 / w9138 12's pcs 35
19 Coated vicryl 0 / w9467 12's pcs 10
20 Coated vicryl 1 / w9365 pcs 10
21 Coated vicryl 1 / w9377 12's pcs 10
22 Coated vicryl 1 / w9421 12's pcs 10
23 Coated vicryl 1 / w9431 12's pcs 90
24 Coated vicryl 2-0 / w9140 12's pcs 253
25 Coated vicryl 3-0 / w9114 12's pcs 49
26 Coated vicryl 3-0 / w9130 12's pcs 172
27 Coated vicryl 3-0 / w9890 12's pcs 106
28 Coated vicryl 4/0 18s15 k pcs 2
29 Coated vicryl 4-0 / w9113 12's pcs 15
30 Coated vicryl 4-0 / w9386 12's pcs 22
31 Coated vicryl 5-0 / w9442 12's pcs 12
32 Connecta plus.100 pcs pcs 6,602
33 Cutisorb 10 x 10 ( putih ) btl 20
34 Cystofix f.10 / braun 8 cm pcs 9
35 Cystofix f.10 / braun 12 cm pcs 7
36 Daryant tulle sterile gauze 10's pcs 2,321
37 Delta lite conformable 3" pcs 14
38 Delta lite conformable 5" pcs 5
39 Dettol ( k ) btl 287
40 Disp. 50 cc - eccentric / munc. Samping pcs 821
41 Disp. Syiringe 10cc kdl pcs 23,236
42 Disp. Syiringe 5cc kdl pcs 19,101
43 Disp. Syringe 1 cc / jms pcs 915
44 Disp. Syringe 100 cc / jms pcs 542
45 Disp. Syringe 20 cc / jms pcs 430
46 Disp. Syringe 3 cc / jms pcs 36,800
47 Double j sten 6 closed pcs 2
48 Elastomull 10 x 4 pcs 115
49 Elastomull 12 x 4 pcs 55
50 Elastomull 8 x 4 pcs 40
51 Electrodes "bix-dsc" 30's pcs 2,720
52 Ethilon 2-0 / w1626t 24's pcs 110
53 Ethilon 3-0 / w320 12's pcs 115
54 Ethilon 4/0 507 pcs 1
55 Ethilon 4/0 w 1620 24's pcs 75
56 Ethilon 4/0 w1612t pcs 25
57 Ethilon 4/0 w319 12's pcs 66
58 Ethilon 5/0 504 pcs 1
59 Ethilon 5-0 / w1611t 24's pcs 55
60 Ethilon 6-0 / w1610t 24's pcs 55
61 Ett 4,0 ideal pcs 2
62 Ett 4,5 ideal pcs 4
63 Ett 5,5 ideal pcs 2
64 Ett 6,0 ideal pcs 7
65 Ett 6,5 ideal pcs 7
66 Ett 7,0 ideal pcs 35
67 Ett 7,5 ideal pcs 175
68 Ett 8,0 ideal pcs 5
69 Ett non king-king no 7 pcs 6
70 Ett non king-king no 7,5 pcs 16
71 Flow sensor pcs 117
72 Foley cath.2 way no.12 bardia pcs 1,050
73 Foley cath.3 way no. 22 bardia pcs 2
74 Foley cath.3 way no.18 bardia pcs 5
75 Foley cath.3 way no.20 bardia pcs 5
76 Foley cath.biocath no08 bardia pcs 12
77 Foley cath.biocath no10 bardia pcs 19
78 Foley silicone 2 way 16fr pcs 355
79 Foley silicone 2 way 18fr pcs 66
80 Formalin 1000 cc / 1 l btl 72
81 Glyserin 1000cc btl 19
82 Guedel pcs 50
83 Guide wire cobra pcs 2
84 Handschoon karet ktk 19,205
 85 Hypafix 10 x 5 ktk 8
86 Hypafix 15 x 5 ktk 415
87 Hypafix 5 x 5 ktk 25
88 Infus set imugard pcs 15
89 Infus set pediatric (oi-30d) pcs 415
90 Infuset otsuka (oi-24) pcs 8,524
91 Insyte autoguard bl-22 ga pcs 42
92 Kapas pembalut 1000 gr swallow bks 309
93 Kapas pembalut 500 gr bks 48
94 Kasa indo husada - polikasa'64 glg 189
95 Kasa kotak swallow - biru ktk 678
96 Kondom cath. With plester (m) pcs 35
97 Leukocrepe 4,5m x 10,0cm (4x5) glg 198
98 Leukocrepe 4,5m x 15,0cm (6x5) glg 108
99 Leukocrepe 4,5m x 7,5cm (3x5) glg 76
100 Leukoplast 4,5m x 7,50cm (3x5) glg 179
101 Lma supreme pcs 11
102 Locoplex l 85 mm pcs 34
103 Mask optichamber advantage pcs 25
104 Masker disp."supermask" 50's pcs 9,215
105 Masker non rebreathing pcs 7
106 Masker o2 child pcs 5
107 Masker o2 dewasa "hudson" pcs 398
108 Medifix line 90 cm pcs 29
109 Medifix scale pcs 22
110 Melolin 10 cm x 10 cm pcs 222
111 Mersilk 2/0 w 327 12's pcs 89
112 Mersilk 3-0 / w328 36's pcs 38
113 Mersilk 3-0 / w570 12's pcs 22
114 Mersilk 4-0 / w501 12's pcs 38
115 Mersilk 5-0 / w528 36's pcs 38
116 Micropore disp. 1"x10 yds 12's pcs 289
117 Micropore disp. 1/2"x10yds 24's pcs 55
118 Monocryl 3-0 /y936h 36's / 4/0 12's pcs 111
119 Mucus extractor pcs 84
120 Nassal oxygen adult / paed pcs 1,098
121 Nebulizer mask dws "hospitech" pcs 555
122 Nebulizer mask paed"hospitech" pcs 101
123 Needle b-d 21g new x-3 point (nal) pcs 4,517
124 Needle novofine 100's pcs 619
125 Nelaton catheter unoplast 10ch pcs 73
126 Ortocast pcs 18
127 Pampers l bks 498
128 Pampers xl bks 350
129 Pds ii 0 9236 24's pcs 23
130 Pds ii w9261 pcs 23
131 Perfusor tubing white - ext. Tube pcs 594
132 Perifix 400 g 18 pcs 80
133 Pisau operasi "aesculap" 100's pcs 1,115
134 Poligyp 10cm x 2,7 / 4" pcs 40
135 Poligyp 15cm x 2,7 / 6" pcs 40
136 Poligyp 7,5cm x 2,7 / 3" pcs 15
137 Prolene 2/0 8833h pcs 40
138 Prolene 3/0 w8684 12's pcs 90
139 Prolene 4/0 w8007 24's pcs 23
140 Prolene 5/0 w8006 pcs 23
141 Q syte closed luer 50's pcs 398
142 Rectal tube unoplast 24 ch pcs 17
143 Safeed feeding tube 5 fr (40cm) pcs 1
144 Safeed feeding tube 5fr(100cm) pcs 3
145 Safeed feeding tube 8 fr(40cm) pcs 3
146 Safeed feeding tube 8fr(100 cm) pcs 3
147 Safeed feeding tube10 fr pcs 35
148 Safeed stomach tube 12fr(125cm pcs 27
149 Safeed stomach tube 14fr(125cm pcs 79
150 Safeed stomach tube 16fr(125cm pcs 610
151 Safeed stomach tube 18fr(125cm pcs 159
152 Sanyo materniy l bks 115
153 Sanyo materniy m bks 65
154 Silk black 4/0 75 cm pcs 2
155 Skin stapler pmw35 6's pcs 20
156 Soffban biru 4" / poliban 10 x 2,7 pcs 20
157 Soffban biru 6" / poliban 15 x 2,7 pcs 15
158 Spinocan g 25 pcs 70
159 Spinocan g 27 pcs 226
160 Suction catheter unoplast 10 cm pcs 348
161 Suprasorb c pcs 15
162 Tegaderm 10cmx12cm / tm1626 50's pcs 215
163 Tegaderm 10cmx25cm/tm1627 20's pcs 315
164 Tegaderm 6cmx7cm / tm1623 100's pcs 1,035
165 Tegaderm pad (9x20 cm) 25's pcs 70
166 Thermometer "safety" pcs 3,600
167 Thermovent 02 pcs 2
168 Thermovent hepa pcs 2
169 Thermovent t pcs 2
170 Tong spatel pcs 41
171 Topi operasi 100's pcs 1,495
172 Trocar & cannula portex 24 fg pcs 1
173 Trocar & cannula portex 28 fg pcs 1
174 Trocar & cannula portex 32 fg pcs 8
175 Tt ( tracheostomy tube ) pcs 4
176 Ultrapro mesh 3's pcs 35
177 Umbilical cord clamp / jms pcs 105
178 Underpad 23"x36" 10's pcs 510
179 Universal arm sling adult pcs 55
180 Urine bag non steril 2 l pcs 1,516
181 Urine bag steril 2 l pcs 168
182 Verban glg.merah 2yx10cm swlow glg 315
183 Verban glg.merah 2yx15 swallow 50's glg 525
184 Verban glg.merah 2yx5cm swalw 100's glg 109
185 Vicryl rapide 3-0 / w9940 12's pcs 14
186 Vicryl rapide 4-0 / w9922 12's pcs 14
187 Winged needle no.25g terumo pcs 5
188 Wound drain no fr 12 pcs 11
189 Wundres b 10 x 10 5's pcs 90
190 Wundres b 10 x 20 5's pcs 59
191 Wundres n 10 x 10 5's pcs 20
B. CREAM
1 Acyclovir cr 5 gr tube 215
2 Albothyl gel 50g btl 105
3 Bactroban cr 10 gr tube 100
4 Betadine obat kumur 175ml btl 63
5 Betason n cr 5 gr tube 219
6 Bio placenton yelly 15 gr tube 165
7 Burnazin cr/35 mg tube 103
8 Burnazin cr/500 mg tube 42
9 Cinolon cr tube 32
10 Cinolon n cr tube 85
11 Counterpain cr 15 gr tube 76
12 Decubal cream 20 gr tube 135
13 Dermakel gel tube 19 gr tube 22
14 Dermakel kids gel 19 gr tube 8
15 Dolones cream tube 42
16 Duoderm gel 30g tube 102
17 Feldene gel 25 gr tube 3
18 Fenicol eye oinment 3,5 gr btl 285
19 Fenicol tetes mata md 0.5% 5's btl 33
20 Formyco cr 10 gr tube 42
21 Garamycin cr 15 gr tube 26
22 Garamycin oint 15 gr tube 209
23 Gentamycin 0,1% salep 5gr 25's tube 392
24 Haemocain oint 15 gr tube 77
25 Hydrocortisone 2,5% cr 5 gr 24's tube 141
26 Iflacort cream 10 gr tube 35
27 Ikaderm 0.05% cr 10 gr tube 22
28 Iodine povidone 10% 60 ml btl 53
29 Isodine oint 20 gr tube 24
30 Isodine soln 55 ml tube 1,703
31 Kaltrofen gel 2.5% 30 gr tube 77
32 Kenalog in orabase 5 gr tube 68
33 Ketoconazole cr 10 gr tube 139
34 K-y jelly 100 gr tube 156
35 Lafalos cr. 20 gr tube 45
36 Levocin eye drop btl 2
37 Lyters cendo minidose 5's dose 246
38 Mederma cr tube 30
39 Miconazole cr 2% tube 106
40 Microlax 5 ml 3's tube 89
41 Myco - z oint 10 gr tube 32
42 Nerilon cream 10 gr tube 2
43 Noroid 80 ml cr tube 26
44 Noroid derma rash cr 60 ml tube 10
45 Pantocain 2% tm minidose 5's dose 15
46 Pibaksin oint 10 gr tube 74
47 Pirofel gel tube 35
48 Prontosan sol 350 ml tube 15
49 Prontosan wound-gel 30 ml tube 15
50 Sagestam cr tube 200
51 Sagestam eye drop 5 ml btl 55
52 Salicil talk tube 20
53 Sanbe tears tube 55
54 Sibro cream 20 gr tube 105
55 Stomahesive gel/paste tube 3
