Rekap Pemakaian 2022

REKAPITULASI PEMAKAIAN
UPT. DINKES PUSKESMAS RIMBA AYU TAHUN 2023

KLAS HARGA JUMLAH PER-BULAN TOTAL
NO KODE OBAT NAMA SEDIAAN SATUAN EXP. DATE NO. BATCH JUMLAH KET
TERAPI SATUAN (Rp.) JAN FEB MAR APR MEI JUN JUL AGS SEP OKT NOP DES HARGA (Rp.)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
1 A001 6.1.1 Albendazol tablet 400 mg Tablet 30 April 2023 D10001BI 366 264 106 2,126 524 4 11 3,035 1,110,810 Pemakaian
2 A002 1.2 Alopurinol tablet 100 mg tablet 31 July 2023 HTA0A14211 89 480 340 720 765 950 3,255 289,695 Pemakaian
3 A003 1.2 Alopurinol tablet 300 mg tablet 31 December 2027 xxx 220 20 50 60 145 65 615 325 100 380 430 300 2,490 547,800
4 A004 - Alprazolam tablet 0,25 mg tablet 30 July 2027 XXX
5 A005 - Alprazolam tablet 0,5 mg tablet 30 November 2022 A92341 94 10 30 35 13 20 108 10,152
6 A006 - Alprazolam tablet 1 mg tablet 31 December 2025 xxx
7 A007 - Ambroxol sirup 15 mg/ml botol 30 September 2023 IM2010 4,886 50 93 50 39 68 300 1,465,800
8 A008 - Ambroxol tablet 30 mg tablet 30 September 2023 2209-01-146 111 94 110 204 22,644
9 A009 26.1 Aminofilin injeksi 24 mg/ml ampul 31 December 2025 85307016 3,349
10 A010 26.1 Aminofilin tablet 200 mg tablet 31 December 2025 2549011,1 153
11 A011 23.2 Amitripilin tablet salut 25 mg (HCI) tablet 30 November 2025 A1440 KY 175 15 36 10 40 30 75 206 36,050
12 A012 17.3 Amlodipin tablet 10 mg tablet 29 March 2025 D10459BJ 275 1,730 860 1,100 1,060 690 2,110 820 1,447 1,680 1,320 580 1,653 15,050 4,138,750
13 A013 17.3 Amlodipin tablet 5 mg tablet 31 May 2025 F10763BJ 55 2,010 1,200 1,510 1,070 580 2,075 1,185 3,065 1,880 1,210 2,955 18,740 1,030,700
14 A014 - Amoksisilin + As. Klavulanat 625 mg tablet tablet 31 December 2025 xxx 6,925
15 A015 6.2.1 Amoksisilin kaplet 250 mg kapsul 31 December 2025 xxx 388
16 A016 6.2.1 Amoksisilin kaplet 500 mg kaplet 31 July 2023 TAMXB12508 299 813 1,017 954 365 542 648 570 590 690 1,355 1,385 1,245 10,174 3,042,026
17 A017 6.2.1 Amoksisilin sirup kering 125 mg/5 ml botol 28 February 2023 B00058 2,050 35 27 33 28 26 22 47 104 92 104 93 142 753 1,543,650
18 A018 - Amoksisilin sirup kering forte 250 mg/5 ml botol 30 September 2025 1909-73-193 3,846
19 A019 6.2.1 Ampisillin serbuk injeksi iv 1000 mg/vial vial 30 November 2022 16436021BF 9,473 2 4 2 4 6 18 170,514
Antasida DOEN I tablet kunyah, Kombinasi :

20 A020 25.1 Aluminium Hidroksida 200 mg clan, Magnesium tablet 31 December 2022 A93350 60
Hidroksida 200 mg
Antasida DOEN II suspensi, Kombinasi : Aluminium

21 A021 25.1 Hidroksida 200 mg/ 5 ml clan, Magnesium botol 30 April 2025 D49208 3,025 54 49 52 50 75 89 94 102 131 97 7 800 2,420,000
Hidroksida 200 mg/5 ml
Anti bakteri DOEN salep kombinasi : Basitrasin 500

22 A022 18.2 tube 31 December 2027 xxx 5,000 10 10 50,000
IU/gr, Polimiksin 10.000 IU/g
Antifungi DOEN kombinasi : Asam Benzoat 6 % +

23 A023 18.3 pot 30 October 2023 195K009 5,517 14 24 11 4 2 2 57 314,469
Asam Salisilat 3 %
Antihemoroid DOEN kombinasi : Bismut Subgalat

24 A024 25.3 supp 31 December 2028 102968W 3,641 18 25 6 5 3 21 22 21 17 21 159 578,919
150 mg + Heksaklorofen 2.5 mg
Antiparkinson DOEN tablet kombinasi : Karbidopa

25 A025 9.0 tablet 30 June 2026 XXX
25 mg Levodopa 250 mg
26 A026 20.3 Aqua pro injeksi steril , bebas pirogen vial 25 ml 16 May 2023 85E50A 2,860 1 4 2 4 4 2 6 3 6 2 3 37 105,820
27 A027 20.3 Aqua pro injeksi steril , bebas pirogen_ vial 20 ml 31 December 2025 12IJ037 5,800
28 A028 - Artesunate dan Amodiaquine HCl Tab (Anak) tablet 1,856
29 A029 - Artesunate dan Amodiaquine HCl Tab (Dewasa) tablet 1,856
30 A030 - Artesunate dan Amodiaquine HCl Tab (Remaja) tablet 1,856
31 A031 - Artesunate injeksi ampul 29 June 2024 LA181007 52,350
32 A032 - Arthemeter injeksi ampul 23,384
Application SPORA v.1.02 print out 07/07/2023

14:09:47 REKAPITULASI
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
33 A033 - Asam Asetilsalisilat 80 mg) tablet 30 June 2024 A21031 132 50 60 30 40 200 40 100 160 80 230 990 130,680
34 A034 29 Asam Askorbat (Vitamin C) tablet 50 mg tablet 30 November 2023 21307111 92 780 1,620 610 1,225 1,191 1,500 2,950 5,050 2,943 3,780 1,190 22,839 2,101,188
35 A035 1.2 Asam Mefenamat kaplet 250 mg kapsul 166
36 A036 1.2 Asam Mefenamat kaplet 500 mg kaplet 31 July 2023 HTMECA14745 117 600 895 1,455 1,130 4,080 477,360
37 A037 - Asam Pipemidat tablet 400 mg kaplet 17 January 2024 T147L002 3,515 10 50 35 95 333,925
38 A038 10.2 Asam Traneksamat 500 mg/ml injeksi ampul 31 December 2025 BN 2661078 1,880
39 A039 10.2 Asam Traneksamat injeksi 100 mg/ml ampul 6 January 2023 4100166 2,374 3 10 13 30,862
40 A040 10.2 Asam Traneksamat tablet 500 mg tablet 31 August 2023 68304 1,927 60 70 40 50 30 30 280 539,560
41 A041 21.2 Asiklovir krim 5 % tube 31 March 2026 22AC3007 3,657 5 3 4 10 7 7 18 11 65 237,705
42 A042 21.2 Asiklovir tablet 200 mg tablet 30 November 2023 A13312V-k94071J 514 100 20 20 22 162 83,268
43 A043 21.2 Asiklovir tablet 400 mg tablet 30 September 2023 26304054 454 44 80 70 30 60 154 70 145 120 69 290 1,132 513,928
44 A044 - Atorvastatin 20 mg tablet 30 September 2027 XXX 471 12 60 30 102 48,042
45 A045 25.4 Atropin injeksi i.m./i.v./s.k. 0.25 mg/ml (sulfat) ampul 30 July 2024 9621G0175A 1,718 3 3 6 10,308
46 A046 - Attapulgite tablet 630 mg tablet 31 March 2023 20058602 481 8 20 4 28 60 28,860
47 B001 - Betahistin Mesilat tablet 6 mg tablet 31 March 2023 52B059 92 60 35 65 250 70 66 146 140 30 862 79,304
48 B002 18.4 Betametason krim 0.1 % (sebagai valerat) tube 31 March 2024 C20619W 1,533 3 3 7 6 16 15 19 14 18 30 28 20 179 274,407
49 B003 - Bisakodil 10 mg suppositoria supp 30 April 2024 20040342 5,900 1 8 9 53,100
50 B004 - Bisakodil 5 mg suppositoria supp 31 December 2025 15020298 5,670
51 B005 - Bisakodil tablet 5 mg tablet 31 May 2022 EDE096 216
52 B006 17.3 Bisoprolol tablet 5 mg tablet 31 December 2025 6070140 626 60 75 70 60 265 165,890
53 B007 - Borax Glycerin 10 % botol 31 October 2024 UO1102 3,498 1 5 5 1 3 2 1 5 23 80,454
54 C001 - Ca Glukonas injeksi i.v. 10 % ( 100 mg/ml ) ampul 31 May 2024 9621E0118A 8,855 2 3 2 1 1 9 79,695
55 C002 - Cefixim kapsul 100 mg kapsul 31 December 2025 PH048046 649
56 C003 - Cefixim sirup 100 ml / 5 ml botol 31 December 2025 PH358046 7,690
57 C004 - Cetirizine syrup 5 mg/5 ml botol 29 July 2023 JG2B11 2,215 48 40 22 42 44 43 46 89 97 49 10 82 612 1,355,580
58 C005 - Cetirizine tablet 10 mg tablet 31 August 2024 AB1421 81 780 530 1,230 760 925 875 1,652 1,593 1,335 1,860 841 12,381 1,002,861
59 C006 - Citicolin tablet 500 mg tablet 6,600
60 C007 - Clonidine tablet 0,15 mg tablet 31 December 2025 1506030 224
61 D001 3 Deksametason injeksi Lv. 5 mg/ml ampul 31 August 2026 F0G663 1,210 5 7 13 17 42 50,820
62 D002 16.4 Deksametason tablet 0.5 mg tablet 31 March 2024 2203-01-150 80 9 380 163 497 60 450 344 496 2,399 191,920
63 D003 11.2 Dekstran 70 - Larutan infus 6 % steril botol 31 December 2025 42G87 39,078
64 D004 18.4 Desoksimetason krim 0,25% tube 31 May 2024 4620896 9,500 11 15 4 13 16 12 10 4 20 22 9 27 163 1,548,500
65 D005 5 Diazepam injeksi 5 mg/ml ampul 31 December 2026 F0C464 1,545 3 2 1 1 1 1 2 11 16,995
66 D006 5 Diazepam rectal 5 mg/2,5 ml supp 31 December 2024 A2669202 13,546 3 2 5 67,730
67 D007 5 Diazepam tablet 2 mg tablet 31 December 2025 A 3104 JS 43
68 D008 5.0 Diazepam tablet 5 mg tablet 30 November 2023 A93244 114 20 10 13 8 46 18 90 205 23,370
69 D009 6.1.2 Dietilkarbamazin Sitrat tablet 100 mg tablet 150
70 D010 3 Difenhidramin injeksi i.m. 10 mg/ml (HCI) ampul 31 October 2026 xxx 5 9 12 10 36
71 D011 17.5 Digoksin tablet 0.25 mg tablet 31 December 2025 A1604 DQ 108
72 D012 17.1 Diltiazem HCL tablet 30 mg tablet 137
73 D013 25.2 Dimenhidrinat tablet 50 mg tablet 31 December 2023 L10250N 109 5 20 20 45 4,905
74 D014 - Docusate Sodium 5 mg Tetes Telinga botol
75 D015 - Doksisiklin 100 mg kapsul
76 D016 25.2 Domperidon syrup 5 mg/5 ml botol 30 October 2022 SCL30449 9,931 37 17 41 95 943,445
77 D017 25.2 Domperidon tablet 10 mg tablet 31 August 2024 JH2461 75 230 160 30 303 473 677 419 770 650 635 535 535 5,417 406,275

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
78 D018 17.7 Dopamin injeksi ampul 11,000
79 E001 26.1 Efedrin tablet 25 mg (HCI) tablet 31 December 2025 H 151087B 210
80 E002 3 Epinefrin (Adrenalin) injeksi 0.1 % (sebagai HCI) ampul 28 February 2024 XXX 1,740 3 1 3 10 17 29,580
81 E003 6.2.2.4 Eritromisin kapsul 500 mg kapsul 31 October 2026 B 1346 IQ 1,023
82 E004 6.2.2.4 Eritromisin sirup 200 mg/5 ml botol 31 December 2025 18030060 7,039
83 F001 - Famotidine tablet 20 mg tablet 153
85 F003 5.0 Fenobarbital tablet 100 mg tablet 68
86 F004 5.0 Fenobarbital tablet 30 mg tablet 31 March 2024 D909738 197 30 30 60 11,820
87 F005 28.2 Fenol Gliserol tetes telinga 10 % botol 31 August 2024 22LH018 3,300 14 4 2 1 3 3 27 89,100
88 F006 10.2 Fitomenadion ( Vit. K ) injeksi i.m. 2 mg/ml ampul 31 March 2023 46478015 1,320 19 5 6 6 6 10 10 13 11 7 8 101 133,320
89 F007 10.2 Fitomenadion (Vit.K) injeksi 10 mg/ml ampul 31 December 2025 XXX
90 F008 10.2 Fitomenadion (Vit.K) tablet salut gula 10 mg tablet 31 December 2024 16381007 781 1 20 21 16,401
91 F009 - Fluconazole tablet 150 mg tablet 31 December 2025 EE 1214 J 20,700
92 F010 14.0 Furosemid injeksi i.v./i.m. 10 mg/ml ampul 31 December 2026 xxx 10 10
93 F011 14 Furosemid tablet 40 mg tablet 30 November 2024 L00652BJ 114 50 50 85 15 164 237 315 387 21 270 1,594 181,716
Garam Oralit I serbuk, kombinasi : Natrium 0.70

94 G001 20.1 gr, Kalium Klorida 0.30 gr, Trinatnum Sitrat sachet 31 October 2023 46373098KF 280 105 120 36 86 126 412 200 99 362 427 1,973 552,440
Dihidrat 0.58 gr, Glukosa Anhidrat 4 gr
95 G002 21.2 Gentamisin injeksi 40 mg/ml ampul 31 December 2025 BF16D0800 3,545
96 G003 21.2 Gentamisin injeksi 80 mg/ml vial 5,101
97 G004 21.2 Gentamisin salep kulit 0.1 % tube 31 March 2026 C20433W 2,670 27 24 17 24 46 2 28 32 52 47 52 351 937,170
98 G005 21.2 Gentamisin salep mata 0,3% tube 30 September 2023 1456014 22,300 23 3 18 13 17 74 1,650,200
99 G006 14.2 Gentian Violet larutan 1 % botol 31 December 2025 11083 1,500
100 G007 16.1.1 Glibenklamida tablet 5 mg tablet 31 December 2025 19GD1011 137 10 20 30 60 30 150 20,550
101 G008 16.2.1 Glimepiride tablet 1 mg tablet 31 August 2023 51I0157 174 230 380 320 340 310 620 770 1,470 580 400 190 190 5,800 1,009,200
102 G009 16.2.1 Glimepiride tablet 2 mg tablet 17 January 2024 HTGMPK21153 123 900 500 500 280 210 20 450 710 1,195 1,195 970 6,930 852,390
103 G010 26.3 Gliseril Gualakolat tabelt 100 mg tablet 30 October 2024 2110-01-155 89 1,244 1,519 1,543 573 663 600 903 1,749 2,664 3,377 3,830 2,420 21,085 1,876,565
104 G011 20.2 Glukosa larutan infus 10 % steril botol 31 January 2023 200218 8,003 13 5 18 144,054
105 G012 20.2 Glukosa larutan infus 40 % steril ampul 6 April 2024 B76062A 581 2 2 1,162
106 G013 20.2 Glukosa larutan infus 5 % steril botol 31 January 2023 200211 6,627 2 5 1 1 9 11 10 39 258,453
107 G014 6.3 Griseofulvin Micronized tablet 125 mg tablet 31 August 2026 111495BJ 233 50 50 11,650
108 H001 15 Hidroklorotiazida tablet 25 mg tablet 30 July 2024 H92059B 178 40 30 50 30 30 40 80 30 30 30 115 505 89,890
109 H002 18.4 Hidrokortison krim 2.5 % tube 28 February 2027 KCHCTA21298 2,890 5 8 9 2 13 17 9 5 9 15 13 19 124 358,360
110 H003 - Hyoscine-N-Butilbromide injeksi 20 mg/ml ampul 31 July 2023 9620G0222B 6,188 5 5 30,940
111 H004 - Hyoscine-N-Butilbromide tablet 10 mg tablet 31 May 2025 T04154BB 1,059 80 70 130 60 340 360,060
112 I001 1.2 Ibuprofen suspensi 100 mg/5 ml botol 30 April 2025 D29216 2,339 15 1 5 22 15 17 7 3 85 198,815
113 I002 1.2 Ibuprofen suspensi 200 mg/5 ml botol 31 August 2023 090909 4,949
114 I003 1.2 Ibuprofen tablet 200 mg botol 31 October 2023 A7905HW-APR20 164
115 I004 1.2 Ibuprofen tablet 400 mg tablet 29 November 2025 2111-13-134 215 560 510 280 280 540 400 800 800 720 640 600 805 6,935 1,491,025
116 I005 6.2.4 Isoniazide (INH) tablet 100 mg tablet 30 April 2024 E80864B 260 60 60 15,600
117 I006 6.2.4 Isoniazide (INH) tablet 300 mg tablet 131
118 I007 17.1 Isosorbid Dinitrat tablet Sublingual 5 mg tablet 31 May 2025 A02363Z 35 30 30 10 225 295 10,325
119 K001 - Kalium Diklofenak tablet 25 mg tablet 528

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
121 K003 29 Kalsium Laktat (Kalk) tablet 500 mg tablet 31 August 2024 A11486 60 1,920 1,510 1,240 1,780 2,090 2,110 1,870 2,960 2,920 2,570 2,610 3,400 26,980 1,618,800
122 K004 - Kanamycin injeksi 1 g ampul 31 December 2025 13833 8,965
123 K005 17.3 Kandesartan tablet 8 mg tablet 18 June 2027 xxx 215 180 120 280 580 124,700
124 K006 17.3 Kaptopril tablet 12.5 mg tablet 31 March 2025 C00032B 69 130 40 61 34 161 200 50 195 871 60,099
125 K007 17.3 Kaptopril tablet 25 mg tablet 31 August 2023 52I0140 138 460 240 226 310 290 485 223 501 230 500 695 596 4,756 656,328
126 K008 17.3 Kaptopril tablet 50 mg tablet 31 December 2025 1505027 143
127 K009 5 Karbamazepin tablet 200 mg tablet 31 December 2022 A93425 250 20 20 5,000
128 K010 - Karbogliserin Tetes Telinga 10 % botol 2,500
129 K011 - Karbon aktif (Norit) botol 31 December 2025 71IA0120 7,954
130 K012 - Ketokonazol krim 2 % tube 30 September 2023 100021 2,420 21 12 21 16 23 93 225,060
131 K013 - Ketokonazol tablet 200 mg tablet 29 July 2023 HTKCZB14112 286 110 160 40 58 205 110 70 30 783 223,938
132 K014 1.2 Ketorolac injeksi 30 mg/ml ampul 31 December 2025 95459043 1,383
133 K015 1.2 Ketorolac tablet 30 mg tablet
134 K016 1.2 Ketoprofen 100 mg suppositoria supp 31 December 2025 G6E074 2,789
135 K017 1.2 Ketoprofen injeksi 50mg/ml ampul 7,628
136 K018 6.2.2.4 Klindamisin kapsul 150 mg kapsul 31 July 2026 ECG047 803
137 K019 6.2.2.4 Klindamisin kapsul 300 mg kapsul 31 January 2026 C11001BK 1,539 20 110 10 20 160 246,240
138 K020 6.2.2.2 Kloramfenikol kapsul 250 mg kapsul 31 December 2025 1110017-07 255
139 K021 21.2.1 Kloramfenikol salep kulit 2 % tube 30 June 2023 10207012 3,760 39 18 10 18 12 33 32 20 48 29 11 6 276 1,037,760
140 K022 6.2.2.2 Kloramfenikol salep mata 1 % tube 31 December 2026 xxx 2,054 8 9 14 9 21 26 15 17 8 127 260,858
141 K023 21.2 Kloramfenikol supensi 125 mg/5 ml botol 31 December 2025 FG21 36 4,000
142 K024 3 Kloramfenikol tetes telinga 3 % botol 31 August 2023 D0655088 8,250 1 2 8 8 5 1 6 5 36 297,000
143 K025 6.4.2.1 Klorfeniramina Malet (CTM) tablet 4 mg botol 28 February 2024 2202060 94 1,245 378 100 395 573 424 688 945 1,219 1,727 1,658 628 9,980 938,120
144 K026 6.4.2.1 Klorokuin tablet 150 mg tablet 115
145 K027 23.4 Klorokuin tablet 250 mg tablet 142
146 K028 23.4 Klorpromazin tablet salut 100 mg (HCI) tablet 31 December 2025 160407 165
147 K029 26.2 Klorpromazin tablet salut 25 mg (HCI) tablet 30 November 2022 46328005 208
148 K030 - Kodein tablet 10 mg tablet 31 October 2025 J13576J 630 10 40 20 70 44,100
Kombinasi Dekstrometorfan dan Senyawa Lain

