LAPORAN PENGGUNAAAN OBAT/ALKES

SATKER: RUMAH SAKIT BHAYANGKARA POLDA DIY

01 OCT 2019 s/d 28 OCT 2019
JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
1 T CHROMIC 0 CG TAPP 4 Buah 89,385 357,540
2 1.6MMX5MM FULLY THD SCREW 3 Buah 376,200 1,128,600
3 1.6MMX6MM FULLY THD SCREW 1 Buah 376,200 376,200
4 ABBOCATH 18 GEA 85 PCS 12,197 1,036,745
5 ABBOCATH 18 (FESCO) 38 Buah 9,240 351,120
6 ABBOCATH 20 GEA 50 PCS 9,240 462,000
7 ABBOCATH 22 (FESCO) 114 PCS 9,240 1,053,360
8 ABBOCATH 22 GEA 107 PCS 11,646 1,246,122
9 ABBOCATH 24 168 PCS 12,197 2,049,096
10 ABBOCATH 24 (FESCO) 13 PCS 9,240 120,120
11 ABBOCATH 26 GEA 7 PCS 12,197 85,379
12 ABBOCATH IV CATHETER NO 22 95 PCS 15,373 1,460,435
13 ABBOCATH NO 20 33 PCS 14,810 488,730
14 ABBOCATH NO 26 3 PCS 60,113 180,339
15 ACARBOSE 100 180 Tablet 1,315 236,700
16 ACARBOSE 50 MG 812 Tablet 721 585,452
ACETYLCYSTEIN / ASETILSISTEIN 200 MG
17 830 Kapsul 1,980 1,643,400
PT. NOVELL
ACETYLCYSTEIN / ASETILSISTEIN 200 MG
18 107 Kapsul 1,742 186,394
PT INDOFARMA
19 ACYCLOVIR / ASIKLOVIR 400 mg TABLET 249 Tablet 2,000 498,000
ACYCLOVIR / ASIKLOVIR 5% GENERIK
20 11 Buah 10,000 110,000
SALEP
21 ADALAT OROS 30MG 210 Tablet 6,191 1,300,110
22 ALKACID 1 CC 5,605 5,605
23 ALKAZYM 32 45,408 1,453,056
24 ALKOHOL 70% 1 LITER/CC 2,476 719 1,780,244
25 ALLETROL TM 1 Botol 25,265 25,265
26 ALLOPURINOL 100 MG 1,839 Tablet 348 639,972
27 ALLOPURINOL 300 MG TABLET 913 Tablet 709 647,317
28 ALPENTIN 100MG 1,263 Kapsul 1,655 2,090,265
29 ALPRAZOLAM 0.5 MG 114 Tablet 2,001 228,114
30 ALPRAZOLAM 1 MG 65 Tablet 2,913 189,345
31 AMBROXOL 30 MG TABLET 670 Tablet 1,320 884,400
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
32 AMBROXOL SYR 7 Botol 9,550 66,850
33 AMITRIPTILIN 25 MG TABLET 139 Tablet 263 36,557
34 AMLODIPIN 10 MG TABLET 2,887 Tablet 189 545,700
35 AMLODIPIN 5 MG TABLET 2,912 Tablet 131 381,472
AMOXICILLIN / AMOKSISILIN 500 MG
36 894 Tablet 1,307 1,168,458
TABLET
AMOXICILLIN / AMOKSISILIN DRY SYRUP
37 7 Botol 10,454 73,178
125 mg/ml 60 ml
38 ANALSIK TABLET 1 Tablet 1,354 1,354
39 ANTASIDA DOEN TABLET 200 Tablet 1,980 396,000
40 ANTASIDA SYR 60 ml 9 Botol 4,620 41,580
41 ANTIMO 58 Tablet 475 27,550
42 ANTIZA SYRUP 1 Botol 21,780 21,780
43 ANTIZA TABLET 336 Tablet 1,800 604,800
44 ANTRAIN INJEKSI 500 MG 8 Ampul 11,550 92,400
45 APRON DISPOSIBLE 90 Buah 5,227 470,430
46 AQUA PI/OTSU WATER INJEKSI 25 ML 925 Botol 4,530 4,190,250
47 ARDIUM TABLET 50 Tablet 12,870 643,500
48 ARM SLING UK M ONEMED / MITELA 6 Box 52,272 313,632
49 ARM SLING UK. L ONEMED / MITELA 6 Buah 43,560 261,360
50 ARM SLING UK. S ONEMED / MITELA 1 Box 52,272 52,272
51 ASAM FOLAT 1 MG TABLET 1,205 Tablet 187 225,335
52 ASAM MEFENAMAT 500 MG 1,687 Tablet 2,000 3,374,000
ASAM TRANEXAMAT / TRAMIX 500 MG/5
53 137 Ampul 3,287 450,319
ML INJEKSI
54 ASAM TRANEXAMAT TABLET 368 Tablet 3,000 1,104,000
55 ASERING INFUS 14 Botol 12,812 179,368
56 ASPILETS CHEWABLE TABLET 20 Tablet 2,000 40,000
57 ATARAX 0,5 MG 30 Buah 1,980 59,400
58 ATARAX 1 MG 2,265 Tablet 3,901 8,835,765
59 ATORVASTATIN 20 MG TABLET 463 Tablet 1,002 463,926
60 ATROPIN SULFAT 0,25 MG INJEKSI 58 Ampul 2,640 153,120
61 ATS INJEKSI (BIOSAT) 18 Ampul 261,360 4,704,480
62 AZITHORMYCIN TABLET 74 Tablet 17,250 1,276,500
63 BAMGETOL 200 MG 104 Tablet 2,979 309,816
64 BARIUM SULFAT 1 GRAM 102 Gram 959 97,818
BENANG TRITON PAKET SC( CAESARIAN
65 17 Buah 287,496 4,887,432
SET)
66 BETADINE HYEGENE 60 ML 2 Botol 21,170 42,340
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
67 BETAHISTINE 6 MG 664 Tablet 2,000 1,328,000
68 BETAMETASON CREAM 5 GR 3 Tube 1,900 5,700
69 BETASON N 4 Tube 15,360 61,440
70 BIOPLACENTON JELLY 1 Tube 19,140 19,140
71 BISOPROLOL 5 MG TABLET 1,206 Tablet 2,000 2,412,000
72 BLEDSTOP INJEKSI 5 Ampul 9,002 45,010
73 BLEDSTOP TABLET 215 Tablet 2,000 430,000
74 BRAXIDIN TABLET 135 Tablet 1,837 247,995
75 BROAD PLATE DCP HOLE 10 (ASA) 1 PCS 1,273,545 1,273,545
76 BRONKRIS 227 Tablet 150 34,050
77 BUNASCAN SPINAL INJEKSI 1 83,160 83,160
78 BUPIVACAINE SPINAL 5 MG / ML 3 Ampul 24,466 73,398
79 BURNAZIN CREAM 35 gr 1 Tube 41,250 41,250
80 CAL 95 TABLET 1,331 Tablet 9,467 12,600,577
81 CALCIUM LACTAS / KALK TABLET 1,704 Tablet 139 236,856
82 CALCUSOL CAPSUL 658 Kapsul 1,770 1,164,660
83 CANCELLOUS SCREW 3,5 UK 20 2 Buah 455,028 910,056