56 Strataderm gel 10 gr tube 5
57 Stratamed 5g tube 5
58 Symbicort turb 160 btl 75
59 Tears naturale ii 15 ml btl 55
60 Thrombophob gel 20 gr tube 125
61 Thrombophob ointment 15 gr tube 4
62 Voltaren emulgel new 1% 20 gr tube 111
63 Xitrol eye drop 5 ml tube 85
64 Xylocaine 2% jelly 10 gr 10's tube 242
C. DROPS
1 Amoxsan paed drops btl 20
2 Apialys drop 10 ml btl 3
3 Breathy nassal drop 30 ml btl 25
4 Cendo xitrol minidose 5's btl 160
5 Daryazinc drop btl 43
6 Iliadin 0,05%nasal drop10ml sp btl 70
7 Iliadin 0,025%nasal drop10ml kd btl 60
8 Interlac drops btl 30
9 Intrizin drop 15 ml btl 43
10 Mycostatin drop 12 ml btl 170
11 Mycostatin drops 30 ml btl 102
12 Nymico drop btl 40
13 Sanmol drop 30 ml btl 129
14 Tempra drop 15 ml btl 50
15 Vometa drop 5 mg /10 ml btl 65
D. INFUS
1 3% sod.chloride(nacl) inj.bp btl 1,245
2 40% magnesium sulfate 25 ml btl 75
3 7,46% potassium chloride (kcl) 25 ml btl 1,175
 4 Aminofluid 500 ml btl 990
5 Aminofusin hepar btl 75
6 Aminofusin l-600 btl 35
7 Aminofusin paed btl 45
8 Aminovel 600 btl gelas / 500ml btl 20
9 Asering 500 ml btl 6,945
10 Atrovent 0.25% sol 20 ml btl 60
11 Avelox iv 250 ml btl 105
12 Ceremax btl 46
13 Ciprofloxacin 0,2 inf btl 265
14 Clinimix 1000 ml btl 239
15 Clinoleic 20 % 250 ml btl 239
16 Comafusin hepar btl 194
17 Cravit iv 100 ml / 500 mg btl 80
18 Cravit iv 750 mg btl 535
19 Difloxin inf 100 ml btl 375
20 Diflucan iv 100 ml btl 35
21 Farmadol infus btl 1,985
22 Flagyl infuse 100 ml btl 353
23 Gelafusal infus 500 ml btl 200
24 Kabiven peripheral btl 45
25 Ka-en 1b sol 500 ml btl 420
26 Ka-en 3a 500 ml btl 97
27 Ka-en 3b / kk 500 ml btl 175
28 Ka-en mg3 sol 500 ml btl 735
29 Kalbamin 500 ml btl 85
30 Kidmin 200 ml btl 95
31 Levocin inf btl 200
32 Levofloxacin infus' btl 241
33 Manitol 20% / 500 ml btl 230
34 Metronidazole inf 100 ml btl 623
35 Neurotam inf 12 gr/60 ml btl 326
36 Otsu - ns / plastik 500 ml / nacl 0,9% btl 6,577
37 Otsu d5 piggyback 100 ml btl 130
38 Otsu ns 1000 ml btl 697
39 Otsu ns piggyback 100 ml btl 6,035
40 Plasbumin 25% / 100 ml btl 75
41 Sanbe hest inf btl 55
42 Sanmol infus btl 2,420
43 Tevox infus 500mg (btl/100ml) btl 266
44 Totilac inf 6's btl 160
45 Trichodazole inf btl 675
46 Tutofusin ops 500 ml 5's btl 128
47 Voluven inf 500 ml btl 255
48 Wida 1/2 dad 500 ml btl 10
49 Wida d10 / 500 ml btl 77
50 Wida d5 - ns 500 ml btl 677
51 Wida d5 1/2 ns 500 ml btl 851
52 Wida d5 500 ml btl 519
53 Wida d5.1/4 ns 500 ml btl 243
54 Wida rd 500 ml btl 499
55 Wida rl 500 ml btl 3,975
56 Wida rs 500 ml btl 3,130
57 Zemyc inf btl 75
58 Zyvox infus 600 mg btl 105
E. INJEKSI
1 Cidex 1 ltr - scx1410001 btl 62
2 0,9% sodium chloride 25 ml (ns 25) btl 642
3 40% dextrose 25 ml btl 631
4 Acran inj 2 ml 5's vial 765
5 Actrapid hm 100 iu vial 30
6 Adona (ac-17) inj 10 ml 10's vial 295
7 Albumin behring 100 ml vial 143
8 Alinamin f inj 5's vial 730
 9 Aminoleban inj 500 cc vial 75
10 Aminophylin 2,4 % inj 24's vial 466
11 Amiparen inj 500 ml vial 116
12 Apidra solostar 5's vial 45
13 Aqua steril 1000 / otsuka vial 775
14 Aquabidest 20 ml 10's vial 7,520
15 Aquacell ag vial 115
16 Arixtra 2,5 mg inj 2's vial 20
17 Artem inj 1 ml 6's vial 20
18 Atropin 0,25 mg/ml inj (sa) 100's vial 1,615
19 Bactesyn inj 1,5 gr vial 44
20 Beclov 250 inj 5's vial 4,576
21 Biotriax 1 gr vial 177
22 Bisolvon amp 10's vial 2,955
23 Brainact 500 inj 5's vial 1,410
24 Broadced hp vial 426
25 Bunascan spinal 0,5% 5's vial 285
26 Buscopan 20 mg amp 10's vial 643
27 Ca gluconas 10% 24'amp vial 130
28 Cefnos 1 gr inj vial 443
29 Cefobactam 1 gr inj vial 209
30 Cefoperazone 1 gr inj 2's vial 85
31 Ceforim 1 gr vial 132
32 Cefotaxim 1 gr inj 2's vial 168
33 Ceftazidime 1 gr 2's vial 216
34 Ceftriaxon 1 gr inj 2's vial 4,146
35 Cernevit inj vial 620
36 Ceteron 8 mg inj 5's vial 1,465
37 Cidex 5 ltr - opa sol vial 55
38 Cidex 5 ltr - scx1450001 vial 60
39 Claforan 1 gr vial 175
40 Cordarone inj 3 ml 6's vial 200
41 Crome inj 50 mg 10's vial 591
42 Dobuject 250 mg/5 ml 5's vial 421
43 Dopac inj 5's vial 55
44 Dynastat inj 40 mg vial 499
45 Ecalta inj 100 mg vial 3
46 Ecron 10 mg inj vial 145
47 Engerix-b inj 0,5 ml vial 7
48 Engerix-b inj. 20 mcg 1 ml vial 133
49 Ephedrin hcl 1 ml 10's vial 215
50 Epinephrine inj 0,1% 1ml 100's vial 1,410
51 Farbivent inj 10's vial 906
52 Fargoxin inj vial 35
53 Farmabes inj vial 332
54 Fentanyl 0,05 mg / 2 ml vial 1,015
55 Flamicort 10 mg inj vial 33
56 Flamicort 40 mg inj vial 220
57 Flixotide nebules 2ml 10's vial 1,715
58 Fluxum 0,4 vial 132
59 Fluxum 0,6 vial 86
60 Fortum 1 gr inj vial 8
61 Fosmicin inj. 1 gr vial 97
62 Fosmicin inj. 2 gr vial 79
63 Glyceryl tri. 50mg/10m vial 19
64 Guardix vial 1
65 H2o2 vial 4,000
66 Hepa-merz inj 5's vial 275
67 Hexilon 125 mg inj vial 605
68 Ikadryl inj vial 315
69 Imipenem cilastatin 1g inj vial 33
70 Intrix 1 gr inj vial 575
71 Inviclot inj vial 40
72 Isoket solution 0,1% inj 10's vial 39
 73 Kalmethasone 5 mg inj 5's vial 730
74 Kanamycin inj. 1 gr / meiji / sanbe vial 515
75 Ketalar inj 100 mg/10 ml vial 10
76 Ketesse inj 50 mg 5's vial 1,160
77 Ketorolac inj vial 2,620
78 Kutoin inj 10's vial 460
79 Lantus solostar 5's vial 66
80 Lasix ampul 2 ml 5's vial 10,390
81 Levemir 5's vial 51
82 Lidocaine 2% comp 2 ml inj 100's vial 3,226
83 Lodomer inj 5 mg 12's vial 75
84 Lovenox 40 mg / 0,4 ml 2's vial 197
85 Lovenox 60 mg / 0,6 ml 2's vial 301
86 Marcain 0,50% pdf 20 ml 5's vial 108
87 Merofen 1 gr vial 146
88 Merofenem 1 gr inj vial 2,295
89 Merofenem 500 mg inj vial 310
90 Meronem i.v. 1 gr vial 56
91 Merosan 0.5 mg vial 77
92 Merosan 1 gr inj vial 309
93 Methycobal inj 500 mg 10's vial 355
94 Methyl prednisolon inj 125 mg vial 130
95 Meylon 8,4% 25 ml vial 195
96 Miacalcic 100 iu 5's vial 5
97 Microshield 5 ltr vial 33
98 Mikasin 500 mg inj vial 477
99 Morphin 10 mg inj 10's vial 165
100 N-ace inj 5's vial 316
101 Narfoz 4 mg inj 5's vial 562
102 Narfoz 8 mg inj 5's vial 1,901
103 Naropin 7.5 mg/20 ml 5's vial 44
104 Neo-k phytonadine 5's vial 650
105 Neurobion 5000 dual amp 20's vial 2,135
106 Neurosanbe inj 10's vial 2,277
107 Neurotam 1 gr inj 10's vial 44
108 Neurotam inj 3 gr 4's vial 320
109 Nexium 40 mg inj vial 467
110 Nicholin 250 mg inj 5's vial 199
111 Novalgin inj 2 ml 5's vial 1,768
112 Novomix-30 5's vial 60
113 Novorapid flexpen 5's vial 165
114 Opigran 3 mg inj 5's vial 950
115 Orasic inj 5's vial 199
116 Ottozol serbuk inj vial 593
117 Pantocer 40 mg inj vial 680
118 Panto-gas serbuk inj vial 102
119 Pantoprazole 40 mg inj vial 155
120 Pantozol iv inj vial 4,562
121 Pehacain inj 20's vial 1,310
122 Penicillin g.cryst. vial 5
123 Pethidin hcl 50 mg inj 10's vial 208
124 Pharodime inj vial 277
125 Primperan inj 6's vial 1,220
126 Prosogan inj vial 50
127 Prostigmin inj 0,5 mg 5's vial 155
128 Pulmicort resp. 0,25 mg/ml 20's vial 222
129 Pulmicort resp. 0,50 mg/2 ml 20's vial 356
130 Pumpisel inj vial 1,792
131 Pumpitor dry inj vial 755
132 Pybactam inj 4.5 vial 149
133 Ranitidine inj 25 mg 10's/100's vial 2,310
134 Rantin 50 mg inj 5's vial 877
135 Rativol inj 5's vial 391
136 Recofol n 10 mg/20 ml 5's vial 288
137 Renadinac-75 inj 5's vial 644
138 Rinofer inj 5's vial 5
139 Ronem 1g inj 2's vial 289
140 Sagestam inj 2 ml 5's vial 246
141 Sandostatin amp 0,1 mg 5's vial 11
142 Scelto 30 mg inj 5's vial 1,255
143 Sedacum inj 15 mg/3 ml 5's vial 259
144 Semax 0,1% sol 3 ml vial 18
145 Serum ats 1.500 iu vial 149
146 Sharox-750 inj 2's vial 66
147 Somanovell dry inj vial 51
148 Stabactam inj 2's vial 119
149 Stabixin injeksi 2's vial 79
150 Stardine sol 1 ltr vial 26
151 Stesolid inj 2ml 5's vial 351
152 Streptomycin inj 1 gr vial 53
153 Sulperazon im/iv 1g vial 55
154 Syntocinon 1 ml inj 10's vial 144
155 Taxegram inj 0.5 gr vial 159
156 Taxegram inj 1 gr 27"s vial 262
157 Tensilo inj vial 955
158 Terfacef inj vial 2,866
159 Tetagam vial 432
160 Tioxad inj 10's vial 741