149 K031 - tablet
tablet ( Batuk )

150 K032 - botol
( Batuk ) syrup
Kombinasi Kaolin dan pectin (sirup antidiare untuk

151 K033 - botol 31 July 2023 N01AL009 5,720 9 10 16 6 19 6 66 377,520
bayi dan anak)
152 K034 - Kombinasi Multivitamin dan Mineral tablet 30 September 2023 JI0131 563 500 1,028 1,322 1,175 4,025 2,266,075
153 K035 - Kombinasi Multivitamin syrup untuk anak botol 30 April 2024 22B0282 CURCUMI 8,325 1 15 35 52 3 106 882,450
154 K036 - Kombinasi Tripolidin dan Pseudoefedrin tablet tablet July 2023 764406 935 20 10 30 70 40 20 20 210 196,350
Kombinasi Polimiksin / Neomisin dan Senyawa Lain

155 K037 - botol 29 October 2027 D008J002 14,216 1 2 1 1 11 2 3 21 298,536
( Tetes Mata )

156 K038 - botol 31 May 2026 xxx 2 3 1 6
( Tetes Telinga )
Kotrimoksazol DOEN I (dewasa) kombinasi :

157 K039 6.2.2 tablet 31 May 2023 A01136 133 50 115 60 130 40 120 54 100 130 200 30 1,029 136,857
Sulfametoksazol 400 mg, Trimetoprin 80 mg

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Kotrimoksazol DOEN II (Pedriatrik) kombinasi :

158 K040 6.2.2 tablet 103
Kotrimoksazol suspensi kombinasi :

159 K041 6.2.2 botol 31 December 2027 A92122 8,950 2 14 16 143,200
Sulfametoksazol 200 mg + Trimetoprin 40 mg/5 ml
160 K042 6.4.2.2 Kuinin tablet 222 mg (H₂SO₄ & H₂O) tablet 737
161 L001 25.1 Lanzoprazol kapsul 30 mg kapsul 31 August 2026 XXX 278 10 100 200 300 37 180 827 229,906
Larutan mengandung Karbohidrat+Elektrolit (NaCl

162 L002 - botol 500ml 31 December 2025 45H80 10,000
1,75g, KCl 1,5 g, Na. Laktat 2,24 g, Dekstrosa 27 g)
163 L003 - Levofloksasin tetes mata 0,5 % botol 16,995

164 L004 14.1 Lidokain compositum injeksi 2 % ampul 31 May 2026 56815004 1,404 23 15 35 17 18 35 23 40 27 233 327,132
165 L005 14.1 Lidokain injeksi 2 % ampul 28 February 2026 56362013-2 891 13 5 18 16,038
166 L006 - Lincomycin tablet 500 mg tablet 878
167 L007 - Loperamide tablet 2 mg tablet 31 October 2023 2110-02-328 139 100 100 50 10 100 90 160 260 210 120 190 110 1,500 208,500
168 L008 - Loratadin tablet 10 mg tablet 29 March 2025 TLRTB10490 129 35 310 25 50 20 35 67 285 827 106,683
169 M001 5 Magnesium Sulfat injeksi (IV) 20 % - 25 ml vial 15 April 2023 B84D51C 4,120 3 3 12,360
170 M002 5 Magnesium Sulfat injeksi (IV) 40 % - 25 ml vial 29 May 2023 B99E51A 4,700 2 11 2 15 70,500
171 M003 - MB Anak ( Obat Kusta) blister 30 November 2022 BJU7220 22,794
172 M004 - MB Dewasa ( Obat Kusta ) blister 30 September 2027 XXX
173 M005 - Meloksikam tablet 15 mg tablet 1,619
174 M006 - Meloksikam tablet 7,5 mg tablet 934
175 M007 - Menadion Natrium Bisulfit (Vit.K3) injeksi 10 mg/ml ampul 478
176 M008 - Metanizol (Antrain) injeksi ampul 30 June 2026 F2F088 3,045 5 10 50 65 197,925
177 M009 16.2.1 Metformin HCl tablet 500 mg tablet 29 July 2023 HTMFNA014885 84 1,110 1,730 660 1,530 1,915 2,270 3,420 1,385 2,280 1,600 2,275 3,050 23,225 1,950,900
178 M010 17.3 Metildopa tablet 250 mg tablet 30 April 2025 B234410 004 1,023 10 30 60 30 80 60 120 80 140 610 624,030
179 M011 22.1 Metilergometrin Maleat injeksi 0.200 mg - 1 ml ampul 31 January 2023 4210221 1,069 5 4 1 1 2 13 13,897
180 M012 22.1 Metilergometrin Maleat tablet salut 0.125 mg tablet 30 April 2023 D81054J 258
181 M013 26.1 Metilprednisolon tablet 4 mg tablet 30 September 2023 52J4156 102 150 50 198 2 261 561 640 602 2,464 251,328
182 M014 26.1 Metilprednisolon tablet 8 mg tablet 644
183 M015 25.2 Metoklopramide injeksi 5 mg/2 ml ampul 31 July 2023 0710111 991 6 12 20 12 38 30 40 30 20 208 206,128
184 M016 25.2 Metoklopramide sirup 5 mg / 5 ml botol 2,835
185 M017 25.2 Metoklopramide tablet 10 mg tablet 31 July 2026 H11163BJ 117 70 100 170 170 40 120 100 74 100 944 110,448
186 M018 6.2.2 Metronidazol infuse botol 39,825
187 M019 - Metronidazol ovula 500 mg suppvag 31 August 2025 XXX 3,590 5 1 3 5 2 5 5 26 93,340
188 M020 6.2.2 Metronidazol tablet 250 mg tablet 31 December 2025 AE91272 98
189 M021 6.2.2 Metronidazol tablet 500 mg tablet 30 April 2024 E91199B99 251 100 50 10 126 35 155 120 91 70 110 867 217,617
190 M022 18.3 Mikonazol krim/salep 2 % (Nitrat) tube 31 December 2027 xxx 1,900 5 14 10 29 55,100
191 M023 - Mineral Mix sachet 31 August 2026 XXX 3,116
192 M024 18.4 Mometason Furoat Krim 0,1% tube 30 November 2022 EDKO81 8,437 1 1 2 1 1 2 8 67,496
193 N001 - N Asetylsistein tablet 200 mg tablet 30 November 2023 21AS1110 317 300 110 20 70 110 170 670 490 860 540 195 3,535 1,120,595
194 N002 1.2 Natrium Diklofenak tablet 25 mg tablet 226
195 N003 1.2 Natrium Diklofenak tablet 50 mg tablet 31 July 2023 46365020 109 510 160 220 390 350 470 340 650 670 1,860 2,235 7,855 856,195
196 N004 20.2 Natrium Klorida larutan infus 0.9 % botol 31 August 2023 2A1A1H035 6,900 19 29 32 20 37 38 55 54 241 79 35 56 695 4,795,500

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
197 N005 17.3 Nifedipin tablet 10 mg tablet 30 June 2024 51664144 242 10 50 70 30 30 95 285 68,970
198 N006 6.3 Nystatin Vaginal tab 100.000 IU/g tablet 31 July 2024 46372004 550 4 10 5 8 27 14,850
199 O001 6.2.4 Obat Anti Tuberkulosis Sisipan paket 183,984
200 O002 6.2.4 Obat Antituberkolosis FDC Katagori 1 paket 31 August 2024 21FD4072/21FD20 481,892 1 3 1 2 3 3 3 2 1 19 9,155,948
201 O003 6.2.4 Obat Antituberkolosis FDC Katagori 2 paket 30 November 2022 xxx 1,379,984
202 O004 6.2.4 Obat Antituberkolosis FDC Katagori Anak paket 30 September 2023 20202 247,234 1 1 1 3 741,702
203 O005 26.3 Obat Batuk Hitam (O.B.H) cairan botol 30 November 2023 K39110 5,772 20 20 115,440
204 O006 - Obat Kumur ( Antiseptik / anastetik lokal ) botol 31 March 2023 20A0248 18,480 4 1 2 1 4 2 1 15 277,200
205 O007 6.2.2 Oksitetrasiklin HCI injeksi i.m.50 mg/ml - 10 ml vial 3,410
206 O007 6.2.2 Oksitetrasiklin HCl Salep Mata 1 % tube 30 October 2027 XXX 9 4 13
207 O008 6.2.2 Oksitetrasiklin Salep Kulit 3 % tube 1,646
208 O009 22.1 Oksitosin injeksi 10 IU/ml - 1 ml ampul 31 August 2023 962OHO239A 1,248 13 15 4 4 13 33 15 7 10 11 15 140 174,720
209 O010 25.1 Omeprazol kapsul 20 mg kapsul 30 September 2023 KOPZB10643 458 290 510 560 605 720 2,685 1,229,730
210 O011 - Ondansentron injeksi 4 mg /2 ml ampul 31 December 2026 xxx
211 O012 - Ondansetron tablet 4 mg tablet 31 August 2026 XXX 429 48 48 20,592
212 P001 - Papaverin tablet 40 mg tablet 30 July 2027 XXX 310 30 10 10 40 90 27,900
213 P002 1.2 Parasetamol drops botol 31 December 2022 2012071 4,950 5 12 5 11 10 43 212,850
214 P003 1.2 Parasetamol infuse botol
215 P004 1.2 Parasetamol rectal supp rectal 31 August 2023 ROO1K019 7,743 6 4 29 6 20 20 14 99 766,557
216 P005 1.2 Parasetamol sirup 120 mg/5 ml botol 30 April 2024 SCH24849 1,160 532 300 105 84 84 116 179 187 140 150 182 2,059 2,388,440
217 P006 1.2 Parasetamol tablet 500 mg tablet 30 November 2024 T200124C 242 3,062 3,001 3,367 1,970 1,965 2,545 2,545 5,397 4,444 5,551 5,486 3,912 43,245 10,465,290
218 P007 - PB Anak ( Obat Kusta ) blister 9,570
219 P008 - PB Dewasa ( Obat Kusta ) blister 9,770
220 P009 - Permetrin krim 5 % Scabimit cream tube 30 June 2025 F22012 11,250 8 3 1 6 3 10 6 9 7 5 7 7 72 810,000
221 P010 - Piracetam tablet 400 mg tablet 609
222 P011 - Piracetam tablet 800 mg tablet 1,084
223 P012 6.1.1 Pirantel syrup 125 mg/ml botol 31 December 2025 2509024 9,100
224 P013 6.1.1 Pirantel tablet score (Base) 125 mg tablet 31 December 2025 1509030 318
225 P014 29 Piridoksin (Vitamin B6) tablet 10 mg (HCI) tablet 30 April 2024 E10667BJ 142 400 160 320 330 200 690 1,160 930 530 870 5,590 793,780
226 P015 - Piroksikam tablet 10 mg tablet 113
227 P016 - Piroksikam tablet 20 mg tablet 31 August 2024 43495 220 30 10 10 71 121 26,620
228 P017 16.4 Prednison tablet 5 mg tablet 31 December 2027 xxx 220 10 100 171 148 50 479 105,380
229 P018 6.4.2.2 Primakuin tablet 15 mg tablet 31 August 2023 16386002 242 6 6 1,452
230 P019 7.1 Propanolol tablet 10 mg ( HCl ) tablet 31 December 2025 1508041 69
231 P020 7.1 Propanolol tablet 40 mg (HCI) tablet 31 August 2026 XXX 20 10 5 35
232 P021 16.3 Propilitourasil tablet 100 mg tablet 31 December 2025 1305003 320
233 R001 25.1 Ranitidin injeksi 25 mg/2 ml ampul 30 November 2023 46486075 858 15 18 25 1 31 25 75 75 50 125 75 50 565 484,770
234 R002 25.1 Ranitidin tablet 150 mg tablet 30 September 2023 51J4242 275 140 170 60 320 265 480 755 940 1,020 720 575 5,445 1,497,375
235 R003 29 Retinol (Vitamin A) 100.000 IU kapsul lunak kapsul 31 July 2025 G21724W 352 100 90 1 1 35 73 1 1 302 106,304
236 R004 29 Retinol (Vitamin A) 200.000 IU kapsul lunak kapsul 31 July 2025 G22079W 637 416 464 14 24 36 71 16 852 12 14 22 40 1,981 1,261,897
237 R005 20.2 Ringer Laktat larutan infus botol 30 June 2025 501704 7,703 56 62 23 49 43 60 64 105 102 176 115 70 925 7,125,275
238 S001 26.1 Salbutamol cairan ih 0,1% (Nebulizer) botol 6 January 2023 4110080 5,400 10 10 10 10 18 32 12 52 15 34 74 3 280 1,512,000
239 S002 26.1 Salbutamol inhalasi/aerosol 100 mcg/dosis botol 31 December 2022 4110080 5,940 9 9 53,460
240 S003 26.1 Salbutamol sirup botol 31 July 2023 34203107 4,189 6 6 25,134
241 S004 26.1 Salbutamol tablet 2 mg tablet 31 December 2026 xxx

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
242 S005 18.4 Salbutamol tablet 4 mg (sebagai sulfat) tablet 31 July 2024 27508207 67 250 360 140 380 180 232 96 80 70 398 420 507 3,113 208,571
Salep 2-4, kombinasi : Asam Salisilat 2 % Belerang

243 S006 - pot 31 December 2025 16SE084B 2,797
Endap 4 %
244 S007 - Salep Luka Bakar tube 31 May 2023 184400 18,557 2 2 1 1 1 8 3 1 3 22 408,254
245 S008 18.8 Salisil Bedak 2 % kotak 30 April 2024 1THYJKK 1,040 5 8 9 8 6 1 9 3 7 56 58,240
246 S009 6.2.1 Sefadroksil kapsul 500 mg kapsul 30 June 2025 KPG39249 581 640 590 470 490 464 674 751 1,165 1,409 1,183 1,420 1,272 10,528 6,116,768
247 S010 6.2.1 Sefadroksil sirup kering 125 mg/5 ml botol 30 September 2023 6009020 4,359 21 4 9 7 9 9 3 42 51 47 23 225 980,775
248 S011 6.2.1 Sefadroksil sirup kering 250 mg/5 ml botol 29 October 2022 D310007BK 5,825 19 5 1 7 2 19 21 3 77 448,525
249 S012 6.2.1 Sefoperazone injeksi ampul 8,140
250 S013 6.2.1 Sefotaksim injeksi 0.5 gram vial 31 December 2025 6606019B 6,485
251 S014 10.1 Sianokobalamin (Vit. B12) tablet 50 mg tablet 31 March 2023 D80715B 49 14 46 50 10 10 130 6,370
252 S015 - Simetidin tablet 200 mg tablet 31 December 2025 61200 198
253 S016 17.8 Simvastatin tablet 10 mg tablet 31 August 2023 HTSVND14384 73 270 260 130 100 60 170 270 110 370 140 460 680 3,020 220,460
254 S017 17.8 Simvastatin tablet 20 mg tablet 31 March 2023 D1021BJ 150 130 140 90 310 670 864 531 570 300 320 580 4,505 675,750
255 S018 6.2.2.6 Siprofloksasin infus 2 % botol 76,950
256 S019 6.2.2.6 Siprofloksasin tablet 500 mg (sebagai HCI) tablet 31 January 2025 TSB0429-APR2020 260 34 148 80 34 240 20 90 70 716 186,160
257 S020 4.1 Sodium Bicarbonate tablet tablet 1,100
258 S021 - Spiramycin tablet 500 mg tablet 31 December 2025 1305002 1,649
259 S022 15.1 Spironolakton tablet 25 mg tablet 30 September 2023 50J4140 226 105 50 155 35,030
260 S023 - Sukralfat susp 500 mg/5 ml, 100 ml botol 30 September 2027 XXX 6,130 64 20 26 23 21 154 944,020
261 T001 10.1 Tablet tambah darah tablet 31 March 2023 A10528 255 2,360 2,420 2,620 2,140 3,720 3,530 2,410 3,750 4,600 3,755 2,465 3,939 37,709 9,615,795
262 T002 6.2.2 Tetrakain HCl tetes mata 0,5% botol 31 December 2025 5P10804 4,585
263 T003 6.2.2 Tetrasiklin kapsul 250 mg kapsul 174
264 T004 6.2.2 Tetrasiklin kapsul 500 mg kapsul 31 December 2025 DC 0929 J 329
265 T005 - Tiamfenikol kapsul 500 mg kapsul 31 December 2025 1309018-48 484
266 T006 - Tiamfenikol syrup 125 mg/ 5 ml botol 28 February 2023 00222-20 8,250
267 T007 29 Tiamin (Vitamin B1) tablet 50 mg (HCI/Nitrat) tablet 31 January 2024 B90311B 94 150 150 200 200 100 200 99 101 100 210 300 110 1,920 180,480
268 T008 1.2 Tramadol injeksi ampul
269 T009 1.2 Tramadol kapsul 50 mg kapsul 446
270 T010 9 Trihexypenidyl tablet 2 mg tablet 30 September 2023 A01839 100 540 480 615 300 460 360 540 462 670 520 560 540 6,047 604,700
271 V001 29 Vitamin B Kompleks tablet tablet 30 November 2023 2111-50-379 60 1,300 1,420 1,710 1,270 1,490 1,890 2,232 3,231 2,662 2,496 3,104 2,878 25,683 1,540,980
272 V002 - Vitamin Neurotropik tablet tablet 1,210
273 Z001 20.1 Zinc syrup 20 mg/5 ml botol 23 February 2023 E0B8075860-E0B80 3,285 9 22 2 5 8 14 21 40 26 8 1 156 512,460
274 Z002 20.1 Zinc tablet 20 mg tablet 30 April 2023 36496015 524 50 240 20 50 150 80 70 280 360 215 385 1,900 995,600
275 SV01 27.1 ABU (Anti Bisa Ular) vial 31 August 2023 4700221 517,132 3 1 4 2,068,528
276 SV02 32 ADS 0,05 ML piece 1 October 2023 18005-JAN20 1,650 17 16 20 23 22 2 100 165,000
277 SV03 32 ADS 0,5 ML piece 31 March 2027 C22DCL-005 1,240 152 164 156 107 169 89 187 156 83 126 846 140 2,375 2,945,000
278 SV04 32.0 ADS 2 ML piece 1,400
279 SV05 32 ADS 5 ML piece 30 September 2023 22101888 1,500 9 5 4 5 24 242 34 8 16 9 7 12 375 562,500
280 SV06 27.2 ATS 1500 IU vial 30 September 2026 xxx 130,999
281 SV07 27.2 BCG 20 DS vial 31 March 2023 0371G029 98,000 4 8 8 10 12 7 12 11 9 10 7 98 9,604,000
282 SV08 27.2 BCG PELARUT vial
283 SV09 27.2 CAMPAK 10 DS vial 31 October 2024 2503216 24,829
284 SV10 27.2 CAMPAK 20 DS vial 41,998
285 SV11 27.2 CAMPAK PELARUT vial

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
286 SV12 27.2 DPT-HB HIB vial 31 August 2023 5042121 85,877 22 19 18 12 23 23 20 20 15 20 23 17 232 19,923,464
287 SV13 27.2 DT 10 DS vial 30 April 2023 0400121 34,400 1 1 34,400
288 SV14 27.2 HEP B PID 1 DS vial 30 September 2024 3654421 258,389 11 14 11 4 24 4 24 10 17 9 9 30 167 43,150,963
289 SV15 27.2 HEPATITIS B Imunoglobulin ( human) ampul 1,300,000
290 SV16 27.2 IPV 10 DS vial 31 May 2024 2100319 158,994 1 9 6 11 9 6 8 6 9 6 6 77 12,242,538
291 SV17 27.2 POLIO 10 DS vial 31 March 2023 2052121 23,643 11 10 7 17 17 17 34 13 126 2,979,018
292 SV18 27.2 POLIO 20 DS vial 28,094
293 SV19 27.2 Td 10 DS vial 31 July 2023 0412520 16,995 3 6 5 5 6 6 5 3 4 4 46 5 98 1,665,510
294 SV20 27.2 TT 10 DS vial 14,498
295 SV21 27.2 VAR vial 174,500
296 HP01 32 Alat suntik sekali pakai 1 ml piece 30 November 2026 21L1401J 995 68 68 40 64 77 77 59 87 34 94 126 28 822 817,890
297 HP03 32 Alat suntik sekali pakai 2.5 ml piece 31 December 2025 01071588 848
298 HP04 32 Alat suntik sekali pakai 3 ml piece 31 May 2027 22F2108J 888 131 123 122 168 234 59 183 375 270 288 306 180 2,439 2,165,832
299 HP05 32.1 Alat suntik sekali pakai 5 ml piece 28 February 2025 20C2309J 1,045 10 12 3 3 23 33 26 35 10 59 20 234 244,530
300 HP02 32 Alat suntik sekali pakai 10 ml piece 30 September 2024 19J0310J-JUNI20 1,338 3 22 5 12 15 8 21 86 115,068
301 HP06 30 Aquadest steril botol 31 December 2025 1234 7,700
302 HP07 - Autoclick Lancing Device piece 31 December 2025 18071788 19,157 1 1 19,157
303 HP08 - Blood lancet botol November 2023 1121588 serenity 715 1 1 1 2 2 2 1 10 7,150
Catgut/Benang Bedah No. 2/0 dengan jarum bedah

304 HP09 32 piece 28 February 2026 102131 36,831 5 5 6 4 15 5 40 1,473,240
(cromic)

305 HP10 32 piece 30 November 2024 911066 37,203 3 12 1 2 5 7 15 20 65 2,418,195
(plain)

306 HP11 32 piece 30 November 2026 111465 34,410 4 2 10 9 2 3 9 6 45 1,548,450
(cromic)

307 HP12 32 piece 31 December 2025 O12013 37,023 5 7 10 4 5 10 1 42 1,554,966
(plain)
308 HP13 - Cathejell ( Gel Catether ) piece 43,092

