LAPORAN OBAT KELUAR KLINIK GRIYA SEHAT

BULAN FEBRUARI 2021

OBAT BPJS OBAT UMUM OBAT GIGI

NO NAMA OBAT Harga Satuan
Jumlah Total Jumlah Total Jumlah
1 AMBROXOL NV Rp 150 312 Rp 46,800 54 Rp 8,100
2 ACYCLOVIR CREAM Rp 5,000 4 Rp 20,000 Rp -
3 AMLODIPIN 5 PH Rp 150 413 Rp 61,950 116 Rp 17,400
4 AMLODIPIN 10 PH Rp 250 264 Rp 66,000 120 Rp 30,000
5 AMOXICILLIN MERCI Rp 500 194 Rp 97,000 42 Rp 21,000 437
6 ANTASID OGB Rp 200 560 Rp 112,000 90 Rp 18,000
7 ARKAVIT Rp 400 147 Rp 58,800 404 Rp 161,600 18
8 AKITA / Kaolin Rp 350 146 Rp 51,100 50 Rp 17,500
9 ANTALGIN (Betalgin) Rp 300 150 Rp 45,000 10 Rp 3,000
10 ALLOPURINOL HJ Rp 300 116 Rp 34,800 30 Rp 9,000
11 ALLERON / CTM Rp 200 384 Rp 76,800 114 Rp 22,800
12 ASAM MEFENAMAT infarmid Rp 350 176 Rp 61,600 30 Rp 10,500 6
13 BETHAMETASON Rp 4,000 36 Rp 144,000 11 Rp 44,000
14 BIOMAAG Rp 450 66 Rp 29,700 190 Rp 85,500
15 BISOPROLOL HJ Rp 600 46 Rp 27,600 40 Rp 24,000
16 CEFADROXIL HJ Rp 900 188 Rp 169,200 170 Rp 153,000 74
17 CEFIXIME dexa Rp 1,150 18 Rp 20,700 70 Rp 80,500
18 CALORTUSIN Rp 550 32 Rp 17,600 20 Rp 11,000
19 CIPROFLOXACIN HJ Rp 550 138 Rp 75,900 30 Rp 16,500
20 CAPTOPRIL 25 ERRITA Rp 150 45 Rp 6,750 20 Rp 3,000
21 CETERIZIN TRIMAN Rp 250 318 Rp 79,500 210 Rp 52,500
22 DOMPERIDON SUSP Rp 5,500 Rp - 2 Rp 11,000
23 DOMPERIDON Rp 300 347 Rp 104,100 270 Rp 81,000
24 DENICAM / Pirox 20 Rp 400 106 Rp 42,400 60 Rp 24,000
25 DIONICOL / Thiamfenicol Rp 1,300 70 Rp 91,000 10 Rp 13,000
26 ERMETHASONE / Dexa Rp 150 751 Rp 112,650 162 Rp 24,300 70
27 ERPHAFILIN Rp 250 22 Rp 5,500 10 Rp 2,500
28 ERPHAFLAM / Kalium Diclo Rp 400 Rp - Rp -
29 ERSOLON / Methylpred 4 mg Rp 550 214 Rp 117,700 140 Rp 77,000 36
30 ERLA TT Rp 11,000 2 Rp 22,000 Rp -
31 ERLA SM Rp 12,000 8 Rp 96,000 1 Rp 12,000
32 ERBIFIN / Metronidazol Rp 600 8 Rp 4,800 Rp - 160
33 ERPHAMOL / Paracetamol Rp 350 8 Rp 2,800 301 Rp 105,350
34 ETAFUSIN SYR Rp 7,000 1 Rp 7,000
35 FLUMIN LOS Rp 400 284 Rp 113,600 Rp -
36 FLUMIN BOX Rp 500 Rp - 30 Rp 15,000
37 FERMIA Rp 400 138 Rp 55,200 30 Rp 12,000
38 FLOXIGRA Rp 700 Rp - Rp -
39 FASORBID / ISDN Rp 300 Rp - 40 Rp 12,000
40 FUROSEMID 40 MG Rp 350 20 Rp 7,000 30 Rp 225,000
41 GG ERLIM Rp 250 154 Rp 38,500 20 Rp 5,000
42 GASELA / Ranitidine Rp 500 Rp - 290 Rp 145,000
43 GENOINT / Gentamycin SK Rp 7,500 40 Rp 300,000 15 Rp 11,250
44 IMODIAR / Loperamid Rp 250 88 Rp 22,000 10 Rp 2,500
45 IFIDEX / Dexa Rp 60 Rp - Rp -
46 ISDN INF Rp 250 48 Rp 12,000 Rp -
47 IFISON / Prednison Rp 150 154 Rp 23,100 23 Rp 3,450
48 KAOTIN Rp 950 Rp - 1 Rp 9,500
49 KETOCONAZOLE Rp 350 30 Rp 10,500 10 Rp 3,500
50 LOSTACEF SYR / Cefad Rp 16,000 2 Rp 32,000 2 Rp 32,000
51 METFORMIN Rp 250 170 Rp 42,500 80 Rp 20,000
52 MELOXICAM Rp 400 110 Rp 44,000 50 Rp 20,000
53 MICONAZOLE Rp 600 4 Rp 2,400 3 Rp 1,800
54 MIRABION Rp 400 Rp - Rp -
55 Miracloven Rp 400 269 Rp 107,600 60 Rp 24,000 166
56 NEOMETHOR Rp 450 72 Rp 32,400 70 Rp 31,500
57 NUSAPLEX / Vit B Plex Rp 80 406 Rp 32,480 10 Rp 800
58 NOVAKALK / Kalk Rp 150 Rp - Rp -
59 NOVAGESIC / Antalgin Rp 300 Rp - Rp -
60 NARMIG Rp 300 186 Rp 55,800 90 Rp 27,000
61 NOVADEX / Dexa Rp 150 Rp - Rp -
62 NEUROBION INJ "5 Rp 4,000 Rp - Rp -
63 ORPHEN / CTM Rp 100 Rp - Rp -
64 OMEGESIC Rp 550 718 Rp 394,900 40 Rp 22,000
65 OMERIC /Allopurinol Rp 400 Rp - Rp -
66 OMEPRAZOLE Rp 450 34 Rp 15,298 90 Rp 40,496
67 PIROXICAM 10 NOVA Rp 150 286 Rp 42,900 40 Rp 6,000
68 PARANERVION Rp 1,050 236 Rp 247,800 570 Rp 598,500
69 PARACETAMOL Rp 150 1061 Rp 159,134 143 Rp 21,448 443
70 PARACETAMOL SYR Rp 4,000 6 Rp 24,000 3 Rp 12,000 7
71 PEHACAIN ("20) Rp 4,500 Rp - Rp -
72 RANITIDINE HEXP Rp 200 702 Rp 140,400 110 Rp 22,000 6
73 SALGEN SK / Gentamycin SK Rp 6,000 Rp - Rp -
74 SIMVASTATIN 10 Rp 250 160 Rp 40,000 40 Rp 10,000
75 SALBUTAMOL Rp 200 84 Rp 16,800 10 Rp 2,000
76 SPASMINAL Rp 950 48 Rp 45,600 30 Rp 28,500
77 SAMCOFENAC / Na Diclo Rp 250 Rp - Rp -
78 TRIDEXON / Dexa Rp 100 Rp - Rp -
79 TRISELA Rp 500 Rp - Rp -
80 VIT C PIM Rp 60 378 Rp 22,680 Rp -
81 VIT C ISI 1000 Rp 60 Rp - 47 Rp 2,820 9
82 VIT K Rp 350 20 Rp 7,000 34 Rp 11,900
83 VISELA Rp 300 138 Rp 41,400 20 Rp 6,000
84 VIT B6 Rp 60 144 Rp 8,640 Rp -
85 VIT B12 Rp 40 597 Rp 23,880 50 Rp 2,000
86 YUSIMOX SYR /Amox syr Rp 6,000 Rp - Rp -
87 ZELONA/Na Diclo Rp 350 345 Rp 120,750 60 Rp 21,000 69
88 ZIPHA/Zinc Rp 900 29 Rp 26,099 36 Rp 32,399
TOTAL Rp 4,210,112 Rp 2,586,413
OBAT GIGI
Total