CANCELLOUS SCREW 6.5 TREAD FULL L
84 1 PCS 188,496 188,496
45
85 CANDESARTAN 8 MG 2,971 Tablet 862 2,561,002
86 CANDESARTAN 16MG 1,375 Tablet 1,493 2,052,875
87 CANNOFIX 6X8 1 PCS 10,164 10,164
88 CAPRIBOSE 50 MG 851 Tablet 851 724,201
89 CAPSUL KOSONG NO 0 80 Buah 62 4,960
90 CAPTOPRIL / KAPTOPRIL 12,5 MG 9 Tablet 1,980 17,820
91 CAPTOPRIL / KAPTOPRIL 25 MG TABLET 154 Tablet 1,980 304,920
92 CARMED CREAM 40 GR 1 Tube 42,448 42,448
93 CARPIBOSE 50 MG TABLET 755 Tablet 851 642,505
94 Cat gut cromic 2-0 1 Sachet 114,125 114,125
95 CATAFLAM 25 MG TABLET 12 Tablet 3,993 47,916
96 CATAFLAM 50 MG TABLET 10 Tablet 9,600 96,000
97 CATARO TABLET EFFERFECENT 1 40,920 40,920
98 CAVIPLEX TABLET 282 Tablet 808 227,856
99 CAZETIN DROPS 8 Botol 29,621 236,968
100 CEBACTAM 1 GR INJEKSI 7 Vial 322,570 2,257,990
CEFADROKSIL / SEFADROKSIL 500 MG
101 809 Kapsul 1,917 1,550,853
KAPSUL
102 CEFADROXYL / SEFADROKSIL DRY SYRUP 12 Botol 11,807 141,684
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
103 CEFALEXIN 500MG 125 Tablet 1,716 214,500
104 CEFIXIME / SEFIKSIM 100 MG TABLET 1,370 Kapsul 1,188 1,627,560
105 CEFIXIME / SEFIKSIM DRY SYR 28 Botol 43,560 1,219,680
106 CEFIXIME 200 MG TABLET 382 Tablet 3,754 1,434,028
107 CEFOTAXIME / SEFOTAKSIM 1 GR INJEKSI 254 Vial 13,939 3,540,506
108 CEFTAZIDIM / SEFTAZIDIM INJEKSI 9 Vial 16,867 151,803
109 CEFTRIAXON INJEKSI 499 Vial 12,545 6,259,955
110 CEFUROXIM INJ 12 Vial 47,480 569,760
111 CEPEZET 100 TABLET 106 Tablet 605 64,130
112 CERNEVIT INJEKSI 10 Vial 228,360 2,283,600
113 CERVICAL COLLAR UK L 3 Buah 363,000 1,089,000
114 CERVICAL COLLAR UK M 3 Buah 264,000 792,000
115 CETIRIZIN TABLET 673 Tablet 545 366,785
CHLORAMPHENICOL / KLORAMFENIKOL
116 510 Tablet 2,000 1,020,000
250 MG
117 CHLORPHENIRAMINE MALEAT 4 MG (CTM) 26 73 1,898
118 CHLORPROMAZINE HCL 100 MG 25 Tablet 171 4,275
119 CHROMIC GUT CG 3/0 TAPER 1 Buah 92,347 92,347
120 CHROMIC GUT 0 CG 817 4 Buah 74,250 297,000
121 Chromic Gut 0 CG 914 (PAKET SC) 5 Buah 93,500 467,500
122 CHROMIC GUT 2/0 CUTT 5 Buah 79,750 398,750
123 CHROMIC GUT 2/0 TAPP 2 Buah 72,875 145,750
124 CIMETIDIN TAB 25 Tablet 159 3,975
125 CINOLON-N CREAM 1 Tube 23,000 23,000
126 CIPROFLOXACIN 500 MG TAB 735 Tablet 2,000 1,470,000
127 CIPROFLOXACIN INFUS 200 MG GENERIK 54 Botol 16,130 871,020
128 CITICOLIN / SITIKOLIN 500 TABLET 90 Tablet 11,848 1,066,320
129 CITICOLIN / SITIKOLIN INJEKSI 250 MG 157 Ampul 60,984 9,574,488
CLINDAMYCIN / KLINDAMISIN 150 MG
130 51 Kapsul 2,000 102,000
TABLET
131 CLINDAMYCIN / KLINDAMISIN 300 MG 85 Kapsul 2,265 192,525
132 CLONIDINE / KLONIDIN 0,15 MG TABLET 318 Tablet 2,000 636,000
133 CLOPIDOGREL 75 TABLET 1,104 Tablet 2,223 2,454,192
134 CLORILEX 100 MG 90 Tablet 18,216 1,639,440
135 CLORILEX 25 MG 210 Tablet 6,621 1,390,410
136 CO AMOXICLAV 625 MG 12 Tablet 6,621 79,452
137 CODEIN 10 MG 256 Tablet 1,084 277,504
138 COMBIVEN NEB 37 Buah 7,135 263,995
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
139 COMBO PACK NO 22 18 Buah 41,382 744,876
140 COMBO PACK NO 24 9 Buah 37,812 340,308
141 COMBO PACK NO 24 PLUS SPALK 6 Buah 69,696 418,176
142 CONCOR 2,5 MG 2,522 Tablet 991 2,499,302
143 CORTEX SCREW 3.5 32MM (ASA) 2 PCS 154,836 309,672
144 CORTEX SCREW 3.5 NO.28 (ASA) 6 154,836 929,016
145 CORTEX SCREW 4.5 NO 30 2 Buah 204,384 408,768
146 CORTEX SCREW 4.5 NO 32 6 154,836 929,016
147 CORTEX SCREW 4.5 NO 36 2 Buah 204,384 408,768
148 CORTICAL SCREW 3,5 DIAMETER 18 MM 1 209,088 209,088
149 CORTICAL SCREW 3,5 DIAMETER 26 DMS 1 Buah 158,400 158,400
150 CORTICAL SCREW 3,5 DIAMETER 30 DMS 1 Buah 229,997 229,997
151 CORTICAL SCREW 3,5 DIAMETER 36 (ASA) 1 154,836 154,836
152 COTER/SURGIPEN(LINA_PEN SINGLE USE) 37 Set 27,500 1,017,500
153 COTRIMOXAZOLE 480mg TABLET 30 Tablet 1,980 59,400
154 COUNTERPAIN CREAM 15 gr 1 Tube 27,300 27,300
155 CROFED SYRUP 1 Botol 29,899 29,899
156 CROFED TABLET 414 Tablet 2,310 956,340
157 CRYSTAL AIRWAY MASK (LMA) NO 3.0 4 Buah 321,221 1,284,884
CURAPOR TRANSPARENT/PLESTER ANTIA
158 28 Buah 53,797 1,506,316
AIR
159 CURCUMA TABLET 446 Tablet 1,542 687,732
160 CURVIPLEX SYR 11 Botol 10,168 111,848
161 CYTOSTOL /MISOPROSTOL TABLET 65 Tablet 11,725 762,125
162 D 40 INFUS 3 Botol 12,012 36,036
163 D5 1/2 NS INFUS 2 Botol 15,484 30,968
164 D5 INFUS 500 ML/ DEXTROSE 26 Botol 12,000 312,000