309 HP14 - Colesterol tes (HUMASENS) strip 31 December 2025 C16070068 27,532
310 HP15 - Cover Glass 20 x 20 mm kotak 29 April 2023 2016-04 137,438
311 HP16 32 Elastis verban 3 inchi roll 30 September 2026 2109234 29,000 1 2 1 3 2 3 1 13 377,000
312 HP17 - Endotracheal Tube 2.5 piece 31 December 2025 11HG16 7,173
313 HP18 - Endotracheal Tube 3 piece 31 December 2025 11JG58 8,250
314 HP19 - Endotracheal Tube 4 piece 31 December 2025 11GG09 8,198
315 HP20 13.2 Etakridin larutan 0.1 % 300 ml botol 31 October 2023 09112088 3,520 2 1 3 10,560
316 HP21 13.2 Etanol 70 % 1 Liter botol 31 October 2024 5112088 30,250 5 2 2 1 4 2 3 4 2 6 4 3 38 1,149,500
317 HP22 13.2 Etanol 70 % 100 ml botol 7,000
318 HP23 - Folley Catheter 12 piece 30 September 2025 20200925 8,727 4 1 2 7 61,089
319 HP24 - Folley Catheter 16 piece 31 July 2026 03082188 10,261 2 6 7 4 4 2 2 5 7 2 41 420,701
320 HP25 - Folley Catheter 18 piece 31 July 2026 09082188 10,261 6 2 3 5 9 1 3 4 5 5 43 441,223
321 HP26 - Glukose tes ( HUMASENS) strip 31 December 2025 G16076054 5,171
322 HP27 - Glukose tes (NESCO) strip 30 August 2026 xxx 4,400
323 HP28 - Hand Scrubs Anti Mikroba botol 30 September 2027 XXX
324 HP29 - Handscoon Gynecology pasang 31 December 2025 0 22,000
325 HP30 32 Handscoon No. 6 Box 31 August 2026 250-08-21 68,000 3 4 3 7 3 8 3 1 3 6 5 46 3,128,000

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
326 HP31 32 Handscoon No. 7 Box April 2024 161611106 68,000 3 1 2 1 3 10 680,000
327 HP32 32 Handscoon No. 7.5 pasang 31 August 2026 21-09-83-04-8 117,500
328 HP33 32.0 Handscoon Steril No. 6 pasang 6,050
329 HP34 32 Handscoon Steril No. 6,5 pasang 31 December 2023 12345 13,200 10 5 8 5 28 369,600
330 HP35 32 Handscoon Steril No. 7 pasang 30 November 2023 1805121 4,950
331 HP36 - Hemoglobin tes (NESCO) strip 5,280
332 HP37 13.1 Hidrogen Peroksida 3 % botol 31 December 2025 24101688 34,000
333 HP38 32 Infusion Set Anak piece 29 April 2023 2018041z12 3,030 1 1 3 5 5 12 5 32 96,960
334 HP39 32 Infusion Set Dewasa piece 30 October 2024 19K14LIJ 8,140 8 27 36 50 54 44 83 50 48 400 3,256,000
335 HP40 32 IV Catheter No. 20 G piece 17 April 2023 200421 7,957 11 9 13 7 28 14 23 14 29 22 25 195 1,551,615
336 HP41 32 IV Catheter No. 22 G piece 23 May 2025 200511 7,937 24 36 37 38 20 155 1,230,235
337 HP42 32 IV Catheter No. 24 G piece 18 May 2023 200503 7,929 8 12 10 8 5 10 15 31 27 31 25 11 193 1,530,297
338 HP43 32 IV Catheter No. 26 G piece 31 May 2024 077 4,481 5 7 2 1 6 7 28 125,468
339 HP44 32.0 Jarum disposible No. 23 G piece 1,210
340 HP45 32 Jarum disposible No. 26 G piece 31 December 2025 130219D 1,210
341 HP46 - Kaca Slide kotak 30 September 2025 3H 720
342 HP47 32 Kapas 500 g bungkus 30 April 2026 18052188 32,409 1 1 1 2 1 1 1 2 2 1 13 421,317
343 HP48 32 Kapas Pembalut/Absorben 250 gram bungkus 31 July 2024 14081988 28,916 1 1 1 2 2 1 1 1 2 12 346,992
344 HP49 32 Kasa Alkohol steril (Alkohol swab) Box 30 September 2026 GM2109154 11,999 5 2 3 2 3 4 2 3 4 7 4 3 42 503,958
345 HP50 32.0 Kasa Gulung 40 x 80 cm roll 31 October 2025 2009683 158,743 1 1 1 1 1 1 1 7 1,111,201
346 HP51 32.0 Kasa Pembalut Hydrofil 4m x 10cm roll 1,100
347 HP52 32 Kasa Pembalut Hydrofil 4m x 15cm roll 31 July 2027 05022288 2,520 3 20 5 15 20 12 13 25 35 148 372,960
348 HP53 32 Kasa Steril 16 x 16 cm piece 31 December 2026 07812288 8,480 27 21 32 23 29 39 68 21 84 22 58 424 3,595,520
349 HP54 32 Kasa Steril mengandung antibiotik piece 30 April 2024 0662AL 9,157 3 5 5 9 8 18 10 3 7 68 622,676
350 HP55 13.2 Lisol botol 30 October 2023 08082088 40,000 1 2 3 120,000
351 HP56 32 Masker - 3 Ply plus Ear Loop Kotak 31 July 2026 23072106 38,500 27 18 11 1 4 15 16 11 103 3,965,500
352 HP57 32 Masker - Plus 3 Ply plus Ear Loop Kotak 30 April 2024 1081986 41,800 21 13 14 16 11 8 4 9 96 4,012,800
353 HP58 32 Masker sungkup oksigen anak piece 31 July 2024 20170722 14,137 1 1 2 28,274
354 HP59 32 Masker sungkup oksigen dewasa piece 29 July 2023 20170721 14,137 2 3 3 2 10 141,370
355 HP60 - Mucus extraktor buah 31 May 2025 19062088 7,462 2 2 3 2 4 1 14 104,468
356 HP61 - Neckkeller ukuran L buah 88,000
357 HP62 - Neckkeller ukuran M buah 83,270
358 HP63 - Neckkeller ukuran S buah 82,500
359 HP64 - Objeck Glass Frosted, box isi 72 kotak 31 December 2024 APBN19 22,097
360 HP65 - Objeck Glass, box isi 72 kotak 6 February 2023 prog hiv 19,242
361 HP66 - Oil Emersi botol 345,000
362 HP67 - Pembalut Elastis piece 30 June 2026 72188 77,600 2 2 2 2 2 3 4 4 3 4 4 32 2,483,200
363 HP68 32 Plester 0.5 x 5 M roll 31 December 2025 62537248 11,000
364 HP69 - Pot Sputum pot 29 February 2024 POTSPUTUMAPBN2 2,958
365 HP70 13.1 Povidon Iodida larutan 10 % 300 ml botol 300 m 30 September 2023 05162088 26,250 1 1 2 1 1 1 2 9 236,250
366 HP71 13.1 Povidon Iodida larutan 10 % 60 ml botol 60 ml 4,725
367 HP72 - PP Test piece 31 July 2024 02082188 2,052 65 20 60 61 50 44 50 10 360 738,720
368 HP73 - Safety Box 2,5 L piece 31 July 2025 12788I19-JULI20 12,500
369 HP74 - Safety Box 5 L piece 31 May 2024 SAFETYBOX5LAPBDI 24,250 4 2 1 5 2 14 339,500
370 HP75 32 Silk (Benang Sutera) No. 3/0 piece 31 July 2026 610925 20,908 3 3 62,724

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
371 HP76 - Underpad piece 9 June 2026 20210610 8,650 25 13 15 10 13 27 15 20 25 27 190 1,643,500
372 HP77 - Uric Acid tes (HUMASENS) Botol 31 December 2025 U16051079 11,141
373 HP78 - Uric Acid tes (NESCO) box25 30 June 2023 xxx 124,412 2 3 3 7 2 1 18 2,239,416
374 HP79 - Urine bag piece 31 March 2026 11210301 6,653 5 8 4 3 2 5 7 5 39 259,467
375 HP80 32.0 Wing Needle No. 21 G piece 2,600
378 HP83 32 Wing Needle No. 27 G piece 31 July 2024 23081988 1,540 1 1 1,540
379 RL01 - Controll HA Convergys X3 3,916,000
380 RL02 - Controll Hematology Analyzer TRILEVEL kit 5,500,000
381 RL03 - Controll Indiko TS 10 x 5 ml kit 2,783,000
382 RL04 - Humatrol N 6 x 5 ml kit 1,375,000
383 RL05 - Kalibrator Indiko TS 10 x 3 ml kit 2,024,000
384 RL06 - Reagen Cholesterol 4 x 100 ml kit 2,123,000
385 RL07 - Reagen Creatinin 1 x 100 ml + 1 x 100 ml kit 737,000
386 RL08 - Reagen Glukose 4 x 100 ml kit 880,000
387 RL09 - Reagen GOT (ALAT) 2 x 40 ml + 1 x 20 ml kit 1,264,982
388 RL10 - Reagen GOT (ASAT) 2 x 40 ml + 1 x 20 ml kit 1,264,982
Reagen HDL Cholesterol (Direct) 1 x 30 ml + 1 x 10
389 RL11 - kit 4,072,860
ml
390 RL12 - Reagen HDL Hemoglobin 10 x 500 ml kit 1,430,000
Reagen LDL Cholesterol (Direct) 1 x 30 ml + 1 x 10
391 RL13 - kit 4,731,705
ml
392 RL14 - Reagen Triglycerides 4 x 100 ml kit 2,696,219
393 RL15 - Reagen Uric Acid 4 x 100 ml kit 1,870,000
394 RL16 - Reagen Diluent HA Labgeo Unit 3,025,000
395 RL17 - Reagen Cleaner HA Labgeo Unit 2,420,000
396 RL18 - Reagen Lyse HA Labgeo Unit 3,630,000
397 RL19 - Raegen Diluent HA Convergys X3 Unit 4,966,500
398 RL20 - Reagen Cleaner HA Convergys X3 Unit 1,366,200
399 RL21 - Reagen Lyse HA Convergys X3 Unit 4,906,000
400 RL22 - Reagen Glukosa Indiko TS 8 x 20 ml kit
401 RL23 - Reagen Asam Urat Indiko TS 8 x 20 ml kit 3,630,000
402 RL24 - Reagen Kolesterol Indiko TS 12 x 20 ml kit 3,850,000
403 RL25 - Reagen Trigliserida Indiko TS 12 x 20 ml kit 5,280,000
404 RL26 - Wash Fluid Indiko TS 8 x 20 ml kit 935,000
405 PP01 - Body Fat Analyzer unit 775,000
406 PP02 - Giemsa botol 420,000
407 PP03 - Rapid Test : Dengue - IgG/IgM box 29 December 2026 xxx 66,000
408 PP04 - Rapid Test HIV box/30 30 September 2027 03ADDF034/SD BIO 342,000 2 2 684,000
409 PP05 - RDT : Dengue - Antigen strip 96,800
410 PP06 - RDT : Hepatitis kotak/25 31 March 2023 L20071 264,867 2 2 1 1 1 50 57 15,097,419
411 PP07 - RDT : Malaria kotak/25 31 December 2026 xxx 192,750
412 PP08 - RDT : Shipilis kotak/ 100 31 December 2025 QSY1018031-FEBRU 1,020,000
413 PP09 - Reagen Zet Nielson paket 30 October 2027 023/2019 345,000
414 PP10 - SD Chikungunya IgM kit 2,475,000
415 PP11 - SD Rapid Test (malaria) box 30 May 2026 xxx

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
416 BG01 - Bonding set 756,250
417 BG02 - Etching set 145,200
418 BG03 14.1 Etil Klorida spray set 31 January 2024 21L9134 176,601 3 1 3 2 2 2 13 2,295,813
419 BG04 14.1 Eugenol cairan 10 ml botol 31 December 2025 035145W 18,333
420 BG05 14.1 Glass Ionomer Cement ART set 532,400
421 BG06 - Komposit set 385,000
422 BG07 - Temporary Filling (bahan tambal gigi sementara) set 34,000
423 DOT001 1 Aminofilin tablet 150 mg Tablet 31 December 2025 xxx 1

424 DOT002 2 Asam Folat tablet 1 mg Tablet 30 October 2022 20TK007 86
425 DOT003 3 Clozapine tablet 25 mg Tablet 31 March 2026 xxx 473 60 60 60 60 240 113,520
426 DOT004 4 DHP Frimal Tablet 31 October 2022 191027 2,134 9 9 19,206
427 DOT005 5 Flufenazinedecanoat injeksi 25 mg/ml Ampul 31 December 2025 xxx 1
428 DOT006 6 Griseufulvin tablet 500 mg Tablet 31 December 2025 xxx 1
429 DOT007 7 Haloperidol injeksi 5 mg/ml Ampul 31 December 2025 460052 1
430 DOT008 8 Haloperidol tablet 5 mg Tablet 30 January 2023 A00013 60 10 120 60 10 200 12,000
431 DOT009 9 Metformin tablet 850 mg Tablet 31 December 2025 xxx 1
432 DOT010 10 Risperidon tablet 2 mg Tablet 30 June 2023 54F0459 287 380 640 625 300 520 450 660 420 800 450 450 486 6,181 1,773,947
433 DOT011 11 IV Catheter No. 18 G Piece 31 December 2025 xxx 1
434 DOT012 12 IV Dressing Piece 30 September 2024 113020023 51,325 50 50 50 25 175 8,981,875
435 DOT013 13 Prontosan 350 ml Botol 31 December 2025 171138W19 164,000
436 DOT014 14 Reagen Cleaner HA Diatro Botol 31 December 2025 xxx 98,600 1 1 98,600
437 DOT016 16 Reagen Diluent HA Diatro Botol 31 December 2025 xxx 2,830,300 1 1 2,830,300
438 DOT015 15 Reagen Control HA Diatro Botol 31 December 2025 xxx 1
439 DOT017 17 Reagen Lyse HA Diatro Botol 31 December 2025 20140708521 2,095,500 1 1 2,095,500
440 DOT018 18 Stabimed 1 Liter Botol 31 December 2025 16062M05 1
441 DOT019 - Nasal Canula ( selang oksigen ) Bayi Piece 30 June 2026 GM 2106062 18,585 5 1 5 11 204,435
442 DOT020 - Nasal Canula ( selang oksigen ) Anak Piece 31 October 2024 190382 4,600 1 5 6 6 2 6 5 31 142,600
443 DOT021 - Nasal Canula ( selang oksigen ) Dewasa Piece 30 April 2026 12210401 14,137 3 2 5 5 9 5 5 5 10 16 5 70 989,590
444 DOT022 - Albendazol tablet 400 mg_ tablet 31 March 2023 D10001BI 367 1,698 506 3 9 184 2,400 880,800
445 DOT023 - Alopurinol tablet 100 mg_ tablet 28 February 2023 A00361 89 220 430 410 390 195 550 5 2,200 195,800
446 DOT024 - Alopurinol tablet 300 mg_ tablet 30 June 2023 TPG55845 220
447 DOT025 - Alprazolam tablet 0,25 mg_ tablet December 2022 xxx
448 DOT026 - Alprazolam tablet 0,5 mg_ tablet December 2022 xxx
449 DOT027 - Alprazolam tablet 1 mg_ tablet December 2022 xxx
450 DOT028 - Aminofilin tablet 200 mg_ tablet December 2022 xxx
451 DOT029 - Amitripilin tablet salut 25 mg (HCI)_ tablet December 2022 xxx
452 DOT030 - Amlodipin tablet 10 mg_ tablet December 2022 xxx
453 DOT031 - Amlodipin tablet 5 mg_ tablet 30 September 2027 XXX 55
454 DOT032 - Amoksisilin kaplet 500 mg_ kaplet 31 December 2026 xxx 231 51 51 11,781
455 DOT033 - Amoksisilin sirup kering 125 mg/5 ml_ botol 31 December 2026 19092596 3,696
456 DOT034 - Aluminium Hidroksida 200 mg clan, Magnesium tablet 6 January 2023 A93350 60 1,330 640 780 870 1,150 1,095 770 1,140 1,185 1,710 1,350 480 12,500 750,000
457 DOT035 - Hidroksida 200
Hidroksida 200 mg/
mg_ 5 ml clan, Magnesium botol December 2022 xxx
Anti bakteri200
Hidroksida DOEN salep
mg/5 ml_kombinasi : Basitrasin 500
458 DOT036 - tube December 2022 xxx
IU/gr, Polimiksin
Antifungi 10.000 IU/g_
DOEN kombinasi : Asam Benzoat 6 % +
459 DOT037 - pot December 2022 xxx
Asam Salisilat 3 %_

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
460 DOT038 - supp December 2022 xxx
150 mg + Heksaklorofen 2.5kombinasi
Antiparkinson DOEN tablet mg_ : Karbidopa
461 DOT039 - tablet December 2022 xxx
25 mg Levodopa 250 mg_
462 DOT040 - Asam Askorbat (Vitamin C) tablet 50 mg_ tablet 30 November 2027 XXX
463 DOT041 - Asam Mefenamat kaplet 250 mg_ kapsul December 2022 xxx
464 DOT042 - Asam Mefenamat kaplet 500 mg_ kaplet 28 February 2024 51I0320 275 1,130 820 440 430 775 1,265 900 1,340 120 100 7,320 2,013,000
465 DOT043 - Asam Pipemidat tablet 400 mg_ kaplet December 2022 xxx
466 DOT044 - Asam Traneksamat 500 mg/ml injeksi_ ampul 30 April 2024 ITACA20115-1 1,880
467 DOT045 - Asam Traneksamat injeksi 100 mg/ml_ ampul December 2022 xxx 1,880
468 DOT046 - Asam Traneksamat tablet 500 mg_ tablet 31 August 2023 68304 1,114
469 DOT047 - Asiklovir krim 5 %_ tube December 2022 xxx
470 DOT048 - Asiklovir tablet 200 mg_ tablet 30 December 2023 1331 236
471 DOT049 - Asiklovir tablet 400 mg_ tablet December 2022 xxx
472 DOT050 - Atropin injeksi i.m./i.v./s.k. 0.25 mg/ml (sulfat)_ ampul December 2022 xxx
473 DOT051 - Attapulgite tablet 630 mg_ tablet December 2022 xxx
474 DOT052 - Betahistin Mesilat tablet 6 mg_ tablet 30 May 2026 xxx
475 DOT053 - Betametason krim 0.1 % (sebagai valerat)_ tube 31 December 2027 xxx 1,465
476 DOT054 - Bisakodil 10 mg suppositoria_ supp December 2022 xxx
477 DOT055 - Bisakodil 5 mg suppositoria_ supp December 2022 xxx
478 DOT056 - Bisakodil tablet 5 mg _ tablet December 2022 xxx
479 DOT057 - Bisoprolol tablet 5 mg_ tablet December 2022 xxx
480 DOT058 - Ca Glukonas injeksi i.v. 10 % ( 100 mg/ml )_ ampul 30 September 2027 XXX
481 DOT059 - Cetirizine syrup 5 mg/5 ml_ botol December 2022 xxx
482 DOT060 - Cetirizine tablet 10 mg_ tablet December 2022 xxx
483 DOT061 - Clonidine tablet 0,15 mg_ tablet December 2022 xxx
484 DOT062 - Deksametason injeksi Lv. 5 mg/ml_ ampul 31 July 2027 XXX
485 DOT063 - Deksametason tablet 0.5 mg_ tablet 31 January 2025 xxx 346 50 4 400
486 DOT064 - Desoksimetason krim 0,25%_ tube December 2022 xxx
487 DOT065 - Diazepam injeksi 5 mg/ml_ ampul 30 September 2023 FIJ379 1,545
488 DOT066 - Diazepam rectal 5 mg/2,5 ml_ supp 30 September 2023 FIJ379 1,545 2 2 2 6 9,270
489 DOT067 - Diazepam tablet 2 mg_ tablet December 2022 xxx
490 DOT068 - Diazepam tablet 5 mg_ tablet December 2022 xxx
491 DOT069 - Dietilkarbamazin Sitrat tablet 100 mg_ tablet December 2022 xxx
492 DOT070 - Digoksin tablet 0.25 mg_ tablet December 2022 xxx
493 DOT071 - Dimenhidrinat tablet 50 mg_ tablet 31 March 2024 D91011B 109 20 5 20 30 23 2 100 10,900
494 DOT072 - Domperidon syrup 5 mg/5 ml_ botol 31 October 2022 SCL30449 9,931
495 DOT073 - Domperidon tablet 10 mg_ tablet 28 February 2023 A5005BX
496 DOT074 - Epinefrin (Adrenalin) injeksi 0.1 % (sebagai HCI)_ ampul 30 September 2027 XXX 2 2 5 11 10 30
497 DOT075 - Eritromisin kapsul 500 mg_ kapsul December 2022 xxx
498 DOT076 - Eritromisin sirup 200 mg/5 ml_ botol December 2022 xxx
499 DOT077 - Fenobarbital tablet 100 mg_ tablet December 2022 xxx
500 DOT078 - Fenobarbital tablet 30 mg_ tablet December 2022 xxx
501 DOT079 - Fenol Gliserol tetes telinga 10 %_ botol 31 August 2023 xxx
502 DOT080 - Fitomenadion ( Vit. K ) injeksi i.m. 2 mg/ml_ ampul 31 May 2026 xxx
503 DOT081 - Fitomenadion (Vit.K) tablet salut gula 10 mg_ botol December 2022 xxx
504 DOT082 - Furosemid injeksi i.v./i.m. 10 mg/ml_ ampul 29 April 2023 4410790 969 7 5 4 9 10 5 15 5 10 70 67,830