Rp 218,500
Rp -
Rp 7,200
Rp -
Rp -
Rp -
Rp -
Rp 2,100
Rp -
Rp -
Rp -
Rp 66,600
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 10,500
Rp -
Rp -
Rp 19,800
Rp -
Rp -
Rp 96,000

Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 66,400
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 66,443
Rp 28,000
Rp -
Rp 1,200
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 540
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 24,150
Rp -
Rp 607,433
 Bulan Obat BPJS Obat Umum Obat Gigi
Februari 2021 4,210,112 2,586,413 607,433
Maret 2021 5,489,793 2,722,292 1,004,840
April 2021 4,307,797 2,698,925 863,193
6,000,000

5,000,000

4,000,000

3,000,000

2,000,000

1,000,000

-
Obat BPJS Obat Umum
 Februari 2021
Maret 2021
April 2021

Obat BPJS Obat Umum Obat Gigi

 LAPORAN OBAT KELUAR KLINIK GRIYA SEHAT
BULAN MARET 2021

OBAT BPJS OBAT UMUM OBAT GIGI

NO NAMA OBAT Harga Satuan
Jumlah Total Jumlah Total Jumlah
1 AMBROXOL NV Rp 150 381 Rp 57,150 59 Rp 8,850
2 ACYCLOVIR CREAM Rp 5,000 9 Rp 45,000 2 Rp 10,000
3 AMLODIPIN 5 PH Rp 150 462 Rp 69,300 110 Rp 16,500
4 AMLODIPIN 10 PH Rp 250 436 Rp 109,000 200 Rp 50,000
5 AMOXICILLIN HJ Rp 600 370 Rp 222,000 72 Rp 43,200 739
6 ANTASID OGB Rp 200 1175 Rp 235,000 70 Rp 14,000
7 ARKAVIT Rp 400 293 Rp 117,200 456 Rp 182,400 28
8 AKITA / Kaolin Rp 350 164 Rp 57,400 80 Rp 28,000
9 ANTALGIN (Betalgin) Rp 300 264 Rp 79,200 10 Rp 3,000
10 ALLOPURINOL HJ Rp 300 102 Rp 30,600 10 Rp 3,000
11 ALLERON / CTM Rp 200 458 Rp 91,600 94 Rp 18,800
12 ASAM MEFENAMAT infarmid Rp 350 250 Rp 87,500 60 Rp 21,000 60
13 BETHAMETASON Rp 4,000 61 Rp 244,000 9 Rp 36,000
14 BIOMAAG Rp 450 126 Rp 56,700 330 Rp 148,500
15 BISOPROLOL Dexa Rp 600 76 Rp 45,600 50 Rp 30,000
16 CEFADROXIL HJ Rp 900 239 Rp 215,100 150 Rp 135,000 56
17 CEFIXIME dexa Rp 1,150 8 Rp 9,200 70 Rp 80,500
18 CALORTUSIN Rp 550 32 Rp 17,600 20 Rp 11,000
19 CIPROFLOXACIN HJ Rp 550 192 Rp 105,600 80 Rp 44,000 8
20 CAPTOPRIL 25 ERRITA Rp 150 144 Rp 21,600 10 Rp 1,500
21 CETERIZIN TRIMAN Rp 250 375 Rp 93,750 160 Rp 40,000
22 DOMPERIDON SUSP Rp 5,500 1 Rp 5,500 Rp -
23 DOMPERIDON Rp 300 410 Rp 123,000 236 Rp 70,800
24 DENICAM / Pirox 20 Rp 400 0 Rp - 0 Rp -
25 DIONICOL / Thiamfenicol Rp 1,300 22 Rp 28,600 10 Rp 13,000
27 ERPHAFILIN Rp 250 0 Rp - Rp -
28 ERPHAFLAM / Kalium Diclo Rp 400 Rp - Rp -
29 ERSOLON / Methylpred 4 mg Rp 550 146 Rp 80,300 150 Rp 82,500 104
30 ERLA TT Rp 11,000 1 Rp 11,000 2 Rp 22,000
31 ERLA SM Rp 12,000 4 Rp 48,000 2 Rp 24,000
32 ERBIFIN / Metronidazol Rp 600 18 Rp 10,800 20 Rp 12,000 272
33 ERPHAMOL / Paracetamol Rp 350 10 Rp 3,500 240 Rp 84,000 40
34 ETAFUSIN SYR Rp 7,000 Rp - Rp -
35 FLUMIN LOS Rp 400 0 Rp - Rp -
36 FLUMIN BOX Rp 500 587 Rp 293,500 44 Rp 22,000
37 FERMIA Rp 400 110 Rp 44,000 80 Rp 32,000
38 FLOXIGRA Rp 700 Rp - Rp -