165 DATAN FORTE KAPLET 455 Tablet 2,352 1,070,160
166 DEPAKOTE TABLET 250 MG 60 Tablet 4,678 280,680
DESOXIMETASONE / DESOKSIMETASONE
167 9 Tube 17,296 155,664
0.25%
DEXAMETHASONE / DEKSAMETASON 0,5
168 83 Tablet 1,001 83,083
MG TABLET
169 DEXAMETHASONE INJEKSI 158 Ampul 3,477 549,366
170 DHP FRIMAL 3 Buah 3,960 11,880
171 DIAMICRON MR TABLET 45 Tablet 4,773 214,785
172 DIGOXIN TABLET FIRST MEDIPHARMA 337 Tablet 226 76,162
173 DIGOXIN TABLET YARINDO 240 Tablet 129 30,960
174 DILTIAZEM 30 MG 21 Tablet 173 3,633
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
175 DIMENHIDRINAT 39 Tablet 130 5,070
176 DIOVAN FCT 160 MG TABLET 1,488 Tablet 2,137 3,179,856
177 DIOVAN FCT 80 MG 1,377 Tablet 1,183 1,628,991
178 DIPHENHIDRAMINE 10MG INJEKSI 39 Ampul 1,733 67,587
179 DOMPERIDON SYR 60 ml 2 Botol 5,941 11,882
180 DOMPERIDON TABLET 272 Tablet 638 173,536
181 DONEPEZIL HCL 5MG TAB 40 Tablet 7,920 316,800
182 DOPAMET/METHYL DOPA 31 Tablet 1,137 35,247
183 DOXYCYCLINE / DOKSISIKLIN 100 MG 20 Kapsul 316 6,320
184 DRESSING ROLL 5CM X 1M WINNER 6 PCS 11,616 69,696
185 ECG ELEKTRODA DEWASA 25 Buah 26,136 653,400
186 ELASTOMULL HAFT 8CMX4M 4 Box 59,310 237,240
187 ELIZAC 20 MG TAB 180 Kapsul 5,500 990,000
188 ELKANA SYRUP 9 Botol 36,590 329,310
189 ENZYPLEX / ENZIPLEX 20 Tablet 1,700 34,000
190 EPERISONE HCL 50 MG / ESPERISON 1,201 Tablet 2,952 3,545,352
191 EPHEDRINE HCL INJEKSI 76 Ampul 33,000 2,508,000
192 EPINEFRIN INJEKSI PHAPROS 9 Ampul 9,635 86,715
193 ERLAMICETIN PLUS TM 1 Buah 37,752 37,752
194 ERLAMICETIN SALEP MATA 5 Tube 14,949 74,745
195 ERLAMICETIN TM 5 Botol 9,756 48,780
196 ERYTROMYCIN / ERITROMISIN 500 21 Kapsul 2,421 50,841
197 ETT 6 NON KINKIN 1 Buah 575,405 719,256
198 ETT 6,5 NON KINKIN 1 Buah 572,765 715,956
199 ETT DISP NO 6,5 RUSCH (CUFF) 1 Buah 97,284 97,284
200 ETT DISP NO 7,5 RUSCH (CUFF) 1 17,160 17,160
201 EXTRACE INJEKSI 1000 1 Ampul 52,800 52,800
202 FACE MASK 434 Buah 1,002 434,868
203 FARBION 5000 INJEKSI 65 Ampul 7,920 514,800
204 FARBIVENT NEBULAZER 29 Ampul 10,940 317,260
205 FARSIX INJEKSI 3 Ampul 15,675 47,025
206 FC (FOLLEY CATHETER) NO 14 4 Buah 47,045 188,180
FC (FOLLEY CATHETER) NO 16 GOLD
207 58 PCS 47,045 2,728,610
RUSCH / FC 16 RUSH
FC (FOLLEY CATHETER) NO 18 GOLD
208 1 PCS 30,888 30,888
RUSCH
209 FENOFIBRAT 100 MG (APT KF) 8 Kapsul 3,485 27,880
210 FENOFIBRATE 100 MG 1 Kapsul 1,885 1,885
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
211 FENOFIBRATE 300 MG 45 Tablet 2,289 103,005
212 FENTANYL INJ 28 Ampul 76,666 2,146,648
213 FETIK SUPPO 5 Suppo 15,675 78,375
214 FG TROCHES 16 Tablet 1,826 29,216
215 FITBON 486 Tablet 4,645 2,257,470
216 FLAMAR EMULGEL 20 GR 16 Tube 27,878 446,048
217 FLAMIGRA 50 MG 1,145 Tablet 2,000 2,290,000
218 FLEET ENEMA 6 Botol 47,220 283,320
219 FLIXOTIDE NEBULE 0,5 mg/2 ml 19 Ampul 10,278 195,282
220 FLUIMUCIL DRY SYR 75 ML 1 Botol 70,620 70,620
221 FLUNARIZINE 10 MG 3 Tablet 4,375 13,125
222 FLUNARIZINE 5 MG 318 Tablet 2,396 761,928
223 FM CREPE 7,5 /BSN (3 inch) 7 Buah 59,812 418,684
224 FOLLEY CATETER 24 1 Tablet 32,075 32,075
225 FORANE 1 CC 10,425 10,425
226 FRAMICETIN SULFAT 1% 3 PCS 12,210 36,630
227 FUJI II LC 1-1 MINI PACK 5 GR/3 GR A3 1 PCS 907,500 907,500
228 FURAMIN INJEKSI 14 Ampul 20,028 280,392
229 FUROSEMIDE 10 MG/ML INJEKSI 121 Ampul 10,865 1,314,665
230 FUROSEMIDE 40 MG TABLET 504 Tablet 400 201,600
231 FUSYCOM 1 Buah 26,400 26,400
232 FUTROLIT INFUS 76 Buah 97,052 7,375,952
233 GABAPENTIN 300 MG 305 Tablet 1,650 503,250
234 GAMMEX 7 1 Pasang 22,800 22,800
235 GARAM INGGRIS 30 GRAM 3 Sachet 1,562 4,686
236 GASTRUL TABLET 10 Tablet 12,736 127,360
237 GELANG BAYI BIRU 37 PCS 2,178 80,586
238 GELANG BAYI PINK 67 PCS 1,742 116,714
239 GELANG DEWASA BIRU 175 Buah 2,178 381,150
240 GELANG DEWASA PINK 235 Buah 2,178 511,830
241 GEMFIBROZIL 300 MG PHAPROS 254 Kapsul 2,000 508,000
242 GENTAMICIN 0.1% 5 GRAM SALEP KULIT 15 Tube 6,584 98,760
243 GENTAMICIN 40 mg/ml Injeksi 13 Ampul 4,062 52,806
244 GENTASOLON CREAM 5gr 2 Tube 25,080 50,160
245 GITAS INJ 3 Ampul 44,823 134,469
246 GLIBENCLAMIDE / GLIBENKLAMID TABLET 30 Tablet 104 3,120
247 GLIKUIDONE tablet 70 Tablet 1,804 126,280
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
248 GLIMEPIRID 1 MG 746 Tablet 318 237,228
249 GLIMEPIRID 2 MG TABLET 526 Tablet 383 201,458