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
505 DOT083 - Furosemid tablet 40 mg_ tablet 31 July 2025 XXX
506 DOT084 - gr, Kalium Klorida 0.30 gr, Trinatnum Sitrat sachet 30 October 2027 XXX
507 DOT085 - Dihidrat 0.58
Gentamisin gr, Glukosa
salep kulit 0.1Anhidrat
%_ 4 gr_ tube December 2022 xxx
508 DOT086 - Gentamisin salep mata 0,3%_ tube December 2022 xxx
509 DOT087 - Gentian Violet larutan 1 %_ botol December 2022 xxx
510 DOT088 - Glibenklamida tablet 5 mg_ tablet 30 December 2028 xxx
511 DOT089 - Glimepiride tablet 1 mg_ tablet December 2022 xxx
512 DOT090 - Glimepiride tablet 2 mg_ tablet December 2022 xxx
513 DOT091 - Gliseril Gualakolat tabelt 100 mg_ tablet December 2022 xxx
514 DOT092 - Glukosa larutan infus 10 % steril_ botol December 2022 xxx
515 DOT093 - Glukosa larutan infus 5 % steril_ botol 31 July 2024 1B9B001
516 DOT094 - Griseofulvin Micronized tablet 125 mg_ tablet 30 May 2026 xxx
517 DOT095 - Hidrokortison krim 2.5 %_ tube 28 February 2027 KCHCTA21298 2,890 7 5 12 34,680
518 DOT096 - Hyoscine-N-Butilbromide injeksi 20 mg/ml_ ampul December 2022 xxx
519 DOT097 - Hyoscine-N-Butilbromide tablet 10 mg_ tablet December 2022 xxx
520 DOT098 - Ibuprofen suspensi 100 mg/5 ml_ botol December 2022 xxx
521 DOT099 - Ibuprofen suspensi 200 mg/5 ml_ botol December 2022 xxx
522 DOT100 - Ibuprofen tablet 200 mg_ botol December 2022 xxx
523 DOT101 - Ibuprofen tablet 400 mg_ tablet December 2022 xxx
524 DOT102 - Isoniazide (INH) tablet 100 mg_ tablet 30 October 2022 A905560/PROG TB 260 7 51 58 15,080
525 DOT103 - Isoniazide (INH) tablet 300 mg_ tablet 31 July 2023 NIE2120A/PROGTB 7,069 30 30 212,070
526 DOT104 - Isosorbid Dinitrat tablet Sublingual 5 mg_ tablet December 2022 xxx
527 DOT105 - Kalsium Laktat (Kalk) tablet 500 mg_ tablet 30 September 2022 A92331 62
528 DOT106 - Kandesartan tablet 8 mg_ tablet 31 January 2024 53B4161 215 160 152 378 280 230 300 305 145 1,950 419,250
529 DOT107 - Kaptopril tablet 12.5 mg_ tablet December 2022 xxx
530 DOT108 - Kaptopril tablet 25 mg_ tablet 31 December 2023 LK1069-APR2020 90
531 DOT109 - Kaptopril tablet 50 mg_ tablet December 2022 xxx
532 DOT110 - Karbamazepin tablet 200 mg_ tablet December 2022 xxx
533 DOT111 - Karbogliserin Tetes Telinga 10 %_ botol December 2022 xxx
534 DOT112 - Ketokonazol krim 2 %_ tube 30 November 2023 K9169OT 4,067 15 12 14 14 8 63 256,221
535 DOT113 - Ketokonazol tablet 200 mg_ tablet 31 December 2026 xxx
536 DOT114 - Ketorolac injeksi 30 mg/ml_ ampul December 2022 xxx
537 DOT115 - Ketorolac tablet 30 mg_ tablet December 2022 xxx
538 DOT116 - Klindamisin kapsul 150 mg_ kapsul December 2022 xxx
539 DOT117 - Klindamisin kapsul 300 mg_ kapsul December 2022 xxx
540 DOT118 - Kloramfenikol kapsul 250 mg_ kapsul December 2022 xxx
541 DOT119 - Kloramfenikol salep kulit 2 %_ tube December 2022 xxx
542 DOT120 - Kloramfenikol salep mata 1 %_ tube December 2022 xxx
543 DOT121 - Kloramfenikol tetes telinga 3 %_ botol December 2022 xxx
544 DOT122 - Klorfeniramina Malet (CTM) tablet 4 mg_ botol 31 May 2026 xxx
545 DOT123 - Kodein tablet 10 mg_ tablet December 2022 xxx
546 DOT124 - Kombinasi Multivitamin dan Mineral_ tablet 31 December 2022 A02479 1,512
547 DOT125 - Kombinasi Multivitamin syrup untuk anak_ botol December 2022 xxx
548 DOT126 - Kombinasi Tripolidin dan Pseudoefedrin tablet_ tablet 31 May 2024 A2E144 110 10 120
549 DOT127 - tablet 31 March 2026 xxx
Sulfametoksazol 400 mg, Trimetoprin 80 mg_

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
550 DOT128 - tablet December 2022 xxx
Sulfametoksazol 100 mg, Trimetoprin
Kotrimoksazol suspensi kombinasi : 20 mg_
551 DOT129 - botol 31 December 2022 A92961 2,190 26 11 2 39 85,410
Sulfametoksazol 200 mg + Trimetoprin 40 mg/5 ml_
552 DOT130 - Kuinin tablet 222 mg (H₂SO₄ & H₂O)_ tablet December 2022 xxx
553 DOT131 - Lanzoprazol kapsul 30 mg_ kapsul 30 May 2026 xxx
554 DOT132 - Lidokain compositum injeksi 2 %_ ampul 30 April 2027 XXX 2,827
555 DOT133 - Lidokain injeksi 2 %_ ampul 30 September 2027 XXX
556 DOT134 - Loperamide tablet 2 mg_ tablet December 2022 xxx
557 DOT135 - Magnesium Sulfat injeksi (IV) 20 % - 25 ml_ vial 30 September 2027 XXX
558 DOT136 - Magnesium Sulfat injeksi (IV) 40 % - 25 ml_ vial 30 December 2027 XXX 4 4
559 DOT137 - MB Anak ( Obat Kusta)_ blister December 2022 xxx
560 DOT138 - MB Dewasa ( Obat Kusta )_ blister December 2022 xxx
561 DOT139 - Meloksikam tablet 15 mg_ tablet December 2022 xxx
562 DOT140 - Meloksikam tablet 7,5 mg_ tablet December 2022 xxx
563 DOT141 - Metformin HCl tablet 500 mg_ tablet 31 May 2026 xxx 85
564 DOT142 - Metildopa tablet 250 mg_ tablet 31 July 2026 XXX 1,088
565 DOT143 - Metilergometrin Maleat injeksi 0.200 mg - 1 ml_ ampul 31 March 2026 xxx
566 DOT144 - Metilergometrin Maleat tablet salut 0.125 mg_ tablet December 2022 xxx
567 DOT145 - Metoklopramide injeksi 5 mg/2 ml_ ampul 31 December 2026 xxx
568 DOT146 - Metoklopramide sirup 5 mg / 5 ml_ botol December 2022 xxx
569 DOT147 - Metoklopramide tablet 10 mg_ tablet 30 September 2026 J112458 117 100 100 11,700
570 DOT148 - Metronidazol infuse_ botol December 2022 xxx
571 DOT149 - Metronidazol tablet 250 mg_ tablet December 2022 xxx
572 DOT150 - Metronidazol tablet 500 mg_ tablet December 2022 xxx
573 DOT151 - Mikonazol krim/salep 2 % (Nitrat)_ tube December 2022 xxx
574 DOT152 - Mineral Mix_ sachet December 2022 xxx
575 DOT153 - N Asetylsistein tablet 200 mg_ tablet December 2022 xxx
576 DOT154 - Natrium Diklofenak tablet 25 mg_ tablet December 2022 xxx
577 DOT155 - Natrium Diklofenak tablet 50 mg_ tablet 29 July 2023 xxx
578 DOT156 - Natrium Klorida larutan infus 0.9 %_ botol 30 September 2027 XXX 6,840
579 DOT157 - Nifedipin tablet 10 mg_ tablet 30 September 2027 XXX
580 DOT158 - Nystatin Vaginal tab 100.000 IU/g_ tablet 31 August 2023 xxx 688
581 DOT159 - Obat Anti Tuberkulosis Sisipan_ paket December 2022 xxx
582 DOT160 - Obat Antituberkolosis FDC Katagori 1_ paket 30 October 2027 H93069J 477,791 2 2 955,582
583 DOT161 - Obat Antituberkolosis FDC Katagori 2_ paket December 2022 xxx
584 DOT162 - Obat Antituberkolosis FDC Katagori Anak_ paket December 2022 xxx
585 DOT163 - Oksitetrasiklin HCl Salep Mata 1 %_ tube 31 May 2026 xxx 9 9
586 DOT164 - Oksitetrasiklin Salep Kulit 3 %_ tube December 2022 xxx
587 DOT165 - Oksitosin injeksi 10 IU/ml - 1 ml_ ampul 30 June 2026 XXX
588 DOT166 - Omeprazol kapsul 20 mg_ kapsul 29 July 2023 KOPZB10627 422 600 290 890 375,580
589 DOT167 - Ondansentron injeksi 4 mg /2 ml_ ampul 31 August 2026 xxx
590 DOT168 - Ondansetron tablet 4 mg_ tablet 31 August 2026 XXX 429
591 DOT169 - Parasetamol drops_ botol December 2022 xxx
592 DOT170 - Parasetamol infuse_ botol December 2022 xxx
593 DOT171 - Parasetamol rectal_ supp rectal December 2022 xxx
594 DOT172 - Parasetamol sirup 120 mg/5 ml_ botol 30 October 2027 D39914-K19810-K2 1,160 150 647 797 924,520

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
595 DOT173 - Parasetamol tablet 500 mg_ tablet December 2022 xxx
596 DOT174 - PB Anak ( Obat Kusta )_ blister December 2022 xxx
597 DOT175 - PB Dewasa ( Obat Kusta )_ blister December 2022 xxx
598 DOT176 - Permetrin krim 5 % Scabimit cream_ tube December 2022 xxx
599 DOT177 - Piracetam tablet 400 mg_ tablet December 2022 xxx
600 DOT178 - Piracetam tablet 800 mg_ tablet December 2022 xxx
601 DOT179 - Pirantel syrup 125 mg/ml_ botol December 2022 xxx
602 DOT180 - Pirantel tablet score (Base) 125 mg_ tablet December 2022 xxx
603 DOT181 - Piridoksin (Vitamin B6) tablet 10 mg (HCI)_ tablet 30 September 2027 XXX
604 DOT182 - Piroksikam tablet 10 mg_ tablet December 2022 xxx
605 DOT183 - Piroksikam tablet 20 mg_ tablet December 2022 xxx
606 DOT184 - Prednison tablet 5 mg_ tablet 30 September 2022 1009072 220
607 DOT185 - Primakuin tablet 15 mg_ tablet 30 September 2027 16386002 253 4 14 10 28 7,084
608 DOT186 - Propanolol tablet 10 mg ( HCl )_ tablet December 2022 xxx
609 DOT187 - Propanolol tablet 40 mg (HCI)_ tablet December 2022 xxx
610 DOT188 - Propilitourasil tablet 100 mg_ tablet December 2022 xxx
611 DOT189 - Ranitidin injeksi 25 mg/2 ml_ ampul 31 January 2022 9620A0020A 858
612 DOT190 - Ranitidin tablet 150 mg_ tablet December 2022 xxx
613 DOT191 - Retinol (Vitamin A) 100.000 IU kapsul lunak_ kapsul 29 June 2024 J72854W 286
614 DOT192 - Retinol (Vitamin A) 200.000 IU kapsul lunak_ kapsul December 2022 xxx 569 150 150 85,350
615 DOT193 - Ringer Laktat larutan infus_ botol 30 December 2027 XXX
616 DOT194 - Salbutamol cairan ih 0,1% (Nebulizer)_ botol 30 November 2023 5212429 5,400 49 49 264,600
617 DOT195 - Salbutamol inhalasi/aerosol 100 mcg/dosis_ botol December 2022 xxx
618 DOT196 - Salbutamol tablet 2 mg_ tablet December 2022 xxx
619 DOT197 - Salbutamol tablet 4 mg (sebagai sulfat)_ tablet 30 September 2022 A 8315 TX 67
620 DOT198 - pot December 2022 xxx
Endap 4 %_
621 DOT199 - Salep Luka Bakar_ tube 30 November 2022 184400 18,557
622 DOT200 - Salisil Bedak 2 %_ kotak December 2022 xxx
623 DOT201 - Sefadroksil kapsul 500 mg_ kapsul December 2022 xxx
624 DOT202 - Sefadroksil sirup kering 125 mg/5 ml_ botol December 2022 xxx
625 DOT203 - Sianokobalamin (Vit. B12) tablet 50 mg_ tablet December 2022 xxx
626 DOT204 - Simvastatin tablet 10 mg_ tablet 31 August 2023 xxx 117
627 DOT205 - Simvastatin tablet 20 mg_ tablet 30 August 2027 XXX
628 DOT206 - Siprofloksasin tablet 500 mg (sebagai HCI)_ tablet December 2022 xxx
629 DOT207 - Spironolakton tablet 25 mg_ tablet December 2022 xxx
630 DOT208 - Sukralfat susp 500 mg/5 ml, 100 ml_ botol 31 March 2026 xxx 6,130
631 DOT209 - Tablet tambah darah _ tablet 31 May 2023 xxx 409
632 DOT210 - Tetrasiklin kapsul 250 mg_ kapsul December 2022 xxx
633 DOT211 - Tetrasiklin kapsul 500 mg_ kapsul December 2022 xxx
634 DOT212 - Tiamfenikol kapsul 500 mg_ kapsul December 2022 xxx
635 DOT213 - Tiamfenikol syrup 125 mg/ 5 ml_ botol December 2022 xxx
636 DOT214 - Tiamin (Vitamin B1) tablet 50 mg (HCI/Nitrat)_ tablet 1 October 2023 181918B
637 DOT215 - Trihexypenidyl tablet 2 mg_ tablet 30 September 2023 A01839
638 DOT216 - Vitamin B Kompleks tablet_ tablet December 2022 xxx
639 DOT217 - Zinc syrup 20 mg/5 ml_ botol 31 December 2026 xxx

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
640 DOT218 - Zinc tablet 20 mg_ tablet 30 September 2027 XXX
641 DOT219 - ABU (Anti Bisa Ular)_ vial December 2022 xxx
642 DOT220 - ADS 0,05 ML_ piece 31 January 2025 20001 1,460 24 14 15 26 25 22 20 146 213,160
643 DOT221 - ADS 0,5 ML_ piece December 2022 xxx
644 DOT222 - ADS 2 ML_ piece December 2022 xxx
645 DOT223 - ADS 5 ML_ piece 31 March 2026 xxx
646 DOT224 - ATS 1500 IU_ vial December 2022 xxx
647 DOT225 - BCG 20 DS_ vial 30 October 2027 0970G007 98,000 8 5 13 1,274,000
648 DOT226 - BCG PELARUT_ vial December 2022 xxx
649 DOT227 - CAMPAK 10 DS_ vial December 2022 xxx
650 DOT228 - CAMPAK 20 DS_ vial December 2022 xxx
651 DOT229 - CAMPAK PELARUT_ vial December 2022 xxx
652 DOT230 - DPT-HB HIB_ vial December 2022 xxx
653 DOT231 - DT 10 DS_ vial 31 August 2024 0400621 24,400 1 28 29 707,600
654 DOT232 - HEP B PID 1 DS_ vial 30 June 2025 XXX
655 DOT233 - HEPATITIS B Imunoglobulin ( human) _ ampul December 2022 xxx
656 DOT234 - IPV 10 DS_ vial December 2022 xxx
657 DOT235 - POLIO 10 DS_ vial 31 December 2022 2050420 23,643 1 15 14 2 17 49 1,158,507
658 DOT236 - POLIO 20 DS_ vial December 2022 xxx
659 DOT237 - Td 10 DS_ vial 30 May 2026 xxx
660 DOT238 - TT 10 DS_ vial December 2022 xxx
661 DOT239 - VAR_ vial December 2022 xxx
662 DOT240 - Alat suntik sekali pakai 1 ml_ piece December 2022 xxx
663 DOT241 - Alat suntik sekali pakai 2.5 ml_ piece December 2022 xxx
664 DOT242 - Alat suntik sekali pakai 3 ml_ piece 31 May 2027 prog hiv 888
667 DOT245 - Blood lancet_ piece December 2022 xxx
668 DOT246 - piece December 2022 xxx
(cromic)_
(plain)_
(cromic)_
(plain)_
672 DOT250 - Elastis verban 3 inchi_ roll December 2022 xxx
673 DOT251 - Etakridin larutan 0.1 % 300 ml_ botol December 2022 xxx
674 DOT252 - Etanol 70 % 1 Liter_ botol 31 August 2024 17092088 27,500
675 DOT253 - Folley Catheter 12_ piece 31 August 2027 XXX
676 DOT254 - Folley Catheter 16_ piece 30 September 2027 XXX 10,261
677 DOT255 - Folley Catheter 18_ piece 30 September 2027 XXX
678 DOT256 - Hand Scrubs Anti Mikroba_ botol December 2022 xxx
679 DOT257 - Handscoon Gynecology_ pasang December 2022 xxx
680 DOT258 - Handscoon Size. S_ Box 31 July 2024 19050580306-1908 48,930
681 DOT259 - Handscoon Size. M_ Box 31 May 2024 19-06-68-05-7 48,931
682 DOT260 - Handscoon Size. L_ Box 31 July 2024 HL2021 137,500
683 DOT261 - Handscoon Size. XL_ pasang December 2022 xxx
684 DOT262 - Handscoon Steril No. 6 _ pasang December 2022 xxx

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
685 DOT263 - Handscoon Steril No. 6,5_ pasang December 2022 xxx
686 DOT264 - Handscoon Steril No. 7_ pasang December 2022 xxx
687 DOT265 - Hidrogen Peroksida 3 %_ botol December 2022 xxx
688 DOT266 - Infusion Set Anak_ piece December 2022 xxx
689 DOT267 - Infusion Set Dewasa_ piece 30 September 2022 20170922 7,413 32 23 20 21 96 711,648
690 DOT268 - IV Catheter No. 20 G_ piece 17 April 2023 200421des20 8,326
691 DOT269 - IV Catheter No. 22 G_ piece 23 May 2025 200511 7,937 3 15 11 22 15 26 11 103 817,511
692 DOT270 - IV Catheter No. 24 G_ piece 31 January 2023 xxx 7,929
693 DOT271 - IV Catheter No. 26 G_ piece December 2022 xxx
694 DOT272 - Kapas Pembalut/Absorben 250 gram_ bungkus December 2022 xxx
695 DOT273 - Kasa Alkohol steril (Alkohol swab)_ piece 30 November 2024 12122101 prog hiv 14,420
696 DOT274 - Kasa Pembalut Hydrofil 4m x 15cm_ roll December 2022 xxx
697 DOT275 - Masker - 3 Ply plus Ear Loop_ piece December 2022 prog TB 87,838 2 2 175,676
698 DOT276 - Masker - Plus 3 Ply plus Ear Loop _ piece 30 June 2023 prog hiv 4 4
699 DOT277 - Masker sungkup oksigen anak_ piece 31 October 2023 123 1
700 DOT278 - Masker sungkup oksigen dewasa_ piece December 2022 xxx
701 DOT279 - Pembalut Elastis_ piece December 2022 xxx
702 DOT280 - Plester 0.5 x 5 M_ roll December 2022 xxx
703 DOT281 - Pot Sputum_ pot December 2022 xxx
704 DOT282 - Povidon Iodida larutan 10 % 300 ml_ botol 300 m 31 December 2026 xxx
705 DOT283 - Safety Box 2,5 L_ piece December 2022 xxx
706 DOT284 - Safety Box 5 L_ piece 28 February 2025 safetybox5lapbd20 15,950
707 DOT285 - Silk (Benang Sutera) No. 3/0_ piece December 2022 xxx
708 DOT286 - Underpad_ piece December 2022 xxx
709 DOT287 - Urine bag_ piece 29 February 2024 16208 8,070 4 1 7 2 14 112,980
710 DOT288 - Giemsa_ botol December 2022 xxx
711 DOT289 - Rapid Test : Dengue - IgG/IgM_ strip December 2022 xxx
712 DOT290 - Rapid Test HIV_ box/25 30 September 2023 J21067/VIROCHEC 206,225 1 1 1 2 5 1,031,125
713 DOT291 - RDT : Dengue - Antigen_ strip December 2022 xxx
714 DOT292 - RDT : Hepatitis_ kotak/25 December 2022 xxx
715 DOT293 - RDT : Malaria_ kotak/25 December 2022 xxx
716 DOT294 - RDT : Shipilis_ kotak/ 25 30 September 2024 J22026/TREPOCHE 232,500 2 2 465,000
717 DOT295 - Reagen Zet Nielson_ paket December 2022 xxx
718 DOT296 - SD Chikungunya IgM_ kit December 2022 xxx
719 DOT297 - SD Rapid Test (malaria)_ box December 2022 xxx
720 DOT298 - Glass Ionomer Cement ART_ set December 2022 xxx
721 DOT299 - Aminofilin tablet 150 mg_ Tablet December 2022 xxx
722 DOT300 - Asam Folat tablet 1 mg_ Tablet December 2022 xxx
723 DOT301 - Clozapine tablet 25 mg_ Tablet December 2022 xxx
724 DOT302 - DHP Frimal_ Tablet 31 December 2026 xxx 2,134
725 DOT303 - Flufenazinedecanoat injeksi 25 mg/ml_ Ampul December 2022 xxx
726 DOT304 - Griseufulvin tablet 500 mg_ Tablet December 2022 xxx
727 DOT305 - Haloperidol injeksi 5 mg/ml_ Ampul December 2022 xxx
728 DOT306 - Haloperidol tablet 5 mg_ Tablet December 2022 xxx
729 DOT307 - Metformin tablet 850 mg_ Tablet December 2022 xxx