39 FASORBID / ISDN Rp 300 Rp - 10 Rp 3,000
40 FUROSEMID 40 MG Rp 350 34 Rp 11,900 Rp -
41 GG ERLIM Rp 250 282 Rp 70,500 8 Rp 2,000
42 GASELA / Ranitidine Rp 500 Rp - 190 Rp 95,000
43 GENOINT / Gentamycin SK Rp 7,500 0 Rp - Rp -
44 IMODIAR / Loperamid Rp 250 53 Rp 13,250 10 Rp 2,500
45 IFIDEX / Dexa Rp 60 Rp - Rp -
46 ISDN INF Rp 250 68 Rp 17,000 Rp -
47 IFISON / Prednison Rp 150 226 Rp 33,900 Rp -
48 KAOTIN Rp 950 Rp - 1 Rp 950
49 KETOCONAZOLE Rp 350 45 Rp 15,750 Rp -
50 LOSTACEF SYR / Cefad Rp 16,000 0 Rp - 1 Rp 16,000
METAFLU Rp 400 28 Rp 11,200 10 Rp 4,000
51 METFORMIN Rp 250 298 Rp 74,500 30 Rp 7,500
52 MELOXICAM Rp 400 80 Rp 32,000 30 Rp 12,000
53 MICONAZOLE Rp 600 28 Rp 16,800 Rp -
54 MIRABION Rp 400 Rp - Rp -
55 Miracloven Rp 400 345 Rp 138,000 120 Rp 48,000 242
56 NEOMETHOR Rp 450 144 Rp 64,800 50 Rp 22,500
57 NUSAPLEX / Vit B Plex Rp 80 998 Rp 79,840 50 Rp 4,000
58 NOVAKALK / Kalk Rp 150 142 Rp 21,300 Rp -
60 NARMIG Rp 300 280 Rp 84,000 120 Rp 36,000
61 NOVADEX / Dexa Rp 150 928 Rp 139,200 186 Rp 27,900 140
62 NEUROBION INJ "5 Rp 4,000 Rp - Rp -
63 ORPHEN / CTM Rp 100 Rp - Rp -
64 OMEGESIC Rp 550 688 Rp 378,400 60 Rp 33,000
65 OMERIC /Allopurinol Rp 400 Rp - Rp -
66 OMEPRAZOLE Rp 450 24 Rp 10,799 70 Rp 31,497
67 PIROXICAM 10 NOVA Rp 150 556 Rp 83,400 210 Rp 31,500
68 PARANERVION Rp 1,050 182 Rp 191,100 686 Rp 720,300
69 PARACETAMOL Rp 150 1675 Rp 251,225 190 Rp 28,497 687
70 PARACETAMOL SYR Rp 4,000 19 Rp 76,000 6 Rp 24,000 2
71 PEHACAIN ("20) Rp 4,500 0 Rp - Rp -
72 RANITIDINE HEXP Rp 200 1014 Rp 202,800 260 Rp 52,000
73 SALGEN SK / Gentamycin SK Rp 6,000 69 Rp 414,000 13 Rp 78,000
74 SIMVASTATIN 10 Rp 250 196 Rp 49,000 30 Rp 7,500
75 SALBUTAMOL Rp 200 74 Rp 14,800 10 Rp 2,000
76 SPASMINAL Rp 950 44 Rp 41,800 40 Rp 38,000
77 SAMCOFENAC / Na Diclo Rp 250 Rp - Rp -
78 TRIDEXON / Dexa Rp 100 Rp - Rp -
79 TRISELA Rp 500 Rp - Rp -
80 VIT C PIM Rp 60 696 Rp 41,760 116 Rp 6,960
81 VIT C ISI 1000 Rp 60 Rp - Rp -
82 VIT K Rp 350 27 Rp 9,450 10 Rp 3,500 4
83 VISELA Rp 300 144 Rp 43,200 Rp -
84 VIT B6 Rp 60 152 Rp 9,120 14 Rp 840
85 VIT B12 Rp 40 620 Rp 24,800 40 Rp 1,600
86 YUSIMOX SYR /Amox syr Rp 6,000 Rp - Rp -
87 ZELONA/Na Diclo Rp 350 420 Rp 147,000 120 Rp 42,000 28
88 ZIPHA/Zinc Rp 900 21 Rp 18,899 58 Rp 52,198
TOTAL Rp 5,489,793 Rp 2,722,292
OBAT GIGI
Total

Rp 443,400
Rp -
Rp 11,200
Rp -
Rp -
Rp -
Rp -
Rp 21,000
Rp -
Rp -
Rp -
Rp 50,400
Rp -
Rp -
Rp 4,400
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 57,200
Rp -
Rp -
Rp 163,200
Rp 14,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 96,800
Rp -
Rp -
Rp -
Rp -
Rp 21,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 103,040
Rp 8,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,400
Rp -
Rp -
Rp -
Rp -
Rp 9,800
Rp -
Rp 1,004,840
 LAPORAN OBAT KELUAR KLINIK GRIYA SEHAT
BULAN APRIL 2021