250 GLIMEPIRIDE 3 MG 217 Tablet 2,000 434,000
251 GLIMEPIRIDE 4 MG 401 Tablet 2,000 802,000
252 GLUBOSE 50 MG TABLET 51 Tablet 2,000 102,000
253 GLUCODEX TABLET 30 Tablet 2,819 84,570
254 GRADILEX 15 Tablet 319 4,785
255 GRAGENTA CREAM 2 Tube 6,409 12,818
256 GRAHABION 1,523 Tablet 822 1,251,906
257 GRALIXA 3,133 Tablet 325 1,018,225
258 GRAMASAL 100 MG 270 Tablet 257 69,390
259 GRATHAZON 84 Tablet 364 30,576
260 GRATHEOS 50 MG 917 Tablet 2,000 1,834,000
261 GUAIFENESIN 19 Tablet 154 2,926
262 GUIDEL MAYO 4 (10 CM) 1 Buah 26,999 26,999
263 GYPSONA 3 4 Roll 30,643 122,572
264 GYPSONA 3' INCH(7.5) 3 Roll 13,021 39,063
265 HALOPERIDOL 5 MG TAB 9 Tablet 132 1,188
266 HALOTANE 250 / CC 30 Botol 3,208 96,240
267 HARNAL OCAS 313 Tablet 8,102 2,535,926
268 HCT / HIDROKLORTIAZID TABLET 247 Tablet 104 25,688
269 HEPA-Q CAPSULE 193 Tablet 7,841 1,513,313
270 HEPAMAX KAPSUL 30 Kapsul 14,269 428,070
271 HERBESSER CD 100 JKN 60 Tablet 5,148 308,880
272 HEXYMER TABLET 915 Tablet 6,353 5,812,995
273 HIBISCRUB / HIBICET / CC 1,660 CC 234 388,440
274 HIOPAR TABLET 270 Tablet 2,101 567,270
275 HUFAGRIP BP SYRUP 3 Botol 19,001 57,003
276 HUFAGRIP TMP / IBUPROFEN SYR 8 Botol 21,329 170,632
277 HYDROCORTISON 2,5 % SK 4 Tube 3,847 15,388
278 HYDROMAL INFUS 29 Botol 120,835 3,504,215
279 HYPAFIX 5cm x 1m 3 Roll 15,840 47,520
280 HYPOBHAC INJEKSI 5 Ampul 228,425 1,142,125
281 HYTRIN 1 MG TABLET 37 Tablet 13,598 503,126
282 HYTROZ 1 MG TABLET 120 Tablet 1,451 174,120
283 IBUPROFEN 400MG TABLET 156 Tablet 2,640 411,840
284 ICOBAL 500 MG 191 Kapsul 4,055 774,505
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
285 IKADRYL INJEKSI 14 Ampul 9,702 135,828
286 IKADRYL SYRUP 60 ML 1 Botol 22,216 22,216
287 IKAMICETIN SK 15 gr 11 Tube 12,458 137,038
288 IMUDATOR SYR 2 Botol 72,600 145,200
289 IMUDATOR TABLET 217 Tablet 11,848 2,571,016
290 INFUSET MAKRO / MAKROSET 292 Buah 26,833 7,835,236
291 INFUSET MIKRO / MIKROSET 57 PCS 17,292 985,644
292 INTUNAL 20 Tablet 653 13,060
293 IRBESARTAN 300 MG 37 Tablet 2,963 109,631
294 ISDN / ISOSORBID DINITRAT 766 Tablet 2,000 1,532,000
295 ISOFLURAN/HALOTANE/MENIT 356 MENIT 8,938 3,181,928
296 JARUM JAHIT NO 10 1 PCS 26,400 26,400
297 K WIRE 1,4 (ASA) 1 PCS 206,997 206,997
298 K WIRE 1.6 (ASA) 2 PCS 155,760 311,520
299 KALMECO INJEKSI 21 Ampul 39,204 823,284
300 KAPSUL KOSONG 0 20 Buah 49 980
301 KAPSUL KOSONG 00 484 Buah 88 42,592
302 KAPSUL KOSONG 1 15 Buah 52 780
303 KAPSUL KOSONG 2 51 Buah 47 2,397
304 KASA GULUNG 5CM 14 Buah 660 9,240
305 KASA KOTAK MASINAL 16 X16 1 PCS 5,108 5,108
KASA KOTAK STERIL 16X16 / KASSA
306 47 Box 8,712 409,464
STERIL AMANDA
307 KASA POTONG 10 CM GASINDO 27 Buah 2,769 74,763
308 KASA STERIL ONEMED 16 X 16 6 Box 14,520 87,120
309 KASSA HYDROFIL / GAS HYDROFIL 1,791 Lembar 417 746,847
310 KERTAS PUYER 652 Lembar 186 121,272
311 KETALAR INJEKSI 2 Ampul 362,017 651,631
312 KETOCID 740 Tablet 11,761 8,703,140
313 KETOKONAZOL 200 mg TABLET 24 Kapsul 487 11,688
314 KETOKONAZOLE 2% CR 10 GR 5 Tube 7,600 38,000
315 KETOKONAZOLE 2% CR 5 GR 3 Tube 4,399 13,197
316 KETOROLAC INJ 30 MG PHAPROS 20 Ampul 1,902 38,040
317 KETOROLAC INJEKSI 509 Ampul 13,015 6,624,635
318 KETOROLAC TABLET 10 MG 120 Tablet 3,036 364,320
319 KLEM TALI PUSAR 34 PCS 3,485 118,490
320 KLODERMA OINTMENT 10 GR 1 Tube 55,103 55,103
321 KRUK M 3 Pasang 522,720 1,568,160
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
322 KSR 316 Tablet 2,779 878,164
323 L BIO 187 Sachet 11,748 2,196,876
324 LANACER TABLET 360 Tablet 1,074 386,640
325 LANSOPRAZOLE 30 MG INDOFARMA 203 Kapsul 388 78,764
326 LANSOPRAZOLE 30 MG KAPSUL 99 1,077 106,623
327 LANTUS SOLOSTAR FLEXPEN 31 Buah 132,975 4,122,225
328 LANZOGRA 30Mg KAPSUL 1,837 Tablet 1,422 2,612,214
329 LASAL EXPECTORAN SYRUP 1 Botol 52,998 52,998
330 LASAL SYRUP 1 Botol 54,816 54,816
331 LAXADINE SYRUP 30 ML 29 Botol 38,333 1,111,657
332 LERZIN SYR 30 Botol 7,318 219,540
333 LEVEMIR FLEX 59 Buah 132,975 7,845,525
LEVOCETIRIZINE DIHYDROCHLORIDE
334 30 Tablet 4,620 138,600
TABLET
335 LEVOFLOXACIN 500 mgTABLET 225 Tablet 2,008 451,800
336 LEVOFLOXACIN INFUS 500 MG GENERIK 59 FLS 39,600 2,336,400
337 LEVOPAR 180 4,752 855,360
338 LIDOCAIN 2 % INJEKSI 157 Ampul 2,614 410,398
339 LIPITOR 20 MG TABLET 30 Tablet 32,477 974,310
340 LISINOPRIL 10 MG 95 Tablet 749 71,155