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
730 DOT308 - Risperidon tablet 2 mg_ Tablet 30 September 2026 XXX
731 DOT309 - IV Catheter No. 18 G_ Piece December 2022 xxx
732 DOT310 - IV Dressing_ Piece 31 May 2027 15062288
733 DOT311 - Nasal Canula ( selang oksigen ) Bayi_ Piece December 2022 xxx
734 DOT312 - Nasal Canula ( selang oksigen ) Anak_ Piece December 2022 xxx
735 DOT313 - Nasal Canula ( selang oksigen ) Dewasa_ Piece December 2022 xxx
736 DOT314 - OAT Kombipak Kat. 1_ Paket December 2022 xxx
737 DOT315 - TUBERCULIN 5 Vial/Kotak_ Vial December 2022 xxx
738 DOT316 - Malaria KIT_ Paket 31 December 2023 p-412-Dinkes-P2PL 1,815,550
739 DOT317 - Reagen Rapid 1 HIV (SD)_ Test December 2022 xxx
740 DOT318 - Reagen Rapid 2 HIV (Diagnostar)_ Test December 2022 xxx
741 DOT319 - Rapid Test Shipilis Ab (Biosensor)_ Test December 2022 xxx
742 DOT320 - RPR Rapid Test (Shipilis) Focus_ Test 31 December 2025 1811088 4,250
743 DOT321 - RDT Hepatitis (HSBSAg)_ Strip 31 August 2023 H21072 8,326 100 150 150 400 3,330,400
744 DOT322 - Reagen Test Anti HCV (+HIV)_ Test 30 January 2027 1821066 13,252
745 DOT323 - HBIG (0.5) ML_ Vial December 2022 xxx
Antiperkinson tablet, Kombinasi : Benserazid 25 mg
746 DOT324 - Tablet December 2022 xxx
+ Levodopa 100 mg ( LEVOPAR )__
Flufennazin injeksi 25 mg/ml (i.m.) ( SIKZONOATE
747 DOT325 - Ampul December 2022 xxx
INJEKSI )__
748 DOT326 - Gentamisin sulfat tetes mata 0.3%__ Botol 31 December 2027 xxx 21,359 6 1 1 1 9 192,231
Hepatitis B imunoglobulin (human) inj 220 IU/mL
749 DOT327 - Vial December 2022 xxx
( HYPERHEP B S / D )__
750 DOT328 - Syringe 1 ml Luer Slip / 26Gx1/2Inch (13mm)__ Piece December 2022 xxx
Syringe 10 ml Luer Lock With Needle 21Gx1-
751 DOT329 - Piece December 2022 xxx
1/2inch
Syringe 3(38mm)__
ml Luer Lock With Needle 23Gx1-1/4inch
(32mm)__
Syringe 5 ml Luer Lock With Needle 22Gx1-1/2inch
(38mm)__
Trifluoperazinehydrochloride (HCI) tablet salut
754 DOT332 - Tablet 28 February 2024 A00442 331 30 100 130 43,030
selaput 5 mg__
Hyoscine-N-Butilbromide 10 mg + Parasetamol 500
755 DOT333 - Tablet 30 September 2026 XXX 30 30
mg tablet_
756 DOT334 - Amoksisillin drops 100 mg/ml_ Botol 31 August 2023 310526801-410526 13,500
757 DOT335 - Benzatin benzil penisilin_ - December 2022 xxx
758 DOT336 - Blue Tipe_ Pcs/Bngks 31 December 2024 10121988 47,468 1 1 47,468
759 DOT337 - Combivent Nebul_ Flash 31 October 2024 9984215 626
760 DOT338 - Ergotamin Caffein_ Tablet December 2022 xxx
761 DOT339 - Euthyrox_ Tablet 31 December 2025 246917APBN 735
762 DOT340 - Fokus HIV_ Kotak 31 October 2023 1818148 333,375
763 DOT341 - Folley Chateter 14 G_ Pcs December 2022 xxx
764 DOT342 - Gluco Protein_ - December 2022 xxx
765 DOT343 - Kasa Pembalut Ukuran 3,6 M x 15 Cm_ Roll 30 June 2025 14620 4,100 5 10 10 10 35 143,500
766 DOT344 - Kloramfenikol tts mata_ Botol 30 May 2026 xxx 5 3 8
767 DOT345 - Kodein 15 mg_ Tablet 30 October 2025 B80196J 1,135 10 10 11,350
768 DOT346 - Lisinopril_ - December 2022 xxx
769 DOT347 - Masker Bedah Tali_ Kotak 30 April 2024 1061987 27,000
770 DOT348 - Masker Karet_ Kotak 30 April 2024 1081986 27,000
771 DOT349 - Sepatu Boot_ Pcs December 2022 xxx
772 DOT350 - MILRUB NR 500 ml ECO_ Botol 30 August 2027 60405200318 84,000
773 DOT351 - MILSCRUB 4% 500 ml ECO_ Botol 30 November 2027 090409191221 125,000
774 DOT352 - MILCIDE Spray 650 ml_ Botol December 2022 xxx

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
775 DOT353 - Kaca Mata GOGLE_ Piece December 2022 xxx
776 DOT354 - Masker N95 _ Piece 31 December 2024 xxx 19,000 20 40 60 1,140,000
777 DOT355 - Masker KN95_ Piece December 2022 xxx
778 DOT356 - Hansanitizer 5 Liter_ Botol 28 February 2023 6032088 973,500
779 DOT357 - Phenytoin_ - December 2022 xxx
780 DOT358 - Tablet Klor_ 1_ Tablet December 2022 xxx
781 DOT359 - Tablet Klor_ 2_ Tablet December 2022 xxx
782 DOT360 - Plesterin Non Woven_ kotak @200 31 January 2025 9072088 42,000 1 1 2 84,000
783 DOT361 - Reagen Golongan Darah Anti A_ Botol 30 September 2027 1010221P 163,900 1 1 1 3 491,700
784 DOT362 - Reagen Golongan Darah Anti A-B_ Botol 31 July 2026 XXX 163,900
785 DOT363 - Reagen Golongan Darah Anti B_ Botol 30 October 2027 102-232P 163,900 1 1 1 3 491,700
786 DOT364 - Reagen Golongan Darah Anti D_ Botol 31 December 2027 1050171P 707,685 2 1 3 2,123,055
787 DOT365 - Reagen Golongan Darah Anti A,B,AB,D_ Botol December 2022 xxx
788 DOT366 - Cairan Desinfectan_ Botol December 2022 xxx
789 DOT367 - Spironolacton 100mg_ Tablet December 2022 xxx
790 DOT368 - Strip Protein Urine_ Pcs/Kotak 6 January 2023 xxx 1 1 1 3
791 DOT369 - Tabung vac K3 EDTA 3ml_ PACK 30 April 2023 210521 200,000 100 300 400 80,000,000
792 DOT370 - Tabung vac K3 plain 3 ml_ pack 30 September 2023 08102188 H 132,000 1 1 1 1 1 2 7 924,000
793 DOT371 - Theophyline (Retaphyl SR)_ Kaplet 31 May 2023 F81197B 1,292 10 10 12,920
794 DOT372 - Trifluoperasin_ - December 2022 xxx
795 DOT373 - Vaksin MR_ Vial 30 June 2023 0121W149 167,860 10 11 7 6 12 16 3 1 3 11 80 13,428,800
796 DOT374 - Ventolin Nebulizer_ Ampul December 2022 xxx
797 DOT375 - Vikia HIV_ Kotak 31 March 2023 31112 487,000
798 DOT376 - White Tipe_ Pcs/Bungkus 31 May 2025 20520 41,277
799 DOT377 - Yellow Tipe_ Pcs/Bungkus December 2022 xxx
TOTAL NILAI REKAPITULASI PEMAKAIAN (Rp.) 418,404,379
Ket : Harga satuan sudah termasuk PPN
Kota Bangun, 31 Desember 2022
MENGETAHUI, YANG MELAPORKAN,

Kepala Puskesmas UPT. Dinkes Puskesmas Tenaga Farmasi Puskesmas
Rimba Ayu
Jaseri, Amd. Kep apt. Ropita, S. Farm

NIP. 19760405 200701 1 012 NIP. -

REKAPITULASI PEMAKAIAN
UPT. DINKES PUSKESMAS RIMBA AYU
KLAS HARGA
NO KODE OBAT NAMA SEDIAAN SATUAN
TERAPI SATUAN (Rp.) JAN
1 2 3 4 5 8 9
1 A001 6.1.1 Albendazol tablet 400 mg Tablet 366
2 A002 1.2 Alopurinol tablet 100 mg tablet 89
3 A003 1.2 Alopurinol tablet 300 mg tablet 220 20
4 A004 - Alprazolam tablet 0,25 mg tablet
5 A005 - Alprazolam tablet 0,5 mg tablet 94
6 A006 - Alprazolam tablet 1 mg tablet
7 A007 - Ambroxol sirup 15 mg/ml botol 4,886
8 A008 - Ambroxol tablet 30 mg tablet 111
9 A009 26.1 Aminofilin injeksi 24 mg/ml ampul 3,349
10 A010 26.1 Aminofilin tablet 200 mg tablet 153
11 A011 23.2 Amitripilin tablet salut 25 mg (HCI) tablet 175
12 A012 17.3 Amlodipin tablet 10 mg tablet 275 1,730
13 A013 17.3 Amlodipin tablet 5 mg tablet 55 2,010
14 A014 - Amoksisilin + As. Klavulanat 625 mg tablet tablet 6,925
15 A015 6.2.1 Amoksisilin kaplet 250 mg kapsul 388
16 A016 6.2.1 Amoksisilin kaplet 500 mg kaplet 299 813
17 A017 6.2.1 Amoksisilin sirup kering 125 mg/5 ml botol 2,050 35
18 A018 - Amoksisilin sirup kering forte 250 mg/5 ml botol 3,846
19 A019 6.2.1 Ampisillin serbuk injeksi iv 1000 mg/vial vial 9,473 2
20 A020 25.1 Aluminium Hidroksida 200 mg clan, Magnesium tablet 60
Hidroksida 200 mg

21 A021 25.1 Hidroksida 200 mg/ 5 ml clan, Magnesium botol 3,025 54
Hidroksida 200 mg/5 ml
22 A022 18.2 tube 5,000 10
IU/gr, Polimiksin 10.000 IU/g
23 A023 18.3 pot 5,517
Asam Salisilat 3 %
24 A024 25.3 supp 3,641 18
150 mg + Heksaklorofen 2.5 mg
25 A025 9.0 tablet
25 mg Levodopa 250 mg
26 A026 20.3 Aqua pro injeksi steril , bebas pirogen vial 25 ml 2,860 1
27 A027 20.3 Aqua pro injeksi steril , bebas pirogen_ vial 20 ml 5,800
28 A028 - Artesunate dan Amodiaquine HCl Tab (Anak) tablet 1,856
29 A029 - Artesunate dan Amodiaquine HCl Tab (Dewasa) tablet 1,856
30 A030 - Artesunate dan Amodiaquine HCl Tab (Remaja) tablet 1,856
31 A031 - Artesunate injeksi ampul 52,350
32 A032 - Arthemeter injeksi ampul 23,384
33 A033 - Asam Asetilsalisilat 80 mg) tablet 132 50
34 A034 29 Asam Askorbat (Vitamin C) tablet 50 mg tablet 92
35 A035 1.2 Asam Mefenamat kaplet 250 mg kapsul 166
36 A036 1.2 Asam Mefenamat kaplet 500 mg kaplet 117
37 A037 - Asam Pipemidat tablet 400 mg kaplet 3,515
38 A038 10.2 Asam Traneksamat 500 mg/ml injeksi ampul 1,880
39 A039 10.2 Asam Traneksamat injeksi 100 mg/ml ampul 2,374
40 A040 10.2 Asam Traneksamat tablet 500 mg tablet 1,927 60
41 A041 21.2 Asiklovir krim 5 % tube 3,657 5
42 A042 21.2 Asiklovir tablet 200 mg tablet 514
43 A043 21.2 Asiklovir tablet 400 mg tablet 454 44
44 A044 - Atorvastatin 20 mg tablet 471
45 A045 25.4 Atropin injeksi i.m./i.v./s.k. 0.25 mg/ml (sulfat) ampul 1,718
46 A046 - Attapulgite tablet 630 mg tablet 481

47 B001 - Betahistin Mesilat tablet 6 mg tablet 92 60
48 B002 18.4 Betametason krim 0.1 % (sebagai valerat) tube 1,533 3
49 B003 - Bisakodil 10 mg suppositoria supp 5,900
50 B004 - Bisakodil 5 mg suppositoria supp 5,670
51 B005 - Bisakodil tablet 5 mg tablet 216
52 B006 17.3 Bisoprolol tablet 5 mg tablet 626
53 B007 - Borax Glycerin 10 % botol 3,498 1
54 C001 - Ca Glukonas injeksi i.v. 10 % ( 100 mg/ml ) ampul 8,855 2
55 C002 - Cefixim kapsul 100 mg kapsul 649
56 C003 - Cefixim sirup 100 ml / 5 ml botol 7,690
57 C004 - Cetirizine syrup 5 mg/5 ml botol 2,215 48
58 C005 - Cetirizine tablet 10 mg tablet 81 780
59 C006 - Citicolin tablet 500 mg tablet 6,600
60 C007 - Clonidine tablet 0,15 mg tablet 224
61 D001 3 Deksametason injeksi Lv. 5 mg/ml ampul 1,210
62 D002 16.4 Deksametason tablet 0.5 mg tablet 80 9
63 D003 11.2 Dekstran 70 - Larutan infus 6 % steril botol 39,078
64 D004 18.4 Desoksimetason krim 0,25% tube 9,500 11
65 D005 5 Diazepam injeksi 5 mg/ml ampul 1,545
66 D006 5 Diazepam rectal 5 mg/2,5 ml supp 13,546
67 D007 5 Diazepam tablet 2 mg tablet 43
68 D008 5.0 Diazepam tablet 5 mg tablet 114
69 D009 6.1.2 Dietilkarbamazin Sitrat tablet 100 mg tablet 150
70 D010 3 Difenhidramin injeksi i.m. 10 mg/ml (HCI) ampul
71 D011 17.5 Digoksin tablet 0.25 mg tablet 108
72 D012 17.1 Diltiazem HCL tablet 30 mg tablet 137
73 D013 25.2 Dimenhidrinat tablet 50 mg tablet 109
74 D014 - Docusate Sodium 5 mg Tetes Telinga botol
75 D015 - Doksisiklin 100 mg kapsul
76 D016 25.2 Domperidon syrup 5 mg/5 ml botol 9,931 37
77 D017 25.2 Domperidon tablet 10 mg tablet 75 230
78 D018 17.7 Dopamin injeksi ampul 11,000
79 E001 26.1 Efedrin tablet 25 mg (HCI) tablet 210
80 E002 3 Epinefrin (Adrenalin) injeksi 0.1 % (sebagai HCI) ampul 1,740 3
81 E003 6.2.2.4 Eritromisin kapsul 500 mg kapsul 1,023
82 E004 6.2.2.4 Eritromisin sirup 200 mg/5 ml botol 7,039
87 F005 28.2 Fenol Gliserol tetes telinga 10 % botol 3,300 14
88 F006 10.2 Fitomenadion ( Vit. K ) injeksi i.m. 2 mg/ml ampul 1,320
89 F007 10.2 Fitomenadion (Vit.K) injeksi 10 mg/ml ampul
90 F008 10.2 Fitomenadion (Vit.K) tablet salut gula 10 mg tablet 781
91 F009 - Fluconazole tablet 150 mg tablet 20,700
92 F010 14.0 Furosemid injeksi i.v./i.m. 10 mg/ml ampul
93 F011 14 Furosemid tablet 40 mg tablet 114
94 G001 20.1 gr, Kalium Klorida 0.30 gr, Trinatnum Sitrat sachet 280 105
Dihidrat 0.58 gr, Glukosa Anhidrat 4 gr
95 G002 21.2 Gentamisin injeksi 40 mg/ml ampul 3,545
96 G003 21.2 Gentamisin injeksi 80 mg/ml vial 5,101
97 G004 21.2 Gentamisin salep kulit 0.1 % tube 2,670 27
98 G005 21.2 Gentamisin salep mata 0,3% tube 22,300
99 G006 14.2 Gentian Violet larutan 1 % botol 1,500
100 G007 16.1.1 Glibenklamida tablet 5 mg tablet 137
101 G008 16.2.1 Glimepiride tablet 1 mg tablet 174 230
102 G009 16.2.1 Glimepiride tablet 2 mg tablet 123 900
103 G010 26.3 Gliseril Gualakolat tabelt 100 mg tablet 89 1,244
104 G011 20.2 Glukosa larutan infus 10 % steril botol 8,003
105 G012 20.2 Glukosa larutan infus 40 % steril ampul 581
106 G013 20.2 Glukosa larutan infus 5 % steril botol 6,627
107 G014 6.3 Griseofulvin Micronized tablet 125 mg tablet 233
108 H001 15 Hidroklorotiazida tablet 25 mg tablet 178 40
109 H002 18.4 Hidrokortison krim 2.5 % tube 2,890 5
110 H003 - Hyoscine-N-Butilbromide injeksi 20 mg/ml ampul 6,188
111 H004 - Hyoscine-N-Butilbromide tablet 10 mg tablet 1,059
112 I001 1.2 Ibuprofen suspensi 100 mg/5 ml botol 2,339
113 I002 1.2 Ibuprofen suspensi 200 mg/5 ml botol 4,949
114 I003 1.2 Ibuprofen tablet 200 mg botol 164
115 I004 1.2 Ibuprofen tablet 400 mg tablet 215 560
118 I007 17.1 Isosorbid Dinitrat tablet Sublingual 5 mg tablet 35 30
121 K003 29 Kalsium Laktat (Kalk) tablet 500 mg tablet 60 1,920
122 K004 - Kanamycin injeksi 1 g ampul 8,965
123 K005 17.3 Kandesartan tablet 8 mg tablet 215 180
124 K006 17.3 Kaptopril tablet 12.5 mg tablet 69 130
125 K007 17.3 Kaptopril tablet 25 mg tablet 138 460
126 K008 17.3 Kaptopril tablet 50 mg tablet 143
127 K009 5 Karbamazepin tablet 200 mg tablet 250
128 K010 - Karbogliserin Tetes Telinga 10 % botol 2,500
129 K011 - Karbon aktif (Norit) botol 7,954
130 K012 - Ketokonazol krim 2 % tube 2,420
131 K013 - Ketokonazol tablet 200 mg tablet 286 110
132 K014 1.2 Ketorolac injeksi 30 mg/ml ampul 1,383
133 K015 1.2 Ketorolac tablet 30 mg tablet
134 K016 1.2 Ketoprofen 100 mg suppositoria supp 2,789
135 K017 1.2 Ketoprofen injeksi 50mg/ml ampul 7,628
136 K018 6.2.2.4 Klindamisin kapsul 150 mg kapsul 803
137 K019 6.2.2.4 Klindamisin kapsul 300 mg kapsul 1,539 20
138 K020 6.2.2.2 Kloramfenikol kapsul 250 mg kapsul 255
139 K021 21.2.1 Kloramfenikol salep kulit 2 % tube 3,760 39
140 K022 6.2.2.2 Kloramfenikol salep mata 1 % tube 2,054 8
141 K023 21.2 Kloramfenikol supensi 125 mg/5 ml botol 4,000
142 K024 3 Kloramfenikol tetes telinga 3 % botol 8,250
143 K025 6.4.2.1 Klorfeniramina Malet (CTM) tablet 4 mg botol 94 1,245
144 K026 6.4.2.1 Klorokuin tablet 150 mg tablet 115
145 K027 23.4 Klorokuin tablet 250 mg tablet 142
146 K028 23.4 Klorpromazin tablet salut 100 mg (HCI) tablet 165
147 K029 26.2 Klorpromazin tablet salut 25 mg (HCI) tablet 208
148 K030 - Kodein tablet 10 mg tablet 630
149 K031 - tablet
tablet ( Batuk )
150 K032 - botol
( Batuk ) syrup
Kombinasi Kaolin dan pectin (sirup antidiare untuk
151 K033 - botol 5,720 9
bayi dan anak)
152 K034 - Kombinasi Multivitamin dan Mineral tablet 563
153 K035 - Kombinasi Multivitamin syrup untuk anak botol 8,325 1
154 K036 - Kombinasi Tripolidin dan Pseudoefedrin tablet tablet 935 20
155 K037 - botol 14,216 1
( Tetes Mata )
156 K038 - botol 2
( Tetes Telinga )
157 K039 6.2.2 tablet 133 50
158 K040 6.2.2 tablet 103

159 K041 6.2.2 botol 8,950
Sulfametoksazol 200 mg + Trimetoprin 40 mg/5 ml
160 K042 6.4.2.2 Kuinin tablet 222 mg (H₂SO₄ & H₂O) tablet 737
161 L001 25.1 Lanzoprazol kapsul 30 mg kapsul 278 10
Larutan mengandung Karbohidrat+Elektrolit (NaCl

162 L002 - botol 500ml 10,000
1,75g, KCl 1,5 g, Na. Laktat 2,24 g, Dekstrosa 27 g)
163 L003 - Levofloksasin tetes mata 0,5 % botol 16,995