OBAT BPJS OBAT UMUM OBAT GIGI

NO NAMA OBAT Harga Satuan
Jumlah Total Jumlah Total Jumlah
1 AMBROXOL NV Rp 150 584 Rp 87,600 68 Rp 10,200
2 ACYCLOVIR CREAM Rp 5,000 9 Rp 45,000 Rp -
3 AMLODIPIN 5 PH Rp 150 307 Rp 46,050 60 Rp 9,000 4
4 AMLODIPIN 10 PH Rp 250 350 Rp 87,500 150 Rp 37,500 4
5 AMOXICILLIN HJ Rp 600 97 Rp 58,200 10 Rp 6,000 560
6 ANTASID OGB Rp 200 871 Rp 174,200 106 Rp 21,200
7 ARKAVIT Rp 400 82 Rp 32,800 490 Rp 196,000 4
8 AKITA / Kaolin Rp 350 145 Rp 50,750 70 Rp 24,500
9 ANTALGIN (Betalgin) Rp 300 154 Rp 46,200 Rp -
10 ALLOPURINOL HJ Rp 300 96 Rp 28,800 20 Rp 6,000
11 ALLERON / CTM Rp 200 370 Rp 74,000 88 Rp 17,600
12 ASAM MEFENAMAT infarmid Rp 350 159 Rp 55,650 70 Rp 24,500 114
13 BETHAMETASON Rp 4,000 51 Rp 204,000 9 Rp 36,000
14 BIOMAAG Rp 450 70 Rp 31,500 300 Rp 135,000
15 BISOPROLOL Dexa Rp 600 84 Rp 50,400 10 Rp 6,000
16 CEFADROXIL HJ Rp 900 108 Rp 97,200 180 Rp 162,000 76
17 CEFIXIME dexa Rp 1,150 Rp - 70 Rp 80,500
18 CALORTUSIN Rp 550 52 Rp 28,600 40 Rp 22,000
19 CIPROFLOXACIN HJ Rp 550 192 Rp 105,600 10 Rp 5,500
20 CAPTOPRIL 25 ERRITA Rp 150 110 Rp 16,500 20 Rp 3,000
21 CETERIZIN TRIMAN Rp 250 293 Rp 73,250 120 Rp 30,000
22 DOMPERIDON SUSP Rp 5,500 5 Rp 27,500 7 Rp 38,500
23 DOMPERIDON Rp 300 407 Rp 122,100 210 Rp 63,000
24 DENICAM / Pirox 20 Rp 400 Rp - Rp -
25 DIONICOL / Thiamfenicol Rp 1,300 Rp - 30 Rp 39,000
27 ERPHAFILIN Rp 250 Rp - Rp -
28 ERPHAFLAM / Kalium Diclo Rp 400 Rp - Rp -
29 ERSOLON / Methylpred 4 mg Rp 550 106 Rp 58,300 150 Rp 82,500 38
30 ERLA TT Rp 11,000 Rp - 1 Rp 11,000
31 ERLA SM Rp 12,000 Rp - 1 Rp 12,000
32 ERBIFIN / Metronidazol Rp 600 24 Rp 14,400 Rp - 226
33 ERPHAMOL / Paracetamol Rp 350 22 Rp 7,700 344 Rp 120,400 200
34 ETAFUSIN SYR Rp 7,000 Rp - Rp -
35 FLUMIN LOS Rp 400 Rp - Rp -
36 FLUMIN BOX Rp 500 680 Rp 340,000 31 Rp 15,500
37 FERMIA Rp 400 141 Rp 56,400 70 Rp 28,000
38 FLOXIGRA Rp 700 Rp - Rp -
39 FASORBID / ISDN Rp 300 28 Rp 8,400 10 Rp 3,000
40 FUROSEMID 40 MG Rp 350 Rp - 20 Rp 7,000
41 GG ERLIM Rp 250 355 Rp 88,750 8 Rp 2,000
42 GASELA / Ranitidine Rp 500 Rp - 436 Rp 218,000
43 GENOINT / Gentamycin SK Rp 7,500 Rp - Rp -
44 IMODIAR / Loperamid Rp 250 30 Rp 7,500 20 Rp 5,000
45 IFIDEX / Dexa Rp 60 Rp - Rp -
46 ISDN INF Rp 250 28 Rp 7,000 10 Rp 2,500
47 IFISON / Prednison Rp 150 204 Rp 30,600 35 Rp 5,250
48 KAOTIN Rp 950 3 Rp 2,850 2 Rp 1,900
49 KETOCONAZOLE Rp 350 13 Rp 4,550 20 Rp 7,000
50 LOSTACEF SYR / Cefad Rp 16,000 Rp - 3 Rp 48,000
METAFLU Rp 400 Rp - 20 Rp 8,000
51 METFORMIN Rp 250 278 Rp 69,500 10 Rp 2,500
52 MELOXICAM Rp 400 76 Rp 30,400 30 Rp 12,000
53 MICONAZOLE Rp 600 12 Rp 7,200 4 Rp 2,400
54 MIRABION Rp 400 Rp - Rp -
55 Miracloven Rp 400 418 Rp 167,200 50 Rp 20,000 154
56 NEOMETHOR Rp 450 218 Rp 98,100 83 Rp 37,350
57 NUSAPLEX / Vit B Plex Rp 80 1020 Rp 81,600 18 Rp 1,440
58 NOVAKALK / Kalk Rp 150 140 Rp 21,000 60 Rp 9,000
60 NARMIG Rp 300 124 Rp 37,200 60 Rp 18,000
61 NOVADEX / Dexa Rp 150 548 Rp 82,200 250 Rp 37,500 214
62 NEUROBION INJ "5 Rp 4,000 Rp - Rp -
63 ORPHEN / CTM Rp 100 Rp - Rp -
64 OMEGESIC Rp 550 538 Rp 295,900 136 Rp 74,800
65 OMERIC /Allopurinol Rp 400 Rp - Rp -
66 OMEPRAZOLE Rp 450 4 Rp 1,800 50 Rp 22,498
67 PIROXICAM 10 NOVA Rp 150 332 Rp 49,800 64 Rp 9,600
68 PARANERVION Rp 1,050 Rp - 480 Rp 504,000
69 PARACETAMOL Rp 150 1513 Rp 226,927 13 Rp 1,950 462
70 PARACETAMOL SYR Rp 4,000 25 Rp 100,000 16 Rp 64,000 5
71 PEHACAIN ("20) Rp 4,500 Rp - 20 Rp 90,000
72 RANITIDINE HEXP Rp 200 880 Rp 176,000 Rp - 6
73 SALGEN SK / Gentamycin SK Rp 6,000 61 Rp 366,000 14 Rp 84,000
74 SIMVASTATIN 10 Rp 250 160 Rp 40,000 50 Rp 12,500
75 SALBUTAMOL Rp 200 52 Rp 10,400 Rp -
76 SPASMINAL Rp 950 74 Rp 70,300 60 Rp 57,000
77 SAMCOFENAC / Na Diclo Rp 250 40 Rp 10,000 70 Rp 17,500 24
78 TRIDEXON / Dexa Rp 100 Rp - Rp -
79 TRISELA Rp 500 Rp - Rp -
80 VIT C PIM Rp 60 494 Rp 29,640 114 Rp 6,840 10
81 VIT C ISI 1000 Rp 60 Rp - Rp -
82 VIT K Rp 350 36 Rp 12,600 Rp -
83 VISELA Rp 300 206 Rp 61,800 Rp -
84 VIT B6 Rp 60 102 Rp 6,120 Rp -
85 VIT B12 Rp 40 479 Rp 19,160 10 Rp 400
86 YUSIMOX SYR /Amox syr Rp 6,000 Rp - 1 Rp 6,000
87 ZELONA/Na Diclo Rp 350 148 Rp 51,800 Rp -
88 ZIPHA/Zinc Rp 900 17 Rp 15,299 64 Rp 57,598
TOTAL Rp 4,307,797 Rp 2,698,925
OBAT GIGI
Total