161 Torasic 30 mg inj 6's vial 455
162 Tramal inj 100 5's vial 365
163 Tranexid 500 inj 10's vial 2,265
164 Trichodazol supp 6's vial 65
165 Trovensis inj 4 ml 5's vial 1,381
166 Tygacil 50 mg inj 10's vial 90
167 Vaks.jerap tetanus/toksoid tet vial 90
168 Valium inj 10 mg 5's vial 96
169 Vancep inj 2's vial 85
170 Vascon 4 mg inj 5's vial 1,973
171 Ventolin nebules 2,5 mg 20's vial 1,991
172 Verorab reguler 0,5 ml 2's/5's vial 135
173 Viccilin injeksi vial 55
174 Viccilin sx 1500 mg inj vial 71
175 Vipime i gr vial 33
176 Vit. C inj 100's vial 306
177 Voltaren inj 75 mg/3 ml 5's vial 42
178 Xylocaine 2% inj 20 ml 100's vial 1,409
179 Zantac 2 ml inj 5's vial 643
180 Zibac 1 gr inj 2's vial 1,059
F. OBAT ORAL
1 Livercare caps 30's caps 2,104
2 Abbotic granules syr 250 mg/50 ml btl 35
3 Abbotic granules syr 30 ml btl 35
4 Acetram fc tab 10's tab 1,835
5 Acitral liquid 120 ml btl 26
6 Acitral tab 100's tab 420
7 Acpulsif 5 mg 50's tab 610
8 Acran 150 tab 30's tab 1,299
9 Acran 300 tab tab 7
10 Actifed syrup 60 ml btl 123
11 Actonel 35 mg tab 4's tab 35
12 Actos 30 mg tab 80
13 Acyclovir 200 mg tab 100's tab 625
14 Acyclovir 400 mg tab 100's tab 2,103
15 Adalat oros 30 mg 30's tab 105
16 Afamed caps 30's caps 2,278
17 Akilen 200 mg tab 30's tab 75
18 Akilen 400 mg tab 30's tab 45
19 Albothyl concentrate 10 ml btl 33
20 Alloris tab 100's tab 815
21 Allupurinol 100 mg 100's tab 2,275
22 Allupurinol 300 mg 100's/30's tab 745
23 Amaryl 1 mg tab 50's tab 455
24 Amaryl 2 mg tab 50's tab 195
25 Amaryl 3 mg 50's tab 335
26 Amaryl 4 mg tab tab 301
27 Amaryl m 1/250 mg'30 tab 206
28 Amaryl m 2/500 mg 30's tab 988
29 Ambroxol 30 mg 100's tab 2,015
30 Amcor 10 tab 2,018
31 Amcor 5 mg tab 30's tab 8,099
32 Aminophyllin 200 mg tab 215
33 Amitriptyline 25 mg tab 100's tab 513
34 Amlodipine 10 mg tab 100's tab 4,019
35 Amlodipine 5 mg 100's tab 7,099
36 Amoxsan 500 mg caps 100's caps 515
37 Amoxsan ds 60 ml / 125 mg btl 4
38 Amoxsan forte ds 60 ml 250 mg btl 30
39 Amoxycillin 125 mg/5 ml syrup btl 69
40 Amoxycillin 500 mg kapl 100's tab 912
41 Anadex dragee 100's tab 313
42 Analsik caplt 100's caps 5,435
43 Anbacim cap 500 mg 20's caps 177
44 Angioten 50 mg tab 86
45 Antasida doen susp 60 ml btl 110
46 Antasida doen tab 1000's tab 1,250
47 Apialys syr. 100 ml btl 8
48 Aprion 150 mg caps 20's caps 1,835
49 Aprovel 150 mg tab 28's tab 462
50 Aprovel 300 mg tab'28 tab 80
51 Arava 20 mg 30's tab 264
52 Arcoxia 120 mg tab 30's tab 2,198
53 Arcoxia 60 mg tab 30's tab 453
54 Arcoxia 90 mg tab 30's tab 1,449
55 Asam mefenamat 500 mg 100's tab 1,920
56 Aspar (k) tab 100's tab 6,862
57 Ativan tab 2,0 mg 100's tab 805
58 Ativan tab. 1,0 mg 100's tab 515
59 Atofar 10 mg tab 20
60 Atorsan 10 mg 30's tab 205
61 Atorsan 20 mg tab 30's tab 4,226
62 Atorvastatin 20 mg tab 30's tab 85
63 Atp dankos tab tab 76
64 Augmentin 1000 mg 14's tab 79
65 Augmentin forte syr btl 3
66 Augmentin syr 60 ml btl 19
67 Avamys nasal spray btl 46
68 Avelox tab 5's tab 489
69 Azithromycin syr 200 mg/5 ml btl 7
70 Baquinor 250 mg tab 20's tab 92
71 Baquinor forte 500 caplt 20's tab 1,689
72 Becom c caplt 100's tab 1,829
73 Becom zet caplt'100 tab 130
74 Becombion forte 100's tab 320
75 Bekarbon / norit tab 40'p tab 156
76 Betaserc 24 mg 20's tab 2,592
77 Bicrolid 250 mg kapl 30's tab 66
78 Bicrolid 500 mg kapl 30's tab 543
79 Binozyt 500 mg tab 3's tab 289
80 Bio curliv kapl 30's tab 362
81 Biobran tab 30's tab 1,531
82 Biodiar 630 mg tab tab 2,720
83 Biosanbe caps 100's tab 509
 84 Biostrath elix syr 100 ml btl 89
85 Biothicol 250 mg caps 100's tab 106
86 Biothicol 500 mg caps 100's tab 1,409
87 Biothicol dry syr btl 29
88 Biothicol forte dry syr btl 31
89 Bisolvon 8 mg tab 100's tab 408
90 Bisolvon elx syr 60 ml btl 44
91 Bisoprolol 5 mg 30's tab 1,899
92 Bmt regular 400 gr btl 46
93 Brainact oral 500 tab 30's tab 3,371
94 Braxidin tab 100's tab 2,416
95 Bufect forte susp syr 50 ml btl 122
96 Bufect susp syr 60 ml btl 106
97 Buscopan 10 mg 100's tab 809
98 Buscopan plus fct tab 100's tab 1,105
99 Calcium lactat 500 mg tab 106
100 Calsivas 10 mg 30's tab 1,377
101 Calsivas 5 mg 30's tab 2,761
102 Canderin 16 mg 30's tab 789
103 Canderin 8 mg 30's tab 274
104 Capsul kosong caps 31,034
105 Captopril 12,5 mg 100's tab 1,352
106 Captopril 25 mg 100's tab 2,103
107 Cardio aspirin tab 30's tab 2,404
108 Cardura 2 mg tab 11
109 Cartogen caps 30's tab 175
110 Cataflam 25 mg 50's tab 206
111 Cataflam 50 mg tab 50's tab 1,409
112 Cavit d3 tab 100's tab 1,701
113 Cdr roche btl 46
114 Cedocard 10 mg tab 60's tab 1,262
115 Cedocard 5 mg tab 60's tab 9,246
116 Cefadroxil 500 mg 100's tab 3,518
117 Cefadroxil dry syr 60 ml btl 77
118 Cefat 500 mg caps 100's tab 1,407
119 Cefat dry syrup btl 55
120 Cefat forte dry syr btl 50
121 Cefixime 100 mg tab 30's tab 906
122 Cefixime 200 mg tab 30's tab 3,310
123 Cefixime dry syr btl 143
124 Cefspan 100 mg kaps 30's tab 305
125 Cefspan 200 mg tab 10's tab 2,612
126 Cefspan dry syrup 30 ml btl 109
127 Celebrex 200 mg 30's tab 3,427
128 Celestamine syr 60 ml btl 44
129 Celestamine tab 30/150's tab 961
130 Cerini tab 20's tab 1,877
131 Cester capl 30's tab 159
132 Ceteron 4 mg tab 12's tab 622
133 Cetinal 10 mg tab 30's tab 1,655
134 Cetinal syr 60 ml btl 73
135 Cetirizine 10 mg tab 30's tab 1,244
136 Chloramphenicol 250 mg tab 406
137 Chlorpheniramine 4 mg tab 1000's tab 3,010
138 Chlorpromazine 100 mg tab tab 477
139 Ciprofloxacin 500 mg 100's tab 8,015
140 Ciproxin 500 mg tab 20's tab 223
141 Ciproxin xr 500 mg 10's tab 41
142 Claneksi capl 30's tab 1,506
143 Claneksi dry syrup btl 55
144 Claneksi forte dry syr btl 91
145 Claritin tab 30's tab 431
146 Clavamox 500 mg 30's tab 122
147 Clavamox ds syr 60 ml btl 3
148 Climadan 300 mg 50's tab 816
149 Clindamycin 300 mg 50's tab 1,853
150 Clobazam 10 mg 100's tab 801
151 Clopidogrel 75 mg tab 30's tab 763
152 Co amoxiclave 625 mg 30's tab 643
153 Co aprovel 150/12.5 mg 28's tab 312
154 Co aprovel 300/12.5 mg'28 tab 93
155 Coartem 20/120 tab 24's tab 144
156 Codein 10 mg 100's tab 806
157 Codein 20 mg tab 100's tab 1,302
158 Codipront cap 100's tab 812
159 Codipront cum expect cap 10's tab 707
160 Codipront cum expect syr btl 88
161 Codipront syrup 60 ml btl 50
162 Cohistan exp 60 ml btl 43
163 Colistine tab 1,5 miu/ 50's tab 403
164 Colistine tabs 0,25 miu/ 100's tab 110
165 Comtro 250 mg tab 20's tab 1,443
166 Comtro syr 30 ml btl 26
167 Comtusi syr 60 ml btl 22
168 Concor 2,5 mg 100's tab 2,379
169 Concor 5 mg 100's tab 406
170 Cordarone tab 30's tab 469
171 Cortidex tab 100's tab 2,253
172 Cotrimoxazole 120 mg/ml susp. btl 26
173 Cotrimoxazole 480 mg tab 100's tab 910
174 Cpg blister tab 30's tab 542
175 Cravit 250 mg 10's tab 122
176 Cravit 500 mg tab 10's tab 1,999
177 Crestor 10 mg 28's tab 226
178 Crestor 20 mg 28's tab 1,446
179 Crome 10 mg tab 100's tab 103
180 Curcuma fct tab 100's tab 624
181 Curliv plus kapl 60's tab 321
182 Curvit cl emulsion 175 ml btl 23
183 Curvit syr 60 ml btl 29
184 Damaben tab tab 77
185 Dansera tab 100's tab 6,473
186 Darvon tab 100's tab 906
187 Degirol tab tab 88
188 Dehaf sach 6's tab 436
189 Depakene syr 250 mg/5 ml btl 79
190 Depakote er 500 mg 100's tab 204
191 Dexaflox 400 mg tab 30's tab 126
192 Dexamethasone 0,5 mg tab 1,009
193 Dextamin 100's tab 503
194 Dextamin syr. 60 ml btl 3
195 Diamicron mr 60 mg 30's tab 410
196 Diazepam 2 mg tab 100's tab 6
197 Difloxin 500 mg 10's tab 2,316
198 Digoxin tab.0,25 mg 100's tab 110
199 Dilantin kapsl. 100 mg tab 206
200 Diltiazem 30 mg tab 100's tab 407
201 Disflatyl tab 100's tab 1,852
202 Dolo neurobion ct 100's tab 5,043
203 Domperidon 10 mg tab 100's tab 4,550
204 Doxycycline 100 mg 100's tab 109
205 Dramasine tab 77
206 Dulcolax 5 mg supp anak supp 10
207 Dulcolax 5 mg tab 200's supp 603
208 Dulcolax supp ad 10 mg 50's supp 207
209 Dumin rectal tube 250mg/4ml tube 41
210 Dumin rt 125mg/2,5ml 5's btl 33