341 LIVRON B PLEX 330 Tablet 444 146,520
342 LMA NO 2 0 Buah 331,050 82,763
343 LMA UNIQUE SIZE 3 1 Buah 243,436 243,436
344 LODIA 2 MG TABLET 50 Tablet 1,699 84,950
345 LODOMER 2 MG 135 Tablet 1,637 220,995
346 LODOMER 5 MG 123 Tablet 1,386 170,478
347 LODOMER 5ML INJEKSI 1 Ampul 15,028 15,028
348 LOMATUELL / DARYANT-TULLE 88 Buah 20,625 1,815,000
349 LORATADINE 10 MG 15 Tablet 521 7,815
350 LORATADINE 5 MG 10 Tablet 1,976 19,760
351 LORAZEPAM 2 MG 30 Tablet 1,038 31,140
352 MAKROSET CABANG Y (OTSU) 1 Buah 10,080 10,080
353 MALTOFER CHEW 19 Tablet 4,386 83,334
354 MALTOFER FOL 28 Tablet 3,960 110,880
355 MANITOL 20 / 500 ML INFUS 2 Botol 68,903 137,806
356 manitol 20/250ml 6 FLABOT 44,788 268,728
357 MASKER HIJAB MD (ABM) 175 Buah 760 133,000
358 MASKER KARET FRESH 33 Buah 315 10,395
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
359 MECOBALAMIN 250 MG TABLET 16 Kapsul 1,077 17,232
360 MECOBALAMIN 500 MG 2,275 Kapsul 1,206 2,743,650
361 MECOBALAMIN INJEKSI 122 Ampul 13,939 1,700,558
362 MECONEURO INJEKSI 6 Ampul 20,328 121,968
363 MELOXICAM 15 MG NULAB TABLET 480 Tablet 2,088 1,002,240
364 MELOXICAM 7,5 MG NULAB TABLET 838 Tablet 1,084 908,392
365 MERLOPAM 0,5 MG 75 Tablet 2,000 150,000
366 MERLOPAM 2 MG TABLET 602 Tablet 4,966 2,989,532
367 MEROPENEM INJEKSI 1 GR 7 Vial 71,295 499,065
368 MERSIBION 5000 TABLET 2 Tablet 3,200 6,400
369 MESS / BISTURI 10 11 PCS 7,920 87,120
370 MESS / BISTURI 15 46 Buah 6,177 284,142
371 MESS / BISTURI 21 48 Buah 6,177 296,496
372 MESS / BISTURI NO 20 4 PCS 7,920 31,680
373 MESS / BISTURI NO 21 4 Buah 3,712 14,848
374 METFORMIN 500 MG 5,279 Tablet 1,340 7,073,860
375 METHERGIN INJEKSI 2 Ampul 14,644 29,288
376 METHYL / METIL PREDNISOLON 4 MG 1,366 Tablet 916 1,251,256
377 METHYLPREDNISOLON 8MG TAB 80 Tablet 1,121 89,680
378 METHYLPREDNISOLONE INJEKSI 33 Vial 44,257 1,460,481
METRIC 3/0 PLAIN CATGUT One Med
379 26 Buah 25,717 668,642
(PAKET PARTUS)
380 METRONIDAZOL INFUS 38 Botol 13,939 529,682
381 METRONIDAZOLE 500 MG TABLET 147 Tablet 2,640 388,080
382 MICONAZOLE 2% CREAM 1 Tube 9,167 9,167
383 MICROLAX 5ML (NEW PACKANIN) 3 Tube 29,910 89,730
384 MILOZ INJ 2 Ampul 5,016 10,032
385 MINIASPI TABLET 2,520 490 1,234,800
386 MINYAK KAYU PUTIH CAP LANG 15 ML 1 Botol 6,493 6,493
387 MINYAK KAYU PUTIH CAP LANG 30 ML 5 Botol 9,625 48,125
388 MISOPROSTOL TABLET 24 Tablet 8,712 209,088
389 MOMETASONE FUROATE 10 GR SALEP 2 Tube 29,040 58,080
390 MOMETASONE FUROATE 5 GR SALEP 9 Tube 24,580 221,220
391 MST CONTINUS 10 MG TABLET 4 Tablet 18,744 74,976
392 MYOTONIC INJ 40 Ampul 12,415 496,600
393 N2O/DINITROGEN MONOKSIDA/ JAM 5 JAM 187,500 937,500
394 N2O/DINITROGEN MONOKSIDA/ MENIT 745 MENIT 3,125 2,328,125
395 NACL 100 ML INFUS SANBE 308 FLABOT 21,912 6,748,896
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
396 NACL INFUS 500 ML 296 FLABOT 7,692 2,276,832
397 NARROW DCP PLATE HOLE 16 (ASA) 1 PCS 1,148,367 1,148,367
NATRIUM DIKLOFENAK 50 MG /
398 24 Tablet 540 12,960
DIKLOFENAC SODIUM 50 MG
399 NEBULIZER MASK ANAK 12 Buah 43,734 524,808
NEBULIZER WITH MASK ADULT / MASKER
400 24 PCS 43,734 1,049,616
NEBULIZER DEWASA
401 NEEDLE 18 1 Buah 1,437 1,437
402 NEEDLE NO 23 48 PCS 1,481 71,088
403 NEEDLE NO 25 11 Buah 550 6,050
404 NEEDLE NO 26 37 Buah 836 30,932
405 NEOSTIGMINE-HAMELN 0,5 MG/ML 6 Ampul 12,284 73,704
406 NEPHROLIT CAPSUL 35 Kapsul 2,100 73,500
407 NEW DIATAB TABLET 2 Tablet 3,308 6,616
408 NGT/Feeding Tube Fr 12 (40 cm) Terumo 2 Buah 50,458 100,916
409 NGT/Feeding Tube Fr 16 (40 cm) 1 Buah 66,211 66,211
410 NGT/Feeding Tube Fr 8 (40 cm) Terumo 1 Buah 66,675 66,675
411 NIFEDIPIN TABLET 66 Tablet 2,000 132,000
412 NITROCAF RETARD 817 Tablet 4,107 3,355,419
413 NO2 1 JAM 187,500 187,500
414 NORAGES INJEKSI 81 Ampul 10,560 855,360
415 NORELUT 5 MG TABLET 40 Tablet 7,492 299,680
416 NOREPINEPHRINE 4 MG INJ 4 Ampul 104,544 418,176
417 NOTRIXUM 50 MG INJEKSI 5 ML 31 Ampul 15,840 491,040
418 NOVALGIN INJEKSI 70 Ampul 14,457 1,011,990
NOVO TWIST 32 G TIPX 5 mm / NEEDLE
419 113 Buah 3,280 370,640
NOVOFINE
420 NOVOMIX FLEXPEN 138 PCS 175,773 24,256,674
421 NOVORAPID FLEXPEN 181 PCS 137,805 24,942,705
422 NURSE CAP 120 Buah 1,552 186,240
423 NUTRIFLAM KAPSUL 2 Kapsul 11,286 22,572
424 NUTRIFLAM NEO 6 Kapsul 13,860 83,160