Rp 600
Rp 1,000
Rp 336,000
Rp -
Rp 1,600
Rp -
Rp -
Rp -
Rp -
Rp 39,900
Rp -
Rp -
Rp -
Rp 68,400
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 20,900
Rp -
Rp -
Rp 135,600
Rp 70,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 61,600
Rp -
Rp -
Rp -
Rp -
Rp 32,100
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 69,293
Rp 20,000
Rp -
Rp 1,200
Rp -
Rp -
Rp -
Rp -
Rp 6,000
Rp -
Rp -
Rp 600
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 863,193
LAPORAN OBAT KELUAR KLINIK GRIYA SEHAT
BULAN APRIL 2021

NO NAMA OBAT Harga Satuan OBAT BPJS OBAT UMUM OBAT GIGI
69 PARACETAMOL Rp 150 1513 Rp 226,927 13 Rp 1,950 462
57 NUSAPLEX / Vit B Plex Rp 80 1020 Rp 81,600 18 Rp 1,440
61 NOVADEX / Dexa Rp 150 548 Rp 82,200 250 Rp 37,500 214
6 ANTASID OGB Rp 200 871 Rp 174,200 106 Rp 21,200
72 RANITIDINE HEXP Rp 200 880 Rp 176,000 Rp - 6
36 FLUMIN BOX Rp 500 680 Rp 340,000 31 Rp 15,500
64 OMEGESIC Rp 550 538 Rp 295,900 136 Rp 74,800
5 AMOXICILLIN HJ Rp 600 97 Rp 58,200 10 Rp 6,000 560
1 AMBROXOL NV Rp 150 584 Rp 87,600 68 Rp 10,200
55 Miracloven Rp 400 418 Rp 167,200 50 Rp 20,000 154
80 VIT C PIM Rp 60 494 Rp 29,640 114 Rp 6,840 10
23 DOMPERIDON Rp 300 407 Rp 122,100 210 Rp 63,000
7 ARKAVIT Rp 400 82 Rp 32,800 490 Rp 196,000 4
33 ERPHAMOL / Paracetamol Rp 350 22 Rp 7,700 344 Rp 120,400 200
4 AMLODIPIN 10 PH Rp 250 350 Rp 87,500 150 Rp 37,500 4
85 VIT B12 Rp 40 479 Rp 19,160 10 Rp 400
68 PARANERVION Rp 1,050 Rp - 480 Rp 504,000
11 ALLERON / CTM Rp 200 370 Rp 74,000 88 Rp 17,600
42 GASELA / Ranitidine Rp 500 Rp - 436 Rp 218,000
21 CETERIZIN TRIMAN Rp 250 293 Rp 73,250 120 Rp 30,000
67 PIROXICAM 10 NOVA Rp 150 332 Rp 49,800 64 Rp 9,600
3 AMLODIPIN 5 PH Rp 150 307 Rp 46,050 60 Rp 9,000 4
14 BIOMAAG Rp 450 70 Rp 31,500 300 Rp 135,000
16 CEFADROXIL HJ Rp 900 108 Rp 97,200 180 Rp 162,000 76
41 GG ERLIM Rp 250 355 Rp 88,750 8 Rp 2,000
12 ASAM MEFENAMAT infarmid Rp 350 159 Rp 55,650 70 Rp 24,500 114
56 NEOMETHOR Rp 450 218 Rp 98,100 83 Rp 37,350
29 ERSOLON / Methylpred 4 mg Rp 550 106 Rp 58,300 150 Rp 82,500 38
51 METFORMIN Rp 250 278 Rp 69,500 10 Rp 2,500
32 ERBIFIN / Metronidazol Rp 600 24 Rp 14,400 Rp - 226
47 IFISON / Prednison Rp 150 204 Rp 30,600 35 Rp 5,250
8 AKITA / Kaolin Rp 350 145 Rp 50,750 70 Rp 24,500
37 FERMIA Rp 400 141 Rp 56,400 70 Rp 28,000
74 SIMVASTATIN 10 Rp 250 160 Rp 40,000 50 Rp 12,500
83 VISELA Rp 300 206 Rp 61,800 Rp -
19 CIPROFLOXACIN HJ Rp 550 192 Rp 105,600 10 Rp 5,500
58 NOVAKALK / Kalk Rp 150 140 Rp 21,000 60 Rp 9,000
60 NARMIG Rp 300 124 Rp 37,200 60 Rp 18,000
9 ANTALGIN (Betalgin) Rp 300 154 Rp 46,200 Rp -
87 ZELONA/Na Diclo Rp 350 148 Rp 51,800 Rp -
76 SPASMINAL Rp 950 74 Rp 70,300 60 Rp 57,000
77 SAMCOFENAC / Na Diclo Rp 250 40 Rp 10,000 70 Rp 17,500 24
20 CAPTOPRIL 25 ERRITA Rp 150 110 Rp 16,500 20 Rp 3,000
10 ALLOPURINOL HJ Rp 300 96 Rp 28,800 20 Rp 6,000
52 MELOXICAM Rp 400 76 Rp 30,400 30 Rp 12,000
84 VIT B6 Rp 60 102 Rp 6,120 Rp -
15 BISOPROLOL Dexa Rp 600 84 Rp 50,400 10 Rp 6,000
18 CALORTUSIN Rp 550 52 Rp 28,600 40 Rp 22,000
88 ZIPHA/Zinc Rp 900 17 Rp 15,299 64 Rp 57,598
73 SALGEN SK / Gentamycin SK Rp 6,000 61 Rp 366,000 14 Rp 84,000
17 CEFIXIME dexa Rp 1,150 Rp - 70 Rp 80,500
13 BETHAMETASON Rp 4,000 51 Rp 204,000 9 Rp 36,000
66 OMEPRAZOLE Rp 450 4 Rp 1,800 50 Rp 22,498
75 SALBUTAMOL Rp 200 52 Rp 10,400 Rp -
44 IMODIAR / Loperamid Rp 250 30 Rp 7,500 20 Rp 5,000
70 PARACETAMOL SYR Rp 4,000 25 Rp 100,000 16 Rp 64,000 5
 39 FASORBID / ISDN Rp 300 28 Rp 8,400 10 Rp 3,000
46 ISDN INF Rp 250 28 Rp 7,000 10 Rp 2,500
82 VIT K Rp 350 36 Rp 12,600 Rp -
49 KETOCONAZOLE Rp 350 13 Rp 4,550 20 Rp 7,000
25 DIONICOL / Thiamfenicol Rp 1,300 Rp - 30 Rp 39,000
40 FUROSEMID 40 MG Rp 350 Rp - 20 Rp 7,000
METAFLU Rp 400 Rp - 20 Rp 8,000
71 PEHACAIN ("20) Rp 4,500 Rp - 20 Rp 90,000
53 MICONAZOLE Rp 600 12 Rp 7,200 4 Rp 2,400
22 DOMPERIDON SUSP Rp 5,500 5 Rp 27,500 7 Rp 38,500
2 ACYCLOVIR CREAM Rp 5,000 9 Rp 45,000 Rp -
48 KAOTIN Rp 950 3 Rp 2,850 2 Rp 1,900
50 LOSTACEF SYR / Cefad Rp 16,000 Rp - 3 Rp 48,000
30 ERLA TT Rp 11,000 Rp - 1 Rp 11,000
31 ERLA SM Rp 12,000 Rp - 1 Rp 12,000
86 YUSIMOX SYR /Amox syr Rp 6,000 Rp - 1 Rp 6,000
24 DENICAM / Pirox 20 Rp 400 Rp - Rp -
27 ERPHAFILIN Rp 250 Rp - Rp -
28 ERPHAFLAM / Kalium Diclo Rp 400 Rp - Rp -
34 ETAFUSIN SYR Rp 7,000 Rp - Rp -
35 FLUMIN LOS Rp 400 Rp - Rp -
38 FLOXIGRA Rp 700 Rp - Rp -
43 GENOINT / Gentamycin SK Rp 7,500 Rp - Rp -
45 IFIDEX / Dexa Rp 60 Rp - Rp -
54 MIRABION Rp 400 Rp - Rp -
62 NEUROBION INJ "5 Rp 4,000 Rp - Rp -
63 ORPHEN / CTM Rp 100 Rp - Rp -
65 OMERIC /Allopurinol Rp 400 Rp - Rp -
78 TRIDEXON / Dexa Rp 100 Rp - Rp -
79 TRISELA Rp 500 Rp - Rp -
81 VIT C ISI 1000 Rp 60 Rp - Rp -
Jumlah Total Jumlah Total Jumlah
TOTAL Rp 4,080,869 Rp 2,696,976
OBAT GIGI
Rp 69,293
Rp -
Rp 32,100
Rp -
Rp 1,200
Rp -
Rp -
Rp 336,000