211 Durogesic 12,5 mg 5's tab 102
212 Durogesic 50 mg 5's tab 6
213 Durogesik 25 mg 5's tab 83
214 Eflagen 25 mg 50's tab 51
215 Eflagen 50 mg 50's tab 106
216 Eliquis 2.5 mg tab 20's tab 583
217 Elkana cl emulsi 120 ml btl 32
218 Elkana syr btl 15
219 Elkana tab 100's tab 106
220 Epexol 30 mg tab 100's tab 1,018
221 Epexol syr 120 ml btl 22
222 Equal 100'cc tab 403
223 Ericaf 30's/100's tab 1,766
224 Erysanbe 500 mg capl 100's tab 409
225 Erysanbe dry syr 60 ml btl 15
226 Esilgan 1 mg tab 100's tab 1,709
227 Esilgan 2 mg tab 100's tab 726
228 Ethambutol 500 tab 100's tab 801
229 Euphylin retard tab 100's tab 1,206
230 Ezetrol 10 mg tab 7
231 Faktu suppositories 10's tab 125
232 Farlev 750 kap 10's tab 315
233 Farmacrol forte syr 200 ml tab 203
234 Farmacrol forte tab 100's tab 3,506
235 Farsix tab 100's tab 1,803
236 Fenofibrate 100 mg tab 113
237 Fenofibrate 300 mg 30's tab 473
238 Fexofed kapl 30's tab 572
239 Flagyl forte 500 mg tab 100's tab 915
240 Flagyl oral suspen 60 ml btl 41
241 Flagyl suppo 1 gr 10's supp 22
242 Flagyl suppo 500 mg 10's supp 43
243 Flamar 25 mg tab 100's tab 206
244 Flamar 50 mg tab 100's tab 416
245 Fleet enema tube 907
246 Fleet phosphosoda tube 11
247 Fluimucil caps 200 mg 60's tab 1,881
248 Fluimucil dry syr 75 ml btl 33
249 Fluimucil eff 600 mg 10's tab 641
250 Fluimucil granule 200 mg 30's bks 992
251 Flutias 125 inhaler btl 104
252 Flutias 50 inhaler btl 32
253 Folavit 400 mg tab 100's tab 503
254 Folic acid tab 504
255 Forbetes 500 tab 210
256 Forbetes 850 tab 100's tab 1,304
257 Formyco tab 200 mg tab 30
258 Fortibi kaps 30's tab 310
259 Frego 10 mg tab 50's tab 710
260 Frego 5 mg tab 50's tab 1,903
261 Frisium tab 100's tab 1,115
262 Fucohelix 100 mg 20's tab 2,463
263 Fucohelix 50 mg 30's tab 365
264 Fucohelix syr 90 ml btl 22
265 Furosemide 40 mg "kf" tab 62
266 GG tab 208
267 Galvus tab 162
268 Galvusmet 50/500 mg 30's tab 2,488
269 Ganin 300 mg 30's tab 993
270 Garam inggris bks 101
271 Gentian violet tab 8
272 Glaucon tab 20's tab 810
273 Glibenclamide 5 mg 100's tab 906
274 Glimepiride 1 mg tab 10
275 Glisodine kapsul 30's tab 1,745
276 Glucobay 100 mg 50's tab 234
277 Glucobay 50 mg 50's tab 109
278 Glucophage 500 mg 100's tab 1,703
279 Glucophage 850 mg 120's tab 488
280 Glucophage xr 500 mg 120's tab 2,162
281 Glucophage xr 750 mg 120's tab 803
282 Glucovance 500/2.5 mg 100's tab 1,523
283 Gludepatic 500 mg 100's tab 2,703
284 Glurenorm 30 mg tab 100's tab 719
285 Haldol 5.0 mg tab 50's tab 203
286 Harnal 0.2 mg tab 28's tab 399
287 Harnal ocas 0.4 tab 30's tab 726
288 Hct 25 mg 100's tab 5,014
289 Hemobion caps 100's tab 708
290 Hepamax kaps 30's tab 5,143
291 Hepatosol lola tab 28
292 Hexymer 2 mg 250's tab 6,007
293 Hezandra capl 30's tab 103
294 Hibone 600 mg 30's tab 7,210
295 Histapan 50 mg tab 100's tab 310
296 Hystolan tab 15
297 Iberet folic 500 mg 100's tab 610
298 Ilos 100 mg tab 30's tab 610
299 Imboost force kapl 30's tab 901
300 Imboost force syr 60 ml btl 44
301 Imdur 60 mg tab 242
302 Imodium 2 mg tab 100's tab 810
303 Imunos kapl 20's tab 310
304 Imunos plus kapl 20's tab 723
305 Imunos plus syr 60 ml btl 53
306 Incidal od kaps 50's tab 203
307 Inh ciba tab 300 mg 100's tab 2,018
308 Inolin tab 100's tab 1,016
309 Inpepsa susp syr 200 ml btl 669
310 Interhistin syr. 60 ml btl 100
311 Interhistin tab 100's tab 610
312 Interzinc tab 10's tab 103
313 Intrizin syr 60 ml btl 63
314 Iodosorb powder tab 75
315 Irbesartan 300 mg tab 50's/30's tab 1,560
316 Irvask 150 mg 30's tab 954
317 Irvask 300 mg 30's tab 44
318 Isoprinosine 500 mg tab 8's tab 465
319 Isoprinosine syr 60 ml btl 25
320 Isoric 300 mg tab 20
321 Isosorbide dinitrat 5 mg tab 20
322 Ixor 150 mg 30's tab 155
323 Kalium diklofenak 25 mg 50's tab 455
324 Kalium diklofenak 50 mg 50's tab 2,316
325 Kalnex tab 500 mg 100's tab 1,607
326 Kaltrofen supp 10's tab 752
327 Keppra 500 mg tab 20's tab 653
328 Ketesse tab 50's tab 265
329 Ketoconazole 200 mg tab 50's tab 106
330 Ketosteril 100's tab 2,020
331 Ksr strip 600 mg 100's tab 3,681
332 Kutoin caps 100's tab 8,066
333 L bio sachet 30's tab 4,899
334 L zinc syr 100 ml btl 120
335 Lacbon tab 100's tab 3,067
336 Lacidofil tab 120
337 Lameson 4 mg tab 100's tab 3,609
338 Lameson 8 mg tab 100's tab 3,610
339 Lametic syr tab 16
340 Lanagogum kapsul 100's tab 2,023
341 Lancid tab 7
342 Lansoprazole 30 mg 20's tab 967
343 Lapibal 500 mg kaps 100's tab 1,209
344 Lapifed tab tab 34
345 Lapiflox tab 500 mg 30's tab 2,355
346 Lapimox kaplt 500 mg tab 213
347 Lapraz caps 20's tab 444
348 Lasal exp syr 100 ml btl 109
349 Lasix tab 100's tab 2,644
350 Lasmalin tab tab 11
351 Laxadine syr 60 ml btl 42
352 Lesichol 300 mg caps 60's tab 430
353 Lethira 500 20's tab 3,489
354 Letonal 100 mg tab 100's tab 810
355 Letonal 25 mg tab 100's tab 2,209
356 Levocin sanbe 500 18's tab 931
357 Levofloxacin 500 mg tab 30's/20's tab 2,320
358 Levopar tab 50's tab 5,461
359 Levopront syr 120 ml btl 186
360 Librax tab 100's tab 1,216
361 Lipanthyl penta 145 mg 30's tab 274
362 Lipanthyl supra 160 mg 30's tab 531
363 Lipitor 10 mg 30's tab 440
364 Lipitor 20 mg 30's tab 849
365 Lipitor 40 mg 30's tab 555
366 Listerine coolmint 250 ml tab 273
367 Lodia 2 mg tab 60's tab 1,448
368 Lodoz 2,5 mg tab 30's tab 192
369 Longatin cap 50 mg 100's tab 302
370 Longcef kaps 500 mg 30's tab 73
371 Longcef syr 125 mg / 60 ml btl 12
372 Longcef syr 250 mg 60 ml btl 12
373 Loratadine tab 50's tab 1,016
374 Losartan 50 mg 30's tab 1,091
375 Lupred tab 30's tab 430
376 Lycalvit syr 60 ml btl 10
377 Lyrica 75 mg caps 14's tab 283
378 Maintate 5 mg tab 10
379 Mefinal 500 mg capl 100's tab 3,425
380 Meiact 200 mg 20's tab 599
381 Meloxicam 15 mg 50's tab 821
382 Meloxicam 7,5 mg 50's tab 2,512
383 Meptin 0,025 mg tab tab 216
384 Meptin 0.05 mg tab tab 213
385 Meptin inh sol 0.5 ml tab 146
386 Meptin swinghaler btl 86
387 Meptin syr 60 ml btl 16
388 Merimac 450 mg 100's tab 615
389 Merimac 600 mg 50's tab 1,061
390 Merislon 6 mg 100's tab 1,212
391 Metformin 500 mg 100's tab 3,112
392 Methycobal 500 mg caps 100's tab 2,424
393 Methyl prednisolon 4 mg 100's tab 2,626
394 Methyl prednisolon 8 mg 100's tab 340
395 Metoclopramide 10 mg tab 52
396 Metronidazole 500 mg 100's tab 916
397 Mezatrin 250 mg caps 30's tab 216
398 Monecto 20 mg 30's tab 41
399 Motilium 1 mg/ml syr 60 ml btl 22
400 Motilium 10 mg tab 50's tab 5,156
401 Moxam 15 mg 30's tab 7,301
402 Moxam 7,5 mg 30's tab 516
403 Mst continus 10 mg 60's tab 810
404 Mst continus 15 mg 60's tab 132
405 Mucohexin 8 mg caps 100's tab 406
406 Mucohexin syr 120 ml btl 12
407 Mucopect 30 mg tab 100's tab 409
408 Mucopect retard 50's tab 164
409 Mucopect syr 15/5 60 ml btl 8
410 Mucopect syr 30/5 60 ml btl 20
411 Mucosta 100 mg tab 100's tab 11,175
412 Mylanta liquid 150 ml btl 33
413 Myonal tab 100's tab 3,216
414 Naprex syr 60 ml btl 195
415 Narfoz 4 mg tab 12's tab 595
416 Nasonex nasal spray 140 dose btl 33
417 Natrilix sr dragee 30's tab 382
418 Natto 10 kapl 30's tab 871
419 Nebacetin powder 5 gr bks 8
420 Neo diaform tab 351
421 Neo kaolana susp 120 ml btl 20
422 Neo mercazole tab 100's tab 3,406
423 Neulin ps tab 30's tab 3,062
424 Neuralgin tab 100's tab 761
425 Neuroaid kapsul 36's tab 666
426 Neurobion ct tab 250's tab 1,275
427 Neurobion forte ct 5000 tab 250's tab 1,532
428 Neurochol caps 50's tab 1,015
429 Neurofenac plus 100's tab 4,533
430 Neurosanbe 5000 tab 100's tab 3,075
431 Neurosanbe plus capl 100's tab 4,322
432 Neurosanbe tab 100's tab 1,715
433 Neurotam 1200 mg tab 50's tab 1,933
434 Neurotam 800 mg 50's tab 432
435 New diatabs 100's tab 1,410
436 Nexium 20 mg tab 28's tab 1,472
437 Nexium 40 mg tab 14's tab 2,216
438 Nifedipine 10 mg tab 100's tab 215
439 Niflec tab 75
440 Nifural syrup 60 ml btl 33
441 Nimotop tab 50's tab 391
442 Nitrokaf retard tab 56
443 Nodrof 100's tab 213