425 OBH BERLICO JERUK NIPIS 1 Botol 8,400 8,400
426 OBH IKA / ITRASAL 100 ML SYR 8 Botol 7,144 57,152
427 OBH LAFIPOL SYR 1 Botol 8,333 8,333
428 OCTENIC BODY WASH GLOVES4S 1 PCS 27,443 27,443
429 OKSIGEN / JAM 1,747 JAM 20,000 34,940,000
430 OKSIGEN / MENIT 1,210 MENIT 333 402,930
431 OKSIGEN / TABUNG 4 Tabung 156,250 664,063
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
432 OMEPRAZOLE 20 MG KAPSUL 538 Kapsul 459 246,942
433 OMEPRAZOLE INJ 40 MG (GENERIK) 87 Vial 12,471 1,084,977
434 ONDANSENTRON 4 MG TABLET 248 Tablet 610 151,280
435 ONDANSENTRON 8 mg TABLET 89 Tablet 5,054 449,806
436 ONDANSETRON INJ 360 Ampul 12,074 4,346,640
437 OPINEURON 35 Tablet 2,000 70,000
438 OPIZOLAM 1 MG 1,245 Tablet 7,544 9,392,280
439 ORALIT 10 Sachet 2,000 20,000
440 OSSOVIT SYRUP 1 Botol 88,440 88,440
441 OTOPAIN EAR DROP 8 ML 6 Botol 100,972 605,832
442 OTSU MGSO4 40 5 Botol 7,562 37,810
443 OTSU SALIN 3 1 Buah 29,040 29,040
444 OXYTOCIN / OKSITOSIN / OXITOSIN INJ 7 Ampul 5,511 38,577
445 PAMOL 125 MG SUPPO 12 Suppo 19,532 234,384
446 PAMOL 250 MG SUPPO 2 Suppo 28,305 56,610
447 PANTOPRAZOLE 20 MG TAB 48 Tablet 13,939 669,072
448 PANTOPRAZOLE 40 MG INJ (BERNO) 4 Vial 24,605 98,420
PANTOPRAZOLE SODIUM 40 MG INJ
449 134 Vial 59,242 7,938,428
PHAPROS
450 PANTOZ INJEKSI 53 Vial 102,192 5,416,176
PARACETAMOL / PARASETAMOL 500 MG
451 2,984 Tablet 1,386 4,135,824
TAB
452 PARACETAMOL INFUS 129 Botol 18,992 2,449,968
453 PARACETAMOL SYR BERNO 7 Botol 4,752 33,264
454 PARACETAMOL SYR MEPRO 1 Botol 4,620 4,620
455 PARASETAMOL / PARACETAMOL SYR 55 Botol 4,978 273,790
456 PEHACAIN INJEKSI 59 Ampul 3,362 198,358
457 PERFUSOR TUB WHITE 1 Buah 129,809 129,809
458 PETHIDIN INJ 61 Ampul 30,858 1,882,338
PHENOBARBITAL / LUMINAL /
459 115 Box 223 25,645
FENOBARBITAL TABLET
PHENOBARBITAL/LUMINAL/FENOBARBITA
460 30 Ampul 3,396 101,880
L 50 MG INJ
461 PHENYTOIN TAB 276 Kapsul 958 264,408
462 PHYTOMENADION INJEKSI / VITAMIN K INJ 48 Ampul 2,175 104,400
463 PIOGLITAZONE 30 MG TAB 7 Tablet 6,600 46,200
464 PIONIX 15 MG 61 Tablet 8,580 523,380
465 PIONIX 30 MG 99 Tablet 6,436 637,164
466 PIRACETAM 800 mg KAPLET 346 Tablet 1,258 435,268
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
467 PIRACETAM INJEKSI 1 GR 64 Ampul 10,454 669,056
468 PIRACETAM INJEKSI 3 GR 40 Ampul 25,080 1,003,200
469 PIROTOP CREAM 10 GR 3 Tube 73,072 219,216
470 PK 4 Buah 9,798 39,192
PLAIN 3/0 1/2 GT ONEMED BENANG
471 5 Buah 7,370 36,850
PARTUS (IHS)
PLESTER ADHESIVE DRESSING ROLL 5CM
472 6 PCS 11,616 69,696
X 1M
473 PLESTER DRESSING ROLL/CM 180 Roll 301 54,180
474 POLIBAN 7,5 cm 1 Buah 45,417 45,417
475 POLICREPE 10 CM 5 Buah 70,812 354,060
476 POLICREPE 15 CM 1 Buah 52,388 52,388
477 POLICREPE 7,5 CM 6 Buah 45,935 275,610
478 POLIFIX / HYPAVIX CANNOFIX PU 30 Sachet 12,540 376,200
479 POLIFIX / METER 5 CMX 1M 4 METER 9,680 38,720
480 poligips 7.5 / "3 2 Buah 22,688 45,376
481 POLIGYP 10 CM/ "4 2 Buah 45,461 90,922
482 POT KECANTIKAN 15 GR 2 Buah 10,000 20,000
483 POT KECANTIKAN BULAT 30 GR 1 Buah 10,000 10,000
484 POVIDINE IODINE / BETADINE / CC /ML 3,627 CC 121 438,867
485 POVIDONE IODINE 60 ML ONEMED 17 Botol 4,439 75,463
486 PREDNISON 5 MG 438 Tablet 143 62,634
487 pregabalin 75 mg 299 Tablet 6,600 1,973,400
488 PREGTENOL TABLET 17 Tablet 4,424 75,208
489 PREMASTON TAB 189 Tablet 6,678 1,262,142
490 PRIMAQUINE 15MG 1 Tablet 2,000 2,000
491 PRIMPERAN INJ 159 Ampul 6,121 973,239
492 PROANES 1% INJEKSI 36 Ampul 137,388 4,945,968
493 PRONEURON TABLET 609 Tablet 1,568 954,912
494 PROPANOLOL TABLET 10 MG 330 107 35,310
495 PROPILTIOURACYL / PTU TABLET 510 Tablet 785 400,350
496 PROSTIGMIN INJEKSI 32 Ampul 22,742 727,744
497 PROTOCYN INJ 45 Ampul 12,545 564,525
498 PULMICORT 0.25MG/2 ML 4 Ampul 21,415 85,660
499 PULMICORT INJEKSI 0.5 MG/2 ML 34 Ampul 37,917 1,289,178
500 PYSOLAN CAPSULE 202 Tablet 10,890 2,199,780
501 QUACEFON INJ 1 Vial 199,400 199,400
502 QUANACAIN SPIN INJ 3 Ampul 66,000 198,000
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
503 RAMIPRIL 5 MG 642 Tablet 387 248,454
504 RANITIDIN TABLET 150 MG 834 Tablet 178 148,452
505 RANITIDINE INJEKSI 582 Ampul 3,803 2,213,346
506 REBAMIPIDE TABLET 228 Tablet 3,311 754,908
507 RECOFOL 10MG/20ML INJEKSI 3 Ampul 118,800 356,400
508 RECONSTRUCTION PLATE 6 HOLE 1 Buah 830,280 830,280
509 REGIVELL INJEKSI 39 Ampul 92,400 3,603,600