164 L004 14.1 Lidokain compositum injeksi 2 % ampul 1,404 23
165 L005 14.1 Lidokain injeksi 2 % ampul 891
166 L006 - Lincomycin tablet 500 mg tablet 878
167 L007 - Loperamide tablet 2 mg tablet 139 100
168 L008 - Loratadin tablet 10 mg tablet 129 35
169 M001 5 Magnesium Sulfat injeksi (IV) 20 % - 25 ml vial 4,120
170 M002 5 Magnesium Sulfat injeksi (IV) 40 % - 25 ml vial 4,700
171 M003 - MB Anak ( Obat Kusta) blister 22,794
172 M004 - MB Dewasa ( Obat Kusta ) blister
173 M005 - Meloksikam tablet 15 mg tablet 1,619
174 M006 - Meloksikam tablet 7,5 mg tablet 934
Menadion Natrium Bisulfit (Vit.K3) injeksi 10
175 M007 - ampul 478
mg/ml
176 M008 - Metanizol (Antrain) injeksi ampul 3,045 5
177 M009 16.2.1 Metformin HCl tablet 500 mg tablet 84 1,110
178 M010 17.3 Metildopa tablet 250 mg tablet 1,023
179 M011 22.1 Metilergometrin Maleat injeksi 0.200 mg - 1 ml ampul 1,069 5
180 M012 22.1 Metilergometrin Maleat tablet salut 0.125 mg tablet 258
183 M015 25.2 Metoklopramide injeksi 5 mg/2 ml ampul 991 6
184 M016 25.2 Metoklopramide sirup 5 mg / 5 ml botol 2,835
185 M017 25.2 Metoklopramide tablet 10 mg tablet 117 70
186 M018 6.2.2 Metronidazol infuse botol 39,825
187 M019 - Metronidazol ovula 500 mg suppvag 3,590
188 M020 6.2.2 Metronidazol tablet 250 mg tablet 98
189 M021 6.2.2 Metronidazol tablet 500 mg tablet 251
190 M022 18.3 Mikonazol krim/salep 2 % (Nitrat) tube 1,900 5
191 M023 - Mineral Mix sachet 3,116
192 M024 18.4 Mometason Furoat Krim 0,1% tube 8,437 1
193 N001 - N Asetylsistein tablet 200 mg tablet 317 300
194 N002 1.2 Natrium Diklofenak tablet 25 mg tablet 226
195 N003 1.2 Natrium Diklofenak tablet 50 mg tablet 109 510
196 N004 20.2 Natrium Klorida larutan infus 0.9 % botol 6,900 19
197 N005 17.3 Nifedipin tablet 10 mg tablet 242
198 N006 6.3 Nystatin Vaginal tab 100.000 IU/g tablet 550
199 O001 6.2.4 Obat Anti Tuberkulosis Sisipan paket 183,984
200 O002 6.2.4 Obat Antituberkolosis FDC Katagori 1 paket 481,892 1
201 O003 6.2.4 Obat Antituberkolosis FDC Katagori 2 paket 1,379,984
202 O004 6.2.4 Obat Antituberkolosis FDC Katagori Anak paket 247,234
203 O005 26.3 Obat Batuk Hitam (O.B.H) cairan botol 5,772
204 O006 - Obat Kumur ( Antiseptik / anastetik lokal ) botol 18,480
205 O007 6.2.2 Oksitetrasiklin HCI injeksi i.m.50 mg/ml - 10 ml vial 3,410
206 O007 6.2.2 Oksitetrasiklin HCl Salep Mata 1 % tube 9
207 O008 6.2.2 Oksitetrasiklin Salep Kulit 3 % tube 1,646
208 O009 22.1 Oksitosin injeksi 10 IU/ml - 1 ml ampul 1,248 13
209 O010 25.1 Omeprazol kapsul 20 mg kapsul 458
210 O011 - Ondansentron injeksi 4 mg /2 ml ampul
211 O012 - Ondansetron tablet 4 mg tablet 429
212 P001 - Papaverin tablet 40 mg tablet 310 30
213 P002 1.2 Parasetamol drops botol 4,950
214 P003 1.2 Parasetamol infuse botol
215 P004 1.2 Parasetamol rectal supp rectal 7,743
216 P005 1.2 Parasetamol sirup 120 mg/5 ml botol 1,160
217 P006 1.2 Parasetamol tablet 500 mg tablet 242 3,062
218 P007 - PB Anak ( Obat Kusta ) blister 9,570
219 P008 - PB Dewasa ( Obat Kusta ) blister 9,770
220 P009 - Permetrin krim 5 % Scabimit cream tube 11,250 8
221 P010 - Piracetam tablet 400 mg tablet 609
222 P011 - Piracetam tablet 800 mg tablet 1,084
223 P012 6.1.1 Pirantel syrup 125 mg/ml botol 9,100
224 P013 6.1.1 Pirantel tablet score (Base) 125 mg tablet 318
225 P014 29 Piridoksin (Vitamin B6) tablet 10 mg (HCI) tablet 142 400
228 P017 16.4 Prednison tablet 5 mg tablet 220
229 P018 6.4.2.2 Primakuin tablet 15 mg tablet 242
230 P019 7.1 Propanolol tablet 10 mg ( HCl ) tablet 69
231 P020 7.1 Propanolol tablet 40 mg (HCI) tablet
232 P021 16.3 Propilitourasil tablet 100 mg tablet 320
233 R001 25.1 Ranitidin injeksi 25 mg/2 ml ampul 858 15
234 R002 25.1 Ranitidin tablet 150 mg tablet 275 140
235 R003 29 Retinol (Vitamin A) 100.000 IU kapsul lunak kapsul 352 100
236 R004 29 Retinol (Vitamin A) 200.000 IU kapsul lunak kapsul 637 416
237 R005 20.2 Ringer Laktat larutan infus botol 7,703 56
238 S001 26.1 Salbutamol cairan ih 0,1% (Nebulizer) botol 5,400 10
239 S002 26.1 Salbutamol inhalasi/aerosol 100 mcg/dosis botol 5,940 9
240 S003 26.1 Salbutamol sirup botol 4,189
241 S004 26.1 Salbutamol tablet 2 mg tablet
242 S005 18.4 Salbutamol tablet 4 mg (sebagai sulfat) tablet 67 250
243 S006 - pot 2,797
Endap 4 %
244 S007 - Salep Luka Bakar tube 18,557 2
245 S008 18.8 Salisil Bedak 2 % kotak 1,040
246 S009 6.2.1 Sefadroksil kapsul 500 mg kapsul 581 640
247 S010 6.2.1 Sefadroksil sirup kering 125 mg/5 ml botol 4,359 21
248 S011 6.2.1 Sefadroksil sirup kering 250 mg/5 ml botol 5,825 19
249 S012 6.2.1 Sefoperazone injeksi ampul 8,140
250 S013 6.2.1 Sefotaksim injeksi 0.5 gram vial 6,485
251 S014 10.1 Sianokobalamin (Vit. B12) tablet 50 mg tablet 49
252 S015 - Simetidin tablet 200 mg tablet 198
253 S016 17.8 Simvastatin tablet 10 mg tablet 73 270
254 S017 17.8 Simvastatin tablet 20 mg tablet 150 130
255 S018 6.2.2.6 Siprofloksasin infus 2 % botol 76,950
256 S019 6.2.2.6 Siprofloksasin tablet 500 mg (sebagai HCI) tablet 260
257 S020 4.1 Sodium Bicarbonate tablet tablet 1,100
258 S021 - Spiramycin tablet 500 mg tablet 1,649
259 S022 15.1 Spironolakton tablet 25 mg tablet 226
260 S023 - Sukralfat susp 500 mg/5 ml, 100 ml botol 6,130 64
261 T001 10.1 Tablet tambah darah tablet 255 2,360
262 T002 6.2.2 Tetrakain HCl tetes mata 0,5% botol 4,585
265 T005 - Tiamfenikol kapsul 500 mg kapsul 484
266 T006 - Tiamfenikol syrup 125 mg/ 5 ml botol 8,250
267 T007 29 Tiamin (Vitamin B1) tablet 50 mg (HCI/Nitrat) tablet 94 150
268 T008 1.2 Tramadol injeksi ampul
269 T009 1.2 Tramadol kapsul 50 mg kapsul 446
270 T010 9 Trihexypenidyl tablet 2 mg tablet 100 540
271 V001 29 Vitamin B Kompleks tablet tablet 60 1,300
272 V002 - Vitamin Neurotropik tablet tablet 1,210
273 Z001 20.1 Zinc syrup 20 mg/5 ml botol 3,285 9
274 Z002 20.1 Zinc tablet 20 mg tablet 524 50
275 SV01 27.1 ABU (Anti Bisa Ular) vial 517,132
276 SV02 32 ADS 0,05 ML piece 1,650
277 SV03 32 ADS 0,5 ML piece 1,240 152
278 SV04 32.0 ADS 2 ML piece 1,400
279 SV05 32 ADS 5 ML piece 1,500 9
280 SV06 27.2 ATS 1500 IU vial 130,999
281 SV07 27.2 BCG 20 DS vial 98,000
282 SV08 27.2 BCG PELARUT vial
283 SV09 27.2 CAMPAK 10 DS vial 24,829
284 SV10 27.2 CAMPAK 20 DS vial 41,998
285 SV11 27.2 CAMPAK PELARUT vial
286 SV12 27.2 DPT-HB HIB vial 85,877 22
287 SV13 27.2 DT 10 DS vial 34,400
288 SV14 27.2 HEP B PID 1 DS vial 258,389 11
289 SV15 27.2 HEPATITIS B Imunoglobulin ( human) ampul 1,300,000
290 SV16 27.2 IPV 10 DS vial 158,994 1
291 SV17 27.2 POLIO 10 DS vial 23,643 11
292 SV18 27.2 POLIO 20 DS vial 28,094
293 SV19 27.2 Td 10 DS vial 16,995 3
294 SV20 27.2 TT 10 DS vial 14,498
295 SV21 27.2 VAR vial 174,500
296 HP01 32 Alat suntik sekali pakai 1 ml piece 995 68
297 HP03 32 Alat suntik sekali pakai 2.5 ml piece 848
298 HP04 32 Alat suntik sekali pakai 3 ml piece 888 131
299 HP05 32.1 Alat suntik sekali pakai 5 ml piece 1,045 10
300 HP02 32 Alat suntik sekali pakai 10 ml piece 1,338
301 HP06 30 Aquadest steril botol 7,700
302 HP07 - Autoclick Lancing Device piece 19,157
303 HP08 - Blood lancet botol 715
304 HP09 32 piece 36,831
(cromic)
305 HP10 32 piece 37,203 3
(plain)
306 HP11 32 piece 34,410 4
(cromic)
307 HP12 32 piece 37,023
(plain)
308 HP13 - Cathejell ( Gel Catether ) piece 43,092
309 HP14 - Colesterol tes (HUMASENS) strip 27,532
310 HP15 - Cover Glass 20 x 20 mm kotak 137,438
311 HP16 32 Elastis verban 3 inchi roll 29,000
312 HP17 - Endotracheal Tube 2.5 piece 7,173
313 HP18 - Endotracheal Tube 3 piece 8,250
314 HP19 - Endotracheal Tube 4 piece 8,198
315 HP20 13.2 Etakridin larutan 0.1 % 300 ml botol 3,520
316 HP21 13.2 Etanol 70 % 1 Liter botol 30,250 5
317 HP22 13.2 Etanol 70 % 100 ml botol 7,000
318 HP23 - Folley Catheter 12 piece 8,727
319 HP24 - Folley Catheter 16 piece 10,261
320 HP25 - Folley Catheter 18 piece 10,261 6
321 HP26 - Glukose tes ( HUMASENS) strip 5,171
322 HP27 - Glukose tes (NESCO) strip 4,400
323 HP28 - Hand Scrubs Anti Mikroba botol
324 HP29 - Handscoon Gynecology pasang 22,000
325 HP30 32 Handscoon No. 6 Box 68,000 3
326 HP31 32 Handscoon No. 7 Box 68,000 3
327 HP32 32 Handscoon No. 7.5 pasang 117,500
328 HP33 32.0 Handscoon Steril No. 6 pasang 6,050
329 HP34 32 Handscoon Steril No. 6,5 pasang 13,200
330 HP35 32 Handscoon Steril No. 7 pasang 4,950
331 HP36 - Hemoglobin tes (NESCO) strip 5,280
332 HP37 13.1 Hidrogen Peroksida 3 % botol 34,000
333 HP38 32 Infusion Set Anak piece 3,030
334 HP39 32 Infusion Set Dewasa piece 8,140
335 HP40 32 IV Catheter No. 20 G piece 7,957 11
336 HP41 32 IV Catheter No. 22 G piece 7,937
337 HP42 32 IV Catheter No. 24 G piece 7,929 8
338 HP43 32 IV Catheter No. 26 G piece 4,481
339 HP44 32.0 Jarum disposible No. 23 G piece 1,210
340 HP45 32 Jarum disposible No. 26 G piece 1,210
341 HP46 - Kaca Slide kotak 720
342 HP47 32 Kapas 500 g bungkus 32,409 1
343 HP48 32 Kapas Pembalut/Absorben 250 gram bungkus 28,916 1
344 HP49 32 Kasa Alkohol steril (Alkohol swab) Box 11,999 5
345 HP50 32.0 Kasa Gulung 40 x 80 cm roll 158,743
346 HP51 32.0 Kasa Pembalut Hydrofil 4m x 10cm roll 1,100
347 HP52 32 Kasa Pembalut Hydrofil 4m x 15cm roll 2,520 3
348 HP53 32 Kasa Steril 16 x 16 cm piece 8,480 27
349 HP54 32 Kasa Steril mengandung antibiotik piece 9,157 3
350 HP55 13.2 Lisol botol 40,000
351 HP56 32 Masker - 3 Ply plus Ear Loop Kotak 38,500 27
352 HP57 32 Masker - Plus 3 Ply plus Ear Loop Kotak 41,800
353 HP58 32 Masker sungkup oksigen anak piece 14,137
354 HP59 32 Masker sungkup oksigen dewasa piece 14,137
355 HP60 - Mucus extraktor buah 7,462 2
356 HP61 - Neckkeller ukuran L buah 88,000
357 HP62 - Neckkeller ukuran M buah 83,270
358 HP63 - Neckkeller ukuran S buah 82,500
359 HP64 - Objeck Glass Frosted, box isi 72 kotak 22,097
360 HP65 - Objeck Glass, box isi 72 kotak 19,242
361 HP66 - Oil Emersi botol 345,000
362 HP67 - Pembalut Elastis piece 77,600 2
363 HP68 32 Plester 0.5 x 5 M roll 11,000
364 HP69 - Pot Sputum pot 2,958
365 HP70 13.1 Povidon Iodida larutan 10 % 300 ml botol 300 m 26,250
366 HP71 13.1 Povidon Iodida larutan 10 % 60 ml botol 60 ml 4,725
367 HP72 - PP Test piece 2,052
368 HP73 - Safety Box 2,5 L piece 12,500
369 HP74 - Safety Box 5 L piece 24,250 4
370 HP75 32 Silk (Benang Sutera) No. 3/0 piece 20,908
371 HP76 - Underpad piece 8,650
372 HP77 - Uric Acid tes (HUMASENS) Botol 11,141
373 HP78 - Uric Acid tes (NESCO) box25 124,412
374 HP79 - Urine bag piece 6,653
378 HP83 32 Wing Needle No. 27 G piece 1,540
379 RL01 - Controll HA Convergys X3 3,916,000
380 RL02 - Controll Hematology Analyzer TRILEVEL kit 5,500,000
381 RL03 - Controll Indiko TS 10 x 5 ml kit 2,783,000
382 RL04 - Humatrol N 6 x 5 ml kit 1,375,000
383 RL05 - Kalibrator Indiko TS 10 x 3 ml kit 2,024,000
384 RL06 - Reagen Cholesterol 4 x 100 ml kit 2,123,000
385 RL07 - Reagen Creatinin 1 x 100 ml + 1 x 100 ml kit 737,000
386 RL08 - Reagen Glukose 4 x 100 ml kit 880,000
387 RL09 - Reagen GOT (ALAT) 2 x 40 ml + 1 x 20 ml kit 1,264,982
388 RL10 - Reagen GOT (ASAT) 2 x 40 ml + 1 x 20 ml kit 1,264,982
Reagen HDL Cholesterol (Direct) 1 x 30 ml + 1 x 10
389 RL11 - kit 4,072,860
ml
390 RL12 - Reagen HDL Hemoglobin 10 x 500 ml kit 1,430,000
Reagen LDL Cholesterol (Direct) 1 x 30 ml + 1 x 10
391 RL13 - kit 4,731,705
ml
392 RL14 - Reagen Triglycerides 4 x 100 ml kit 2,696,219
393 RL15 - Reagen Uric Acid 4 x 100 ml kit 1,870,000
394 RL16 - Reagen Diluent HA Labgeo Unit 3,025,000
395 RL17 - Reagen Cleaner HA Labgeo Unit 2,420,000
396 RL18 - Reagen Lyse HA Labgeo Unit 3,630,000
397 RL19 - Raegen Diluent HA Convergys X3 Unit 4,966,500
398 RL20 - Reagen Cleaner HA Convergys X3 Unit 1,366,200
399 RL21 - Reagen Lyse HA Convergys X3 Unit 4,906,000
400 RL22 - Reagen Glukosa Indiko TS 8 x 20 ml kit
401 RL23 - Reagen Asam Urat Indiko TS 8 x 20 ml kit 3,630,000
402 RL24 - Reagen Kolesterol Indiko TS 12 x 20 ml kit 3,850,000
403 RL25 - Reagen Trigliserida Indiko TS 12 x 20 ml kit 5,280,000
404 RL26 - Wash Fluid Indiko TS 8 x 20 ml kit 935,000
405 PP01 - Body Fat Analyzer unit 775,000
406 PP02 - Giemsa botol 420,000
407 PP03 - Rapid Test : Dengue - IgG/IgM box 66,000
408 PP04 - Rapid Test HIV box/30 342,000
409 PP05 - RDT : Dengue - Antigen strip 96,800
410 PP06 - RDT : Hepatitis kotak/25 264,867 2
411 PP07 - RDT : Malaria kotak/25 192,750
412 PP08 - RDT : Shipilis kotak/ 100 1,020,000
413 PP09 - Reagen Zet Nielson paket 345,000
414 PP10 - SD Chikungunya IgM kit 2,475,000
415 PP11 - SD Rapid Test (malaria) box
416 BG01 - Bonding set 756,250
417 BG02 - Etching set 145,200
418 BG03 14.1 Etil Klorida spray set 176,601 3
419 BG04 14.1 Eugenol cairan 10 ml botol 18,333
420 BG05 14.1 Glass Ionomer Cement ART set 532,400
421 BG06 - Komposit set 385,000
422 BG07 - Temporary Filling (bahan tambal gigi sementara) set 34,000
423 DOT001 1 Aminofilin tablet 150 mg Tablet 1

424 DOT002 2 Asam Folat tablet 1 mg Tablet 86
425 DOT003 3 Clozapine tablet 25 mg Tablet 473
426 DOT004 4 DHP Frimal Tablet 2,134
427 DOT005 5 Flufenazinedecanoat injeksi 25 mg/ml Ampul 1
428 DOT006 6 Griseufulvin tablet 500 mg Tablet 1
429 DOT007 7 Haloperidol injeksi 5 mg/ml Ampul 1
430 DOT008 8 Haloperidol tablet 5 mg Tablet 60
431 DOT009 9 Metformin tablet 850 mg Tablet 1
432 DOT010 10 Risperidon tablet 2 mg Tablet 287 380
433 DOT011 11 IV Catheter No. 18 G Piece 1
434 DOT012 12 IV Dressing Piece 51,325 50
435 DOT013 13 Prontosan 350 ml Botol 164,000
436 DOT014 14 Reagen Cleaner HA Diatro Botol 98,600
437 DOT016 16 Reagen Diluent HA Diatro Botol 2,830,300
438 DOT015 15 Reagen Control HA Diatro Botol 1
439 DOT017 17 Reagen Lyse HA Diatro Botol 2,095,500
440 DOT018 18 Stabimed 1 Liter Botol 1
441 DOT019 - Nasal Canula ( selang oksigen ) Bayi Piece 18,585
442 DOT020 - Nasal Canula ( selang oksigen ) Anak Piece 4,600
443 DOT021 - Nasal Canula ( selang oksigen ) Dewasa Piece 14,137
444 DOT022 - Albendazol tablet 400 mg_ tablet 367
445 DOT023 - Alopurinol tablet 100 mg_ tablet 89 220
446 DOT024 - Alopurinol tablet 300 mg_ tablet 220
447 DOT025 - Alprazolam tablet 0,25 mg_ tablet
448 DOT026 - Alprazolam tablet 0,5 mg_ tablet
449 DOT027 - Alprazolam tablet 1 mg_ tablet
450 DOT028 - Aminofilin tablet 200 mg_ tablet
451 DOT029 - Amitripilin tablet salut 25 mg (HCI)_ tablet
452 DOT030 - Amlodipin tablet 10 mg_ tablet
453 DOT031 - Amlodipin tablet 5 mg_ tablet 55
454 DOT032 - Amoksisilin kaplet 500 mg_ kaplet 231 51
455 DOT033 - Amoksisilin sirup kering 125 mg/5 ml_ botol 3,696
456 DOT034 - Aluminium Hidroksida 200 mg clan, Magnesium tablet 60 1,330
Hidroksida 200 mg_