444 Nonflamin caps 60's tab 802
445 Norvask 10 mg 30's tab 285
446 Norvask 5 mg (regular) 30's tab 2,177
447 Novalgin syrup 60 ml btl 52
448 Noza kapl 100's tab 410
449 Nutribaby hypo allerg 400 g tab 3
450 Nutribaby pepti junior 400 g tab 26
451 Obh ika 100 ml btl 395
452 Obimin af blister tab 30's tab 982
453 Ob-ivy syr 100 ml btl 244
454 Obucort swinghaler btl 83
455 Ocuson tab 100's tab 633
456 Omeprazole 20 mg kaps 30's/20's tab 14,453
457 Onbrez inhaler 150 30"s btl 52
458 Opipentin 300 mg kaps 30's tab 72
459 Opisar 150 tab 30's tab 513
460 Opisar 300 tab 30's tab 792
461 Oralit 200 ml 100's btl 1,092
462 Osteocare liquid btl 7
463 Osteocare tab 30's tab 3,552
464 Pamol syr. 60 ml btl 11
465 Pan enteral 40 gr 10's tab 99
466 Panadol caplet 100's tab 1,715
467 Panadol extra 100's tab 312
468 Panadol syrup 60 ml btl 29
469 Pantocer 40 mg 30's tab 1,242
470 Pantozol 20 mg 7's tab 1,032
471 Pantozol 40 mg 7's tab 3,410
472 Paracetamol 120 mg/5 ml syr btl 185
473 Paracetamol 500 mg tab tab 4,016
474 Pariet 20 mg tab 14's tab 1,578
475 Pehavral 100's tab 2,109
476 Peptisol vanila klg 88
477 Pharolit 60's tab 673
478 Phenobarbital 30 mg tab 100's tab 6,010
479 Pionix m 500 tab 19
480 Piracetam 1200 mg tab 30's/100's tab 7,070
481 Piracetam 800 mg kap 100's tab 490
482 Piroxicam 10 mg 100's tab 106
483 Pk (kalium permanganat) tab 15
484 Pladogrel 30's tab 2,751
485 Plasmin 36's tab 6,477
486 Plavix 300 mg 10's tab 62
487 Plavix 75 mg 28's tab 999
488 Pletaal 100 mg tab 30's tab 795
489 Pletaal 50 mg tab 100's tab 1,015
490 Plexion 50 mg 100's tab 11,015
491 Polysilane kapsul 60's caps 312
492 Polysilane suspensi 180 ml btl 155
493 Polysilane tab 40's tab 1,299
494 Pospargin 0.125 tab 53
495 Pradaxa 150 mg 30's tab 302
496 Pralax syr btl 415
497 Prednison 5 mg tab tab 2,015
498 Prenamia capsl 100's tab 118
499 Primadol capl 100's tab 803
500 Primet tab 25 mg 100's tab 210
501 Primperan 10 mg tab 100's tab 713
502 Primperan 5 mg 100's tab 215
503 Primperan syr 50 ml btl 10
504 Probiokid 10's tab 216
505 Profenid sup.100 mg 10's btl 265
506 Profertil tab tab 12
507 Profibrat 200 mg 30's tab 477
508 Profibrat 300 mg 30's tab 410
509 Prome exp. 60 ml btl 33
510 Promedex syr 60 ml btl 83
511 Propranolol 10 mg tab 100's tab 4,385
512 Prorenal tab tab 66
513 Proris 200 mg kapl 50's tab 495
514 Proris supp 10's supp 201
515 Prosogan fd tab 15 mg 28's tab 155
516 Prosogan fd tab 30 mg 28's tab 465
517 Prospan syr 100 ml btl 82
518 Protos 28's tab 416
519 Prove-c tab 75
520 Provelyn 75 mg tab 14's tab 482
521 Provital plus tab 50's tab 2,710
522 Proxime tab 30's tab 3,815
523 Ptu 100 tab 235
524 Pulna forte fc tab 100's tab 3,519
525 Pumpitor caps 20's tab 933
526 Purubex caps 100's tab 45
527 Pyrazinamide 500 mg 100's tab 1,230
528 Qutan tab 30's tab 492
529 Ranitidine 150 mg tab 100's tab 8,138
530 Ranivel syr 60 ml btl 20
531 Rantin 150 mg tab 100's tab 1,312
532 Rebal plus caps 100's tab 3,123
533 Rebamipide 100 mg tab tab 141
534 Recolfar 0.5 tab 192
535 Redacid kapl 30's tab 703
536 Renalyte tab 212
537 Renapar tab 100's tab 412
538 Requip 4 mg 28's tab 713
539 Rhinofed tab 50's tab 1,160
540 Rhinos sr 50's tab 1,085
541 Rhodium tab 30's tab 2,232
542 Rifampicin 450 mg 100's tab 315
543 Rifampicin 600 mg kapl 100's tab 213
544 Riklona 100's tab 1,510
545 Rillus tab 30's tab 1,782
546 Rimactazid paed 50's tab 215
547 Rimactazid tab 450/300 mg 30's tab 2,677
548 Rimcure paed 60's tab 562
549 Rimstar 4-fdc 30's tab 9,785
550 Salbutamol 2 mg tab 100's tab 1,415
551 Salbutamol 4 mg tab 100's tab 403
552 Sanadryl 120 ml syr btl 110
553 Sanadryl 60 ml syr btl 93
554 Sanadryl plus 120 ml btl 88
555 Sanadryl plus 60 ml btl 65
556 Sanaflu plus batuk syr btl 43
557 Sanazet 500 mg 100's tab 112
558 Sanmag susp 120 ml syr btl 45
559 Sanmag tab 100's tab 115
560 Sanmol 500 mg tab 100's tab 6,642
561 Sanmol syr 60 ml btl 136
562 Sanprima forte capl 100's tab 2,320
563 Sanprima syr btl 77
564 Santibi 500 mg tab 100's tab 67
565 Seebri breezhaler 30"s btl 102
566 Seretide discus 500 mg btl 210
567 Seretide inhaler 50 mg btl 10
568 Sibelium 10 mg tab 100's tab 215
569 Sibelium 5 mg tab 100's tab 2,013
570 Sibital 50 mg tab 100's tab 1,715
571 Siclidon 100 mg caps 20's tab 572
572 Simarc-2 100's tab 713
573 Simucil 200 mg 100's tab 3,715
574 Simvastatin 10 mg 50's/30's tab 3,777
575 Simvastatin 20 mg 50's tab 1,510
576 Siramid 500 mg 100's tab 3,610
577 Siran forte 600 mg 10"s tab 163
578 Sistenol capl 60's tab 1,132
579 Smecta 30's tab 645
580 Sodium bicarbonat 500 mg tab 942
581 Spiriva 2.5 mcg respimat tab 40
582 Spiriva combo pack pack 5
583 Sporetik 100 mg caps 30's tab 462
584 Sporetik dry syr btl 135
585 Starmuno kapl 30's tab 3,336
586 Starmuno syr 60 ml btl 82
587 Stesolid rt 10 mg 5's tab 49
588 Stesolid rt 5 mg 5's tab 66
589 Stesolid syrup/60 ml btl 36
590 Stilnox 10 mg tab 20's tab 2,820
591 Stobled caps 16's tab 2,577
592 Sumagesic tab 100's tab 11,472
593 Susu ensure fosvan 1000 gr klg 3
594 Sysmuco tab 30's tab 6,841
595 Tantum verde oral rinse 120 ml btl 30
596 Tebokan tab 40 mg tab 102
597 Tegretol tab 200 mg 50's tab 112
598 Telfast hd 180 mg 10's tab 103
599 Telfast od 120 mg 100's tab 213
600 Telfast plus tab 100's tab 416
601 Tempra syr. 60 ml btl 55
602 Teosal tab 10
603 Tetracycline 250 mg kaps tab 254
604 Tetrasanbe 500 mg caps tab 63
605 Theobron ex 100 ml syr btl 212
606 Theragran - m 100's tab 2,282
607 Thiampenicol 500 mg 100's tab 310
608 Thiamycin caps 500 mg tab 83
609 Thrombo aspilets 150's tab 7,961
610 Tibitol 500 mg 100's tab 3,915
611 Toplexil syr 60 ml btl 20
612 Tradosik caps 100's tab 410
613 Trajenta 5 mg 30's tab 630
614 Trajenta duo tab 500 mg tab 23
615 Tramadol 50 mg caps 50's/100's tab 3,152
616 Tramal supp 10's supp 63
617 Tremenza tab 100's tab 2,816
618 Triatec 5 mg tab 103
619 Trichodazol 500 mg tab 100's tab 612
620 Trolip 300 mg 30's tab 623
621 Trolit sach 6's sach 220
622 Trovensis 8 mg 10's tab 103
623 Truxanthin 20's tab 1,206
624 Tuzalos capl 15 mg 100's tab 3,820
625 Twynsta 80/10 mg 28's tab 32
626 Twynsta 80/5 mg 28's tab 119
627 Ubi q 100 mg 30's tab 770
628 Ultravita capl 100's tab 413
629 Urdahex 30's tab 2,610
630 Urispas 200 mg tab 30's tab 314
631 Urogetix tab 75
632 Urotractin 400 mg caps 60's tab 315
633 Valeptik syr 120 ml btl 10
634 Valisanbe 2 mg tab 100's tab 106
635 Valisanbe 5 mg tab 100's tab 415
636 Venosmil 200 mg kaps 20's tab 265
637 Ventolin 2 mg tab 30's tab 641
638 Ventolin exp 100 ml btl 392
639 Ventolin syr 100 ml btl 55
640 Vestein 300 mg 20's tab 3,182
641 Vestein dry syr 60 ml btl 10
642 Vipalbumin 30's tab 6,753
643 Vipalbumin plus sach 3's sach 30
644 Vit a 10000 / 6000 unit tab 208
645 Vit b6 10 mg tab 2,019
646 Vit b6 25 mg tab 108
647 Vit. B complex tab tab 1,148
648 Vit. C tab 25 mg tab 1,014
649 Vit. K 10 mg tab tab 261
650 Vitazym tab 100's tab 3,110
651 Voltaren ec tab 50 mg 50's tab 260
652 Vometa flash tab 50's tab 5,430
653 Vometa syr 1 mg /60 ml btl 102
654 Vosedon susp syr 60 ml btl 31
655 Vosedon tab 100's tab 5,119
656 Vostem forte tab 30's tab 371
657 Vytorin 10/20 tab 30's tab 76
658 Xanax tab 1 mg 100's tab 415
659 Xanax tab. 0,50 mg 100's tab 2,406
660 Xanax tab.0,25 mg 100's tab 410
661 Xyzal tab 5 mg tab 328
662 Zaldiar 10's tab 2,162
663 Zanidip tab 10 mg tab 10
664 Zantac 150 mg tab 30's tab 461
665 Zegavit kapl 50's tab 109
666 Zigat 400 mg 10's tab 891
667 Zinnat 250 mg tab 10's tab 40
668 Zinnat 500 mg tab 10's tab 251
669 Zithrax 500 mg kapl 6's tab 140
670 Zitromax 500 mg fct tab 3's tab 443
671 Zitromax pos 600 / 15 ml btl 45
672 Zonegran 100 mg 100's tab 109
673 Zumafib micro 160 30's tab 986
674 Zyloric 100 mg tab 60's tab 452
675 Zyloric 300 mg tab 100's tab 1,206
676 Zypraz 0,5 mg 50's tab 1,288
677 Zypraz 0.25 mg 50's tab 1,315
678 Zypraz 1 mg 50's tab 3,440
 RENCANA PEMBIAYAAN SUMBER DAYA MANUSIA RS