510 RELAXON TABLET (EPERISONE HCL) 2 Tube 2,236 4,472
511 RISPERIDONE 1 MG 300 2,483 744,900
512 RISPERIDONE 2 MG 1,155 Tablet 3,136 3,622,080
513 RL (RINGER LAKTAT) INFUS 1,733 Botol 30,492 52,851,784
514 ROFIDEN SUPPOSITORIA 39 Suppo 20,146 785,694
515 S PLATE 6 HOLL 1 Buah 2,192,400 2,192,400
516 SALBUTAMOL 2 MG TABLET 459 2,000 918,000
517 SALBUTAMOL 4 MG 40 Tablet 3,485 139,400
518 SALICYL TALK MENTHOL 130 GR 1 Botol 6,772 6,772
519 SALICYL TALK MENTHOL 80 GR 1 Botol 10,312 10,312
520 SALOFALK 250 MG TABLET 45 Tablet 5,610 252,450
521 SANMOL DROP 1 20,196 20,196
522 SANSULIN LOG-G DISPOPEN 9 Buah 109,201 982,809
523 SARUNG TANGAN GAMMEX 7,5 312 Pasang 27,878 8,697,936
524 SARUNG TANGAN GAMMEX NO 6,5 10 Pasang 27,720 277,200
525 SARUNG TANGAN INTOUCH 6,5 1 Pasang 21,120 21,120
526 SARUNG TANGAN INTOUCH 7,5 1 Buah 27,878 27,878
527 SAVLON/CC 581 CC 312 181,272
528 SCABIMITE 5% CREAM 30GR 2 Tube 124,582 249,164
529 SCOPAMIN PLUS KAPLET 10 Tablet 3,300 33,000
530 SCOPMA PLUS 1 Tablet 1,529 1,529
531 SEDACUM INJ 5 MG / 5 ML 81 Ampul 24,750 2,004,750
532 SELANG O2 ANAK OXYFLOW BESMED 32 Buah 13,939 446,048
SELANG O2 DEWASA OXYFLOW BESMED /
533 178 Buah 13,939 2,481,142
GEA / MPM / HOSPITECH
534 SELANG O2 NRM DEWASA 1 PCS 39,072 39,072
535 SELEDIAR TABLET 201 Tablet 438 88,038
536 SELESDIAR 14 Tablet 458 6,412
537 SERETIDE DISKUS 100 7 Buah 143,891 1,007,237
538 SERETIDE INHALER 50 1 76,230 76,230
539 SEVOFLURANE / MENIT 451 MENIT 13,303 5,999,653
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
540 SEVOFLURANE 250 ML / CC 70 CC 18,731 1,311,170
541 SIBITAL 50 MGTABLET 96 Tablet 2,000 192,000
542 SIKZONOATE INJEKSI 1 Ampul 109,248 109,248
543 SIMARC 2 MG 150 Tablet 1,991 298,650
544 SIMVASTATIN 10 MG 553 Tablet 1,045 577,885
545 SIMVASTATIN 20 MG 360 Tablet 2,091 752,760
546 SISTENOL CAPLET 108 Tablet 3,485 376,380
547 SITUROXIME INJ 4 Vial 27,720 110,880
548 SNMC (STRONGE NEO MINOPHAGEN C) 5 Ampul 182,952 914,760
549 SOFBAN GYP 3 INCH (7,5 cm) 3 Buah 34,028 102,084
550 SOFBAN GYP 6 INCH (15 cm) 2 CC 59,433 118,866
551 SOFRATULLE 3 Lembar 10,911 32,733
552 SOFSILK 3/0 GS 832 2 Buah 68,750 137,500
553 SOFTBAND 3' 1 Roll 25,780 25,780
554 SOFTBAND 6' 1 Roll 45,025 45,025
555 SOTATIC INJEKSI 33 Ampul 4,002 132,066
556 SOTATIC TAB 83 Tablet 481 39,923
557 SPALK ANAK XL/ S-25 5 Buah 10,400 52,000
558 SPALK DEWASA 30 1 Buah 25,265 25,265
559 SPALK DEWASA 90 CM 3 Buah 68,825 206,475
560 SPALK DEWASA UK L/F-100 3 Buah 37,900 113,700
561 SPALK STANDAR 10X90 2 Buah 52,140 104,280
562 SPALK STANDAR 9X60 3 Buah 34,980 104,940
563 SPALK UKURAN 5X15 2 Buah 20,473 40,946
564 SPASHI PLUS TABLET 21 2,689 56,469
565 SPASHI TABLET 71 Tablet 2,962 210,302
SPINOCAN 26 G BBRAUN / JARUM SPINAL
566 43 PCS 74,749 3,214,207
NO 26
567 SPIRONOLACTONE 25MG 120 Tablet 1,848 221,760
568 SPUIT 1 CC TERUMO 263 Buah 8,448 2,221,824
569 SPUIT 10 CC TERUMO 1,442 PCS 9,636 13,895,112
570 SPUIT 20 CC TERUMO 1 Buah 13,970 13,970
571 SPUIT 3 CC TERUMO 2,103 Buah 6,072 12,769,416
572 SPUIT 5 CC TERUMO 689 Buah 2,640 1,818,960
573 SPUIT 50 CC + CATH (LBG TNGH) TERUMO 6 Buah 69,696 418,176
574 SPUIT 50 CC TERUMO (LUBANG PINGGIR) 5 Buah 36,939 184,695
575 STARFOLAT TABLET 1,365 Tablet 247 337,155
576 STARMUNO KAPLET 396 Tablet 13,765 5,450,940
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
577 STESOLID 5MG RECTAL 1 Suppo 31,363 31,363
578 SUCTION CATH FR 12 1 Buah 11,220 11,220
579 SUCTION CATH NO 10 4 Buah 10,560 42,240
Suction Catheter (Thumb) fr.8
580 41 Buah 16,553 678,673
Pahsco/HOSPITECH
581 SULFADIAZIN SILVER 3 Buah 24,840 74,520
582 SUMAGESIC TAB 181 Tablet 539 97,559
583 SUSU FF MAMA 200 30 Box 29,164 874,920
584 SUVESCO 10 MG 60 Tablet 2,666 159,960
585 SYMBICORT TURB 80 DOS 3 FLS 166,109 498,327
586 SYMBICORT TURBUHALER 160 5 Buah 166,109 830,545
587 T CHROMIC 2 90CM TAPPER 8 Buah 89,385 715,080
588 T CHROMIC C56 4-0 1 PCS 85,800 85,800
589 T LENE 2-0 CUTTING L20 76CM 3 Buah 97,416 292,248
590 T LENE 2-0 L36 1 Buah 87,047 87,047
591 T LENE 2/0 CUTTING 8 Buah 128,589 1,028,712
592 T LENE 3-0 L19 CUTTING 2 Buah 115,416 230,832
593 T LENE 3-0 76cm 24mm 3 Buah 116,580 349,740
594 T PLAIN 2-0 P121 1 Buah 97,625 97,625
595 T PLAIN 3/0 CUTTING 1 Buah 68,280 68,280
596 T PLAIN 3/0 TAPPER 3 Buah 65,281 195,843