Rp 61,600
Rp 600
Rp -
Rp 1,600
Rp 70,000
Rp 1,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 600
Rp -
Rp 68,400
Rp -
Rp 39,900
Rp -
Rp 20,900
Rp -
Rp 135,600
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 6,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 20,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -

Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Total
Rp 762,200
 LAPORAN OBAT KELUAR KLINIK GRIYA SEHAT
BULAN MEI 2021

OBAT BPJS OBAT UMUM OBAT GIGI

NO NAMA OBAT Harga Satuan
Jumlah Total Jumlah Total Jumlah
1 ACYCLOVIR CREAM Rp 5,000 7 Rp 35,000 2 Rp 10,000
2 AKITA / Kaolin Rp 350 157 Rp 54,950 58 Rp 20,300
3 ALLERON / CTM Rp 200 342 Rp 68,400 116 Rp 23,200
4 ALLOPURINOL HJ Rp 300 56 Rp 16,800 60 Rp 18,000
5 AMBROXOL NV Rp 150 545 Rp 81,750 107 Rp 16,050
6 AMLODIPIN 10 PH Rp 250 384 Rp 96,000 120 Rp 30,000
7 AMLODIPIN 5 PH Rp 150 271 Rp 40,650 100 Rp 15,000
8 AMOXICILLIN HJ Rp 600 183 Rp 109,800 20 Rp 12,000 464
9 ANTALGIN (Betalgin) Rp 300 154 Rp 46,200 Rp -
10 ANTASID OGB Rp 200 947 Rp 189,400 30 Rp 6,000
11 ARKAVIT Rp 400 266 Rp 106,400 310 Rp 124,000
12 ASAM MEFENAMAT infarmid Rp 350 187 Rp 65,450 10 Rp 3,500 146
13 BETHAMETASON Rp 4,000 52 Rp 208,000 8 Rp 32,000
14 BIOMAAG Rp 450 Rp - 450 Rp 202,500
15 BISOPROLOL Dexa Rp 600 74 Rp 44,400 20 Rp 12,000
16 CALORTUSIN Rp 550 52 Rp 28,600 40 Rp 22,000
17 CAPTOPRIL 25 ERRITA Rp 150 130 Rp 19,500 Rp -
18 CEFADROXIL HJ Rp 900 169 Rp 152,100 177 Rp 159,300 18
19 CEFIXIME dexa Rp 1,150 20 Rp 23,000 122 Rp 140,300
20 CETERIZIN TRIMAN Rp 250 313 Rp 78,250 100 Rp 25,000
21 CIPROFLOXACIN HJ Rp 550 182 Rp 100,100 20 Rp 11,000
22 DENICAM / Pirox 20 Rp 400 Rp - Rp -
23 DIONICOL / Thiamfenicol Rp 1,300 30 Rp 39,000 Rp -
24 DOMPERIDON Rp 300 373 Rp 111,900 204 Rp 61,200
25 DOMPERIDON SUSP Rp 5,500 10 Rp 55,000 2 Rp 11,000
27 ERBIFIN / Metronidazol Rp 600 8 Rp 4,800 Rp - 156
28 ERLA SM Rp 12,000 1 Rp 12,000 1 Rp 12,000
29 ERLA TT Rp 11,000 1 Rp 11,000 1 Rp 11,000
30 ERPHAFILIN Rp 250 12 Rp 3,000 Rp -
31 ERPHAFLAM / Kalium Diclo Rp 400 Rp - Rp -
32 ERPHAMOL / Paracetamol Rp 350 12 Rp 4,200 340 Rp 119,000 50
33 ERSOLON / Methylpred 4 mg Rp 550 152 Rp 83,600 120 Rp 66,000 22
34 ETAFUSIN SYR Rp 7,000 Rp - 1 Rp 7,000
35 FASORBID / ISDN Rp 300 38 Rp 11,400 Rp -
36 FERMIA Rp 400 181 Rp 72,400 30 Rp 12,000
37 FLOXIGRA Rp 700 10 Rp 7,000 Rp -
38 FLUMIN BOX Rp 500 641 Rp 320,500 56 Rp 28,000
39 FLUMIN LOS Rp 400 14 Rp 5,600 Rp -
40 FUROSEMID 40 MG Rp 350 16 Rp 5,600 Rp -
41 GASELA / Ranitidine Rp 500 Rp - 340 Rp 170,000
42 GENOINT / Gentamycin SK Rp 7,500 Rp - Rp -
43 GG ERLIM Rp 250 323 Rp 80,750 40 Rp 10,000
44 IFIDEX / Dexa Rp 60 Rp - Rp -
45 IFISON / Prednison Rp 150 206 Rp 30,900 33 Rp 4,950
46 IMODIAR / Loperamid Rp 250 40 Rp 10,000 10 Rp 2,500
47 ISDN INF Rp 250 Rp - Rp -
48 KAOTIN Rp 950 5 Rp 4,750 Rp -
49 KETOCONAZOLE Rp 350 33 Rp 11,550 Rp -
50 LOSTACEF SYR / Cefad Rp 16,000 Rp - 3 Rp 48,000
MELOXICAM Rp 400 66 Rp 26,400 40 Rp 16,000
51 METAFLU Rp 400 Rp - Rp -
52 METFORMIN Rp 250 258 Rp 64,500 30 Rp 7,500
53 MICONAZOLE Rp 600 15 Rp 9,000 1 Rp 600
54 MIRABION Rp 400 Rp - Rp -
55 Miracloven Rp 400 424 Rp 169,600 80 Rp 32,000 62
56 NARMIG Rp 300 144 Rp 43,200 40 Rp 12,000
57 NEOMETHOR Rp 450 191 Rp 85,950 110 Rp 49,500
58 NEUROBION INJ "5 Rp 4,000 Rp - Rp -
60 NOVADEX / Dexa Rp 150 751 Rp 112,650 203 Rp 30,450 58
61 NOVAKALK / Kalk Rp 150 104 Rp 15,600 96 Rp 14,400
62 NUSAPLEX / Vit B Plex Rp 80 1007 Rp 80,560 25 Rp 2,000 6
63 OMEGESIC Rp 550 624 Rp 343,200 50 Rp 27,500
64 OMEPRAZOLE Rp 450 Rp - 100 Rp 44,996
65 OMERIC /Allopurinol Rp 400 Rp - Rp -
66 ORPHEN / CTM Rp 100 Rp - Rp -
67 PARACETAMOL Rp 150 1600 Rp 239,976 30 Rp 4,500 358
68 PARACETAMOL SYR Rp 4,000 22 Rp 88,000 16 Rp 64,000 8
69 PARANERVION Rp 1,050 12 Rp 12,600 530 Rp 556,500
70 PEHACAIN ("20) Rp 4,500 Rp - Rp - 20
71 PIROXICAM 10 NOVA Rp 150 296 Rp 44,400 100 Rp 15,000
72 RANITIDINE HEXP Rp 200 936 Rp 187,200 150 Rp 30,000
73 SALBUTAMOL Rp 200 42 Rp 8,400 10 Rp 2,000
74 SALGEN SK / Gentamycin SK Rp 6,000 63 Rp 378,000 12 Rp 72,000
75 SAMCOFENAC / Na Diclo Rp 250 Rp - Rp -
76 SIMVASTATIN 10 Rp 250 80 Rp 20,000 130 Rp 32,500
77 SPASMINAL Rp 950 104 Rp 98,800 30 Rp 28,500
78 TRIDEXON / Dexa Rp 100 Rp - Rp -
79 TRISELA Rp 500 Rp - Rp -
80 VISELA Rp 300 206 Rp 61,800 Rp -
81 VIT B12 Rp 40 409 Rp 16,360 80 Rp 3,200
82 VIT B6 Rp 60 102 Rp 6,120 Rp -
83 VIT C ISI 1000 Rp 60 Rp - Rp -
84 VIT C PIM Rp 60 618 Rp 37,080 151 Rp 9,060
85 VIT K Rp 350 36 Rp 12,600 Rp -
86 YUSIMOX SYR /Amox syr Rp 6,000 Rp - 2 Rp 12,000 5
87 ZELONA/Na Diclo Rp 350 62 Rp 21,700 130 Rp 45,500 90
88 ZIPHA/Zinc Rp 900 49 Rp 44,098 32 Rp 28,799
TOTAL Rp 4,677,494 Rp 2,585,304
OBAT GIGI
Total