NO JENIS PEMBIAYAAN RINCIAN TOTAL

1 2 3
1 Biaya Gaji
2 Biaya Insentif
2 Biaya Lembur
3 Biaya Penghargaan
3 Biaya Pengobatan
4 Biaya Pelatihan & pendidikan
a. Pelatihan Keterampilan perawat di unit critical care
- ICU
- OK
- UGD
b. Pelatihan untuk IPCN ( Infection Preventife Control Nurse )
c. Pelatihan Assesor Keperawatan
d. Pelatihan Perawatan luka
e. Pelatihan Manajemen
f. Pelatihan Pasien Safety
g. Pelatihan BHD
h. Pelatihan komunikasi efektif
i. Pelatihan peningkatan pemahaman akreditasi
 j. Pelatihan Keterampilan PSP2RS
5 Biaya Panitia-Panitia RS
BIAYA HONOR PENANGGUNG JAWAB UNIT PENUNJANG MEDIS
a. Honor Penanggung Jawab Unit Lab
b. Honor Penanggung Jawab Unit Fisiotherapy
c. Honor Penanggung Jawab Unit Ro & USG
6 Honor dokter Jaga
7 Pajak Honor Dokter
8 Honor Dokter Rawat inap
9 Alat dokter

RENCANA PEMBIAYAAN KEBUTUHAN PANITIA-PANITIA DIDALAM RS KASIH IBU

NO HARGA
NAMA BARANG / URAIAN KEGIATAN SATUAN JUMLAH TOTAL
SATUAN JUMLAH
1 PANITIA PPRA RS
PENGADAAN RUANGAN & FASILITAS 1
ATK
DIKLAT
KEBUTUHAN LAINNYA

2. PANITIA PONEK
N95

3. PANITIA HIV DAN DOTS TB

Apd (Buat Jenisnya)
Pelatihan Diklat
 4 PANITIA PKRS
Website

5 PMKP
SIM RS BERBASIS IT

RENCANA PEMBIAYAAN KEBUTUHAN INSTALASI/UNIT KERJA DIDALAM RS KASIH IBU

1 UNIT RAWAT INAP

Tim Pelayanan Geriatri
Nebulaiser
APD

2 Unit Radiologi :
Apron

UGD
EKG
Unit Laboratorium
Eye Washer

RENCANA PEMBIAYAAN PERKANTORAN & ADM RS

NO HARGA
NAMA BARANG / URAIAN KEGIATAN SATUAN JUMLAH TOTAL
 NAMA BARANG / URAIAN KEGIATAN SATUAN JUMLAH TOTAL
SATUAN JUMLAH
1 2 3 4 5 6
A. ALAT TULIS KANTOR
1 Amplop bks 120
2 Atom no. 3 box 25
3 Baterai kalkulator LR44 bh 10
4 Binder Clip 111 lsn 12
5 Binder Clip 155 lsn 12
6 Buku Ekspedisi lsn 15
7 Buku Ekspedisi STD lsn 15
8 Buku Folio 200 Ganda bh 55
9 Buku Folio 400 L bh 35
10 Buku tulis kuarto lsn 20
11 Buku Kustum lsn 50
12 Catridge EPSON bh 15
13 Catridge Tinta Hitam IP 2770 bh 12
14 Double Tip bh 24
15 Etona no. 11 box 18
16 Flasdisck 8 GB bh 8
17 Foto paper bks 20
18 HDD WDC 64 GB pcs 1
19 HDD WDC TB 64 GB pcs 1
20 Isi Ulang Tinta stempel pcs 48
21 Kabel Perpanjangan USB pcs 10
22 Kartu Absensi lbr 5000
23 Kertas Fax glg 36
24 Kertas HVS rim 120
25 Kertas Printer 2 ply ktk 50
26 Kertas Printer 3 ply ktk 36
27 Kertas Printer 1 ply ktk 5
28 Lakban bks 15
29 Lem bh 20
30 Map 312 lsn 20
31 Map 401 bh 15
32 Map 4033 bh 36
33 Map Besar bombi bh 50
34 Materai pcs 1000
35 Mouse Optical Logitech bh 10
36 Slasiban 2" bh 16
37 Pembatas Buku bh 550
38 Pena Ae7 Std lsn 70
39 Penghapus bh 50
40 Pita printer Epson LX-310 pcs 30
41 Plastik Laminating rim 5
42 Ribbon Catrdige LX 310 bh 12
43 Selotip 1/2 x 72 bh 24
44 Spidol hitam , merah , hijau , biru ktk 15
45 Kabel spiral bh 24
46 Spring File 312 bh 35
47 Stempel Otomatis pcs 12
48 Tinta Canon Aiflo btl 48
49 Tinta Mesin Fotokopi paket 12
50 Tinta Printer Epson bh 230
51 Tinta Printer Canon btl 200
52 Tinta Stempel bh 24
53 USB FD bh 5
54 USB HUB Port bh 5

B.BIAYA PERCETAKAN
1 Amlop Coklat Kecil lbr 5000
2 Amplop Hijau Kwitansi lbr 5000
3 Catatan Kunjungan Dokter / R.MEDIS buku 100
4 Catatan Medis Awal Rawat Inap / R. MEDIS set 10,000
5 Catatan R3x1 dihekter / R. MEDIS set 1,505
 6 Daftar Gaji rim 1
7 Daftar Hadir Rapat rim 3
8 Format Pengkajian 14 Hal / R. MEDIS set 252
9 Format Pengkajian RS / R. MEDIS set 2000
10 Format Team Time Out / R.MEDIS rim 2
11 HVS Kuning / R.MEDIS rim 9
12 HVS Merah / R. MEDIS rim 5
13 HVS Putih 60 Gr / R. MEDIS rim 40
14 Kartu Honor Dokter Biru lbr 1000
15 Kartu Honor Dokter Putih lbr 1000
16 Kartu Nama dokter poliklinik box 20
17 Kartu Pemeriksaan Khusus, Putih Folio / R.MEDIS lbr 1,000
18 Kartu Stok Biru lbr 1000
19 Kas Bon blok 200
20 Kop Surat R.S.U DELI rim 10
21 Kwitansi Lab rangkap 2 blok 46
22 Kwitansi P3k, rangkap 3 blok 160
23 Kwitansi RS. R2x50 blok 40
24 Laporan Anesthesi / R.MEDIS lbr 1000
25 Laporan EKG / R.MEDIS lbr 250
26 Map Biru Tebal / R.MEDIS lbr 4,500
27 Map Biru Tebal Full Color / R.MEDIS lbr 543
28 Map Hijau Tipis / R. MEDIS lbr 975
29 Map Putih / R. MEDIS lbr 1,294
30 Map Putih Tebal / R. MEDIS lbr 1,200
31 Map Putih Tebal THT / R. MEDIS lbr 646
32 Persetujuan Rawat Inap / R.MEDIS buku 15
33 Print & psg Roll Banner lbr 5
34 Register Pasien Rawat Inap / R.MEDIS rim 5
35 Resume Pasien Pulang / R.MEDIS blok 10
36 Rincian Rawat Mondok rim 55
37 Roll Banner RS uk. 85x200 cm set 1
38 Rujukan Pasien / R.MEDIS blok 20
39 Status Pasien / R. MEDIS rim 10
40 Stempel Kayu Besar bh 4
41 Stiker 2015 Biru Cyan / R.MEDIS lbr 10,000
42 Surat Konsultasi / R.MEDIS rim 12
43 Surat Pengantar Lab / R.MEDIS buku 150
44 Surat Persetujuan Perkiraan B.Operasi rim 5
45 Daftar Infus dan Balance Cairan rim 10
46 Daftar Obat Infus rim 5
47 Daftar Obat Oral rim 5
48 Label Obat Biasa rim 24
49 Stiker High Alert mata 5000
50 Stiker Infus Kertas lbr 10,000
51 Stiker LASA mata 4000
52 Stiker berkas pasien lbr 4,000
53 Etiket Makan Obat ( tablet, syrup , pemakaian luar ) rim 100
54 Resep Obat blok 700
55 ID Card Pegawai bh 250
56 ID Card Tamu diluar kunjungan bh 50
57 Formulir rencana asuhan keperawatan set 6000
58 Formulir sensus harian rim 30
59 Formulir persetujuan tindakan Pembiusan rim 30
60 Formulir Pengkajian Anak Rawat Inap set 6000
61 Formulir Resume pasien pulang rawat inap dokter buku 200
62 Formulir daftar DPJP rim 36
63 Formulir Sur veilans infeksi Nosokomial rim 36
64 Formulir Terapi Oral rim 36
65 Formulir catatan terintegrasi Rawat Jalan rim 36
66 Formulir catatan terintegrasi Rawat Inap rim 36
67 Formulir Catatan medis Gawat Darurat rim 36
68 Daftar Obat Injeksi , Supp , cream rim 36
69 Formulir Resiko Jatuh Dewasa rim 36
70 Formulir Daftar identifikasi pasien yang beresiko rim 36
71 Formulir pengkajian dekubitus rim 36
72 Formulir Surat Peralatan pengobatan rim 36
73 Formulir pengkajian resiko jatuh anak rim 36
74 DPJP dan case manager rim 36
75 Formulir persetujuan penolakan Transfusi Darah rim 36
76 surat Keterangan Opname buku 36
77 Formulir Pengkajian awal nyeri rim 20
78 Formulir surat keterangan istirahat Rawat Jalan buku 36
79 Formulir Persetujuan Opname rim 20
80 Formulir Tindakan Harian Perawat dan Bidan rim 10
81 Formulir manajemen pelayanan pasien rim 20
82 Formulir Kertas Saran rim 12
83 Formulir check list keselamatan pasien operasi rim 36
84 Formulir Identitas pasien rim 25
85 pencetakan buku pedoman u/ pegawai dan dokter buku 250
86 Stiker Rumah Sakit bks 50
87 Leaflet/ Banner Rumah Sakit lbr 250