597 T PLAIN 4/0 TAPPER 1 Buah 99,143 99,143
598 T SILK 3-0 CUTTING S21 6 Buah 64,922 389,532
599 T SILK 3-0 S22 TAPPER 12 Buah 82,223 986,676
600 T SILK 4-0 CUTTING 6 Buah 79,923 479,538
601 T SILK 4/0 TAPPER 1 Buah 79,541 79,541
T SILK S24 2-0 CUTTING / SOFTSILK SS 679
602 3 Buah 37,890 113,670
2-0
603 T SILK S25 2-0 / SOFTSILK GS 833 2-0 6 PCS 66,490 398,940
604 T VIO 1 90cm 40mm CUTTING 4 Buah 89,350 357,400
605 T VIO 1 TAPERCUT 1 Buah 89,400 89,400
606 T VIO 1 V13 TAPPER 3 PCS 141,657 424,971
607 T VIO 2-0 CUTTING V40 90CM 18 PCS 130,470 2,348,460
608 T VIO 2/0 TAPERCUT 1 Buah 92,640 92,640
609 T VIO 2/0 TAPPER 2 Buah 74,106 148,212
610 T VIO 3-0 CUTTING 4 Buah 79,134 316,536
611 T VIO 3/0 TAPER 2 PCS 134,930 269,860
612 T VIO 4/0 V2 TAPPER 1 Buah 116,514 116,514
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
613 T-CHROMIC CATGUT 3-0 CUTING 2 PCS 92,050 184,100
614 T-SILK 2-0 76cm 2 Buah 81,264 162,528
615 TANTUM VERDE ORAL RINSE 60 ML 1 Botol 36,590 36,590
616 TARIVID OTIC 50 LOTION 2 Box 101,640 203,280
617 TENSOCREPE 10 CM 6 Buah 56,250 337,500
618 TENSOCREPE 15 CM 1 Buah 71,500 71,500
619 TENSOCREPE 4 INCH (10 CM) UMUM 2 Buah 110,500 221,000
620 TENSOCREPE FL 3 INC (7,5 CM) UMUM 1 Buah 116,600 116,600
621 TENSOCREPE FL 6 INCH (15 CM) UMUM 2 Buah 184,250 368,500
622 TEOSAL TAB 117 Tablet 2,000 234,000
623 THIAMFENICOL 500 TABLET 20 Kapsul 1,716 34,320
624 THROMBOPHOB 20 GR GEL 1 Tube 86,249 86,249
625 TIARYT TABLET 70 Tablet 2,856 199,920
626 TOFEDEX INJEKSI 7 Ampul 65,340 457,380
627 TRAMADOL 100 MG INJEKSI 92 Ampul 9,217 847,964
628 TRAMADOL TABLET 245 Tablet 557 136,465
629 TRAMIFEN 67 Tablet 8,316 557,172
630 TRAMIFEN TAB 30 Tablet 10,977 329,310
631 TRAMIX INJEKSI 70 Ampul 8,837 618,590
632 TRAMUS 25 mg INJEKSI 4 Ampul 63,250 253,000
633 TRANFUSI SET SUREPLUS 197 Buah 20,909 4,119,073
634 TRIHEXYLPENIDIL (THP) 2 MG 30 Tablet 2,743 82,290
635 TRILAC INJEKSI 6 Vial 59,158 354,948
636 TROMBOFLASH 20GR 3 Tube 69,696 209,088
637 TRUVAS 20 MG 90 Tablet 17,820 1,603,800
638 TUTUP KEPALA DISPOSIBLE 124 Buah 809 100,316
639 UBIQUINOL 20 Tablet 49,592 991,840
640 ULSAFATE / SUKRALFAT SYRUP 242 Botol 28,462 6,887,804
641 ULSIDEX TABLET 62 Tablet 601 37,262
642 ULTRAPROCT N SUPPO 19 Buah 25,125 477,375
643 UNDERPAD 100 PCS 14,218 1,421,800
644 UNDERPAD PD 15 Buah 6,072 91,080
645 UNIFLEX 10 CM 11 29,759 327,349
646 UNIFLEX 3' (4.5Mx7.50CM) 9 24,359 219,231
647 UNIFLEX 6' (4.5Mx15CM) 6 40,440 242,640
648 URDAFALK CAPS (APT KF) 90 Kapsul 13,033 1,172,970
649 URESIX INJ 19 Ampul 3,600 68,400
 JUMLAH
NO. NAMA OBAT/ALKES SATUAN HARGA SUBTOTAL
PENGELUARAN
650 URINE BAG STERIL 2000 cc CORONA 54 Buah 13,939 752,706
651 URINTER CAPSUL 164 Tablet 8,358 1,370,712
URSODEOXYCHOLIC ACID / ASAM
652 430 Kapsul 3,590 1,543,700
URSODEOXYCHOLIC 250MG
653 VALISANBE 2 MG TABLET 101 Tablet 2,640 266,640
654 VALISANBE 5 MG 23 Tablet 2,640 60,720
655 VALISANBE INJEKSI 3 Ampul 22,612 67,836
656 VBLOC 480 Tablet 3,300 1,584,000
657 VENFLON BD NO 22G 3 Buah 36,438 109,314
658 VENFLON BD NO 20 G 2 Buah 36,438 72,876
659 VENFLON NO 24 1 Buah 54,102 54,102
660 VENTOLIN INHALER 2 Botol 79,200 158,400
661 VENTOLIN NEBULES 42 Ampul 9,599 403,158
662 VERAPAMIL 60 MG 60 Tablet 402 24,120
663 VINERTON KAPSUL 398 Kapsul 2,701 1,074,998
664 VIP ALBUMIN TABLET 131 Kapsul 9,932 1,301,092
665 VITAMIN B COMPLEX LOS2AN 15 Tablet 104 1,560
666 VITAMIN B KOMPLEKS 98 Tablet 226 22,148
667 VITAMIN B1 TABLET 14 Tablet 661 9,254
668 VITAMIN B6 10 MG 25 Tablet 417 10,425
VITAMIN K / PHYTOMENADION /
669 66 Tablet 1,199 79,134
FITOMENADION 10 mg TABLET
670 VITAMIN K INJ 2MG/ ML (DNR) 6 Ampul 10,454 62,724
671 W CARE AH 1 Buah 60,693 60,693
672 WATER FOR IRIGATION I LITER 3 24,948 74,844
673 WING NEEDLE NO 23 62 Buah 29,969 1,858,078
674 WING NEEDLE NO 25 19 Buah 14,784 280,896
675 ZEVITON KAPLET 113 Tablet 3,036 343,068
676 ZINC TABLET 38 810 30,780
677 ZINCPRO SYRUP 15 Botol 9,357 140,355
678 ZINCPRO TAB 23 Tablet 1,985 45,655
TOTAL 665,890,925

KASUBBID JANGMEDUM
KA INSTALASI FARMASI
SIPA: 446/8200/172/XII-21

ANDI SABRIANA, S.Farm, Apt. TSALISAH DAMAYANTI, S Farm,

 MMR, Apt
PENATA
PEMBINA NIP.197812212005012008
NIP.1985070620011012001
Mengetahui
KARUMKIT BHAYANGKARA
POLDA DIY

dr.THERESIA LINDAWATI, Sp.F

KOMPOL NRP.78091226