457 DOT035 - Hidroksida 200 mg/ 5 ml clan, Magnesium botol
Hidroksida 200 mg/5 ml_
458 DOT036 - tube
IU/gr, Polimiksin 10.000 IU/g_
459 DOT037 - pot
Asam Salisilat 3 %_
460 DOT038 - supp
150 mg + Heksaklorofen 2.5 mg_
461 DOT039 - tablet
25 mg Levodopa 250 mg_
462 DOT040 - Asam Askorbat (Vitamin C) tablet 50 mg_ tablet
463 DOT041 - Asam Mefenamat kaplet 250 mg_ kapsul
464 DOT042 - Asam Mefenamat kaplet 500 mg_ kaplet 275 1,130
465 DOT043 - Asam Pipemidat tablet 400 mg_ kaplet
466 DOT044 - Asam Traneksamat 500 mg/ml injeksi_ ampul 1,880
467 DOT045 - Asam Traneksamat injeksi 100 mg/ml_ ampul 1,880
468 DOT046 - Asam Traneksamat tablet 500 mg_ tablet 1,114
469 DOT047 - Asiklovir krim 5 %_ tube
470 DOT048 - Asiklovir tablet 200 mg_ tablet 236
471 DOT049 - Asiklovir tablet 400 mg_ tablet
472 DOT050 - Atropin injeksi i.m./i.v./s.k. 0.25 mg/ml (sulfat)_ ampul
473 DOT051 - Attapulgite tablet 630 mg_ tablet

474 DOT052 - Betahistin Mesilat tablet 6 mg_ tablet
475 DOT053 - Betametason krim 0.1 % (sebagai valerat)_ tube 1,465
476 DOT054 - Bisakodil 10 mg suppositoria_ supp
477 DOT055 - Bisakodil 5 mg suppositoria_ supp
478 DOT056 - Bisakodil tablet 5 mg _ tablet
479 DOT057 - Bisoprolol tablet 5 mg_ tablet
480 DOT058 - Ca Glukonas injeksi i.v. 10 % ( 100 mg/ml )_ ampul
481 DOT059 - Cetirizine syrup 5 mg/5 ml_ botol
482 DOT060 - Cetirizine tablet 10 mg_ tablet
483 DOT061 - Clonidine tablet 0,15 mg_ tablet
484 DOT062 - Deksametason injeksi Lv. 5 mg/ml_ ampul
485 DOT063 - Deksametason tablet 0.5 mg_ tablet 346
486 DOT064 - Desoksimetason krim 0,25%_ tube
487 DOT065 - Diazepam injeksi 5 mg/ml_ ampul 1,545
488 DOT066 - Diazepam rectal 5 mg/2,5 ml_ supp 1,545 2
489 DOT067 - Diazepam tablet 2 mg_ tablet
490 DOT068 - Diazepam tablet 5 mg_ tablet
491 DOT069 - Dietilkarbamazin Sitrat tablet 100 mg_ tablet
492 DOT070 - Digoksin tablet 0.25 mg_ tablet
493 DOT071 - Dimenhidrinat tablet 50 mg_ tablet 109
494 DOT072 - Domperidon syrup 5 mg/5 ml_ botol 9,931
495 DOT073 - Domperidon tablet 10 mg_ tablet
496 DOT074 - Epinefrin (Adrenalin) injeksi 0.1 % (sebagai HCI)_ ampul
497 DOT075 - Eritromisin kapsul 500 mg_ kapsul

498 DOT076 - Eritromisin sirup 200 mg/5 ml_ botol
499 DOT077 - Fenobarbital tablet 100 mg_ tablet
500 DOT078 - Fenobarbital tablet 30 mg_ tablet
501 DOT079 - Fenol Gliserol tetes telinga 10 %_ botol
502 DOT080 - Fitomenadion ( Vit. K ) injeksi i.m. 2 mg/ml_ ampul
503 DOT081 - Fitomenadion (Vit.K) tablet salut gula 10 mg_ botol
504 DOT082 - Furosemid injeksi i.v./i.m. 10 mg/ml_ ampul 969 7
505 DOT083 - Furosemid tablet 40 mg_ tablet
506 DOT084 - gr, Kalium Klorida 0.30 gr, Trinatnum Sitrat sachet
Dihidrat 0.58 gr, Glukosa Anhidrat 4 gr_
507 DOT085 - Gentamisin salep kulit 0.1 %_ tube
508 DOT086 - Gentamisin salep mata 0,3%_ tube
509 DOT087 - Gentian Violet larutan 1 %_ botol
510 DOT088 - Glibenklamida tablet 5 mg_ tablet
511 DOT089 - Glimepiride tablet 1 mg_ tablet
512 DOT090 - Glimepiride tablet 2 mg_ tablet
513 DOT091 - Gliseril Gualakolat tabelt 100 mg_ tablet
514 DOT092 - Glukosa larutan infus 10 % steril_ botol
515 DOT093 - Glukosa larutan infus 5 % steril_ botol
516 DOT094 - Griseofulvin Micronized tablet 125 mg_ tablet
517 DOT095 - Hidrokortison krim 2.5 %_ tube 2,890
518 DOT096 - Hyoscine-N-Butilbromide injeksi 20 mg/ml_ ampul
519 DOT097 - Hyoscine-N-Butilbromide tablet 10 mg_ tablet
520 DOT098 - Ibuprofen suspensi 100 mg/5 ml_ botol
521 DOT099 - Ibuprofen suspensi 200 mg/5 ml_ botol
522 DOT100 - Ibuprofen tablet 200 mg_ botol
523 DOT101 - Ibuprofen tablet 400 mg_ tablet
524 DOT102 - Isoniazide (INH) tablet 100 mg_ tablet 260
525 DOT103 - Isoniazide (INH) tablet 300 mg_ tablet 7,069
526 DOT104 - Isosorbid Dinitrat tablet Sublingual 5 mg_ tablet
527 DOT105 - Kalsium Laktat (Kalk) tablet 500 mg_ tablet 62
528 DOT106 - Kandesartan tablet 8 mg_ tablet 215
529 DOT107 - Kaptopril tablet 12.5 mg_ tablet
530 DOT108 - Kaptopril tablet 25 mg_ tablet 90
531 DOT109 - Kaptopril tablet 50 mg_ tablet
532 DOT110 - Karbamazepin tablet 200 mg_ tablet
533 DOT111 - Karbogliserin Tetes Telinga 10 %_ botol
534 DOT112 - Ketokonazol krim 2 %_ tube 4,067 15
535 DOT113 - Ketokonazol tablet 200 mg_ tablet
536 DOT114 - Ketorolac injeksi 30 mg/ml_ ampul
537 DOT115 - Ketorolac tablet 30 mg_ tablet
538 DOT116 - Klindamisin kapsul 150 mg_ kapsul
539 DOT117 - Klindamisin kapsul 300 mg_ kapsul
540 DOT118 - Kloramfenikol kapsul 250 mg_ kapsul
541 DOT119 - Kloramfenikol salep kulit 2 %_ tube
542 DOT120 - Kloramfenikol salep mata 1 %_ tube
543 DOT121 - Kloramfenikol tetes telinga 3 %_ botol
544 DOT122 - Klorfeniramina Malet (CTM) tablet 4 mg_ botol
545 DOT123 - Kodein tablet 10 mg_ tablet
546 DOT124 - Kombinasi Multivitamin dan Mineral_ tablet 1,512
547 DOT125 - Kombinasi Multivitamin syrup untuk anak_ botol
548 DOT126 - Kombinasi Tripolidin dan Pseudoefedrin tablet_ tablet
549 DOT127 - tablet
550 DOT128 - tablet

551 DOT129 - botol 2,190
Sulfametoksazol 200 mg + Trimetoprin 40 mg/5 ml_
552 DOT130 - Kuinin tablet 222 mg (H₂SO₄ & H₂O)_ tablet

553 DOT131 - Lanzoprazol kapsul 30 mg_ kapsul
554 DOT132 - Lidokain compositum injeksi 2 %_ ampul 2,827
555 DOT133 - Lidokain injeksi 2 %_ ampul
556 DOT134 - Loperamide tablet 2 mg_ tablet
557 DOT135 - Magnesium Sulfat injeksi (IV) 20 % - 25 ml_ vial
558 DOT136 - Magnesium Sulfat injeksi (IV) 40 % - 25 ml_ vial 4
559 DOT137 - MB Anak ( Obat Kusta)_ blister
560 DOT138 - MB Dewasa ( Obat Kusta )_ blister
561 DOT139 - Meloksikam tablet 15 mg_ tablet
562 DOT140 - Meloksikam tablet 7,5 mg_ tablet
563 DOT141 - Metformin HCl tablet 500 mg_ tablet 85
564 DOT142 - Metildopa tablet 250 mg_ tablet 1,088
565 DOT143 - Metilergometrin Maleat injeksi 0.200 mg - 1 ml_ ampul
566 DOT144 - Metilergometrin Maleat tablet salut 0.125 mg_ tablet
567 DOT145 - Metoklopramide injeksi 5 mg/2 ml_ ampul
568 DOT146 - Metoklopramide sirup 5 mg / 5 ml_ botol
569 DOT147 - Metoklopramide tablet 10 mg_ tablet 117
570 DOT148 - Metronidazol infuse_ botol
571 DOT149 - Metronidazol tablet 250 mg_ tablet
572 DOT150 - Metronidazol tablet 500 mg_ tablet
573 DOT151 - Mikonazol krim/salep 2 % (Nitrat)_ tube
574 DOT152 - Mineral Mix_ sachet
575 DOT153 - N Asetylsistein tablet 200 mg_ tablet
576 DOT154 - Natrium Diklofenak tablet 25 mg_ tablet
577 DOT155 - Natrium Diklofenak tablet 50 mg_ tablet
578 DOT156 - Natrium Klorida larutan infus 0.9 %_ botol 6,840
579 DOT157 - Nifedipin tablet 10 mg_ tablet
580 DOT158 - Nystatin Vaginal tab 100.000 IU/g_ tablet 688
581 DOT159 - Obat Anti Tuberkulosis Sisipan_ paket
582 DOT160 - Obat Antituberkolosis FDC Katagori 1_ paket 477,791
583 DOT161 - Obat Antituberkolosis FDC Katagori 2_ paket
584 DOT162 - Obat Antituberkolosis FDC Katagori Anak_ paket
585 DOT163 - Oksitetrasiklin HCl Salep Mata 1 %_ tube
586 DOT164 - Oksitetrasiklin Salep Kulit 3 %_ tube
587 DOT165 - Oksitosin injeksi 10 IU/ml - 1 ml_ ampul
588 DOT166 - Omeprazol kapsul 20 mg_ kapsul 422 600
589 DOT167 - Ondansentron injeksi 4 mg /2 ml_ ampul
590 DOT168 - Ondansetron tablet 4 mg_ tablet 429
591 DOT169 - Parasetamol drops_ botol
592 DOT170 - Parasetamol infuse_ botol
593 DOT171 - Parasetamol rectal_ supp rectal
594 DOT172 - Parasetamol sirup 120 mg/5 ml_ botol 1,160 150
595 DOT173 - Parasetamol tablet 500 mg_ tablet
596 DOT174 - PB Anak ( Obat Kusta )_ blister
597 DOT175 - PB Dewasa ( Obat Kusta )_ blister
598 DOT176 - Permetrin krim 5 % Scabimit cream_ tube
599 DOT177 - Piracetam tablet 400 mg_ tablet
600 DOT178 - Piracetam tablet 800 mg_ tablet
601 DOT179 - Pirantel syrup 125 mg/ml_ botol
602 DOT180 - Pirantel tablet score (Base) 125 mg_ tablet
603 DOT181 - Piridoksin (Vitamin B6) tablet 10 mg (HCI)_ tablet
604 DOT182 - Piroksikam tablet 10 mg_ tablet
605 DOT183 - Piroksikam tablet 20 mg_ tablet
606 DOT184 - Prednison tablet 5 mg_ tablet 220
607 DOT185 - Primakuin tablet 15 mg_ tablet 253
608 DOT186 - Propanolol tablet 10 mg ( HCl )_ tablet
609 DOT187 - Propanolol tablet 40 mg (HCI)_ tablet
610 DOT188 - Propilitourasil tablet 100 mg_ tablet
611 DOT189 - Ranitidin injeksi 25 mg/2 ml_ ampul 858
612 DOT190 - Ranitidin tablet 150 mg_ tablet
613 DOT191 - Retinol (Vitamin A) 100.000 IU kapsul lunak_ kapsul 286
614 DOT192 - Retinol (Vitamin A) 200.000 IU kapsul lunak_ kapsul 569
615 DOT193 - Ringer Laktat larutan infus_ botol
616 DOT194 - Salbutamol cairan ih 0,1% (Nebulizer)_ botol 5,400
617 DOT195 - Salbutamol inhalasi/aerosol 100 mcg/dosis_ botol
618 DOT196 - Salbutamol tablet 2 mg_ tablet
619 DOT197 - Salbutamol tablet 4 mg (sebagai sulfat)_ tablet 67
620 DOT198 - pot
Endap 4 %_
621 DOT199 - Salep Luka Bakar_ tube 18,557
622 DOT200 - Salisil Bedak 2 %_ kotak
623 DOT201 - Sefadroksil kapsul 500 mg_ kapsul
624 DOT202 - Sefadroksil sirup kering 125 mg/5 ml_ botol
625 DOT203 - Sianokobalamin (Vit. B12) tablet 50 mg_ tablet
626 DOT204 - Simvastatin tablet 10 mg_ tablet 117
627 DOT205 - Simvastatin tablet 20 mg_ tablet
628 DOT206 - Siprofloksasin tablet 500 mg (sebagai HCI)_ tablet
629 DOT207 - Spironolakton tablet 25 mg_ tablet
630 DOT208 - Sukralfat susp 500 mg/5 ml, 100 ml_ botol 6,130
631 DOT209 - Tablet tambah darah _ tablet 409
632 DOT210 - Tetrasiklin kapsul 250 mg_ kapsul
633 DOT211 - Tetrasiklin kapsul 500 mg_ kapsul
634 DOT212 - Tiamfenikol kapsul 500 mg_ kapsul
635 DOT213 - Tiamfenikol syrup 125 mg/ 5 ml_ botol
636 DOT214 - Tiamin (Vitamin B1) tablet 50 mg (HCI/Nitrat)_ tablet
637 DOT215 - Trihexypenidyl tablet 2 mg_ tablet
638 DOT216 - Vitamin B Kompleks tablet_ tablet
639 DOT217 - Zinc syrup 20 mg/5 ml_ botol
640 DOT218 - Zinc tablet 20 mg_ tablet
641 DOT219 - ABU (Anti Bisa Ular)_ vial
642 DOT220 - ADS 0,05 ML_ piece 1,460 24
643 DOT221 - ADS 0,5 ML_ piece
644 DOT222 - ADS 2 ML_ piece
645 DOT223 - ADS 5 ML_ piece
646 DOT224 - ATS 1500 IU_ vial
647 DOT225 - BCG 20 DS_ vial 98,000 8
648 DOT226 - BCG PELARUT_ vial
649 DOT227 - CAMPAK 10 DS_ vial
650 DOT228 - CAMPAK 20 DS_ vial
651 DOT229 - CAMPAK PELARUT_ vial
652 DOT230 - DPT-HB HIB_ vial
653 DOT231 - DT 10 DS_ vial 24,400
654 DOT232 - HEP B PID 1 DS_ vial
655 DOT233 - HEPATITIS B Imunoglobulin ( human) _ ampul
656 DOT234 - IPV 10 DS_ vial
657 DOT235 - POLIO 10 DS_ vial 23,643 1
658 DOT236 - POLIO 20 DS_ vial
659 DOT237 - Td 10 DS_ vial
660 DOT238 - TT 10 DS_ vial
661 DOT239 - VAR_ vial
662 DOT240 - Alat suntik sekali pakai 1 ml_ piece
663 DOT241 - Alat suntik sekali pakai 2.5 ml_ piece
664 DOT242 - Alat suntik sekali pakai 3 ml_ piece 888
667 DOT245 - Blood lancet_ piece
668 DOT246 - piece
(cromic)_
669 DOT247 - piece
(plain)_
670 DOT248 - piece
(cromic)_
671 DOT249 - piece
(plain)_
672 DOT250 - Elastis verban 3 inchi_ roll
673 DOT251 - Etakridin larutan 0.1 % 300 ml_ botol
674 DOT252 - Etanol 70 % 1 Liter_ botol 27,500
675 DOT253 - Folley Catheter 12_ piece
676 DOT254 - Folley Catheter 16_ piece 10,261
677 DOT255 - Folley Catheter 18_ piece
678 DOT256 - Hand Scrubs Anti Mikroba_ botol
679 DOT257 - Handscoon Gynecology_ pasang
680 DOT258 - Handscoon Size. S_ Box 48,930
681 DOT259 - Handscoon Size. M_ Box 48,931
682 DOT260 - Handscoon Size. L_ Box 137,500
683 DOT261 - Handscoon Size. XL_ pasang
684 DOT262 - Handscoon Steril No. 6 _ pasang
685 DOT263 - Handscoon Steril No. 6,5_ pasang
686 DOT264 - Handscoon Steril No. 7_ pasang
687 DOT265 - Hidrogen Peroksida 3 %_ botol
688 DOT266 - Infusion Set Anak_ piece
689 DOT267 - Infusion Set Dewasa_ piece 7,413 32
690 DOT268 - IV Catheter No. 20 G_ piece 8,326
693 DOT271 - IV Catheter No. 26 G_ piece
694 DOT272 - Kapas Pembalut/Absorben 250 gram_ bungkus
695 DOT273 - Kasa Alkohol steril (Alkohol swab)_ piece 14,420
696 DOT274 - Kasa Pembalut Hydrofil 4m x 15cm_ roll
697 DOT275 - Masker - 3 Ply plus Ear Loop_ piece 87,838
698 DOT276 - Masker - Plus 3 Ply plus Ear Loop _ piece
699 DOT277 - Masker sungkup oksigen anak_ piece 1
700 DOT278 - Masker sungkup oksigen dewasa_ piece
701 DOT279 - Pembalut Elastis_ piece
702 DOT280 - Plester 0.5 x 5 M_ roll
703 DOT281 - Pot Sputum_ pot
704 DOT282 - Povidon Iodida larutan 10 % 300 ml_ botol 300 m
705 DOT283 - Safety Box 2,5 L_ piece
706 DOT284 - Safety Box 5 L_ piece 15,950
707 DOT285 - Silk (Benang Sutera) No. 3/0_ piece
708 DOT286 - Underpad_ piece
709 DOT287 - Urine bag_ piece 8,070
710 DOT288 - Giemsa_ botol
711 DOT289 - Rapid Test : Dengue - IgG/IgM_ strip
712 DOT290 - Rapid Test HIV_ box/25 206,225
713 DOT291 - RDT : Dengue - Antigen_ strip
714 DOT292 - RDT : Hepatitis_ kotak/25
715 DOT293 - RDT : Malaria_ kotak/25
716 DOT294 - RDT : Shipilis_ kotak/ 25 232,500
717 DOT295 - Reagen Zet Nielson_ paket
718 DOT296 - SD Chikungunya IgM_ kit
719 DOT297 - SD Rapid Test (malaria)_ box
720 DOT298 - Glass Ionomer Cement ART_ set
721 DOT299 - Aminofilin tablet 150 mg_ Tablet
722 DOT300 - Asam Folat tablet 1 mg_ Tablet
723 DOT301 - Clozapine tablet 25 mg_ Tablet
724 DOT302 - DHP Frimal_ Tablet 2,134
725 DOT303 - Flufenazinedecanoat injeksi 25 mg/ml_ Ampul
726 DOT304 - Griseufulvin tablet 500 mg_ Tablet
727 DOT305 - Haloperidol injeksi 5 mg/ml_ Ampul
728 DOT306 - Haloperidol tablet 5 mg_ Tablet
729 DOT307 - Metformin tablet 850 mg_ Tablet
730 DOT308 - Risperidon tablet 2 mg_ Tablet
731 DOT309 - IV Catheter No. 18 G_ Piece
732 DOT310 - IV Dressing_ Piece
733 DOT311 - Nasal Canula ( selang oksigen ) Bayi_ Piece
734 DOT312 - Nasal Canula ( selang oksigen ) Anak_ Piece
735 DOT313 - Nasal Canula ( selang oksigen ) Dewasa_ Piece
736 DOT314 - OAT Kombipak Kat. 1_ Paket
737 DOT315 - TUBERCULIN 5 Vial/Kotak_ Vial
738 DOT316 - Malaria KIT_ Paket 1,815,550
739 DOT317 - Reagen Rapid 1 HIV (SD)_ Test
740 DOT318 - Reagen Rapid 2 HIV (Diagnostar)_ Test
741 DOT319 - Rapid Test Shipilis Ab (Biosensor)_ Test
742 DOT320 - RPR Rapid Test (Shipilis) Focus_ Test 4,250
743 DOT321 - RDT Hepatitis (HSBSAg)_ Strip 8,326
744 DOT322 - Reagen Test Anti HCV (+HIV)_ Test 13,252
745 DOT323 - HBIG (0.5) ML_ Vial
Antiperkinson tablet, Kombinasi : Benserazid 25 mg
746 DOT324 - Tablet
+ Levodopa 100 mg ( LEVOPAR )__
Flufennazin injeksi 25 mg/ml (i.m.) ( SIKZONOATE
747 DOT325 - Ampul
INJEKSI )__
748 DOT326 - Gentamisin sulfat tetes mata 0.3%__ Botol 21,359
Hepatitis B imunoglobulin (human) inj 220 IU/mL
749 DOT327 - Vial
( HYPERHEP B S / D )__
750 DOT328 - Syringe 1 ml Luer Slip / 26Gx1/2Inch (13mm)__ Piece
Syringe 10 ml Luer Lock With Needle 21Gx1-
751 DOT329 - Piece
1/2inch (38mm)__
752 DOT330 - Piece
(32mm)__
753 DOT331 - Piece
(38mm)__
Trifluoperazinehydrochloride (HCI) tablet salut
754 DOT332 - Tablet 331
selaput 5 mg__
Hyoscine-N-Butilbromide 10 mg + Parasetamol 500
755 DOT333 - Tablet 30
mg tablet_
756 DOT334 - Amoksisillin drops 100 mg/ml_ Botol 13,500
757 DOT335 - Benzatin benzil penisilin_ -
758 DOT336 - Blue Tipe_ Pcs/Bngks 47,468 1
759 DOT337 - Combivent Nebul_ Flash 626
760 DOT338 - Ergotamin Caffein_ Tablet
761 DOT339 - Euthyrox_ Tablet 735
762 DOT340 - Fokus HIV_ Kotak 333,375
763 DOT341 - Folley Chateter 14 G_ Pcs
764 DOT342 - Gluco Protein_ -
765 DOT343 - Kasa Pembalut Ukuran 3,6 M x 15 Cm_ Roll 4,100 5
766 DOT344 - Kloramfenikol tts mata_ Botol
767 DOT345 - Kodein 15 mg_ Tablet 1,135 10
768 DOT346 - Lisinopril_ -
769 DOT347 - Masker Bedah Tali_ Kotak 27,000
770 DOT348 - Masker Karet_ Kotak 27,000
771 DOT349 - Sepatu Boot_ Pcs
772 DOT350 - MILRUB NR 500 ml ECO_ Botol 84,000
773 DOT351 - MILSCRUB 4% 500 ml ECO_ Botol 125,000
774 DOT352 - MILCIDE Spray 650 ml_ Botol
775 DOT353 - Kaca Mata GOGLE_ Piece
776 DOT354 - Masker N95 _ Piece 19,000
777 DOT355 - Masker KN95_ Piece
778 DOT356 - Hansanitizer 5 Liter_ Botol 973,500
779 DOT357 - Phenytoin_ -
780 DOT358 - Tablet Klor_ 1_ Tablet
781 DOT359 - Tablet Klor_ 2_ Tablet
782 DOT360 - Plesterin Non Woven_ kotak @200 42,000
783 DOT361 - Reagen Golongan Darah Anti A_ Botol 163,900
784 DOT362 - Reagen Golongan Darah Anti A-B_ Botol 163,900
785 DOT363 - Reagen Golongan Darah Anti B_ Botol 163,900 1
786 DOT364 - Reagen Golongan Darah Anti D_ Botol 707,685
787 DOT365 - Reagen Golongan Darah Anti A,B,AB,D_ Botol
788 DOT366 - Cairan Desinfectan_ Botol
789 DOT367 - Spironolacton 100mg_ Tablet
790 DOT368 - Strip Protein Urine_ Pcs/Kotak
791 DOT369 - Tabung vac K3 EDTA 3ml_ PACK 200,000
792 DOT370 - Tabung vac K3 plain 3 ml_ pack 132,000 1
793 DOT371 - Theophyline (Retaphyl SR)_ Kaplet 1,292 10
794 DOT372 - Trifluoperasin_ -
795 DOT373 - Vaksin MR_ Vial 167,860 10
796 DOT374 - Ventolin Nebulizer_ Ampul
797 DOT375 - Vikia HIV_ Kotak 487,000
798 DOT376 - White Tipe_ Pcs/Bungkus 41,277
799 DOT377 - Yellow Tipe_ Pcs/Bungkus
TAH
JUMLAH PER-BULAN
FEB MAR APR MEI JUN JUL AGS SEP OKT NOP DES
10 11 12 13 14 15 16 17 18 19 20
264 106 2,126 524 4 11
480 340 720 765 950
50 60 145 65 615 325 100 380 430 300
10 30 35 13 20
50 93 50 39 68
94 110
15 36 10 40 30 75
860 1,100 1,060 690 2,110 820 1,447 1,680 1,320 580 1,653
1,200 1,510 1,070 580 2,075 1,185 3,065 1,880 1,210 2,955
1,017 954 365 542 648 570 590 690 1,355 1,385 1,245
27 33 28 26 22 47 104 92 104 93 142
4 2 4 6
49 52 50 75 89 94 102 131 97 7
14 24 11 4 2 2
25 6 5 3 21 22 21 17 21
4 2 4 4 2 6 3 6 2 3
60 30 40 200 40 100 160 80 230