C. PLN bln 12
D. PAM bln 12
E. Biaya Telephone & internet
2 Rekening Telepon bln 12
3 Pulsa telp untuk petugas Teknisi bln 12
4 Pulsa telp untuk Supir Ambulance bln 12
5 Pulsa telp untuk petugas Informasi bln 12
6 IP Internet pertahun
F. GAS ELPIJI
1 Gas Negara bln 12
2 Gas Elpiji 12 KG bh 15
G. BIAYA BBM AMB & GENSET
1 BBM Ambulance
2 BBM Genset
H. Biaya parkir bln 12
I. Biaya POS
J. Biaya sanitasi & dobi / Laundry
1 Abu pak 30
2 Alkohol 70% ml 300
3 Bayfresh btl 30
4 Baygon btl 20
5 Brus Closet bh 7
6 Brus Hitam bks 35
7 Brus Ijok bh 30
8 Brus Kain bh 50
9 Cairan Cuci Tangan Steril btl 15
10 Cairan Pembersih Kaca btl 10
11 Dashwashing Liquid 20 liter bh 25
12 Dustbin 30 ltr bh 2
13 Dustbin 50 ltr bh 3
14 Ember bh 10
15 Ember Bertutup bh 10
16 Floor Cleaner 20 ltr bh 20
17 Gaun / Apron ktk 12
18 Gayung bh 12
19 Goni Kosong bh 350
20 Hand Scoon ktk 300
21 HIT btl 24
22 Hypo ltr 465
23 Kaca Mata Pelindung bh 100
24 Kamper ltr 10
25 Kaporit cair ltr 240
26 Kaporit Tablet kg 150
27 Kapur Barus bks 145
28 Karbol ltr 500
29 Keset Kaki ptg 50
30 Masker biasa ktk 300
31 Micro Fabric grey bh 3
32 Mop Head bh 10
33 Penutup Kepala ktk 120
34 Plastik Asoi Hitam kg 300
35 Plastik Asoi Kuning kg 100
36 Plastik Hitam 75X85 kg 1100
37 Plastik Klep pack 10
38 Plastik Kuning 65X85 kg 950
39 Polytex kg 50
40 Pompa Wastafel bh 3
41 Porstex btl 50
42 Racun Tikus bks 20
43 Sabun Detergen bks 3000
44 Sabun Telepon pak 20
45 Sapu Nilon bh 20
46 Sapu Pel bh 10
47 Sepatu Boot psg 26
48 Sikat bh 50
49 Sikat lantai bh 10
50 Skop Sampah bh 10
51 Spare Microfiber Mop bh 6
52 Spon Busa bh 150
53 Stella btl 25
54 Sumbu Pel bh 12
55 Tong sampah injak SIP 710 pcs 48
56 Tong sampah injak SIP 720 pcs 3
57 Tong sampah injak SIP 725 pcs 24
58 Yuri Handsoap galon 23
59 Tissue Petak bks 500
60 Cairan Handrub btl 200
61 Biaya pembakaran limbah padat paket 12
62 pembuatan TPA
63 Biaya laporan limbah UKL & UPL paket 1 tahun

K. Biaya Perlengkapan CCTV

1 Camera CCTV unit 10
2 CCTV Outdoor bh 10
3 DVR 3 bh 2
4 HDD 1TB WDC unit 2
5 Jumper Kabel pcs 48
6 Kabel Conector CCTV bh 20
7 Timah , solder roll 5
L. Biaya Perlengkapan Tenun
1 Baju kamar operasi untuk dokter stel 12
2 Baju kamar operasi untuk perawat stel 12
3 Baju kamar Pasien di ICU stel 12
4 Duk operasi bh 50
5 Duk untuk pasien UGD bh 20
6 Sprei , sarung bantal set 140
7 Selimut / bed cover set 22
8 Karet Sprei bh 50
9 Bantal bh 70
10 Kain Perlak bh 140
11 Gordyn / Sekat T.tidur pasien , jendela set 5
M. Biaya keperluan kamar bedah
1 Cidex 1 ltr ltr 120
2 Parafin / steril alat ok btl 20
3 Hibiscrub 500 ml btl 24
4 Alat cukur bh 2
5 Steam indicator tape glg 10
M.Biaya perlengkapan listrik & K3
1 Baterai 6 V bh 4
 2 Baterai AA Metal Panasonic lsn 4
3 Baterai AA Panasonic bh 275
4 Baterai AAA Panasonic psg 200
5 Baterai Alkaline bh 24
6 Baterai Evolta Panasonic AAA ppn 120
7 Bola Lampu 10 W bh 10
8 Bola Lampu 6 W pcs 10
9 Bola Lampu Fujilight 15 W bh 300
10 Bola Lampu Fujilight 20 W bh 168
11 Bola Lampu Fujilight 35 W bh 50
12 Bola Lampu Fujilight 45 bh 50
13 DL 15 W bh 10
14 Imbodus bh 50
15 Jeck TV bh 50
16 Kabel Gepeng m 20
17 Kabel NYA 2,5 GL rol 36
18 Kabel NYM rol 24
19 Kabel Strika bh 10
20 Kabel Transparant m 20
21 Kap 40 W bh 3
22 Kunci Box Panel bh 3
23 Lampu Emergency bh 3
24 Lampu Led Merah bh 4
25 Lampu Pijar 40 W bh 4
26 Lampu Tornedo bh 4
27 Lampu UV 7 W bh 3
28 MCB 16 A bh 6
29 MCB 20 A bh 5
30 MCB 25 A bh 5
31 MCB 32 A bh 5
32 Over Steker bh 7
33 Panel 100 A bh 4
34 Panel 18 W pcs 80
35 Panel 250 A bh 4
36 Panel 40 A bh 3
37 Panel 50 A bh 5
38 Panel 60 A bh 3
39 Panel Fuse 400 A bh 5
40 Piting Duduk Philips bh 5
41 PL 15 W bh 384
42 PL 20 W bh 500
43 Plate Arde bh 7
44 Remote TV bh 7
45 S/K 3 lubang Uticon bh 3
46 S/K 4 lubang Uticon bh 5
47 S/K 5 lubang bh 4
48 S/K Arde bh 3
49 S/K segi Clipsal bh 11
50 S/K Segi VYBA bh 3
51 S/Seri bh 5
52 Saklar Tripel VYBA bh 5
53 Sceal Tape rol 12
54 Senter Cas Surya SYT L163 bh 2
55 Senter Cas Surya SYTL 161 bh 3
56 Slasiban Stealgrip bh 15
57 Solder Gun bh 1
58 Steker AC bh 5
59 Steker Arde Uticon bh 45
60 Steker T Arde Uticon bh 35
61 Setrika bh 1
62 T Duck btg 7
63 T4 28 W Hannoch set 2
64 T5 28 W Matsuna btg 2
65 T8 18 W led bh 5
66 Tang bh 1
67 TD 2 btg 3
68 TD 3 btg 6
69 Test Pen bh 12
70 TL 10 W Nyamuk bh 35
71 TL 18 W btg 45
72 TL 36 W bh 280
73 TL Ring 22 W bh 1
74 Trafo Panel Led 12 W bh 6
75 Grenda Bosch unit 1
76 Martil Karet bh 1
77 Meteran Besi bh 1
78 Obeng Ketok 6" pcs 2
79 Seal Tape roll 20
80 Senter Kepala FHL bh 1
81 Timah Solder roll 1
82 Tool Box bh 5
83 Racun Api ( isi ulang ) tbg
N. Biaya Pemeliharaan
1. Pemeliharaan Kendaraan
1 Ganti Ban Luar bh 8
2 Ganti Baterai GS bh
3 Ganti bola lampu halogen bh 10
4 Ganti Oli Amb paket 12
5 Service rutin dan ganti spare part
2. Pemeliharaan inventaris
1 Baterai HT
2 Ganti Penampungan tinta printer 20
3 Bongkar Pasang Genset Lama
4 Bungkus kulit + busa kursi 50
5 Ganti 8 pcs Roda Slide Window 8
6 Ganti Bak Cuci Piring 1
 7 Ganti Baterai UPS dan Charger 10
8 Ganti Busa & Bungkus Kursi K. Pasien 30
9 Ganti Cok Kabel Cas Genset
10 Ganti Connector Server
11 Ganti Door Close Dorma / pintu kaca
12 Ganti Engkol Kaca Jendela
13 Ganti HDD WDC 1 TB SATA II
14 Ganti Hub Port / conection
15 Ganti Kain Sandaran T.T. Pasien
16 Ganti Kaki Roda Berangkat
17 Ganti Otomatis Cas Genset
18 Ganti Pagar Pembatas Parkir 2,8 m
19 Ganti Roda T. Tidur
20 Ganti Selang Kompor Gas
21 Roda Gepeng 5" + Rem set 10
22 Roda Trolley set 10
23 Sarung Galon Aqua bh 50
24 Service 2 Mesin Tik rutin kali 4
25 Service Lift rutin kali 12
26 service rutin hardware & software paket 12
27 service rutin alat-alat radiologi paket 12
28 service rutin alat-alat kamar bedah paket 12
29 service rutin alat-alat kamar icu paket 12
30 kalibrasi alat kamar bedah
31 Ganti pintu kaca kamar bedah / engsel tanam unit 1
3. Pemeliharaan Kamar mandi
1 Bon-Bon dan Saringan
2 Bongkar Pasang Closet
3 Kran shower set 25
4 kran wastafel set 25
5 sifon leher angsa set 25
6 wastafel " toto " set 10
 7 stop kran kepala x set 5
8 selang fleksible set 25
9 Karet Closet set 100
10 sifon wasser set 25
11 kran tembok set 10
12 Ganti Selang Cebok set 25
13 Service Rutin Closet per2 bulan 6
4. Pemeliharaan Instalasi AC
1 Freon khusus ac daikin tbg 1
2 Service Cuci AC
3 Bongkar pasang dan biaya lainnya
5. Pemeliharaan Instalasi air
1 Pemasangan tangki air baru
2 Pergantian pipa air
3 Pasang Pompa Air
4 Ongkos bongkar pasang
5 Pemindahan Instalasi Mesin Saringan Air Minum
6 Pembersihan Sumur Bor
6. Pemeliharaan Gedung
1 Aqua Proof klg 6
2 Batu Bata bh 2000
3 Bearing BPH pcs 3
4 Cat Air Dulux klg 30
5 Cat Bee Brand klg 42
6 Ganti Keramik Dinding
7 Gypsum lbr 50
8 HPL Pearl White kpg 5
9 Kayu btg 24
10 Minyak Silinder klg 3
11 Pail Cat Catylac klg 15
12 Pail Dulux Catalac klg 15
13 Pail Siler ltr 2
14 Pasir motor 6
15 Poly Putih kpg 10
16 Semen zak 45
17 Siku Besi btg 4
18 Siku Besi ptg 35
19 Selang Nilon mtr 20
20 Tepung Dempul klg 5
21 Tepung Nat bks 3
22 Triplex kpg 20
23 Vinyl mtr 24
O.Biaya ADM Bank
P.Biaya Bunga Pinjaman Bank
Q.Biaya Perijinan & perpajakan , Iuran Tetap, lain-lain
1 Perpanjangan Kartu Induk Perusahaan
2 Perpanjangan K3 / pemeriksaan berkala
3 Perpanjangan ijin tenaga kerja dinas malam
4 Perpanjangan ijin Papan Reklame
5 Perpanjangan ijin TDP
6 Perpanjangan SIUP
7 Perpanjangan HO
8 Pemeriksaan sample air, makanan ( rutin )
9 Perpanjangan Merek " Deli "
10 Perpanjangan STNK mobil dinas
11 Biaya Konsultan Pajak
12 Biaya kontrak Pengharum Ruangan 12
13 Retribusi Sampah 12
14 Extra Iuran Sampah 12
15 Pajak Air Bawah Tanah 12
16 Iuran gg Kebakaran 12
17 Biaya Asuransi
18 Biaya lain- lain
R.Biaya Pajak penghasilan yang harus disetorkan
 Medan, Januari 2018
Diketahui Oleh
Direktur