Rp -
Rp -
Rp -

Rp -
Rp -
Rp 278,400
Rp -
Rp -
Rp -
Rp 51,100
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 16,200
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 93,600
Rp -
Rp -
Rp -
Rp -
Rp 17,500
Rp 12,100
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 24,800
Rp -
Rp -
Rp -
Rp 8,700
Rp -
Rp 480
Rp -
Rp -
Rp -
Rp -
Rp 53,695
Rp 32,000
Rp -
Rp 90,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 30,000
Rp 31,500
Rp -
Rp 740,075
 LAPORAN OBAT KELUAR KLINIK GRIYA SEHAT
BULAN MEI 2021

OBAT BPJS OBAT UMUM OBAT GIGI

NO NAMA OBAT Harga Satuan
Jumlah Total Jumlah Total Jumlah
67 PARACETAMOL Rp 150 1600 Rp 239,976 30 Rp 4,500 358
72 RANITIDINE HEXP Rp 200 936 Rp 187,200 150 Rp 30,000
62 NUSAPLEX / Vit B Plex Rp 80 1007 Rp 80,560 25 Rp 2,000 6
60 NOVADEX / Dexa Rp 150 751 Rp 112,650 203 Rp 30,450 58
10 ANTASID OGB Rp 200 947 Rp 189,400 30 Rp 6,000
84 VIT C PIM Rp 60 618 Rp 37,080 151 Rp 9,060
38 FLUMIN BOX Rp 500 641 Rp 320,500 56 Rp 28,000
63 OMEGESIC Rp 550 624 Rp 343,200 50 Rp 27,500
8 AMOXICILLIN HJ Rp 600 183 Rp 109,800 20 Rp 12,000 464
5 AMBROXOL NV Rp 150 545 Rp 81,750 107 Rp 16,050
24 DOMPERIDON Rp 300 373 Rp 111,900 204 Rp 61,200
11 ARKAVIT Rp 400 266 Rp 106,400 310 Rp 124,000
55 Miracloven Rp 400 424 Rp 169,600 80 Rp 32,000 62
69 PARANERVION Rp 1,050 12 Rp 12,600 530 Rp 556,500
6 AMLODIPIN 10 PH Rp 250 384 Rp 96,000 120 Rp 30,000
81 VIT B12 Rp 40 409 Rp 16,360 80 Rp 3,200
3 ALLERON / CTM Rp 200 342 Rp 68,400 116 Rp 23,200
14 BIOMAAG Rp 450 Rp - 450 Rp 202,500
20 CETERIZIN TRIMAN Rp 250 313 Rp 78,250 100 Rp 25,000
32 ERPHAMOL / Paracetamol Rp 350 12 Rp 4,200 340 Rp 119,000 50
71 PIROXICAM 10 NOVA Rp 150 296 Rp 44,400 100 Rp 15,000
7 AMLODIPIN 5 PH Rp 150 271 Rp 40,650 100 Rp 15,000
18 CEFADROXIL HJ Rp 900 169 Rp 152,100 177 Rp 159,300 18
43 GG ERLIM Rp 250 323 Rp 80,750 40 Rp 10,000
12 ASAM MEFENAMAT infarmid Rp 350 187 Rp 65,450 10 Rp 3,500 146
41 GASELA / Ranitidine Rp 500 Rp - 340 Rp 170,000
57 NEOMETHOR Rp 450 191 Rp 85,950 110 Rp 49,500
33 ERSOLON / Methylpred 4 mg Rp 550 152 Rp 83,600 120 Rp 66,000 22
52 METFORMIN Rp 250 258 Rp 64,500 30 Rp 7,500
87 ZELONA/Na Diclo Rp 350 62 Rp 21,700 130 Rp 45,500 90
45 IFISON / Prednison Rp 150 206 Rp 30,900 33 Rp 4,950
2 AKITA / Kaolin Rp 350 157 Rp 54,950 58 Rp 20,300
36 FERMIA Rp 400 181 Rp 72,400 30 Rp 12,000
76 SIMVASTATIN 10 Rp 250 80 Rp 20,000 130 Rp 32,500
80 VISELA Rp 300 206 Rp 61,800 Rp -
21 CIPROFLOXACIN HJ Rp 550 182 Rp 100,100 20 Rp 11,000
61 NOVAKALK / Kalk Rp 150 104 Rp 15,600 96 Rp 14,400
56 NARMIG Rp 300 144 Rp 43,200 40 Rp 12,000
27 ERBIFIN / Metronidazol Rp 600 8 Rp 4,800 Rp - 156