780 1,620 610 1,225 1,191 1,500 2,950 5,050 2,943 3,780 1,190
600 895 1,455 1,130
10 50 35
3 10
70 40 50 30 30
3 4 10 7 7 18 11
100 20 20 22
80 70 30 60 154 70 145 120 69 290
12 60 30
3 3
8 20 4 28
35 65 250 70 66 146 140 30
3 7 6 16 15 19 14 18 30 28 20
1 8
60 75 70 60
5 5 1 3 2 1 5
3 2 1 1
40 22 42 44 43 46 89 97 49 10 82
530 1,230 760 925 875 1,652 1,593 1,335 1,860 841
5 7 13 17
380 163 497 60 450 344 496
15 4 13 16 12 10 4 20 22 9 27
3 2 1 1 1 1 2
3 2
20 10 13 8 46 18 90
5 9 12 10
5 20 20
17 41
160 30 303 473 677 419 770 650 635 535 535
1 3 10
30 30
4 2 1 3 3
19 5 6 6 6 10 10 13 11 7 8
1 20
10
50 50 85 15 164 237 315 387 21 270
120 36 86 126 412 200 99 362 427
24 17 24 46 2 28 32 52 47 52
23 3 18 13 17
10 20 30 60 30
380 320 340 310 620 770 1,470 580 400 190 190
500 500 280 210 20 450 710 1,195 1,195 970
1,519 1,543 573 663 600 903 1,749 2,664 3,377 3,830 2,420
13 5
2
2 5 1 1 9 11 10
50
30 50 30 30 40 80 30 30 30 115
8 9 2 13 17 9 5 9 15 13 19
5
80 70 130 60
15 1 5 22 15 17 7 3
510 280 280 540 400 800 800 720 640 600 805
60
30 10 225
1,510 1,240 1,780 2,090 2,110 1,870 2,960 2,920 2,570 2,610 3,400
120 280
40 61 34 161 200 50 195
240 226 310 290 485 223 501 230 500 695 596
20
21 12 21 16 23
160 40 58 205 110 70 30
110 10 20
18 10 18 12 33 32 20 48 29 11 6
9 14 9 21 26 15 17 8
1 2 8 8 5 1 6 5
378 100 395 573 424 688 945 1,219 1,727 1,658 628
10 40 20
10 16 6 19 6
500 1,028 1,322 1,175

15 35 52 3
10 30 70 40 20 20
2 1 1 11 2 3
3 1
115 60 130 40 120 54 100 130 200 30
2 14
100 200 300 37 180
15 35 17 18 35 23 40 27
13 5
100 50 10 100 90 160 260 210 120 190 110

310 25 50 20 35 67 285
3
2 11 2
10 50
1,730 660 1,530 1,915 2,270 3,420 1,385 2,280 1,600 2,275 3,050
10 30 60 30 80 60 120 80 140
4 1 1 2
150 50 198 2 261 561 640 602
12 20 12 38 30 40 30 20
100 170 170 40 120 100 74 100
5 1 3 5 2 5 5
100 50 10 126 35 155 120 91 70 110

14 10
1 2 1 1 2
110 20 70 110 170 670 490 860 540 195
160 220 390 350 470 340 650 670 1,860 2,235
29 32 20 37 38 55 54 241 79 35 56
10 50 70 30 30 95
4 10 5 8
3 1 2 3 3 3 2 1
1 1 1
20
4 1 2 1 4 2 1
15 4 4 13 33 15 7 10 11 15
290 510 560 605 720
48
10 10 40
5 12 5 11 10
6 4 29 6 20 20 14
532 300 105 84 84 116 179 187 140 150 182
3,001 3,367 1,970 1,965 2,545 2,545 5,397 4,444 5,551 5,486 3,912
3 1 6 3 10 6 9 7 5 7 7
160 320 330 200 690 1,160 930 530 870
30 10 10 71
10 100 171 148 50
6
20 10 5
18 25 1 31 25 75 75 50 125 75 50
170 60 320 265 480 755 940 1,020 720 575
90 1 1 35 73 1 1
464 14 24 36 71 16 852 12 14 22 40
62 23 49 43 60 64 105 102 176 115 70
10 10 10 18 32 12 52 15 34 74 3
360 140 380 180 232 96 80 70 398 420 507
2 1 1 1 8 3 1 3
5 8 9 8 6 1 9 3 7
590 470 490 464 674 751 1,165 1,409 1,183 1,420 1,272
4 9 7 9 9 3 42 51 47 23
5 1 7 2 19 21 3
14 46 50 10 10
260 130 100 60 170 270 110 370 140 460 680
140 90 310 670 864 531 570 300 320 580
34 148 80 34 240 20 90 70
105 50
20 26 23 21
2,420 2,620 2,140 3,720 3,530 2,410 3,750 4,600 3,755 2,465 3,939
150 200 200 100 200 99 101 100 210 300 110
480 615 300 460 360 540 462 670 520 560 540
1,420 1,710 1,270 1,490 1,890 2,232 3,231 2,662 2,496 3,104 2,878
22 2 5 8 14 21 40 26 8 1
240 20 50 150 80 70 280 360 215 385
3 1
17 16 20 23 22 2
164 156 107 169 89 187 156 83 126 846 140
5 4 5 24 242 34 8 16 9 7 12
4 8 8 10 12 7 12 11 9 10 7
19 18 12 23 23 20 20 15 20 23 17
1
14 11 4 24 4 24 10 17 9 9 30
9 6 11 9 6 8 6 9 6 6
10 7 17 17 17 34 13
6 5 5 6 6 5 3 4 4 46 5
68 40 64 77 77 59 87 34 94 126 28
123 122 168 234 59 183 375 270 288 306 180
12 3 3 23 33 26 35 10 59 20
3 22 5 12 15 8 21
1
1 1 1 2 2 2 1
5 5 6 4 15 5
12 1 2 5 7 15 20
2 10 9 2 3 9 6
5 7 10 4 5 10 1
1 2 1 3 2 3 1
2 1
2 2 1 4 2 3 4 2 6 4 3
4 1 2
2 6 7 4 4 2 2 5 7 2
2 3 5 9 1 3 4 5 5
4 3 7 3 8 3 1 3 6 5
1 2 1 3
10 5 8 5
1 1 3 5 5 12 5
8 27 36 50 54 44 83 50 48
9 13 7 28 14 23 14 29 22 25
24 36 37 38 20
12 10 8 5 10 15 31 27 31 25 11
5 7 2 1 6 7
1 1 2 1 1 1 2 2 1
1 1 2 2 1 1 1 2
2 3 2 3 4 2 3 4 7 4 3
1 1 1 1 1 1 1
20 5 15 20 12 13 25 35
21 32 23 29 39 68 21 84 22 58
5 5 9 8 18 10 3 7
1 2
18 11 1 4 15 16 11
21 13 14 16 11 8 4 9
1 1
2 3 3 2
2 3 2 4 1
2 2 2 2 3 4 4 3 4 4
1 1 2 1 1 1 2
65 20 60 61 50 44 50 10
2 1 5 2
3
25 13 15 10 13 27 15 20 25 27
2 3 3 7 2 1
5 8 4 3 2 5 7 5
1
2
2 1 1 1 50
1 3 2 2 2
60 60 60 60
9
10 120 60 10
640 625 300 520 450 660 420 800 450 450 486
50 50 25
1
1
1
5 1 5
1 5 6 6 2 6 5
3 2 5 5 9 5 5 5 10 16 5
1,698 506 3 9 184
430 410 390 195 550 5
640 780 870 1,150 1,095 770 1,140 1,185 1,710 1,350 480
820 440 430 775 1,265 900 1,340 120 100

50 4
2 2
20 5 20 30 23 2
2 2 5 11 10
5 4 9 10 5 15 5 10
7 5
7 51
30
160 152 378 280 230 300 305 145
12 14 14 8
110 10
26 11 2
100
290
647
4 14 10
150
49
14 15 26 25 22 20
1 28
15 14 2 17
23 20 21
3 15 11 22 15 26 11
2
4
4 1 7 2
1 1 1 2
100 150 150

6 1 1 1
30 100
10 10 10
5 3
20 40
1 1
1 1 1
1 1
2 1
1 1 1
100 300
1 1 1 1 2
11 7 6 12 16 3 1 3 11
TOTAL NILAI REKAPITULASI PEMAKAIAN (Rp.)

TAHUN 2023
TOTAL rata-rata
JUMLAH KET
HARGA (Rp.) perbulan
21 22 23 24
3,035 1,110,810 505.83
3,255 289,695 651
2,490 547,800 226.36
108 10,152 21.60
300 1,465,800 60
204 22,644 102
206 36,050 34.33

15,050 4,138,750 1,254.17
18,740 1,030,700 1,703.64
10,174 3,042,026 847.83

753 1,543,650 62.75
18 170,514 3
800 2,420,000
66.67
10 50,000 10
57 314,469
159 578,919
37 105,820
990 130,680
22,839 2,101,188
4,080 477,360
95 333,925
13 30,862
280 539,560
65 237,705
162 83,268
1,132 513,928
102 48,042
6 10,308
60 28,860
862 79,304
179 274,407
9 53,100
265 165,890
23 80,454
9 79,695
612 1,355,580
12,381 1,002,861
42 50,820
2,399 191,920
163 1,548,500
11 16,995
5 67,730
205 23,370
36
45 4,905
95 943,445
5,417 406,275
17 29,580
9 11,820
27 89,100
101 133,320
21 16,401
10
1,594 181,716
1,973 552,440
351 937,170
74 1,650,200
150 20,550
5,800 1,009,200
6,930 852,390
21,085 1,876,565
18 144,054
2 1,162
39 258,453
50 11,650
505 89,890
124 358,360
5 30,940
340 360,060
85 198,815
6,935 1,491,025
60 15,600
295 10,325
26,980 1,618,800
580 124,700
871 60,099
4,756 656,328
20 5,000
93 225,060
783 223,938
160 246,240
276 1,037,760
127 260,858
36 297,000
9,980 938,120
70 44,100
66 377,520
4,025 2,266,075
106 882,450
210 196,350
21 298,536
1,029 136,857
16 143,200
827 229,906
233 327,132
18 16,038
1,500 208,500
827 106,683
3 12,360
15 70,500
65 197,925
23,225 1,950,900
610 624,030
13 13,897
2,464 251,328
208 206,128
944 110,448
26 93,340
867 217,617
29 55,100
8 67,496
3,535 1,120,595
7,855 856,195
695 4,795,500
285 68,970
27 14,850
19 9,155,948
3 741,702
20 115,440
15 277,200
13
140 174,720
2,685 1,229,730
48 20,592
90 27,900
43 212,850
99 766,557
2,059 2,388,440
43,245 10,465,290
72 810,000
5,590 793,780
121 26,620
479 105,380
6 1,452
35
565 484,770
5,445 1,497,375
302 106,304
1,981 1,261,897
925 7,125,275
280 1,512,000
9 53,460
6 25,134
3,113 208,571
22 408,254
56 58,240
10,528 6,116,768
225 980,775
77 448,525
130 6,370
3,020 220,460
4,505 675,750
716 186,160
155 35,030
154 944,020
37,709 9,615,795
1,920 180,480
6,047 604,700
25,683 1,540,980
156 512,460
1,900 995,600
4 2,068,528
100 165,000
2,375 2,945,000
375 562,500
98 9,604,000
232 19,923,464
1 34,400
167 43,150,963
77 12,242,538
126 2,979,018
98 1,665,510
822 817,890
2,439 2,165,832
234 244,530
86 115,068
1 19,157
10 7,150
40 1,473,240
65 2,418,195
45 1,548,450
42 1,554,966
13 377,000
3 10,560
38 1,149,500
7 61,089
41 420,701
43 441,223
46 3,128,000
10 680,000
28 369,600
32 96,960
400 3,256,000
195 1,551,615
155 1,230,235
193 1,530,297
28 125,468
13 421,317
12 346,992
42 503,958
7 1,111,201
148 372,960
424 3,595,520
68 622,676
3 120,000
103 3,965,500
96 4,012,800
2 28,274
10 141,370
14 104,468
32 2,483,200
9 236,250
360 738,720
14 339,500
3 62,724
190 1,643,500
18 2,239,416
39 259,467
1 1,540
2 684,000
57 15,097,419
13 2,295,813
240 113,520
9 19,206
200 12,000
6,181 1,773,947
175 8,981,875
1 98,600
1 2,830,300
1 2,095,500
11 204,435
31 142,600
70 989,590
2,400 880,800
2,200 195,800
51 11,781
12,500 750,000
7,320 2,013,000
400
6 9,270
100 10,900
30
70 67,830
12 34,680
58 15,080
30 212,070
1,950 419,250
63 256,221
120
39 85,410
4
100 11,700
2 955,582
890 375,580
797 924,520
28 7,084
150 85,350
49 264,600
146 213,160
13 1,274,000
29 707,600
49 1,158,507
96 711,648
103 817,511
2 175,676
4
14 112,980
5 1,031,125
2 465,000
400 3,330,400
9 192,231
130 43,030
30
1 47,468
35 143,500
8
10 11,350
60 1,140,000
2 84,000
3 491,700
3 491,700
3 2,123,055
3
400 80,000,000
7 924,000
10 12,920
80 13,428,800
418,404,379

Rekap Pemakaian 2022

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Rekap Pemakaian 2022

Uploaded by

Copyright:

Available Formats

REKAPITULASI PEMAKAIAN

UPT. DINKES PUSKESMAS RIMBA AYU TAHUN 2023

Antasida DOEN I tablet kunyah, Kombinasi :

Antasida DOEN II suspensi, Kombinasi : Aluminium

Anti bakteri DOEN salep kombinasi : Basitrasin 500

Antifungi DOEN kombinasi : Asam Benzoat 6 % +

Antihemoroid DOEN kombinasi : Bismut Subgalat

Antiparkinson DOEN tablet kombinasi : Karbidopa

Application SPORA v.1.02 print out 07/07/2023

Application SPORA v.1.02 print out 07/07/2023

Garam Oralit I serbuk, kombinasi : Natrium 0.70

Application SPORA v.1.02 print out 07/07/2023

Kombinasi Dekstrometorfan dan Senyawa Lain

Kombinasi Dekstrometorfan dan Senyawa Lain

Kombinasi Kaolin dan pectin (sirup antidiare untuk

Kombinasi Polimiksin / Neomisin dan Senyawa Lain

Kombinasi Polimiksin / Neomisin dan Senyawa Lain

Kotrimoksazol DOEN I (dewasa) kombinasi :

Application SPORA v.1.02 print out 07/07/2023

Kotrimoksazol DOEN II (Pedriatrik) kombinasi :

Kotrimoksazol suspensi kombinasi :

Larutan mengandung Karbohidrat+Elektrolit (NaCl

163 L003 - Levofloksasin tetes mata 0,5 % botol 16,995

Application SPORA v.1.02 print out 07/07/2023

Application SPORA v.1.02 print out 07/07/2023

Salep 2-4, kombinasi : Asam Salisilat 2 % Belerang

Application SPORA v.1.02 print out 07/07/2023

Catgut/Benang Bedah No. 2/0 dengan jarum bedah

Catgut/Benang Bedah No. 2/0 dengan jarum bedah

Catgut/Benang Bedah No. 3/0 dengan jarum bedah

Catgut/Benang Bedah No. 3/0 dengan jarum bedah

308 HP13 - Cathejell ( Gel Catether ) piece 43,092

Application SPORA v.1.02 print out 07/07/2023

Application SPORA v.1.02 print out 07/07/2023

Application SPORA v.1.02 print out 07/07/2023

423 DOT001 1 Aminofilin tablet 150 mg Tablet 31 December 2025 xxx 1

Application SPORA v.1.02 print out 07/07/2023

Application SPORA v.1.02 print out 07/07/2023

Application SPORA v.1.02 print out 07/07/2023

Application SPORA v.1.02 print out 07/07/2023

Application SPORA v.1.02 print out 07/07/2023

Application SPORA v.1.02 print out 07/07/2023

Application SPORA v.1.02 print out 07/07/2023

Application SPORA v.1.02 print out 07/07/2023

TOTAL NILAI REKAPITULASI PEMAKAIAN (Rp.) 418,404,379

Ket : Harga satuan sudah termasuk PPN

Kota Bangun, 31 Desember 2022

MENGETAHUI, YANG MELAPORKAN,

Jaseri, Amd. Kep apt. Ropita, S. Farm

Application SPORA v.1.02 print out 07/07/2023

Antasida DOEN II suspensi, Kombinasi : Aluminium

46 A046 - Attapulgite tablet 630 mg tablet 481

Kotrimoksazol suspensi kombinasi :

Larutan mengandung Karbohidrat+Elektrolit (NaCl

163 L003 - Levofloksasin tetes mata 0,5 % botol 16,995

423 DOT001 1 Aminofilin tablet 150 mg Tablet 1

Antasida DOEN II suspensi, Kombinasi : Aluminium

472 DOT050 - Atropin injeksi i.m./i.v./s.k. 0.25 mg/ml (sulfat)_ ampul

473 DOT051 - Attapulgite tablet 630 mg_ tablet

496 DOT074 - Epinefrin (Adrenalin) injeksi 0.1 % (sebagai HCI)_ ampul

497 DOT075 - Eritromisin kapsul 500 mg_ kapsul

Kotrimoksazol suspensi kombinasi :