dr. Muhammad Saiful Ahyar

RENCANA BIDANG INVESTASI / PENGEMBANGAN RS KASIH IBU

TAHUN 2018

NO. JENIS INVESTASI SATUAN JUMLAH HARGA SATUAN TOTAL

1 2 3 4 5
1 Pembuatan tangga pegangan tempat jemuran baju set 1
2 Pintu PVC 70 x 200 bh 10
3 Renovasi dapur
4 renovasi ruangan tambahan ruang 1 Panitia PRA
5 CR Merek Agfa / Radiologi set 1
6 Endoscopi set THT set 1
7 Peralatan medis set THT set 1
8 Instrumen THT set 1
9 Pulse Oximeter fingertip pcs 10
10 Reusable Anesthesi " Breathin " set 1
11 Tensimeter Nova - Presameter set 5
12 Tromol 36 cm set 1
13 Aesculap set bedah tulang / kamar bedah set 1
14 Sterilisator 42 CM SMIC pcs 4
15 AC 1 PK " Daikin " unit 15
16 AC 1,5 PK " Daikin unit 6
17 Pasang Instalasi AC Baru Tk. IV
18 Pompa air ESPA Pump bh 2
19 Rak dari papan dan kayu bh 1
20 Rak Dispenser bh 1
21 Kursi Olive bh 1
22 Alat Press botol limbah medis bh 1
23 Pintu besi tutup bak sampah / TPS bh 1
24 Rak limbah medis set 1
25 Vacum debu bh 1
26 Tilam busa tempahan 87 cm x 193 cm pcs 25
27 Ceret listrik pcs 1
28 Tilam Busa 100 x 200 x 13 pcs 3
29 Bingkai cermin dari Aluminium 90 x 170 set 2
30 Bingkai cermin dari Aluminium 90 x 140 set 2
31 Tapak meja steril 60 x 65 bh 1
32 DVR 16 CH " Manhatan " bh 1
33 Ozonator ( RMB 2.100 )
34 Pompa air " Hitachi " bh 1
35 Kursi " Futura " bh 1
36 Ent. Chair manual u/ Poli THT set 1
37 Meja meeting uno oval bh 1
38 Emergency Light 60 LED unit 20
39 Waste Basket / kernajnag baju pcs 5
40 Kursi putar sandaran rendah tanpa tangan bh 2
41 Meja Instrumen 2 TK bh 1
42 Wire Rope Elevator 220 mtr mtr
43 Dispenser " Miyako " bh 5
44 Lemari pakaian 2 pintu bh 1
45 Tangga Pasien bh 20
46 Exhausfan KDK WZ-56 P bh 10
47 Kulkas " Sanyo " bh 1
48 LED TV Chang Hong bh 12
49 Lemari Sayur 2 pintu / aluminum bh 1
50 Meja makan pasien / stainless steel bh 40
51 Jendela kaca rangka 52( 98 x 99 ) / Psiotherapi bh 1
52 Jendela Sliding Rangka 802 bh 2
53 Rak Rangka Aluminium / monitor OK unit 1
54 HDD Transcend 2 TB USB 3.0 bh 1
55 Player Android " Himeida " bh 1
56 Laminating Interfan A3 unit 1
57 Locker pintu kaca / pegawai bh 1
58 Mainboard HIS Intel bh 1
59 Media Player Xtreamer bh 1
60 Meja Kaki Besi + Triplek bh 1
61 Meja komputer model LMC - 83 bh 1
62 Meja lipat 120 x 80 cm bh 2
63 Meja piket bh 1
64 Meja Tulis 1 biro bh 2
65 Memory 2 GB DDR 2 bh 1
66 Notebook " Lenovo " bh 1
67 Printer Canon IP 2770 + Infus bh 10
68 Printer Direct Thermal 6,5 " / Informasi bh 1
69 Printer Epson L300 bh 4
70 Program sistem diagnosa pasien / RM paket 1
71 Rangka Aluminium Rak u/ UPS CT-Scan bh 1
72 Rangka Aluminium Rak u/ Printer CT-Scan bh 1
73 Rangka Aluminium Rak u/ UPS Alat THT bh 1
74 Stabilizer 5 KVA / CT-Scan bh 1
75 UPS ICA CE 1200 VA bh 5
76 Locker Rak Obat stainless steel unit 1
77 Locker Obat uk. 30 x 50 x 40 unit 1
78 Rak obat stainless steel 7 TK unit 1
79 Locker / barang pasien bh 1
80 Speaker + Mic set set 1
81 Trolley Emergency bh 3

TOTAL ………………………………………………….
Medan, Januari 2018
Diketahui Oleh
Direktur

dr. Muhammad Saiful Ahyar

3216 3 4 1361004 Rp 8 Rp 1,364,235 9
 REKAPAN ANGGARAN PEMBIAYAAN RS
TAHUN 2017

NO. URAIAN PEMBIAYAAN / URAIAN KEGIATAN JUMLAH BIAYA

1 BIAYA PELAYANAN PASIEN
a. Biaya konsumsi pasien
b. Biaya Keperluan pasien
c. Biaya Gas Medik
d. Biaya Penunjang Medis
e. pembelian obat-obatan
2 BIAYA SDM
a. Biaya Gaji
b. Biaya Insentif
c. Biaya Lembur
d. Biaya Penghargaan
e. Biaya Pengobatan
f. Biaya Pelatihan dan pendidikan
g. Biaya Honor penanggung jawab unit penunjang medis
h. Honor dokter Jaga
i. Pajak honor dokter
j. Honor dokter Rawat Inap
k. Alat Dokter
3 BIAYA PERKANTORAN & ADM
a.Biaya alat tulis kantor
b.Biaya Percetakan
c.Biaya PLN
d.Biaya PAM
e.Biaya Telp dan Internet
f.Biaya Gas Negara & Elpiji
g.Biaya BBM Amb & Genset
h.Biaya Parkir
i.Biaya POS
j.Biaya Sanitasi & Dobi / Laundry
k.Biaya Perlengkapan CCTV
l.Biaya Perlengkapan Tenun
m.Biaya keperluan kamar bedah
n.Biaya Perlengkapan listrik & K3
4 Biaya Pemeliharaan
- Pemeliharaan Kenderaan
- Pemeliharaan inventaris
- Pemeliharaan Kamar Mandi
- Pemeliharaan Instalasi AC
- Pemeliharaan Instalasi Air
- Pemeliharaan Gedung
5 Biaya ADM bank
6 Biaya Bunga pinjaman bank
7 Biaya lain-lain ( perizinan , konsultan , biaya tdk terduga)
8 Biaya pajak penghasilan yang harus disetorkan
Total Biaya yang di rencanakan …….
 REKAPITULASI REALISASI PENERIMAAN RS
TAHUN 2017

NO. URAIAN PENERIMAAN JUMLAH

1 2 3
I. UNIT RAWAT INAP
I.1. Penerimaan Kamar Rawatan
I.2.Penerimaan ICU
I.3.Penerimaan Administrasi dan Umum
I.4.Penerimaan Pemakaian Alat Medis
I.5.Penerimaan Lain-lain

II. UNIT RAWAT JALAN

II.1.Penerimaan UGD
II.2.Penerimaan Poliklinik
II.3.Penerimaan Pemakaian Alat Medis

III. UNIT KAMAR BEDAH

III.1.Penerimaan Sewa Kamar Bedah
III.2.Penerimaan Sewa Alat Medis Kamar Bedah

IV. UNIT KAMAR BERSALIN

IV.1.Penerimaan Kamar Rawat Bersalin
IV.2.Penerimaan Kamar Bersalin
IV.3.Penerimaan Kamar Baby & Inkubator
IV.4.Penerimaan Pemakaian Alat Medis

V. UNIT PENUNJANG
V.1.Penerimaan Unit USG
V.2.Penerimaan Unit RO"
V.3.Penerimaan Unit Laboratorium
V.4.Penerimaan Unit Psiotherapi
V.5.Penerimaan Fasilitas Ambulance

VI. UNIT FARMASI

VI.1.Penjualan Obat pasien R.Inap
VI.2.Penjualan Obat pasien R. Jalan

VII. HONOR DOKTER

VII.1.Pajak Honor Dokter
VII.2.Honor dokter Rawat Inap
VII.3.Alat Dokter
TOTAL RENCANA PENERIMAAN ……..
 REKAPAN RENCANA PENERIMAAN RS KASIH IBU
TAHUN 2018

NO. URAIAN PENERIMAAN JUMLAH

1 2 3
I. UNIT RAWAT INAP
I.1. Penerimaan Kamar Rawatan
I.2.Penerimaan ICU
I.3.Penerimaan Administrasi dan Umum
I.4.Penerimaan Pemakaian Alat Medis
I.5.Penerimaan Lain-lain

II. UNIT RAWAT JALAN

II.1.Penerimaan UGD
II.2.Penerimaan Poliklinik
II.3.Penerimaan Pemakaian Alat Medis

III. UNIT KAMAR BEDAH

III.1.Penerimaan Sewa Kamar Bedah
III.2.Penerimaan Sewa Alat Medis Kamar Bedah

IV. UNIT KAMAR BERSALIN

IV.1.Penerimaan Kamar Rawat Bersalin
IV.2.Penerimaan Kamar Bersalin
IV.3.Penerimaan Kamar Baby & Inkubator
IV.4.Penerimaan Pemakaian Alat Medis

V. UNIT PENUNJANG
V.1.Penerimaan Unit USG
V.2.Penerimaan Unit RO"
V.3.Penerimaan Unit Laboratorium
V.4.Penerimaan Unit Psiotherapi
V.5.Penerimaan Fasilitas Ambulance

VI. UNIT FARMASI

VI.1.Penjualan Obat pasien R.Inap
VI.2.Penjualan Obat pasien R. Jalan

VII. HONOR DOKTER

VII.1.Pajak Honor Dokter
VII.2.Honor dokter Rawat Inap
VII.3.Alat Dokter
TOTAL RENCANA PENERIMAAN ……..
 REKAPITULASI REALISASI BIAYA OPERASIONAL RS KASIH IBU
TAHUN 2018
NO. URAIAN PEMBIAYAAN / URAIAN KEGIATAN JUMLAH BIAYA
1 BIAYA PELAYANAN PASIEN
a. Biaya konsumsi pasien
b. Biaya Keperluan pasien
c. Biaya Gas Medik
d. Biaya Penunjang Medis
e. pembelian obat-obatan
2 BIAYA SDM
a. Biaya Gaji
b. Biaya Insentif
c. Biaya Lembur
d. Biaya Penghargaan
e. Biaya Pengobatan
f. Biaya Pelatihan dan pendidikan
g. Biaya Honor penanggung jawab unit penunjang medis
h. Honor dokter Jaga
i. Pajak honor dokter
j. Honor dokter Rawat Inap
k. Alat Dokter
3 BIAYA PERKANTORAN & ADM
a.Biaya alat tulis kantor
b.Biaya Percetakan
c.Biaya PLN
d.Biaya PAM
e.Biaya Telp dan Internet
f.Biaya Gas Negara & Elpiji
g.Biaya BBM Amb & Genset
h.Biaya Parkir
i.Biaya POS
j.Biaya Sanitasi & Dobi / Laundry
k.Biaya Perlengkapan CCTV
l.Biaya Perlengkapan Tenun
m.Biaya keperluan kamar bedah
n.Biaya Perlengkapan listrik & K3
4 Biaya Pemeliharaan
- Pemeliharaan Kenderaan
- Pemeliharaan inventaris
- Pemeliharaan Kamar Mandi
- Pemeliharaan Instalasi AC
- Pemeliharaan Instalasi Air
 - Pemeliharaan Gedung
5 Biaya ADM bank
6 Biaya Bunga pinjaman bank
7 Biaya lain-lain ( perizinan , konsultan , biaya tdk terduga)
8 Biaya pajak penghasilan yang harus disetorkan
Total Biaya yang di rencanakan …….