9 ANTALGIN (Betalgin) Rp 300 154 Rp 46,200 Rp -
19 CEFIXIME dexa Rp 1,150 20 Rp 23,000 122 Rp 140,300
77 SPASMINAL Rp 950 104 Rp 98,800 30 Rp 28,500
17 CAPTOPRIL 25 ERRITA Rp 150 130 Rp 19,500 Rp -
4 ALLOPURINOL HJ Rp 300 56 Rp 16,800 60 Rp 18,000
MELOXICAM Rp 400 66 Rp 26,400 40 Rp 16,000
82 VIT B6 Rp 60 102 Rp 6,120 Rp -
64 OMEPRAZOLE Rp 450 Rp - 100 Rp 44,996
15 BISOPROLOL Dexa Rp 600 74 Rp 44,400 20 Rp 12,000
16 CALORTUSIN Rp 550 52 Rp 28,600 40 Rp 22,000
88 ZIPHA/Zinc Rp 900 49 Rp 44,098 32 Rp 28,799
74 SALGEN SK / Gentamycin SK Rp 6,000 63 Rp 378,000 12 Rp 72,000
13 BETHAMETASON Rp 4,000 52 Rp 208,000 8 Rp 32,000
73 SALBUTAMOL Rp 200 42 Rp 8,400 10 Rp 2,000
46 IMODIAR / Loperamid Rp 250 40 Rp 10,000 10 Rp 2,500
68 PARACETAMOL SYR Rp 4,000 22 Rp 88,000 16 Rp 64,000 8
35 FASORBID / ISDN Rp 300 38 Rp 11,400 Rp -
85 VIT K Rp 350 36 Rp 12,600 Rp -
49 KETOCONAZOLE Rp 350 33 Rp 11,550 Rp -
23 DIONICOL / Thiamfenicol Rp 1,300 30 Rp 39,000 Rp -
70 PEHACAIN ("20) Rp 4,500 Rp - Rp - 20
40 FUROSEMID 40 MG Rp 350 16 Rp 5,600 Rp -
53 MICONAZOLE Rp 600 15 Rp 9,000 1 Rp 600
39 FLUMIN LOS Rp 400 14 Rp 5,600 Rp -
25 DOMPERIDON SUSP Rp 5,500 10 Rp 55,000 2 Rp 11,000
30 ERPHAFILIN Rp 250 12 Rp 3,000 Rp -
37 FLOXIGRA Rp 700 10 Rp 7,000 Rp -
1 ACYCLOVIR CREAM Rp 5,000 7 Rp 35,000 2 Rp 10,000
86 YUSIMOX SYR /Amox syr Rp 6,000 Rp - 2 Rp 12,000 5
48 KAOTIN Rp 950 5 Rp 4,750 Rp -
50 LOSTACEF SYR / Cefad Rp 16,000 Rp - 3 Rp 48,000
28 ERLA SM Rp 12,000 1 Rp 12,000 1 Rp 12,000
29 ERLA TT Rp 11,000 1 Rp 11,000 1 Rp 11,000
34 ETAFUSIN SYR Rp 7,000 Rp - 1 Rp 7,000
22 DENICAM / Pirox 20 Rp 400 Rp - Rp -
31 ERPHAFLAM / Kalium Diclo Rp 400 Rp - Rp -
42 GENOINT / Gentamycin SK Rp 7,500 Rp - Rp -
44 IFIDEX / Dexa Rp 60 Rp - Rp -
47 ISDN INF Rp 250 Rp - Rp -
51 METAFLU Rp 400 Rp - Rp -
54 MIRABION Rp 400 Rp - Rp -
58 NEUROBION INJ "5 Rp 4,000 Rp - Rp -
65 OMERIC /Allopurinol Rp 400 Rp - Rp -
66 ORPHEN / CTM Rp 100 Rp - Rp -
75 SAMCOFENAC / Na Diclo Rp 250 Rp - Rp -
78 TRIDEXON / Dexa Rp 100 Rp - Rp -
79 TRISELA Rp 500 Rp - Rp -
83 VIT C ISI 1000 Rp 60 Rp - Rp -
TOTAL Rp 4,677,494 Rp 2,585,304
OBAT GIGI
Total
Rp 53,695
Rp -
Rp 480
Rp 8,700
Rp -
Rp -
Rp -
Rp -
Rp 278,400

Rp -
Rp -
Rp 24,800
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 17,500
Rp -
Rp -
Rp 16,200
Rp -
Rp 51,100
Rp -
Rp -
Rp 12,100
Rp -
Rp 31,500
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 93,600
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 32,000
Rp -
Rp -
Rp -
Rp -
Rp 90,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -

Rp 30,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 677,200